political gain and praising the media -- praise in the media will make things more expensive for the poor and middle class, enabling a small handful of wealthy and well connected interests to benefit from it. the fact that it's bipartisan shouldn't obscure the problems with it. i hope we'll have an opportunity to address those problems and that we'll give this legislation the due consideration it deserves. thank you, mr. president. i yield the floor. the prthe presiding officer: the senate stands adjourned -- the presiding officer: the senate standsoften make.

i'm more down than you are. i know more about this than you do. i'm actually more down than you and now i'm going to call you out. i've been studying this for three months and i'm going to tell robin d'angelo how long she is. i just got the call back. sometimes i'll go to youtube and now see something. five reasons why robin d'angelo is wrong. and the top one will be she says all white people are racist,can you believe that . what i want to ask is much every white person to do is take a moment and define yourself what is the criteria by which you would grant that somebody's racist. what is the criteria? i don't think many white peoplehave thought deeply about that . if you're astounded that i would say all white people are racist, then tell me what you think it takes. and is probably going to come down to some version of

individual conscious meanness across base and that's the framework. that paradigm just couldn't be more effective at protectingracism . because it one exempts virtually all white people . guarantees distance. guarantees that then nice people couldn't possibly participate and weend up with racism without racist . and so let me just be clear since i said it. when i say all white people are racist what i mean is that we live in a society in which it confuses racist ideology ideology is circling all thetime . the vast majority of white people live segregated lives not only feel no loss about that which for me is the deepest message of all. that i could go cradle to grave as most white people will with no authentic sustained relationship with black people.

and not only not feel anything of value has been missed. defined my life as gaining value from the absence of blacks. >> like, what's a good school . what's a good neighborhood. what's happening when a neighborhood is going up. or coming up, what's happening when it's coming down. what are we talking about when a violent crime happens and somebody has to stay on camera you wouldn't believe that would ever happen here . that's, you already know what kind of neighborhood we're talking about and it begs thequestion where should that happen . so. >> this is a key play, my own work i talk about the value. this belief that some people because of thecolor of their skin but to be valued more . and that valuation evidences

itself in the distribution of advantaged discipline where some people are treated with a generalized sense of disregard. >> .. when i read this, i never really thought about it in this way, that we know what our social groups are homogeneous, right, for the most part, that when people talk about network racism, they're talking about the fact our networks are so homogeneous that opportunities are passed along in certain

because that's it's all e networks they are not robust. i'm playing ball with my friends dad and the like. this segregated world, white world, right, which of course all of these benefits and advantages almost as you put it earlier this is the water you swim in. you can't come out of that without even a drop on you. it reminds me of that moment in their hidden world where he says racism comes to as natural as language, as this kentucky born guy. what do you make of that? >> guest: it such an important point because it's such a sticking point. this gets us up against very precious ideology of individualism, which causes lots of white people to melt down into white frigidity, you don't know me, how can you say that about me? it's true i don't know all of

you. i don't know most of the white people i'm talking about. that's what each individual white person to look at all right how have i been shaped by this? was my class position, magenta, what is been my life experiences within a society that white supremacy, the idea that white is the stand-in for human, the ideal human, and the further you are away from that standard, the less human as argued, it's really an argument that the white body is the standard by which all bodies humanity shall be measured, and so the further you are away from that whiteness, then the less human you are, right? that's the society we live in. we are all shaped by it so that's why say we change the question from if two how.

-- two how. i don't think anyone would argue the moment a baby is born and the declaration is made, boy or girl, a whole set of socialization kicks in and you cannot avoid it. the blanket they wrap you in is going to be shaped i whatever gender they see you as. you can resist it but you will have to resist it and not to resisted every step of the way from everyone you meet. they will be responded to you consciously or not as a male or female. these categories categories are being challenged but none of us can be exempt from it come from gender conditioning. and yet we think we can be exempt from racial conditioning. so if that framework is helpful i i would offer it to white people to think, to use. >> host: sorry, go ahead and try to i a thought because i can imagine what i call that yeah,

but. white folks listening but yeah, but, and he says he lives a secular life overall. the difference is black people who may also lived separate from white people, one, that is the result of decades and decades and decades of policies and practices that were forced on black people. this idea people prefer to live with her own i don't think some people prefer to live with her own with all the resources and some prefer with none of the resources. that's been imposed and so now it seems natural that it is the result of the policies. and you are not sitting at the table as a homogeneous group of people making decisions that affect my life. but my group is sitting at the table making decisions that affect your life. can you see that picture in your mind of the governor of georgia surrounded by other white people signing the voting restrictions

with the picture of the plantation? behind him. so yes, biden administration will be the most diverse administration we have ever had, but not one person listening right now was raised in a society which biden's administration was in office. all of our conditioning doesn't unravel the moment there some diversity in front of us. the people who are enacting these policies, banning whether you could, you or i could be having this conversation on the college campus, who has the power to ban these conversations? nacho group. my group. >> host: just listening to you and reminded me of a moment in the book that he found really interesting, and it's these deeply personal moments. my social group, predominantly black, people of color because

it's exhausting at times, right? then yet to make the decision, you wrote about this in the book, the people who are in your close groups who happen to be white, who are white, make a distinction. there's a distinction between being white and happening to be white. let's make that distinction. you have to make a decision in those moments, , do i risk our friendship to tell him or her what she just did, or what he just did wax do i just let that slide or do we just move on? to have to interpret the drums today? that is, always being asked to give an account for why a, b, and c, right? there's not only the broad macro question but also the internal

demands that are placed on relationships, interracial relationships. i've got this in your own book when you found yourself doing certain things you would call your black friends and say, who do similar work, and they would have to walk you through it, right? what kind of labor that is, that's an additional kind of labor you don't have with other kinds. does it make sense? >> guest: absolute. there are two concepts that are useful for me and one is allostatic load and that refers to chronic pressure lots of people carry allostatic load, but racial weathering is the result of allostatic load that is due to the stress of living and a society in which systemic racism is the foundation. all that i can you come here and i just said that thing, it's

coming from a racist assumption. it's coming from a bias that i'm oblivious to it and i say it and i carry on. i had a great time at the party and you are sending that hours agonizing, is it worth it? what i risk losing the relationship? how often has since gone well for me? you know what, it's not worth it. unfortunately, as it argued in white for julie, often the punishment gets worse not better. that's what i see white for julie as a kind of every day white racial bullying, a a fof everyday white racial control, right? we have this interaction and then you have to think that whether it's worth it to talk to me, and baby futures, no, it's not. i've got to get to the day, a country to give get my family at home, and so i didn't get called

in. i wasn't accountable. racism got to fly. you got to bear the brunt of it and we keep on keeping on with me being comfortable and you being uncomfortable. i want to share a really powerful moment that drives this home. i was in front of a -- back anything we could be in front of groups, and i've gone over white fragility and all of these dynamics and i post a question to the people of color in the room. i said how often have you tried to get a white person feedback on our inevitable and often unaware racist habits and assumptions, and have it go well for you? they laughed. they rolled their eyes. the number one response is never. the number two response is, rarely. i followed up by saying, asking,

welcome what he could give us that feedback? and have us receive it with grace, reflect and seek to change our behavior, what would that be like? i'll never forget this black man raised his hand and he said, it would be revolutionary. revolutionary is a really strong word, right? that's a difficult white people are, but that is a frickin', if i may, revolution, give us the feedback and have us receive it with grace, reflect and seek to change. that's a difficult we are. on the other hand, that doesn't seem like a very tall order. it really doesn't but it is a tall order from the current paradigm that says only that people. that guarantees i'll have to defend myself and then you well be in a position of deciding whether it's worth it. >> host: this is a wonderful way of handing out, right?

the work speaks to the cross racial interracial relationships, kind of personal interactions, how they run aground in which allies are pushing this as a philanthropic issue. they are not seeing themselves. they understand instances decently. we can go through all that. we are in a moment where we're seeing this work at the macro level, in very, very clear ways. senator tim scott declares america is not a racist country. vice president harris echoes, we are not a racist country have to do with our racism. okay. another kind of moment, critical race theory as a catchall phrase for the kind of work that you do, the kind of work that even room does.

this effort to re-narrate 1619 project, right? all of these are a tense to kind of tell a different story about our beginnings, about who we are, confronting our wrongdoings and the like, and we see the depths of the vitriol. we see the intensity of the response. reading "nice racism," we see it broadly across the country at large. bring the two together, talk about "nice racism" and talk about we are as a country in this moment which is supposed to be, supposed to be a moment of profound possibility and transformation trick to precisely because it is a moment of profound possibility we are seeing incredibly amplified efforts to stop it from being that moment.

so carol anderson so beautifully argues in white rage, every inch a black progress has been met by white rage. i believe the current moment is a backlash to obama presidency. i think this blocking of critical race theory is a reaction to what happened this summer. and that more impolite people are being awoken and galvanized to get involved. the forces that are invested in racial justice are deep, but the forces that are invested in maintaining a racist status quo are also very, very deep. and for the most part have the reins of power. so i see both those sides, if you will, absolutely amplified. i don't believe those who want to protect the racist status quo can come out and say that. they can't so they have to find the bogeyman, which have always

been effective at doing. the southern strategy where you manipulate the white populists and racial animus. you caused them to be afraid. you reinforced this idea of scarcity, that any game for you as a loss for me. heather mickey talks about that in the sum of us, that jonathan talks about it in dying of whiteness, right? critical race theory, and registered tim white call it conservative racist theory -- i just heard tim white dashed it's a standard standard for anyone who acknowledges that systemic racism is real. it's the perfect standing in a way to cover that. you have the word critical, and outside of academia a lot of people here that as meaning criticism, and that sounds bad,

right? critical thinking means thinking deeply with nuance and with education. then you have the word theory. that sounds like some radical crackpot thing. if it is just a theory then it's not true or established and its such a perfect little mima to dismiss the conversation. it is being protected. there's a part of me that doesn't want to talk about it because i don't want to reinforce the legitimacy of is it right or wrong? let me be clear. true critical race theory of course comes out and legal scholarship, like kimberly or derek bell. i'm not a critical race theorist but, of course, it's been applied, the premises that racism is structured into the society. and that absolutely --

>> host: like you switch the question, to how come with regard to the critical race theory debate, i want to ask the question why. why critical race theory, why now? so it seems to me that these moments, to attack 1619, all of this is aimed at as we sit at the beginning of this particular conversation is aimed at arresting change, to limit the scope of remedy. we are not bad so we can't engage in this wholesale transformation of who we are. we are not that, we are this year instead of debating crt on its merits, because at least then we know what it is, we need

to ask ourselves why is is being asked. i want to get to this, seems to me this is where -- at the level of politics, because you have two sites as you describe them, and i don't want to make all of those persons on the right daily callers, progressive subscribers or white nationals or the like. they seem to be, there seems to be some level of solidarity with regards to maintaining the idea that america must remain a white nation. on the other side you have nice racism. those who are fighting for a more just america who claim, this is what makes your books are interesting to me at a certain level, is that among

those who are supposedly fighting against those folks come you have joe manchin and the like, and you can use your text to see what he's doing in real time at the love of politics. talk a little bit about what does it mean for these people to be on the side of a more just world? >> guest: yeah. i hope white people keep fighting. i hope nice white people are out there fighting. unfortunately, i haven't seen that the energy that we saw last summer is being sustained. running down to approach us on some level is exciting and exhilarating, but the daily work of putting racism on the table looking at your policies and practices in the workplace, challenging one another, that's the really hard stuff. and in case i don't say earlier,

or later, it takes courage, it takes commitment but it also takes courage, and niceness is not courageous. so my point around that is that so many white people see the present of niceness as an indicator of absence of racism. and a culture of niceness is actually one that prevents us having difficult conversations about racism. it's generally a culture that's nice for me but not necessarily nice for you. there's this idea that the way that i experienced the world was must be the way you explained ee world, so i find our campus to be a very welcoming place, wouldn't you feel it to be a welcoming place? or this idea that if a policy displayed to everybody then it is there, even if the outcomes are not going to be the same. right? so it takes a lot of commitment and courage, and that i want to

see sustained and this ties back. the moment i think i've arrived i will be complacent. i'm also going to be defensive about any feedback to the contrary. any idea, this is why one of the chapters is called there is no choir. the moment i think i am the choir, i'm going to be part of the problem. there is a level of humility that white people need to have, a level of understanding that this construct is hundreds of years old at this point back to its nuanced, complicated, charged. it's not simple. it's not going to change just because we are friends. and so my learning will never be finished. >> host: what about my trauma, robin? >> guest: i'm curious, you

teach in college classrooms i assume and when you talk about race you may see some of these moves. so there's a chapter called what about my trauma? that's a pattern i often see amongst progressive white people, that as soon as we start having hard conversations where they become implicated, we're not going to talk about it out here, with likely to talk to everybody else's challenges, we're going to whatever we talk about we're going to connect to do so. what does it look like in your life? the number one question i get when i give a talk is how do i tell my friend about racism? i reply like this. how would i tell you about your racism? the question always implies it's not me. i'm good to go, i have to go forth and tell other people. as soon as it starts to implicate us, many white progresses will move into their

own pain and her own approach. maybe you could imagine if it starts getting hard i start feeling implicated and i'm going to start talking about growing up poor and others people said that thing about me when i was young and had that hurt me, and now i'm going be a victim. right? one going to say this conversation bringing up my old traumas and i can't continue in this conversation. i wanted to call, call that in. and again ask people to think deeply, so how this function in the conversation, what happens to the conversation when you move to that place. i also want to push -- people are wrong. i'm not denying you have trauma but i am going to hold firm that talking about racism is in and of itself traumatic. >> host: so here we are -- >> guest: for white people. >> host: here we are. we've had this wonderful

conversation. people have come to you. they have read white for julie. they are going to read "nice racism." hopefully it will read some of those articles, too. the scholarship that informs it all year what is the source of hope for the work that you do and what you've seen over the years of doing this work? where is your source? not that we have to end with hope, the typical american narrative the talk about what you see on the immediate horizon as he continued to do this work. >> guest: you know i'm an educated cybersex a little bit about the politics but before i sailed what has given me hope, i think hope is political. because it tries behaviors and responses, just like i think emotions are political. because they are informed by the framework through which we are making meaning which is why if you told me 20 years ago what you're doing is racist, i would've interpreted that to a

particular framework and would've had a set of emotions, and they would have triggered some responses which would've been at the time white for julie. today at a different framework and have different feelings if you were to say that to me. and hope function similarly. it doesn't function the same for black people as a test for white people. i can't speak to your relationship to that concept, but what i can tell you is after 25 years of doing this work and seeing where we are right now, do i struggle with hopelessness? yes ideal. and i cannot go there -- yes, i do. as a white person i cannot succumb to it. because the moment i do, great, give up, give up and do does it serve? what does that serve? because it's a system that benefits me if i give up hope within it, if i give up hope to fight it, i continue to benefit

from it. on the other hand, too much hope can make me call in and can cause me to be complacent and there were lots of white folks who felt completely hopeful following the civil rights movement of the '60s, and look where we are. so it is something i navigate, i have to push to it. but what gives me hope is there's a couple maybe concrete things that on the stage, the world stage at the democratic debate, reparation for black people was discussed with absolute legitimacy. i didn't think that would happen in my lifetime. ta-nehisi coates article on reparations is brilliant and powerful and started to make headway in the culture. there was a time when you couldn't critique capitalism,

and there's a a time when you couldn't say white supremacy. and now from the president office, i'm talking about biden, jesus saying systemic racism -- he is saying systemic racism is among the urgent issue of our time. that's incredible and it gives me hope and it's tempered by the fact we will see what happens when he isn't president anymore, whether that be four years from now or 12 years from now. >> it is been an absolute delight to have an opportunity to talk with you and am reminded of a wonderful phrase from tammy baldwin who says hope is every day. if you have to end in everyday that means you're battling the spirit. it's been a pleasure. >> guest: thank you so much. thank you so much. >> afterwards is available as a podcast here to listen visit c-span.org/podcasts or search c-span "after words" on your

podcast app and watch this and all previous "after words" interviews at booktv.org here just click the "after words" button near the top of the page. >> a a look at some books being published this week.

>> find these titles this coming week wherever books are sold and watch for many of the authors to appear in the near future on booktv. >> weekends on c-span2 are an intellectual feast. every saturday you'll find events at people that explore our nation's past on in american history tv. on sundays booktv bring to the latest in nonfiction books and authors. it's television for serious readers. learn, discover, explore. weekends on c-span2. >> former investment banker carol roth argued government bureaucrats use the covid-19

pandemic to crush small businesses to make wall street richer. here's a portion of that discussion. >> i talk to people about how many big businesses versus small businesses to most people don't have a really good sense of the scope, they think there are millions of big businesses answer like a niche of small business but it's the reverse. with summer between ten, 15,000 large businesses in this country, and before covid we had 30.2 million small businesses come 6 million of which had employees and it accounted for about half the gdp and about half the unemployment of the country. so it really is a very significant part of the economy over all and also just an important path for economic freedom as you think about the path for wealth creation, wealth creation comes with ownership. so small business enables anybody and the people from all

over the globe who like to come to try to pursue that economic freedom, pursue that wealth creation, or in some cases just of the kinds of freedom, flexibility to do what they want or to pursue a passion or whatnot, and so preserving that opportunity and the decentralization that comes along with small business and really looks a lot more like free-market capitalism and a lot of the big businesses do, make it so critically important, but man come when i tell you a you and says important small business is, we hear it from politicians and we do not have enough people walking the talk. >> to watch the rest of this program visit booktv.org, search for carol roth or the title of her book "the war on small business." >> so now i'm very excited to introduce tonight speakers. science journalist lauren has used nearly every medium to produce award-winning journalism

for pbs nova including documentaries, podcast, short form video series, interactive games, blogs and more. her articles on memory and on addiction have been featured in the "boston globe" stats on dark magazine the atlantic in "scientific american." this book in particular was supported by a grant from the alfred p. sloan foundation broke him public understanding of science and technology. the night lauren is join the conversation science journalist deborah balaam, the office of "the poison squad." a recipient of the culture dabber nesters as a director of the night science journalism program at mit. the night the two will be discussing her debut book trent nine held by "science" magazine as extensively researched, cinematic and accessible. joining us tonight dabber

appraises the book saying the memory thief moves with a roller coaster speed of a first-rate suspense novel. simultaneously offering a deeply compassionate and insightful look at our understanding of what makes and what breaks human memory. we are so pleased to have them both here with us for this event tonight. without further ado the digital podium is yours, deborah and lauren. >> thank you and i'm so honored to be here in part because i'm such a fan of the harvard book store and a part because i'm such a fan of this book. lauren, when i first got, a look at your book i found myself deeply annoyed because a lot of times i can just skim through a book and go on to other things but i got sucked into your story so often that it actually interfered with some of my work over at the journalism program, so this is the saying i'm very

happy to be talking to you about this book. and i want to start by saying, and your book reminded me of this, sometimes there are scientists who will talk about the brain as a black box, so mysterious, and memory as an even more mysterious part of what happens in the brain. and your book reminded me of both that mystery and at the detective work that goes on to try to solve it. so i'm hoping that we can start this with you reading a brief excerpt that sort of illustrates some of the detective part of this, and then go on to the conversation. >> great. so this is a scene from early on in the book. on the first friday of october, barash leaned forward in his chair and stared at the mri scan on his monitor.

he's looking at the brain of a a young man admitted to the hospital last night and the image is so strange and beautiful that he knows something has to be wrong. woe, he says out loud to his empty office. this is weird. floating brightly against the darker background of the rest of the brain are two t-shaped structures talked on either side of the central fluid filled cavity. together they make up the hippocampus, the place that holds the keys to memory and the intense glow is a distress signal from many millions of cells. some mysterious marauding force has laid waste to adjust this tiny region leaving the rest of the brain unharmed. barash looks at his door to the still quite waiting room upon the seventh floor at late hospital and medical center in burlington massachusetts just outside boston. then he looks back at the monitor. last nights phone call from nearby winchester hospital

requesting permission to transfer this patient suddenly makes more sense. the distraught 22-year-old has recently overdosed. he was dragging one leg and repeatedly asking his mother he was dying. winchester is a small hospital that handles routine emergencies like a broken wrist or an appendicitis. but when patients with complex conditions are unexplained symptoms come in, the staff of offense in the over to leahy, facility that has hundreds of specialists in more equipment. with a high quality image in front of him, barash can see what the winchester death could not and it explains why the patient was acting strangely. in ten years of medical training, barash has reviewed thousands of scans, brains shrinking from also missed disease, brain started tiny broken blood vessels, brains with tumors in different sizes shapes and locations. in every case, , no matter what

the damage looked like, it was pretty clear what was going on. but what barash sees on the screen in front of him is strange and alien, the longitudinal category he can imagine. it looks like someone took a page out of this medical school textbook and deliberately highlighted the brains memory center. he re-examines the mri, scrolling up from the base of the skull to the familiar brain structure until the hippocampus comes back into view. it seems certain that this patient will fail the memory test it will give him today at the damage has triggered his interest in strange cases and rare brain diseases. he believes more intense and in destiny, but still, he thinks, it's almost as if this year's of study have guided him directly to this moment sitting in his office looking at this startling image.

>> so i think that excerpt gives everyone who's watching here a sense of description of your book as a cinematic. but let's sort of not overdo the image year but let's sort of widen the lens a little. i'm wondering if before we go any further you can just talk a little bit about who he is and explain a look at some of this way that he starts and starts building this sort of mystery detective part of your book? >> okay. first i should say that jed is a friend of mine and we sort of sheer fascination with weird brains because i have a somewhat weird brain. i suppose we all do, but i thought his opinion for a neurological problem using -- very helpful.

barash initially, he's a puzzle solving the also happens and as an epidemiologist, so he really looks for patterns and tries to explain well, when you see something new, sort of a disease detective in addition to being a neurologist, when you see something new, how do you make sense of it? so for him when he saw this first patient i described, it was well, this is weird and this is what we know about what happened to him but the really wasn't enough to go on it, but to see what actually caused that very unusual damage. it wasn't until he saw the second case when he noticed a a link, and he said okay, there's a link with both of them with heroin use of people have been using heroin for decades. what's changed? well, what the change was in 2012 fentanyl had started to work its way into the drug supply in massachusetts. so that was the new thing

certainly the rest of the book he setting out to find out if his hunch is right, and it's much harder than it would seem from the service of it to figure that out. >> and he builds a kind of network of people who are equally both puzzled and fascinated by this particular syndrome, mostly in massachusetts. the story isn't only set in massachusetts but it's heart is really with this ministry that begins here, i say because i'm living in boston. >> yes. it's also a very interesting story because it's kind of science on a shoestring budget or really no budget. because it's this weird syndrome that doesn't fall in anyone's particular area. it's not part of someone's research project. crosses two areas, addiction and opioids and memory. part of his job was really roping in other people who read

the expertise that he didn't have and the resources that he didn't have. so that was sort of years of late-night e-mails to anyone he could think of who might be able to help and cajoling and badgering until he was able to pull together people who could help him solve the mystery. >> yes, that was one of the things i like so much about it is you start saying all these different people have different parts of the puzzle and trying to connect the dots essentially in making this work. let's back up a little bit though because one of the things, and this struck me again in looking, in reading your book, is that our understanding of memory, i'm not sure this is a good thing or a bad thing, and you can contradict me, too, but it strikes me reading your book and from other books i've read that much of our understanding

of memory comes from injury injury to the brain, injury to memory. if we don't go and seek that in humans, so a lot of times, and this is why his fascination with these two cases to start with, and another gets to be more, is so interesting, but a lot of time it's really just one case. but to go backwards in history a little bit and just to talk both about the hippocampus itself and why it's so important but a single case, one of the moment in history that you reference is very famous case in neuroscience of hbm. and i wonder, because i was such a breakthrough moment in memory if you talk love it about that and also a little bit about how they led us to the central feature of this sort of group of

detectives who are looking at damage to the hippocampus to recognize the role of the hippocampus in memory? >> so the famous story of hm, was later revealed to be henry melissa congressman hice in this are talking about, he had really terrible epilepsy and they couldn't treat it with medicine and finally in a last-ditch effort to save him, a service wash buckling surgeon decided to remove both of his hippocampus. it was good reason to think that that might work because hippocampus very bold global region can break citable and very prone to seizures. but no one knew what it did. and if you think about it, removing like both of the whole brain structure, it's got to do something, it was risky but they were hoping to save his life. it wasn't until he woke up in

the hospital and kept asking his mother with a bathroom was, that they realized they had really hurt his memory. so he was studied extensively for the rest of his life by brenda milner and suzanne corrigan and others who really were able to tease out, we talk about memory, memory that most of us talk about that we care about is a memory that our hippocampus shapes and creates. it's been memory for things that you know you know, whether it's events or facts or episodes from your life that are stories that you can remember. he lost the ability to create the new memories of that sort but he was able, he had some procedural memory meaning he could learn how to do things that were like motor skills but he would never like recognize another new person. he didn't know suzanne corrigan despite having worked with her for decades.

so yes his misfortune was a boon to science. >> yes, and it also, and i'm glad you talk about hippocampus itself are obviously there's a number of kinds of memories, right, we do look at the hippocampus as this kind of central structure, and it's not just because of agm. it's because of work that followed in that sense, but there's another character in your book, owing and i should say what i came up in science journalism hm's name was not revealed. how is a more recent decision and a lot of times in these kinds of journal scientists will protect dead denny of a test subject by just using their initials. so to this day my hippocampus

insist on calling him hm. i've always felt so sorry for him, right? he's part of a group of cases in which damage to the brain, this is not the same as thing but there was a famous case of a worker name phineas gage who had an iron bar that accidentally was forced right through l cortex of his brain and a loud, that injury again come single injured but allowed people to start to recognize what part of the brain help with impulse control. so hm was usual influential but you actually follow a patient, evan thach come and allow this, he writes essay, invited essay at the end of your book, owing, you draw some parallels to hm in a way his condition helps us understand memory and how injury

affects memory. and it went if you would just talk a little bit about him as a case study, not only in what we see in these glowing amazing images of the hippocampus that what we see in the way that these kinds of injuries affect people's lives. >> he's a remarkable person and also grateful that he was willing to share his story with me for the book. so he overdosed after 18 months of sobriety on fentanyl, and woke up in hospital with this injury. but because he had actually long cared about memory and it studied memory in college, he understood immediately when the doctor said you injured your hippocampus what it meant for him. and to this day he still can't remember where he parked his car. he can't remember that his best

friend might've broken up with his girlfriend the day before. but because he is an incredibly organized person and has incredible executive function key actually has managed to rebuild his life and has a job and takes classes at a community college. he's really just a testament to, not to sound hallmark card, but resilience and the ability to carry on and is also very generous in agreeing to participate in this research at the university of california san francisco memory and aging center. and so there they learned, they did some very tailored mri scanning through a strange confluence of events come here actually had an mri scan just before his overdosed. so they knew what his brain look like before the overdosed, and there was imaging done right at the time of the overdosed that

showed that glowing image i described before, just the hippocampus. then he came back to ucsf and they measured the volume of his hippocampus and you get short by 10% which is much as a 60-year-old would lose in a decade. they. they also did this very detailed testing of his memory and other cognitive functions. and again what is called episodic memory, is explicit memory for numbers or events, he scored on par with someone with alzheimer's disease but it the rest of his cognitive function is perfect. what his case really showed is that fentanyl can zero in on just this one structure in the brain, just the hippocampus, and damage it. this was completely unrecognized -- actually i'll correct myself.

there was an anesthesiologist who did recognize that and then research for 20 years and finally gave up because no one wanted to fund it anymore. but it was really not at all well known. so now the question becomes, now we know that opioids can damage the hippocampus, can we turn the inside around and use that knowledge to find ways to protect the hippocampus? >> and about 20 in on that point that, that sort of precise point of mechanism of injury for a minute and then open it back up to other issues in memory, leading as may be even to as you mention the comparison between the memory affects that are comparable to alzheimer's. so lots and lots of people have been prescribed fentanyl, or you know, abused illegal versions of

the same, and yet we don't see an epidemic of memory loss in an exposure to person one in one kind of way, you know. and numbers, even in your bood there's probably more since the book, you research the book, but still were not talk about what anyone to talk about is like, i don't, not a pandemic but an epidemic, right? do we and has the research been done, each as i always find this part of what, in this i think relates to alzheimer's, what causes the damage to memory? two people understand that, why this is so case specific, what is about fentanyl? >> there's two questions in the. one is what causes damage and in the second is why does it not happen to most people. >> yes. >> so the first one how does it cause the damage it's a little bit wonky but basically there's

two main classes of neurons in the brain. there's a the excitatory neurs we think about that they get enough input and a fire in the past the message along. and those represent the majority of neurons in the brain, but they are also called inhibitory neurons and their job is to actually manage everything. they are like the bouncers at the bar and to keep things under control. so when they are out of commission you have chaos, and that's what happens with fentanyl, is it locks onto these specific opioid receptors on the inhibitory neurons and it shuts them down. so they're they are outn and then the excitatory neurons are firing wildly out of control and burning up more energy than they have, this is compounded by what people use opioids, not in a hospital setting, let's say, it suppresses the drive to breathe. they are also usually somewhat hypoxic so that just exacerbates

the problem because the not getting enough oxygen to this vulnerable structure. that's the idea of the mechanism of damage, but why it doesn't happen to most people is definitely still a mystery. it could be a genetic predisposition that is rare. it could be a prior use. it could be, for example, oh one had used drugs since age 11 -- owing -- but had been sober for your and after wasn't the prolonged use followed by sobriety, followed by a traumatic overdosed that was a problem for him? is it vascularization? is it had different people's hippocampus is that in different ways by the blood supply? that they really don't know and that will be very hard to tease out just because there are so few people, and just get right there are probably many more people than we realize but even so there are few.

i also want to speak to your point about let's say fentanyl is used in anesthesia everyday and 80-90% of surgeries 90% surgeries and clearly this doesn't happen to those people. but those people are two things, they are supported with but they also, that drug is given with another drug that counteracts the sort of excitatory effect of fentanyl. protective. >> that's reassuring. but also the kind of, and i think it's a question that goes way beyond this and to all of the different diseases and responses to diseases that we see, you know, what's the individual response and what is the more general response. so still many mysteries involved here, which leads me to ranch out into other issues of memory.

let's talk about memory and then go and sort of expand this to something that probably people think of as an epidemic, which is alzheimer's, , so diseases of memory, right? which is the more we understand memory and how it works and what triggers injury and how we best treat that injury, you can generalize out way beyond well, this person abuse fentanyl to, well, what about this vast series of unknowns about memory? that would include our understanding of alzheimer's, right? >> and i don't know if myself i would describe alzheimer's as an epidemic because it's always, isn't just that we are able to do better diagnostics and so we are more aware of this specific condition, but certainly alzheimer's and other dimensions

that affect memory, why do they matter so much? and i think it's not just about daily function but i also, this gets back to the core of the memory issue, are we our memories, right? it's great to know where you left the car and all of the sort of navigate through daily life stuff but in the more existential who are we, are we, in fact, our memories, why does this matter so much? >> yeah. we are our memories. i look back briefly to the neurological episode i referenced in the beginning because it's part of what drew me to this story is i had an episode where i lost my memory for a couple of minutes, meaning i had no idea where i was, what century it was, or who i was. like if you asked me my name at that moment i couldn't have told

you. there was no connection to the past, the present, the future, and that was deeply, deeply terrifying because yes, without your memories you actually don't feel like anyone. i want to sort of softened that a little bit because they're still, even someone with severe memory problems still feels love and connection. it's not sort of as black and white as i described it, but memory is also, we think it's about remembering the past and who we are. but it's also about imagining the future. this is one of the more interesting experiments that ari talked about in the book, which is a woman eleanor maguire in london worked with people with severe amnesia, also damage to the -- she found conscious all of them come about the day at the beach, like look around,

what do you see? so that people who didn't have the memory problems told a whole story, there's a boat going by and i hear the seagulls and lots of details. the people with the damage to the hippocampus, there is nothing. i mean, they know conceptually that there's white sand and a blue sky, but that's really all they can say when she probed seeman says what else do you see? they say that's it, , i'm kind f floating. they can't imagine something. they can't create a new scene out of their mind, and that's part of what makes us so human in who we are is imagining things that don't exist yet and rejecting yourself into the future. it's as much about having a future as having a past. >> that such an interesting point. i hadn't thought about that come the sort of backwards and forwards nature of life regarding memory.

when we look at, i'm sort of making a huge leap over to the larger memory related diseases by opening up the alzheimer's box here. if we look at the complications and effects of alzheimer's, do you yourself see parallels and how alzheimer's affects the brain and how this particular condition affects the brain, , r is it more or less here is another issue in which we see the way memory is so central to our lies and we don't understand best have to protect our memories? >> yeah. well, there are some parallels which i wasn't aware of between this, , what's called the opioid associated syndrome and alzheimer's, which was a really clear very early on except for

the fact they both target hippocampus. so in most forms of alzheimer's disease, the hippocampus is where the damage first begins. so that's why in most cases memory loss is the first sign, and then the damage spreads out from there. but going back to those excitatory and inhibitory neurons and that in balance between them that can be damaging, that is also known to be a feature of both aging and especially in the face before alzheimer's disease. ..

>> the results are. >> are good, the fda could approve this drug and that would happen in late 2021, if it works. so it's fairly far along and, of course, easier when you're starting with a drug that is known and you don't have to go through all of this testing to, you know, determine if it's safe

or not. and i want to come back at some point and i expect there might be some interest in -- in the issue of how the fda decides to approve treatments. let me ask you, i mean, at this point, i don't -- both membrane and going back to analogy. you know, i wouldn't say that we've written the book on how memory works. you can contradict me. you know more about this. what causes are triggers or fully plays roles in memory loss either. yes? >> you are absolutely right. we have not written the book on either of those things.

you know, there's no hammer of truth and every finding comes with asterisks and it's always incomplete. >> that's one of the reasons why i love the stories of scientists who recognize the importance of the henryses and the owens and the all of these different case studies which remind because, you they say something and we have individual very response but we also have universals about how the brain works. so going back to alzheimer's for a minute, when you think about alzheimer's and the way that it affects memory, how do you -- i

mean, what do you see as the primary loss, what's your best understanding of some of the mechanisms and -- and i'm going to very shortly start, we have a few questions already in the q&a and i don't want to encourage people if they have questions about memories or alzheimer's or anything in the book, you know, this is a great moment to add them into the q&a but talk about alzheimer's a little bit and i'm curious whether working on this book made you think about alzheimer's in a different way or feel that you understood it or -- or understood its impacts in a way you hadn't thought about before? >> well, i hadn't actually really thought about alzheimer's before and i think that's true for many of us because by the time someone has alzheimer's, they are usually, you don't see

them, they don't go out. so they are invisible unless you know someone who has it or you know someone who is taking care of someone with alzheimer's. but, you know, we know a lot about alzheimer's but we don't know what causes it. so that makes it very, very hard to treat, so it's known a lot of features of alzheimer's or what they call biomarkers like the toxic proteins that build in the brain and hyperactivity and the inflammation and where the damage is. it's possible to see all of those things but how that process got started is believed to have happened way, way earlier and it's not clear why it begins and -- and there may not be a cause, there may be multiple causes, there may be multiple on-brands to this

disease. so it's very hard to figure out the cause because it does happen so early and it's a disease of aging. so there's a ton of other things going on in the human brain at the same time and many people with alzheimer's disease may have some other disease as well. they might have some cerebral vascular disease. so it can be sort of hard to see the part. >> you're right that i think we think more about alzheimer's if there's a personal connection. most of us actually hope to go through our lives with no connection at all, i think. i'm going to briefly mention mind and that will allow me to segue into personal stories which is one of the questions i've gotten in the q&a here which is that my favorite who was also the smartest person in her family, right, always super sharp is the one person, this is

my father's side of the family who was diagnosed with alzheimer's and so i was shocked actually, right, of the family, of all the people that i would have predicted who have ended up with an alzheimer's memory disorder. my aunt was the last person for me on that list and i will add that, you know, due to covid-19 which also comes up in your book in the way that it, you know, has been researched disruptive in some ways. the things that aren't focused in infectious disease. she ended up in a unit care unit that was locked down due to covid and that did not go well. i have very strong feelings about alzheimer's. i have a question here that is

related to something that you raised in the book. also personal, lauren, can you say more about your own experience with amnesia, what cause understood, did your memory simply returned or what happened? >> so what happened is it turned out that it was a type of seizure that was caused by a brain legislation. -- lesion, i went through testing that owen rivers went through after his injury and i got -- i was advised to have surgery by the chief of neurosurgery at a boston area hospital and i didn't like that idea so i got a lot of second opinions and i was told by neurologists to just hang tight and take some medicine and i'd be fine and that has been the

case, tons of mri's, you know, that lesion is there still. fortunate for me it was a one-time event and, you know, i consider myself extremely lucky. >> that's what people with opioid associated were missing, is what happened to me and why am i the only person out there?

>> right, no, that makes perfect sense. this is a question from pat, also related to the people with an opioid-related syndrome. it does sound that fentanyl damages memory suddenly where alzheimer's disease is a slower development. do we know of other chemicals that affect the memory suddenly or slowly i suppose especially what we might call chemical? >> well, not lifestyle chemicals that i'm aware of. there is another toxin that can damage and it's called a shellfish poisoning and toxic that accumulates in shellfish during algae blooms. so similarly it just zeros in on

hipa campus and damages severely and so people who suffer from that will have exactly the same kind of presentation but in terms of the hipa campus, i'm not aware of any research that suggests there's a toxin that's particularly targeting and that's when the toxic proteins accumulating many years in the brain and when they get together in hipa campus that's when the damage really begins and then it spreads out from there in regions. >> i don't want -- i have enough questions that i don't want to go down this path too much, but you do make the point in the book that we do know of other exposures that are implicated in neurological conditions such as parkinson's. memory but definitely neurological in the chemical. i have a series of questions

related to art and craft and -- and the telling of the book itself. evan would like to know how did dr. barry feel about story researched and publicized and this is a complementary question in your great book in such depth. he turned relevant emails over years and can you tell us how the project worked? >> right, so he actually didn't turn over the emails to me. it was the department of public health that turned over the emails through a freedom of information act request. but he and one of the neurologist that he worked closely monroe butler, did turn over their text messages which were fascinating because they show the kind of back and forth and the evolution of ideas over the years as they try to sort out, you know, what does this mean, what can we learn from

owen rivers, you know, what are the implications, could this form the basis of new mouse animal model for alzheimer's. i mean, actually i was a little surprised that he let me do this because he doesn't like the limelight. i think he was motivated by wanting to get the word out because there are undoubtedly more people out there who just don't know what happened to them. so, you know, it's possible that now more people will be aware of it. >> no, that makes perfect sense. this is a related question from allison. throughout the book you include, speaking of text messages, text messages, personal notes that owen, one of your main characters wrote and other primary source material. how did you choose what material to include and why did you want to include those personal

snapshots? >> i will take the personal snapshots first. you know, science -- this sounds silly, but science is done by people. i think how science advances depends so much on people's personalities and how they think about problems and who they talk to and luck. so those text messages and those emails really revealed people's personalities and their persistence and how they thought about ways that would have been boring for me to just describe in an ammunition voice and it was more interesting to hear directly from those people and, of course, there were tons of boring emails that i swifted through from the dph that you have to choose, the ones that tell the story even the story of your day, you're not going to sit down and tell everyone everything that happened. you will choose the highlights,

so that's what i did. >> that's just good writing. and related to that was there anything fascinating that you learned during research that ended up so to speak in the cutting room floor, a story that you didn't tell? >> well, i think it was more some interesting science that i learned which i could not work in because it derailed the story but researchers at uc san francisco who were trying to see can we image opioid receptors when they are being activated and by accident they found out that the opioids we take -- the ones we take like fentanyl, those actually behave differently and go inside of neurons and they go into parts

that regular opioids don't and i just thought that was fascinating because i always wondered, we already have opioids, why are these so different. well, maybe that's why. i just thought that was fascinating? >> that was really interesting. so i'm going to go back to interesting kind of question from cindy here which has to do with health exceptionally good memory and retention. i mean, describing an 88-year-old friend who has an incredible memory given the question of counting backwards from 7 to 100 which i'm not sure i could do. [laughter] >> totally nails that and in other sort of test, memory test, she's all over it. i mean, i've heard and i

actually think about this myself that, you know, when you get to be middle-aged and thinking not so much about diseases here, but just generally memory and longevity that we tend to lose some of our memory for nouns or names as we get older and i certainly see some of that in myself sadly enough, i don't remember names as well as i wish i did these days. not only like, you know, memory defects and memory diseases but do we actually understand any of the biology behind an exceptional memory? >> you know, that's a great question and i don't know the understand and i don't know if that's actually been studied so -- >> not something that i looked into. i definitely -- i actually met on one of my research trips

someone like that who remembered every day of her life she could go back and tell me what was happening and conversations and it was -- it was wild and she seemed perfectly happy and some people you hear about who have the exceptional memories not necessarily a great thing to remember everything but for her it just seems fine. she enjoyed it. >> i would love actually and totally say that should be your next book. [laughter] >> memory geniuses and amazing stories. i don't know if it'll be as good as this one but it really is an interesting question and related to that in a very pinpoint way here is another question, is there any evidence that memory exercises, games, cross words, whatever actually have any effect in preventing memory or enhancing memory loss or

enhancing memory? >> yes, so there's this concept called cognitive research which is the ability for your brain to still keep functioning well even in the face of damage that's happening. so there is evidence that exercise is helpful in scathing off memory loss and dementia but not the kind of things that the crossword puzzle that you do every day. it has to be something hard, you know, just like exercise if you want to build me muscle. if you want the kind of cognitive workout that is thought to be helpful. you know, learning a new language or really challenging yourself in some way and it's also being socially engaged. so, you know, having experiences, your brain needs input. it's also why having hearing loss is problematic because you're just not interacting with

the world as much. so anything you can do to basically be working your brain is a good idea. >> that's really helpful and, you know, sadly reminds me of the many times that people say to me, have to do the work. as a couple of book-related questions and then i will -- which i hope we can get to and then question about -- and i expect you have gotten these before the new drug related to alzheimer's and provide to the fda but let's do the book ones quickly. memory, amnesia, alzheimer's that you recommend related partly because i think the opioid discussion we had, have you read the new book about the family and have you had any thoughts about that book? >> i have not read that book about the sackler family.

one of the books that i turned to early on it's an oldy but a goody is the 7 sense of memories by daniel because the concept that is he talks about in terms of memory and what it's for and how it fails us, you know, still holds true today. i think there's two recent books, the problems alzheimer's by jason if you want to dig in alzheimer's and how we should be caring for people with alzheimer's. that one is very good. there's a new book out about remembering, how remembering by lisa genova who wrote still alis that is focused more on the science of memory. if so if that's your interest, then one of the books that i read about addiction that i found interesting is called the biology of desire by mark lewis. and that -- that takes the position that addiction is as much of a disorder of learning and memory as it is a disease.

>> i actually have to say that i really liked still alice and some of the points about memory and who we are. >> yeah. >> you should definitely look at this. so the fda and this has been incredibly -- geeky science writer community, incredibly controversial. recently approved a drug that was really targeting plaques as one of the issues in alzheimer's and the approval process actually caused 3 scientists on the fda advisory board to quit the board because they were so unhappy about how it turned out and yet there is a lot of people whose hope that this is going on the helpful so if we can finish, you know, talking a little bit about that, that would be wonderful. >> okay. >> yeah, so as you said, the

advisory panel recommended against approval and that is not to say that they know it doesn't work. it's to say that the evidence isn't there in their opinion to show that it does work. so many people were very surprised that it was approved because there had been 25 press clinical trials targeting so the same approach didn't work and why this one finally was approved, there were lots of ideas of why this was approved and, of course, everyone wants a drug to work. you know, i think a concern that a lot of people have expressed is that this is going to make it harder to develop other drugs because there's already a shortage of people for clinical trials and now that will be made worse because there will be so many people taking this drug that they then aren't available to try other things. so that is a concern, you know,

but it's also possible that because the fda has approved this drug people will feel more confidence in investing money in coming up with other strategies, so there were -- i mean, before this decision was made, i spoke with a lot of researchers who said, this is a great time in the field. like we are finally truly optimistic about finding a treatment, you know, it's a renaissance and we can see it 3 years, 5 years, 10 years, so i don't think people are going to abandon all the other strategies and so, you know, i think despite all of the concerns about this new drug which i think are real, there's still a sense of optimism in the field about if not what the answers are like they can see how to get to the answers so that we can develop treatments. >> that makes me feel a little less bitter.

[laughter] >> as we close this evening out, lauren, other points that you think, either you would like to say about memory or the particular investigation, the secrets how we remember, the points that you would like to leave our audience with? >> so, i mean, one of the things i really looked about the story is, again, it goes back to sort of personality and -- and what drives science, so i think, you know, the case study is sort of scorned in science. it's at the bottom tier of, you know, compared to sort of work with mice. it's considered sort of low-level, you know, one-off, but for me and for many scientists those one-offs are the opportunity to say, what did we miss? when something doesn't make

sense, it's either the observation wasn't correct or we didn't know something that's important. you are seeing it for the first time so, you know, what does it mean and, you know, most people are -- everyone is busy so you file in the back of your mind and move on or are you in a position to say, okay, i want to figure out what this -- what this means and sometimes, you know, it really unlocks a whole new way of -- of understanding human health that is really valuable. so for me it's about the twin -- sometimes opposing ideas of pay attention to things that make sense, don't make sense, you know, be open-minded, but also be skeptical and check yourself before you jump to conclusions. so you have to be both critical and -- and open to new ideas at the same time. i think to be a great scientist, that's what you have to do. >> that's such a wonderful way to close this discussion and i wish we could do it longer.

you know, you've been great and i really want to thank everyone who have stayed with us. people stayed through the whole discussion which is always wonderful to see and the questions have been so smart, so from my own perspective, it feels very lucky to come talk about a book like this. thank you to everyone. >> thank you, great to be here. great conversation. >> i will just echo you both thank you once again tremendously to both of you for sharing this discussion with us tonight and so relevant with the recent fda decision as well. i'm really glad that you touched on that and thank you everyone out there all over the country for spending your evening with us. please learn more about the book and feel free to purchase memory thief at harvard.com and on behalf of harvard bookstore,

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