One of Hardy’s later plaque analyses of another Neanderthal individual revealed traces of poplar, which contains the natural painkiller salicylic acid, and the mold penicillium, the source of one of our most successful antibiotics. While we can’t be sure that Neanderthals deliberately ingested these substances for medicinal purposes, it’s telling that this individual suffered from a severe tooth abscess. Within the plaque, Hardy also found traces of microsporidia parasites, which cause acute diarrhea in humans. “The best guess is that it had to do with one or both of these infections,” she told me.

At least one form of Neanderthal health care seems more certain: midwifery. Skeletal remains demonstrate that, like anatomically modern humans, the size and shape of a Neanderthal baby’s head and the mother’s pelvis would have made unassisted childbirth dangerous. “The only way those heads could have got out of the birth canal is with that characteristic ‘twist’ which happens with modern humans at birth,” says Spikins—a maneuver that presents a high risk without assistance. From this, we can be fairly certain that they had developed some kind of midwifery to reduce the mortality rates, she says.

These findings don’t just sketch out a new branch to the history of medicine, showing that Neanderthal health care was remarkably similar to our own ancestors’ strategies; the research might also help us to better understand Neanderthals’ long-term adaptations to their environment. Many Neanderthals lived in colder and more arid regions across Western and Central Europe and some parts of Asia, where they ventured as far north as the Altai Mountains in Siberia. In the more northern areas, the main food source would have been hulking great creatures such as mammoths and woolly rhinos, the hides of which were so thick that they could only be hunted with spears at a dangerously close range. In southern regions such as modern-day Spain, meanwhile, Neanderthals appear to have chased ibex over mountainous terrains, which came with a serious risk of falls. That’s not to mention the many predators—including hyenas and saber-toothed cats—in these regions that posed their own dangers.

As a result of these challenges, injury rates were extraordinarily high, with one estimate suggesting that between 79 and 94 percent of Neanderthals sustained at least one traumatic injury in their lifetime. Spikins believes it simply would not have been possible for them to have adapted and spread so widely in these areas if they had not found the means to treat serious injuries. “As primates, we’re not naturally adapted to hunting large animals,” she explains of Neanderthals and Homo sapiens alike. “But health care allowed groups to sustain much higher rates of injury than they would otherwise be able to sustain, so they move into an ecological niche that they weren’t really well-suited for.”