Speaker 1: M Hey everybody, it's Josh and for this week's select,
Speaker 1: I've chosen our two thousand fifteen episode on therapeutic hypothermia.
Speaker 1: It sounds weird and boring and it's a really super
Speaker 1: science EPP. But sometimes sometimes those can be the best ones.
Speaker 1: This topic is super interesting. It's a look at how
Speaker 1: science can stave off death and hopefully it's the direction
Speaker 1: that modern medicine is heading. Plus, if you get bored,
Speaker 1: you can thrill the hearing us. Try to say cellular
Speaker 1: level here or there. It's hilarious. Enjoy. I command you.
Speaker 1: Welcome to Stuff you Should Know, a production of I
Speaker 1: Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.
Speaker 1: There's Charles W. Eager Beaver, Chuckers Bryant ready to get
Speaker 1: its therapeutic hypothermia on. Yeah, baby, I'm chilling. Yeah, moving
Speaker 1: at a glacial paste today, right, I am um, I'm
Speaker 1: sorry for that. That was actually a poke at the
Speaker 1: author of this article. Yeah, that's uh. That stood out
Speaker 1: to me as well. I'm not telling you Jerry's over
Speaker 1: there and stuff you should know. No, I'm done. Um. Yeah,
Speaker 1: we were goofing off about this article and how stuff works.
Speaker 1: That there were way too many cold puns for my liking.
Speaker 1: There was a lot of puns, you know, a lot
Speaker 1: lots of them. Yeah, this article stinks of punt it reeks.
Speaker 1: So how you doing, man, how you feeling? I'm good? Uh,
Speaker 1: it seems there's a sickness going around the office. Yeah,
Speaker 1: which I thought we knew here in two thousand and
Speaker 1: fifteen that if you're sick, you don't come into work,
Speaker 1: especially when you have a liberal telecommune policy right like
Speaker 1: we do. I realized, Um, I realized that people need
Speaker 1: to come in and shoot video and recording all that.
Speaker 1: But come in, you do that, and you leave, and
Speaker 1: you wear like a plague doctor's mask the whole time
Speaker 1: you're here too. Yeah. I mean, I have a biohazard
Speaker 1: suit at my desk, but has a RiPP in it.
Speaker 1: Anyone can wear it, has a ripping. It's very small
Speaker 1: rental and cleaning fee. You're going to take a blood
Speaker 1: sample of mine wearing that thing. And it occurred to
Speaker 1: me as you were about to put it on, like
Speaker 1: I don't know where that thing has been, Like, that's
Speaker 1: a real biohazard suit and Chuck's going to use it
Speaker 1: to open my skin. Yeah, this sounds very odd. Um,
Speaker 1: we don't just do this in the office. We did
Speaker 1: our blood Types episode live here in Atlanta, and we
Speaker 1: actually took Josh's blood type on stage because you didn't
Speaker 1: know it. No, I when we recorded the version in
Speaker 1: the studio, I genuinely did not know it. Yeah, so
Speaker 1: I took your blood on stage. You trusted me. I
Speaker 1: did not wear the contaminated suit. No, you. You just
Speaker 1: used your dirty hands with no like rubber gloves or anything.
Speaker 1: Look at you. You're fine ish and you know your
Speaker 1: blood type now, which was a positive like Jarius, So
Speaker 1: we should release that whole live show. Is a just
Speaker 1: a special yeah little bonus. Yeah bonus. That was the
Speaker 1: word I was looking for. There's something special about it.
Speaker 1: It's just a bonus. That was special. Yeah, it's a
Speaker 1: good idea. Look for that soon people. So, uh, today, Chuck,
Speaker 1: we're talking about therapeutic hypothermia and I am very excited
Speaker 1: about this. This is my idea of this article. Yeah, Um,
Speaker 1: it's pretty neat. I don't remember. I guess I first
Speaker 1: heard of it from that Mosaic article that we both
Speaker 1: read to the big sleep awesome article. And uh, if
Speaker 1: you haven't figured out by now we have started to
Speaker 1: on the podcast page for each episode, put related links
Speaker 1: on there on our site stuff you should know dot com,
Speaker 1: so that articles on there. There's a bunch of other
Speaker 1: stuff on there too that will cover UM. But be
Speaker 1: sure to check out that mosaic article. It's very neat
Speaker 1: um and that article first introduced me to the concept
Speaker 1: of therapeutic hypothermia or medically induced hypothermia as another another
Speaker 1: term for it. I don't prefer target targeted temperature management.
Speaker 1: That sounds yeah corporate, Yeah, very corporate. You know the
Speaker 1: HMO term for it, like we'll we'll call it this
Speaker 1: because it'll less than the likelihood that we'll get sued
Speaker 1: or something exactly. Yes, yeah, I agree. But it's been
Speaker 1: around for a while, and the the idea that exposing
Speaker 1: people to lower temperatures to allow for better medical interventions,
Speaker 1: which is the whole basis of therapeutic hypothermia UM, has
Speaker 1: been around at least since the Napoleonic Wars. Yeah, it's
Speaker 1: pretty neat. I was interested to find that out. They
Speaker 1: noticed way back when in the eighteen hundreds early eighteen hundreds,
Speaker 1: uh that troops in battlefield trauma, wounded soldiers would the
Speaker 1: ones who were not kept warm and cozy by the
Speaker 1: fire or in their tents, right, they're just left out
Speaker 1: on the battlefield and the coals. Yeah, they actually fared better.
Speaker 1: And they were like, wait a minute, is uh And
Speaker 1: of course they had no idea at the time what
Speaker 1: was going on. No, they're like, did you notice that? Yes,
Speaker 1: I did notice that the heart well back to our brandy, Yeah,
Speaker 1: pretty much. But they did notice that the ones who
Speaker 1: were warm did a lot worse than the ones that
Speaker 1: were left out in the cold, which is super interesting. Yeah,
Speaker 1: But the the real investigation into what was going on
Speaker 1: there didn't start until the thirties with a guy named
Speaker 1: Dr temple Faye, and he was actually the first guy
Speaker 1: to write about using therapeutic hypothermia. I think in n
Speaker 1: was the first paper about it. But he was using
Speaker 1: it for a full decade or so before then, basically
Speaker 1: putting his patients in ice baths, opening the windows to
Speaker 1: their room during the winter, and um, just basically using
Speaker 1: any means he could to lower the temperature for I
Speaker 1: think I think he had he was using in a
Speaker 1: traumatic brain injury patients. Yeah, and I'm sure he did
Speaker 1: a lot of explaining along the way to family members
Speaker 1: that were like, hey, can you close the window and
Speaker 1: warm up my husband here? And that. He was like,
Speaker 1: all right, you wanted to I think back then too,
Speaker 1: he was like, it's the thirties and this guy is
Speaker 1: a traumatic brain injury. Really, there's nothing I can do
Speaker 1: to make it worse, the prospects worse, So why don't
Speaker 1: you just lighten up their family member? So there was
Speaker 1: another pioneer in the fifties named Dr Peter safar Um
Speaker 1: s A f A R. And he actually began experimenting
Speaker 1: around with this in the e er as well, trying
Speaker 1: to reduce tissue injury uh and brain image from a
Speaker 1: lack of blood flow. Uh. And this was mainly at
Speaker 1: the time in like stroke patients, cardiac arrest patients and
Speaker 1: what we'll talk more about it. There's all sorts of
Speaker 1: well not all sorts. There are several uses like cases
Speaker 1: where you would want to use this and UM ranging
Speaker 1: from cardiac arrest to like a gunshot wound to I think,
Speaker 1: what is the infant situation? Come again, it is called chuck.
Speaker 1: It's a type of encephalofy were ummic encephalofy. Yeah, where
Speaker 1: your natal basically the blood flow the lack of blood
Speaker 1: flow to the brains cut off for whatever reason, like
Speaker 1: maybe the umbilical cord gets rappidly on the baby's neck
Speaker 1: or what have you. Um, it leads to a swelling
Speaker 1: in the brain, and they started using it to medical
Speaker 1: the hypothermia to treat that. That's right, And that was
Speaker 1: in the fifties, right, Yeah, the fifties and sixties is
Speaker 1: when Dr Safar was doing his work. So this this
Speaker 1: is all kind of going on on the side and
Speaker 1: um experiments into hypothermia had kind of a bad name
Speaker 1: thanks to the Nazis, and a little bit also the
Speaker 1: Japanese and World War Two. But the Nazis, especially at
Speaker 1: Dock how the concentration camp or the death camp there
Speaker 1: um experimented using unwilling human subjects. Uh, they experimented on
Speaker 1: the effects of hypothermia in people's bodies. They did all
Speaker 1: manner of horrible, grizzly, gruesome stuff for they recorded the
Speaker 1: data and there was a long debate over the years
Speaker 1: over whether that data could be ethically used. And on
Speaker 1: one hand, people were saying, no, it's the Nazis. They
Speaker 1: used unwilling subjects. Is it amounted to torture in the
Speaker 1: name of science, and I just used air air quotes, right.
Speaker 1: And then other people said, well, wait a minute, these
Speaker 1: people died, um whether and we're whether they wanted to
Speaker 1: or not. They were made to be these test subjects
Speaker 1: and they gave their lives. We can honor them at
Speaker 1: least by using the data that was cold from it. Well,
Speaker 1: once they really dug into the data that the Nazis
Speaker 1: had accumulated, it was just like rank amateurs performing scientific experiments.
Speaker 1: They followed like almost no protocol. They did terrible record
Speaker 1: keeping of descriptions of subjects and things like that. So um,
Speaker 1: it's almost like you just have to toss it out
Speaker 1: because you just can't trust it scientifically the data. But
Speaker 1: but the idea that people were exposed forcibly to hypothermic
Speaker 1: conditions kind of gave hypothermia a bad name. So these
Speaker 1: guys experimenting with the stuff, it was fringe science for
Speaker 1: a while. Yeah, and then it started to come into
Speaker 1: the mainstream and then everybody said, well, wait a minute,
Speaker 1: hypothermia has all these bad side effects. Let's just table
Speaker 1: it for now. Yeah. In the in the fifties to
Speaker 1: NASA was doing a lot of work during the Space
Speaker 1: Race because the idea was and this is really sort
Speaker 1: of two parts. There's the the modern day uh cooling
Speaker 1: like that's not freezing somebody basically, and then we also
Speaker 1: have what's called suspended animation, which we'll get too later.
Speaker 1: Those are totally different things, totally different things, but they
Speaker 1: follow the same process initially, right yeah, um, well sort of,
Speaker 1: I mean the methods are different, but the same idea
Speaker 1: basically is to slow the body down, sown the heart rate,
Speaker 1: slow down everything, your metabolism. Yeah. Um. But NASA was
Speaker 1: doing this because they put a lot of money into
Speaker 1: it because they thought two things. One you could protect
Speaker 1: astronauts from cosmic rays and the other is basically straight
Speaker 1: up alien like we can freeze people on long journeys
Speaker 1: into space and then unfreezing when they get there, which
Speaker 1: is not just alien. That's a bunch of sci fi movies.
Speaker 1: But there was a doctor named James Lovelock back in
Speaker 1: the day who was um freezing hamsters until they froze
Speaker 1: and then basically until he couldn't hear heartbeat frozen, yeah,
Speaker 1: they were clinically dead. Yeah, and then they would he
Speaker 1: would put a little, uh, a little hot teaspoon against
Speaker 1: their belly and warm him back up, and he found
Speaker 1: that they were actually okay, and he was able to
Speaker 1: revive them some of them. Well sure, yeah, I'm sure
Speaker 1: there were losses along them, but I mean even one
Speaker 1: coming back to life and seeming normal again, it is
Speaker 1: pretty significant. It's a significant finding, Yeah, because basically the
Speaker 1: idea was planted all of a sudden that hypothermia can
Speaker 1: kill you or it can preserve you and keep you
Speaker 1: from dying in an extreme situation, right, which is kind
Speaker 1: of counterintuitive. Like you think of people who undergo hypothermia
Speaker 1: or you know, being exposed to extremely cold temperatures, they're dead.
Speaker 1: I mean, we've all seen the shining, we know the end. Yeah,
Speaker 1: But apparently there's a rule of thumb among the er
Speaker 1: physicians and staff that there's no such thing as a
Speaker 1: cold dead body. I thought it was measured twice cut once.
Speaker 1: It's a little different. That's for the surgeons. Um, No,
Speaker 1: there's no such thing as a as a cold dead body.
Speaker 1: You're only dead when you're warm and dead, right, Because well,
Speaker 1: there's been some some cases throughout the years. The one
Speaker 1: that spectacular one. Yeah, this lady um was she with
Speaker 1: Norwegian on a boggenhorn. Um, I don't even know what
Speaker 1: that is. It's not an oom out, it's a single
Speaker 1: circle above that A. That's a it's a very Norwegian. Yeah,
Speaker 1: death metal band name totally. Uh So she was skiing
Speaker 1: and um, actually I think she was Swedish, but she
Speaker 1: was on holiday skiing in Norway. Um fell headfirst into
Speaker 1: a frozen stream and was trapped under ice, submerged for
Speaker 1: eighty minutes, stopped breathing, heart stopped. Yeah. I mean she
Speaker 1: was well known. She didn't drown. They thought she drowned
Speaker 1: until they reheated her. Ten days they reheated her and
Speaker 1: she was fine, Like weeks and months later she fully recovered.
Speaker 1: And basically, if you're underwater warm water, you have a
Speaker 1: few minutes at most. But what they discovered was if
Speaker 1: you actually go into hypothermia, it can preserve your body. Um,
Speaker 1: which was amazing and a big breakthrough into like, hey,
Speaker 1: maybe we can use this right. Yeah, she was one
Speaker 1: of a few a handful of people and we'll talk
Speaker 1: about some others too, but um, that what researchers into
Speaker 1: hypothermia I've learned and why they figured out that they're
Speaker 1: you're not cold and dead you're just warm. And debt
Speaker 1: is that it's not the the the addition of cold
Speaker 1: or the exposure to cold that kills you. It's warming
Speaker 1: back up in the wrong way too rapidly under the
Speaker 1: wrong circumstances stances that that's what can kill you. Yeah,
Speaker 1: it seems like it's a very fine line between well,
Speaker 1: we'll talk about the process, but you have to do
Speaker 1: it just right on the cooling side and the warming
Speaker 1: side if you want to be successful right exactly. You know,
Speaker 1: it's they haven't quite figured it all out yet. This
Speaker 1: is in the very uh nascent stages. Still. It is
Speaker 1: ridiculously primitive and and to the point where it's kind
Speaker 1: of like if you're a doctor experimenting with this, you
Speaker 1: you would be like, there's a d chance that your
Speaker 1: dad is going to die under normal circumstances. We have
Speaker 1: this one radical technique we can try that might help.
Speaker 1: Can we try this? And that that that whether they
Speaker 1: had lives or dies after being given medical hypothermia, he's
Speaker 1: still going to end up as like the subject of
Speaker 1: a major paper that would be written, because that's where
Speaker 1: it's at right now. Yeah, And I read one doctor
Speaker 1: said that they they think they pretty much know, it's
Speaker 1: super possible and we'll work, he said, But it's the
Speaker 1: the doing of it that's just really really hard. Exactly. Yeah,
Speaker 1: I mean like it makes a complete sense intuitively, we
Speaker 1: understand like what it's doing. It's just yeah, the fine tuning,
Speaker 1: the nuance behind it that it's still kind of mysterious.
Speaker 1: The most brilliant doctors say, it's just really hard. He said,
Speaker 1: it's really dog gone hard to do. It kind of
Speaker 1: makes you go, yeah, you know, is that the quote?
Speaker 1: He know, his quote was, it's really dog gone hard.
Speaker 1: And then my quote was, but we'll talk about medical
Speaker 1: hypothermia and what it is specifically, uh, in just a
Speaker 1: minu alright, so therapeutic hypothermia. Hypothermia is basically when you
Speaker 1: lower the body temperature for various reasons to keep it alive.
Speaker 1: And right now, what they're mainly doing now, this isn't
Speaker 1: the second wave, which is freezing somebody. This is just
Speaker 1: cooling a body before and after surgery to help them
Speaker 1: increase their chances of survival. Basically, right, your your body. Um,
Speaker 1: and they're doing that now on this side, they're just
Speaker 1: not doing the other quite yet on humans. Yes, um,
Speaker 1: so under normal circumstances, your body maintains a normal core
Speaker 1: body temperature, normative temperature because what it's called, right, and um,
Speaker 1: that's somewhere between like nineties in nine point six degrees
Speaker 1: is a normal human core body temperature. And all of
Speaker 1: this is and dude, do you remember and like when
Speaker 1: I went on that crazy, weird metaphysical tangent and does
Speaker 1: the body replace itself? Somebody wrote in and said, check
Speaker 1: this article out, like here's a really great explanation of
Speaker 1: why things live, where life comes from. And it was this, um,
Speaker 1: this idea, it's a physics based idea of life and evolution.
Speaker 1: And it says that because of entropy, because of one
Speaker 1: of the laws of thermodynamics, that atoms will arrange themselves
Speaker 1: in a way that they can take in energy and
Speaker 1: dissipate heat in a really efficient manner. And so of
Speaker 1: course they're gonna atoms are eventually going to arrange themselves
Speaker 1: into life. It just makes total sense. Right, So, being
Speaker 1: living things like we are, we take in energy and
Speaker 1: we dissipate heat, and that's what forms our core body temperature. Right.
Speaker 1: With therapeutic hype of thermia, what you're doing is lowering
Speaker 1: the metabolic rate through the addition of cold, and so
Speaker 1: we put out less heat, and by doing that, we're
Speaker 1: also lowering our energy demand, so that that that little
Speaker 1: engine that's going all the time and our cells and
Speaker 1: our body in general gets slowed down. And it's not
Speaker 1: altered in any way except for the speed and the
Speaker 1: energy consumption. It's just slowed down. It's doing everything slower.
Speaker 1: And you can do that simply by lowering the temperature
Speaker 1: of the person. Yeah, and it's it's not just lower,
Speaker 1: it's um it doesn't need to be faster. Does that
Speaker 1: make sense, Like the heart beat slower because it doesn't
Speaker 1: need to beat any faster, not like your body is struggling.
Speaker 1: Your body is still doing fine. It's just reducing the
Speaker 1: demand for stuff like blood flow and neurotransmitter action and
Speaker 1: stuff like that exactly. And ultimately, what your heart does
Speaker 1: is pumps blood. And what your blood has this, among
Speaker 1: other things, oxygen, and your cells need oxygen to carry
Speaker 1: out these metabolic processes to burn energy, right, So if
Speaker 1: they need less, then your heart doesn't have to beat
Speaker 1: as much. It's like you said, it's just the normal processes,
Speaker 1: but on a much slower scale. Pretty awesome stuff. It is,
Speaker 1: and it's just through the application of colder temperatures. Oh yeah,
Speaker 1: and in this case UM, and we'll get to how
Speaker 1: to do it. But in this case you're not I
Speaker 1: mean you're literally cooling the body with like ice packs
Speaker 1: and cold blankets and stuff like that pre surgery and
Speaker 1: post surgery. It's not the suspended animation one that we'll
Speaker 1: get to when they're actually like pumping frozen saline through
Speaker 1: your pains. No, there are, but there are some UM
Speaker 1: techniques for medically induced hypothermia that do put in like
Speaker 1: chilled saline to chill your body down very quickly. But
Speaker 1: it's not like replacing your blood. Yeah yeah, yeah, I
Speaker 1: hear you. So there's a couple of applications at this point.
Speaker 1: End the cases are either involved intervention or prevention, and
Speaker 1: intervention is when they're trying to prevent further damage from
Speaker 1: an incident like a stroke or cardiac arrest or sort
Speaker 1: of the two main ones UM and then preventative wise,
Speaker 1: it's to extend operating time because back in the day
Speaker 1: you could not operate on UM. Well, back in the
Speaker 1: day you couldn't stop the heart to operate on it. No,
Speaker 1: which was I do remember we did like this day
Speaker 1: in history about the first guy to ever do open
Speaker 1: heart centuries of Black surgeon in Chicago the early twentieth century,
Speaker 1: I think, and he did an emergency open heart surgery
Speaker 1: with a beating heart. That guy was totally awesome, champion. UM.
Speaker 1: This was the case for a very long time, and
Speaker 1: you couldn't stop the heart. They finally invented a machine
Speaker 1: UM that basically does the work of the heart and
Speaker 1: the lungs, called the Heart Lung machine. Exactly where you're
Speaker 1: transferring blood through this machine and UM, it's removing c
Speaker 1: O two, it's adding oxygen, and it's pumping it back
Speaker 1: into the body while the heart and lungs are stopped.
Speaker 1: Revolutionized open heart surgery. There's problems with it. One of
Speaker 1: the problems is um when the blood comes back in
Speaker 1: the body, since it's been through this machine, it may
Speaker 1: have picked up some sort of foreign in bacteria, and
Speaker 1: the immune system sometimes mounts an attack on the blood.
Speaker 1: So this this machine poses its own problems. And alternatively,
Speaker 1: an alternative method for stopping the heart or slowing the
Speaker 1: heart is to use medically induced hypothermia. So that's an intervention, no,
Speaker 1: a prevention preventative use of medically induced hypothermia. But intervention
Speaker 1: is another way, like you said, and it can have
Speaker 1: to do a stroke or heart attacks or cardiac arrest. Right,
Speaker 1: aren't those two different things? I think so technically, but
Speaker 1: in some sort of cessation of the heart pumping blood.
Speaker 1: And the big problem with that it doesn't really matter
Speaker 1: whether your hand is getting blood for a while. The
Speaker 1: big problem that comes from a heart attack is your
Speaker 1: brain not getting blood for a while. Right, So here's
Speaker 1: what happens when blood stops flowing into your brain. Right,
Speaker 1: And we we covered this somehow in the How Dying
Speaker 1: Works episode. Yeah, the dying process. Okay, because it's not
Speaker 1: a it's not a black and white thing. Uh, you're
Speaker 1: not alive and then you're dead. It's comes in many
Speaker 1: many stages. And we talked about the stages of death. Yeah,
Speaker 1: so there's when what they've discovered is that, yeah, you're
Speaker 1: not like I'm alive and now I'm dead. Is what
Speaker 1: we covered in the How Dying Works episode? Right, Like
Speaker 1: dying in your sleep? I mentioned that the other day.
Speaker 1: How like nobody dies in their sleep. That's just a
Speaker 1: nice thing. That's a nice way to say they died
Speaker 1: in their bed. Yes, overnight, overnight, Yeah, exactly. Um so, yeah,
Speaker 1: there's with medically induced hypothermia, they've been able to extend
Speaker 1: that that time between when you appear to be dead
Speaker 1: and when you're actually dead, and by extending that time
Speaker 1: they can intervene UM better. And Yeah, even a little
Speaker 1: bit of time can go a long way. So one
Speaker 1: of the one of the things that medically induced hypothermia
Speaker 1: has been shown to really help is what's called return
Speaker 1: of spontaneous circulation after uh, you have a heart attack.
Speaker 1: The problem is is your heart and lungs can your
Speaker 1: cardio pulmonary system can start working again, but you might
Speaker 1: not regain consciousness. And in that case, that's a sign
Speaker 1: that your brain may be in trouble, your cognitive function,
Speaker 1: you may be suffering brain damage at that moment. Yeah,
Speaker 1: And isn't the stat one and ten cardiac arrest outside
Speaker 1: of a hospital has a like goes on to live
Speaker 1: like a without brain damage. Yeah, ten, only because you
Speaker 1: have a very small window and that window is usually
Speaker 1: longer than it takes to get to the hospital. Right,
Speaker 1: So if they bring you in and you are showing
Speaker 1: signs of um r OSC without return to consciousness, too um.
Speaker 1: They may induce medical medical hypothermia. And the reason why
Speaker 1: is the heart pumps blood, and blood contains things including
Speaker 1: oxygen right um. And one of the organs that uses
Speaker 1: probably the most oxygen of all, is the brain, and
Speaker 1: the brain uses its oxygen to um burn energy. Basically,
Speaker 1: it uses it to oxidize glucose. And when it does that,
Speaker 1: the reason it does is because you're neurons, your little
Speaker 1: neural cells that fire. The way they fire is because
Speaker 1: their chemical battery, their chemical battery with the stored potential charge,
Speaker 1: and they do that by keeping a lower concentration of
Speaker 1: electrolytes inside the cell than outside. So this difference creates
Speaker 1: the electrical charge that your neurons used to fire. Right
Speaker 1: on normal circumstances, that's all well and good, but when
Speaker 1: they stop, when they stop getting oxygen, they can switch
Speaker 1: to anaerobic mode for a little while, so they're still
Speaker 1: burning energy, but they're like, you need to start breathing again,
Speaker 1: because this is not very efficient. It's like the like
Speaker 1: when the emergency lights go on exactly exactly. So um.
Speaker 1: As a byproduct of anaerobic um respiration, you get the
Speaker 1: stuff called lactic acid. Lactic acid in and of itself
Speaker 1: isn't bad, but it can build up. One of the
Speaker 1: other things that happens to when these um when this uh,
Speaker 1: when that runs out, is the difference between electrolytes inside.
Speaker 1: Now inside the cell stops like it, it evens out,
Speaker 1: and now all of a sudden you have things like calcium, potassium,
Speaker 1: sodium coming in and out of the cell as much
Speaker 1: as they please, and the cell is like, what is
Speaker 1: going on? This isn't good and releases its store of glutamate.
Speaker 1: And glutamate is a neurotransmitter that excites neurons, and again
Speaker 1: in very small amounts, totally fine, it's needed. But when
Speaker 1: a neuron just freaks out and dumps all that into
Speaker 1: a synapse, it sets off that neuron and all these
Speaker 1: other neurons and makes them go totally crazy, and it
Speaker 1: also um lowers their structural integrity. So all of a
Speaker 1: sudden you have neurons going nuts, dumping their contents everywhere,
Speaker 1: and then creating also free radicals, which are um atoms
Speaker 1: with unpaired electrons, and they run up against the cellular
Speaker 1: structure and the cell walls and start borrowing electrons from
Speaker 1: those atoms, and that weakens the structure even more so,
Speaker 1: even more stuff gets dumped out into the inter cellular matrix,
Speaker 1: and you have a problem. This is a really big
Speaker 1: problem in and of itself. Right, you're still with me, Okay,
Speaker 1: that's what happens when you stop getting blood flow. It's
Speaker 1: just as bad, if not worse, when you start getting
Speaker 1: blood flow again, because you have all these damaged cells.
Speaker 1: You have dead cells. And when you have dead cells
Speaker 1: that have dumped their contents, one of the roles that
Speaker 1: your white blood cells, your immune system plays is to
Speaker 1: come clean up dead cells because that's toxic stuff. That's
Speaker 1: bad stuff, and you need to get it out of
Speaker 1: your body. So when blood flow reach turns again, all
Speaker 1: of those white blood cells come to the site of
Speaker 1: this problem, your brain, and they start cleaning up. Well.
Speaker 1: When they do, and inflammatory reaction happens, and all of
Speaker 1: a sudden you have swelling in your brain and the
Speaker 1: process gets even worse. So these these um structurally challenged
Speaker 1: neurons don't just erupt immediately. They do immediately, but it
Speaker 1: can continue for hours and days afterwards. And all of
Speaker 1: this happens from a heart attack. But by applying cold
Speaker 1: temperatures and bringing hypothermion and somebody you can actually stop
Speaker 1: this process. You can stop the glutamate from ever being dumped.
Speaker 1: They're finding and so give time basically for your brain
Speaker 1: to to rebuild itself in the way it needs to
Speaker 1: by lowering that metabolic rate that your your neurons need.
Speaker 1: That's what it does for for a heart attack, cardiac arrest.
Speaker 1: They're definitely two different things. I looked it up and
Speaker 1: someone's gonna say, you guys should do a podcast on
Speaker 1: that because you don't know what you're talking about. Right,
Speaker 1: it's coming. So probably after that we should take a
Speaker 1: little break, huh, I think. So you want to get
Speaker 1: some tea, yeah, and uh we'll be back with more
Speaker 1: cool stuff. All right, So how is this magic done?
Speaker 1: It's pretty easy. Actually, yeah, it's easy in theory. But
Speaker 1: there are generally three stages UM for therapeutic hypothermia, and
Speaker 1: they are induction, maintenance, and rewarming, and they are all
Speaker 1: very carefully monitored and have to be done just right. Uh.
Speaker 1: So when they go to cool the patient, um, they
Speaker 1: will first thing you'll do is sedate them because shivering. Uh,
Speaker 1: shivering is the body's way of trying to stay warm.
Speaker 1: Like your body wants to be warm, is going to
Speaker 1: do everything it can until you die, like Jack Nicholson
Speaker 1: outside the maze and the shining exactly to stay warm. Yeah,
Speaker 1: and you can't have a body shivering because number one,
Speaker 1: it fights off that hypothermia you're inducing, right. Number two,
Speaker 1: that uses a lot of energy, which is what you're
Speaker 1: combating right there. You're trying to slow the metabolic right,
Speaker 1: not increase it, right, and you want a patient that's
Speaker 1: still as well. Like one of the problems I've seen
Speaker 1: is the problem with doctors like performing in these conditions
Speaker 1: because like stop squirming. Well that too, and they have
Speaker 1: to keep the room very cold. It's not like they're
Speaker 1: in like an eighty degree room and they're trying to
Speaker 1: keep them like everything is cold. So the doctors have
Speaker 1: to perform under those circumstances too, so they may shiver themselves.
Speaker 1: But to keep the patient from shivering, they just solve
Speaker 1: that problem by injecting them with the paralytic exactly, so
Speaker 1: now they're nice and still they're cooling down. Uh. The
Speaker 1: cheap way to do it, which is um and they're
Speaker 1: not doing it because it's cheap, but um ice packs
Speaker 1: basically armpits growing chest. They're basically wrapping your legs up
Speaker 1: and everything they can with ice packs, and that's just
Speaker 1: gonna cool you down pretty quickly. Um. Like you said,
Speaker 1: they will sometimes use like catheters or a chilled saline solution.
Speaker 1: Those are more invasive and more dangerous. They also work
Speaker 1: a lot quicker. Yes, very much. And I think they
Speaker 1: want to cool people down pretty quickly too, um, which
Speaker 1: is I don't think they want to do the cooling
Speaker 1: parts slow. No, And that's a really good point. I'm
Speaker 1: glad you brought that up. Especially if you're bringing a
Speaker 1: patient's body down, um to a really low temperature, you
Speaker 1: have to protect against ice crystals forming in the cells
Speaker 1: because that can erupt your cells and that's a whole
Speaker 1: set of other problems. Right, So if you bring the
Speaker 1: temperature down very quickly, you can prevent ice crystals from forming,
Speaker 1: that's right, because they require time to form. Yeah, if
Speaker 1: it's so, if it's super fast, they won't they won't form.
Speaker 1: That's the impression I have. Okay, So during the maintenance phase,
Speaker 1: it's you know exactly how it sounds, are just maintaining
Speaker 1: that temperature, keeping a very close eye again, using these
Speaker 1: cold water packs or forced cold, forced air blankets and
Speaker 1: things like that. Um huh, they sound kind of cool,
Speaker 1: the forced cold their blanket that. Yeah, they'd be nice
Speaker 1: for these Atlanta summers. Get ahold of one of those. Uh.
Speaker 1: And there are a lot of risks along the way.
Speaker 1: Arrhythmia is a very big risk. Uh. And electrolytes leaving
Speaker 1: like potassium, which is necessary for the heart muscle to
Speaker 1: function as it should. Um, so they're they're pumping the
Speaker 1: electrolytes back into you because you're losing them. So again
Speaker 1: they're just maintaining everything. And then the rewarming part has
Speaker 1: to be done very very slow. Uh, otherwise you know,
Speaker 1: very bad things can happen. And we're talking um point
Speaker 1: to seven to point nine degrees per hour fahrenheit fahrenheit
Speaker 1: point one five to point five degrease celsius per hour. Yeah,
Speaker 1: those super very slow rewarming process, that's right. But if
Speaker 1: you've got a good forced air blanket, you can really
Speaker 1: control the warming. You get a good brand, not some
Speaker 1: off brand. And again they're not like, oh well if
Speaker 1: we um, if we heat the person back up at
Speaker 1: point one five degree celsius per hour, then this is
Speaker 1: what's going to happen. On a cellular level, like they're
Speaker 1: not quite there yet. They just know that that's the
Speaker 1: sweet spot for rewarming somebody, So chuck. One of the
Speaker 1: really um problematic side effects with rewarming a person is um. Yeah,
Speaker 1: they're like, why you start to get gaming while you
Speaker 1: were under um is uh blood clots. So when you're
Speaker 1: when your blood stops pumping because your metabolic rate is
Speaker 1: so low, the blood inside you starts to form clots
Speaker 1: thanks to your red blood cells and your platelets and um.
Speaker 1: When you warm back up, all of a sudden, you
Speaker 1: have clots all over your body. And that's a real
Speaker 1: problem that that alone can kill you. And that's part
Speaker 1: of the problem with the rewarming process. But it turns
Speaker 1: out that investigation into animals that hibernate, they found that
Speaker 1: animals have some sort of technique to where their red
Speaker 1: blood cells just kind of disappear, and then once the
Speaker 1: animal comes out of hibernation, it reappears. They don't even
Speaker 1: know where they go, no, but they do know that
Speaker 1: they don't get rid of them somehow and then regenerate
Speaker 1: some other ones because their reappearance is so fast that
Speaker 1: they just think the body somehow absorbs them and then
Speaker 1: releases them again. Yeah. And the other really cool thing
Speaker 1: and we're kind of into hibernation right now, which we'll
Speaker 1: talk about in more detail, but um, white blood cells. Uh,
Speaker 1: Hibernators remove white blood cells from their blood and storm
Speaker 1: in the lymph nodes and then about an hour and
Speaker 1: a half after these animals awake, they reappear. And this
Speaker 1: has a couple of functions. One is, when you're an
Speaker 1: animal undergoing hibernation, Uh, your immune system is going to
Speaker 1: be compromised because as white cells are in storage. Right,
Speaker 1: that's a problem. Yeah, it's a problem. But just knowing
Speaker 1: that animals can do these neat little tricks with their
Speaker 1: platelets and white blood cells, uh, could have like big
Speaker 1: effects on us if we can figure that out for ourselves.
Speaker 1: Well yes, specifically also chuck, because remember when we were
Speaker 1: talking about, um, your your neurons dying. Yeah, and when
Speaker 1: you reperfuse, when you bring blood back to the brain again,
Speaker 1: one of the things that brings with it is those
Speaker 1: white blood cells and they start going on the attack.
Speaker 1: So if you can figure out how to take white
Speaker 1: blood cells out of the equation, it's going to reduce
Speaker 1: things like post warming swelling, which can give you brain
Speaker 1: damage itself. Yeah, and you talked about the heart lung machine.
Speaker 1: One of the big dangers with that machine is a
Speaker 1: septic sepsis. And if you have those uh white blood
Speaker 1: cells stripped away, then you're not going to be at
Speaker 1: risk for that, right and um, they'll be able to
Speaker 1: uh hang on to blood longer. Right now. Blood donations
Speaker 1: can only be kept a weak um it goes rank quick, yeah,
Speaker 1: and um transplant organs can be UM basically cryo protected
Speaker 1: for longer too, which is pretty neat. So uh, I
Speaker 1: guess we should talk about hibernation for a minute because
Speaker 1: it's one of the neatest things in nature. I think,
Speaker 1: uh in torp or basically torpor short periods of hibernation
Speaker 1: reduced body temperature and inactivity. And when you link a
Speaker 1: bunch of torpors together, that's full on hibernation. So yeah,
Speaker 1: it's also like a like hibernation light too, Yeah, you
Speaker 1: know what I mean, Like you can you can be
Speaker 1: I think a bear inners torpor where it's it wakes
Speaker 1: up like every once in a while and eats or
Speaker 1: poops or does something. And then there's some animals where
Speaker 1: you can just shake them like this and they will
Speaker 1: not wake up and they're in full on hibernation. Yeah,
Speaker 1: and the animals have to prepare for this. They just
Speaker 1: don't go betty by and stay asleep for a long time. First,
Speaker 1: they become diabetics basically by gorging on food and becoming obese.
Speaker 1: It sounds familiar, uh and um, but it doesn't affect
Speaker 1: like humans does. It doesn't make them unhealthy, like their
Speaker 1: body knows it's preparation for hibernation, knows what to do
Speaker 1: with it exactly. Plus they're probably also eating unprocessed foods too,
Speaker 1: which I think makes a difference. Yeah, you know, I
Speaker 1: think so. Um, they don't atrophy like humans do. Like
Speaker 1: when we lay around in bed, we don't our muscles
Speaker 1: will atrophy. Um. Animals can go months and months without moving.
Speaker 1: Spectacular spectacular. It also kind of suggests that humans aren't
Speaker 1: supposed to hybridate. Yeah. Well, although you know, when they
Speaker 1: found some of these frozen people, they start to think
Speaker 1: maybe human hibernation isn't such a bad thing. Um. Their
Speaker 1: lungs when you hibernate, become covered at the really thick
Speaker 1: like mucacy uh deposits um. It basically looks like a
Speaker 1: human with asthma, but it's you know, a protective measure. Again. Uh,
Speaker 1: they go in their brains kind of um go into
Speaker 1: a stage that looks like early Alzheimer's. Again, not a
Speaker 1: bad thing, it's just preparation. Uh. And it's weird. I mean,
Speaker 1: it looks like animals are almost dying when they're preparing
Speaker 1: for hibernation. Well some cases, and sometimes they do, especially
Speaker 1: when they're forced to come out of hibernation and then
Speaker 1: go back in. Their energy stores aren't aren't built for
Speaker 1: that kind of thing, like, so they probably will die
Speaker 1: because they'll start to death because it required so much
Speaker 1: energy to wake back up again. Or they're also vulnerable
Speaker 1: to predators too. Yeah, good point, which makes you wonder, like,
Speaker 1: what's the point of hibernation, And the point is, well,
Speaker 1: it's they don't have enough energy to go elsewhere when
Speaker 1: temperatures get cold, so they just kind of shut down
Speaker 1: their metabolic demand when food becomes years. Yeah and um,
Speaker 1: for the longest time, we didn't think that any um
Speaker 1: uh primates could hibernate until two thousand four when they
Speaker 1: found a lemur from Madagascar that could hibernate and uh,
Speaker 1: well at least go into the regular torpor hibernation light
Speaker 1: still and they said, we share about nine of our
Speaker 1: genes with the lemur, and they said it's basically like
Speaker 1: our cousin. Yeah, I mean that. The doctor basically said
Speaker 1: it would be really remarkable if the ability to hibernate
Speaker 1: light within that two that we don't have, So basically
Speaker 1: humans may have more of an ability to do this
Speaker 1: than we think. It would just have to be medically induced. Well,
Speaker 1: you know who demonstrates that very well, Chuck. Who's that?
Speaker 1: A man named mitsu take Uchi Koshi. Oh, yeah, we
Speaker 1: talked about him. What do we talk about him? And
Speaker 1: was it cryogenics episode? It was a long time ago.
Speaker 1: I do remember that one. Yeah, that's a good one.
Speaker 1: That was a good title. But yeah, I remember this
Speaker 1: guy though. For so. He is a Japanese man who,
Speaker 1: at age thirty five, was hiking with some friends in
Speaker 1: Japan and he decided to turn back by himself to go,
Speaker 1: I don't know, get something out of his car, and
Speaker 1: he wandered off and apparently in a meadow, um tripped
Speaker 1: over a rock and fell and hit his head on
Speaker 1: another rock and laid there in exposed to these cold
Speaker 1: temperatures on this mountain for twenty four days, and he
Speaker 1: was found basically in a state of hibernation. His body
Speaker 1: temperature was through the floor and um, he had almost
Speaker 1: no pulse. His temperature was seventy one degrees which is
Speaker 1: twenty two degrees celsius. That's his body temperature. That's pretty
Speaker 1: that's like a hypothermic state. And he was in this
Speaker 1: weird kind of state of suspended animation for twenty four days.
Speaker 1: He went without food, water, nothing, just laying there um
Speaker 1: living in some weird way until he was rescued and
Speaker 1: returned to um complete normalcy. Yeah, it's like the lady
Speaker 1: the skier who was frozen, not nearly for as long.
Speaker 1: But these cases where humans bodies are defying what we
Speaker 1: thought they could do, you can give us insight into, like, hey,
Speaker 1: how do we manipulate this for good? How do we
Speaker 1: use this to get to the stars. Alright, So I
Speaker 1: mentioned earlier that NASA was kind of leading the charge
Speaker 1: for UM this really cool suspended animation where you're basically
Speaker 1: freezing a person like Han Solo um in carbonite. Yeah,
Speaker 1: except it's not carbonite. It's not exactly like that, but
Speaker 1: it's it's sort of like that. Actually, it's not like
Speaker 1: that at all. Right, um And where NASA dropped off,
Speaker 1: the U. S. Army picked back up with some funding
Speaker 1: because they basically said on the trauma hospitals during wartime
Speaker 1: are chaos because you're trying to to save a person.
Speaker 1: You're trying to treat their immediate wound, you're trying to
Speaker 1: stabilize them, you're trying to make them better, you're trying
Speaker 1: to prevent blood loss. It's it's not an easy thing
Speaker 1: to do. It's not like mash you know, where they
Speaker 1: just make it look super simple. Right, Well, everybody's drunk
Speaker 1: on homemade gin. Yeah, so they're thinking, Um, I wonder
Speaker 1: what that stuff tasted like I always wondered. But they're
Speaker 1: still they seem to like it pretty much pretty well
Speaker 1: because they didn't have anything, I know, but they really
Speaker 1: seemed to enjoy it well. The way they handled it
Speaker 1: was very much like a fine martini. But you know,
Speaker 1: it's just like swill. I don't know they were at
Speaker 1: it for several years. Yeah, that's true. We'll have to
Speaker 1: ask Allan all of the um Man, I'd love to
Speaker 1: meet that guy. Oh yeah, one of my heroes. For attention,
Speaker 1: Alan all the reach out to us. So Chuck can
Speaker 1: meet too, that would be great. My brother met him,
Speaker 1: I'm sure he did. Probably gets Christmas cards, phone, No,
Speaker 1: but he did get a picture with him, which is
Speaker 1: pretty neat. It's nice. Um, So where was I? Oh, yeah,
Speaker 1: mash operating rooms. Yeah, because if you're a doctor, even
Speaker 1: in a battle field hospital, you're like, I want a
Speaker 1: coffee break too, and so to be like, I don't
Speaker 1: have time for this guy right now. Freeze him to
Speaker 1: have that ability that would be magnificent. Or if you
Speaker 1: did have time for the guy, but you literally didn't
Speaker 1: have time to fix these horrific wounds that he came
Speaker 1: in with, you could also say, freeze him to buy
Speaker 1: me some time, and that will let will give you
Speaker 1: the time to basically operate on this guy and completely
Speaker 1: repair heart or his brain or what have you. Um.
Speaker 1: And that's what medically induced hypothermia does. It's just it
Speaker 1: buys you time for either the body to heal itself
Speaker 1: in ways we don't understand, or for you, the surgeon
Speaker 1: to sew somebody up who without hypothermia would just be
Speaker 1: a lost cause. Yeah. There's a doctor named Sam Tishrman
Speaker 1: from the University of Maryland chirps working with the University
Speaker 1: of Pittsburgh. UM, what are they panthers? University of Pittsburgh,
Speaker 1: pitt panthers. I think so that sounds right. It does,
Speaker 1: we'll go with panthers. Panthers. Uh. If I got that right,
Speaker 1: I'm so sorry, Pittsburgh. We'd love you. UM. But he
Speaker 1: is working hard to UM basically UH put patients into
Speaker 1: severe hypothermia or suspended animation. And they're calling this emergency
Speaker 1: preservation and resuscitation. And this is the one that they
Speaker 1: haven't yet experimented on humans. They think they're pretty close,
Speaker 1: but this is the one where they flushed the body
Speaker 1: with freezing cold saline solution UM, which prevents ice from forming. Yeah,
Speaker 1: and it's worked on dogs, and I think it works
Speaker 1: on dogs. Got work on humans. Well, they did some
Speaker 1: experiments on pigs too, because one of the one of
Speaker 1: the things they think they can do where it's not
Speaker 1: like if you've had a hard cardiac arrest or a stroke,
Speaker 1: but again with trauma like a gunshot, you just can't.
Speaker 1: And I didn't I never knew this. You can't resuscitate
Speaker 1: a person with CPR that's had blood loss due to
Speaker 1: trauma it's completely different than cardiac arrest. Why because it's
Speaker 1: a close circulatory system has been opened. I have no idea.
Speaker 1: I bet that's it. Because of the dropping blood pressure.
Speaker 1: It's just not working. It's like sucking through a straw
Speaker 1: that has a hole beneath your lips. Like a lot
Speaker 1: of it's escaping, A lot of the air's escaping, so
Speaker 1: you can't get as much draw. Yeah, I guess that
Speaker 1: makes I bet that's what it is. All right, Well
Speaker 1: we'll probably find out. Um, but with ellen all with
Speaker 1: trauma like a gunshot wound or something, or a stab
Speaker 1: wound where you've lost so much blood you're dying. Um.
Speaker 1: This is when they're using these super super cold temperatures. Um.
Speaker 1: It's a tube inserted into the a orda literally And
Speaker 1: they've done this on pigs. In two thousand six, they
Speaker 1: examined um deep profound and ultra profound freezing of pigs
Speaker 1: who had uncontrolled bleeding wounds. And I imagine and then
Speaker 1: imagine they induced those as well. Piggy grad student. Yeah,
Speaker 1: there's one creep post doc to get to do you know,
Speaker 1: all the stabbings. Um, that's why I'm here. I'll get Ronnie.
Speaker 1: Um and they found that the ones who went underwent
Speaker 1: the most profound hypothermia had the highest survival rates, like
Speaker 1: those French soldiers on the battle exactly. And then in
Speaker 1: two thousand they did the same thing with dogs, except
Speaker 1: that why they weren't stabbed, it was dogs and cardiac arrest. Um,
Speaker 1: they may have induced that too though, come to think
Speaker 1: of it, they'd be like, do you want this bone?
Speaker 1: Now you can't have it. But they used ice cold
Speaker 1: ceiling in that case, and their chances of survival with
Speaker 1: no brain damage really increased. So, um, it's you know,
Speaker 1: there are risks though it's not the easiest thing to do,
Speaker 1: like we said, and um, I know pneumonia was one
Speaker 1: of the risks for years, um, even with just the
Speaker 1: regular cooling, right. Uh. Yeah, pneumonia slowed heart rate. Apparently
Speaker 1: you can enter hyperthermia while you're being rewarmed, Like you
Speaker 1: get way too hot, your body temperature increases too dramatically.
Speaker 1: There's a lot of problems that. Blood clotting is still
Speaker 1: an issue and probably will be for a while. Yeah.
Speaker 1: With Tishrmann's case, trying to use humans though, there's a
Speaker 1: couple of problems. Um. One is they have to get
Speaker 1: consent from a person to undergo an experiment like this,
Speaker 1: but you can't give consent when you're wheeled in there
Speaker 1: unconscious from a cardiac arrest. So what he's trying to
Speaker 1: do is just spread the word, literally, just spread the
Speaker 1: word to the citizens in his area that there's this thing,
Speaker 1: and if your husband or wife has the cardiac arrest,
Speaker 1: ask for the cold treatment where we completely pumped their
Speaker 1: blood out and replace it with frozen sailine. Using cold sailine.
Speaker 1: It's pretty amazing, it is. And you know, there's a
Speaker 1: lot of people who are still very skeptical of the
Speaker 1: idea that medically induced hypothermia can actually work, but there's
Speaker 1: also a growing body of studies that show that it
Speaker 1: does that has a significant impact. Like there were a
Speaker 1: couple there were several in two thousand two that really
Speaker 1: broke the thing open where it was like, these people
Speaker 1: have a twenty five percent chance of recovery without it,
Speaker 1: they have a fifty or seventy five percent chance of
Speaker 1: recovery with it, And that's really tough to ignore. It's amazing,
Speaker 1: amazing stuff into the future, Chuck, let's go. If you
Speaker 1: want to know more about medically induced hypothermia. Check out
Speaker 1: our podcast page for this episode. It's got a bunch
Speaker 1: of cool links and you can type therapeutic hypothermia in
Speaker 1: the search part how stuff works dot com and it
Speaker 1: will bring up this article of puns. And Uh, since
Speaker 1: I said search parts, time for listener mail, I'm gonna
Speaker 1: call this um Josh's theory on satire. Remember that we
Speaker 1: talked about that in the very recent show Clowns CNN. Uh.
Speaker 1: Do you want to summarize your position real quick that
Speaker 1: maybe satire is just a release and does it affect change?
Speaker 1: Is that the nuts and bolts of it. Yeah, Basically
Speaker 1: it lets the populace who's angry let off steam at
Speaker 1: the leadership without actually forcing the leadership to change. All right,
Speaker 1: So that brings us up to speed. And this is
Speaker 1: from Chelsea. Uh. She said, I just started listening under
Speaker 1: a year ago when a change in jobs landed me
Speaker 1: with a twenty five minute walk to and from work
Speaker 1: every day. I think she's in dublin. Um, she says,
Speaker 1: I find myself laughing out loud at your repartee. And
Speaker 1: my boyfriend is affectionately started referring to you as my
Speaker 1: nerd friends. But he's a listener. Now to it sounds
Speaker 1: like Dublin I'm actually writing in regard to Josh's theory
Speaker 1: on satire. It's a really interesting point, an angle I
Speaker 1: had not considered myself. I think though, that there's another
Speaker 1: way to look at it, which is that satire has
Speaker 1: the ability to plant the seed of dissent in a
Speaker 1: non threatening way and thus can eventually be a force
Speaker 1: of change. For example, someone may not be aware of
Speaker 1: a particular foible of a leader. That satirist points it
Speaker 1: out in a funny way. Now that someone has an awareness,
Speaker 1: without feeling preached at, and has it in their mind
Speaker 1: the next time the leader does something untoward, or perhaps
Speaker 1: they were just uh, they were aware of said foible,
Speaker 1: but the satirists opened their eyes to just how ridiculous
Speaker 1: and or dangerous it is. So while there's certainly a
Speaker 1: possibility satire connect as a placation or a way of
Speaker 1: letting off steam, there's also a very real possibility that
Speaker 1: can spark be the spark that ignites an eventual change.
Speaker 1: It is a good point. Yeah, that's from Chelsea and
Speaker 1: Morgan Hoffman. Thanks a lot, Chelsea Morgan Hoffman of Dublin, Ireland.
Speaker 1: Probably h well, she just said Dublin, Dublin, Georgia. I'm
Speaker 1: gonna go ahead and assume Ireland. Yeah, and boyfriend, yes,
Speaker 1: thank you both for listening. We appreciate it. Uh. And
Speaker 1: if you have a counterpoint, or your own theory or hypothesis,
Speaker 1: or just want to say hi or whatever, you can
Speaker 1: tweet to us at s y s K podcast. You
Speaker 1: can join us on Facebook dot com slash Stuff you
Speaker 1: Should Know, UH, you can send us an email to
Speaker 1: Stuff Podcast at how Stuff Works dot com, and as always,
Speaker 1: joined us at our luxurious home on the web, Stuff
Speaker 1: you Should Know dot com. Stuff you Should Know is
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