Podcast #16: Health Care in North Korea

Join our podcast host and former NYT Science Times editor David Corcoran as he discusses Undark’s latest Case Study “Health in the Hermit Kingdom,” about medical problems in refugees from North Korea, with writer Sara Talpos. Also: Seth Mnookin on how the media cover health care and addiction, and reporter Andy Short on what will happen to your body if you decide to be buried at sea.


A full transcript of the podcast is below.

David Corcoran: This is Undark. We’re a magazine devoted to exploring the intersection of science and society, and we’re this podcast. Hello again. Welcome to episode 16. I’m David Corcoran.

For our cover story, studying public health in one of the world’s most famously closed societies. The country is North Korea, and as reporter Sara Talpos writes in Undark, it’s something of a black box to the rest of the world. We see it mainly through satellite images, government approved photographs, and reports from humanitarian agencies, but now some medical experts in South Korea are trying to do more. Sara Talpos joins us now to talk about it. Sara, welcome to the podcast.

Sara Talpos: Hi David. Thanks for having me.

David Corcoran: So North Korea is in the news a lot these days, but your story is about an extraordinary study based at Korea University in South Korea that is the opposite of the warlike rhetoric we’ve been hearing. What are researchers trying to learn?

Sara Talpos: Their goal is to document the health of North Korean refugees, sometimes referred to as defectors, when they first arrive in South Korea and then later after they’ve had time to adapt to the more westernized lifestyle of their new country. To this end, researchers at Korea University developed a study called NORNS. This is short for North Korean Refugee Health in South Korea. It’s notable for it’s size — they’ve managed to recruit over 1,000 refugees And for it’s breadth — they’re tracking things like mental health, cardiovascular health, metabolic health using survey questions, as well as a large variety of lab tests to monitor things like liver function and vitamin D levels.

David Corcoran: You said they’re studying 1,000 defectors from North Korea. How many defectors, former North Koreans, are there in South Korea?

Sara Talpos: Right now there are approximately 30,000 North Korea defectors living in South Korea.

David Corcoran: That’s an extraordinary participation rate. It’s practically, what, about 3 percent of all the North Koreans now living in South Korea are taking part in this study. What prompted the South Korean researchers to do this study in the first place?

Sara Talpos: Well, this may sound strange to Americans, but many Koreans in the North and the South believe that one day their countries should be unified, and historically the South Korean government has invested some resources into this. For example, in 1969 it established a Ministry of Unification with the goal of promoting inter-Korean dialogue and exchange. The idea behind NORNS is that the results can inform present day public health policy for North Korean defectors, but also that the results can be a repository of knowledge for developing a post-unification health care system.

David Corcoran: So the idea is that at some point North Korea and South Korea will be united under one government and they will of necessity have to deal with whatever public health issues there are affecting the population of North Korea. What prompted your interest in the NORNS study?

Sara Talpos: Well, three years ago when my son was in second grade, he befriended a classmate who was from Seoul. The boy’s father was a physician and he was spending a year working at our local hospital.

David Corcoran: We should say you’re in Ann Arbor, Michigan.

Sara Talpos: That’s right. Yes. When the boy and his family moved back to South Korea, we visited there, and I became really fascinated with South Korean history. When the Korean War ceasefire was declared in 1953, the country was totally devastated. Millions of civilians had died. The per capita GDP was less than $100, and yet today the country is highly educated, highly wired. It has the 13th highest GDP in the world and life expectancy is 82 years, which is better than in the United States.

The quality of life in South Korea is far from perfect, but the older generation of South Koreans has seen some pretty extraordinary changes. At the same time, you’ve got North Korea on the other side of the border, which is a poor, closed, and underdeveloped country. Some progress has been made there in the past decade. For example, thanks to international aid agencies, the population is pretty well vaccinated, and there’s something of a middle class in the capital of Pyongyang, but for much of the nation, life is very difficult. Food insecurity, for example, is a huge problem. Thirty-two percent of children under the age of five are stunted because of chronic malnutrition, and there are huge regional disparities.

In one northeastern province, 45 percent of children are stunted, which is among the worst rates of childhood malnutrition in the world. Many North Koreans are still experiencing the lingering effects of the famine, which occurred in the 1990s and killed up to a million people. Those who survived, and particularly those who were young, are now at increased risk for health problems. The NORNS study is helping us understand health conditions inside North Korea, but it’s also helping us understand how North Koreans will adjust to a more prosperous society. I think it’s really fascinating from a health standpoint, but also from a social standpoint, this idea that medical collaboration can build bridges where political negotiations have failed.

David Corcoran: Now you yourself were not able to get into North Korea. Is that right?

Sara Talpos: That’s right. From the very, beginning I’ve been aware of North Korea’s history of imprisoning Americans, so no, I did not go to North Korea.

David Corcoran: So how did you report this story?

Sara Talpos: It was a little like putting together a puzzle, where you draw on these different pieces to try and get a feel for the whole. The pieces I relied on included interviews with defectors, researchers, and North Korea scholars. I also visited classes at Korea University, which has developed a new public health program to lay the groundwork for a post-unification health care system. I’ve also drawn on some data from a few international agencies.

David Corcoran: Let’s talk about some of the people you met starting with the lead researcher on this study, who’s name is Dr. Sin-gon Kim. He’s quite a guy.

Sara Talpos: Yes. He is an endocrinologist and professor at Korea University Medical School, who also helped found the public health program. Dr. Kim was born 15 years after the Korean War ceasefire. His family members were Christian, and as a young child, he learned that communist North Koreans had, during the fighting, herded 21 of his family members into a church and killed them because of their religion. Then once the South Korean army came in and North Koreans had to retreat, there were still some villagers there who had supported the North. They were then killed in an act of retribution.

From an early age, Dr. Kim felt a personal connection to Korean history. This motivates his current work, which he sees as a way to foster peace between Koreans.

David Corcoran: How does Dr. Kim present himself? You’re an American. You’re learning about his study. I guess maybe there’s something of a language barrier there. How did the two of you get on?

Sara Talpos: I would say we got on really well. I’ll admit I was a little intimidated partly because I’m an American coming into this culture that I’m not very familiar with, and also because I’m speaking with this well established doctor and researcher, but I would say he wears his authority very lightly, and he’s a pretty funny guy. When we first met, I think I said one word in Korean and he immediately said my Korean was way better than his English, which is not even close to true, but he made for a fun interview.

David Corcoran: Of course you were able to interview refugees from North Korea, some of whom were actually part of the NORNS study. They have some pretty harrowing stories.

Sara Talpos:Yes. This was the most interesting part of my research. The defectors that I spoke with were a diverse group, so one woman who was a NORNS participant, referred to as Ms. J in the article, was struggling to survive when she escaped, but other defectors I spoke with had enough food and they had shelter. Instead they left because they wanted human rights. As you can imagine, day to day life in North Korea is tightly regulated. For example, if you want to travel to a border town or to the capital of Pyongyang, you have to apply for a special passport, and there’s no guarantee that you’ll get it. One young woman that I spoke with, Eun-hee Park, frequently was brought to a local jail for infractions like changing her hairstyle.

Now North Koreans know that things are different on the outside. They only have to look across the border to see Chinese towns, which are all lit up at night. This is in contrast to their own towns, which are dark due to fuel shortages. There’s also a black market for South Korean media, and some North Koreans have family members in China who communicate with them about life elsewhere. But for those who are motivated to leave, the route is pretty treacherous.

The first thing they have to do is escape into China, but China’s policy is to return North Korean refugees where they’re beaten and jailed. Some of the ordinary refugees I interviewed spoke of being caught and then returned to their home country where they were tortured. Then amazingly upon their release, they crossed the border again. Some do remain in China, but their undocumented status makes them very vulnerable. It’s reported that large numbers of female defectors are victims of human trafficking and male defectors have to work longer hours at lower wages than Chinese workers. Because of these conditions, many defectors decide to leave China.

To do this the most common route is to pay a broker thousands of dollars to lead them on a 2,500-mile journey through China into Laos and finally to Thailand where there’s a refugee center in Bangkok and from there they fly to South Korea, which is required by its constitution to accept all North Koreans.

David Corcoran: The woman in your lead Ms. J, who was a refugee from North Korea, got out of North Korea by sprawling across a frozen river. She described some really tough health problems in her own family. Can you tell us about her?

Sara Talpos: Yes. Ms. J was a really interesting person because she was actually born into a fairly well off family, but like many North Koreans, she had most of her savings confiscated in the 1990s when the famine came and the country fell into an economic spiral. As time went on, she struggled to make ends meet, but she also had problems getting health care. When her baby was 10 months old, he was just in a lot of pain for stomach problems. She took him to a nearby hospital, and the doctors were unable to help. I can only speculate that this was because they didn’t have the kind of scanning equipment that we have in the United States that might have helped them identify the problem, so soon thereafter the baby died.

Then after that, her husband who had been a heavy drinker and I assume an alcoholic, contracted cirrhosis of the liver, and she was pregnant at the time. He had told her, “Don’t worry about me. Just focus on your newborn baby.” He soon died, and then she miscarried. So I asked her, do you think that some of these deaths could have been prevented if you had lived in a different country? She said, “Probably all of them.”

David Corcoran: You also talked to a defector from North Korea who’s a doctor, Dr. Ko.

Sara Talpos: Yes.

David Corcoran: What’s his story?

Sara Talpos: Dr. Ko is also a really interesting story. He was a doctor. He did his medical training during the time of the famine. He talked about how he was able to go through the training, but some of his classmates had to drop out of medical school because they just didn’t have the resources to survive. He was a tuberculosis doctor in North Korea for many year and was able to see patients who were really struggling. One of the things that makes your susceptible to TB is lack of nutrition. If you’re not well nourished, you suffer from side effects of the medication.

He saw a lot of this happening and meanwhile, he was growing increasing frustrated with his life in North Korea. One of the things he said to me is that there is no such thing as private in North Korea. Everything is controlled by the state. Although he was a doctor and by some people’s standards in North Korea was living well, he wanted to get out. He escaped once and was returned and was jailed and tortured. He spent the next year preparing for another escape. This time he made it over. He was working a lot of different odd jobs in China. He eventually settled working in a mannequin factory, which was owned by a South Korean.

He eventually told a couple of his Chinese friends that he was going to try to escape into South Korea. He hid in a little box on top of these mannequins and drilled a hole for air and stowed away on this boat and eventually found his way to South Korea. Once he got to South Korea, his life was still pretty difficult. To become a doctor in South Korea … If you’re trained as a doctor in North Korea, you don’t have to go to medical school again, but you do have to pass a licensing exam. This is a really big hurdle for a lot of North Korean defectors.

One of the things that I was so surprised by is that English is a huge skill that these defectors have to learn pretty much immediately, partly because colloquial Korean in the South has a loanwords from English, but the medical terminology also incorporates a lot of loanwords. He had to learn all of those, and then he also had to learn more about some of the resources that are available in South Korea that are not in available in North Korea, such as chemotherapy and different treatments for cardiovascular disease. But he eventually passed and now he’s a surgeon, and in my opinion seems just to be really starting over in a great way.

David Corcoran: Sara, going into this story you must not have known what to expect, what you’d find out. Is there any detail or story that particularly struck you as surprising?

Sara Talpos: Yes, I was really surprised by a do-it-yourself ethic of medical care that has developed among the people in North Korea. The thing you have to know is that North Korean hospitals are woefully understocked. Although medical care is supposed to be free, in reality patients often have to pay a bribe for care. As a result, if a person gets sick, their first stop is often the local market where they buy IV fluids, medicines, syringes. They might then take all of this equipment to the hospital, but they often treat themselves at home. Traditionally Chinese medicine self-administered is also popular. One refugee I interviewed talked about the woman in her hometown who gave people eyebrow tattoos. She performed these procedures out of her home and didn’t use an anesthetic or numbing cream.

David Corcoran: Well, obviously the political situation on the Korean Peninsula is pretty unpredictable. Do the experts you spoke to have any outlook for the future, whether optimistic or pessimistic?

Sara Talpos: Yeah, the people I spoke with were more optimistic than one might expect, especially given news reports in the American media. One of the things that they point to is the new president, Moon Jae-in. His parents actually fled the North during the Korean War, so President Moon grew up separated from family members, and he campaigned on a pledge to reopen talks with North Korea. I think that older South Koreans especially would like to see some form of reconciliation and among them there is a sense of urgency to make that happen in their lifetime.

David Corcoran: Sara Talpos is a freelance writer whose recent work appears in Mosaic and the Kenyon Review, a special issue on science writing. Her article on public health in North Korea appears this month in Undark at undark.org. Sara Talpos, thanks so much for doing this story and for coming onto the podcast to tell us about it.

Sara Talpos: Thanks David. It was my pleasure.

David Corcoran: Joining us as always is Seth Mnookin to talk about science in the media. Hi Seth.

Seth Mnookin: Hi David. How are you?

David Corcoran: I’m good. Thank you. So we’ve got a lot to talk about this month. Let’s start by talking about two really big stories that seemed to be getting swept under the rug. The U.S. Senate is considering repealing and replacing the Affordable Care Act, better known as Obamacare. A few weeks ago, President Trump with some fanfare pulled the United States out of the Paris Climate Accord. Let’s talk about those two things together, shall we?

Seth Mnookin: Sure. Yeah. What’s interesting about these stories is that it obviously wouldn’t be accurate to say that they’re not being covered. I don’t think anyone who’s following the news is unaware of either the fact that the Senate is going about writing this bill in secret or that Trump pulled out of the Paris Climate deal. I think what is notable is that they are not getting the sustained coverage that one might think they would deserve based on both public opinion and the enormous impact that both of these things will have not only on the country, but in the case of the Paris Climate Accord, the world as a whole.

I think what we are seeing here is the media getting caught up in a cycle that occurred again and again during the campaign, and it’s this cycle of chaos and scandal that is constantly attached to Trump, either through incompetence or because of malfeasance on his part. Because of that, you have these explosive revelations about Russia connections. You have the Jeff Sessions testimony. You have the possibility of Trump firing the FBI director, the possibility of firing a special investigator.

This is what is getting the sustained drumbeat attention, and you don’t see the more detailed deep dive into what it would mean if tens of millions of people in this country lose their health care or of what the potential day-to-day impacts of the U.S. withdrawing from the climate accord are. Those are both arguably more important stories and stories that certainly are going to have more far reaching effects than Jeff Sessions slightly unintentionally humorous testimony before the Senate.

David Corcoran: Just talking about health care though, the fact is that these discussions are going on in secret, and so it’s very hard for the news media to penetrate the exclusive club that is the U.S. Senate. What would you have the media do if you were the king of the media?

Seth Mnookin: Yeah, yeah. If I was Howard Stern. Isn’t he king of all media?

David Corcoran: There you go.

Seth Mnookin: Well, I think we as a profession are incredibly creative. When we want to give attention to something, we find a way to do it. We know that one of the things that is likely to happen from this new bill is people losing their health care. It’s very easy for me to envision a series of stories on people, on families, on children, who got coverage because of the Affordable Care Act and then will lose coverage and what that would look like and what that would be like. I would very interested to find out what various Senators, what ties they have to the health care industry, the the insurance industry, what is going on that we might be able to tease out.

I think this is a situation where this is occurring in secret because there is not a sufficient outcry about the fact that it’s occurring in secret. You saw an outcry recently when the Senate tried to change the rules in terms of how reporters could cover the Capitol and whether they could just go in and do video interviews and do interviews without getting clearance beforehand. There was an effort to change that. There was a huge outcry, and so that effort was scrapped. This is completely without precedent, what’s going on right now. I think certainly if there was sufficient outcry, it’s unlikely this would be happening, but in order for there to be sufficient outcry, you need to find some way to pay sustained attention to it.

I don’t think there are a shortage of ways. On the one hand, it’s probably an issue of resources and an issue of attention span, but this is a case where I think the media could play a more definitive role in helping to decide what the most important story is and not chasing events.

David Corcoran: There’s also the old conundrum and increasingly new conundrum of what do you mean when you say the media? Because while The New York Times, The Washington Post, and Vox, and BuzzFeed may be doing a fine job covering the health care debate, most people don’t get their news from those sources.

Seth Mnookin: That’s absolutely true. Well, most people don’t get their news from any one of those individual sources. I do still think that what we considered the quote, unquote mainstream news, which includes things like Vox and BuzzFeed, does not include Infowars, it remains the majority of the country that gets their news from legitimate news sources in total. While it is certainly true that The New York Times and BuzzFeed, and a lot of places have been covering the health care debate, I think that still if you looked at what their lead stories are, if you looked at what’s on the front page or what’s at the top of the website day after day after day, you are not going to very easily be able to pick up a thread about this or you’re not going to be able to pick that up as easily as you are picking up a thread about what’s going on in the Russia investigation or whether Trump is considering firing Mueller. That gatekeeper role is one that the, again I use the term loosely, but the mainstream media could be more proactive about right now.

David Corcoran: Switching gears here to another part of the mainstream media, the Associated Press has just revised its stylebook, which is a very influential guide to grammar and usage for the Associated Press members who are most U.S. newspapers, magazines and new outlets. They have just issues a substantial revision of their style book on the subject of addiction.

Seth Mnookin: They have decided that they are no longer going to use the term addict as a noun. They are going to refer to people either as having substance use disorders or engaging in risky use or risky behavior. It’s a change that is the result of some really interesting research as well as this change in thinking. It’s something that’s come about fairly quickly, really within the last 7 to 10 years. The reason for that change is there was a couple of studies, one really elegant study, that looked at health care and specifically mental health professionals who dealt with drug use in their professional lives, and it tracked their reactions to stories when someone was described as having a drug use disorder versus being a drug addict.

These people who, their entire career they’ve been trained to work with drug use, were much more putative and much less compassionate when the person in the story was described as an addict. This is one of those semantic changes that I think is actually fairly important. It’s not PC run amuck or something like that. It’s something that I have history of I guess. I have a history of heroin addiction. I used to describe myself as a recovering heroin addict. Now I describe myself as someone with a history of substance use disorder. It’s been very interesting to me to try and track people’s reactions as I describe myself in one way or the other, but it’s something that when it first started coming about I didn’t think a lot of it, and the more I thought about it, the more important and the substantial I think it could be.

The reason why I think it could be important and substantial is because clearly we have an enormous problem with opioid use and abuse in the country at the moment, an enormous number of deaths, and overdoses, and wrecked lives. Even today decades and decades after everyone agreed that drug use disorders, alcohol use disorders are medical conditions and not some personality failing, there’s still an enormous stigma attached to people who are using illicit drugs, an enormous stigma. I think that really in many, many cases, not I think, there’s a lot of evidence, that that contributes to people not getting the assistance and help they need. Anything that we can do as a culture that lessens that stigma I think is going to be a positive step.

David Corcoran: The AP Stylebook is really quite influential. I was quite surprised when I joined the staff of Undark to realize it’s the stylebook that we use and that many thousands of member new media outlets use. This change will really filter into the language don’t you think?

Seth Mnookin: Yeah, absolutely. We talk about the gatekeepers and the waning influence of the media. This is one case where you have a very old school media outlet that still exercises just a enormous amount of influence on how we use language in the media and oftentimes how we use language in the media filters down to society as a whole. Obviously not every place uses it. A lot of places have their own stylebooks, but I think anyone who’s worked in various news organizations very quickly realizes that even places with their stylebooks, those are oftentimes the AP Stylebook with some of that organization’s own peculiarities or specific regionalisms or whatever built in. Yeah, this is something that really stands to have a huge effect.

The New York Times does not use the AP Stylebook. They have not yet made this shift. I would not be surprised if it is a shift that they make in the relatively near future.

David Corcoran: Seth Mnookin is our media and science commentator. He’s the author of a number of books about science and journalism including The Panic Virus, and he’s director of the graduate program in science writing at MIT. Seth, as always, thanks.

Seth Mnookin: Thank you so much David. Great to be here.

David Corcoran: What happens when we die is typically a spiritual or religious question. But while beliefs about the afterlife may vary one thing is certain, there is always a body left behind. On land, decomposition is a well understood process, but some people don’t choose to be buried on land or cremated. They choose a watery grave. Andy Short has our story. Before we get started just a word to listeners, the details are scientific, but they’re pretty graphic, so it’s not for the squeamish or for young children.

Andy Short: Imagine a soft off white cloth coffin. It’s called a burial shroud. That’s where the body goes. At the bottom is a pouch for the cannon balls, a thematic attach that helps weigh down the shroud in the water. These are the tools of Brad White’s trade.

Brad White: What I say is I bury people at sea. What? Yes, we bury people at sea by boat, scattering, airplane scattering, and full body burials. I didn’t know you could do that. Well, you can. I thought it was illegal. Well, it’s not, and I explain the rules and regulations.

Andy Short: Brad White is the founder of New England burials at sea in Marshfield, Massachusetts. He says demand for full body sea burials started in 2011.

Brad White: I hate to say this, but it started after Bin Laden the bad guy got buried at sea. Our phones ring off the hook.

Andy Short: Bin Laden, according to Brad, he was just a great big billboard. People choose sea burials for all kinds of reasons.

Brad White: We’re about one-third of the price of a traditional cremation or full body burial. They’re traveling the ocean with incredible wildlife and forever. Then you get closure. When you add all that together Andy, it’s pretty cool because I’m going to be traveling with the loggerhead sea turtles, and the right whales, and the humpback whales, and the dolphins and seals. It sells itself.

Andy Short: The groundwork for Brad’s business was laid years before he started with ash scatterings in 2006. In 1977, a young environment protection agency issued a general permit to allow full body burials at sea. Any such burial would have to be at least three miles offshore and 600 feet deep. The EPA needs to be alerted to the locations of that final splash, and that sound — for Brad — it’s the grand finale.

Brad White: A big splash and a meaningful splash and a fast splash because you’ve got 150 pounds of weight plus the body. People usually take a toast, and we circle the area and we come in. It’s great relief to the family when they see that happen.

Andy Short: Naturally that’s Brad’s focus, the families, not what happens after. On land, this part of the process is more widely studied. We know that bodies pass through four basic stages of decomposition. A quick warning, here’s where things get a little graphic. Take it away science robot.

Science Robot: Step one: autolysis. Cells begin to rupture, rigor mortis sets in, skin loosens. Step two: bloat. Bacteria previously kept in check by the immune system spread throughout the body. They begin to consume our dead cells. They produce gases as a byproduct. The body swells, things get smelly. Depending on environmental conditions, bugs and scavengers move in. Step three: active decay. Fluids exit the body. Organs, muscles, and skin become a liquid stew. Most mass is lost here. Step four: skeletonization. Remaining organic materials are absorbed by the environment. Only bones are left.

Andy Short: Brad told me most bodies are consumed by sea life within 60 days of burial, but what consumes them. How is the normal decomposition process warped and interrupted? What about the bodies that aren’t gone so quickly? One woman is on the cutting edge of this soggy science.

Gail Anderson: I’m Dr. Gail Anderson from Simon Fraser University.

Andy Short: Dr. Anderson is a forensic entomologist meaning she studies how bugs break down human bodies. Starting in 1999, she sought to answer these deep sea questions. She deployed several pig carcasses to the ocean floor along with a camera to monitor the progress. She assures me pigs are a good substitute for human bodies. Most of her results were variations on a theme, and they all started on the same note.

Gail Anderson: When you get the bottom, you’re going to make a thump noise. All those animals are going to recognize that. Then they’re going to smell it.

Andy Short: So they smell me and then what happens?

Gail Anderson: They’re going to come and eat you.

Andy Short: Oh god. It turns out the bottom of the ocean is a other world entirely. The cold and water pressure pause normal decomposition. Bodies become lighter, almost as if dumped on the surface of the moon. After about 100 meters of water, a body will not bloat or breakdown as it would on land. That job gets outsourced to the creatures on the bottom.

Gail Anderson: We found sharks came in and bit the exposed carcass, but they’re very inefficient feeders. I guess that’s why so many people do survive shark attacks.

Andy Short: Sharks.

Gail Anderson: They take a bite, but they don’t seem to like it very much. They toss their heads to either side and then they let go. Then as I say very, very quickly, the sea lice came in.

Andy Short: Sea lice, the true monsters. They’re little underwater swarm bugs. Their scientific name is Orchomenella obtusa. They look like tiny shrimp and like shrimp, they’re cousins of crabs and lobsters. I asked Gail what happened next.

Gail Anderson: They just covered the carcass several inches thick. Then as they began to recede you could just see almost the shape of the carcass, just deflating.

Andy Short: The sea lice enter through a nostril or wound and feast from the inside out. The brain and guts are the first to go. They leave the skin for dessert. I watched the video Gail’s talking about. It looks like a sort of sea lice mosh pit. After the little sea maggots disperse, squat lobsters and crabs move in to pick at the cartilage and a seal might come to play with the bones. Eventually worms that live on the sea floor might feast on the calcium rich leftovers or they’ll just be covered with layers of sediment perhaps to be unearthed in a few hundred thousand years by future researchers.

Gail would be the first to admit her study is not definitive. The ecosystems and water conditions on the sea floor are varied, but this was the basic template: shark bite, sea lice, crabs. The biggest surprise for Gail came when nothing happened at all. See, all that pressure at the bottom of the ocean, it can squeeze out oxygen from the environment. When there’s no oxygen, not even sea lice can get to you. You’ll just float there, suspended in place.

So how long theoretically could a body just be intact down there?

Gail Anderson: Depending where they end up, possibly years.

Andy Short: Would you ever be buried at sea?

Gail Anderson: Oh no, I don’t think so.

Andy Short: Why not?

Gail Anderson: Well, not because of any of this I don’t think. I just don’t like the idea of being underwater.

Andy Short: Is it because it’ll be suffocating you feel like?

Gail Anderson: Yes. Yes, which is totally silly because you’re dead, but don’t really fancy it.

Andy Short: It used to be that you were buried wherever you died. You were laid to rest and you stayed there forever pretty much. The choice wasn’t in the location, but the ceremony. But modern preservation techniques and business people have conspired to give us options. Some choose embalming and tombstones. Some choose ashes in the wind, and some cast off all the certainty for one final splash. For Undark, I’m Andy Short.

David Corcoran: And that’s all for this episode of Undark, a project of the Knight Science Journalism program at MIT. Our show is produced by Katie Hiler. We’ll be back next month with more news and interviews from the intersection of science and society. Until then, I’m David Corcoran for Undark.