0:00

Welcome to you stuff you should know from

0:03

house stuff Works dot com.

0:10

Hey, and welcome to the podcast. I'm Josh

0:12

Clark. There's Charles W. Chuck Bryant. There's Jerry,

0:15

who's about to go to the hardware store

0:17

any second now, which no,

0:20

Jerry doesn't find that very funny. Yeah,

0:23

I give the background there or to leave people wondering,

0:26

well, we need a trash cannon and dimmer background.

0:29

But we've been asking for I feel

0:31

like months, but yeah, it can't be months because

0:33

we haven't even been here that long. It's

0:35

been like four days. But what

0:38

what? What's the problem here? Why isn't there any movement

0:40

on this? There's a home depot

0:42

a thousand yards Crossromt. Yeah.

0:45

I specifically didn't mention their name, but

0:47

yes, it is the closest well in Orange

0:49

big box hardware retailer.

0:52

We could also support local business and go to

0:54

an ACE instead, yeah,

0:58

or we could just talk about and it's like

1:00

we're supposed to. ACE is a big chain too,

1:02

though, Yeah, but I think they're locally

1:04

owned. Oh right, like Henry's

1:07

ACE Hardware. Sure.

1:10

I like, Yeah, it's good stuff, very

1:12

helpful, very very knowledgeable

1:15

staff, much more helpful.

1:17

Than some of the other big Bucks

1:20

their orange and blue. Okay,

1:24

that was a great start to Uh,

1:29

Chuck, Yes, do

1:31

you know how to spell anesthesia?

1:34

I haven't. I struggle. It's one of those And in fact,

1:36

when you were out of the room getting

1:38

your coffee, Jerry was asking how

1:41

to spell it. I know, and I think she spelled

1:43

it right or maybe missed a letter. And

1:47

Jerry, I think she put an A

1:50

where there was supposed to be an E. Oh

1:52

well, I think that it used to be an accepted

1:54

spelling. You know how in some uh

1:58

distant times, the forties

2:00

the thirties, which Jerry identifies with and

2:04

like, anesthesia would have been spelled with an

2:06

A E rather than just an E because there

2:08

was another sound that. Yeah,

2:11

it is a tricky one them. Uh okay,

2:13

Well, then my next question, Chuck, do

2:16

you know what anesthesia means? I

2:18

do. Uh. It's from Greek, like a lot

2:21

of medical terms, and this one stands for

2:23

the loss of sensation. And

2:25

uh, we'll talk about our personal

2:27

experience as I assume, but I've never been under general

2:30

anesthesia. Yeah the big Daddy,

2:33

Yeah, fully under view. No,

2:36

so neither one of us has had major surgery like

2:38

that then no knock would yeah,

2:41

because after doing some research

2:43

on this, like, I don't know that I ever

2:45

would want to It's scary,

2:48

I mean. And let me just say also to anybody

2:50

who is listening to this prior

2:53

to undergoing a surgical procedure

2:56

that requires general anesthesia, we don't

2:58

mean to scare you know, but because

3:00

it's uh, we'll talk about rate

3:02

of death and and problems with it, which

3:04

there are still but it's

3:06

super safe now for the most part. But

3:09

when you when you when I was reading this, I was

3:11

like, man, what they're doing is is

3:14

like bringing you toward

3:16

death and then stopping at a certain

3:18

point, yeah, and just letting you hover

3:20

there then bringing you out when they're getting

3:23

with a lot of like crazy

3:25

heavy heavy drugs that

3:27

are only slightly different from what they used

3:30

in the like early history, which

3:32

we're about to talk about. But it's really like it's

3:34

it's kind of nuts that and they still don't

3:36

know exactly how it works. And

3:39

the reason why they don't know how it works, especially

3:41

we understand local anesthesia

3:44

and um twilight sedation, sure,

3:47

well we don't understand is general anesthesia. And the reason

3:49

why we don't understand because we don't understand how consciousness

3:52

works, so how can we understand

3:54

how unconsciousness works. Yeah, it's pretty

3:56

weird, and which is what

3:58

it works? Yes, it

4:01

definitely does, and although there

4:03

are some risks associated with it, it is far,

4:05

far, far better than

4:07

the alternative, which is no anesthesia,

4:11

which was the way it was for a very long

4:13

time. I mean anesthesia is a relatively

4:16

recent thing. Or getting you super

4:18

drunk, or hitting you in the head and knocking you unconscious,

4:20

which is not so knocking you unconscious

4:23

that qualifies anesthesia, but

4:25

it's still not medical anesthesia. Giving

4:27

you drunk, giving you morphine, giving

4:30

you marijuana, jim some weed, um,

4:33

yeah, rubbing stinging nettles on you to distract

4:35

you from the pain of having your leg cut off, belladonna,

4:38

using ice, all the stuff. These

4:40

are so horrifics. These are narcotics. These

4:43

are just plain old distractions, um,

4:46

but they don't qualifies anesthesia.

4:48

And the big difference, the the

4:50

thing that was such a huge, huge

4:53

progression forward um

4:56

with anesthesia is that it

4:58

doesn't just dull the pain. It dulls

5:00

the pain, it takes away your

5:02

consciousness and it also prevents you

5:04

from creating memories during this experience,

5:07

it gives you amnesia. So it basically cuts

5:09

a chunk out of your lifetime

5:11

that as far as your subjective

5:13

experience goes, does not exist.

5:16

It didn't happen like you were on the

5:18

gurney going into the O. R room and

5:20

you wake up and you're in the hospital

5:23

bed and you have stitches, but there

5:25

is nothing there in between,

5:27

ideally for general anesthesia,

5:29

right, And that's how we can

5:32

conduct surgery, because before that there

5:34

was surgery, but it was very rare

5:37

and it was very very

5:39

awful. Yeah, and when you know,

5:41

we flew by some of those, but um, we did mention

5:43

a lot of this, uh sopaphorics and narcotics

5:46

that they use. They did knock you in the

5:48

head, they did get you drunk. Um.

5:50

In fact, in the mid forties, those

5:52

were you know, opium and alcohol where

5:55

the two go toss like and

5:57

a towel to bite on, I guess, and

6:00

just to make you like be able to tolerate

6:02

the pain, which didn't really help.

6:04

No, I mean I'm sure it helped. Uh,

6:06

it dulled the pain, but it's

6:09

not gonna do what you want, which

6:11

is to kill it completely or knock you

6:13

out. Or render you an asiatic an

6:15

asiatic right, um.

6:18

But the so the those were the two

6:21

go to that they use. I mean there

6:23

were other ones to like um blood lighting

6:25

until a stupor or basically a

6:27

coma was induced, like you lost so much blood

6:30

that's pretty dangerous. But

6:33

these were the These were the go to um

6:36

pain killers for surgery, and

6:38

they still didn't work very well. But what's weird

6:40

is in the eighteen forties all

6:43

that changed, like not one, not

6:46

two, but three anesthesia

6:50

is UH came into

6:53

We're basically discovered for medical

6:55

use, like almost all at the same time. Yeah,

6:58

people now they basically say Crawford

7:01

Long from right here in Georgia,

7:04

University of Georgia graduate fellow

7:07

bulldog. UH. He was the first.

7:09

He performed a surgery

7:11

removed a tumor from a neck from

7:13

a mr A bentable in UH late

7:16

March eighteen forty two, and also

7:18

later did an amputation in a childbirth

7:21

with ether and UM.

7:24

He was he was the guy, but he

7:26

was you know, it was pretty regional and

7:29

people just didn't know about it. Basically. I all

7:31

think it's the impression that he wasn't as much of a self

7:34

promoter as Dr William

7:36

Morton. Uh, yeah, he did

7:38

um well William Morton

7:40

in eighteen forty six. We might as well go ahead and say he

7:42

demonstrated it for the first time in like

7:45

a public surgical theater, right, and said,

7:47

here is what I'm doing, and this is new

7:49

and it's exciting, and I'm in

7:51

Massachusetts on not some yokel in Georgia

7:55

pretty much, and that's how he gained the acclaim.

7:57

But yeah, I guess Crawford Long was able to prove that

7:59

he'd done he'd used ether earlier. He's

8:01

just like it just wasn't being

8:04

a big shot about it. I was just using it.

8:06

But you know, he discovered ether by

8:08

hanging out with friends who were

8:10

huffing ether at a party and supposedly

8:13

he saw one guy run into

8:15

a door and like cut his head open,

8:18

and Crawford Long, being a doctor,

8:20

was like, are you okay? And the guy was like, what are you talking

8:22

about? With like blood spurting out of his forehead,

8:25

and Crawford Long went, that's

8:28

pretty funny. Uh. And he went

8:30

on to uh tell Congress about

8:32

it, as did doctor Charles Jackson,

8:35

who said that he had done it before Morton as well. They

8:37

both independently went to Congress. I was

8:39

okay, man, I did that first.

8:42

All right, it's a bit of self promotion. Ye, but

8:45

Morton is the guy who gets who gets the credit.

8:47

He's the one who really introduced it to the public.

8:50

Well, it gets your credit as the first demonstrator.

8:52

Yeah, he's the one that you

8:54

hear of typically. Yeah,

8:56

I would say Crawford Long though. Yeah, I guess you're right.

8:59

Yeah. Lots of hospitals named after him,

9:01

at least one here, although now no

9:03

it's not cropfit Long anymore. Did they change it, yeah,

9:06

to home depot um.

9:11

So a little bit later on, there

9:13

was a dentist, Dr Horace Wells, who

9:16

used the first dude to use nitrous oxide

9:18

bull teeth, and then

9:20

chloroform was used by Dr James Simpson

9:24

and these things. You know, you

9:26

don't want to be using that though, it's toxic. So

9:29

Dr Horace Wells actually is a pretty interesting

9:31

story. It's where chloroform

9:34

um and nitrous

9:36

oxide converge as a beautiful place.

9:39

So he tried. He extracted one

9:41

of his own teeth on nitrous and

9:43

was like, this is great. Did you read that history of Hippie

9:45

crack article? Yeah, so this

9:48

all came after somebody, a guy named Joseph

9:50

Priestley in the eighteenth century synthesized

9:53

nitrous oxide, and then very

9:56

shortly after that, a teenage

9:58

prodigy named Humphrey Davy

10:01

started huffing it. And he actually

10:03

had a box built for himself and

10:05

was placed in it for over an hour once,

10:07

just huffing nitrous oxide.

10:10

That I am too, and he did

10:13

because that's so dangerous. Yes it is, but this

10:15

guy was huffing it like crazy. There

10:17

must have been like some escaping

10:19

or other air getting at something, but he huffed

10:21

it for like an hour just for self experimentation.

10:24

By the time Horace Wells tried it on a tooth

10:27

um, there was a lot of confidence

10:29

and understanding of nitrous oxide.

10:32

Um. He was able to successfully

10:34

remove his own own tooth when he

10:36

demonstrated it. He didn't

10:38

dose the patient properly, and the patient apparently

10:41

cried out, and so Wells

10:44

had staked all his reputation on this demonstration

10:47

just failed utterly and ended up on skid

10:50

row in New York. Went on a chloroform

10:52

bender and ended up throwing acid

10:54

on a couple of women. Was put

10:56

in, yeah, was put in jail and ended

10:59

up committing aside by slashing

11:01

his fomoral artery with the razor from

11:03

a shaving kit. But he was

11:05

on chloroform, so he

11:07

was anesthetized ironically when

11:09

he died. Oh well that's good. Weird,

11:13

Yeah, what it's strange history. But so

11:15

the point is in in the chloroform,

11:18

nitrous ox side in ether all emerged

11:20

to form anesthesia. Yeah,

11:22

and um, I mean it would have come around eventually, but

11:25

it's not so different today. Like I

11:27

said that, we're still using heavy

11:29

duty drugs

11:31

to knock people clean out and

11:34

monitor them so they don't die from it. It's

11:37

pretty crazy. Well, what one other thing about

11:39

the introduction of anesthesia is that

11:41

it took another fifty or so

11:44

years before the medical establishment

11:46

said yes, we need, we need to use this

11:48

widely and and as part of standard

11:51

and best practices. And part

11:53

of that was because pain was seen as

11:55

necessary. It was a sign that the

11:57

patient was alive, was still idle.

12:00

Um, there's a bit of a macho edge

12:03

to it from what I understand. Uh.

12:05

And then um,

12:07

there was also a reluctance to draw attention

12:10

to the fact that surgery is extremely

12:12

painful. Yeah, because they didn't want people

12:14

to not go to the doctor much.

12:17

Yea. So it took like fifty years to catch

12:19

on. So imagine being one of those patients where

12:22

the modern medicine is well aware

12:24

of anesthesia, but it hasn't adopted

12:27

it yet. That's worse than being

12:29

a patient before they understood

12:32

there was such a thing as anesthesia. Yeah, Or

12:34

imagine being because there was a lot of figuring

12:36

it out along the way, you know, as far

12:38

as dosage and stuff like that. Because so there

12:40

are a lot of you know, unwitting guinea

12:42

pigs. I guess there were Doc

12:45

that hurts, don't take a little more that,

12:48

or Doc, I'm dead, you

12:50

know. Like you remember the castration

12:52

episode we did, and they

12:54

talked about how they would use opium as

12:56

an anesthesia, but it was very

12:58

easy to accidentally overdose the

13:00

little boys when you were removing their testicles.

13:04

I think the same thing happened when you were cutting

13:06

off a man's leg in the Civil War. Wait, removing

13:08

testicles. Yeah, for castration,

13:11

circumcision. The castration said circumcision,

13:14

man, We've we've done both. Yeah,

13:16

But I thought I was like, man, I

13:18

thought circumcision was something different. No, that's

13:21

that means the circumcision is going horribly awry.

13:24

Yeah. Man, we've covered some gruesome stuff.

13:27

We really have, you know. All

13:29

right, well, I guess we'll take a break here and talk

13:32

about some of the different methods

13:34

UH of anesthesia right

13:37

after this. All

13:51

right, before we broke, we teased you a little

13:54

bit with the different types, and here we go.

13:56

And up first is my favorite

13:59

twilight sleep. UH. If

14:01

you've had your wisdom teeth out or maybe an

14:03

endoscopy. Um,

14:06

there's plenty of procedures that use it. You might

14:08

have had twilight sleep or conscious

14:10

sedation or twilight anesthesia,

14:13

and UM, I had some for when

14:16

I had my my tooth replaced my front

14:18

tooth. And it's always fun

14:20

because it feels great going in. You

14:23

just relish those like ten or fifteen seconds,

14:26

and then it feels fun coming out because

14:29

you know you don't know what's going on. It's

14:31

more fun when you're picking up you're a

14:33

loved one. Picked up

14:35

Emily after her endoscopy and

14:37

I went in and I don't know why I didn't think that my video

14:40

going already, but she was like, I think

14:42

everyone's throwing a party for me. Like

14:44

what the people behind the curtain. They're throwing

14:46

a party. I saw balloons and it

14:49

was very cute because they're like so out of it. And

14:51

when I came out of my wisdom teeth, I think I may have

14:53

told this before, but I my friend

14:55

told me that this particular doctor put

14:58

bunny ears on you and took a picture

15:00

because you're all puffed up and you have bandages around

15:02

your face. And I was like, that's

15:04

not gonna happen to me. I guarantee it. And

15:07

I remember distinctly seeing the lady

15:09

come in with the bunny ears, put

15:11

them on my head and get the polaroid out

15:14

and said smile, and I just went I

15:17

gave a big smile, so that that actually,

15:20

that's well, that's definitely

15:22

twilight sedation, Yes, because you

15:25

are out of it. You're

15:27

but you're still conscious and you're still able

15:30

to follow instructions. Yeah, but you don't

15:32

know that. When you wake up,

15:34

quote unquote, you feel like I

15:36

did nothing happen, but they're like, no, you were talking

15:39

to us and stuff. So weird.

15:41

It is very weird. Um, the

15:43

Twilight sedation, they used virtually

15:45

the same drugs in a lot of cases

15:47

that they used for general anesthesia,

15:51

right, just smaller doses. So they'll use a

15:53

sedative or something like that, like

15:56

ketamine. Right, Like

15:58

we said major drugs. I mean, if you've heard of

16:00

you know, falling into a k hole. Uh,

16:04

that's the same drug. Yeah,

16:07

it's just crazy. That's like we're like, oh, back in

16:09

the days, they use cocaine on people and that's nuts, right,

16:12

Kee, big

16:14

difference. Um. Yeah, so there's

16:16

like ketamine there. They might use something

16:18

like valium or at a van or

16:21

something like that. Um. They'll probably

16:23

also use the dissociative, which

16:25

apparently disconnects

16:28

your nerves from your brain. Yeah, that's

16:30

what value is. Okay, that makes

16:32

sense. Yeah. Um. And then also they'll

16:35

use an analgesic, which is just

16:37

another word for pain killer. So you've got

16:39

all these strings working in combination, probably

16:41

given to you intravenously, and

16:44

you're a little bit wasted. But the

16:46

point of twilight sleep, and the thing that

16:48

that um, that separates it

16:50

from other types of anesthesia, is that you

16:53

are not so wasted that you

16:55

can't breathe on your own, that your

16:57

heart beat, your heart can't beat

16:59

on its own, it needs to be you'll

17:01

be monitored, but really they've

17:04

given you such a low dose of this cocktail

17:06

of chemicals that you're you're

17:08

still able to do things like smile

17:10

when the the dnnis put twenty

17:12

years on you. Yeah to. I

17:14

also remember, Um,

17:17

when I woke up, I remember seeing a

17:20

poster that said locomotive

17:22

Lasagna on the wall, and

17:24

Um, of course it didn't say that unless

17:27

they went so far to like switch out posters

17:30

to mess with you. I could see that because this

17:32

didn't clearly had a sense of humor. It's putting bunny

17:35

ears on people. It's like Tim Watley from Seinfeld.

17:37

Yeah, but I was a little kid, you know. You know,

17:40

I've never even had a drop of alcohol, so I've

17:42

never had my head altered in anyway.

17:44

So I was like, this is crazy. Did you start going to

17:47

dentist every Friday at all?

17:49

Fifty wisdom teeth removed? You're

17:52

like, I know there's another one in there. Uh.

17:54

The only uh. The other good thing about

17:56

UM the Twilight Sleep is it's not going to have the

17:58

after effects is general like, um,

18:01

probably won't be nausea, have nausea

18:03

or dizziness or vomiting. Maybe a little bit like

18:06

they will give you a prescription probably

18:08

but um, you probably want need to use

18:10

it, right, you know, Yeah, anti

18:13

nausea stuff. So that's uh, that's

18:15

twilight sleep a k A procedural

18:18

sedation. I don't know if we ever called it that. That's

18:20

the clinical term for it. Twilight sleep

18:22

is the prettier name for it. UM.

18:25

Then there's also a local anesthetic,

18:27

which is the other common

18:30

type of anesthesia UM,

18:32

where basically a is a small

18:34

area or a specific region of the body

18:37

is um basically numbed. Yeah,

18:39

that's when you get the worst thing that can

18:41

happen to you in life, which is uh, shots

18:44

into the gum, a needle in

18:46

the gum in the dentist, which is why

18:48

the dentist will frequently use a topical

18:51

um. A topical anesthesia.

18:54

It helps a little, right, Uh, so

18:56

that they'll it

18:58

will numb your gum when they put the needle

19:01

in. Yeah, they'll put like that gel and that will

19:03

them in a little bit. Or if you're getting sometimes

19:06

like an ivy in the arm, they'll spray it with

19:08

the cold stuff and that all

19:10

helps, for sure. It does. You'll still feel

19:13

the pressure of the needle going into

19:15

your jaws, but you don't feel the pain, right

19:18

and the the reason why these

19:20

things work is, Uh, they a

19:22

local anesthetic actually goes

19:25

to the area it's delivered to and

19:27

blocks the nerve receptors. It actually

19:30

keeps your potassium and your sodium

19:32

ions um from

19:34

firing, right, which means

19:36

that it's not conducting electricity, which

19:38

means that your nerves aren't capable of passing

19:41

along the sensation of pain to your brain. They're just

19:43

shut down. That's what a local

19:45

anesthetic does. And if you pay attention,

19:48

the local anesthetics all in an ain

19:51

and for a pretty good reason, like light decane

19:53

or no vocaine. Even they don't use novocaine

19:55

that much anymore. Um. It's a

19:57

derivative of cocaine, and cocaine

19:59

has a topical numbing effect, and they

20:01

used to use it to do that, right.

20:04

And then they said, why is

20:06

everybody showing up to the dentist all the

20:08

time? Uh? And then they said,

20:10

oh, yes, it's because of the cocaine. So let's

20:12

figure out a a synthesized

20:15

version of it. And they came up with no vocane,

20:17

lydocane all that, UM. And they stopped using

20:19

no vocane apparently because there were a lot

20:22

the potential for adverse reactions

20:24

was greater UM, but people

20:26

still do have allergies

20:29

to UM local

20:31

anesthetics once amount, but it turns out

20:34

it's not the local anesthetic itself. It's

20:36

not the no vocane, it's not the lydocane.

20:38

What it is is UM. When you use

20:40

a local anesthetic, it has

20:42

the effect of vasodilation, which means

20:45

that it makes your blood

20:47

vessels relax, which lowers your blood pressure

20:50

UM, which is good, but

20:52

it also is not so good. So

20:54

they add epinephrine, which is a vasso

20:57

constrictor, and it actually

20:59

makes the local anesthetic

21:01

work better. So if you get a local anesthetic,

21:04

you're getting the local anesthetic like Clyda cane

21:06

mixed with epinefrin and a preservative

21:09

to keep the epine and fresh. And it's the preservative

21:12

that you're having the adverse reaction to.

21:14

Yeah, and again just a well balanced

21:17

cocktail to give

21:19

you exactly what you need. UM. Local

21:22

is gonna wear off in a few hours, It depends

21:24

on how much you have UM. When

21:26

you leave the dentist, you know you'll still have your mouth

21:28

numb for a while, and they always

21:30

want you not to eat or talk too much

21:32

because UM. You can accidentally bite your tongue in your

21:35

cheek and not know it, uh,

21:37

which actually happened to me recently, and I

21:39

did bite my cheek man a lot, Yeah, bled

21:42

a little bit too. Yeah, I'm

21:44

fine. So it's such just um,

21:46

it's such just dental that you're gonna

21:48

get like a local anesthetic.

21:51

You could also be given a local anesthetic

21:53

for what's called awake brain surgery.

21:56

But yes, so

21:58

in some some type some brain surgery,

22:01

you need to be conscious. You can't be unconscious.

22:04

They need to keep track of what

22:06

the brain is doing and they need it to be in a conscious

22:09

state. So they will give

22:11

you some drugs where you're not necessarily

22:13

like you you might be sedated in the

22:16

like you might be on a little bit of valium or something

22:18

like that, but you're not. You're still conscious, you're

22:20

still able to respond to questions. But they give

22:22

you a local and aesthetic because they take the top

22:24

of your head off and work on your

22:26

brain. I think it's in Hell Raiser there's

22:29

like awake brain surgery is shown.

22:31

Yeah, I think I've seen that in another movie too. Um.

22:35

Yeah, because they need to be able to ask you things like in

22:37

the nuts, can you believe that your

22:39

brain is exposed that crazy. Oh

22:43

it is weird. Um

22:45

are we onto regional? I believe? Uh?

22:48

Local regional anesthesia is

22:51

sort of like local, but it's covers a wider

22:53

area of your body. Um. So like

22:55

if you need your whole leg numbed

22:57

for an operation, um and just

23:00

like a small portion of your leg, that

23:02

would be regional. Uh. It's

23:04

also called a nerve block basically

23:06

because they're just taking a single nerve or bundle

23:09

of nerves and blocking that. Right, they're going after

23:11

like one of the big dad he's rather than a little

23:13

one. But again localized. Um.

23:16

Like if you know women who have given birth,

23:18

sometimes we'll get an epidural uh,

23:21

and that's what that is. It is injected

23:24

via catheter into the epidural space

23:27

in the lower back. But that

23:29

doesn't necessarily mean uh,

23:32

directly into the spine, which also

23:34

can happen with a spinal block, right

23:37

into that cerebro spinal fluid, which

23:39

is about as direct as you can get. And

23:41

if you get a c section or maybe hurning a surgery,

23:44

and that's when they want you awake again,

23:47

um during the surgery, like

23:49

with epidurals. Chuck I was wondering, So

23:51

an epidural, it's in the space outside

23:54

of the spinal column um,

23:56

but it's used to numb you're

23:58

from the waist down, like when you're give birth or something

24:00

like that. Right, And it's actually a catheter

24:02

is introduced in a continuous I V.

24:05

Cocktails given to your into

24:07

your almost your spine, but not

24:09

into the spine. No, that would be a spinal

24:13

right. I wondered, how do

24:15

they make it so it's it's

24:17

your waist down that's getting numb. Why isn't your waist

24:19

up? Oh? Like, how does how

24:22

do they know the path is going downward? Yes?

24:24

So I looked it up and it turns out it

24:26

doesn't always. Sometimes

24:29

it can reverse and

24:31

numb you from the waist up, in which case

24:33

you're in like, that's a problem because

24:35

your breathing can stop. Um,

24:37

your heart can stop. There's a bunch of stuff

24:39

that can stop. But apparently it's

24:42

extraordinarily rare, but it can happen.

24:45

Where like the the intended area

24:47

is reversed when they give you an epidural,

24:50

there can also be complications from the epidural

24:52

um that aren't great. Um,

24:56

hopefully that doesn't happen giving birth right,

24:59

well, the same same with this final as well. Like there

25:01

there there are complications, like you can get

25:03

a meningel infection

25:06

or an abscess something like that. I happen to be a

25:08

friend of ours. That's why I got dodgy. I didn't want to say

25:10

it on the air. I'll

25:13

tell you after, just

25:16

write it down, okay. Um,

25:19

yeah, I talked about the spinal block. Um,

25:22

there's a little bit more risk, like we said, then

25:24

local obviously like seizures

25:26

and heart attacks. Um.

25:29

And sometimes it doesn't give enough

25:31

pain relief and you have to move on to general.

25:34

They're like, Doc, this ain't working right. Um,

25:36

can you just knock me out? Because some patients

25:40

want to be awake and some patients

25:42

don't. And sometimes they will defer to you on that.

25:45

Who will defer to who? The doctor?

25:47

And like you want to be awake for

25:49

this or not, especially during childbirth,

25:52

to like give me the

25:54

drugs, give me the drugs or

25:56

the common refrain, yeah, or I want

25:58

to be awake at least, um,

26:01

but give me the epidural. Uh.

26:04

Like I'll go in thinking natural

26:06

childbirth is the way to go, and then I

26:08

changed my mind, which is, hey,

26:10

that's you're right, Yeah, sure,

26:13

given birth, you should do it. However you want to totes

26:15

at home in a tub, uh

26:19

water boat with a goat. Very

26:22

funny. Uh So, Chuck, you

26:25

had a pretty great segue that we just trod

26:28

all over into general anesthesia

26:31

again. The big Daddy is

26:33

what I think most people call it. That's when you're

26:35

put under, and that is when you are

26:37

out. You don't remember anything, you're

26:40

asleep, you're you're unconscious,

26:42

and that's the one where they don't completely understand

26:44

how it works, which is a little scary. It is

26:47

a little scary UM and there have been

26:49

people who have tried to figure out how to quantify

26:51

it UM using magical boxes

26:54

and trans magnetic transcranial

26:57

magnetic stimulation stimulation,

27:00

and I flubbed that one the thinking yeah,

27:02

um, but ultimately

27:05

we just we don't know. So there's there's

27:07

a there's a general idea, basically

27:09

a working theory, and that is that UM

27:11

anesthesia the drugs that we use, and

27:14

it's a bunch of different ones working

27:16

in conjunction, but they depressed the

27:18

activity of the spinal cord, so

27:20

you're paralyzed UM. The brain

27:23

stem rearticular activating system

27:26

which is basically they think responsible

27:28

for sleepiness and wakefulness

27:30

that's stimulated or depressed,

27:32

depending on your way of looking at it. And

27:34

then, um, your cerebral cortex

27:37

is affected as well, so you're not thinking,

27:40

you're not forming memories, you're not um

27:42

making associations with any of this, and

27:45

all of that in conjunction with one another,

27:47

comes to anesthesia.

27:50

General anesthesia, which is utter and

27:52

complete unconsciousness. That's right, And it

27:55

can last a few hours or up to six

27:57

hours. Um, if you're having like serious

27:59

comp gated surgery. But there

28:01

is a limit. They can't just be like this is a twelve

28:03

hour surgery. Um. Yeah,

28:06

I thought there are worse surgeries like that where

28:08

they're like the surgery lasted seventy

28:10

two hours, but the guy was

28:13

successfully transplanted. Yeah,

28:15

that is true. How do they do that? Because really

28:18

dangerous to get someone under general anesthesia

28:21

for that long. Yeah,

28:23

that's a good point. I didn't I meant

28:25

to look into that. Someone will let us know. Sure,

28:28

we'll follow up on that for sure. Uh,

28:30

if you are going to be

28:32

put under general anesthes you don't just walk

28:35

in and start huffing the gash.

28:37

There there's a lot of work that goes into

28:39

that. Um, you have to be invited. You have to

28:42

be invited by her. You have to get a

28:44

a party invite from your anesthesiologist.

28:47

Um, you will meet with them

28:49

and he or she will basically

28:52

ask you a bunch of questions about your lifestyle

28:55

and your medical history. Are you a natural

28:57

redhead? Yeah? Because we covered

28:59

that in the Redhead episode. You might need a little more.

29:01

Are you a little kid are you? Yeah?

29:04

I can tell by looking Yeah, because little kids

29:06

livers process these drugs a lot faster,

29:08

so they need uh higher

29:11

dose. Basically, Um, are you

29:13

a huge alcoholic? Not? Well,

29:16

depends on what you say, sir. Are

29:18

you heroin addict? Not anymore?

29:20

So, like the depending on the answers to these

29:23

questions, they're gonna need to adjust your

29:25

dose depending do you have low blood

29:27

pressure? High blood pressure? Yeah? And this is where you want

29:29

to be super honest about your drinking and drugs.

29:32

Yeah. If you're a heroin addict, you need to fast up.

29:34

You can be like, hey man, can you be cool

29:36

and keep a secret? You don't like lie like

29:38

you do to your shrink, Right, you know you

29:41

really want to be honest because you want this to work

29:43

well and be safe. Um.

29:46

After they have all that, they're gonna basically,

29:48

um, put together your

29:50

your program on what you're gonna

29:52

need, and then they're going to tell you not to eat

29:55

because if you eat before you go under anesthesia,

29:58

you can aspirate and

30:01

basically breathe in what's in your stomach.

30:03

So this is not everybody believes

30:06

this any longer, supposedly about

30:08

eating before surgery. There's what

30:10

I understand is that when there

30:14

are so few cases of aspiration

30:16

under anesthesia, especially twilight

30:19

sedation, because that well,

30:21

no, oh, yeah, that's a pretty good that's a good

30:23

point. I hadn't thought of, um, but

30:26

apparently, well,

30:28

yeah, you just answered that question. You

30:31

say, Well, from what I understood,

30:33

there was a study that looked at all these different

30:36

um the cases of aspiration

30:38

and found it's very rare. And they

30:40

concluded that the danger,

30:42

the potential danger of aspirating

30:45

under sedation is low

30:47

enough that it's

30:49

it's outweighed by the benefits

30:51

of eating. Because if you don't eat and you undergo

30:54

sedation on an empty stomach, which is what they

30:56

want you to do, it's a lot

30:58

harder on your system. You're much or likely to

31:00

be nauseated, to vomit afterward,

31:03

be dizzy, whereas if you eat something,

31:05

you can your body can process these drugs

31:07

a little better. So are they advising people to eat

31:09

now. I think that they're starting to get to

31:12

that point, but I don't believe it's

31:14

like current widespread practice.

31:17

Yeah, I don't think I would. I don't know,

31:19

Maybe I'm superstitious. I don't know if i'd be chowing

31:21

on a burrito before I go in for my

31:23

heart surgery. Well, just for the surgeon's

31:26

benefit, I think you might want to avoid

31:28

burritos before going under for

31:30

being knocked on content. Yeah, you're right.

31:33

Um, you will be wearing a breathing

31:35

mask when you're under general anesthesia

31:38

or a breathing too, because uh

31:40

you basically your your muscles are so relaxed

31:43

that your air was airways won't stay open.

31:45

So that's a little creepy in itself. Um.

31:49

And they're going to monitoring lots

31:51

and lots of things while you're

31:53

under there in the room, and probably have

31:55

an assistant in the room with them to monitor

31:58

all this stuff like blood

32:00

pressure, heart rate, O two

32:02

levels, um CEO two

32:04

levels, temperature, brain

32:06

activity, and there's even a little alarm

32:08

if you're O two level drops, which is

32:11

great. I think they should have an alarmed for everything.

32:13

Yeah, you know, the more alarm is better in that case.

32:16

And I guess we should talk about the four stages um

32:19

of general anesthetic YEP. Stage

32:21

one is the induction stage, or the

32:23

one you were talking about those fifteen seconds where

32:25

you're like pure bliss, right uh,

32:28

and then stay that quickly moves

32:30

to stage two, which is the twitchy stage

32:33

where you're just kind of like well twitching,

32:36

it's your body going like what the heck is going

32:39

on? What is this? And then you move

32:41

quickly to stage three, which is the stage

32:43

that they're after, where you're not twitching

32:45

anymore, you're not conscious any longer, and

32:48

you are under a state

32:50

of general anesthesia. You're anesticized,

32:53

right uh. And this is where you want to

32:55

be. But there is, like you said, a fourth

32:58

stage. You don't want to go there. No, that's the over

33:00

dose stage. And once you're in this

33:02

stage, it is now a medical emergency

33:05

and you have to be managed brought out of

33:07

before you suffer brain damage or death

33:09

or all sorts of other problems. Yeah,

33:12

and I remember when I read this the first time,

33:14

I thought, why did they even have this fourth

33:16

stage? I don't think they

33:18

think it's just there. Yeah, but it's

33:21

you know, anesthesia is a thing.

33:23

It doesn't mean like if you don't

33:25

have a great anesthesiologist, there can be

33:27

that fourth stage. I think even

33:29

with a good anesthesiologists having

33:31

a bad day, things can happen. You know, Um,

33:34

I hit a squirrel and now this guy

33:36

is dead. When you do

33:39

go under, you are

33:41

um, like I said, gonna get the gas

33:43

or an ivy or both. Um.

33:47

There are lots of different drugs that they will combine

33:49

again, katamine, valium,

33:52

sodium pentethal. Well, the go to is

33:54

they're going to knock you out first with the I V usually

33:57

and almost across the board it's propafile

34:00

Michael Jackson's milk, that's right, Uh,

34:02

And that's what they do to initially knock

34:05

you out. And then they're gonna put ad that. He actually

34:07

needed that to sleep and it didn't even

34:09

work. It's a crazy thing, like he was so

34:11

wound up that even probe fall

34:14

wouldn't work. Unbelievable. Um.

34:19

You might also get a muscle relaxer to

34:22

make sure that paralysis really takes hold. Yeah,

34:24

and if this is all kind of familiar,

34:27

go back and listen to our lethal

34:30

injection episode, because

34:32

that is stage four and

34:35

technically stage five and general

34:37

anesthesia is lethal injection.

34:40

Yeah, that's again, that's why this is so nuts. Is there

34:42

there almost killing you? Yeah,

34:44

well maybe that's overstating it, but

34:47

they're they're not bringing you to the brink of death,

34:50

but they went to close enough to where you're out.

34:53

You know. Um, after

34:55

surgery, Um, you don't just get up

34:57

and dance out of the room. You're gonna go to

35:00

the pack you the post anesthes anesthesia

35:02

care unit, and then you're gonna keep

35:04

getting monitored. You're gonna be dehydrated

35:07

and cold because you're heading

35:09

toward death, so they're gonna warm you up

35:11

some warm I v s. There are also

35:14

some drugs that they've started to use. Now, Um,

35:16

I had some oral surgery and you mean picked

35:18

me up, and I can't remember any of the stories or

35:20

whatever, but I remember going from

35:22

being out to just being totally with it.

35:25

And apparently I've been given a drug that's

35:28

like a revers sedation drug

35:31

to wake you up. Yeah, there's one called flu mazanell,

35:34

another called nax alone, and

35:36

it's just basically they also used them for overdoses

35:38

of certain kinds in the e R. But

35:41

they can use them post sedation

35:44

to get you going again pretty quickly.

35:46

They stick it directly into your heart. Yeah,

35:49

just sit up and inhale

35:51

deeply. It's not

35:53

like I had that when I had mine.

35:56

Yeah, I'm cutting

35:58

edge. Yeah. Uh, I

36:00

still couldn't eat ahead of time. Oh

36:03

really, yeah, but you did anyway, You're

36:06

like, I read that it was fine, I

36:08

could have a breed. Um.

36:11

You might actually get a little morphine too for

36:13

the pain after your room. Yeah.

36:16

Um, but you might also have those side

36:18

effects like we talked about with the vomiting and nausea.

36:21

Um, and maybe

36:23

we're pretty out of it, you know, Yeah, you might fall over

36:26

if you get up to use the bathroom. There is

36:28

a help. There's a probably the

36:30

worst potential side effect of

36:32

anesthesia possible.

36:34

It's something called anesthesia awareness.

36:37

And we'll would say death, but

36:39

we'll talk about both of those, right, we'll

36:41

get into both after this, So,

36:57

Chuck, we're gonna talk about anesthesia awareness,

36:59

but we should probably talk about anesthesiologists

37:02

first, right, Yeah, there's um

37:04

many levels of anesthesiology

37:08

g jobs. You

37:12

can be an anesthesiologist full blown, which

37:14

means you've gone to PREMD undergrad,

37:17

you've gone to med school, you have

37:19

done your to year residency. Sometimes three

37:23

in your income goes to malpractice insurance

37:25

doesn't really I would guess not that much,

37:27

but a lot um

37:30

and you can. I didn't see where

37:32

you had to be certified, but

37:35

you were eligible to take the A B A

37:37

exam I think, and that I

37:39

think if you want to be a physician an stysiologist,

37:43

you actually have to be certified. All

37:46

you have to do is be able to say anthologists

37:49

correct, Actually that's not true. It's

37:51

physician. Anesthesiologists are

37:53

certified and most of these physicians

37:56

an aestusiologists um do a one year

37:58

of specialty training as well. Um

38:01

with either there are several

38:03

different subspecialties like hospice

38:05

and palliative medicine, critical

38:07

care medicine, and pain medicine. So

38:10

basically just it's almost like postgraduate

38:12

graduate school. Or

38:15

you can be an assistant, which means you

38:17

have your four year undergrad in pre med

38:20

and then you've gone through an accredited program

38:23

and then take an exam. Or you can

38:25

be a nurse anesthesia

38:28

anesthesias anesthetist.

38:31

Anesthetist, Man,

38:34

that sounds like such a dope. It's this is

38:36

some tough words, man. I know. It's a

38:38

lot of stuff going on in there, a lot of teas and ages.

38:40

And that means you're a

38:42

registered nurse who has completed UM

38:45

a training program which

38:47

last two to three years. You're gonna have

38:49

to have your b s. Degree and

38:51

at the end of one year of practice

38:54

experience UM is when

38:56

you go through that training program and take an exam, so again

38:58

many years. It's like serious, serious stuff.

39:01

It's not like, oh, I want

39:03

to you know, I want to be a

39:05

doctor, but I don't want to go through all the schooling, so I'll

39:08

just be an anesthesiologist. I want to have access

39:10

to the finest drugs available on the planet

39:12

Earth. Right now, it's still serious,

39:14

like you're a doctor, you know, well,

39:17

you're not like you're any lesser of a You're

39:19

a nurse. What

39:21

do you mean And an estatistic said, was a nurse?

39:23

I No, I'm just talking about all of those jobs require

39:26

lots and lots of schooling. It's not like the easy

39:28

way out, I certainly hope. No, No,

39:30

it's very serious. Job. Okay,

39:33

so it is a very serious job.

39:35

Again, we said you are being

39:38

brought to the brink of death or stupor

39:41

unconsciousness or whatever you want to call it,

39:43

and then brought back without any side

39:45

effects as few side effects as possible.

39:48

That's right, and certainly no lasting side

39:50

effects. But there is something. There's a

39:52

pernicious UH syndrome

39:55

that doctors have been aware of, the

39:57

anesthesiologists have been aware of at least since

39:59

the six these, which is called anesthesia

40:02

awareness. And basically, anesthesia

40:05

awareness is where you are given

40:07

anesthesia, which includes a paralytic

40:10

which means you can't move your body at

40:12

all UH, and

40:15

your eyes have been taped shut so you can't see,

40:18

but you are conscious. You are

40:20

aware during surgery, so

40:23

you're the pain killers would have probably worked

40:26

too, but something went wrong and you're

40:28

not unconscious, so you're

40:30

able to form memories. You're

40:32

able to hear the doctors talking about you like

40:34

you're a piece of meat. You're able to

40:36

hear the cutting, the squishing,

40:38

the tearing of your organs being moved

40:40

around. You can smell the singed

40:43

hair and claterized flesh.

40:45

You're able to feel genuine

40:47

fear in some cases if the pain

40:50

reliever hasn't worked, you're able to experience

40:52

this excruciating pain and

40:55

you're not able as badly

40:57

as you want to to alert and

41:00

anybody on the surgical teams like you're locked

41:02

in that you're, yes, that your experienced.

41:04

It's yes, you're It's like performing

41:06

surgery on a locked in person. Yeah, without

41:08

any kind of pain killer or anything like that.

41:11

Yeah. I didn't know your eyes were taped shut during

41:13

surgery either, because, Um,

41:16

you never see that on TV shows, do

41:18

you. I've never noticed that. Uh,

41:22

yeah I don't. I've seen it before, but I'm

41:24

probably on like one of those like remember they

41:26

used to have real surgeries on Any

41:29

Discovery in the early days. Yeah, back

41:31

when they were doing stuff like that. I

41:34

looked into that though, and um, that's for a

41:36

couple of reasons. Obviously, to keep the eyes from

41:38

drying out, because apparently eyelids

41:40

do not close in fifty of

41:43

patients when under general anesthesia.

41:45

They'll just say it's so

41:48

as to keep the eyes from drying. And I didn't

41:50

realize this is to prevent corneal abration.

41:52

Apparently that had been or

41:55

can be a real problem. Um,

41:57

even if your surgery is not on your eyes. There's

41:59

just a lot of activity

42:01

around your face like a stethoscope

42:04

and scratch your eye or yeah, a lot

42:06

of stuff can happen. So we'll take your eyes shut,

42:09

so they tape it shut so you can't

42:11

see. But again you can still here. You can still

42:13

feel and even if you're not feeling pain,

42:15

you can still feel the pressure. Remember,

42:17

even with like a local and aesthetic, you

42:20

can't feel the pain, but you can feel the pressure of the needle

42:22

going in your jaw. This is the same

42:24

thing with like stomach surgery or your heart

42:26

being taken from your

42:28

chest or what have you. Um

42:30

So a lot of people, apparently, studies

42:33

have found since the sixties that

42:35

about two out of every

42:37

thousand patients or

42:39

centuries will experience

42:42

anesthesia awareness. Yeah, they said that's super

42:44

rare. That's not rare enough for now. I

42:46

was hoping to see like one in a hundred thousand

42:48

or a hundred million. Yeah, yeah, No,

42:51

it's like two out of every thousand,

42:53

and supposedly seventy of

42:56

people who experience anesthesia awareness

42:58

suffered from clinical petz TSD, which

43:01

is five times more than soldiers returning

43:03

from Iraq and Afghanistan. And we're getting

43:05

this stuff from an Atlantic article called

43:08

Awakening by Joshua Lang. Just

43:10

go read it. It's um it's

43:12

a really great article. Yeah, they gave this

43:14

one case. There's a bunch of cases in there, but this

43:16

one. Um. Sherman Sizemore Jr.

43:18

Was a Baptist minister and coal miner,

43:21

former coal miner. He's seventy three, and

43:23

he had exploratory uh

43:25

laparotomy that

43:28

right in two thousand

43:30

six. And any kind of exploratory

43:32

surgery is you know, it's

43:35

not fun because they're basically looking

43:37

around for stuff, well, moving

43:39

things around. Yeah, they cut away like

43:41

the flesh and his belly fat and all that stuff.

43:44

And we're looking um at the the

43:46

film that holds your guts in place. Yeah,

43:48

they're poking around in there and

43:51

um. He of course had interoperative

43:53

recall, which is another term for anesthesia

43:56

awareness, that's right, and he um

43:59

Basically his family

44:01

couldn't understand what was going on with

44:04

them. You know a lot of times you'll have these

44:06

bad dreams, these nightmares

44:08

about blood and people coming

44:10

at you and trapping you, and it's

44:12

it's severe PTSD. And he

44:15

eventually uh killed

44:17

himself even though he had no history of psychiatric

44:19

illness. Within two weeks of his surgery, yeah,

44:21

shot himself dead. And his family

44:23

had settled with a lawsuit because

44:26

they claim that no one even said

44:28

that this could happen or you should

44:30

see counseling or anything like that. So

44:33

sad. Oh, yeah, it's very sad.

44:35

Supposedly, people who suffer from PTSD,

44:38

from anesthesia awareness um almost

44:40

across the board, can't lay down

44:42

and sleep. They have to sleep in chairs because laying

44:44

down with uh memories

44:46

of you know, being on the O R table. It's

44:49

uh yeah. And again, anesthesiologists,

44:52

philosophers, any kind of scientists,

44:54

they don't know how this is happening because we

44:57

don't understand consciousness, so we don't understand

44:59

the mechan aism that produces unconsciousness.

45:01

And then even further, we don't understand

45:04

when that mechanism that's supposed

45:06

to produce unconsciousness fails to produce

45:08

unconsciousness and someone remains

45:10

conscious and experiences anesthesia

45:13

awareness. Yeah, I would think there's got

45:15

to be some fail safe for

45:17

this. Untake

45:20

the eyes midway and say like

45:23

blink, if you can feel

45:26

me, feel this, but you're you've

45:28

been paralyzed. You can't move, you can't even

45:30

blink. It

45:32

seems like they should. It's got I mean, I don't

45:35

know. It seems like there's gotta be something that could do, Like there's a machine

45:37

that has to breathe for you because your

45:39

lungs can't even move well. And that's why they take

45:41

your eyes shut to begin with. I guess because you can't blink. That's

45:45

creepy that people like their eyes remain

45:47

open. Yeah,

45:49

I wonder it's like the mom from Throw Mama

45:51

from the Train, Like even if you can't blink,

45:53

I wonder if there's any kind of sign like

45:56

that you could give. Well. So in this

45:58

awakening Um article they

46:00

talk about there was a guy who like

46:02

came up with this box that was

46:04

meant to it gave like a number

46:07

between zero and a hundred that

46:10

supposedly reflected a level of

46:12

consciousness to be used in

46:14

the operating room for anesthesia,

46:16

so that that anesthesiologist could be confident

46:18

that somebody wasn't experiencing anesthesia

46:21

awareness. And they found that it doesn't really work.

46:23

So there are there are people who

46:26

have undertaken this quest to two

46:29

basically show somehow there's

46:31

some outward sign of whether someone's

46:33

conscious or not. But we just haven't licked

46:36

it yet. Yeah. I can't believe there's not some sort

46:38

of machine that could pick up on that. But they've tried,

46:40

or maybe they're just like, uh, it's

46:43

two in every thousand. Yeah. I can live

46:45

with those numbers and that that's

46:47

no, that's not that's way too

46:49

common, man. That scares me to

46:51

death. Yeah, well you said that's the worst thing

46:53

that can happen. I vote for death is

46:56

the worst thing. UM. In the

46:58

nineteen forties, uh, for

47:00

every one million patients

47:02

who had full anesthesia, six hundred

47:04

and forty of them died. By the eighties,

47:07

that was down to four for every

47:09

million, which to me, that's good and rare,

47:12

four out of every million. Yeah, but that number

47:14

is actually scarily on the rise since

47:16

the nineteen eighties. UM

47:19

a German publication called Deutscheses

47:22

uh arts ablat it's

47:25

the German Medical Association's UM

47:27

science journal, and they

47:29

said that worldwide death rate is

47:32

on the rise to about seven now per million,

47:35

and the number of deaths within one year after

47:37

general anesthesia is one

47:39

in twenty or if you're over sixty one

47:41

and ten what and

47:44

that's within the year after. Yeah,

47:46

but even still that's not good. No,

47:48

and that that doesn't necessarily mean that's due to the anesthesia,

47:51

because they make the point that it's

47:53

not like the quality of anesthesiological

47:56

care is different. It's that older

47:58

people are having surgery these that's

48:00

that's so good

48:03

point. Yeah, that's probably what it's due

48:05

to. But yeah,

48:07

I mean they said, for a patient to actually die on the operating

48:10

table is super super rare from

48:12

anesthesiology. Um, it's apparently

48:15

much more common to experience

48:17

anesthesia awareness two

48:20

and every thousand. Why don't they say one in five? Yeah,

48:23

really trying to you know, when

48:25

every thousand nah,

48:32

and that's not one in five patients

48:35

surgeries. There's a lot more surgeries than patients.

48:37

Yeah. And you know when you go, when you take your pets

48:40

in, they undergo general

48:42

anesthesi too for surgery. They always say

48:44

like your pet could die, like

48:46

it's rare and it happens this often. But

48:49

um, it can happen. And you

48:52

know, you have to sign the waivers and that's always especially

48:54

if of an older animal. It's a little

48:56

bit of a quandary you're in, you know, whether

48:59

or not to get the surgery. Is it worth the risk? All

49:02

that stuff? That's

49:04

all I got. I got nothing else to Uh,

49:07

it's anesthesia. If you

49:09

are feeling confident about spelling that word

49:11

correctly, go ahead and type it into the search

49:14

bar at how stuff works dot com. And

49:16

I said search for everybody, which means it's time

49:18

for a listener mail. Uh,

49:21

this one, I'm gonna call ESP. We

49:24

heard from a lot of people on this one so far. Yeah,

49:26

but it wasn't as bad as I thought. No. Um,

49:29

hey, guys, just listen to ESP. It was great as usual.

49:32

Your podcast help me get through my work day and make

49:34

me laugh because I learned new and random things.

49:37

With regards to ESP or whatever people

49:39

want to call it. I don't know if I believe in it exactly,

49:42

but I do strongly believe that some individuals are much

49:44

more intuitive or connected than others. Uh.

49:46

And here's an example. When I was eleven, my mother

49:48

died. We were living in Vancouver at

49:50

the time, and she had died at home. We had not yet

49:53

called any of the family to notify them until

49:55

a few hours later. But about fifteen

49:57

minutes after she passed away, my paternal

50:00

grandmother, who was in Hong Kong called

50:02

and said, is Lana okay. I

50:04

suddenly got a very strong and bad feeling about her, and I

50:06

thought I should call uh. And again we hadn't

50:08

told anyone yet and it had only been fifteen minutes.

50:11

My grandmother has always been very intuitive. It

50:13

always felt like no matter where our family was,

50:15

she always somehow had her eye on us

50:17

in a comforting way, not creepy. Right.

50:21

She points out she was devout

50:24

in practicing Buddhist her whole life, and it is partly

50:26

her devotion to Buddhism somehow makes

50:28

me believe that she was a soul deeply connected

50:30

to the rest of the world. Uh

50:33

yeah, kind of cool. YEA explain

50:35

that I think we pointed out in the ESP podcast

50:38

that probably the likeliest

50:40

explanations that the Buddha hands it out to

50:42

his most devout followers. There you have. It

50:45

looks like granny Uh. I

50:47

don't have her last name, but that is from

50:49

Joy and can in Hong Kong.

50:52

Uh. That's right, even though Joy is in Australia

50:55

can Canberra, Canberra,

50:58

Canberra, Australia and Thesia,

51:01

Hong Kong. Joy. Thanks

51:04

Joy, Yeah, thanks a lot. Joy. That's a good

51:06

story. Uh, and we got

51:08

some like that, Actually didn't We probably

51:11

more of those than Peter

51:13

doesn't work. We got very

51:15

few of those. I was really surprised. Yeah,

51:18

I thought we did a good job of laying it out

51:20

there. Uh. Well, if

51:22

you want to share a good family story

51:24

like Joy did, you can tweet

51:26

to us at s Y s K podcast. You

51:28

can join us on Facebook dot com, slash stuff

51:31

you Should Know. You can send us an email to Stuff

51:33

Podcast at how stuff Works dot com, and you

51:35

can visit our home on the web, Stuff you

51:37

Should Know dot com

51:43

for more on this and thousands of other topics.

51:46

Does it how stuff Works dot com