2026-02-19 Brothers of (Mis)fortune (R. Kalisher)

Hello and welcome to the lecture series disability in the ancient Middle East and Mediterranean. The program is co-sponsored by the archaeological research facility at UC Berkeley and the Bad Museum of Archaeology at Pacific School of Religion. My name is Melissa Kretic and I am assistant director and curator of the body museum. Before I introduce today's speaker, I would like to take a moment to read an introductory statement about this program on behalf of the body museum. The Body Museum is an institution dedicated to advancing knowledge of the archaeology and history of the ancient Levant. Over the course of a few years, we at the museum have come to realize that advancing such knowledge means reflecting on and engaging with perspectives that have been largely ignored by modern-day society and as a result have been erased from mainstream historical narratives. The body museum particularly welcomes scholars who are engaging with marginalized perspectives that contribute to creating better equity and scholarship and in society more broadly. The series disability in the ancient Middle East and Mediterranean provides a platform for such research on the experience of people with disabilities whose voices have been frequently overlooked in study of the ancient world. The program bridges past and present through the study of disability and antiquity, its contemporary reception, accessibility, and is continuing impact today, contributing to a more nuanced, inclusive, and complete narrative of the past. Thank you for joining us. With that said, it is now my great pleasure to introduce today's speaker, Dr. Rachel Callisher. Rachel Callisher is a post-doctoral scholar and lecturer at the University of California, San Diego. She's a bioarchchaeologist of the Southern Levant, having worked among other places at sites of Ashcolon, Megiddo, and Shimra. Her research interests center on life history, kinship, and maternity in antiquity, which she explores through biomolecular and hyological lenses. Rachel received her PhD from Brown University in 2024 concurrent with an SCM in ecology evolution and organi organismal biology. She has published in journal venues such as plus one cell American journal of primatology biology letters and the international journal journal of osteoarchchaeology as well as co-edited the recently released Ashcolon 10 final report which centers on the site's Philistines cemetery. Dr. Kasher will present be presenting on the topic of brothers of misfortune a story of wealth and health at ancient Miko. Rachel, the floor is yours. >> Thank you so much, Melissa. Thank you to the Bad Museum for inviting me for this awesome speaker series. Um, as Melissa said, my name is Rachel Kalisher. I'm a posttock and lecturer at UC San Diego. And today I am going to be sharing a little bit of my research uh mostly based off of a paper that I published actually with Melissa uh back in 2023 called Brothers of Misfortune, a story of wealth and health at ancient Megiddo. Now before I jump into today's talk, I just want to give a couple of notes. So the first is that Melissa mentioned I'm a bioarchchaeologist and what that means is that I study ancient human remains. And so because of that, there will be images of human skeletal remains in this presentation. And so I put this up now so that if you are particularly sensitive to seeing images of human skeletal remains that you have the time to prepare. Now this is a whole speaker series on disability and its reception in the kind of ancient Mediterranean Middle East area, but I think that it still bears relevance to define some of the terms that I'll be talking about today. um especially how they relate to what I'm looking at in the skeleton. So disability is an umbrella term for the complex interplay between an individual and their society particularly with respect to their physical or mental barriers that prevent them from an autonomous lifestyle. And what I want to urge folks to think about when they think about disability is that disability is a poorest category. We all have moments of our lives where we are ostensibly disabled which we rely on others. We depend on others to kind of get through the day. Um from infancy to elderhood to illness or pregnancy or injury, right? So um people can move in and out of that disability category. But that is a completely separate thing from health care, right? And I think of health care as the kind of social response to disability. These are the provisions of assistance to an individual experiencing a disease or disorder related ability. And we have tons of evidence that in antiquity um there were these kind of codified systems of care. Um we have not only like medical texts and and other types of um treatment manuals, but we have all of this evidence from the material culture of objects that would be used to treat uh individuals with illnesses for surgical practices and whatnot. Um, now we don't have a ton of direct evidence for what people might have been doing as an anesthetic at this time. It just depends on the time and place that one is working archaeologically. Um, but for instance, a surgical procedure might have been done with uh using medicinal herbs as some kind of anesthetic or sedative. Now as a bioarchchaeologist I work with skeletal remains and talking about disease disability and whatnot and healing kind of requires a preamble on this foundational premise in biological anthropology which is the osteological paradox. So the osteological paradox is a term put forth by wood and colleagues in the early 90s and it is founded on this principle that bone is always remodeling. It's always changing. So right now, me sitting here, you sitting there, 10 years from now, if you're watching this on YouTube, um your bones are constantly in a state of flux and change. And it is essentially this normal um uh maintenance that our body does. And I use this image here, which is a very kind of sciency looking image of the bone remodeling cycle where we have cells that come and they break bone down and then that that kind of triggers other cells to come and put new bone in. And it's you can just think of it as like a like a cycle that's just constantly going. So when we are responding to stress whether that is illness, whether that is something like um a pregnancy or even um a psychosocial stress, anything that kind of disrupts the balance in our body um usually has some kind of adaptive mechan the skeleton usually has some kind of adaptive response to it. Um however, it is not an immediate thing. So it's not like you get a really really bad flu and your b your bone is suddenly like okay we're going to record the flu right now. Um it takes some time to respond. And so what this means for us when we're looking at disease and pathology in the ancient world um and specifically through the lens of the skeleton, we have to recognize that when we see a lesion um or even a prolific set of lesions like this um example of a of an individual with metastatic cancer. So you can see these lesions that had completely kind of um spread throughout the whole part of the skeleton that's visible here. When we see a lesion, what this means is that the person had survived long enough for those lesions to kind of manifest in the skeleton. And so a person who might have had, let's say, metastatic cancer that does not show evidence of these lesions probably died before they were able to attain um that that extensiveness of the of the lesion spreading. So it's something important to think about when we are looking at past peoples um that when we see disease it doesn't it it tells us that they might have been sick but it doesn't tell us um about the others in the in the society that might have not been sick. Um so with this I also want to kind of lay out that there are limitations of skeletal data. So, not only because of this paradox are we unable to see things like short-term illnesses or sudden systems failures, right, from like a heart attack or a stroke, but we also don't see anything that's not recorded in the skeleton. So, conditions like being blind or deaf or mute. Um, we don't have any kind of direct coralate for cognitive and personality disorders. Um, so there's a whole kind of aspect of past people that we cannot access by just looking at the only by very nature of what we do looking at mortalities. We are only seeing the people who did not survive um their illness. And so the the the catchy title of wealth and health in my um in my talk title is is a little deceiving because health is really this slippery um almost existential topic that we cannot approximate from the skeletal evidence because we do not see the healthy people who survived. We only see the sick people who died. So with all of that said, now we move into the um regionally relevant portion of this talk, which is that this is a talk uh or a speaker series rather on disability in the Mediterranean and ancient Middle East. And so I show you this map of the ancient near east in the late Bronze Age period roughly 1500 to,300 B.CE. And what you can see is that there are a lot of large um kingdoms, cultures, societies um throughout this region kind of extending from uh Egypt through the southern Levant up into the northern Levant and then west into uh Anatolia and east into kind of Mesopotamia region. And this is an important thing that I also want to mention because this is an a really important um period overall in the region. The late bronze age is this period in which we see kind of this explosion of international trade and connections. There's famously the archive at Amarna in Egypt um where there's all of these administrative letters kind of going back and forth between kingdoms and all different parts of this region. And so we know that there was a lot of sharing of ideas, sharing of resources. Um, and that kind of lends itself a little bit to the argument that I'm going to make about, you know, trying transfer of knowledge, transfer of information with respect to healthcare. Um, I'm going to be focusing on the site of Megiddo. Now, Megiddo is in the southern Levant, uh, in the country that is modernday Israel. Um, and so we are going to zoom into this part of the map and focus on this site. So, Megiddo you might recognize as the um or might sound familiar rather as the biblical Armageddon. This is coming from the Hebrew um which is mountain. So, Mount Megiddo Harageddon. Um and Megiddo is a tel site. So, it's a multioccupational site that is this artificial mound that has kind of accumulated over millennia of use over and over and over again. Um this image on the left is it looking really beautiful and lush. Um and Megiddo is this super important um site for the ancient near east in general. Not just because it has this kind of historic relevance. Um but it is one of these major cities um that surround the Jezel Valley. That's what you're looking at on the right image. There's kind of this bowl that forms and all of these major powers kind of dot the the landscape of the bowl. And Megiddo specifically was along this trade route known as the Viamarus. So it was kind of um in control so to speak of movement of goods between Egypt and Mesopotamia. Uh and so it it exerted a lot of uh uh control over what was happening in the region in this way. And what that also means is that you could very easily have people coming in and out of the city. Um and because of this we can think of it in that in the middle bronze age specifically. So just before the late Bronze Age, the middle bronze age, which started uh really around 1900ish BC, um it was a very cosmopolitan and a very densely populated area. It became slightly less so in the late Bronze Age, but the middle bronze age is really where it started to um uh become much more populated. And we see this in the evidence from all of the domestic structures that have kind of popped up in this period. Um, and what's interesting about this particular period as well is that as we have all of these houses that are being built up, we see this new tradition or at least this um, let's say this resurgence of a tradition known as residential burial where people were burying their dead under house floors. Um, we see this in a lot of different forms. So for instance, we have jar burials. So these this is an an example of these were uh, twins that were buried together in one jar. We have simple pits where people were kind of just um put into simple pits beneath their house. Um and then also the cyst tombs which are usually um stone or mud brick that lines the burial and um and the person is put in it and then covered in some other way. Um and what's interesting about this custom is that these were people buried beneath their houses when the house was still being used. So there is a certain amount of memory that would have had to go into selecting a location that there would have been have to have to remember where people are right if you're going to go and pay respects. So this is a very interesting phenomenon. Um we also have this this very different type of burial which we call um masonry constructed chamber tombs. This is a particular tomb that is the um has been really well researched by Melissa Kratic here. This is tomb 100 from area K. And what you can see here is that as opposed to the other images that I just showed you. Here we have um this giant tomb where a lot of individuals would be buried over and over and over again. And so this was by design made to be opened um as individuals died and needed to be placed in it. And what you're seeing on the left is the kind of before and after images of this tomb. And then what you're seeing on the right is the kind of what look what it looks like inside where you have this amalgamation of pottery and objects and bone um that just kind of happens from the use over and over and over again of this of this tomb. And I introduce these because they will have some amount of relevance for the case study that we're talking about today. So this is an image from Neolithic Chat Hoyuk. This was a practice in that area in that time period. Um this is not exactly what the house would have looked like at Megiddo in this period of course but it's just to kind of illustrate or bring home that these people were buried underneath um a very lively space. Um and so it was a very intentional integration of the mortuary landscape with the living landscape. Now where I'm focusing on um today is in this area called area H. So area H is in the what we might think of as like the elite sector of the city. Um, this is where we have the city gate. This is where we have administrative buildings. This is where we have evidence of palatial um, kind of uh, architecture. And so, area H's proximity to this kind of elite sector, as well as all of the other things that kind of give away elite status, right? Like really nice u masonry and fines and all of this stuff. All of this tells us that this the house that was in this area was one of the elites. whereas all of the images that I just showed you of burials um at Megiddo come from a middleclass house in area K on the other side of the city. And so this um image on the right is showing you kind of how area H fits in with um University of Chicago's area AA. So you can see how kind of uh the architecture lines up really well. And specifically, this trench, while being very narrow, um has revealed an incredible amount of information about the city and and how it operated in the middle and late Bronze Age. Um so this is an image the the guys that we want to talk about today are these two individuals here in the red circle, but I do think that it's necessary to contextualize what we can learn from them with the people that are buried in this area, which is the the blue circle. So this blue circle um contains a tomb which we call very affectionately tomb 50. Um and this was an incredibly beautiful constructed chamber tomb. Um much nicer than the one that I just showed a few slides ago from area K. Um this is a reconstruction of what it would have looked like with this dramos area going down into the tomb. Um and this tomb dates to the terminal middle bronze age. to middle bronze age 3 or around 16 to 50 to 1550 B.CE. And this tomb, this is showing you just like a smattering of images from this tomb. You can see that there's um there are dozens of vessels kind of clustered at the front. There's this beautiful corbal architecture. We have individuals with uh jewelry still in seu. Um there have been a number of studies uh that have come from this particular tomb including one of the earliest publications on evidence for vanilla in some of the ceramics in this tomb which is kind of unheard of in the region. Uh thus kind of lending this idea to a prestige item. Um there was another follow-up study that um our colleague Ayala Amir did where she was looking at the amount of wine that was in some of these vessels. And so we have evidence that there was like really really nice stuff that was being housed in these vessels, not just the vessels themselves. Um, this tomb is so awesome that it in fact is the kind of main subject of Megiddo 7. Um, this tomb and the one that I'll be talking about, which uh came out last year, uh, co-edited by Melissa Krak. You can see here this reconstruction of a a bone inlay box, which is honestly one of the most incredible things, um, that I think I've ever seen. And so this tomb is just really pulling out all the stops with respect to um just really nice items, really beautiful architecture, just things that you don't usually see in a less elite part of the area. And this tomb had three primary burials within it, which means these are people that were just laid down and were not disturbed after they were buried. There was an adult male and adult female. So the adult male is in yellow and the adult female is in green. And then just beneath the adult male, but kind of in the opposite direction was a female child. And we know that this child was a female. And we know all of these sex estimates because of ancient DNA um a very robust ancient DNA program that we have at Megiddo. And we will be publishing a more updated version of that somewhat soon. So we have these three primary individuals in this tomb. Um they are buried with a beautiful object, beautiful gold diadem and necklaces and pins. The adult female had this unbelievable um line of shells, perforated shell beads that were just around her uh her uh her waist area. So probably some kind of belt. And we also have at the very back of the tomb this uh very densely co-mingled pile of disarticulated skeletal remains. And this is a pretty common thing that we see in the area, especially with respect to these chamber tombs. Um, people would revisit these chamber tombs when they are opening it up for a new burial. And then if they encounter remains that had pretty much fully decomposed, they would just move them to the peripheries of the tombs. And so this densely co-mingled pile of individuals ended up yielding um an additional kind of dozen people or so for a final minimum number of 17 individuals that were buried in this tomb. And you can read more about the osteology um of this uh tomb context in Megiddo7 if you are so interested. Now what it means for us in this idea of um disease and disability and health care um is there are extensive signs of pathological lesions in this tomb both in the individuals the primary individuals and those that were buried secondarily in that comingled context. And these are things from you know degenerative joint disease so living to older age. These are things like potentially um uh blood packing disorders. uh uh we have evidence for infectious disease and and you know contact facetses from from kind of repetitive labor. So all of these things kind of point towards being able to live for a long time with certain types of conditions such that it appears in the skeleton. Right? Going back to the osteological paradox and I will note that um I as the bioarchchaeologist at Megiddo I have also done the skeletal analysis for kind of comparable uh burials in other parts of the tel and these are um examples of lesions that we just don't really see in other areas. And so the likelihood is that everybody was probably dealing with the same types of illnesses. It's just that not everybody was able to live with them. So that's the context. This is the that was the tomb 50. It was from the middle bronze age three. Now we move on to the brothers of misfortune, so to speak. And that's these two individuals here in the red. Now these two individuals date to the the phase immediately after the tomb. They date to the late Bronze Age one period around 1550 to 1450 B.CE. And you might look at at least the photographs and say I don't see two people here. And the reason for that is just like in tomb 50 where the folks at the very back of the tomb were disarticulated and co-mingled. Um that's what's happening here. So you have one individual, individual one who's this blue person that's laid out in a primary burial. And then you have this other individual um who's individual two in green who had previously decomposed and then was collected, rebundled and placed in the burial with the uh with the individual one. In addition to these two humans, we also have some non-human bones, some vessels um al together. It's a very interesting assemblage. And what's also interesting to note is that if you look at the image on the right, you can kind of make out um there's these I I I don't even think I can point to the screen, but you might be able to make out that there is an articulated foot and leg in that pile. Um and so what that means is that the entire body was not fully skeletonized when it was at least excavated and or or gathered up and put into this burial. So, I'm not entirely sure how much time elapsed between the deaths of these two individuals. Um, it depends on a number of factors when we're trying to estimate decomposition in different types of environments. Um, but it wouldn't have been necessarily like years and years and years. It was probably that they died not so far off from one another. And just like tomb 50, these individuals were buried with some pretty nice things. some really beautiful decorated pottery, um, gold, beads, and and other types of fashions. So, we know that these people were elite, not just by proxy of them being in this same house, uh, buried beneath the same house as tomb 50, but that they are just kind of afforded a lot of the same things that we would expect to see in an elite household. Then when I say that they're brothers, um in a 2020 article that we did uh in cell, which was a genomic history of the southern leavant, these two individuals were identified as brothers. Um so they are both adult males and they um were buried at the same time. Sorry, my coffee maker's going off. So let's start with the individual who died first. So this is individual two, the person in the bundle. Um, when you when I do a skeletal analysis, you know, I usually just start I open up a bag, I start looking at the things and I make notes of them. And this was one of the first things that I saw with individual 2. Um, they we usually have three mers in each quadrant of our mouth. The third mer is your wisdom tooth. And this was an interesting case because I knew that this person was an adult. Um, but on one side of their mouth, they had only two mers. And as I continued to clean, I noticed that there was this little kind of thing peeking through between those two mers. And what that was was an unerupted adontogenic cyst. So you can see that's what is in panel B here. Um this is a tooth that has been kind of never erupted and then just kind of accumulated uh hard tissue material around it and so it stayed in the jaw and as a result the third mer which you're seeing in panel D had this nice little impression in it. Now, teeth are a really interesting thing for us to think about because teeth are um they they erupt in this kind of epigenetic pattern. So, we have these signals that we get in uterro that are telling our teeth how to how to form and when to form and whatnot. And so, when we see dental anomalies, these are typically referring to something that already exists in the person's epigenetic landscape, right? So, a dental anomaly is something that we think of as a congenital situation. um this tooth would have theoretically erupted around 12 years of age. So it was already forming in earlier childhood. So this is something that was affecting this individual from very early phases of their life. Now there are also kind of diffuse signs of disease throughout the entire skeleton um without even necessarily knowing what a a normal bone looks like. You can appreciate that all of the images on the left are showing pits and lines and porocities and openings that are not typical to bones. And these are going to be telling us something about the body mounting an infectious response. Um so it's going to be the bone is basically compensating for the the imbalance that exists in the body and um and and so it results in these types of appearances here. And then on the right, what you're looking at are are two parts of the of the nasal area. So these are uh proximal portions of the um the maxilla, right? So these are the the bones that kind of frame um around our nose. And what you might be able to see or maybe not from the the yellow arrows is that there's a lot of erosion of some of those surfaces including that surface that would articulate theoretically with the other maxilla and the kind of the the nasal aperture itself which gets very thin and wispy. And I'm going to revisit what all of this means uh in a couple of slides. So if I had to just basically give a a presence absence of types of lesions that we see on individual 2, that's what this table is showing you that we have um a lot large portions of this individual's body are showing evidence of some kind of um uh pathological lesion. And if it's all over the body like that, especially bilaterally, that's telling us that the the thing that they are dealing with is a systemic infection. Now, individual one um is the individual that was in their primary position and they too had a dental anomaly. Rather than having one less tooth that had erupted, they had one more tooth that had erupted. Um in their right upper jaw, they had a fourth mer and that's what you're seeing there. This is also telling us something about their developmental situation because teeth are those highly patterned um and and highly heritable, right? So it makes sense that these two brothers both had some kind of dental anomaly. We also see the retention of a suture in the cranium known as the mytopic suture. This is a suture that bisects your forehead and in most individuals it's completely fused in infancy. Um but you can retain it into adulthood. So we have these two kind of congenital things for this individual, the extra tooth and the mtopic suture. And then we also have evidence that they had a broken nose at some point. You can see it on panel C here with this tiny little healed fracture. Um, and then if we look top down onto the cranium, you can see that the nose has completely um, shifted to the left. So, this would have been pretty outwardly obvious change in this person's facial appearance. Now, just like their brother, we see extensive pathology and paracity on this individual's skeleton, especially on joint surfaces. We see evidence of uh, periodontal disease. um we see those lines, we see those pits, those crackings and so very similarly to individual two, individual one has this bilateral and systemic um instance of some kind of infectious disease response. Now what's most obvious about individual one and where the healthc care aspect of this talk comes in is that individual one had this large tffation in the middle of their forehead and that's what you're looking at um in the reconstruction on the right. You can also very clearly see that suture that is going uh halfway through the forehead here. Um and this is a a procedure treation or trepation is a procedure where there's an intentional removal or excision of cranial bone and civilizations globally um have practiced tffenation. There's a lot of different ways that you can perform treation. That's what you're looking at here. You know, you could use a a stone and scrape away along the curvature of the cranium. Um, you can chisel circular grooves, you can do burr holes, or you could do what we're seeing here, um, this practice called linear incisions, angular notches, however you want to call it. It's basically when you do a series of lines that intersect. And if we look at the tffonation here um in high resolution, we can see not only are these edges super fine um but that we have evidence of the scalping, the removal of the soft tissue on the cranium prior to accessing the bone itself. Um there are these in panel A, you can see these little these little uh scratches. That's what would have been kind of the remnants of the tool. And then in panel B, you're seeing the the the sharpness of this cut. So, this would have been a really fine instrument. Um, I don't know whether it's made of stone or metal. I I would have to do further analyses in order to test that. Um, but whatever it is, it was an extremely sharp instrument. And what's super unique about this context is not only did we find an individual with this opening, but we found the actual pieces that were removed from the opening, or at least we found two of them. Um, that's what you're looking at here. You can see that I tried my very best to refit some of the pieces in a way. So, so you could also see that this was not just one square that was cut. It was a series of cuts that were happening. Um, and I do think that it is important and worth mentioning that we have a a cut that started just next to that suture, which you might be able to see at the top of panel A. um because sutures were not typically trafined along because they increase your likelihood for hemorrhage. Um and so we we see increased fatalities when people uh trfine along sutures and so the fact that the mtopic suture was there in this individual would not have been something that would have been known until um the soft tissue was removed and opened. So I do think that it's an interesting kind of interplay that I'm not going to go into much here. Um these are just some other views of the same pieces. So you can see on either side of them these really fine edges um and that we had these two pieces al together. Um if I were to reconstruct the kind of shape of this opening, it's pretty exact. I mean obviously it's not perfect, but we do have some pretty nice right angles, including that one on the top left. And these are just some other views where you can see um how deep these tools would have gone into the bone before stopping. um and as well as appreciating some of the other more minor scratches and incisions that would have been left on the bone itself. Now, the way that this would have been done is by using that sharp instrument and just cutting those intersecting lines and then wedging out with leverage as necessary. Um so the size the ultimate final size of the opening is kind of decided upon by the practitioner um and can be essentially uh uh uh expanded upon if necessary. So once you have your initial opening you can continue to expand it if need be. Now this particular tffenation type is not very well attested in the archaeological record of the southern levant. Uh I've only been able to find these three examples uh that come from much later periods. So the first set are two individuals from Lish and you can see that they are both done on the back of the head. So the one on in A is done on the kind of back right and the one in B is done on the back left. Um they both kind of hit over the suture a little bit so or or approximating sutures but not necessarily to the same degree. the individual at Megiddo is and the other example is from Timna which the scholar the authors of the study say date to does dates to the Iron Age or the Roman period and it's not that different of a location um this Timna tffenation as the Megiddo individual it's just that in the Timna individual there was no uh mtopic suture so um it it's it's not crazy to believe that this was a location of the head that people might have refined upon um it's just that In this situation, there was the complicating factor of having that suture present. So, I know that there are a ton of questions that kind of arise when I introduce this this case study because there's um there's just so many ways that it can go and and unfortunately for all of the issues that I outlined at the very beginning of the talk, there are so many limitations with what we can actually say. Um you know, one of the questions like why would they have been refined upon in the first place, right? Um, all of these things kind of get speculative after a while because we don't have the texts that say, um, you know, so and so had so and so and so we called the doctor and the doctor came and they did this. So we don't have that type of record. So everything that I presented here on out is kind of trying to make the best educated guess. So the first question, what diseases or syndromes did the brothers have and was it the same disease? So I in in in bioarchchaeology what we do is we produ we produce something called a differential diagnosis and that's because there are lesions that look the same for different types of diseases. And so what I'm trying to do here is just present you some of the options that we have. But I want to really focus on the one that has kind of gotten the most attention and that is leprosy. because there are certain skeletal changes with leprosy that are unique to leprosy including the erosion of the uh nasal aperture. So that's what you're seeing in the image on the left. Those were that that erosion of those joints and that's what you're seeing on the image of the right in this individual known leprosy case. So you have erosion of the nasal opening as well as erosion of the upper um maxillary uh arcade. And this is another example that's kind of showing a very similar um process in an individual with leprosy. And we also see with leprosy these kind of systemic um infectious responses. So in the skeletons of these individuals, you'll see all those little porous lesions and bony growths. And that's not so dissimilar from what we're seeing in the Megiddo case. Um the other kind of weird clue from Megiddo is that the um bones of the foot of individual one had a very strange appearance to them. They were kind of pinched at the end and they had these little pin prick um almost depressions in them. And so for me I'm thinking well maybe this is relative to leprosy as well because um in leprosy there is erosion of the digits the fingers and the toes and this kind of results in this penciling effect of the of the digits and the bones of the hands and feet. And so that is kind of my best guess um as to explain what we're seeing here. Um so the differential diagnosis of the infectious diseases includes leprosy. It could also be something like tuberculosis or osteomiolitis. I don't have a great um differential diagnosis for the congenital situation because unfortunately there's not a lot of information out there as to like what conditions have both dental anomalies and mytopic sutures. Um so it's it's a much weaker argument to to say that they necessarily had something that they were dealing with since birth, but it is clear to me that they did have some kind of anomalies that they shared. And as for did they have the same illness, um we don't know for sure that they had the same illness, but if they are genetically related and they lived together, it does stand to um to to reason that an infectious disease could have affected both of them. The same infectious disease could have affected both. Um why were the removed pieces kept with the body after death? Uh we don't know. That's the short answer. There are not a lot of uh examples in the archaeological record of uh there's a lot of examples of tffonations but there's not a lot of examples where removed pieces are kept with the with the head. One example here is from Kusco Peru published by Verono and Andrusko where they found this uh female with a truffenation that the the the removed piece of bone was put back into the opening and covered with kind of like plant fiber. Um, and they also say in their publication that this was the first example that they'd seen of it. And so they are speculating that maybe this was meant to be medicinal or maybe it was the thought was that it would help heal the wound a little bit faster. Um, there's another example from the UK um, of this large round tffonation where that roundell was put back into the head. Um, there's not really a great explanation for this. We can't, I don't think, separate like a magical or a medical um or a religious intention with this. Um but I I would hypothesize that it was an attempt um to try to close up the whole um faster by giving it more meshwork to to latch on to. Whether or not that's medically uh true or not is kind of beyond the point, but like the intention was to keep the person whole or to um facilitate the healing of that opening. If when we ask about was individual one alive during the treffation, this is a very tough question to answer. Um it's pretty easy to know whether somebody really survived an injury or um was very dead when the injury hap or when the when the when the um damage happened. But this very specific threshold of like just alive or just dead is very difficult to tell the difference between. um Gonzalez Darter kind of puts forth in his paper on treffenation um that there are these kind of clear signs that we can see to try to estimate how long a person had lived with their um with the surgical procedure prior to dying. Um so for instance um if you die immediately or it's or the preferation is done immediately postmortem, you're going to not see any signs of a biological reaction. Right? that remodeling process that I mentioned at the very beginning of the talk is not going to be able to take effect. But around 1 to four weeks, you're going to start seeing an infectious response to that uh to that uh insult that occurred to the body. So you would start to see this superficial osteoporotic ring around the opening. Um ultimately there will be bone that dies because it's been cut off from the blood supply. Um and that bone will die off. And then around eight weeks, you start to see remodeling really happening where edges become smoother and more regular and round and it might even be new bone growth in that area. So obviously in the case of individual one, we don't really get to to point two on this list. We don't see any signs of a bio biological reaction. And so whether or not we can say this person um had detonation when they were alive or just freshly dead is very difficult to say. But I argue that they were alive or at least conscious um when this procedure happened because there is care to not completely go through the the cranial vault. So we do see this maintaining of that inner cranial bone. Now that could just be an artifact of the wedging process and leaving a little bit of bone there on the bottom. But I do I take it you know in combination with the fact that those excised bone pieces were kept with the body. And so perhaps kind of trying to to facilitate healing. Um as well as if we contextualize it with the extensive pathological lesions on this individual um it could have been this inter intervention. So this individual was dying if they did have the same disease as their brother who had died and did not have a treffation. Perhaps this was kind of a a last stitch effort um in order to save the person. So if we were to kind of piece all of this together, we can think about all of this data um as as showing that brothers were able to survive to adulthood enduring maybe a congenital condition, but certainly an inquired infectious disease. Um this indicates that they had to have been provisioned with adequate care that might not have been afforded to those of lesser status. the fact that we don't really have that many instances of treffonation. We have only these three instances of the similar type of treffation but only something like 12 examples of treffonation in the Levant in all of you know archaeological history. So this is not something that people were just getting done constantly. Um and so this is this is telling us something about access. I also want to emphasize that these two individuals were not otherred or separated from the traditions of their contemporaries. They were buried beneath their house um in a time when the house was still occupied. So they were still incorporated into the kind of household memory by being buried beneath it. Um they were buried in very close proximity to the clearly elite tomb 50 with fine offerings. And I also want to emphasize that there was care taken to inhume these two individuals together even though they had died apart. Right? So this was a very intentional choice with whoever buried individual one to con to to bury him with his brother. And so if you want to read more about this paper, I um direct you to plus one. Um this is where we first published the evidence. You can also check out the Megiddo7 um excavation report which has more on the kind of nitty-gritty details of the skeletons um from both the brothers as well as from the tomb. And with that, I want to thank you for listening and thank my collaborators and funding partners. Thank you so much for that fantastic talk. It's um especially um awesome for me to be listening to you present this research um because we publish on it together. So it's just wonderful to hear it get this visibility um and interest. So um I'm going to start us off with a couple of questions for you. Um and the f most most of them are methodological. Um so the first question relates to the example that you showed of of the the brothers of misfortune and perhaps applying >> my question to them. So the question is about ancient DNA. You mentioned that these two are genetically related based on DNA testing and analysis. So I'm wondering what role ancient DNA plays in testing for disease markers or predispositions to certain diseases and disorders in addition to just simply not simply because it's nothing about it is simple um but in addition to um let's say mapping a genetic code and linking people together who are genetically related and could ancient DNA has it yet been helpful a helpful line of inquiry and analysis for addressing disease and pathology and other medical questions in the past. >> That's a great question. So, um, ancient DNA, especially from human skeletal remains, is something that we've only really been able to start accessing in this region once, um, we started looking for DNA in a different location. We used to sample like large robust bones like the femur or the humorous for DNA and it was not particularly well DNA was not well preserved in those bones. And so once we started sequencing this portion of the the cranium called the temp the temporal bone or the petrus portion of the temporal bone this is where we see like really well preserved DNA. So because of this we've been able to access the kind of genomes of ancient individuals. Um, so with this with the particular example of these two brothers, we are able to kind of estimate through the the the amount of preserved DNA from both of them their biological relationship to one another. As for whether or not they had any kind of congenital conditions that would have manifested genetically, um, that is something that kind of requires a different set of skills from researchers that are like trying to work out these questions. Um there are there's a group of researchers at the Mox Plonc that I believe had started working on this. Um I don't know the status of that uh study yet, but um that that is they would basically have to comb through the genome to see if they can find markers consistent with you know disease A or syndrome A B C or D. Um as for the actual pathogen, so the like leprosy for instance is caused by mcoacterium lepre and so that is a um a specific bacteria that is its own pathogen. It's its own living organism. And so if you're going to find evidence for those um for that type of disease, you actually have to find the DNA of that pathogen itself. And so people have successfully uh sequenced pathogen DNA from things like calcified dental plaque, dental calculus. Um as well as from actually just the lesions on the bones themselves, there's this idea that especially with something like leprosy that there's that the skin the layer of tissue that is touching the bones is infected. And so if like at the area of the lesion, you could sequence that and theoretically find that pathogen DNA. Um my understanding from the study of the these two individuals who we did send for that type of analysis was that they did not find any evidence at all that there was um any kind of pathogen on their skeleton. However, because we see this reaction, this response in the skeleton, we know that something happened. So I think it's just a matter of preservation when it comes to the pathogen DNA. Um but it is certainly possible and people have done this with all different types of diseases like your senia pestus has been something that for the black plague that people had been um really trying to um find evidence for and have successfully found evidence for. So it's certainly possible. It's just DNA is this like huge frontier that requires so many different skill sets in order to wade through the type of information that you're getting and and and make sense of it with a socially relevant conclusion. Yeah, thank you. Um I think yeah, the plague is a great example that has gotten a lot of media um attention, although a bit different in that it's communicable um as opposed to let's say a congenital disease, but um yeah, it sounds like it is quite a complex sort of issue. So a similar sort of question. Um what are some of the methodological challenges of identifying ancient pathologies and diseases and disorders based on let's say their modern names, their modern symptoms and bodily expressions, the way that they're understood in today's primarily western global north medical framework. Um, and I know that's a really big question. Um, but could you could you speak broadly? >> Yeah. >> About that issue. >> Sure. So, you know, pathogens as living organisms are going through their own evolution kind of alongside us, right? So, the the way that a a pathogen behaved in the past isn't necessarily the same way that it would behave today. um usually on the scale like for instance the scale of what we're talking about here. So let's say like 4,000 years max um you can kind of imagine how much evolution is really happening in that period of time within that pathogen. But um we so so it's kind of like a known thing in bioarchchaeology that we we expect to see similarities to what we see today um but not necessarily like a full onetoone relationship with what we see today. The other thing that makes it really challenging is that most of the time that we think about diseases um is in a clinical sense and in the clinical context people are just trying to heal patients. They are not necessarily like looking at their bones and seeing how any different type of disease is manifesting in the bone. So we don't have like bioarchchaeologists and paleopathologists are kind of getting the dregs from clinical data um trying to understand if we can find relationships between a skeletal response and some kind of lived experience with the disease. So there is a lot that we just don't know. Um, and if you think about like medi medicine medicine today and you were to open up a clinical journal, you'll see that like there's just so it's like a neverending list of possible things that we as humans um can contract, can be born with, can be can experience. Um, and we just will not I don't know if we'll ever have that same clarity. I can't imagine we would um in the ancient world. So I think that there are a lot of things that kind of have only developed in modernity that that come from this like increased urbanization and close contact and different introduction of different foods, you know, like we have all of these different rates of things and and new types of of diseases and pathologies that we can see today. But um there was certainly more in the past than what we're able to see, right? Um, and and people can I know that like a lot of folks look at disability through other types of media, right? So, I'm talking about the skeleton, but some people look at text, some people look at art. Um, there's just so much missing from what we're able to see. Um, and so I think that one of the challenges with doing these types of studies and trying to understand, you know, what was a social reaction to a disease or what was the prevalence of a disease? It's just really difficult because we're just kind of missing um everything else. Like we as archaeologists are and and historians are kind of just seeing either what was purposefully put out there or what was kind of unintentionally left behind, but we don't see anything in between. So um it's just it's just tough and and paleopathology is is a very tough thing to look at because as I said at the beginning of the talk um so many lesions so many similar lesions are present across different types of diseases. So um you know you're never I don't I don't know at what point we'd ever get the smoking gun to say like this is 100% this maybe if you had the pathogen DNA but for the most part it's a lot of guesswork. Um, and so it's just it's just difficult. I don't know how else to say it. >> Thank you. Um, so we're just about out of time, so I'm going to ask one final question, and that has to do with pain and pain response and medical interventions to pain. Do we know anything about the methods, if any, for numbing pain or using any kind of anesthetics for individuals who were subjected to these kinds of surgical and other intensive and potentially painful interventions? >> Yes. So pain is is another um just like health, pain is a very tough thing to measure um because we have no real way of quantifying it. Um, certainly just cutting into somebody's head and bone when they're alive and coherent would be pretty horrendous. Um, and it's possible that this was just how it is. You know, I think about like Civil War surgeons, right, who have to just like kind of act as as needed in order to to act really quickly. So, I think it's it's possible. I I think that that the the likelihood is that they were using other kind of things in their environment to to numb the pain, whether that's alcohol, right? I mean, I think most people feel pretty good after a few drinks. So, if you just get really really drunk, you know, it might kind of numb the pain from the procedure. Um, we also assume that people were using um, you know, medicinal plants or or hallucinogenic plants. Um, certainly like opium or poppy plant is possible. Um, so as for like the actual um numbing aspect or or preventing the kind of physical pain while like uh coherent and awake, I don't I don't know that I could speak to that, but we certainly know that there's mindaltering substances that would have existed in this period um that could have been used to kind of knock the person silly before going through something like this. Um, and if if it was the case that this person had just died, um, you know, like they passed away and then immediately this procedure happened, you know, obviously that would not they wouldn't need to do anything specific for it. But, um, I I think that people were pretty resourceful in in trying to find ways, especially for like an elite person who um, you wouldn't want to necessarily put through something so horrible. Not that you want to put a non- elite person through it, but you know, like there was probably more resources available to try to uh mitigate the pain and risk involved in a person who had the like wide financial resources to deal with um to deal with it. >> Yeah, thank you. And I'll just add to that that even at Megiddo in a contemporaneous tomb context 2100 which you showed towards the beginning of your talk in the middle class neighborhood of area K uh residue analysis so basically testing for chemical components of the residues and ceramic vessels has identified traces of um opiate compon chemical components um so in an oil lamp so potentially suggesting fumigation at least of the tomb context perhaps related to aerary ritual, not necessarily a medical intervention, but we know that these substances are around. You also mentioned Ayella Amir at alls, one of those at all um co-authored studies on the residue analysis identifying traces of wine. Same with Vanessa Laneras um in these tombs. So we certainly know not only that these substances are around to alter minds in various ways but that they are readily available to the very people that we see buried in these tombs. Now whether or not that was applied in medical settings you can't say but um so that that is it concludes my question. Um, I saw Aaron put himself on camera. So before I conclude, I just want to give you a chance if you wanted to say something. Oh, I mean, well, first of all, Rachel, thank you. This was a fascinating talk. um you know as a as an outsider to bioarchchaeology I I personally would be a little less hesitant about you know I mean of course we don't know if this individual was given um you know some concoction made with opium but we know that it was traded in the region um certainly in the late Bronze Age if not preceding um and uh yeah I mean so I happen to have excavated a contemporary or at least an LB1 tomb at uh Ashcolon. >> Mhm. >> You know, where the um criate um uh ceramics that sort of imitates the form of an opium poppy, you know, head uh was even located there. So, you know, again, I mean, in this case, um, the the skeletal remains were studied and published and there was no, you know, evidence of any kind of, uh, well, what a non-professional would call disease or marks left on the boat, whatever. Um, you know, but it certainly was plentiful, especially along the coast. Uh, and then, you know, Megiddo isn't that far from the coast. Um, so I I would I would hazard that it's not even a guess, it's an inference that that and of course they probably didn't call themselves doctors, but whoever was treating, you know, your particular individuals, you know, had a wide array of not just imported items like opium, which I would again presume is stronger. I've never taken any myself personally, but um you know, but I mean there there's later evidence that that there was um that there were canniboids in the area that you know people were smoking dope. Um >> so you know and of course there there are local uh herbs and and then we already spoke about the wine. So any combination thereof um would certainly help dull the pain. I know it has for me um got me partially through graduate school. So that's a that's a different kind of pain. But if you understand what I'm getting at um I appreciate your hesitancy, but you know I mean the whole thing about about modeling is that none of us whether it's human skeletal remains or studying you know burials in general um or ceramics or animal bones none of us have a full picture or even text dare I say. Because when one turns to a text, it may be an individual example, but who knows happening, you know, 15 years before that text was finally written down or >> yeah, >> 100 years after. Um, >> yeah. >> So, but you know, we have parallels in terms of medical texts from uh from Egypt, probably contemporary with the late Bronze Age, but again, I'm not familiar with that corpus. Um so one can begin to to hazard I would say inferences you know as to the kinds of painkillers that were I mean again that's a modern term right or when we think of opioids >> we don't think of it for necessarily for the control of pain >> but it certainly was both available I'm sure there are Roman texts that talk about all this stuff >> in again just because the preservation right from a later period the Roman period um and especially the textual corpus uh is so is so rich uh and in some ways it's a way of doing um you know ethnoarchchaeology and >> yeah um sorry I'm forgetting the uh apologies I'm forgetting the name of the researcher at Yale who's who's trying to work on essentially ethnarmarmacology uh and then compare it with um >> um you know ancient um remains and um and the analyses of you know what was actually in the jars um just as your colleagues did for you know the wine jars and the the vanilla or vanilla that was present in some of these tombs. Um but again even the the wine or the traces of vanilla or later on um we have evidence for cinnamon for instance uh you know which is of course we all think is tasty on in terms of sprinkling it on top of our mochas or you know putting it on cakes but also I believe has a tooth numbing effect you know that kind of thing >> and it's antimicrobial. >> There we go. So again, >> I put it on my plants when I to stop fungus from growing. >> I've seen some of those YouTube shorts now. No. >> Um, but I think what I I what I'm getting at is our modern notions of these substances and our modern uses are so different um that turning to ancient texts even from or especially from other cultures, you know, or modern traditional medicinal practices might give insights uh into the some of the things that you're hesitant to. And I'm not hesitant. I'm just in my career and don't you know study small in specific. Um so I'm happy to add further interpretation but anyway but thank you um it was a fascinating talk uh and it's wonderful material and congratulations to both you and Melissa for for making sure that it's published and shared with the rest of the scholarly community. So thank you. Well, with that, I would like to very warmly thank today's speaker, Dr. Rachel Kasher, for generously sharing her research with us. And to point everyone's attention to the next talk in the series, which will be held on March 12th at the same time, 9:30 a.m. Pacific. Dr. Julie Ramat Swana will be sharing a talk titled Disability and the David Narratives in Light of Armed Conflicts in Africa. We look forward to seeing you then. Thank you.