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Speaker 1: Hello, friends, just a heads up that on today's episode,

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Speaker 1: we're going to be talking about the history of anesthesia.

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Speaker 1: We'll also be discussing medical procedures in the pre anesthesia era,

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Speaker 1: and we'll touch on triggering topics like mental health crises

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Speaker 1: and suicides. Since one of my best friends is a

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Speaker 1: physicist who likes to get philosophical from time to time,

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Speaker 1: I sometimes find myself in discussions about time travel, which

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Speaker 1: inevitably bring up the question of when in space and time.

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Speaker 2: I'd like to be alive.

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Speaker 1: If it were up to me, it would be amazing

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Speaker 1: to see early human species create complex tools, or communicate

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Speaker 1: complicated ideas to each other for the first time, or

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Speaker 1: sit at a table with Antoine von Lewinhook and ask

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Speaker 1: him how to pronounce his name correctly while looking through

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Speaker 1: his microscope, to see microscopic creatures swimming around in a

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Speaker 1: drop of water, or to sit in the hall at

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Speaker 1: the Royal City Society when Charles Darwin and Alfred Russell

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Speaker 1: Wallace's theory of natural selection is shared publicly for the

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Speaker 1: first time. Any of those moments would be amazing to

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Speaker 1: witness firsthand, But my answer is way more practical. I

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Speaker 1: want to be alive in a time and place that

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Speaker 1: has good sanitation, antibiotics, and critically anesthesia. Doctor Lindsay Fitzharris

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Speaker 1: is a medical historian and author, and the prologue to

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Speaker 1: her book The Butchering Art makes it incredibly clear why

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Speaker 1: living in the age of anesthesia is super awesome. Here,

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Speaker 1: I'm going to recall a story from the beginning of

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Speaker 1: her book. It was December twenty first, eighteen forty six,

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Speaker 1: and the crowd of medical professionals and spectators were settling

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Speaker 1: in to the operating theater at London's University College Hospital.

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Speaker 1: In the middle of the room was a blood soaked table.

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Speaker 1: The floor was covered in sawdust to soak up the

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Speaker 1: anticipated forthcoming pools of blood. Surgery on that day would

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Speaker 1: be performed by the famous doctor Robert Liston, who was

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Speaker 1: well known for completing surgeries in thirty seconds or less.

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Speaker 1: And we know that it took thirty seconds or less

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Speaker 1: because he often started his surgeries by proclaiming time me, gentlemen,

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Speaker 1: time me. Now, if you have a limb that needs

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Speaker 1: to be amputated, you can be forgiven for wanting to

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Speaker 1: get it done by the guy who does.

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Speaker 2: It in under a minute.

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Speaker 1: But speed sometimes came at the cost of accuracy, as

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Speaker 1: Liston once coupled a like amputation with an accidental testicle ectomy.

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Speaker 1: Most people avoided surgeries at all costs. Not only was

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Speaker 1: it an absolutely miserable experience to be held down by

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Speaker 1: surgeon assistants while you were cut into, but if that

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Speaker 1: experience didn't kill you, subsequent infection often did. As this

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Speaker 1: was in the era before sterile technique and antibiotics, and

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Speaker 1: it was gruesome to watch too. Physician James Simpson once

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Speaker 1: fled an operating theater because it was too much for

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Speaker 1: him to watch a breast removal surgery. After escaping the theater,

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Speaker 1: he proclaimed that he would instead study law. He did, however,

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Speaker 1: go on to complete medical training, and we'll hear more

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Speaker 1: about his pioneering work on anesthetics for childbirth later in

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Speaker 1: the episode. But anyway, on this day, in front of

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Speaker 1: a crowded theater, Liston was trying the anesthetic ether for

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Speaker 1: the first time. A thirty six year old butcher who

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Speaker 1: needed a leg amputation was laying on the bench and

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Speaker 1: the ether was administered, knocking him out. The leg was

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Speaker 1: quickly sawed off, the arteries tied off, and the flesh

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Speaker 1: closed up. All this was completed in just a few minutes.

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Speaker 1: When the groggy patient came to, he looked at Liston

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Speaker 1: and asked, when would the surgery begin?

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Speaker 2: Amazing. Welcome to Daniel and Kelly's Extraordinary Universe.

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Speaker 3: Hi. I'm Daniel. I'm a particle physicist, and my most

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Speaker 3: terrifying experience with anesthesia was having my ten year old

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Speaker 3: old son go under.

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Speaker 4: Oh.

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Speaker 2: Hi, I'm Kelly Waitersmith.

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Speaker 1: I study space and parasites, and thus far, none of

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Speaker 1: my kids have had to go under anesthesia. I've had

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Speaker 1: anesthesia make me vomit and embarrass myself many times, but

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Speaker 1: I've never never been scared about it. What was so

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Speaker 1: scary about your kid going under.

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Speaker 3: The fact that nobody knows what they're doing or how

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Speaker 3: it works. And they're like, there's a pretty good chance

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Speaker 3: he'll wake up, And we're like, what.

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Speaker 1: Dan, you know it's more than just a pretty good chance. Like,

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Speaker 1: we've got a lot of experience with this by now.

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Speaker 3: Yeah, we have played a resturan roulette with this many

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Speaker 3: many times, and mostly people survive, and that all is

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Speaker 3: fine scientifically, But when it's your kid going under, it's

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Speaker 3: an emotional decision and probabilities and statistics are irrelevant. Yeah,

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Speaker 3: it's just terrifying.

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Speaker 1: Yeap, Have you ever said anything particularly stupid coming out

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Speaker 1: of anesthesia?

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Speaker 3: That assumes I don't say stupid things when I'm not

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Speaker 3: under anesthesia, So I think my distribution of intelligence and

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Speaker 3: stupid doesn't change. How about you? Have you said absurd

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Speaker 3: stuff coming out of anesthesia?

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Speaker 1: I don't remember, but Zach told me that after I

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Speaker 1: came out of a procedure, I just kept asking was

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Speaker 1: I polite to everyone? Was I polite to everyone? And

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Speaker 1: I just kept asking. I was really panicking about whether

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Speaker 1: or not I was polite to everyone, and Zach said

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Speaker 1: I was fine, and then I threw up. But I

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Speaker 1: didn't feel the procedure, which is great.

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Speaker 3: Well, I'm sure you're always polite to even when you're

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Speaker 3: in pain or when you're out of it.

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Speaker 2: Thanks. Yeah, apparently I really worry about that.

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Speaker 3: And I'm sure that today you're going to give us

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Speaker 3: a very painless tour of the history of anesthesia, what

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Speaker 3: we know about it, how we've discovered it, and how

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Speaker 3: many humans have suffered unnecessarily through history.

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Speaker 1: Yes, well, I am attempting today to politely answer a

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Speaker 1: wonderful question from our listener Eric, and let's go ahead

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Speaker 1: and hear that question.

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Speaker 2: Now.

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Speaker 5: Hey, there's a whole lot of important stuff that we

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Speaker 5: don't fully understand. Tangents as part of the plain episode

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Speaker 5: was my favorite part. I think I remember ones that

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Speaker 5: we don't really know how anesthesia works?

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Speaker 3: Is that true?

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Speaker 5: Seems like a cool episode idea history of anesthesia back

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Speaker 5: when getting someone really drunk was the best we could do,

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Speaker 5: to what we do now and if we actually understand it,

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Speaker 5: to the differences between anesthesia and sleep.

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Speaker 3: Thanks.

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Speaker 1: Oh my gosh, there are so many cool topics in

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Speaker 1: that question. I got to go down so many amazing

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Speaker 1: rabbit holes. And if you would like to submit a

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Speaker 1: question about whatever it is that keeps you up at night,

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Speaker 1: please send us those questions at questions at danieland Kelly

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Speaker 1: dot org.

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Speaker 3: This question makes me wonder how much we do and

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Speaker 3: don't know about why things work in medicine. I actually

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Speaker 3: asked Katrina about this when I read this question, and

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Speaker 3: she was like, you should be less surprised we don't

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Speaker 3: know how tailent all works. I was like, I'm less

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Speaker 3: surprised now, but I'm more terrified. I guess all right, Like,

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Speaker 3: basically our bodies are huge Rube Goldberg machines, and we

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Speaker 3: don't know how they work, but we have discovered if

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Speaker 3: you press this button and pull this lever, that this

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Speaker 3: thing happens, and now we rely on that for all

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Speaker 3: of modern medicine.

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Speaker 1: I think my scariest example of this, and I think

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Speaker 1: I've said this on the show before, so I'll keep

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Speaker 1: it brief. As I was talking to someone about why

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Speaker 1: deep brain stimulation works, where you essentially like stick an

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Speaker 1: electrode in the center of someone's brains and shock it,

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Speaker 1: which is usually to stop a seizure, and they were like,

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Speaker 1: we don't know. I was like, wow, we're shocking the

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Speaker 1: insides of people's brains and we're like it works, and

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Speaker 1: that's great, but why I know?

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Speaker 5: I know?

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Speaker 3: And the physicist to me wants to be like really

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Speaker 3: reductionists and be like, we have to understand how these

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Speaker 3: things work if we're going to do them right, like,

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Speaker 3: because who knows what other consequences there could be. And

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Speaker 3: also it makes me wonder like, how did we figure

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Speaker 3: this stuff out if we don't know how it works

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Speaker 3: or what it was going to do? Have we basically

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Speaker 3: just been experimenting on ourselves unethically on other people for millennia,

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Speaker 3: like this is terrible. On the other hand, like you know,

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Speaker 3: you've got to make progress. It's going to be a

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Speaker 3: long time before we have an understanding of the human

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Speaker 3: body that would satisfy a physicist. And we have kids

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Speaker 3: who need anesthesia when they go under.

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Speaker 1: So yeah, yeah, well, and so that's actually a really

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Speaker 1: nice transition into a book that I used to do

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Speaker 1: a bunch of the research for this episode. It's doctor

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Speaker 1: Lawrence Altman's book, Who Goes First, And it's essentially trying

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Speaker 1: to figure out who should we test this stuff out

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Speaker 1: on first to make sure that it's safe. And this

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Speaker 1: book is all about self experimentation in medicine. Basically doctors

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Speaker 1: who decided I am the right person to test it

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Speaker 1: on first because I understand the risks and I'm the

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Speaker 1: one who has the idea, and so they tested it

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Speaker 1: on themselves. And there's a lot of self experimentation in

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Speaker 1: the history of anesthesia.

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Speaker 3: Is that sort of on the down low? I know

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Speaker 3: that you're not allowed to experiment on people unless you

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Speaker 3: have all sorts of ethical reviews, et cetera. But are

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Speaker 3: there such reviews for experimenting on yourself. Can you basically

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Speaker 3: do anything you want to your own body?

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Speaker 2: Why should I start here?

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Speaker 1: So I got kind of interested in this question and

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Speaker 1: after World War Two, and I promise I won't do

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Speaker 1: like nearly one hundred years of history on this question.

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Speaker 1: But after World War two there was the Nuremberg Code,

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Speaker 1: and this was in response to the horrible experiments that

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Speaker 1: Nazi doctors did on people in their concentration camps. And

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Speaker 1: one of the things that they were encouraging was like,

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Speaker 1: if you're going to do a procedure on someone, you

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Speaker 1: need to be willing or actually you need to do

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Speaker 1: it on yourself, because that is a way to show

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Speaker 1: that like you think this is safe, you're invested, blah

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Speaker 1: blah blah.

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Speaker 2: So for a while there it was encouraged for people

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Speaker 2: to do it on themselves.

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Speaker 1: Now, you're not supposed to experiment on yourself unless you

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Speaker 1: were included in the permits and protocols that you submitted

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Speaker 1: to get permission. And so you can say I need

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Speaker 1: one hundred subjects and the first one is going to

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Speaker 1: be me. But yeah, you're not supposed to just willing

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Speaker 1: nilly experiment on yourself. Though I have heard of people

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Speaker 1: who do that anyway.

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Speaker 3: And I wonder if once you do that, if you

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Speaker 3: break the rules, if that did is not allowed to

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Speaker 3: be considered in future questions, you know, sort of like

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Speaker 3: doctor Mangela's data, or if they're like, well, you have

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Speaker 3: this data, you did it already, so let's use it.

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Speaker 3: You know.

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Speaker 1: I've also come a lot across a lot of examples

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Speaker 1: where people have experimented on themselves. They got the answer

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Speaker 1: they expected, and then they moved forward as so they

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Speaker 1: knew what they needed to know, but it's turned out

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Speaker 1: their sample size of one was completely misleading. And I've

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Speaker 1: seen this in like, you know, trials for vaccines. Yeah,

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Speaker 1: not anymore, these kinds of data would not fly anymore.

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Speaker 1: Just to be clear, okay, but in the past, people

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Speaker 1: have like tried a vaccine on themselves, been like this

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Speaker 1: worked great on me, and then distributed it widely and

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Speaker 1: turned out it works very different in different kinds of bodies.

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Speaker 1: So you can learn something from a sample size of one,

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Speaker 1: but then you need to follow it up with much better,

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Speaker 1: much more broad trials.

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Speaker 3: So let's zoom in and talk about today's topic, which

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Speaker 3: is not how the whole human body works, but how

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Speaker 3: we put parts of it to sleep. Yeah, let's go

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Speaker 3: all the way back to very early history, like what

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Speaker 3: were people doing thousands of years ago when they needed

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Speaker 3: to have surgery?

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Speaker 1: So I don't know many thousands of years ago, but

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Speaker 1: something like one to two thousand years ago. We were

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Speaker 1: just trying stuff out, which is maybe not so different

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Speaker 1: than what we do now, but we've got better evidence now.

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Speaker 1: But so there's evidence of Chinese and Arab positions inhaling

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Speaker 1: very kinds of drugs, mixing things in alcohol, and this

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Speaker 1: apparently helped with surgery, but we've sort of lost the recipes.

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Speaker 3: The physicians were doing drugs and that helped them with

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Speaker 3: the surgery, or the patients are getting the truck.

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Speaker 1: If I needed to amputate someone's limb, maybe I would

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Speaker 1: want to be not completely present for that process.

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Speaker 3: But it's like past the pipe there, dude, when you're done.

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Speaker 2: With this, that's right, that's right.

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Speaker 1: But so we don't really have great data on what

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Speaker 1: it was that they were doing, but we do have

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Speaker 1: some fun stories from like French surgeons from a long

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Speaker 1: time ago who would knock people out, not with drugs,

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Speaker 1: but by putting a wooden bowl over someone's head and

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Speaker 1: hitting it with a hammer to like literally knock you out,

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Speaker 1: Oh my gosh. And then for a while, attempting to

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Speaker 1: mesmerize patients, you know, like hypnotizing them was popular. But

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Speaker 1: then it became clear that some people were saying this

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Speaker 1: worked and they were actually just like tricking a bunch

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Speaker 1: of people, so that fell out of favor. But then

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Speaker 1: what is kind of frustrating is that, around seventeen ninety

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Speaker 1: nine it was discovered that actuallyitrous oxide does make it

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Speaker 1: so that you don't feel pain. So Humphrey Davy was

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Speaker 1: he a physics guy?

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Speaker 3: I don't know, I've never heard of him.

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Speaker 2: Oh gosh. I heard his name before, and I just

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Speaker 2: assumed he was a physicist.

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Speaker 1: Why did you assume he was a physicist, because people

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Speaker 1: don't care about old biologists.

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Speaker 4: Uh.

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Speaker 3: He sounds to me like a guy who would sit

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Speaker 3: on a wall and fall off.

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Speaker 2: And crack yep, yep. Oh he's a chemist.

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Speaker 3: Oh god, all right, yeah, knock him off that wall.

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Speaker 2: That's right, that's right.

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Speaker 1: So in seventeen ninety nine, Humphrey Davy had a job

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Speaker 1: where he was experimenting on various things, and one of

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Speaker 1: the things he was experimenting with was nitrous oxide. Which

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Speaker 1: is also called laughing gas. And he was experimenting with

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Speaker 1: his friends, who included the poet Samuel Taylor Cooleridge and

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Speaker 1: doctor Peter Roget who was the guy who compiled with Thesaurus.

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Speaker 1: But anyway, they were sort of like knocking themselves out

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Speaker 1: with nitrous oxide, and Humphrey Davy mentioned, oh, hey, when

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Speaker 1: I take this, my headaches go away and my wisdom

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Speaker 1: teeth don't hurt anymore, And so he noted it could

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Speaker 1: be used for surgeries to remove pain. But then he

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Speaker 1: goes on and does other stuff, like he gets knighted

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Speaker 1: for inventing the minors safety lamp, and he never pursues

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Speaker 1: this line of reasoning. So from as early as seventeen

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Speaker 1: ninety nine, we could have been using things like nitrous

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Speaker 1: oxide to knock people out in surgeries. But this just

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Speaker 1: sort of like disappeared into the ether and was an

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Speaker 1: idea that didn't get followed up on chemists.

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Speaker 3: Oh my gosh, what are you doing keeping secrets of

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Speaker 3: painless surgery from the masses?

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Speaker 1: Well, I mean no, he shared this result like in

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Speaker 1: a report, but then he moved on to other things.

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Speaker 2: But you know, let's both agree that chemists could be

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Speaker 2: doing better.

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Speaker 3: So before seventeen nine nine, before the discovery of nitrous oxide,

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Speaker 3: people would just like Grin and Barrett, you know, they

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Speaker 3: would like drink whiskey or smoke cannabis or pull from

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Speaker 3: the opium pipe. It must have meant that a lot

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Speaker 3: of people like avoided necessary surgeries because they were just like, yeah,

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Speaker 3: it's just not worth it.

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Speaker 1: Yeah, So literally you would be you know, you'd take

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Speaker 1: a couple shots of some alcohol. Of big dudes would

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Speaker 1: be brought in to hold you down, and then the

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Speaker 1: surgeon would try to do things as fast as they could.

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Speaker 1: And so surgeons were often picked not for their skill

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Speaker 1: but for their ability to saw through things really super fast.

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Speaker 1: Lindsay Fitzharris has this great book called The Butchering Art

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Speaker 1: that included a bunch of stories of really horrible things,

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Speaker 1: like a surgeon who was trying to cut through a

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Speaker 1: leg and did it really fast and also took half

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Speaker 1: of a scrotum with the leg and no bonus, I

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Speaker 1: guess not for the guy who was under the knife.

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Speaker 1: But yeah, So there were a lot of surgeries that

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Speaker 1: they wouldn't do. Like maybe they had an inkling that

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Speaker 1: surgery would help in this case, but it was a

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Speaker 1: procedure that just would have been too hard to hold

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Speaker 1: someone down for they might have lost too much blood.

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Speaker 1: And so only the things that could be done fast

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Speaker 1: were done, and they were done by people who were

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Speaker 1: moving quickly, perhaps at the expense of moving carefully.

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Speaker 3: Right, maybe it's more of a last ditch option.

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Speaker 2: Oh god, yeah.

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Speaker 3: Well, But as a research and nerd, I'm curious, how

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Speaker 3: do we know these things about the earliest surgeries, Like

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Speaker 3: do we have written records from China or you know,

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Speaker 3: the Islamic world, or what is the sort of earliest

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Speaker 3: record we have of medicine and surgery.

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Speaker 1: So the earliest record that I came across while doing

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Speaker 1: the research was two hundred CE where a Chinese physician

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Speaker 1: was mixing alcohol with some other stuff. But the references

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Speaker 1: that I read never included and we learned this from

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Speaker 1: an ancient scroll that was found in such and such

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Speaker 1: tomb or something like that. So I don't know the

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Speaker 1: history of how this information came to be known, but

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Speaker 1: I do know that more recently, for example, some of

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Speaker 1: the stuff I'm going to be talking about next was

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Speaker 1: like in the news and in letters written from one

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Speaker 1: physician to another. But this was all much more recent fascinating.

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Speaker 3: I wonder what they did in ancient Egypt, for example.

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Speaker 3: You know those guys are pretty advanced, especially in surgery,

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Speaker 3: or are They like took organs out and put them

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Speaker 3: in weird vessels and stuff, so they knew their way

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Speaker 3: around a body.

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Speaker 1: Does it count as surgery if they're dead? Though, Like,

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Speaker 1: I mean, it didn't.

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Speaker 2: I think.

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Speaker 1: I think they were also unimpressed with the brain, for example,

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Speaker 1: and thought that, like the heart is where most of

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Speaker 1: the important stuff happened. So I don't know that i'd

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Speaker 1: want an ancient Egyptian surgeon to be working on me.

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Speaker 3: All right, So let's fast forward back to the present.

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Speaker 3: You said, Humphrey Davy missed his opportunity to save people

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Speaker 3: from pain and just enjoyed hanging out with his friends

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Speaker 3: Sam Coleridge and Peter Rodgit. What happened next? When did

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Speaker 3: we actually start to figure stuff out and use it

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Speaker 3: to save people from suffering.

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Speaker 1: Well before we were saving people from suffering, we were

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Speaker 1: allowing people to have a really stinking good time. And

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Speaker 1: so in the early to mid eighteen hundreds, there were

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Speaker 1: events called ether frolics or jags, where essentially people would

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Speaker 1: get together huff ether and appreciate how awesome it made

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Speaker 1: you feel. And there was no sort of surgical implication

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Speaker 1: or plans to understand how this would work in surgery.

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Speaker 1: It was just like, whoa, it's really fun when you

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Speaker 1: huff ether or huff nitrous oxide.

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Speaker 3: And let's have a biology physics disentanglement moment here, because

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Speaker 3: physics ether refers to this concept that space is filled

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Speaker 3: with something for like to propagate through, famously disproven by

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Speaker 3: the Michaelson Morley experiment in the late eighteen hundreds. That's

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Speaker 3: not where people are snuffing at your biology parties.

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Speaker 1: Right, No, a chemist would tell you that ether is

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Speaker 1: an organic compound. It's a mix of oxygen with alkyl groups.

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Speaker 1: And you know, we both know that I don't know

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Speaker 1: much about chemistry, but no, it's not a made up

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Speaker 1: idea it is.

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Speaker 2: It's an actual chemical compound.

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Speaker 3: And what happens when you sniff it, you just like

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Speaker 3: feel good or you pass out or what happens.

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Speaker 1: Well, we'll go into more detail about what it's doing

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Speaker 1: to the brain a little bit later, but for the

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Speaker 1: purpose of these parties, it just sort of made you

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Speaker 1: feel kind of silly and anything that heard stopped hurting

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Speaker 1: and you'd laugh a lot more.

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Speaker 2: And you know that all sounds fantastic.

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Speaker 3: That sounds great. Why did you go out of fashion?

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Speaker 1: Well, because it's also kind of dangerous. It can lead

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Speaker 1: to vomiting and death, and if you do it too often,

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Speaker 1: it can like impact your organs, and it's yeah, bad news.

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Speaker 1: And we will encounter worries about some people who are

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Speaker 1: thought to have maybe gone a little bit mad on

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Speaker 1: account of all the ether and stuff they were taken.

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Speaker 2: Probably chemists, yeah, I know, right, almost certainly chemists. God guys.

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Speaker 1: All right, so let's take a break here, and when

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Speaker 1: we get back from the break, we'll talk about the

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Speaker 1: four men who brought anesthetics to the medical world and

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Speaker 1: their downfall afterwards as they all fought for credit for

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Speaker 1: being the first to come up with this idea.

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Speaker 4: Oh no, all right, we're back.

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Speaker 1: We were talking about ether parties, which do sound fun,

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Speaker 1: but I would not engage in an ether party because I'm.

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Speaker 3: A whimp and you're so wholesome, Kelly.

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Speaker 2: Yeah.

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Speaker 1: I work in this lab once where somebody said something

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Speaker 1: to me to the effect of you're really nice, and

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Speaker 1: it was like, in a condescending I've never had anyone

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Speaker 1: be like, you're nice and that kind of sucks. But

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Speaker 1: like anyway, so I have been told that I'm not fun,

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Speaker 1: but that's fine.

400
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Speaker 2: I'm not fun.

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00:19:19,160 --> 00:19:20,720
Speaker 3: You're a lot of fun. You're a lot of ways.

402
00:19:20,760 --> 00:19:22,439
Speaker 3: Let me ask you a more personal question, which is

403
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Speaker 3: what is your drug of choice? Are you an alcohol drinker?

404
00:19:26,960 --> 00:19:30,120
Speaker 3: Do you chew on banana peels? How does Kelly unwined?

405
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Speaker 1: Kelly does not enjoy chewing on banana peels at all.

406
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Speaker 1: It makes Kelly feel really uncomfortable. Kelly enjoys a glass

407
00:19:38,240 --> 00:19:42,760
Speaker 1: of red wine and caffeine. Kelly mostly lives a stimulant

408
00:19:42,760 --> 00:19:45,200
Speaker 1: free like you know what. Kelly's favorite stimulant is the

409
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Speaker 1: anti anxiety medication.

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Speaker 2: She's hot. That's how eye roll.

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Speaker 3: That's the modern day ether.

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Speaker 2: What about you.

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Speaker 3: I'm a big believer in caffeine as well, and I

414
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Speaker 3: enjoy red wine, and for many years I did also

415
00:19:59,040 --> 00:20:02,959
Speaker 3: enjoy banana peel. It helped to stimulate some creativity in

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Speaker 3: my research, but no longer.

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Speaker 1: Ah well, we all have had youthful indiscretions.

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Speaker 3: All right, So now let's talk about the indiscretions of

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Speaker 3: various men in history who brought us anesthesia.

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Speaker 1: So the first person we're going to chat about is

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Speaker 1: doctor Crawford Long, and he was at one of these

422
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Speaker 1: ether frolics and he was really enjoying it, and he

423
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Speaker 1: noted to himself that when he or others did things

424
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Speaker 1: that should be painful, they didn't seem to feel the pain.

425
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Speaker 1: And he was a physician and this made him think, oh,

426
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Speaker 1: you know, maybe this could be used in surgery. And

427
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Speaker 1: so he was the first person to actually test it out.

428
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Speaker 1: So he had a patient who needed two small cysts removed,

429
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Speaker 1: and the patient was nervous about getting the surgery done

430
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Speaker 1: because it was painful, and he was like, look, this

431
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Speaker 1: isn't critical. I don't want these things taken out. And

432
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Speaker 1: the patient had also tried ether recreationally and really enjoyed it,

433
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Speaker 1: and so Long was like, look, let's try it.

434
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Speaker 2: I'm going to put you under the ether.

435
00:20:58,480 --> 00:21:00,360
Speaker 1: You know that you don't feel as much much pain

436
00:21:00,440 --> 00:21:02,280
Speaker 1: under the ether, so let's see how it goes. And

437
00:21:02,400 --> 00:21:06,199
Speaker 1: actually it went great. Wow, and Long started using this

438
00:21:06,359 --> 00:21:10,160
Speaker 1: gas for other operations as well. But the big thing

439
00:21:10,240 --> 00:21:13,199
Speaker 1: here is that he didn't share this information with the

440
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Speaker 1: medical profession widely, so he didn't like write a paper

441
00:21:16,600 --> 00:21:19,200
Speaker 1: or go to a surgery that was watched by a

442
00:21:19,240 --> 00:21:21,439
Speaker 1: lot of other people. So at the time, surgeries were

443
00:21:21,480 --> 00:21:25,440
Speaker 1: done in operating theaters where students of medicine were sort

444
00:21:25,480 --> 00:21:27,440
Speaker 1: of sitting in the same room. So now, like you know,

445
00:21:27,480 --> 00:21:29,879
Speaker 1: if you've watched Gray's Anatomy, you know that there is

446
00:21:29,960 --> 00:21:32,399
Speaker 1: like a elevated area and you can be behind glass

447
00:21:32,400 --> 00:21:33,440
Speaker 1: and you can sort of peek in.

448
00:21:33,600 --> 00:21:35,240
Speaker 3: Like a splash guard there and make sure, you know,

449
00:21:35,320 --> 00:21:36,200
Speaker 3: get sprayed in the face.

450
00:21:36,440 --> 00:21:39,240
Speaker 1: I'm wondering if maybe they're protecting the patient more than anything,

451
00:21:39,320 --> 00:21:41,240
Speaker 1: like you're you know, when you sneeze, they don't want

452
00:21:41,240 --> 00:21:43,360
Speaker 1: the germs settling into the patient's abdomen.

453
00:21:43,480 --> 00:21:45,400
Speaker 3: But uh, I wonder if they used to pass around

454
00:21:45,520 --> 00:21:47,359
Speaker 3: raincoats the way they do it like SeaWorld in the

455
00:21:47,359 --> 00:21:48,480
Speaker 3: first few rows, you know.

456
00:21:48,640 --> 00:21:49,560
Speaker 2: Oh so gross.

457
00:21:50,680 --> 00:21:52,960
Speaker 1: I know they used to put sawdust under the operating

458
00:21:53,000 --> 00:21:57,159
Speaker 1: tables to absorb the blood. Uh yeah, intense, And I

459
00:21:57,160 --> 00:21:59,720
Speaker 1: don't think they always cleared the sawdust before the next person.

460
00:22:00,040 --> 00:22:01,639
Speaker 1: And I read some stories where the guy would like

461
00:22:01,680 --> 00:22:03,760
Speaker 1: take the saw where he had amputated a leg and

462
00:22:03,800 --> 00:22:06,320
Speaker 1: he'd kind of like wipe it off on his apron

463
00:22:06,640 --> 00:22:10,000
Speaker 1: and then get to the next guy, which we don't

464
00:22:10,040 --> 00:22:10,720
Speaker 1: do anymore.

465
00:22:10,760 --> 00:22:12,679
Speaker 3: And who would come to these things anyway? Is it

466
00:22:12,800 --> 00:22:15,000
Speaker 3: just medical students or is this like, you know, an

467
00:22:15,040 --> 00:22:16,959
Speaker 3: afternoon with the family. What are we going to do?

468
00:22:17,000 --> 00:22:19,199
Speaker 3: This is before movies. Let's go see some legs get

469
00:22:19,240 --> 00:22:19,640
Speaker 3: cut off.

470
00:22:20,240 --> 00:22:22,040
Speaker 1: I don't know if you bring little Susie with you,

471
00:22:22,240 --> 00:22:25,320
Speaker 1: but like, definitely the medical students are there. And this

472
00:22:25,480 --> 00:22:28,679
Speaker 1: isn't too far after people used to go to like

473
00:22:28,720 --> 00:22:30,400
Speaker 1: public executions for fundsies.

474
00:22:30,480 --> 00:22:31,520
Speaker 3: Yeah, that's what I was thinking.

475
00:22:31,720 --> 00:22:33,640
Speaker 1: Yeah, and so I do think some people did come

476
00:22:33,760 --> 00:22:37,359
Speaker 1: off the streets just to kind of watch. That's probably

477
00:22:37,359 --> 00:22:41,240
Speaker 1: not how I'd spend my day. What was Shakespeare around?

478
00:22:41,280 --> 00:22:41,359
Speaker 5: Like?

479
00:22:41,400 --> 00:22:43,280
Speaker 1: Were the options to go to the globe and see

480
00:22:43,280 --> 00:22:46,280
Speaker 1: a Shakespearean play or watch someone get their leg amputated

481
00:22:46,720 --> 00:22:48,159
Speaker 1: my timeline of history?

482
00:22:48,320 --> 00:22:52,680
Speaker 3: Not a hard choice, I mean, geez, yeah, Shakespeare's a

483
00:22:52,680 --> 00:22:55,240
Speaker 3: couple hundred years before He's like early sixteen hundreds, late

484
00:22:55,280 --> 00:22:56,080
Speaker 3: fifteen hundreds.

485
00:22:56,200 --> 00:22:58,160
Speaker 1: Oh all right, well, and maybe I would watch the amputation.

486
00:22:58,240 --> 00:22:59,760
Speaker 1: You know, what else are you going to do in London?

487
00:23:00,240 --> 00:23:03,440
Speaker 1: So anyway, Long gets the ball rolling but doesn't share

488
00:23:03,520 --> 00:23:06,280
Speaker 1: with anyone, so it stops with him. But then in

489
00:23:06,359 --> 00:23:10,320
Speaker 1: eighteen forty four, a dentist called Horace Wells goes to

490
00:23:10,520 --> 00:23:13,360
Speaker 1: a nitrous oxide demonstration. So there were people who would

491
00:23:13,359 --> 00:23:16,000
Speaker 1: travel around the country and they would essentially get up

492
00:23:16,040 --> 00:23:18,320
Speaker 1: on a stage and they'd be like, this nitrous oxide

493
00:23:18,320 --> 00:23:21,400
Speaker 1: stuff is great. Is there a volunteer from the audience

494
00:23:21,400 --> 00:23:24,399
Speaker 1: who would like to feel, you know, what nitrous oxide

495
00:23:24,440 --> 00:23:27,080
Speaker 1: feels like. So they'd have them inhale some nitrous oxide

496
00:23:27,160 --> 00:23:27,920
Speaker 1: and then they'd be like.

497
00:23:27,880 --> 00:23:29,800
Speaker 2: I feel great. He he he would be so fun, and.

498
00:23:29,800 --> 00:23:32,320
Speaker 3: People would watch this and they're like, let's amputate your leg. Sure,

499
00:23:32,400 --> 00:23:33,159
Speaker 3: he he he he.

500
00:23:34,040 --> 00:23:39,840
Speaker 1: Well and so uh, so Wells was watching this demonstration

501
00:23:40,119 --> 00:23:42,480
Speaker 1: and one of the people who got sort of exposed

502
00:23:42,520 --> 00:23:45,600
Speaker 1: to nitrous oxide got a pretty big laceration on their leg,

503
00:23:45,680 --> 00:23:48,439
Speaker 1: but clearly didn't feel it while it was happening, And

504
00:23:48,520 --> 00:23:51,679
Speaker 1: so Wells afterwards goes to the guy doing the demonstration

505
00:23:51,760 --> 00:23:54,600
Speaker 1: and is like, whoa, hey, I saw that someone got

506
00:23:54,680 --> 00:23:57,800
Speaker 1: hurt and then they were totally fine. And I'm a dentist,

507
00:23:57,880 --> 00:23:59,760
Speaker 1: so can you like come with me to my dentist

508
00:23:59,760 --> 00:24:02,840
Speaker 1: off and we can try like knocking out my patients

509
00:24:03,160 --> 00:24:04,400
Speaker 1: before doing the procedure.

510
00:24:04,800 --> 00:24:07,199
Speaker 3: This is a dentist who cares, who doesn't want to

511
00:24:07,240 --> 00:24:08,360
Speaker 3: cause his patient's pain.

512
00:24:08,560 --> 00:24:09,720
Speaker 2: That's right, it's amazing.

513
00:24:09,800 --> 00:24:12,399
Speaker 1: I miss oh you. This is a joke about dentists

514
00:24:12,440 --> 00:24:14,960
Speaker 1: in general. I didn't get it because I have an

515
00:24:14,960 --> 00:24:17,120
Speaker 1: amazing dentist. I love him so much.

516
00:24:19,080 --> 00:24:20,879
Speaker 3: I hope he listens to the pod. And here's how

517
00:24:20,960 --> 00:24:21,600
Speaker 3: much you love him.

518
00:24:21,760 --> 00:24:23,080
Speaker 2: You're the best doctor, Cayton.

519
00:24:26,200 --> 00:24:28,400
Speaker 1: Okay, So before he started using it on his patients,

520
00:24:28,400 --> 00:24:30,359
Speaker 1: he decided he wanted to try it on himself. So

521
00:24:30,440 --> 00:24:33,879
Speaker 1: this is an example of self experimentation. So Wells calls

522
00:24:33,960 --> 00:24:36,399
Speaker 1: over a dentist friends of his. The guy who did

523
00:24:36,400 --> 00:24:41,200
Speaker 1: the nitrous oxide demonstration knocks Wells out, and the friend

524
00:24:41,320 --> 00:24:44,200
Speaker 1: dentist who came over pulled out a molar, and Wells

525
00:24:44,240 --> 00:24:45,040
Speaker 1: doesn't feel a thing.

526
00:24:45,240 --> 00:24:48,640
Speaker 3: So we just like sacrifices a healthy molar to science.

527
00:24:49,320 --> 00:24:50,600
Speaker 2: Yes, amaz, yeah he does.

528
00:24:50,720 --> 00:24:51,520
Speaker 3: I like this dentist.

529
00:24:51,800 --> 00:24:52,640
Speaker 2: Yeah, no, me too.

530
00:24:52,680 --> 00:24:55,040
Speaker 1: He's willing to get his hands dirty for the arts.

531
00:24:55,080 --> 00:24:55,879
Speaker 1: I appreciate that.

532
00:24:56,000 --> 00:24:57,879
Speaker 3: All right, So far I'm voting for Horace Wells to

533
00:24:57,880 --> 00:24:58,600
Speaker 3: get credit for this.

534
00:24:58,840 --> 00:24:59,640
Speaker 2: I like Wells too.

535
00:24:59,680 --> 00:25:02,480
Speaker 1: So Els does this on fifteen other patients, and he

536
00:25:02,560 --> 00:25:05,880
Speaker 1: decides this is awesome, right, Yeah, So in eighteen forty five,

537
00:25:05,920 --> 00:25:08,400
Speaker 1: he goes to Massachusetts General Hospital and they're doing one

538
00:25:08,400 --> 00:25:12,440
Speaker 1: of these big public surgeries, and he decides he's going

539
00:25:12,480 --> 00:25:15,879
Speaker 1: to remove a tooth from a volunteer. But he doesn't

540
00:25:15,880 --> 00:25:19,280
Speaker 1: give the volunteer enough nitrous oxide. Oh no, And so

541
00:25:19,359 --> 00:25:21,880
Speaker 1: now we know that, you know, some people require more

542
00:25:21,960 --> 00:25:24,399
Speaker 1: nitrous oxide to get knocked out, some require less, and

543
00:25:24,440 --> 00:25:26,919
Speaker 1: this guy just didn't get the right amount for whatever reason.

544
00:25:27,400 --> 00:25:30,600
Speaker 2: And so the patient is clearly feeling pain during this.

545
00:25:30,560 --> 00:25:34,520
Speaker 1: Procedure, and it is very embarrassing to doctor Wells because

546
00:25:34,520 --> 00:25:37,119
Speaker 1: he's got this whole audience and it's clearly not working,

547
00:25:37,200 --> 00:25:39,960
Speaker 1: and so this was sort of devastating for him.

548
00:25:40,119 --> 00:25:41,320
Speaker 3: This is his big moment.

549
00:25:41,480 --> 00:25:43,600
Speaker 1: Wow, this was his big moment. And we'll see that

550
00:25:43,640 --> 00:25:45,840
Speaker 1: he doesn't actually emotionally recover from this.

551
00:25:46,040 --> 00:25:48,920
Speaker 2: Oh no, I know, I know some.

552
00:25:49,000 --> 00:25:51,840
Speaker 3: Like emotional nitros oxide. He needs some of that antidepressants.

553
00:25:51,920 --> 00:25:55,320
Speaker 1: He does need some antidepressants, as we'll see. So then

554
00:25:55,400 --> 00:25:58,000
Speaker 1: the next group that gets in on this at around

555
00:25:58,080 --> 00:26:02,679
Speaker 1: the same time is doctor William Morton and his chemistry teacher,

556
00:26:03,080 --> 00:26:07,960
Speaker 1: doctor Charles Jackson. Morton starts experimenting with ether instead of

557
00:26:08,040 --> 00:26:10,040
Speaker 1: nitrous oxide. And it turns out that ether sort of

558
00:26:10,040 --> 00:26:12,280
Speaker 1: works a little bit better. And at the time, the

559
00:26:12,320 --> 00:26:14,960
Speaker 1: professors and the students were playing with ether too, so

560
00:26:15,000 --> 00:26:17,200
Speaker 1: they were doing these ether parties and you'd get together

561
00:26:17,200 --> 00:26:19,200
Speaker 1: with your professors and like get high on ether.

562
00:26:20,000 --> 00:26:21,040
Speaker 2: Times have changed and.

563
00:26:21,240 --> 00:26:23,120
Speaker 3: So no, no, no, I do that all the time

564
00:26:23,160 --> 00:26:24,240
Speaker 3: with my classes. Yeah.

565
00:26:24,280 --> 00:26:27,439
Speaker 2: Absolutely, Oh yeah, I don't. Uh, we're moving on.

566
00:26:27,600 --> 00:26:31,240
Speaker 3: So if any administrators that you see or Vara listening, I.

567
00:26:31,320 --> 00:26:33,560
Speaker 1: Was a joke, of course, good, yes, yes, So I

568
00:26:33,560 --> 00:26:36,399
Speaker 1: think Morton had been aware of what Wells was doing,

569
00:26:36,600 --> 00:26:39,639
Speaker 1: and he starts using ether instead of nitrous oxide. He

570
00:26:39,640 --> 00:26:42,080
Speaker 1: talks to his chemistry professor, He's like, can you get

571
00:26:42,080 --> 00:26:45,600
Speaker 1: me some ether? And to try out the ether, Morton

572
00:26:45,640 --> 00:26:48,560
Speaker 1: wasn't willing to test on himself. He extracted the tooth

573
00:26:48,600 --> 00:26:51,480
Speaker 1: of one of his assistants. Oh, but the ether he

574
00:26:51,600 --> 00:26:53,879
Speaker 1: was using wasn't pure enough and it was painful for

575
00:26:53,920 --> 00:26:56,520
Speaker 1: the assistant. So Morton's like, oh shoot. So then he

576
00:26:56,600 --> 00:26:58,879
Speaker 1: starts testing on himself because he can tinker with the

577
00:26:58,920 --> 00:27:01,800
Speaker 1: doses and the purity. And apparently his wife is like

578
00:27:02,160 --> 00:27:05,159
Speaker 1: super not excited that he's doing this, because he's like

579
00:27:05,680 --> 00:27:07,600
Speaker 1: I put sid a timer and I knocked myself out

580
00:27:07,640 --> 00:27:09,000
Speaker 1: for eight minutes, and she's.

581
00:27:08,880 --> 00:27:10,680
Speaker 3: Like, no, that's not good.

582
00:27:11,080 --> 00:27:12,480
Speaker 2: It's not good. What are you doing.

583
00:27:12,680 --> 00:27:14,040
Speaker 3: You're getting drained brimage.

584
00:27:14,480 --> 00:27:14,960
Speaker 2: Oh god.

585
00:27:15,240 --> 00:27:17,320
Speaker 1: So later he tries it out on a patient who

586
00:27:17,359 --> 00:27:19,879
Speaker 1: has a toothache and it works great. So he also

587
00:27:19,960 --> 00:27:24,080
Speaker 1: goes to Massachusetts General Hospital in eighteen forty six and

588
00:27:24,280 --> 00:27:27,439
Speaker 1: there is a surgeon who is doing a procedure to

589
00:27:27,720 --> 00:27:31,320
Speaker 1: excize a neck tumor. At the time, Morton was a

590
00:27:31,520 --> 00:27:34,879
Speaker 1: second year Harvard medical student, and he gets permission to

591
00:27:34,920 --> 00:27:38,480
Speaker 1: administer ether well. The surgeon is removing the tumor, and

592
00:27:38,520 --> 00:27:41,040
Speaker 1: the procedure goes so well that when it's done, the

593
00:27:41,080 --> 00:27:44,480
Speaker 1: surgeon looks out at the audience and says, gentlemen, this

594
00:27:44,560 --> 00:27:45,440
Speaker 1: is no humbug.

595
00:27:47,200 --> 00:27:50,359
Speaker 3: You have to translate for me. Is that good? Humbug

596
00:27:50,440 --> 00:27:52,119
Speaker 3: is bad? So no humbug is good?

597
00:27:52,240 --> 00:27:55,479
Speaker 2: That's right. Yes, Yeah, the double negative threw you a bit.

598
00:27:55,560 --> 00:27:57,600
Speaker 3: So if you're getting like comments from a reviewer in

599
00:27:57,640 --> 00:27:59,719
Speaker 3: the eighteen hundreds, and a reviewer too is like, this

600
00:27:59,720 --> 00:28:01,720
Speaker 3: paper is no humbug, then that's good.

601
00:28:01,760 --> 00:28:04,840
Speaker 2: That's good. Yeah, you probably got past reviewer too. Good job.

602
00:28:06,440 --> 00:28:09,080
Speaker 1: So it worked but Morton at this point sees a

603
00:28:09,119 --> 00:28:11,960
Speaker 1: cash cow, and so he doesn't want to tell anybody

604
00:28:11,960 --> 00:28:15,320
Speaker 1: what it is, and so he names it Lethion, which

605
00:28:15,359 --> 00:28:18,760
Speaker 1: is after the mythological river LETHI. I think it's pronounced

606
00:28:18,800 --> 00:28:21,600
Speaker 1: where the souls of the dead forget their earthly lives.

607
00:28:22,000 --> 00:28:24,000
Speaker 1: I don't know if I'd want to be taking something

608
00:28:24,040 --> 00:28:27,199
Speaker 1: that's usually associated with helping the dead forget things, like

609
00:28:27,320 --> 00:28:30,120
Speaker 1: I'd rather stay alive while I forget the procedure.

610
00:28:30,160 --> 00:28:32,360
Speaker 3: Would you like to take a trip on the river sticks?

611
00:28:32,680 --> 00:28:35,360
Speaker 2: Yeah, no, thank you, I'll pass. Can you just take

612
00:28:35,359 --> 00:28:36,359
Speaker 2: this moler out please?

613
00:28:36,920 --> 00:28:38,600
Speaker 3: That's one big humbug for that idea.

614
00:28:38,720 --> 00:28:39,520
Speaker 2: That's right, amen.

615
00:28:39,880 --> 00:28:42,360
Speaker 1: But ether has a super distinct smell, and so Surgeon's

616
00:28:42,360 --> 00:28:45,120
Speaker 1: pretty quickly figured out what he was doing, and he

617
00:28:45,200 --> 00:28:47,800
Speaker 1: tried to get money some other ways. He tried to

618
00:28:47,800 --> 00:28:51,800
Speaker 1: make this like very particular device for administering the ether,

619
00:28:52,240 --> 00:28:54,880
Speaker 1: but other people figured out better devices, and so anyway,

620
00:28:54,880 --> 00:28:57,640
Speaker 1: eventually Morton realizes he's not going to make a ton

621
00:28:57,680 --> 00:29:01,120
Speaker 1: of money, and everybody now transitions to trying to figure

622
00:29:01,160 --> 00:29:02,760
Speaker 1: out who can get the most credit for it. So,

623
00:29:02,800 --> 00:29:04,400
Speaker 1: if you're not gonna get rich, at least you can

624
00:29:04,440 --> 00:29:05,480
Speaker 1: impress the whole world.

625
00:29:05,560 --> 00:29:07,520
Speaker 3: Right here comes the dark side of science.

626
00:29:07,600 --> 00:29:08,520
Speaker 2: That's right. Here we go.

627
00:29:08,640 --> 00:29:11,720
Speaker 1: So Wells who was the first to do a public

628
00:29:11,760 --> 00:29:14,880
Speaker 1: demonstration of it, and if you remember, he's the one

629
00:29:15,000 --> 00:29:17,160
Speaker 1: where he did the public demonstration. It didn't work. He

630
00:29:17,200 --> 00:29:20,680
Speaker 1: was super embarrassing. So Wells is interested in this, but

631
00:29:20,680 --> 00:29:22,840
Speaker 1: he's trying out some other ways to maybe make it

632
00:29:22,880 --> 00:29:24,880
Speaker 1: work better because it was embarrassing when he did the

633
00:29:24,960 --> 00:29:28,680
Speaker 1: nitrous oxide thing. So he starts trying chloroform instead. But

634
00:29:28,920 --> 00:29:32,120
Speaker 1: he gets addicted to the chloroform and it seems to

635
00:29:32,160 --> 00:29:34,840
Speaker 1: have eventually like sort of messed with his mental health,

636
00:29:34,880 --> 00:29:38,320
Speaker 1: messed with his mind. So he goes to jail for

637
00:29:38,520 --> 00:29:41,120
Speaker 1: throwing sulfuric acid on prostitutes.

638
00:29:41,280 --> 00:29:41,920
Speaker 3: Oh boy.

639
00:29:42,320 --> 00:29:45,280
Speaker 1: Yeah, And while he's in prison, he had apparently managed

640
00:29:45,320 --> 00:29:49,920
Speaker 1: to smuggle some chloroform in and he commits suicide using

641
00:29:49,920 --> 00:29:53,560
Speaker 1: the chloroform and a razor blade in prison. So and

642
00:29:53,640 --> 00:29:55,440
Speaker 1: the worst well not the worst. The worst thing is

643
00:29:55,480 --> 00:29:55,800
Speaker 1: he died.

644
00:29:55,880 --> 00:29:56,360
Speaker 2: That's awful.

645
00:29:56,600 --> 00:29:59,080
Speaker 1: But his wife a few days later gets a letter

646
00:29:59,200 --> 00:30:02,840
Speaker 1: from the Paris Medical Society and they have concluded that

647
00:30:02,880 --> 00:30:04,920
Speaker 1: Wells is the one who should get credit for doing

648
00:30:04,920 --> 00:30:07,040
Speaker 1: the first painless surgery under anesthesia.

649
00:30:07,200 --> 00:30:10,720
Speaker 3: Oh no, so that letter could have saved his life probably.

650
00:30:10,920 --> 00:30:13,040
Speaker 1: Yeah, it seems like he was super concerned about the

651
00:30:13,120 --> 00:30:16,520
Speaker 1: credit anyway. So next up we'll talk about Morton.

652
00:30:16,640 --> 00:30:17,800
Speaker 3: Well, that's a big humbug.

653
00:30:17,920 --> 00:30:20,840
Speaker 1: That is a huge humbug. Humbug of the year maybe.

654
00:30:21,240 --> 00:30:21,560
Speaker 2: Yeah.

655
00:30:21,600 --> 00:30:23,680
Speaker 1: So Morton is the guy who was trying to make

656
00:30:23,680 --> 00:30:25,880
Speaker 1: a bunch of money off of ether and he had

657
00:30:25,960 --> 00:30:28,120
Speaker 1: kind of worked with his chemistry professor, and he and

658
00:30:28,200 --> 00:30:30,560
Speaker 1: his chemistry professor, it turns out end up in this

659
00:30:30,680 --> 00:30:34,200
Speaker 1: giant debate about who should get the credit. And Morton,

660
00:30:34,280 --> 00:30:36,760
Speaker 1: as I mentioned, he had this device that people stopped using,

661
00:30:36,800 --> 00:30:40,200
Speaker 1: and then he's frustrated because other dentists are using this procedure.

662
00:30:40,240 --> 00:30:42,080
Speaker 1: So now he's not even making money by having the

663
00:30:42,120 --> 00:30:43,080
Speaker 1: most patients.

664
00:30:43,400 --> 00:30:46,000
Speaker 3: In the meantime, a lot of people are now having

665
00:30:46,040 --> 00:30:47,960
Speaker 3: surgeries and procedures without pain.

666
00:30:48,080 --> 00:30:50,600
Speaker 1: So that's good, that should be huge, right, Yeah, But

667
00:30:50,680 --> 00:30:52,880
Speaker 1: that's not doing it for him. And in eighteen sixty eight,

668
00:30:53,000 --> 00:30:56,960
Speaker 1: a magazine article comes out saying that Morton's professor Jackson

669
00:30:57,360 --> 00:30:59,120
Speaker 1: is the one who should get the credit, and that

670
00:30:59,200 --> 00:31:02,480
Speaker 1: seems to drive Morton absolutely crazy, and he drives to

671
00:31:02,560 --> 00:31:05,480
Speaker 1: New York to confront the editors and dies of a

672
00:31:05,480 --> 00:31:06,600
Speaker 1: stroke in Central Park.

673
00:31:06,760 --> 00:31:09,000
Speaker 2: Oh my gosh, at forty eight.

674
00:31:08,960 --> 00:31:10,440
Speaker 3: This whole area is like cursed.

675
00:31:10,760 --> 00:31:12,000
Speaker 2: I know, it's horrible.

676
00:31:12,320 --> 00:31:14,160
Speaker 3: Or maybe it's just the product of all this self

677
00:31:14,160 --> 00:31:16,160
Speaker 3: experimentation with these crazy drugs.

678
00:31:16,280 --> 00:31:18,960
Speaker 1: I mean, I do think that the fact that these

679
00:31:19,040 --> 00:31:21,560
Speaker 1: drugs are a bit mind altering and had been used

680
00:31:21,680 --> 00:31:24,640
Speaker 1: maybe way too often and at way too high doses,

681
00:31:24,760 --> 00:31:26,960
Speaker 1: could have had something to do with the mental health

682
00:31:27,000 --> 00:31:31,360
Speaker 1: problems these people had. But anyway, Jackson, the chemistry professor

683
00:31:31,640 --> 00:31:34,680
Speaker 1: is backed by the Academy of Sciences of the Institute

684
00:31:34,720 --> 00:31:36,600
Speaker 1: of France, so it looks like the medical communities in

685
00:31:36,640 --> 00:31:37,520
Speaker 1: France are sort of.

686
00:31:37,680 --> 00:31:39,160
Speaker 2: Divided on who they're going to back.

687
00:31:39,600 --> 00:31:42,240
Speaker 1: Jackson gets told that he's getting the credit, but he

688
00:31:42,280 --> 00:31:46,280
Speaker 1: becomes an alcoholic and he's found screaming at Morton's gravestone.

689
00:31:46,800 --> 00:31:49,680
Speaker 1: Like even after Morton dies, he's still angry enough to

690
00:31:49,760 --> 00:31:51,800
Speaker 1: like go to his gravestone and yell at him. He

691
00:31:51,880 --> 00:31:54,040
Speaker 1: ends up in an asylum where he stays for twelve

692
00:31:54,120 --> 00:31:55,920
Speaker 1: years and dies at seventy five.

693
00:31:56,200 --> 00:31:58,600
Speaker 3: I hope to never be found yelling at gravestone.

694
00:31:58,760 --> 00:32:02,320
Speaker 1: Yeah, Like wow, you know, that seems that's pretty high end,

695
00:32:02,440 --> 00:32:05,080
Speaker 1: Like at the point where your enemy has passed on,

696
00:32:05,320 --> 00:32:05,800
Speaker 1: I feel like.

697
00:32:05,800 --> 00:32:06,640
Speaker 3: You can move on.

698
00:32:07,840 --> 00:32:09,280
Speaker 2: But I guess it's not always that easy.

699
00:32:10,400 --> 00:32:12,160
Speaker 3: On the other hand, gravestones are kind of there for

700
00:32:12,200 --> 00:32:14,920
Speaker 3: you to like visit someone who's passed and talk to

701
00:32:14,960 --> 00:32:17,760
Speaker 3: them and connect with them. And so if Yellen's what

702
00:32:17,840 --> 00:32:19,880
Speaker 3: you gotta do, I guess that is the place for it.

703
00:32:20,080 --> 00:32:23,640
Speaker 1: Yeah, I guess, sure, sure, but maybe i'd want to

704
00:32:23,640 --> 00:32:25,960
Speaker 1: like smoke some banana peels to chill me out before

705
00:32:25,960 --> 00:32:26,480
Speaker 1: I get there.

706
00:32:26,680 --> 00:32:29,520
Speaker 3: Yeah, But I'm also intrigued by this facet of history

707
00:32:29,840 --> 00:32:34,040
Speaker 3: where like societies are deciding who gets credit for something. Yeah,

708
00:32:34,080 --> 00:32:36,200
Speaker 3: you know, that's not the way we do things these days,

709
00:32:36,240 --> 00:32:38,800
Speaker 3: at least not on physics. Like if you make a discovery,

710
00:32:39,120 --> 00:32:41,400
Speaker 3: you argue about the paper, or you argue about who

711
00:32:41,440 --> 00:32:44,600
Speaker 3: gets prizes. But it's never like the American Physical Society

712
00:32:44,640 --> 00:32:47,920
Speaker 3: decides Daniel gets credit for this idea or Sally gets

713
00:32:47,920 --> 00:32:48,840
Speaker 3: credit for that idea.

714
00:32:49,040 --> 00:32:50,959
Speaker 1: I mean, I feel like the Nobel Prize has just

715
00:32:51,080 --> 00:32:53,440
Speaker 1: like that is the ultimate arbiter of who gets credit

716
00:32:53,480 --> 00:32:57,320
Speaker 1: for the idea, and maybe nobody else minds. I guess

717
00:32:57,360 --> 00:32:59,760
Speaker 1: I don't or nobody else feels like it's worth weighing in.

718
00:32:59,880 --> 00:33:00,360
Speaker 2: I don't know.

719
00:33:00,680 --> 00:33:03,440
Speaker 3: Yeah, yeah, I guess this is all pre Nobel Prize stuff,

720
00:33:03,480 --> 00:33:06,800
Speaker 3: so m M, maybe that plays a role. Fascinating all right, So,

721
00:33:06,800 --> 00:33:09,200
Speaker 3: so far three folks have tried to take credit for

722
00:33:09,240 --> 00:33:12,680
Speaker 3: it and either died or gone mad. Who's up next?

723
00:33:12,920 --> 00:33:16,320
Speaker 1: I saved the best for last, so remember the No,

724
00:33:16,400 --> 00:33:19,040
Speaker 1: this is actually the best. So the first person who

725
00:33:19,080 --> 00:33:22,920
Speaker 1: we talked about who didn't share his results publicly and

726
00:33:23,080 --> 00:33:24,360
Speaker 1: was just like, oh, this is great. I'm going to

727
00:33:24,400 --> 00:33:25,960
Speaker 1: make sure that all of my patients are well taken

728
00:33:26,000 --> 00:33:30,040
Speaker 1: care of from here on out. He continues his medical practice,

729
00:33:30,200 --> 00:33:33,320
Speaker 1: owns a pharmacy in Georgia, and has a happy life.

730
00:33:33,520 --> 00:33:36,040
Speaker 3: Oh my gosh, I was waiting for the disaster there.

731
00:33:36,040 --> 00:33:37,959
Speaker 3: But no, I'm glad he lives happily.

732
00:33:38,000 --> 00:33:40,160
Speaker 1: Ever after he does well, he dies at sixty two.

733
00:33:40,680 --> 00:33:43,240
Speaker 1: He dies well prepping to give ether to a woman

734
00:33:43,280 --> 00:33:45,440
Speaker 1: in labor. So that wasn't great for her. I'm sure

735
00:33:45,480 --> 00:33:47,720
Speaker 1: she was like no at first, give me the either.

736
00:33:48,200 --> 00:33:52,040
Speaker 3: But that's not a good sign if your doctor drops

737
00:33:52,080 --> 00:33:53,120
Speaker 3: dead during labor.

738
00:33:53,760 --> 00:33:54,280
Speaker 4: No.

739
00:33:54,280 --> 00:33:57,120
Speaker 1: No, But actually, before we go to a commercial, I

740
00:33:57,160 --> 00:33:59,440
Speaker 1: want to real quick tell you this story about chloroform

741
00:33:59,480 --> 00:34:03,040
Speaker 1: in the UK. So the UK was more interested in chloroform.

742
00:34:03,080 --> 00:34:06,400
Speaker 1: We were more interested in nitrosoxide and ether. And a

743
00:34:06,760 --> 00:34:10,360
Speaker 1: very important time when you can use ether is during childbirth.

744
00:34:10,600 --> 00:34:13,479
Speaker 1: So there was the Scottish obstetrician James Simpson. We talked

745
00:34:13,480 --> 00:34:15,400
Speaker 1: about this guy in the intro. He ran out of

746
00:34:15,400 --> 00:34:18,560
Speaker 1: the operating theater and thought about becoming a lawyer because

747
00:34:18,560 --> 00:34:21,640
Speaker 1: it was so upsetting to watch surgeries without ether. But anyway,

748
00:34:21,680 --> 00:34:25,600
Speaker 1: around eighteen forty seven he's experimenting with different gases, decides

749
00:34:25,680 --> 00:34:28,400
Speaker 1: chloroform is best. But there was this idea at the

750
00:34:28,440 --> 00:34:31,440
Speaker 1: time that women needed to actually go through the process

751
00:34:31,440 --> 00:34:33,160
Speaker 1: of labor and that the pain was sort of part

752
00:34:33,200 --> 00:34:36,040
Speaker 1: of it, and taking the pain away was unethical or like,

753
00:34:36,160 --> 00:34:39,760
Speaker 1: wasn't okay on religious grounds, and so he wasn't able

754
00:34:39,800 --> 00:34:43,759
Speaker 1: to start administering it widely until John Snow and any

755
00:34:43,760 --> 00:34:45,560
Speaker 1: epidemiology nerds out there are.

756
00:34:45,440 --> 00:34:49,040
Speaker 2: Like John Snow with the cholera pump and the Broad

757
00:34:49,040 --> 00:34:49,640
Speaker 2: Street pump.

758
00:34:49,640 --> 00:34:51,840
Speaker 1: But anyway, so he helped figure out the cause of cholera.

759
00:34:51,920 --> 00:34:53,680
Speaker 1: I think the pandemic was wrapping up by the time

760
00:34:53,680 --> 00:34:56,799
Speaker 1: he figured it out. He in eighteen fifty three administers

761
00:34:57,000 --> 00:35:00,600
Speaker 1: chloroform to Queen Victoria while she's giving We're to her

762
00:35:00,640 --> 00:35:03,480
Speaker 1: eighth child. That's high stakes, that's super high stakes.

763
00:35:03,480 --> 00:35:06,160
Speaker 2: But it goes great. Queen Victoria is like, awesome.

764
00:35:06,360 --> 00:35:09,000
Speaker 1: Everyone should have access to this, and now it becomes

765
00:35:09,239 --> 00:35:12,920
Speaker 1: super widespread. It has since been sort of superseded by

766
00:35:12,920 --> 00:35:15,319
Speaker 1: other methods because it is kind of nasty stuff, and

767
00:35:15,320 --> 00:35:17,480
Speaker 1: if you use it for too long it damages like

768
00:35:17,560 --> 00:35:21,280
Speaker 1: the liver, kidney, hearts, and eventually chloroform falls out of favor.

769
00:35:21,400 --> 00:35:26,080
Speaker 1: But Queen Victoria and obstetrician James Simpson helped bring some

770
00:35:26,280 --> 00:35:28,839
Speaker 1: pain relief to women in childbirth.

771
00:35:29,120 --> 00:35:32,600
Speaker 3: Hurrah, Hurrah James and Queen Victoria. It's amazing how these

772
00:35:32,640 --> 00:35:35,440
Speaker 3: things are cultural, right have, Like, yeah, one person in

773
00:35:35,440 --> 00:35:38,320
Speaker 3: one country can turn a whole society in one direction

774
00:35:38,600 --> 00:35:41,439
Speaker 3: or another to use chloroform and not just oxide. It's

775
00:35:41,480 --> 00:35:44,080
Speaker 3: incredible how random history really is.

776
00:35:44,320 --> 00:35:46,560
Speaker 2: Oh my gosh, yeah, it absolutely is. Agreed.

777
00:35:46,880 --> 00:35:48,319
Speaker 3: All right, Well, let's take a break and when we

778
00:35:48,360 --> 00:35:51,000
Speaker 3: come back, we'll learn what we do and don't know

779
00:35:51,200 --> 00:36:07,280
Speaker 3: about how anesthesia actually works.

780
00:36:14,920 --> 00:36:17,520
Speaker 1: All right, So let's chat about what we know about

781
00:36:17,520 --> 00:36:20,799
Speaker 1: how anesthesia works. And let's just clarify there's different kinds

782
00:36:20,840 --> 00:36:24,040
Speaker 1: of anesthesia. In this episode, we've been talking about general anesthesia,

783
00:36:24,080 --> 00:36:26,839
Speaker 1: where you breathe it in and it totally knocks you out,

784
00:36:26,880 --> 00:36:27,720
Speaker 1: you feel no pain.

785
00:36:27,960 --> 00:36:30,000
Speaker 2: We're going to go into a bit more detail about that.

786
00:36:30,120 --> 00:36:32,680
Speaker 3: Well, you don't remember feeling pain, right, Isn't There still

787
00:36:32,680 --> 00:36:35,360
Speaker 3: some debate about like are you actually feeling pain? But

788
00:36:35,400 --> 00:36:38,000
Speaker 3: then the experiences are wiped from your memory, and so

789
00:36:38,160 --> 00:36:39,680
Speaker 3: it's like you didn't feel pain.

790
00:36:40,080 --> 00:36:43,400
Speaker 1: If you're taking a local anesthetic, you are awake, and

791
00:36:43,440 --> 00:36:45,200
Speaker 1: so like when I got an epidural when I was

792
00:36:45,200 --> 00:36:47,840
Speaker 1: giving birth to my second kiddo, I was awake, you know,

793
00:36:47,880 --> 00:36:51,439
Speaker 1: but I didn't feel any pain. I felt very itchy, right,

794
00:36:51,480 --> 00:36:52,840
Speaker 1: but I didn't feel any pain.

795
00:36:54,000 --> 00:36:55,280
Speaker 2: And he was a ten pounder.

796
00:36:55,360 --> 00:36:57,600
Speaker 1: And so I don't think that my memory was wiped

797
00:36:57,640 --> 00:36:59,480
Speaker 1: because if so, I would have been feeling pain in

798
00:36:59,520 --> 00:37:00,200
Speaker 1: the moment, right.

799
00:37:00,239 --> 00:37:03,000
Speaker 3: But general anesthesia you're not conscious of right. So it's

800
00:37:03,040 --> 00:37:06,200
Speaker 3: possible that you are aware of the pain, you just

801
00:37:06,239 --> 00:37:09,760
Speaker 3: don't remember it, right because generalisty you don't remember the procedure.

802
00:37:09,880 --> 00:37:12,840
Speaker 1: Yeah, I think there is a subset of people who

803
00:37:12,960 --> 00:37:17,000
Speaker 1: like will wake up sometimes and they can't move, Yeah,

804
00:37:17,040 --> 00:37:19,040
Speaker 1: but I don't think they feel pain. They're just like,

805
00:37:19,480 --> 00:37:21,719
Speaker 1: this is a very disconcerting experience.

806
00:37:22,640 --> 00:37:24,680
Speaker 3: Well, let's hope not. But it strikes me that, like,

807
00:37:24,719 --> 00:37:27,160
Speaker 3: if I went through a very painful experience and then

808
00:37:27,200 --> 00:37:29,799
Speaker 3: somebody came and deleted those memories, I wonder how that

809
00:37:29,840 --> 00:37:32,680
Speaker 3: would be different, oh from the experience of general anesthesia.

810
00:37:32,800 --> 00:37:33,839
Speaker 2: Right, yeah, I don't know.

811
00:37:33,800 --> 00:37:36,839
Speaker 3: Anyway, Maybe that's more philosophy question. But tell us what

812
00:37:36,880 --> 00:37:39,799
Speaker 3: we know about how this actually works medically and neurologically.

813
00:37:39,960 --> 00:37:40,600
Speaker 2: Not a lot.

814
00:37:40,920 --> 00:37:45,200
Speaker 1: So. The Proceedings of the National Academy of Sciences is

815
00:37:45,239 --> 00:37:48,320
Speaker 1: a big, prestigious group of scientists in the United States,

816
00:37:48,400 --> 00:37:51,960
Speaker 1: and a twenty twenty paper started by saying anesthetics are

817
00:37:52,040 --> 00:37:55,080
Speaker 1: used every day in thousands of hospitals to induce loss

818
00:37:55,080 --> 00:37:58,719
Speaker 1: of consciousness, Yet scientists and the doctors who administer these

819
00:37:58,760 --> 00:38:01,760
Speaker 1: compounds lack am a lie secular understanding for their action.

820
00:38:02,200 --> 00:38:05,120
Speaker 3: This is twenty twenty twenty. I'm talking about ancient history anymore.

821
00:38:05,120 --> 00:38:06,200
Speaker 3: This is basically today.

822
00:38:06,280 --> 00:38:08,359
Speaker 1: That's right, that's where we are. But another thing that

823
00:38:08,400 --> 00:38:11,600
Speaker 1: was sort of interesting is that they mentioned in eighteen

824
00:38:11,680 --> 00:38:16,680
Speaker 1: forty six William Morton demonstrated general anesthesia with inhaled anesthetic

825
00:38:16,719 --> 00:38:22,200
Speaker 1: diethyl ether. So apparently they picked team Morton, Like, I

826
00:38:22,280 --> 00:38:23,439
Speaker 1: don't know if they you know.

827
00:38:23,400 --> 00:38:25,040
Speaker 3: We're wading into this controversy.

828
00:38:25,120 --> 00:38:27,680
Speaker 2: Yeah, that's right, that's right, but they're giving credit to him.

829
00:38:27,719 --> 00:38:30,000
Speaker 3: Well, I hope that the descendants of these four gentlemen

830
00:38:30,080 --> 00:38:32,319
Speaker 3: are not like still battling it out. I hope they

831
00:38:32,320 --> 00:38:36,000
Speaker 3: get together and toast these guys and all of their achievements,

832
00:38:36,040 --> 00:38:37,080
Speaker 3: and I'll get along.

833
00:38:37,239 --> 00:38:39,200
Speaker 1: I think it would be much nicer to just appreciate

834
00:38:39,239 --> 00:38:41,960
Speaker 1: the memory of people who took pain away for so

835
00:38:42,040 --> 00:38:44,120
Speaker 1: many of us, as opposed to like turning it into

836
00:38:44,120 --> 00:38:47,920
Speaker 1: a nasty fight for credit. But yeah, anyway, Okay. So

837
00:38:48,640 --> 00:38:53,160
Speaker 1: I ended up reaching out to two different anesthesiologists because

838
00:38:53,480 --> 00:38:57,120
Speaker 1: it was really complicated working through the literature and I

839
00:38:57,120 --> 00:38:59,880
Speaker 1: couldn't tell if I was reading sort of fringe idea

840
00:39:00,200 --> 00:39:02,320
Speaker 1: or the main idea, And so I ended up talking

841
00:39:02,320 --> 00:39:07,319
Speaker 1: to doctor Shannon Stem and doctor a Joa Botang Evans. So,

842
00:39:07,360 --> 00:39:09,880
Speaker 1: the main mechanism that we think is important here is

843
00:39:10,120 --> 00:39:15,960
Speaker 1: a neurotransmitter called gabba aminobeic acid or just GABBA. Your

844
00:39:16,000 --> 00:39:21,719
Speaker 1: neurons have receptors and these receptors are responsible for tinkering

845
00:39:21,760 --> 00:39:24,520
Speaker 1: with the electrical charge inside of the neuron, So let's

846
00:39:24,520 --> 00:39:27,120
Speaker 1: talk about why that's important. So our neurons are connected

847
00:39:27,160 --> 00:39:30,200
Speaker 1: to each other, there's like this open area in between

848
00:39:30,239 --> 00:39:33,319
Speaker 1: neurons called the synaps, and when chemicals are released into

849
00:39:33,360 --> 00:39:35,719
Speaker 1: that synapse, one cell has talked to another and a

850
00:39:35,760 --> 00:39:38,880
Speaker 1: message passes between the neurons. The way you get that

851
00:39:39,000 --> 00:39:42,080
Speaker 1: message into the synapse is that your cell needs to

852
00:39:42,160 --> 00:39:45,839
Speaker 1: pass a certain electrical charge to initiate what's called an

853
00:39:46,000 --> 00:39:49,160
Speaker 1: action potential. So usually your neuron has a little bit

854
00:39:49,160 --> 00:39:51,960
Speaker 1: of a negative charge and when it starts to accumulate

855
00:39:52,000 --> 00:39:54,560
Speaker 1: a positive charge, at some point it'll pass the threshold,

856
00:39:54,840 --> 00:39:57,400
Speaker 1: an electrical charge will pass through the neuron, the chemicals

857
00:39:57,400 --> 00:40:00,239
Speaker 1: will get released into the synaps, and the conversation between

858
00:40:00,320 --> 00:40:01,120
Speaker 1: neurons will happen.

859
00:40:01,280 --> 00:40:04,360
Speaker 3: This is fascinating to hear about because I think about

860
00:40:04,440 --> 00:40:07,080
Speaker 3: neurons all the time, but from the point of view

861
00:40:07,200 --> 00:40:09,800
Speaker 3: artificial neural networks. They do a lot of machine learning

862
00:40:09,840 --> 00:40:12,600
Speaker 3: and AI, and we use neural nets all the time,

863
00:40:12,719 --> 00:40:15,319
Speaker 3: but we never think about them as neurons anymore. Where

864
00:40:15,320 --> 00:40:17,799
Speaker 3: we use the same language. You know, in our mathematical

865
00:40:17,840 --> 00:40:20,240
Speaker 3: model is that a neuron is like a little blob

866
00:40:20,280 --> 00:40:22,520
Speaker 3: and it has inputs, and if the inputs are high

867
00:40:22,600 --> 00:40:24,799
Speaker 3: enough that they add up to a certain amount, then

868
00:40:24,800 --> 00:40:27,080
Speaker 3: the neuron is activated and it sends like a pulse

869
00:40:27,160 --> 00:40:30,000
Speaker 3: to its output, which is linked to other neurons. Of course,

870
00:40:30,080 --> 00:40:32,480
Speaker 3: and my understanding of the brain basically is that it's

871
00:40:32,480 --> 00:40:35,279
Speaker 3: this big network of neurons that are all firing and

872
00:40:35,320 --> 00:40:38,200
Speaker 3: stimulating each other. And so you're talking about the bit

873
00:40:38,320 --> 00:40:41,560
Speaker 3: between the neurons, the sydnaps, the connection and whether that

874
00:40:41,600 --> 00:40:44,440
Speaker 3: thing is allowed to fire or is inhibited from communicating

875
00:40:44,440 --> 00:40:45,560
Speaker 3: with other neurons. Is that right?

876
00:40:45,800 --> 00:40:46,480
Speaker 2: Yeah, pretty much.

877
00:40:46,680 --> 00:40:48,920
Speaker 1: I mean we're focusing on the neurons too. So what

878
00:40:49,000 --> 00:40:53,200
Speaker 1: GABA does is it inhibits the action potential. So what

879
00:40:53,280 --> 00:40:55,279
Speaker 1: essentially happens is that your neuron has all of these

880
00:40:55,280 --> 00:40:58,040
Speaker 1: receptors on it, and it has three different kinds of

881
00:40:58,120 --> 00:41:03,080
Speaker 1: GABA receptors for them. When this chemical GABA binds, they

882
00:41:03,160 --> 00:41:06,719
Speaker 1: open up and they let chloride ions in, and so

883
00:41:06,800 --> 00:41:10,000
Speaker 1: these ions have a negative charge, and so the negative

884
00:41:10,080 --> 00:41:13,400
Speaker 1: charge in the neuron gets more negative, which makes the

885
00:41:13,440 --> 00:41:16,600
Speaker 1: cell less likely to hit that action potential point and

886
00:41:16,640 --> 00:41:19,680
Speaker 1: talk to the next neuron price. There is another kind

887
00:41:19,760 --> 00:41:22,880
Speaker 1: of receptor that when GABA binds to it, it opens

888
00:41:23,000 --> 00:41:26,319
Speaker 1: up and it lets potassium ions out, and these are

889
00:41:26,360 --> 00:41:29,400
Speaker 1: positive charge, so the positive charge is fleeing, and so

890
00:41:29,560 --> 00:41:32,319
Speaker 1: here again the cell is getting more negative, but just

891
00:41:32,320 --> 00:41:35,360
Speaker 1: through a slightly different mechanism. So in all of these cases,

892
00:41:35,840 --> 00:41:39,719
Speaker 1: GABA is making the cell more quiet less likely to

893
00:41:39,760 --> 00:41:42,080
Speaker 1: communicate with the next cell down the line.

894
00:41:42,320 --> 00:41:44,560
Speaker 3: And it's just like a hypothesis or something we can

895
00:41:44,600 --> 00:41:47,640
Speaker 3: observe by taking like a single neuron and putting it

896
00:41:47,680 --> 00:41:50,960
Speaker 3: in an experiment and you know, connecting it to electrodes.

897
00:41:51,280 --> 00:41:54,080
Speaker 1: So I can't say that I am an expert in

898
00:41:54,200 --> 00:41:57,160
Speaker 1: how we know this. One of the women that I

899
00:41:57,239 --> 00:42:00,400
Speaker 1: talked to did mention that there was some experiment done

900
00:42:00,400 --> 00:42:04,200
Speaker 1: in mice where they genetically tinkered with the mouse so

901
00:42:04,239 --> 00:42:07,759
Speaker 1: that their GABA receptors were kind of messed up. And

902
00:42:07,800 --> 00:42:11,080
Speaker 1: when you do that, anesthesia doesn't work the same way

903
00:42:11,120 --> 00:42:14,680
Speaker 1: in these mice. So that's pretty good evidence that GABBA

904
00:42:15,000 --> 00:42:18,560
Speaker 1: is somehow involved in anesthesia. But in terms of what

905
00:42:18,600 --> 00:42:21,600
Speaker 1: we know about what these neurons are doing in our

906
00:42:21,640 --> 00:42:23,759
Speaker 1: brains in response to GABBA, like, I don't know that

907
00:42:23,800 --> 00:42:26,479
Speaker 1: we've been able to observe that happening in real time.

908
00:42:26,640 --> 00:42:28,880
Speaker 3: Yeah, although the system is so complicated, it's hard to

909
00:42:28,960 --> 00:42:32,040
Speaker 3: draw conclusions. Right. There's the famous example of the scientist

910
00:42:32,120 --> 00:42:35,400
Speaker 3: who trains frogs to jump when he says jump and

911
00:42:35,400 --> 00:42:37,879
Speaker 3: then it cuts their legs off, and he says jump

912
00:42:37,880 --> 00:42:39,359
Speaker 3: and they don't jump, and it's like, oh, see, they

913
00:42:39,400 --> 00:42:43,560
Speaker 3: can't hear me, so therefore they must hear with their legs. Yeah, right, Like,

914
00:42:43,640 --> 00:42:45,680
Speaker 3: you can obviously draw the wrong conclusion when you're dealing

915
00:42:45,719 --> 00:42:48,560
Speaker 3: with a complex system. Was that a ridiculous example?

916
00:42:48,680 --> 00:42:50,400
Speaker 2: Yeah, what famous experiment does that?

917
00:42:50,440 --> 00:42:52,239
Speaker 3: I've never heard it without a real experiment. It's a

918
00:42:52,239 --> 00:42:56,200
Speaker 3: famous anecdote illustrating how you can draw the wrong conclusion

919
00:42:56,239 --> 00:42:59,120
Speaker 3: from your data, even if it sounds reasonable. Right, So,

920
00:42:59,360 --> 00:43:01,680
Speaker 3: in this case, saying like it interferes with the gabba

921
00:43:01,880 --> 00:43:03,799
Speaker 3: and the anesthetics don't work the same way, and that

922
00:43:03,880 --> 00:43:06,120
Speaker 3: is suggestive, but I don't know how conclusive it is.

923
00:43:06,440 --> 00:43:10,040
Speaker 1: Yes, absolutely, I agree, and further highlighting the fact that

924
00:43:10,080 --> 00:43:12,719
Speaker 1: we don't really know what's going on. We've looked at

925
00:43:12,800 --> 00:43:16,480
Speaker 1: the structure of the chemicals that are used as general anesthetics,

926
00:43:16,840 --> 00:43:19,520
Speaker 1: and based on the chemical structures. We've tried to predict

927
00:43:19,680 --> 00:43:22,960
Speaker 1: other kinds of chemicals that should also act as anesthetics

928
00:43:22,960 --> 00:43:25,560
Speaker 1: because we think we understand what's going on. In some

929
00:43:25,600 --> 00:43:28,200
Speaker 1: cases that works and other cases it doesn't, So there's

930
00:43:28,520 --> 00:43:32,640
Speaker 1: something we don't understand. Also, doctor Shannon stem was telling

931
00:43:32,680 --> 00:43:36,600
Speaker 1: me that xenon kind of has similar characteristics when you

932
00:43:36,800 --> 00:43:39,040
Speaker 1: give it to people, like it acts as an anesthetic,

933
00:43:39,360 --> 00:43:41,960
Speaker 1: and xenon is a noble gas, so it's not supposed

934
00:43:41,960 --> 00:43:43,120
Speaker 1: to be reacting with anything.

935
00:43:43,200 --> 00:43:46,359
Speaker 2: So what the heck is happening there? We don't know.

936
00:43:46,600 --> 00:43:49,600
Speaker 3: Maybe it just interferes. Xenon can also like kill you

937
00:43:49,880 --> 00:43:52,600
Speaker 3: because you can breathe it in and it can interfere

938
00:43:52,640 --> 00:43:55,600
Speaker 3: with you breeding oxygen, right, so maybe it just gets

939
00:43:55,600 --> 00:43:56,000
Speaker 3: in the way.

940
00:43:56,239 --> 00:43:58,120
Speaker 1: Yeah, yep, maybe it does just get in the way.

941
00:43:58,200 --> 00:44:00,319
Speaker 1: And then it also seems like the function some of

942
00:44:00,320 --> 00:44:03,040
Speaker 1: the different kinds of anesthetics that we try is making

943
00:44:03,080 --> 00:44:06,080
Speaker 1: sells more excitatory, so more likely to talk to each other.

944
00:44:06,560 --> 00:44:09,719
Speaker 1: And so I saw what appeared to be a hypothesis

945
00:44:09,760 --> 00:44:13,120
Speaker 1: where the idea was just that it messes up communication.

946
00:44:13,239 --> 00:44:15,440
Speaker 1: So instead of having like a clear signal traveling from

947
00:44:15,440 --> 00:44:18,919
Speaker 1: neuron to neuron, there's just all kinds of things communicating

948
00:44:18,960 --> 00:44:21,120
Speaker 1: with each other at weird times, and it's more about

949
00:44:21,120 --> 00:44:24,360
Speaker 1: like the pattern of communication getting thrown off. But anyway,

950
00:44:24,400 --> 00:44:26,200
Speaker 1: I want to make clear that anything that I have

951
00:44:26,280 --> 00:44:28,759
Speaker 1: gotten incorrect is my fault and not the fault of

952
00:44:28,760 --> 00:44:32,759
Speaker 1: the anaesiologists who very patiently tried to explain this all

953
00:44:32,760 --> 00:44:32,920
Speaker 1: to me.

954
00:44:33,120 --> 00:44:35,480
Speaker 3: And how terrified you think they are by not really

955
00:44:35,600 --> 00:44:38,160
Speaker 3: knowing how this works. Doesn't that make it something of

956
00:44:38,200 --> 00:44:40,399
Speaker 3: an art For every patient you have to really monitor them.

957
00:44:40,400 --> 00:44:43,520
Speaker 3: Maybe they're reacting differently because you can't always predict how

958
00:44:43,560 --> 00:44:45,080
Speaker 3: much anesthetics somebody is going to need.

959
00:44:45,239 --> 00:44:48,520
Speaker 1: Yeah, so they both highlighted to me during our conversations

960
00:44:49,040 --> 00:44:53,239
Speaker 1: how amazing the monitoring equipment is now. So yes, you

961
00:44:53,320 --> 00:44:55,120
Speaker 1: do need to be careful. Some people need more, some

962
00:44:55,160 --> 00:44:59,200
Speaker 1: people need less. Some people have strong reactions, but they're

963
00:44:59,239 --> 00:45:01,719
Speaker 1: monitored very carefully, and as long as the people know

964
00:45:01,760 --> 00:45:04,600
Speaker 1: what they're doing, you know, and I'm sure hopefully all

965
00:45:04,680 --> 00:45:07,040
Speaker 1: certified anesthesiologists do know what they're doing.

966
00:45:07,440 --> 00:45:07,640
Speaker 2: You know.

967
00:45:07,719 --> 00:45:09,560
Speaker 1: They felt like it would be good if we knew

968
00:45:09,560 --> 00:45:12,080
Speaker 1: the mechanism, maybe that would help us become even better

969
00:45:12,120 --> 00:45:15,360
Speaker 1: at this stuff. But they felt like not knowing the

970
00:45:15,440 --> 00:45:19,200
Speaker 1: mechanism didn't keep us from doing a good and safe job.

971
00:45:19,320 --> 00:45:21,479
Speaker 1: And I feel like there's got to be all kinds

972
00:45:21,480 --> 00:45:24,120
Speaker 1: of physics stuff that you apply that even though you

973
00:45:24,120 --> 00:45:27,560
Speaker 1: don't understand it at a like atomic level or whatever,

974
00:45:27,880 --> 00:45:30,840
Speaker 1: you can still form predictions and you know, do amazing

975
00:45:30,880 --> 00:45:31,640
Speaker 1: new experiments.

976
00:45:31,920 --> 00:45:33,839
Speaker 3: Oh for sure, there's so many cases where we don't

977
00:45:33,920 --> 00:45:37,520
Speaker 3: understand the microphysics. It's too complicated for us to model that.

978
00:45:37,640 --> 00:45:40,799
Speaker 3: We know generally how things behave and so absolutely you

979
00:45:40,800 --> 00:45:42,960
Speaker 3: don't need to know all the details. I'm just super

980
00:45:43,000 --> 00:45:45,600
Speaker 3: curious and oh yeah, you know, somebody's life is at

981
00:45:45,600 --> 00:45:49,000
Speaker 3: stake here, and so it seems pretty important. You get

982
00:45:49,040 --> 00:45:51,399
Speaker 3: a sense from them, like what is the cutting edge?

983
00:45:51,440 --> 00:45:55,200
Speaker 3: Are we gonna in ten years develop new amazing anesthetics

984
00:45:55,200 --> 00:45:59,359
Speaker 3: that are better or safer or transcendently wonderful or something.

985
00:46:00,840 --> 00:46:02,759
Speaker 1: I didn't get a clear answer on that. They did

986
00:46:02,840 --> 00:46:05,480
Speaker 1: mention in passing again how great we are getting it

987
00:46:05,600 --> 00:46:08,200
Speaker 1: monitoring and how we're getting a better understanding of how

988
00:46:08,239 --> 00:46:11,279
Speaker 1: people from different backgrounds respond differently to anesthesia so that

989
00:46:11,320 --> 00:46:13,880
Speaker 1: we can try to make things even safer for everyone.

990
00:46:14,360 --> 00:46:18,400
Speaker 1: My conversations with Shannon highlighted that they are trying to

991
00:46:18,719 --> 00:46:21,560
Speaker 1: predict different compounds that would make good anesthetics, and they're

992
00:46:21,560 --> 00:46:23,880
Speaker 1: trying those out. So maybe we'll even have better tools

993
00:46:23,920 --> 00:46:27,040
Speaker 1: in the future. But if they were here, they might

994
00:46:27,040 --> 00:46:32,200
Speaker 1: give a much better answer, no surprise. So the final

995
00:46:32,280 --> 00:46:36,360
Speaker 1: question we got from the listener is going under anesthesia

996
00:46:36,440 --> 00:46:39,000
Speaker 1: different than sleeping or is it the same? And it's

997
00:46:39,040 --> 00:46:42,279
Speaker 1: definitely different than sleeping. So the anesthesiologists I talked to

998
00:46:42,360 --> 00:46:45,960
Speaker 1: said that it's more like a drug induced reversible coma.

999
00:46:46,080 --> 00:46:46,920
Speaker 2: Whoa, yeah.

1000
00:46:46,960 --> 00:46:49,280
Speaker 1: So the main criteria or that you want the person

1001
00:46:49,320 --> 00:46:53,480
Speaker 1: to be unconscious, not feeling pain, not moving, and making

1002
00:46:53,520 --> 00:46:58,320
Speaker 1: no memories. So when you're sleeping, one you move, people

1003
00:46:58,360 --> 00:47:02,320
Speaker 1: sleepwalk sometimes Two if somebody were to poke you, you

1004
00:47:02,360 --> 00:47:03,120
Speaker 1: would feel pain.

1005
00:47:03,880 --> 00:47:04,160
Speaker 4: Three.

1006
00:47:04,680 --> 00:47:06,920
Speaker 1: As I understand it, the main function of sleep is

1007
00:47:06,920 --> 00:47:09,759
Speaker 1: that it helps us consolidate memories and sometimes you even

1008
00:47:09,840 --> 00:47:12,160
Speaker 1: remember the dreams that you had, whereas when you are

1009
00:47:12,280 --> 00:47:16,640
Speaker 1: knocked out under general anesthesia, you don't make any memories. Additionally,

1010
00:47:16,800 --> 00:47:20,799
Speaker 1: when you are sleeping, when you do an EEG, you're

1011
00:47:20,840 --> 00:47:23,919
Speaker 1: looking at the activity in your brain and you'll see

1012
00:47:23,920 --> 00:47:27,640
Speaker 1: that we alternate between two different kinds of brain waves.

1013
00:47:27,640 --> 00:47:30,440
Speaker 1: So when we're in rapid eye movement sleep, our brains

1014
00:47:30,640 --> 00:47:32,759
Speaker 1: are doing one thing, and when we get out of

1015
00:47:32,840 --> 00:47:35,280
Speaker 1: rapid eye movement sleep, our brains are doing something different.

1016
00:47:35,480 --> 00:47:37,120
Speaker 1: And we're going to probably go into a lot more

1017
00:47:37,160 --> 00:47:39,399
Speaker 1: detail about this in a future episode because we're getting

1018
00:47:39,440 --> 00:47:41,359
Speaker 1: doctor Gina Poe on the show to tell us all

1019
00:47:41,400 --> 00:47:44,919
Speaker 1: about sleep and why we sleep, So more on that later.

1020
00:47:44,960 --> 00:47:47,080
Speaker 1: But the point is that when we're sleeping, our brains

1021
00:47:47,080 --> 00:47:49,600
Speaker 1: are sort of alternating between two modes, and when you

1022
00:47:49,640 --> 00:47:53,080
Speaker 1: go under anesthesia, you are staying in the same mode

1023
00:47:53,120 --> 00:47:55,560
Speaker 1: the whole time. And I believe it also just like

1024
00:47:55,640 --> 00:47:59,680
Speaker 1: creates different sort of electrical patterns altogether, so there's really

1025
00:47:59,680 --> 00:48:01,680
Speaker 1: no way in which it's sleep. And this is we

1026
00:48:01,680 --> 00:48:04,439
Speaker 1: can sort of end on a moderately interesting story, which

1027
00:48:04,480 --> 00:48:09,360
Speaker 1: is Michael Jackson used to take this drug called propofol

1028
00:48:09,719 --> 00:48:11,840
Speaker 1: and it's an anesthetic. It helped knock him out and

1029
00:48:11,880 --> 00:48:14,640
Speaker 1: it made him feel good, and so he was given

1030
00:48:14,680 --> 00:48:17,840
Speaker 1: it by his doctor at night to help him sleep.

1031
00:48:17,600 --> 00:48:18,720
Speaker 3: Because he has sleep problems.

1032
00:48:18,800 --> 00:48:22,439
Speaker 1: Right, Okay, yeah, but it's not actually sleep. So all

1033
00:48:22,480 --> 00:48:25,040
Speaker 1: of the important things that your body does while you're

1034
00:48:25,080 --> 00:48:27,840
Speaker 1: sleeping are not getting done, or at least they're not

1035
00:48:27,840 --> 00:48:30,960
Speaker 1: getting done as well when you're knocked out by something

1036
00:48:31,000 --> 00:48:34,200
Speaker 1: like propofol. And so part of why it's thought that

1037
00:48:34,280 --> 00:48:36,839
Speaker 1: he ended up dying was because he was laying down,

1038
00:48:36,880 --> 00:48:38,200
Speaker 1: but he was actually over time.

1039
00:48:38,040 --> 00:48:39,320
Speaker 2: Being deprived of sleep.

1040
00:48:39,400 --> 00:48:40,040
Speaker 3: Oh my god.

1041
00:48:40,400 --> 00:48:42,360
Speaker 1: So it is different than sleep in a way that

1042
00:48:42,440 --> 00:48:43,920
Speaker 1: is very meaningful and important.

1043
00:48:44,120 --> 00:48:47,640
Speaker 3: It's amazing how vital and how crucial all these brain

1044
00:48:47,680 --> 00:48:51,080
Speaker 3: functions are, how little we understand them, and yet how

1045
00:48:51,200 --> 00:48:55,879
Speaker 3: much we rely on all these medical advances to manipulate them.

1046
00:48:56,160 --> 00:48:57,279
Speaker 2: Yeah, it's incredible.

1047
00:48:57,320 --> 00:48:59,759
Speaker 1: And you know, despite the fact that we don't really

1048
00:49:00,160 --> 00:49:03,040
Speaker 1: stand this at a mechanistic level, I am still on

1049
00:49:03,160 --> 00:49:06,479
Speaker 1: team anesthesia. I would not want to live and any

1050
00:49:06,520 --> 00:49:09,400
Speaker 1: time that didn't have it. And you know, in addition

1051
00:49:09,440 --> 00:49:12,120
Speaker 1: to not needing to be like literally pinned down and

1052
00:49:12,200 --> 00:49:15,719
Speaker 1: restrained while someone cuts into you for surgeries, Yeah, anesthesia

1053
00:49:15,760 --> 00:49:20,040
Speaker 1: opened up much longer, much more complicated surgeries. And it has, uh,

1054
00:49:20,120 --> 00:49:22,200
Speaker 1: i'd say, really changed our lives in a lot of

1055
00:49:22,239 --> 00:49:22,760
Speaker 1: great ways.

1056
00:49:22,880 --> 00:49:25,920
Speaker 3: Yeah, and it's so recent right until Yeah, just a

1057
00:49:25,920 --> 00:49:29,040
Speaker 3: couple hundred years ago, surgery was horrible suffering.

1058
00:49:29,239 --> 00:49:29,600
Speaker 2: M M.

1059
00:49:30,000 --> 00:49:33,320
Speaker 3: Makes me wonder what medical advances in a few years

1060
00:49:33,400 --> 00:49:36,239
Speaker 3: or a few hundred years people will be unable to

1061
00:49:36,320 --> 00:49:38,960
Speaker 3: live without or imagine what it was like before we

1062
00:49:39,040 --> 00:49:39,399
Speaker 3: had them.

1063
00:49:39,600 --> 00:49:41,319
Speaker 1: Yeah, no, it's incredible. I mean I had to have

1064
00:49:41,320 --> 00:49:43,680
Speaker 1: my wisdom teeth out. I can't imagine someone just yanking

1065
00:49:43,680 --> 00:49:46,120
Speaker 1: those out with pliers without being knocked out. And clearly

1066
00:49:46,160 --> 00:49:48,640
Speaker 1: that is one of the easier surgeries I've never I've

1067
00:49:48,640 --> 00:49:51,160
Speaker 1: never had someone have to cut into my abdomen, for example,

1068
00:49:52,160 --> 00:49:54,400
Speaker 1: So hurrah for living today.

1069
00:49:56,480 --> 00:49:58,759
Speaker 3: All right, Well, we hope that journey into the history

1070
00:49:58,800 --> 00:50:01,480
Speaker 3: of anesthesia didn't put you you all to sleep numb.

1071
00:50:01,640 --> 00:50:03,279
Speaker 3: Your brain couldn't have.

1072
00:50:03,440 --> 00:50:04,359
Speaker 2: It was fascinating.

1073
00:50:05,920 --> 00:50:08,400
Speaker 3: Some folks like to listen to the podcast to fall asleep,

1074
00:50:08,480 --> 00:50:12,040
Speaker 3: so we hope that they're now asleep. Pleasantly. Have a

1075
00:50:12,040 --> 00:50:12,520
Speaker 3: great night.

1076
00:50:12,560 --> 00:50:16,439
Speaker 1: Everyone sleep tight, And let's end by hearing what Eric

1077
00:50:16,520 --> 00:50:19,919
Speaker 1: thought about our hour long episode on anesthesia.

1078
00:50:20,320 --> 00:50:23,960
Speaker 6: Eric, that definitely answered my questions. I went to college

1079
00:50:23,960 --> 00:50:26,080
Speaker 6: in Atlanta, so I think I'm definitely gonna have to

1080
00:50:26,080 --> 00:50:29,200
Speaker 6: be on Team Crawford Long in the Great Anesthesia Wars.

1081
00:50:29,680 --> 00:50:31,719
Speaker 6: And I admit to a little disappointment that I was

1082
00:50:31,760 --> 00:50:34,880
Speaker 6: born too late for ether parties and too early to

1083
00:50:34,920 --> 00:50:37,279
Speaker 6: live in a city on Mars. But I do live

1084
00:50:37,360 --> 00:50:39,719
Speaker 6: in the golden Age of podcasts. So thank you so

1085
00:50:39,840 --> 00:50:40,759
Speaker 6: much and.

1086
00:50:40,880 --> 00:50:41,680
Speaker 3: Have a great day.

1087
00:50:48,640 --> 00:50:52,200
Speaker 1: Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio.

1088
00:50:52,400 --> 00:50:54,000
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1089
00:50:54,040 --> 00:50:57,000
Speaker 3: We really would. We want to know what questions you

1090
00:50:57,200 --> 00:50:59,880
Speaker 3: have about this Extraordinary Universe.

1091
00:51:00,120 --> 00:51:02,960
Speaker 1: Want to know your thoughts on recent shows, suggestions for

1092
00:51:03,040 --> 00:51:03,840
Speaker 1: future shows.

1093
00:51:04,000 --> 00:51:06,319
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1094
00:51:06,600 --> 00:51:10,120
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1095
00:51:10,160 --> 00:51:13,360
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1096
00:51:12,440 --> 00:51:14,479
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1097
00:51:14,600 --> 00:51:18,440
Speaker 1: We have accounts on x, Instagram, Blue Sky and on

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Speaker 1: all of those platforms.

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Speaker 2: You can find us at D and K Universe.

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Speaker 3: Don't be shy, write to us.