Speaker 1: This episode of Stuff You Should Know is sponsored by
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Speaker 1: and set your website apart. Welcome to Stuff you Should
Speaker 1: Know from House Stuff Works dot com. Hey, and welcome
Speaker 1: to the podcast. I'm Josh Clark, and there's Chuck Bryant
Speaker 1: and there's Jerry and it's Stuff you Should Know. How's
Speaker 1: going pretty good? Do you like my Scotland shirt? That's great.
Speaker 1: You're gonna wear that in Scotland. Yeah, that's why I
Speaker 1: got it. Okay, I got a shirt for each city
Speaker 1: nice country. Well Edinburgh, yeah, yeah, that's the city. Yeah.
Speaker 1: I think they'll be behind the Scotland shirt. And they
Speaker 1: will too. They're gonna stand up and do that Arsenio like, yeah,
Speaker 1: because they're living in the eighties. Yeah, about a shirt
Speaker 1: for each city on our UK tour because I'm just
Speaker 1: you know, I can write it off and that's just
Speaker 1: the very mean thing to do. I'll keep the Manchester
Speaker 1: shirt a secret. Oh I know what it is, do you?
Speaker 1: I think? So? All right, Well, we'll talk later. Okay.
Speaker 1: In the meantime, Chuck, let's talk about trias. Let's talk
Speaker 1: about the French language. Okay, tree a okay means too short?
Speaker 1: Did you know that? Which means that Lars von Trier's
Speaker 1: name is Lars Vaughan. To sort, Yeah, sort or sift.
Speaker 1: I saw another meaning, but everywhere else said sort, and
Speaker 1: apparently it was originally used exclusively in reference to sorting vegetables. Yeah,
Speaker 1: a little known fact. But the pre industrial French society
Speaker 1: was a grarian, so they would say, and that means
Speaker 1: and they snapped their fingers and point and pile of vegetables,
Speaker 1: sort of veggies, root veggies in France. Yeah, they have
Speaker 1: those everywhere, but but they they're bonkers for root veggies
Speaker 1: in France. They have good, clean, simple food in that country. Yeah,
Speaker 1: good good food. Yeah. What's it called the French food?
Speaker 1: It's not not the trinity that's like a Cajun, but
Speaker 1: the mere poix. Oh I've not heard that before. Is
Speaker 1: it the same thing? No? I think mere poise carrot onion,
Speaker 1: and one other thing parsley, celery, celery. Jerry's the celery Jerry.
Speaker 1: I think you're right? Are you right? You know you're right, okay,
Speaker 1: in Cajun Land, it's like Bell Pepper onion and what
Speaker 1: and uh garlic it would meet garlic. I was trying
Speaker 1: to think of something funny and I failed my brain
Speaker 1: just like, yeah, well it's late in the day, trying
Speaker 1: to think of something about like an angel Heart reference. Man,
Speaker 1: that movie is crazy. Still holds up. I saw it
Speaker 1: really well. Actually I can't say it holds up because
Speaker 1: I never saw it as a kid. I saw it
Speaker 1: as an adult recently. I think it's still on Netflix.
Speaker 1: You know, Lisa Bonet is in the season of Ray
Speaker 1: Donovan and she looks exactly the same vampire perhaps very
Speaker 1: pretty lady. I was crushed on her big when I
Speaker 1: was a kid, and she's super laid back. Um, what
Speaker 1: was it Lisa Huxtable? Yeah, for sure they didn't. Her
Speaker 1: name wasn't Lisa Huxtable. It was something huxtable. Well probably
Speaker 1: not because the real names Lisa. Yes. You know, sometimes
Speaker 1: shows like used the actor's first name as the character's name,
Speaker 1: even though they're not playing themselves. I always thought that
Speaker 1: was weird. Yeah. I always wonder if it's because they
Speaker 1: have a hard time I'm remembering their characters right, or
Speaker 1: the writers like I just can't come up with a name.
Speaker 1: Just call him the real name, okay, sue me. And
Speaker 1: I know people get so tired of screaming at us
Speaker 1: about like, oh, what was the name of that? And
Speaker 1: they're like her name was this? I do that to
Speaker 1: other podcasts, so I feel your pain. I heard one
Speaker 1: just the other day. I think Judge John Hodgement he
Speaker 1: couldn't think of something, and I was like, no navy blue. Anyway,
Speaker 1: I apologize for all the things we don't know. Uh.
Speaker 1: Treer to sort was to sort vegetable foundation of the
Speaker 1: term triage. Yeah. And the reason why the French got
Speaker 1: to got naming rights for this process that will describe
Speaker 1: in a minute is because it was basically invented by
Speaker 1: a French person. Pretty remarkable guy from what I can tell.
Speaker 1: He had a great name. He was Napoleon's surgeon, the
Speaker 1: chief surgeon of Napoleon's Imperial Guard. His name was Baron
Speaker 1: Dominique Jean Larrey. Yeah, and he was, uh, he was
Speaker 1: a bad dude in all the best ways. He was.
Speaker 1: And this was at a time when warfare was getting
Speaker 1: pretty serious. Um, I mean it was already serious, but
Speaker 1: people were dying and massive amounts of people soldiers dying
Speaker 1: on the field and great, great numbers. And so he said,
Speaker 1: you know what, we need to come up with the system,
Speaker 1: a way to take care of these dudes. Uh, so
Speaker 1: they're not waiting over there with a bone sticking out
Speaker 1: of their leg waiting for attention. Well this dude also,
Speaker 1: I mean he came to this conclusion because he was
Speaker 1: running around battlefields like performing amputations and um, just in
Speaker 1: a sea of bodies. Like bite, bite on your gun
Speaker 1: barrel while I cut your leg off. Yeah that kind
Speaker 1: of thing. Yeah, um, and he barrel but stuck. Sure
Speaker 1: could bite on yourn, but be really, they needed up
Speaker 1: needing new teeth. Um, the wood is much more comfortable
Speaker 1: when you're having your leg amputative without anesthetic, I would
Speaker 1: say so. Um, but while he's running around performing these
Speaker 1: battlefield amputations, he realizes quite quick quickly that some people
Speaker 1: are in need of help more urgently than others. And
Speaker 1: he decided it would be pretty awesome if you could
Speaker 1: figure out a way, like you were saying, to devise
Speaker 1: a system of arranging people very quickly so that, um,
Speaker 1: you could give aid to the people who needed it most.
Speaker 1: And Uh, to do that, you would need to sort
Speaker 1: through the people, hence triage as if they were root vegetables.
Speaker 1: Uh so what he did initially, and it's gone through
Speaker 1: some changes that we're going to talk about, but the
Speaker 1: initial incarnation of triage was only based on severity of injuries,
Speaker 1: no other factor. Well even before that, and this is
Speaker 1: another reason this guy is awesome when he like, there
Speaker 1: was a very vague form of triage before, but it
Speaker 1: was based on your social standing. Oh really, so yeah,
Speaker 1: I was reading that, like, if you have a of course,
Speaker 1: a guy who's like, uh, an aristocrat with a broken leg, yeah,
Speaker 1: and just a grunt whose bowels are hanging out, you
Speaker 1: fix the broken leg first, which is senseless. And laure
Speaker 1: was like, no, we're not gonna do that anymore. It's
Speaker 1: going to be based on severity of of injury, yeah,
Speaker 1: their need for help. And Napoleon was like, that's great,
Speaker 1: but you know, I'm at the top of the list
Speaker 1: no matter what. Right, Hey, have you heard people calling
Speaker 1: me the anti Christ behind my back? Because I could
Speaker 1: hear rumblings about this and it's bugging me. You know,
Speaker 1: I'm not really short, I'm average. Yeah, that's true. Uh.
Speaker 1: And the process went on to change a little bit more.
Speaker 1: With British surgeon naval surgeon John Wilson in six he said,
Speaker 1: you know what, let's refine this a little bit and
Speaker 1: let's put some focus on people who can be successfully treated,
Speaker 1: so not necessary early. That guy's got all his bowels
Speaker 1: hanging out, he's the most severely injured. He thought, well,
Speaker 1: you know what, that guy might not make it, so
Speaker 1: maybe we shouldn't spend so much time. It's harsh, but
Speaker 1: it's war, it is. And that was a huge shift
Speaker 1: because it up to that point, if you were a
Speaker 1: medic um like you just treated people. Now you have
Speaker 1: a decision to make with each person. Do you let
Speaker 1: that person die? Um, because they're probably going to die
Speaker 1: and you could be saving other people rather than wasting
Speaker 1: your talents and resources on this person right here, Make
Speaker 1: them comfortable, maybe throw some morphine their way, and then
Speaker 1: you know, go about your business. That was a big
Speaker 1: big shift in in triage, in battlefield triage, and in
Speaker 1: the US it didn't um, they didn't, We didn't. We
Speaker 1: didn't catch up very quickly by the Civil War. So
Speaker 1: that guy uh Laura was was working on triage, inventing
Speaker 1: it in the seventeen nineties. Um, John Wilson refined it
Speaker 1: in the eighteen forties in the Civil War. Still we
Speaker 1: were doing like first come, first served. Whoever was closest
Speaker 1: to the medic was who got worked on first in
Speaker 1: the Civil War in the eighteen sixties. Still, it wasn't
Speaker 1: until um, I think the late eighteen sixties or early
Speaker 1: eighteen seventies that the US first started adopting even basic triage.
Speaker 1: So Britain led the way in this case, well, France
Speaker 1: and then Britain. Yeah, yeah, France led the way in mercy.
Speaker 1: Britain led the way in um saying like, no, we
Speaker 1: gotta let some people die here. Well, I would say
Speaker 1: efficiency in saving lives overall. Yeah, I mean it's a
Speaker 1: very utilitarian way of looking at and like they're they're
Speaker 1: like gotta be gotta have nerves of steel, gotta have
Speaker 1: a kung fu grip. World War One things changed again. Uh,
Speaker 1: they tweaked it and now they said, all right, maybe
Speaker 1: we should treat and you know, if this was what country,
Speaker 1: this was just generally this is a US Army manual.
Speaker 1: It was, but apparently the US wasn't alone in this.
Speaker 1: It was like a it seems like a worldwide movement
Speaker 1: shift in in triage, which was to treat, uh, how
Speaker 1: many people can you treat in the shortest amount of time,
Speaker 1: So like maybe people that don't need as much. But yeah,
Speaker 1: and the basis of this is even more steely nerved
Speaker 1: than than um John Wilson's shift, because this is saying
Speaker 1: not ignore that person, they're probably going to die. It's
Speaker 1: this person is going to die, you could probably save,
Speaker 1: but it's gonna take up too much time. And the
Speaker 1: time that it takes to save this person's life and
Speaker 1: you probably could save it. You could have fixed up
Speaker 1: twelve people who weren't going to die but can get
Speaker 1: back out and fight the war a lot faster if
Speaker 1: you work on them. And that was I think the
Speaker 1: thinking behind it, patching up people who are more likely
Speaker 1: to be a will it returned to battle, rather than
Speaker 1: saving lives of people who UH might not be able
Speaker 1: to or who would take up a lot of time,
Speaker 1: hard choices. Yeah, that's super utilitarian. That was, like you said,
Speaker 1: a surgical manual out of the military at the time
Speaker 1: said this quote, a single case, even if it urgently
Speaker 1: requires attention, may have to wait for in that time
Speaker 1: a dozen others almost equally exigent but requiring less time
Speaker 1: might be cared for. And four people died while I
Speaker 1: read that on the battlefield it could have really sum
Speaker 1: that up quicker. Uh, should we take a little break? Sure? Man, No,
Speaker 1: all right, my friend, Uh, there are we've been talking
Speaker 1: about the battlefield so far in its history. That was
Speaker 1: the origin of it. But uh, if you go to
Speaker 1: the e R. And actually I haven't been to the
Speaker 1: e R much at all in the last jeez much
Speaker 1: at all in my life. That's good. But since I
Speaker 1: was a kid, but I did go in New York remember,
Speaker 1: Oh yeah, that's right. When I got sick. I went
Speaker 1: to the emergency room in New York City, Beth Israel.
Speaker 1: And it was, man, it was a little a little scary,
Speaker 1: just the scene there. Sure, yeah, it wasn't like I'm
Speaker 1: sort of used to the hospitals around here, kind of nicer,
Speaker 1: like it had seen its better days, the e R
Speaker 1: room and the waiting room, and it was it's sad
Speaker 1: to see the people that are in there that need help,
Speaker 1: you know, in a big city like that. It's um,
Speaker 1: it's not like you know, my kid fell down and
Speaker 1: bumped his head. It's like, you know, it was disturbing.
Speaker 1: I'll just say that. Yeah, but I was triaged when
Speaker 1: I first got there. And that's what will happen to
Speaker 1: you when you go to a er there. There's gonna
Speaker 1: be a triage nurse. Somebody runs up to you and
Speaker 1: throws glitter in your face and said, you've been triaged.
Speaker 1: That's after someone already threw molasses on your face. That
Speaker 1: glitter would sticks. Yeah, So triage nurse is gonna come
Speaker 1: by and that that dude to that lady is gonna say, hi,
Speaker 1: welcome to Beth Israel. Sorry about the mess. Um, let's
Speaker 1: check you out. I'll watch your step. There's some blood. Seriously,
Speaker 1: it's kind of like that. Um and uh, they will
Speaker 1: do an assessment. They're gonna look at you and say,
Speaker 1: you know, deep, this guy has a spoon coming out
Speaker 1: of his ear, so I can make a snap judgment
Speaker 1: that you need quick help. Yeah. Or this dude in
Speaker 1: my case was just holding his belly and so he
Speaker 1: looks like he can wait, Yeah, he looks like he
Speaker 1: was shooted duck. He can sit here and hold that
Speaker 1: for a little while. She said, here, let me pull
Speaker 1: your finger. Everything will be all right. And there's what
Speaker 1: you're describing this e er triage that's done by a
Speaker 1: triage nurse, right, the first person about the first person
Speaker 1: you see when you come to an e er when
Speaker 1: they're doing triage. It's not constant necessarily they have been
Speaker 1: trained to do this, but they're also following float charts.
Speaker 1: There's there's triage protocols, different ones, and there's one from Manchester,
Speaker 1: UK and it's from what I understand, the international gold
Speaker 1: standard for triage, the Manchester Triage system And it's a band. Yeah,
Speaker 1: it is like Manhattan Transfer. Um. But it's like it's
Speaker 1: a flow chart and it basically says like, um, are
Speaker 1: they breathing? No, get them immediate help, like stop right
Speaker 1: now and immediately get them into a place where a
Speaker 1: lifesaving intervention can be carried out right. Um. And there's
Speaker 1: some other ones, but it seems like breathing is the
Speaker 1: focus of it. That's good, Yeah it is, but but
Speaker 1: I mean you think about it, you would think there'd
Speaker 1: be some other ones too, like as are there is
Speaker 1: their blood coming out of their ear or something like that. No,
Speaker 1: it's mostly breathing. Like if if you're breathing, there's a
Speaker 1: pretty good chance you're you're gonna make it, especially if
Speaker 1: you have a normal breathing pattern, right. Um. And but
Speaker 1: then there's some other ones like if if the person
Speaker 1: is not responsive or if they're drooling. Apparently it's another one. Um,
Speaker 1: there are a couple of jewelers in the r Israel.
Speaker 1: They should have been seen immediately according to the Manchester
Speaker 1: UM triage system. So, um, there's like a float chart.
Speaker 1: You don't have to It's not necessarily just the nurses
Speaker 1: subjective judgment. It's not supposed to be. I'm sure it
Speaker 1: is in like high stress situations and with really highly
Speaker 1: trained triage nurses they can just be like, yeah, this
Speaker 1: move that person there, you go sit down, you go home. Um.
Speaker 1: But for the most part, it's supposed to be a
Speaker 1: UM an objective system that you can just consult and
Speaker 1: be like, okay, well here here's where you fit paper.
Speaker 1: You're so smart, why don't you just treatage everybody yourself?
Speaker 1: Well beyond the initial UH flow chart to they're also
Speaker 1: going to take some vitals. Um, here your complaint in
Speaker 1: your medical history, allergies, all that good stuff, medications you
Speaker 1: might be on, and then take your vitals, blood pressure, temperature,
Speaker 1: all that good stuff. Yeah, if if you're not in
Speaker 1: that group where they're just like to send them right back. Yes,
Speaker 1: And by the way, I'm not knocking beth is reel
Speaker 1: because Nurse Eddie there, this dude, the guy who didn't
Speaker 1: believe that you were sick. Yeah, a little bit. He
Speaker 1: was amazing and took wonderful care of me and was
Speaker 1: like the typical New York nurse that you might think
Speaker 1: of this sort of like he had the accent, and
Speaker 1: he was like a very kind of cool customer dude,
Speaker 1: like I would have felt very comfortable walking into his
Speaker 1: arms like a gunshot, because I'm sure he could have
Speaker 1: like totally taken care of me. But he did get
Speaker 1: a little like like I couldn't figure out what's wrong
Speaker 1: with me at first, and then after I got better
Speaker 1: and they knocked me out and gave me fluids and
Speaker 1: I woke up. I had a I was like, all right, great,
Speaker 1: and you know, I'm out of here. And I felt
Speaker 1: this lump, remember that, I felt a lump behind my
Speaker 1: ear the size of a golf ball. And I walked
Speaker 1: back in. I was like, Nurse Eddie, dude, I got like,
Speaker 1: what is this? And he kind of gave me one
Speaker 1: of those looks like, oh, you're one of those guys.
Speaker 1: And I was like, I'm not a hypochondriac. I'm never
Speaker 1: at the doctor. I've never been to the e R hardly, like,
Speaker 1: please don't look at me those eyes. Nurse Eddie and um,
Speaker 1: he felt it and I was like, see, it's like
Speaker 1: it's huge. And I think he determined that it was
Speaker 1: some kind of like he had a doctor come over
Speaker 1: and they determined it was just a swelling of lymph
Speaker 1: node from hypochondria brought on by my sickness. But anyway,
Speaker 1: big shout out. It turned out to be you had
Speaker 1: snakes in your belly. Yeah. If I passed out on
Speaker 1: the subway, woke up two days later in Coney Island,
Speaker 1: I had thirteen snakes in my belly, no more, no less.
Speaker 1: So weird. So um. They gather these details in the
Speaker 1: triage didn't take long. They use the color coded system
Speaker 1: in some hospitals. Numbers and some were both things on
Speaker 1: where you are. Yeah, what's this is astounding to me?
Speaker 1: It's not universal, Like the colors aren't universal. Numbers seem
Speaker 1: to be like nobody does it backwards, but the color
Speaker 1: should be the exact same too. So for example, like
Speaker 1: in Manchester's jam Like the worst of all is red.
Speaker 1: See red? Making sense? No another trio system blues? The
Speaker 1: worst code blue. Yeah, I think you hear that a
Speaker 1: lot on American TV, but it's a It's a real thing,
Speaker 1: at least in the States. So I I think that
Speaker 1: everybody should get together and agree on a color system
Speaker 1: because the whole point of triage is rapid fire. Let's
Speaker 1: get this done. Not oh, well, which system did you
Speaker 1: triage them? Because I'm I'm I enjoy a spotted t
Speaker 1: so I'm a fan of the Manchester system, so this
Speaker 1: this red is completely odd to me. Yeah, but you
Speaker 1: know the one your hospital uses, so you're probably not
Speaker 1: getting confused as the triage nurse. Yeah, I guess it's true,
Speaker 1: But I mean, I know what you mean. There's just
Speaker 1: you should you should go out of your way to
Speaker 1: um take out any possible you get transferred to another hospital. Yeah,
Speaker 1: there's just I think there should be universal colors. I
Speaker 1: have a strong opinion on that. I totally agree. If
Speaker 1: you're a kid, you may get sent to closer to
Speaker 1: the front of the line um or if you have
Speaker 1: a history of illness or like you have cancer or
Speaker 1: something like, if you have an outstanding condition already, you
Speaker 1: may be shuffled to the front um or. And this
Speaker 1: makes a lot of sense to me. A lot of
Speaker 1: times now they have what they call it a different track.
Speaker 1: They have two tracks. Um, if you're in severe distress,
Speaker 1: you're in one gets you right away. But if you
Speaker 1: have another one doesn't necessarily mean you're gonna wait eight hours.
Speaker 1: They'll just put you in a different track, right for
Speaker 1: the less severe cases. Yeah, you go see the doctor
Speaker 1: who's been caught drinking on the job. You know that's right.
Speaker 1: All right, Well, let's talk about those color codes since
Speaker 1: you mentioned it. Okay, here in the US, code blue,
Speaker 1: like you said, is the most that means come right away.
Speaker 1: I understand the use of blue. It's um like they're
Speaker 1: turning blue, yes, cyanotic? Okay, right, that it makes sense.
Speaker 1: But again red makes sense too. Yeah, you hear code
Speaker 1: red and that doesn't sound great. It doesn't make me
Speaker 1: think like, oh, they'll be fine. Well code red it's
Speaker 1: category too though, so it is serious. That means they
Speaker 1: require immediate attention. But they're just not blue, right, they're
Speaker 1: still breathing. Uh, then what he got got an orange
Speaker 1: mid level Okay, you got gray, which means you're sick,
Speaker 1: but it's like a bad cold. Really, gray should be
Speaker 1: the worst. If you're gray, you've already passed blue. That's true,
Speaker 1: you're uh. And then the least urgent is green, which
Speaker 1: just means you want someone to love you. Yeah, it
Speaker 1: means you're you're med seeking. Yeah, you shouldn't be in
Speaker 1: the er basically, right, and that's not a joke. That
Speaker 1: literally means you don't have an emergency, right they they
Speaker 1: if if you are deemed code green five, do they
Speaker 1: send you home? Yeah? Or else they'll be like, there's
Speaker 1: a minute clinic down the street, go there. Yeah, you don't,
Speaker 1: you're wasting valuable resources here, go away. So then across
Speaker 1: the pond and then under the Manchester scale, the worst
Speaker 1: is code red, followed by code orange, then code yellow,
Speaker 1: then code green, then code blue, then code earl gray. Wow,
Speaker 1: code blue is the least Yes, yeah, see you got
Speaker 1: a point like that's you can't have one color be
Speaker 1: the worst possible thing and one color be the the
Speaker 1: least dangerous, especially in an increasingly globalized world. I don't
Speaker 1: like it either, Um, what can we do? Should we
Speaker 1: start a movement? Yes? We should online petitions. How does
Speaker 1: that get done? Or just yell about it on Facebook?
Speaker 1: I think the Facebook wanna that's that's the best shot
Speaker 1: we have. That's how you accomplish things. Um, triage if
Speaker 1: there's I mean, we talked about battlefield, we talked about
Speaker 1: regularly er. But then there's of course, like when bad
Speaker 1: things happen, like in New York when that building exploded. Yeah,
Speaker 1: those are called incident triage. Yea, like a natural disaster
Speaker 1: or something. Yeah, uh that Harlem explosion, right, it was
Speaker 1: a gas explosion in Harlem. Yeah. Um, so triage works
Speaker 1: anytime there's a scarcity of resources in a high demand
Speaker 1: of for medical care. It's a good way to say.
Speaker 1: It's just it's healthcare rashing. It's it's it's saying like,
Speaker 1: we don't have enough resources for all you people, so
Speaker 1: we're gonna have to figure out who's worse, right, and
Speaker 1: you're supposed to do it very quickly. But yeah, with
Speaker 1: incident triage. Um, there's actually a really clever thing called
Speaker 1: the met tag. Then that article you sent was awesome
Speaker 1: and it was a fast code design article, and there's
Speaker 1: basically a triage code system that's used out in the
Speaker 1: field Um that you'll see people who are victims of
Speaker 1: like an explosion or a plane crash or something like that,
Speaker 1: and they'll have tags around their necks with the color
Speaker 1: code attached. And that was invented by a guy named
Speaker 1: Robert bludgett Um in Jacksonville, Florida, in the early nineteen sixties,
Speaker 1: in response to the Cuban missile crisis. Yeah. I thought
Speaker 1: that was so interesting. It did not exist. Um, he
Speaker 1: was a civil defense director and America was super scared,
Speaker 1: especially Florida at the time time, because the Soviet Union
Speaker 1: had nuclear missiles pointed at us right off the coast,
Speaker 1: what ninety miles off the coast of Florida, and people
Speaker 1: were freaking out. And um, he was one of him.
Speaker 1: He wasn't freaking out, and he seemed like a cool customer. Yeah,
Speaker 1: but he was definitely worried. But no, he doesn't seem
Speaker 1: like he was freaking He wasn't running around going like
Speaker 1: oh my god, oh my god. But he had a
Speaker 1: bomb shelter at his house. Sure don't you think anybody
Speaker 1: who was anybody had a bomb shelter back then? I
Speaker 1: told I think I mentioned before my dad went to
Speaker 1: build one after the day after movie, and um it
Speaker 1: was his obsession for a month, like you know, every
Speaker 1: Saturday for a month. I don't remember. Did he complete it.
Speaker 1: He got about a third of this dirt room dug
Speaker 1: out behind the wall. Like my brother and I basically
Speaker 1: were the was We were the cheap labor, you know,
Speaker 1: we were carrying buckets of dirt out in the woods.
Speaker 1: He'd come down with like a high left and be like,
Speaker 1: how's it going down here? How my project coming? He
Speaker 1: didn't drink, but yeah he would come down with his
Speaker 1: his buttermilk and corn bread I know, right, Um yeah,
Speaker 1: he know. Of course he didn't finish any didn't because
Speaker 1: you guys went on strike or something. Uh No, he
Speaker 1: just like a lot of people that probably saw the
Speaker 1: day after a month later, they're like, yeah, not so scared.
Speaker 1: That's an awesome story. Um So anyway, this guy has
Speaker 1: uh Mr Blodgett definitely had completed shelter. Oh yeah, there's
Speaker 1: no way he bailed. He probably swept it like every
Speaker 1: couple of days. Even well, his deal was he made it.
Speaker 1: It was really pretty brilliant. It was a two sided
Speaker 1: laminated card on lanyard and he said, you know what
Speaker 1: this thing needs to be kind of universal. Um, so
Speaker 1: I'm gonna put pictures and colors and things of uh,
Speaker 1: like you know a symbol that represents blood pressure in
Speaker 1: your sex and what time it is. Imagine those little
Speaker 1: clock on there. Um, So anyone can read this thing
Speaker 1: no matter what happened. Right. And then, um, you would
Speaker 1: be assigned a color code depending on the severity of
Speaker 1: your injury, your illness. Right, um, just like in an
Speaker 1: e er. Um. But this this lanyard around your neck,
Speaker 1: they would tear off the colors that you weren't. So
Speaker 1: it was progressive, right if you had one, I think
Speaker 1: it was green, You're fine, no problems. Uh. And then
Speaker 1: it got progressively worse. And like you said, there were
Speaker 1: some pretty clever symbols, including, um, I think on the
Speaker 1: green one, there's an ambulance with a circle with a
Speaker 1: slash through it, Like, don't even put this person on
Speaker 1: an ambulance. They're fine, they can probably, they can probably
Speaker 1: help you out if you need assistance in like applying
Speaker 1: pressure to a wound. Right, Green's fine. Um, it went
Speaker 1: all the way to black, and the black said morgue
Speaker 1: on it, and it's said in this article, it's really
Speaker 1: unsettling that if you had uh met around your neck
Speaker 1: and the only tag that was left was a black
Speaker 1: one because they ripped them off one by one, right,
Speaker 1: or they could rip off like three if like they
Speaker 1: just knew it meant you're a goner. You might still
Speaker 1: be alive right now, you're looking you're about to die
Speaker 1: where you're laying right now, and that awful because it
Speaker 1: said Morgan it too, so you could look and be like, oh,
Speaker 1: I imagine if you're in that kind of condition, you
Speaker 1: don't need that black tag to let you know that
Speaker 1: time is near. Yeah, probably not. But if you're holding
Speaker 1: out hope, it does not help. No, Yeah, no, that's good.
Speaker 1: You give up the ghost. But again, the whole idea
Speaker 1: of disaster or a battle battlefield triages. It's a necessary
Speaker 1: kind of sad thing that you have to do to
Speaker 1: save more people. It's the mercilessness of a compassionate um profession.
Speaker 1: Yeah all right, well let's take a break and we'll
Speaker 1: talk a little bit more about these tags right after this.
Speaker 1: So oh alright, So this guy Mr Blodgett, he actually
Speaker 1: sold these through I don't know if he got the money,
Speaker 1: that's what I was He didn't. I think he found
Speaker 1: somebody who was like, we can distribute these widely. Your
Speaker 1: your idea will be set in stone. But we're keeping
Speaker 1: the money. The American Civil Defense Association is who he
Speaker 1: gave them too to sell. That's the impression I have.
Speaker 1: All Right, Well, good on him, you know, hero hero,
Speaker 1: anybody who gives up intellectual property rights as a hero. Agreed. Um.
Speaker 1: So it's said here in the heyday that they were
Speaker 1: selling about a hundred thousand of these a year, two agencies,
Speaker 1: which is uh no small number. And um I didn't
Speaker 1: see how much they sold them for though. Yeah, they
Speaker 1: were in bulk, so like scantron sheets or something, probably
Speaker 1: not a lot of money. But um they went on
Speaker 1: to be refined years later in when was this? This
Speaker 1: was after the Oklahoma building explosion, right, yeah, the bombing, Yeah,
Speaker 1: the Alfred P. Murrah building. Is that pronounced right, Murmur?
Speaker 1: I think I'm pretty sure it's Maura. I just see
Speaker 1: out of the corn mon Jerry nodding and shaking her head.
Speaker 1: I don't know what means. What's speaking circle? Um. There
Speaker 1: was a l A. P. D Fire department. Um. Well,
Speaker 1: two guys actually, Dennis Ortiz and his brother, and they
Speaker 1: were working that, like I said, at l A County
Speaker 1: Fire Department and when when were they on the scene
Speaker 1: in Oklahoma at the time or were they think they
Speaker 1: were moved by it? They were like, uh, if something
Speaker 1: happened like that in l A, would we do we
Speaker 1: have like the resources we need. That's pretty amazing. So
Speaker 1: he went to get these tags from l A County
Speaker 1: and these MET tags, he said, we're basically disintegrating in
Speaker 1: my hand, I guess because they were just so old.
Speaker 1: And he said, there's there should be a new tag
Speaker 1: and this is sad but also necessary for terrorist disasters
Speaker 1: and terrorist attacks, and it was pretty great idea. So
Speaker 1: he now included this new tag with things like biological contamination,
Speaker 1: radioactive contamination, UM diagrams for blast injuries, personal property receipts,
Speaker 1: stuff like that. Yeah, it's like a trifold package. It's
Speaker 1: it's got everything all the bells and whistles you need, right,
Speaker 1: including basically a revised, improved MET tag. So a MET
Speaker 1: tag for the new Yeah. I think they're called smart
Speaker 1: tags now, really smart everything. Yeah. Well, another thing they
Speaker 1: can do too is UM, a lot of times you
Speaker 1: might not have these tags, so they'll literally right go
Speaker 1: around with sharpie's and write on people. Uh in in
Speaker 1: the case of a disaster. I wonder if people can
Speaker 1: feel you writing write the word on your forehead or something. Yeah,
Speaker 1: I can feel you're writing morge on my forehead. I
Speaker 1: know what you're doing. That's not good. Did you ever
Speaker 1: play that game when you're a little word You would
Speaker 1: draw on someone's back and you would try to guess
Speaker 1: what they were. I was. That was terrible at that
Speaker 1: I was bad too, but it felt so good. Yeah,
Speaker 1: I love back scratches. So it was always like, draw
Speaker 1: something really elaborate, Jah Lawrenz attractor, that'd be wonderful, but chuck.
Speaker 1: Whether it's in an incident triage or e ER trias
Speaker 1: or something like that, it's um well, I should say.
Speaker 1: And an e R triage. There's a spectrum of triage, right,
Speaker 1: and e R is about the most calm, stable version
Speaker 1: of it, even a chaotic, crazy e ER in a
Speaker 1: big city, compared to on the other end, the site
Speaker 1: of a massive disaster that's not just impacted a bunch
Speaker 1: of people, it's probably affected like the health care infrastructure
Speaker 1: as well. Within within that spectrum, there's different types of triage,
Speaker 1: and usually the worst it is the faster your assessment
Speaker 1: has to be. So like out on a battlefield. Um,
Speaker 1: they've come up with basically a two two point um
Speaker 1: triage assessment. It's called the field triage score. It's part
Speaker 1: of the technical combat casualty care methodology, right where they
Speaker 1: feel your pulse and then they give you a rating
Speaker 1: of awareness on the Glasgow Coma scale, which we covered
Speaker 1: in our comma. Yeah, and apparently if you put those together,
Speaker 1: it's a pretty good predictor of whether somebody's going to
Speaker 1: survive their injuries or not. So like, if you're out
Speaker 1: of it and your pulse is low, move along, that
Speaker 1: person is a goner in that situation. Whereas if that
Speaker 1: person came into an e R in the suburbs um
Speaker 1: or or trauma center or something like that, they might
Speaker 1: have a really good chance of making it. But depending
Speaker 1: on the situation along that spectrum of triage, UM, you're
Speaker 1: you're going to depending on where you are on that
Speaker 1: spectrum physically literally, Um, you may just get passed over
Speaker 1: or you may have your life saved. Man, You've got
Speaker 1: to have nerves of steel to be a first responder. Yeah,
Speaker 1: and we should also say to once you're given a code. Um,
Speaker 1: but you're like, that's not it's not static, like it
Speaker 1: can change, You're you can deteriorate over right, switch tags
Speaker 1: that person next to you, right, But no, you're absolutely right,
Speaker 1: like to to to say, like I want to save
Speaker 1: your life, but I can't. I've got to leave you
Speaker 1: there to die. You're absolutely right. I mean it's metal,
Speaker 1: not for me. That's metal in both spellings, two D
Speaker 1: s and a T, you know, two teas and an
Speaker 1: L E. Oh, it's M E T T L E.
Speaker 1: Why do I think it was emmy D D L E.
Speaker 1: Because it's like meddling. If you went and rearranged everybody's tags,
Speaker 1: that would be meddling. It's amazing metal and like metal.
Speaker 1: I know, it's amazing the amount of dope things I
Speaker 1: say on the show, and people still think I like
Speaker 1: have anything to offer the world. I've got you beat
Speaker 1: by like four or five times. I think I don't
Speaker 1: think so, I think so. Um, all right, well let's
Speaker 1: talk a little bit about what's well, we've talked about
Speaker 1: what's good about it, um, pretty much everything because it
Speaker 1: will say ultimately more lives, yeah, but has its critics
Speaker 1: well yeah, and a lot of times you know when
Speaker 1: you go to the e er. We're not talking battlefield
Speaker 1: or disaster, but when you go to the er, you
Speaker 1: want to get seen as quickly as possible because it's
Speaker 1: the worst. My thumb hurts, Yeah, and so long you
Speaker 1: look around and you're like, well, that person doesn't look
Speaker 1: so bad off, why are they going in? Or I've
Speaker 1: been here for an hour. This guy just came in
Speaker 1: and he got seen and he didn't look too bad
Speaker 1: that the kids breathing, Yeah, why is he going ahead
Speaker 1: of me? Yeah? I mean they hear a lot of
Speaker 1: I mean e ers have to feel a lot of complaints,
Speaker 1: yeah about wait times. And there's a lot of people
Speaker 1: who end up in what's called the l w B
Speaker 1: S category. Is that where they send complainers left without
Speaker 1: being seen. Some people just give up there, like forget it,
Speaker 1: I'm not sitting around here any longer. I could see
Speaker 1: me doing that. Yeah, you just become indignant or you're
Speaker 1: like I feel like eating some cereal. Well, I just
Speaker 1: don't like to wait. And maybe it would have to
Speaker 1: be something where it's subsided enough to rouse like I
Speaker 1: think I'll be all right, right, not like an injury, right,
Speaker 1: Unless I thought I could set it up myself or
Speaker 1: Rambo style, which Emily's dad did once. What did you
Speaker 1: like soda cut in his arm himself one time with
Speaker 1: needle and thread? Did he put gunpowder in it and
Speaker 1: light it on fire? He should have that would have
Speaker 1: done it. Uh. And apparently that they interviewed someone from
Speaker 1: for our House to Works article from our great children's
Speaker 1: hospital here Scottish right, and this doctor said, especially at
Speaker 1: children's hospitals, a lot of upset parents that don't really
Speaker 1: get the triage thing. Well, um, there's been studies actually
Speaker 1: that there was. There was one very famous study from
Speaker 1: the nineteen nineties I think actually, and then it had
Speaker 1: there was such an outcry against it as far as
Speaker 1: criticism of the study went, because the study, the studies
Speaker 1: findings were very critical the trio triage as a whole,
Speaker 1: like the concept of it. Um that the authors actually
Speaker 1: wrote another study responding to the criticisms of their original study.
Speaker 1: And I was reading that and they're basically in the
Speaker 1: original study they found that triage when it's actually done,
Speaker 1: leads to longer wait times for the people who need
Speaker 1: the most immediate care, like gets in the way, and
Speaker 1: that it didn't have any impact patient satisfaction, meaning people
Speaker 1: didn't feel like they were being cared for better than
Speaker 1: when they weren't exposed to triage. So um, they the
Speaker 1: the people just said this is what we found. A
Speaker 1: lot of people were like, this is a B S study,
Speaker 1: but it does make sense. There are critics to triage
Speaker 1: saying like, no, this is unnecessary. Uh, it's clumsy, it
Speaker 1: gets in the way. It's an extra layer, a barrier
Speaker 1: between a patient and treatment. Um, like someone's gotta say
Speaker 1: this guy's got a spoon in his ear. I think
Speaker 1: for the most part, the critics don't have an alternative
Speaker 1: and that you know, triage can help. But I think
Speaker 1: there's a it's almost a cult of triage, where like, yeah,
Speaker 1: of course triage helps. You're an idiot for saying anything different.
Speaker 1: Scientists are saying like, it's not it's not perfect. Um,
Speaker 1: but I don't know what an alternative would be in
Speaker 1: the case of really scarce resources. Well, here's one, not alternative,
Speaker 1: but one other way of doing things. And they did this,
Speaker 1: uh at the Kaiser Permanent South Sacramento Medical Center Kaiser Permanente.
Speaker 1: They forgot the e oh they did Kaiser Permanent. What
Speaker 1: they said here, Um, what does permanente? I mean either
Speaker 1: what does what does it think? It means permanent in Spanish? Okay,
Speaker 1: who's kaiser? Uh? That means permanent in German? So the
Speaker 1: permanent permanent. No, that means a role, A delightful type
Speaker 1: of role that's permanent, a German role forever. Uh yeah
Speaker 1: yeah four times. So. Um they employed something from the
Speaker 1: l e A and the lean thinking principle in Japan
Speaker 1: and their businesses. Is this like when they have people
Speaker 1: do like calistinics and that kind of thing. Now, I
Speaker 1: don't know, I want to look into what that is.
Speaker 1: It sounds interesting. Well, it's like a cutting down on waste.
Speaker 1: But I'm sure that the Japanese probably figured out a
Speaker 1: way to insert calisthenics into it. Um are Actually I
Speaker 1: might be thinking of China. No, Japanese are into too, okay. Um.
Speaker 1: So they used this lead methodology and what they would do,
Speaker 1: and this makes a lot of sense. It was sort
Speaker 1: of like the two track thing. But if you have
Speaker 1: the minor injury, you actually have a doctor come out
Speaker 1: to the waiting room and treat you in the waiting room,
Speaker 1: or at least see you at first in the waiting room.
Speaker 1: And I think that definitely would give someone a sense
Speaker 1: of while I'm being tended to, at least I'm not
Speaker 1: just sitting over here holding my belly in pain. But
Speaker 1: it's also not like, uh, you're on track to go
Speaker 1: sit over there and wait for a bed to come
Speaker 1: open so you can see. It's like, you there, you
Speaker 1: don't have to wait for a bed. The doctor came
Speaker 1: to you instead. Yeah, that's a great idea. And they
Speaker 1: found it reduced the left without being seen rate from
Speaker 1: four point five percent to one point five percent. Uh,
Speaker 1: and the wait times fell by half. Yeah, that's right.
Speaker 1: Wait times are one of my biggest complaints with modern medicine. Sure,
Speaker 1: it's the worst. Your appointments at one, you get in
Speaker 1: there at two. Oh man, boy, oh boy, you want
Speaker 1: to see me get mad? Stick me in the waiting
Speaker 1: room with bad magazines. But if you got some mad magazines,
Speaker 1: you're like, this is delightful. The other criticism of triage
Speaker 1: is that it shouldn't be done at all, That withholding
Speaker 1: care under any circumstances is unethical. So I just have
Speaker 1: like eight times as many doctors and nurses. I guess
Speaker 1: it's come on. Uh, if you want to know more
Speaker 1: about triage you're sorting. Um, you can type those words
Speaker 1: into the search part how stuff works dot Com. And
Speaker 1: since I said that it's time for listening mail, I'm
Speaker 1: gonna call this lighthouse follow up. We've got a lot
Speaker 1: of really great pictures and emails from lighthouse enthusiasts. Yeah,
Speaker 1: it's pretty cool. Uh, including ones that were for sale
Speaker 1: so I could live about my fantasy. Yeah. Are you
Speaker 1: going to know how much are they didn't see? Um,
Speaker 1: I don't know. I didn't. I don't remember any crisis
Speaker 1: looking up on Zilo. I bought like two of them
Speaker 1: and I didn't catch the price. You're just like, here's
Speaker 1: a bunch of money. Bring me those lighthouses. Hey, guys,
Speaker 1: I listened to your lighthouse episode and it was so
Speaker 1: excited to hear this. Last year, I visited every lighthouse
Speaker 1: on Oregon's coast her state. Uh, such a good year
Speaker 1: long goal, That's what she said. I agree. Anyhow, I
Speaker 1: wanted to tell you about one of our coolest in
Speaker 1: my opinions, is Terrible Tilly. She was built on a
Speaker 1: rock a mile off shore and see pictures is really neat.
Speaker 1: That's what I needs. It's like just out there in
Speaker 1: the middle of the ocean. Many men died trying to
Speaker 1: construct in eighteen seventies, and many men died while keeping
Speaker 1: the light that was decommissioned in nineteen fifty seven and
Speaker 1: was sold after her sale, until he became a graveyard
Speaker 1: so to speak. Sailors would be cremated and had their
Speaker 1: ashes stored in the lighthouse. During the seasonal storms, when
Speaker 1: the waves break into the lighthouse, the ocean chooses who
Speaker 1: she takes back with her to be buried in her bosom. Well,
Speaker 1: it's very poetic. It's pretty romantic in a Victorian or
Speaker 1: Gothic way. I totally agree. Thanks for all you guys do.
Speaker 1: I look forward to listening to your podcast every week.
Speaker 1: And I evangelized stuff you should know, the stuff you
Speaker 1: should know gospel to all my friends. And that is
Speaker 1: from Kendra, and Kendra used the word evangelizing bosom in
Speaker 1: the same email and Gothic, so that means straight to
Speaker 1: the top of the pile. Thanks a lot, Kendra, that
Speaker 1: was indeed to create email. Uh. If you want to
Speaker 1: get in touch with us, you can tweak to us
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