Sonic Poison? The Genesis of Havana Syndrome
37:04 Share

So I have some big news for vegans and vegetarians everywhere. It's Hellman's plant-based mayo spread and dressing. Made for people with a plant-based diet or anyone really who wants to enjoy the great taste of Hellman's real without the eggs. Hellman's plant-based is perfect for sandwiches, salads, veggie burgers, or any of your family favorites.

To celebrate, Hellman's is sharing some easy, delicious plant-based recipes at hellmans.com. Hellman's plant-based mayo spread and dressing. Same great taste, plant-based. I'm Malcolm Gladwell, and I'd like to take a moment to talk about an amazing new podcast I'm hosting called Medal of Honor.

It's a moving podcast series celebrating the untold stories of those who protect our country. And it's brought to you by LifeLock, the leader in identity theft protection. Your personal info is in a lot of places that can accidentally expose you to identity theft. And not everyone who handles your personal info is as careful as you.

LifeLock makes it easy to take control of your identity and will work to fix identity theft if it happens. Join the millions of Americans who trust LifeLock. Visit LifeLock.com slash metal today to save up to 40% off your first year.

The most innovative companies are going further with T-Mobile for Business. Red Bull harnessed the strength of the T-Mobile 5G network to launch point-of-view drones and give fans unmatched views of their extreme sports, while broadcasting in real time from some of the most remote locations in America. This is heart-pounding fan experiences. This is Red Bull with T-Mobile for Business.

Take your business further at T-Mobile.com slash now. Pushkin. Havana, Cuba, in the fall of 2016. The island's longtime ruler, Fidel Castro, an implacable foe of the United States, has just died. What upheavals, what power struggles his passing might set in train are of considerable interest to America's intelligence agencies today.

In a pleasant neighbourhood of the capital, one of the CIA's agents has returned home for the evening. Fairly certain in the knowledge that Cuban operatives have him under surveillance. And then... The American feels as if he's been hit by a beam of sound. Young and fit at the time of the incident, the agent eventually seeks medical attention at the clinic inside the US embassy.

He's been having headaches with acute pain in one ear and his hearing in general isn't what it was. Two other officers soon say they too remember strange, sharp and disorienting sounds in their homes around the same time. A few more reports come in. The wife of one embassy official says she heard a strange sound and looking out the window saw a van rush by. Was a Cuban operative at the wheel?

You need to call a meeting. One diplomat tells the head of the American mission, the rumor mill is going mad. So he does. He tells the embassy staff that they may be being targeted by some kind of unknown sonic weapon. And after the meeting, cases of Havana syndrome explode.

Staffers and their families report hearing the strange sounds at home, even in some cases a hotel room. They complain of dizziness, mental fog, ear pain and headaches. By summer 2017, news was getting out. At first, the US State Department guardedly said they were looking into incidents, which caused a variety of physical symptoms.

But a journalist from the Associated Press got officials to speak off the record. He reported their belief that this was some kind of advanced device that operated outside the range of audible sound. Soon, the official language became more assertive. Not incidents, but attacks. Then-President Donald Trump said he believed Cuba was responsible.

In October, the Associated Press published another scoop. They'd obtained one of the recordings of the mysterious sounds that led to suspicions of a sonic weapon.

The recordings themselves are not believed to be dangerous to those who listen, wrote the Associated Press. Sound experts and physicians say they know of no sound that can cause physical damage when played for short durations at normal levels through standard equipment like a cell phone or computer. So I should be safe in playing it to you. How to describe the sound?

The Associated Press had a go. It sounds sort of like a mass of crickets. What device produced the original sound remains unknown. One obvious possibility is that the device could have been a mass of crickets. But the sound of mere insects can't reduce the CIA's finest to physical wrecks, can it? I'm Tim Harford.

and you're listening to Cautionary Tales. CAUTIONARY TALES

In an elementary school in Miami in 1974, a couple of hundred children are rehearsing a musical. The fourth, fifth and sixth graders are singing in the school's cafetorium. That's a room that doubles as a cafeteria and an auditorium. At half past nine in the morning, one 11-year-old girl begins to feel unwell. Let's call her Sandy.

That's the name the New Yorker magazine gave her when they wrote an article about what happened next. Sandy doesn't want to disrupt the rehearsal, so she tries to slip out of the cafetorium without anyone noticing. The teacher doesn't see her, but some of the other children do. Sandy goes to see the school nurse. The nurse isn't there, but the head secretary is passing by and she sees Sandy slump unconscious on the nurse's couch.

The secretary takes out her smelling salts and wafts them under Sandy's nose. But Sandy doesn't come round. The secretary calls the emergency services. They arrive just as the rehearsal ends. As the kids file out of the cafetorium, they see Sandy being carried off on a stretcher. And now another child says she's feeling ill. And another. And another.

Some say they're dizzy, some have headaches, some complain of abdominal pain, some are hyperventilating. Soon, seven more children have been rushed to hospital. Another 25 are sick enough that the school calls their parents to come and collect them. What could be happening? A neighbourhood doctor arrives to offer his help and immediately notices a funny smell, some kind of

Poison gas, perhaps? Leaking from a broken pipe? Police cars join the ambulances. So does the rescue squad from the fire department. The local media routinely look for stories by listening in to transmissions on the emergency services radio frequency. So word of the suspected poison gas leak soon gets around. Reporters from newspapers turn up. So do four film crews from the local TV news stations.

Worried parents flock to the school. They're joined by curious neighbours and passers-by. By the time Joel Nitzkin arrives to investigate, the scene is chaotic. Dr Nitzkin heads the county's Department of Public Health. He and his colleague have to park half a block away as the street is jammed with assorted emergency vehicles, their lights all flashing.

Nitzkin is 6 feet 9 inches tall, so he's able to pick a path through the crowds of people. As he enters the school grounds, Nitzkin sees hundreds of children sitting quietly in the shade of some trees, looking bemused but perfectly healthy. That's reassuring, Nitzkin thinks. Whatever's going on, hundreds of children are obviously unaffected. Nitzkin and his colleague go into the school building.

They notice the unusual smell, but they can't immediately place it. The school's head secretary greets them. "There's been some kind of poison gas leak," she tells them. Or that's what she's heard. It all started with this girl, Sandy. She started to feel ill when rehearsing a musical in the cafetorium. Then more children got sick, dozens of them. Some have gone to hospital, some have gone home. We're treating about 40 more now, as best we can.

"Where are you treating these sick children?" asks Nitzkin. "In the cafetorium," says the secretary. Nitzkin exchanges a glance with his colleague. "In the cafetorium? If that's where Sandy got ill, wouldn't that be where the poison gas must have been leaking?" "Oh," says the secretary, "I don't know about that."

Nitzkin and his colleague head into the cafetorium, where, sure enough, they find children stretched out on the floor, and nurses and police and fire rescue workers buzzing anxiously around them. That strange smell is nowhere near as strong in here, Nitzkin notices. He locates an office with a telephone and calls the hospital where Sandy and the other children were taken.

They're doing fine, says the doctor. They all seem to be feeling better. The lab tests haven't all come back, but everything's coming up normal so far. Nitskin hangs up the phone and sees another colleague from the county's environmental health department. He's arrived separately, and he's been checking out the school building. About that funny smell when you come into the school, Nitskin asks, did you notice it? Any idea what it is?

Sure comes the reply. It's carpet adhesive. They laid a new carpet in the library a few days ago. Is it toxic? No, laughs the colleague. Not at all. Have you found any hint of toxic gas? Nope. I'll investigate further, of course, but on a first check, everything seems normal. Dr. Nitskin ponders as he walks back to the cafetorium. He trusts his colleague from environmental health. It doesn't seem to be poisoned gas.

It can't be viral or bacterial. There wasn't time for Sandy to have infected everyone else. Anyway, the kids are complaining of all kinds of different symptoms. That wouldn't make sense if it's an infectious disease. In Nitzkin's mind, the pieces are starting to fall into place when he's accosted by a woman who works in the kitchen. You're a doctor, right? You're in charge here? Yes, says Nitzkin. I am.

Then why don't you do something? Why don't you straighten out this mess? You know as well as I do that there's nothing the matter with these kids. Get them up on their feet. Get them out of here. I have to start setting up for lunch. Nitzkin stares at the woman, his mouth open. She's just bluntly put into words exactly where his own thoughts had been tentatively leading. Now he's pretty sure he knows what's wrong and how to fix it.

"Listen up," says Dr. Nitzkin. "I've got an announcement to make." He's soon commanding the attention of everyone in the cafetorium. "We've conducted an initial investigation into claims of poison gas," he says. "We haven't found any. There's no evidence of any infectious disease either." By now, the journalists are crowding round. Nitzkin has cameras on him, microphones thrust in his face. "What's happened here," he continues, "is an outbreak

Nitzkin scans the faces around him. Nobody says a word. The nurses look stunned. The teachers look thoughtful. He sees his colleague nodding and smiling.

And the parents? The parents look appalled. Has Nitskin just said that their kids are crazy? But it's as if a spell has been broken. People start to talk to each other. The kids who'd been feeling ill perk up. The teachers take them back to their classrooms and bring in the kids from under the trees outside. The first responders from the various emergency services begin to drift off.

Dr. Nitzkin drives back to his office, thinking, I hope I got that right. Cautionary Tales will be back in a moment.

The problem is that AI needs a lot of speed and processing power. So how do you compete without costs spiraling out of control? It's time to upgrade to the next generation of the cloud, Oracle Cloud Infrastructure, or OCI.

OCI is a single platform for your infrastructure, database, application development, and AI needs. OCI has four to eight times the bandwidth of other clouds, offers one consistent price instead of variable regional pricing, and of course, nobody does data better than Oracle. So now you can train your AI models at twice the speed and less than half the cost of other clouds. If

If you want to do more and spend less, like Uber, 8x8, and Databricks Mosaic, take a free test drive of OCI at oracle.com slash strategic. That's oracle.com slash strategic. oracle.com slash strategic. I love cycling, and I'm eager to get my kids cycling too. It's a great way for them to stay fit and move around our home city independently. But of course, I also want them to be confident and safe.

which is where Guardian Bikes comes in. The bike comes in a box and it's easy to assemble with all the tools you need and simple online instructions. My son and I unboxed his bike together, spent about 20 minutes working as a team to assemble it

And then he was on the bike and ready to ride. The bike looks great and with the SureStop braking system it brakes quickly and safely without locking the front wheel and sending you over the handlebars. Guardian bikes offer a 365-day money-back guarantee covering returns, repairs and spare parts. Join hundreds of thousands of happy families by getting a Guardian bike today.

Visit GuardianBikes.com to save up to 25% off bikes. No code needed. Plus, receive a free bike lock and pump with your first purchase after signing up for the newsletter. That's GuardianBikes.com. Happy riding! If you're listening to this right now, you probably like to stay on top of things, which is why I want to mention The Economist. Today, the world seems to be moving faster than ever. Climate and economics, politics and culture, science and technology, wherever you look,

Events are unfolding quickly, but now you can save 20% off an annual subscription to The Economist so you won't miss a thing. The Economist broadens your perspective with fact-checked, rigorous reporting and analysis. It's journalism you can truly trust. There is a lot going on these days, but with 20% off, you get access to in-depth, independent coverage of world events through podcasts, webinars, expert analysis, and even their extensive archives. So where

Whether you want to catch up on current events or dive deeper into specific issues, The Economist delivers global perspectives with distinctive clarity. Just to give an example, What's Next for Amazon as it turns 30? analyzes how Amazon's fourth decade looks like an area of integration for the company. Go beyond the headlines with The Economist. Save 20% for a limited time on an annual subscription. Go to economist.com and subscribe today.

When Joel Nitzkin spoke in that Miami school cafetorium, he described what was happening as mass hysteria. That was half a century ago. Language evolves and hysteria is, for good reason, no longer a medical diagnosis.

It's an ancient Greek word from hysteria, meaning uterus. Hysteria was thought to affect people with a uterus, and over the years it's often been used to describe any kind of behaviour by women that men find annoying. Aristotle, for example, said women shouldn't have the vote because of their hysterical disposition.

As for mass hysteria, that seems to have first become common in the Middle Ages, especially with outbreaks of the dancing plague. Here's one historical account.

The streets were filled with men and women who joined hands, formed circles and seemingly lost all control over their actions. They danced together ceaselessly for hours or days and in wild delirium the dancers collapsed and fell to the ground exhausted. Groaning and sighing as if in the agonies of death.

People believed that they were seeing God or being possessed by demons. Here's an especially striking case recounted by a German physician. I have read in a good medical work that a nun in a very large convent in France began to meow like a cat.

Shortly afterwards, other nuns also meowed. At last, all the nuns meowed together every day at a certain time for several hours. The whole surrounding Christian neighbourhood heard, with equal chagrin and astonishment, this daily cat concert, which did not cease until all the nuns were informed that a company of soldiers were placed by the police before the entrance of the convent and...

that they were provided with rods and would continue whipping them until they promised not to meow anymore. When you hear stories like this, mass hysteria sounds like something from a long gone age of superstition. But it still happens. Only today we have a different name for it: Mass Psychogenic Illness.

Psychogenic means beginning in the mind. In contrast, an illness that begins in the body is called physiogenic. For example, if you've breathed in poison gas. We all find it easy to understand physiogenic illnesses. If a doctor tells you you're ill because a bacteria or a toxin has got into your body, you believe them. Psychogenic illnesses are much more mysterious.

How does our own mind make us ill? And yet, it does. It's lunchtime at a secondary school in the small Belgian town of Bornham. The year is 1999. As usual, the canteen has crates of Coca-Cola that the children can buy to drink with their lunch. But today, something seems different. Not quite right. A buzz of conversation goes round the canteen.

Does this bottle of coke smell funny to you? Some of the children shrug and gulp down the Coca-Cola regardless. Others start to drink theirs, but find that the taste is a bit off, so they leave their bottles unfinished. Still others are concerned enough by the smell to take their bottle back to the canteen staff and ask to swap it for a new one.

After this happens a few times, the canteen staff decide they'd better stop selling the coke. The children go back to their lessons. But within half an hour, several are starting to feel ill. They have headaches, nausea, dizziness, abdominal pain. Some are having trouble with their breathing. The school phones their medical helpline for advice. Better take all the kids to hospital, they're told, to be on the safe side.

The teachers don't yet know what they're dealing with. They decide to go round all the classrooms. Did any of you drink Coca-Cola at lunchtime and you're now feeling ill? More children come forward, 22 in all. The teachers drive them all to the hospital. At home that evening, still more children start to feel unwell. Another 11 turn up at the emergency room. Investigators later analyse the Coke the children had drunk.

There was indeed a problem with it. The gas that makes fizzy drinks fizzy is carbon dioxide. But in bottles from this batch of drinks, it had been contaminated by two other gases: carbonyl sulfide and hydrogen sulfide. These are gases that smell like rotten eggs. They can make you ill in large quantities, although the investigators didn't find large quantities. Enough to cause a strange smell, yes,

Enough to harm someone? They didn't think so. Still, the story is all over the Belgian news. Kids drank funny-tasting Coca-Cola and now they're in hospital. And soon reports come in from different schools in different towns. Some children are feeling ill. They drank cans of Coca-Cola Light from a vending machine. We've seen the news and we're assuming that must have had something to do with it.

Actually, some of the kids hadn't had Coca-Cola Light. They'd had Fanta. That's made by the Coca-Cola company too. It soon turned out that these cans of Coca-Cola Light and Fanta had been produced at a different facility from the Coke bottles. The carbon dioxide in them is perfectly fine. So, have two different problems hit two different factories at the same time?

Investigators looked into the cans too and they did find another problem, although it didn't seem very serious. The wooden pallets used to transport the crates had apparently been treated with fungicide. And that fungicide might have reacted chemically with the chlorinated cleaning products used in the vending machines. And that reaction might have caused a smell on the outside of the can. Could it have poisoned people?

didn't look plausible. Meanwhile, the storm in the media grows. More and more reports come in. And not just from schools or from children, adults too become convinced that Coca-Cola products are making them ill.

Hundreds of members of the public call the 24-hour hotline of Belgium's poison control centre, reporting symptoms and wondering if they should attribute those symptoms to the fizzy drink they've recently consumed. Most of the symptoms aren't too serious, like the ones originally reported in the media. Headaches, nausea, dizziness, abdominal pain, that kind of thing.

But one doctor calls the Poison Control Center hotline to ask about a condition that's much more worrying: hemolysis, a disorder of the red blood cells. The doctor explains that he's treating a child with hemolysis and he's curious to know whether or not anyone has reported hemolysis as one of the conditions potentially linked to Coca-Cola. Nobody has.

But the doctor's inquiry goes into the database. And when Belgium's Minister of Health asks for a list of the possible effects of drinking Coca-Cola, that list contains hemolysis. The minister mentions the term at a press conference. Soon after, the media finds a hospital that's treating people with hemolysis who've also recently drunk Coca-Cola. The minister decides that urgent action is needed.

Six days after the first school children fell ill, the Ministry of Health bans the sale of all Coca-Cola products in Belgium. The Coca-Cola company puts out a statement saying: "We deeply regret any problems encountered by our European consumers in the last few days."

And they issue a mass product recall for Coca-Cola, Coca-Cola Light, Fanta, Nestea, Aquarius, Bon Aqua, Kinley Tonic and Lilt. They temporarily shut down three factories. They throw away stocks of soft drinks worth over $100 million. Gradually, the media reports die down and the calls to the poison hotline start to dry up.

After a couple of weeks, the minister lifts the ban. And Coca-Cola's CEO issues an abject apology. We let down the people of Belgium. But had the Coca-Cola company let down the people of Belgium by making lots of the meal? Or had they, in fact, let people down by not being more like no-nonsense Dr. Nitskin?

Cautionary Tales will return in a moment.

I love cycling and I'm eager to get my kids cycling too. It's a great way for them to stay fit and move around our home city independently. But of course, I also want them to be confident and safe, which is where Guardian Bikes comes in. The bike comes in a box and it's easy to assemble, with all the tools you need and simple online instructions. My son and I unboxed his bike together, spent about 20 minutes working as a team to assemble it

And then he was on the bike and ready to ride. The bike looks great and with the SureStop braking system it brakes quickly and safely without locking the front wheel and sending you over the handlebars. Guardian bikes offer a 365-day money-back guarantee covering returns, repairs and spare parts. Join hundreds of thousands of happy families by getting a Guardian bike today.

Visit GuardianBikes.com to save up to 25% off bikes. No code needed. Plus, receive a free bike lock and pump with your first purchase after signing up for the newsletter. That's GuardianBikes.com. Happy riding! If you're listening to this right now, you probably like to stay on top of things, which is why I want to mention The Economist. Today, the world seems to be moving faster than ever. Climate and economics, politics and culture, science and technology, wherever you look,

Events are unfolding quickly, but now you can save 20% off an annual subscription to The Economist so you won't miss a thing. The Economist broadens your perspective with fact-checked, rigorous reporting and analysis. It's journalism you can truly trust. There is a lot going on these days, but with 20% off, you get access to in-depth, independent coverage of world events through podcasts, webinars, expert analysis and even their extensive archives. So where

Whether you want to catch up on current events or dive deeper into specific issues, The Economist delivers global perspectives with distinctive clarity. Just to give an example, What's Next for Amazon as it turns 30? analyzes how Amazon's fourth decade looks like an area of integration for the company. Go beyond the headlines with The Economist. Save 20% for a limited time on an annual subscription. Go to economist.com and subscribe today.

After Dr. Nitskin told the children in Miami that there was no poison gas and they should get back to their classrooms and carry on as normal, some parents were furious with him. One mother called his office, demanding that he apologize for insulting her daughter. How dare he imply that she's insane? Dr. Nitskin tried to explain that he'd done no such thing.

He had implied that she was suggestible. We all are, he explained, to some degree. It's not a sign of insanity, especially at the age of 11. Here's how that suggestibility works. I see other people feeling ill. Someone tells me it's because of a mystery gas. I smell it too. I expect to start feeling ill, and I do. And it's not my imagination. I really do feel ill.

Exactly how our beliefs and expectations translate into actual real symptoms is still not well understood. It's one of the many mysteries of the human mind. But there's no room for doubt that it happens. Many people, though, seem to find that hard to get their heads around. When a doctor suggests that their illness might be psychogenic, the patient thinks they're being accused of something, of imagining their symptoms or faking them.

A few weeks into the Coca-Cola scare in Belgium, some scientists publicly raised the idea that mass psychogenic illness could have been the cause. The backlash from the general public was immediate. What do these scientists know? They haven't examined a single patient. Are they saying doctors were fooled or people simply imagined their symptoms? No, they weren't.

They were saying people had real symptoms, caused not by drinking poisonous soda, but by mistakenly believing they'd drunk poisonous soda. But if experts struggled to get that idea across to an irate public, imagine what would have happened to the Coca-Cola company if they'd come out at the height of the media storm and said, our drinks seem fine to us, maybe it's psychogenic. It would have been a public relations disaster.

No wonder they preferred to pour a hundred million dollars of soda needlessly down Belgian trains. From the backlash against Dr. Nitschken and the scientists in Belgium, it seems clear that mass psychogenic illnesses are widely misunderstood. And that's a problem, because when a mysterious new syndrome comes along, it can be hard to have a dispassionate discussion of the possible causes.

I was inspired to write this cautionary tale about mass psychogenic illnesses by a book recently published by two distinguished academics, Robert Bartholomew and Robert Ballot. The book is well researched and it's convincingly argued, but it also has some terrible reviews from readers. Propagandistic garbage, unbridled ignorance and pseudoscience, wild speculations, disinformation at its finest.

The book is called Havana Syndrome. Remember the story. It started with an undercover officer at the U.S. Embassy in Havana, Cuba, complaining that he felt ill after hearing a mysterious sound at his home. As news about the case got around, more and more people started reporting symptoms after hearing similar sounds. Officials became convinced they were dealing with some kind of sonic weapon.

A weapon that sounded sort of like a mass of crickets. The FBI took recordings of the sounds to an expert in crickets. He listened to them. That's crickets, he said. Crickets, cicadas or katydids. One of them. Probably cicadas, actually. Cuban cicadas can be pretty loud, he pointed out. 95 decibels. That's about as loud as a motorcycle engine. But...

Could a cicada damage your hearing? No, he said. Not unless you shoved it into your ear canal. There might, of course, have been a sonic weapon that sounded a lot like cicadas. But think of it this way. You're about to be posted to Havana. You're quietly taken aside and played a recording that sounds very much like Cuban cicadas. You're told, we think this may be a sonic weapon that's making people ill.

You get to Havana, and one night, you predictably hear cicadas. As the authors Bellot and Bartholomew put it, this is a classic setup for an outbreak of mass psychogenic illness. There's another reason to consider psychogenic explanations. Nobody seemed able to suggest how the mooted sonic attack device might actually work.

Still, militaries don't tend to publicise their cutting-edge technologies, and some experts say it can't all have been psychogenic because a few people's symptoms were too serious for that. Below and Bartholomew disagree. I don't feel qualified to judge. But I do think I can judge the quality of debate around the suggestion that Havana syndrome might have been a mass psychogenic illness.

That debate was depressing. And not just in the reader reviews of Ballot and Bartholomew's book. Senator Marco Rubio, for example, sarcastically dismissed the idea that a bunch of people are just being hypochondriacs and making it up. Well, no. That's not how psychogenic illness works. Whether an illness begins in the body or the mind, the symptoms are real. But that leads to another question. How do we treat them?

In London, in 1990, more than 50 schoolchildren were rushed to hospital when they started feeling sick after lunch. They had abdominal pain, nausea and vomiting. They all recovered pretty quickly. You know the drill by now. This looks like a mass psychogenic illness, right? Actually, no.

After careful investigation, it turned out that the cucumbers served at school lunch were probably contaminated with insecticide. Lots of things can make us ill, especially with the kind of symptoms I've been mentioning through this tale. Fatigue, nausea, dizziness, headaches. These are common ailments, with all kinds of causes,

It shouldn't surprise us if we happen to find a Belgian with some of these symptoms who just had a coke, or a US diplomat in Havana who recently heard cicadas. Diagnosis is hard, and we need to keep an open mind, especially because cases of physiogenic and psychogenic illnesses often crop up together.

The London investigators blamed the cucumbers, but they also reckoned that some of the later cases might have been psychogenic. Kids seeing their friends getting ill and thinking themselves into illness too. Some people think that might also have happened in Belgium. Those first few bottles of coke might have caused children to feel sick. And from that starting point, the problem ballooned through psychogenic contagion.

Maybe that'll turn out to be the story with Havana syndrome too. A mix of physiogenic and psychogenic cases. We don't yet know all the answers. The trouble is that psychogenic and physiogenic illnesses need treating in completely different ways. If you're ill because something's got into your body, a toxin or a virus or a bacteria, you need to figure out what that thing is. And if it has an antidote.

If the cause is psychogenic, then there isn't a cure as such. At least if we discount the medieval method of sending soldiers to whip the meowing nuns. But there is an approach that makes sense. If the power of expectation made someone ill, the power of expectation can also help them recover. When Dr. Nitzkin told the children in Miami that there was no toxic gas, they stopped worrying.

and their symptoms melted away. Of course, what's an inspired diagnosis if you're right looks like an arrogant rejection of your patient's experiences if you're wrong. For every Joel Nitzkin who decisively cures a psychogenic outbreak, there's a doctor brusquely telling their patients to snap out of it, when in fact the illness has a physical cause that the doctor has overlooked.

Joel Nitzkin knew he'd taken a risk he'd have to justify to his bosses. I'd made a bold move, he told the New Yorker. And bold moves are not encouraged in the bureaucratic world. The safe thing to do would have been to close the school for the day. When the report came back, no poison gas, Sandy had a viral illness, all the other kids thought themselves into feeling ill too, nobody would have blamed Dr Nitzkin for erring on the side of caution.

I'm not sure that makes sense. If a doctor tells us he thinks we've probably got a viral illness and it turns out to be bacterial, we're not going to get more or less upset than if it made the opposite mistake. But we don't feel the same symmetry about psychogenic illnesses. Nobody's happy when a doctor makes a mistake. But the mistake of declaring an illness to be psychogenic is the one we can't seem to forgive.

And if we wrongly see the suggestion of psychogenic illness as a personal insult, we'll make doctors scared to mention it. Joel Nitzkin took a risk because he understood how psychogenic illnesses work. He knew that if he allowed the idea of poison gas to linger, more kids would have felt ill. And he understood that their symptoms would have been genuine.

Those 40 kids in the cafetorium, complaining of nausea or breathing problems, weren't faking or imagining they were suffering. With one calm and authoritative statement, Dr. Nitzkin cured them all. For a full list of our sources, please see the show notes at timharford.com.

Cautionary Tales is written by me, Tim Harford, with Andrew Wright. It's produced by Alice Fiennes, with support from Edith Ruslow. The sound design and original music is the work of Pascal Wise. Julia Barton edited the scripts.

It features the voice talents of Ben Crow, Melanie Guttridge, Gemma Saunders and Rufus Wright. The show wouldn't have been possible without the work of Jacob Weisberg, Ryan Dilley, Greta Cohn, Leet Almalad, John Schnarz, Carly Migliori and Eric Sandler.

Cautionary Tales is a production of Pushkin Industries. It was recorded in Wardour Studios in London by Tom Berry. If you like the show, please remember to share, rate and review. Go on, you know it helps us. And if you want to hear the show ad-free, sign up for Pushkin Plus on the show page in Apple Podcasts or at pushkin.fm slash plus. ♪

I'm Malcolm Gladwell, and I'd like to take a moment to talk about an amazing new podcast I'm hosting called Medal of Honor. It's a moving podcast series celebrating the untold stories of those who protect our country. And it's brought to you by LifeLock, the leader in identity theft protection. Your personal info is in a lot of places that can accidentally expose you to identity theft.

and not everyone who handles your personal info is as careful as you. LifeLock makes it easy to take control of your identity and will work to fix identity theft if it happens. Join the millions of Americans who trust LifeLock. Visit LifeLock.com slash metal today to save up to 40% off your first year.

So I have some big news for vegans and vegetarians everywhere. It's Hellman's plant-based mayo spread and dressing. Made for people with a plant-based diet or anyone really who wants to enjoy the great taste of Hellman's real without the eggs. Hellman's plant-based is perfect for sandwiches, salads, veggie burgers, or any of your family favorites.

To celebrate, Hellman's is sharing some easy, delicious plant-based recipes at hellmans.com. Hellman's Plant-Based Mayo Spread and Dressing. Same great taste, plant-based.

The news isn't always good news, but when you're getting quality journalism and in-depth expert analysis that's held up for more than 180 years, that is definitely good news. So if you haven't already, save 20% with The Economist's summer sale today and stay on top of the stories that matter to you. You'll instantly gain unlimited digital access to daily articles, special reports, award-winning podcasts, subscriber-only events, and so much more. Now that's

Good news. Go to economist.com and subscribe today.