Thanks to Linode for supporting  this episode of SciShow.  You can go to linode.com/scishow  to learn more and get a  $100 60-day credit on a new Linode account. [♫ INTRO]  In September of 2022, archaeologists in Borneo announced the discovery of the   remains of a person who’d had their lower leg amputated,   possibly during that person’s childhood.  That person survived for  several more years, as evidenced  by the leg having fully healed.  The twist here: the remains  were 31,000 years old.

The discovery was further   evidence that the practice of caring for our sick or injured   companions is way older than previously thought, and knowing   exactly how old can help us understand our ancestors’   capacity for compassion. The research team in Borneo   is pretty confident that the missing foot was an intentional   amputation because of the way the bones were broken,   and the way that the fractured bones healed.  And it all happened many  thousands of years before the  previous oldest intentional  amputation on record, which  dates to just 7,000 years ago.

This tells us a few major things   about this group of people from 31,000 years ago.  One, they knew enough about the body to know when amputation was necessary and how to do it.  Two, they had the tools and  skills to perform precise  surgical procedures. And three, they were also   willing to care for one of their group members while they   recovered from surgery, and for the rest of that person’s life as   a permanently disabled individual.  This, at its core is health care. So what is health care anyway?

Well,   it’s more than just some people in white coats sticking   a patient with needles. Most narrowly,   health care is the organized system of direct support for someone’s physical acute needs.  Basically, “making them better”. But it's also considered   giving health care to accommodate someone’s permanent or chronic needs to allow that  person to live longer than  they otherwise would without  care.

And some of the   earliest evidence for the practice of health care is a lot older than you’d think.  We have evidence that health  care is not even unique to  our species, which can give  us insights into some of our  other hominin relatives and  their capacity for care.  Remains from a 1.7 million year  old site in the Republic of  Georgia called Dmanisi include  the skull of a Homo erectus  individual with major gaps in their smile. The individual’s jaw shows evidence   that they had lost all but one of their teeth,   due to either disease or aging. While losing your teeth is   not great in the long run, the invention of tools like juicers   or blenders with more horsepower than a car   means that getting enough calories to stay alive is possible even without pearly whites.  However, Homo erectus was  not quite so technologically  developed as we are today, which  begs the question: What did  this individual eat?

It’s debatable whether   this population would have been able to cook their foods at all.  But we know that this toothless  individual lived for years  after losing their teeth since  their sockets were closed over  in a process called resorption.  So we know that they had  access to something soft  they could get their gums on.  At the time, the soft foods  that were available to them  would be things like bone  marrow, brain tissue, or soft  plants, likely mashed or cut  up using stone tools, which  takes extra time and energy to do.  So when it came time for this  Homo erectus group to gather  for dinner, this individual’s  need for specific foods was made  clear, and the group would have  traded or given those foods  to this individual. And the whole group was   okay with this adjustment for years. That's a long time to be giving away   some of what were likely prime pieces of protein!  Now, we don’t know the extent  to which this food sharing  happened, but it’s likely that  the individual in question’s  needs were supported at least  in part by their companions.  We also know that caring  for sick and injured group  members is not unique to Homo erectus.

Our evolutionary cousins the   Neanderthals went even further than Homo erectus in   providing care to group members.  By and large, Neanderthals in  the fossil record have a lot  of injuries, more than we see  in earlier hominin species,  suggesting that their lives  were dangerous and survival in  their environments involved a lot  of bumps and bruises. For example,   anthropologists discovered an individual from a site in Iraq called Shanidar who’d been   through the ringer.  He was either fully or  partially blind in one eye, was  missing one hand and forearm,  sported several leg and  foot deformities, and had both  a degenerative joint disease  and hearing impairment. And somehow, he still   lived to be between 35 and 50 years old, which was the standard lifespan   for a Neanderthal adult.  He wouldn’t have been able  to hunt or gather food as  effectively as his healthier  companions, so it seems likely  that the only way he could  have survived was if someone  was providing him food and assistance every day.

Another individual from France showed   signs of tooth loss, arthritis in his back,   shoulders, and jaw, a fractured rib, and degeneration of his foot bones,   and he also lived to be a pretty normal adult age,   between 25 and 40 years old. Keeping both of these individuals   alive that long would have required managing   fevers, keeping them clean, and repositioning their joints as they   healed from their various injuries.  Plus, both of these individuals  would have had limited  mobility for life, and their  groups would need to help them  travel long distances as the group moved around. So it seems like Neanderthals had a   pretty high capacity for care.

Which is not   surprising, in a species where as many as 80-90% of adults suffer   at least one traumatic injury in their lifetimes.  And they didn’t just support  these injured group members,  they probably used medicine  to treat their injuries too.  Tartar on the teeth of  Neanderthals from Spain indicates  that they ate yarrow and  chamomile, both of which are  extremely bitter and not  pleasant to eat, but do have  medicinal benefits. So they probably   weren’t eating them for funsies or as a primary food source, since there were much   tastier things to eat.  Other Neanderthals’ plaque  contained traces of poplar, a  plant that has lots of salicylic acid in it. Salicylic acid is the active   ingredient in aspirin, so these individuals may have been using it   as an early form of pain management.  And at the Iraqi site where  archaeologists found Shanidar,  they also found a burial site  where an individual appears to  have been buried with a whole  bunch of medicinal plants,  including yarrow, cornflower,  ragwort, and ephedra.  So these plants may not have  just been useful, they may  have been important enough  to these people to include  them in burials along with other grave goods.

This isn’t the only interpretation of the site,   however. Some have argued that   the flowers may not have been put there by Neanderthals at all, and were brought   by rodents storing food.  Whether this “flower burial”  represents a ceremonial  practice using medicinal plants  or just a shared cave with a  hungry rodent, we do know  that Neanderthals had a pretty  high-level understanding of  many medicinal plants in their  environment. But this also raises a   pretty big question: Why was it so important to all these different   hominins to keep their sick and injured group members alive?  Some anthropologists think  that these care behaviors  might have evolved to increase  group survival rates in  societies where individuals  were all super dependent on  each other.

For example,   some foods need to be processed after they are gathered and brought to camp. So,   maybe your injured groupmate can’t hunt for elks,   but he can help crack nuts all day.  This ability and willingness  to care for each other might  have allowed Neaderthals  to move into northern areas  where there was more risk for  disease, famine, injury, and,  you know, freezing to death,  because providing health care  meant individuals actually  had a chance to survive their  injuries. Of course,   it’s also possible that Homo erectus and Neanderthals just liked their friends   and family and wanted to keep them around longer.  Sadly, compassion and love  don’t fossilize, so with these  species long gone, we probably  will never know their exact  motivations for providing  health care to each other.  But what we do know is that it suggests they had a relatively high capacity for empathy,   plus the cognitive ability necessary to take care of each other.  And in the end, compassion  and empathy are what drives  most modern health care, too.

So it sounds like individuals   have had the cognitive ability to take care of each other   for a long time. But the cognitive ability to work a computer is much newer.  And that’s why we need this  video’s sponsor: Linode, a  cloud computing company from Akamai. They power the internet by providing   additional storage space, databases,   analytics and more to you or your company, across the world.

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