Aug 19, 2010

Henrietta's Tumor

We end with the extraordinary story of Henrietta Lacks. Though she died of cervical cancer in 1951, she unknowingly held the key to unlocking medical advancements (from polio vaccines to chemotherapy drugs) in her tumor cells. After taking a biopsy of Henrietta's cervical cancer, researcher Dr. George Gey and his lab assistant Mary Kubicek, discovered that Henrietta's cells could not only reproduce, but THRIVE outside the body--a breakthrough that would change modern medicine. Later, Dr. Stanley Gartler found that Henrietta's cells were even capable of jumping out of the petri dish and colonizing other cell strains. Now, decades after Henrietta's death, her cells are still alive.

But who was the long-obscured woman behind these famous cells? And how did Henrietta's family feel when they learned that part of their mother was still alive? Writer Rebecca Skloot takes us on a journey into Henrietta's world, with Henrietta's daughter Deborah as the guide.

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[music]

Announcer: Listener-supported WNYC Studios.

Jad: Hey, I'm Jad Abumrad.

Robert: I am Robert Krulwich.

Jad: This is Radiolab and our topic today is-

Robert: -totally tumors.

Jad: Yes, totally tumors. You call it what you want. It doesn't matter. It doesn't matter because the topic is tumors, famous tumors. Our next and final tumor-related tale is one I've been--

Robert: You've been wanting to do this particular tumor story forever.

Jad: Oh, forever. Forever.

Robert: Two years ago, I think.

Jad: Longer than that. It's a story that comes from a friend of mine, Rebecca Skloot.

Rebecca Skloot: You may talk, make noise.

Jad: That's her.

Rebecca: We can move me closer from--

Jad: She's a journalist.

Rebecca: Is that better?

Jad: She has been wanting to tell the story-

Robert: Even longer. [laughs]

Jad: -since she was in the womb. She's been researching this story for 10 years.

Rebecca: Hello, hello, hello.

Jad: She just wrote a book called The Immortal Life of Henrietta Lacks. The story is about a tumor that expands and never stops. Begins in 1950, a black woman in Baltimore is in her bathroom and she discovers pretty much all on her own that she has cancer.

Rebecca: It's all a little bit of a mystery how she initially knew this, but she knew it was there.

[music]

Rebecca: A 'knot', she called it. She had told her cousins for a while that she felt there was something wrong with her womb. She climbed into her bathtub and she slid her fingers up inside of herself and found this lump.

Jad: Chapter 1.

Rebecca: First, she went into her local doctor.

Dr. Howard Jones: By chance, I happen to be an attending at that time.

Jad: The guy she eventually ended up seeing at Johns Hopkins University was this fellow, Dr. Howard Jones.

Howard: I'm 98, next month I'll be 99.

Jad: Wow. [laughs] When she came in to see you, can you tell me anything about what she was like?

Howard: She was a--

Jad: You don't remember anything.

Howard: No, I really don't.

Jad: You remember her tumor, right?

Howard: Oh, absolutely. I never saw anything like it before or after.

Rebecca: This didn't look like a normal tumor. It was deep purple and-

Howard: -about as big as a quarter.

Rebecca: So shiny.

Howard: Very soft. That was another thing about it. On examination-

Rebecca: Slightly raised.

Howard: -when you touch it, you might think it was red Jello.

Rebecca: There was something very strange about the way it looked.

Howard: I was somewhat worried about it.

Jad: Doctors took a sample.

Rebecca: Yes, they would cut off these little, teeny-tiny pieces.

Jad: Really small.

Rebecca: Teeny-tiny.

Howard: A bite or two.

Rebecca: They would take a piece-

Jad: -put it in a tube-

Rebecca: -and one would go to the lab for diagnosis.

Jad: In this case, since it was Hopkins?

Rebecca: They would take an extra piece and give it to a man named George Gey.

Jad: Two. George Gey was a researcher who worked at Hopkins. He had a deal with the clinic that anytime they got a patient with cervical cancer, they'd give him a tiny piece of the tumor. What he really wanted to do, his main mission, actually, not just his, scientists everywhere we're trying to do this. They wanted to find a way to grow human cells outside of a human being.

Robert: In a dish?

Jad: In a dish.

Rebecca: George Gey had been trying to do this, working on this for decades.

Jad: Why, exactly?

Rebecca: It's like having a little, tiny bit of a person in a lab that's detached from them so that you can do whatever you want with them. You can't bombard some person with a bunch of drugs and just wait to see how much they can tolerate before their cells all explode, but you can do that in cell culture.

Jad: This is the basic thing you need to study human biology. You need cells in a dish.

Rebecca: Yes.

Jad: Problem was anytime they tried to grow human cells in a dish, they would die.

Mary: My dog. Come here.

Rebecca: Yes, they'd die.

Jad: This is George Gey's former lab assistant. Can you just tell me your name? My name is so and so.

Mary Kubicek: My name is Mary. I'll put my maiden name in there.

Jad: Oh, sure.

Mary: Toy Kubicek.

Jad: Mary lives just outside of Baltimore, about an hour from where she used to work with George Gey.

Mary: This is Dr. Gey.

Jad: She showed me some pictures.

Mary: He's sitting at a microscope.

Jad: Look at him. He seems like a really big guy, like a really tall guy.

Mary: He was a big guy.

Jad: At least 6'5", judging from the picture.

Mary: Yes, he was.

Jad: In every slide that she showed me, he had a crazy smile on his face like he's having a good time.

Mary: He's like a big bear of a man, that's what I always thought of him

Jad: Oh, yes. In any case, Mary says they were completely stumped at why the human cells always died, but they just did. On the day that George Gey walked in, handed Mary a tube with a little chunk of a nameless woman's cervical cancer inside-

Mary: I knew nothing about her.

Jad: -no one expected anything.

Mary: No, he probably is ever hopeful, but. I was eating lunch and I thought, "Oh, the heck with it. It's not going to grow. I'm going to finish this sandwich." That's what I did.

Jad: Three.

Mary: Then, I went in and-

Jad: She gave the cells some food-

Mary: -did my usual.

Jad: -turned on all the machines and left, came back the next day, they hadn't died. She came back the next day, they were growing. Then, the next day, still growing.

Mary: They just kept plugging along.

Jad: And the next.

Rebecca: They grew a lot.

Jad: Rebecca says they doubled in size-

Rebecca: -every 24 hours. They just grew.

Mary: All of a sudden. I kept transferring them and making more tubes, and transferring them, making more tubes, and transferring. They were very reliable.

Rebecca: Stronger.

Mary: They just kept plugging along.

Jad: Meanwhile, the woman who had spawned all these cells died.

Rebecca: Officially, she died of uremia, which is a toxicity of the blood because she wasn't able to get rid of the toxic waste that usually goes out in your urine.

Mary: Plugging along.

Jad: Not her cells.

Speaker 3: To tell us this story, it's a privilege to introduce Dr. George Gey.

Jad: It wasn't long after that George Gey appeared on TV holding in his hand a little bottle.

Howard: Now, let me show you a bottle in which we have grown massive quantities of cancer cells.

Speaker 4: Did you want to look a the photos and look at-- [crosstalk]

Jad: You can't really get a sense of how aggressive this tumor was until you go to the Hopkins archives and look at George Gey's pictures and videos.

Speaker 4: This is the film can here if you have a cell phone.

Jad: Then, it hits you.

Howard: These are enlarged 10,000 times.

Jad: Oh my God. Swarming hurricanes of cells just like thousands of little pods.

Howard: Some small and some very large.

Jad: Swam together.

Mary: I kept transferring them and making more tubes.

Howard: See them under the microscope.

Jad: It's like something has just exploded.

Speaker 1: Plugging along.

Howard: Undergoing division.

Jad: That's amazing.

Mary: They just kept plugging along.

Speaker 5: Keeps getting bigger and bigger.

Rebecca: Stronger.

Speaker 6: It's indestructible. It's indescribable. Nothing can stop it.

Rebecca: Why hers just took off and grew and the other ones that they had tried before didn't is just a little bit of a mystery. Nobody really knows.

Jad: Four. Unless George Gey knew what he had, this new cell line was what they'd all been waiting for. Early on, right after this woman died, George Gey sent Mary back down to get more cancer cells from the corpse.

Mary: Oh, he sent me down to the morgue, yes.

Jad: Really?

Mary: Oh, yes. I went down there and the coroner, I don't know who he was, Dr. Gog was there too, and they were standing down at her feet.

Jad: Meanwhile, she's what?

Mary: She's lying out there. She's already open. I got some samples. The coroner would take them out and give them to me.

Jad: What did she look like?

Mary: I couldn't look at her face. I couldn't look at her. The only thing I looked at were her toes and they had chipped nail polish on them and that was really like, "Oh, this is a real person."

Jad: What was it about the nail polish that hit you?

Mary: Oh, because it was chipped because you know that she hadn't been able to take care of her nails for a long time if they got chipped like that. It showed that she was proud of herself. Not everyone wears nail polish on their toes.

Jad: Over the next several months, while this woman's body lay decomposing in the ground, George Gey and Mary produced hundreds of thousands of her tumor cells. He named them the HeLa Strain.

Robert: HeLa?

Jad: HeLa, H-E-L-A. No one would actually know why he had named them that for about two decades. What he did with these cells would be unusual nowadays. If somebody now found a cell that was special, they'd run off to the patent office and then sell it to Merck for $1 billion. [laughs] George Gey-

Mary: He just passed them out freely.

Jad: He didn't try and make any money off of it.

Speaker 5: He was just [crosstalk].

Mary: Because it a nice new thing that could help science.

Jad: Mary says that George Gey began to send HeLa all over the world and pretty soon, she was in hundreds of labs.

Rebecca: This was in the midst of the polio epidemic.

speaker 4: This is the season when polio is at its worst.

Jad: We're talking early '50s, right?

Rebecca: Yes. There's 1951, '52, schools are being closed, kids are being kept inside.

Speaker 4: To this cruel disease, medical science still has no complete answer.

Rebecca: There was this enormous effort to develop a polio vaccine.

Jad: The problem was in order to develop a vaccine, you have to have enough poliovirus. Enough quantity to be able to study it in a lab, and they had no way of making enough.

Robert: What did they do?

Jad: One of the guys that Gey had sent the cells to-

Rebecca: This collaborator friend of Gey's.

Jad: -discovered something amazing, which was that polio loved the HeLa cell. Put polio inside a HeLa cell, HeLa would copy and, in the process, make more polio.

Robert: It's the super Xerox cell. No matter what you want to do, it'll be like, "Make a copy, make a copy, make a copy."

Jad: Yes. Now, they had a way of making polio.

Rebecca: HeLa could just be a polio factory.

Jad: The government made a factory.

Rebecca: At the Tuskegee Institute.

Jad: A real one.

Rebecca: Literally a factory. They had these big stainless steel [unintelligible 00:10:00] of culture medium that were sort of rotated constantly. Autoclaves for sterilizing all the equipment over with modified microscopes crazy Frankenstein-ish gizmos. They had this machine that was like an automatic cell dispenser and that it had this sort of long chemical arm and squirt a certain amount of this cultural medium filled with HeLa cells into a tube.

Jad: Wow, this is what the beauty of industry right here.

Rebecca: Yes, it is. Absolutely.

Jad: The cells that were produced at this factory she says were used to test the polio vaccine.

Speaker 5: A potent vaccine to prevent the dreaded disease.

Rebecca: These tests that they were doing in North, it was the largest field trial ever done. At its peak, the Tuskegee HeLa production Center was producing about 6 trillion cells a week.

Jad: Wow.

Rebecca: Which is kind of inconceivable.

Jad: That was actually only the beginning, says Rebecca because this factory led to an even bigger one. It was for-profit and that second factory--

Rebecca: Was the first time any human biological material was commercialized.

Jad: This was the first biotech company?

Rebecca: Yes, basically.

Jad: When they first started mass producing HeLa, what sorts of things were done to these cells? What sorts of problems were investigated?

Rebecca: Like anything you can imagine. They infected HeLa cells with every kind of virus. Hepatitis, equine, encephalitis virus, yellow fever, herpes, measles, mumps, rabies whatever. Just any vaccine and it was a revolution for scientists. There was [unintelligible 00:11:29] chemotherapy drugs, HeLa cells went up into the first space missions.

Jad: Really?

Rebecca: Yes. They were-

Jad: HeLa went into space?

Rebecca: HeLa went into space. Every time I hear it I think of like, “HeLa in space.”

Jad: Why? Just because?

Rebecca: The premise was to see what happens to human cells in zero gravity. If we're going to be sending people off into space, what's going to happen to them up there. HeLa went up before any humans did and then she eventually went up, she-- the cells, there was actually--

Jad: That was an interesting little slip up there.

Rebecca: Yes, I know.

Jad: Okay, so let's actually skip forward in the story to the point where that slip up we just heard, that pronoun confusion gets personal.

Robert: Wow, what happens?

Jad: Okay, it's the late '60s, and HeLa has led to a revolution in science and now there are hundreds of cell lines, not just HeLa but hundreds, and somewhere along the way scientists discover that HeLa is so aggressive that she's actually been contaminating and taking over all of these other cell lines.

Robert: Men you just said she, but I get your point.

Jad: It does it in the strangest way.

Rebecca: HeLa cells can float on dust particles. They can ride on--

Jad: They can what? They can float on dust particles?

Rebecca: Yes.

Jad: You mean they can hop out of a dish and just get on a particle and just float? Out the door.

Rebecca: Up the stairs.

Jad: Down the hall, into a lab.

Rebecca: One HeLa cell drops into--

Jad: Into a dish.

Rebecca: A cell culture where there's other cells growing, and because HeLa cells are sort of powerful cells they take over.

Jad: On the heels of this catastrophe someone at Hopkins decides to make a test. Let's make a test that will allow us to genetically determined if a cell is HeLa or if it isn't, and to make a long story short this desire for a genetic test led scientists and then journalists, to ask a question which amazingly for 25 years had not been asked. “Who was this woman?” That's when we found out her name. Henrietta Lacks. This is the sound of Rebecca reading Henrietta's medical records for the first time.

Rebecca: This is a 30-year-old colored woman.

Jad: She's sitting with Henrietta's youngest daughter, Deborah.

Rebecca: This is 2nd November so this is again when she was pregnant with you.

Deborah: Okay.

Jad: Henrietta had five kids when she died at the age of 31. Most have no memory of her because they were too young. That's especially true of Deborah.

Deborah: I was only 15 months old and I don't remember anything about my mother.

Rebecca: She had spent her entire life just sort of longing to know who her mother was and did she like dancing.

Deborah: I always wanted to know what she liked to do, where she went, what she liked to eat?

Rebecca: Did she breastfeed Deborah? She was really almost fixated on that idea and she wanted to know if she was breastfed.

Deborah: Oh, I don't know what I will give up just to have her here, I tell you, just to see her and hold here.

Jad: In 1973, when a scientist calls the Lacks family and Deborah hears that little bits of the mother that she never knew are still alive and, “Oh, by the way, can we take a blood test from you and your families are having some contamination problem, we need these genetic markers blah blah blah.” Well as you could imagine.

Deborah: It took me by surprise. It really did.

Jad: It was really confusing.

Deborah: How much of her cells is out there?

Jad: Eventually she went online, did some searches and found-

Rebecca: Thousands and thousands of hits.

Jad: Like for instance on HeLa clones.

Rebecca: Deborah had heard-- various journalists in the past that come to her and mentioned, Dolly the Cloned Sheep, and said, “They did this with your mom too,” meaning, that's actually where the technology started. The first cells ever cloned were HeLa cells, but that was just cloning a cell not cloning an entire being. That distinction is very complicated particularly for somebody who doesn't know what a cell is.

Deborah, between what journalists had told her, and googling Henrietta Lacks and Clone thought there were thousands of clones of her mother around.

Jad: Really? You mean like a bunch of Henrietta’s?

Rebecca: Thousands.

Jad: Walking the street?

Rebecca: Walking around.

Jad: Rebecca says that one of Deborah's biggest fears was bumping into one of these clones.

Rebecca: She would say, “I would have to go talk to her and she wouldn't know that I was her daughter and I don't know that I could handle that.”

Jad: Wow.

Rebecca: It sounds so fantastical, how could someone believe that there are copies of her mother walking around but at one point 25 years after their mother died someone called and said, “Hey, part of her still alive and we've grown enough of her so that it could wrap around the Earth several times.”

Jad: At that point, all bets are off.

Rebecca: Yes, exactly.

Jad: Not to mention that it's actually not that crazy because your DNA is in your cells so if your cells are taken out of you and they still grow, well, isn't that still you, alive?

Robert: It's of you but it's clearly not you and then yet it’s going on and on and that’s funny middle space. That's for sure.

Jad: Yes. Here's what happened. As Rebecca went off in search of Henrietta Lacks, every so often Deborah would come along and sit with her as they interviewed anyone that could find. Friends, family, and eventually over many, many years a picture does emerge of who this woman was.

Rebecca: She was born in Roanoke.

Jad: 1920, Virginia.

Rebecca: I think she was the 10th of the 11 children.

Jad: Apparently she was the one that stood out.

Rebecca: Everybody talked about her as just being-- she was the catch.

Sadie Sturdivant: Oh my goodness, I don't think I could top her.

Jad: This is Sadie Sturdivant, Henrietta's cousin.

Sadie: Henri was a beautiful girl. I was beautiful myself but Henri was very pretty.

Gladys Pleasant Lacks: Brown eyes, long hair.

Jad: This is Henrietta sister, Gladys.

Gladys: Light tanned complex.

Jad: Everyone they spoke with zeroed in on the same few points like first-

Rebecca: She was really meticulous about her nails.

Jad: Always painted them red.

Rebecca: This very deep red.

Jad: Second, Henrietta just had this strength.

Rebecca: She was very straight forthright. Very sassy.

Jad: Like her cells. Now the unfortunate thing is that when it comes to her life, how she lived, there's not a ton of detail.

Gladys: [inaudible 00:18:02] October so this is when she first ran into cancer.

Jad: In that hotel room when the two of them were flipping through the medical records, they did start to get some detail.

Gladys: Now, here is her autopsy.

Jad: About how she died.

Rebecca: These are things I want to take notes about.

Jad: Was she in a lot of pain when she died.

Rebecca: Yes. This was the hardest thing that she was eventually in a pretty unbelievable amount of pain.

Deborah: She complained of pain in the right lower quadrant.

Rebecca: Wailing and crying and moaning for the Lord to help her and-

Jad: According to the records doctors tried everything.

Rebecca: Morphine they injected 100% alcohol straight into her spine.

Jad: Wow.

Gladys: SHe complained of pain, spitted the alcohol injection last week.

Rebecca: She would have these fits of pain, some spasms where these waves of pain would hit her and she would rise out of the bed and thrash around. They strapped her to the bed and her sister, well along with one of her friends, one of them would tighten the straps and the other one would put a pillow in her mouth so that she wouldn't bite her tongue.

Gladys: If I just had the chance to take care of her.

Jad: Now, dealing with how her mother died was one thing, but the cells made it more complicated.

Rebecca: For Deborah, her mother was alive in the cells somehow so if that's true that left very big questions, and the first of them for Deborah was, how can Henrietta rest in peace if part of her with part of her soul is being shot up to the moon and injected with all these chemicals and are radiated and bombarded?

Deborah: It was just so painful knowing they had her cells on the back with a donkey, grow to Turkey, in the airplanes, just growing all over the world. I just don't know.

Rebecca: She worried about them, she worried that it hurt her mother.

Jad: Really?

Rebecca: When you infect the cells with Ebola, did somehow her mother feel the pain that comes with Ebola?

Jad: Had a scientist ever sat down with her and--

Rebecca: No.

Jad: No. Just explain to her like this is-

Rebecca: No, no never. Nothing.

Jad: It just strikes me that it wouldn't be that hard to explain it like, "When you take cells out of a body it's like when you cut your fingernail off." It just doesn't-

Rebecca: But your fingernail doesn't keep growing and living after you cut it off. It's really hard. There is no other example of someway that you can take something from someone's body and have it keep living and not have a person feel it.

Jad: "All these worries," says Rebecca began to build in Deborah's mind and build and build.

Rebecca: There came at this point, we were at her cousin's house.

Jad: This is her cousin Gary.

Rebecca: She was broken out in hives and she was telling him all the stuff that she had recently learned.

Jad: You can almost hear it on the tape. She says to him-

Deborah: [unintelligible 00:20:52] leave it there.

Jad: she can't carry the burden of these cells anymore. She can't do it.

Deborah: I can't cry no more. I don't want to cry to them no more.

Rebecca: I had been trying to talk her down and he was trying to talk her down. Then just out of nowhere, he just started singing.

Gary: [singing]

I know the Lord did good, yo,

I know the Lord did good,

He put food on my table,

I know the Lord did good.

Rebecca: And he started preaching.

Gary: There are some things the doctors cannot do.

Rebecca: He held her head in his hands.

Gary: We come to you tonight the author and the finisher of our faith. We thank you for being a way maker. You made a path in the mighty waters, you cause the mountains to skip like rams and the little hill like lambs. We thank you tonight.

Deborah: Thank you, Lord.

Gary: Thank you for that.

Deborah: Thank you, Lord.

Gary: Thank you.

Deborah: Thank you, Lord.

Gary: Thank you.

Deborah: Thank you, Jesus. Hallelujah, hallelujah, hallelujah. Amen. Amen. Amen. Thank you, Jesus. Amen, thank you, Jesus.

Rebecca: She just relaxed.

Deborah: I feel light.

Rebecca: Amen.

Deborah: I feel light. [laughs]

Jad: She didn't realize it then but that night Deborah was on the verge of a stroke.

Rebecca: You want to walk up and see the building?

Deborah: You want to walk?

Rebecca: He said it's just up this hill.

Jad: One of the most striking moments of this story is when the two of them visit Hopkins.

Rebecca: How do you feel?

Deborah: Fine.

Rebecca: Yes?

Deborah: So far so good.

Jad: And Deborah meets her mother's cells for the first time.

Christoph Lengauer: I show you that room and I can show you the cells.

Deborah: Okay.

Jad: Because a scientist had finally contacted her.

Rebecca: Christoph Lengauer the scientist who invited us into his lab to see the cells he had projected them unto a screen.

Christoph: Don't be confused. They look green here okay?

Rebecca: They're sort of neon green in this particular case because of the way they were stained and projected. They're very ethereal looking. They're very sort of-- they glow. When you think about angels you think of something glowing. Christoph turned on this screen and she just-- Deborah just gasped. She just, "Ah."

Deborah: Oh my God.

Christoph: This is about 200 times bigger than what they really are.

Jad: A swirling hurricane of cells.

Rebecca: Did you say all that's my mother?

Deborah: Yes.

Rebecca: Pretty good, pretty good yes.

Deborah: It's hard to leave. Oh my God.

Rebecca: Christoph, he gave her a vial of these cells that she could hold in her hand and they came out of a freezer so they were really cold. She rubbed her hands together with the vial in her hand to warm them up and blew on them to keep them warm. Then she just whispered to the cells. It was incredible. She just raised them up to her lips and she said, "You're famous but nobody knows it."

[music]

Jad: Just a week before Rebecca and I spoke in the studio, she got a call that Deborah had died.

Rebecca: She had a heart attack and died in her sleep.

[music]

Jad: Before we close I want to thank Rebecca Skloot for giving us her raw tapes. Her book The Immortal Life of Henrietta Lacks is truly spellbinding. Everything that we just did is a very, very condensed version of what's in that book. You can get more information at radiolab.org sign up for our podcast there. Radiolab.org. I'm Jad Abumrad.

Robert: I'm Robert Krulwich.

Jad: Thanks for listening.

Rebecca: Hello, this is Rebecca Skloot. Radiolab is produced by Jad Abumrad. Our staff includes Ellen Horne, Michael Raphael, Soren Wheeler, Lulu Miller, Tim Howard, and Pat Walters. With help from Adi Narayan, Erin Sand, and Sharon Shattuck. Special thanks to Tim Clark and Timothy Wadzinski. With a name like Skloot, I'm allowed to stumble on people's last names.

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