WEBVTT - Your limb is torn off - now what? 0:00:00.120 --> 0:00:04.680 Brought to you by the all New Toyota Corolla. Welcome 0:00:04.720 --> 0:00:14.360 to Stuff you Should Know front House, Stuff Works dot Com. Hey, 0:00:14.400 --> 0:00:16.759 and welcome to the podcast. I'm Josh Clark and there's 0:00:16.840 --> 0:00:19.560 Charles W Chuck Bryant, and this is stuff you should 0:00:19.600 --> 0:00:23.240 know because Jerry's over there. Dame, are you doing, buddy? 0:00:23.320 --> 0:00:27.080 Besides sick, I'm not sick. I'm just I've got a 0:00:27.120 --> 0:00:30.319 little bit of a bug. But never well, no, do 0:00:30.320 --> 0:00:33.000 you think that's the first step in Yeah, and being 0:00:33.040 --> 0:00:37.040 sick is saying I'm sick. I definitely believe in psycho 0:00:37.240 --> 0:00:40.760 semitic effects. Yea, you know the mine has an impact 0:00:40.800 --> 0:00:42.680 on the body. Well, if you can be a hypochondria, 0:00:42.680 --> 0:00:46.040 actually you can do the officer right, Yeah, yeah, you 0:00:46.080 --> 0:00:48.800 can will yourself in not being sick. Anyway, people, the 0:00:48.840 --> 0:00:50.559 show must go on. And I just want to point 0:00:50.600 --> 0:00:53.239 out how dedicated my partner here is to his craft. Well, 0:00:53.280 --> 0:00:55.400 I also want to say I want to promise that 0:00:55.440 --> 0:00:58.520 it's not going to be like the great six weeks 0:00:58.560 --> 0:01:01.080 on this of No. You know gets that was back 0:01:01.080 --> 0:01:04.479 in the old days, the unhealthy days. I smoked and everything. Yeah, 0:01:04.520 --> 0:01:06.400 your body didn't know how to heal, so it was 0:01:06.480 --> 0:01:10.039 enjoying nicotine. Now I'm just like I'm I'm not getting sick. 0:01:10.080 --> 0:01:11.800 I said it to myself last night, and here I 0:01:11.840 --> 0:01:14.880 am better than you ever Josh two point oh, thank you. 0:01:15.120 --> 0:01:18.959 All right, let's do this okay, ready, Yeah, I got 0:01:18.959 --> 0:01:21.200 a story for you. I bet I know it. I'll 0:01:21.240 --> 0:01:25.840 bet you. Yeah. Yeah. You saw. His name is Everett 0:01:25.880 --> 0:01:30.200 Knowles Jr. But everybody called him Eddie two days in 0:01:30.280 --> 0:01:33.399 a why I find the unwholesome. Yeah, And I didn't 0:01:33.400 --> 0:01:35.520 know Eddie could be short forever it never heard that. 0:01:35.720 --> 0:01:37.399 I don't think it is. I think he just didn't 0:01:37.440 --> 0:01:40.200 like his name, Okay, because it seems like you should 0:01:40.200 --> 0:01:46.280 call him every Yeah, heavy heavy Evie. Yeah, of the Biggie, 0:01:47.680 --> 0:01:50.160 the big So he was a little e though he's 0:01:50.160 --> 0:01:55.120 a little guy, tiny, like a little Elvis. That's right. Uh, well, Eddie, 0:01:55.200 --> 0:01:57.160 we'll call him Eddie because that's what he preferred to 0:01:57.160 --> 0:02:00.720 be called. Sure. He was walking home from school one 0:02:00.800 --> 0:02:04.280 day in Somerville, Massachusetts, which is a suburb of Boston, 0:02:05.120 --> 0:02:07.800 and he was walking along the railroad tracks and there 0:02:07.840 --> 0:02:12.639 just happened to be a train loaded with gravel hauling 0:02:12.680 --> 0:02:16.839 out of the area very slowly while he was walking 0:02:16.840 --> 0:02:19.120 alongside and said, you know what, I'm just gonna have 0:02:19.200 --> 0:02:22.760 a little thrill right now and grab onto this train. 0:02:22.960 --> 0:02:26.440 And he did. He successfully grabbed onto the train, was 0:02:26.520 --> 0:02:31.040 hanging with I believe his right arm. Yeah, and uh 0:02:31.320 --> 0:02:33.959 was having the time of his life just dangling there 0:02:34.440 --> 0:02:37.720 when he misjudged the distance between the train side of 0:02:37.720 --> 0:02:42.040 the train and the side of a tunnel and he 0:02:42.360 --> 0:02:46.720 was pulled into the tunnel support and smacked it and 0:02:46.960 --> 0:02:49.560 hung on for a second before he was dropped off 0:02:49.560 --> 0:02:51.880 of the train. The train kept going through the tunnel, 0:02:52.280 --> 0:02:56.400 leaving Eddie kind of crumpled and in a little shivering 0:02:57.880 --> 0:03:02.160 mass at the mouth of the tunnel. So he stands 0:03:02.240 --> 0:03:03.800 up and he grabs his arm. He's like, oh, my 0:03:03.919 --> 0:03:07.680 arm doesn't feel very good. And he starts walking toward town. 0:03:07.880 --> 0:03:11.960 And apparently he walked about a hundred yards uphill when 0:03:12.040 --> 0:03:15.799 some workers saw him and said, grab that kid, because 0:03:15.800 --> 0:03:18.240 he was covered in blood, he was staggering, he looked 0:03:18.280 --> 0:03:20.000 like he was out of he's clearly in shocks, and 0:03:20.040 --> 0:03:23.040 they grabbed it, ran and got a woman. Because at 0:03:23.040 --> 0:03:25.359 the time, this is nineteen sixty two, a woman was 0:03:25.400 --> 0:03:27.720 the only one who could provide any kind of initial 0:03:27.760 --> 0:03:32.680 emergency care um and a clerk at I believe some 0:03:32.760 --> 0:03:35.800 sort of warehouse um came out and started to apply 0:03:35.920 --> 0:03:40.440 pressure to this boy's wounds. But she had a little 0:03:40.440 --> 0:03:43.240 bit of trouble when she tried to close the wound 0:03:43.360 --> 0:03:47.800 with a tourniquet, she found that his arm wasn't attached 0:03:47.840 --> 0:03:50.480 to his body any longer, and he's just kind of 0:03:50.520 --> 0:03:53.280 holding it there. Very Luckily he was wearing a jacket, 0:03:53.360 --> 0:03:54.800 or else his arm would have been back at the 0:03:54.840 --> 0:03:58.360 mouth of the tunnel. Man. Can you imagine, like the 0:03:58.400 --> 0:04:02.280 guy's holding his arm basically to keep it from falling 0:04:02.280 --> 0:04:04.320 out of his jacket, although he didn't know that, you know, no, 0:04:04.440 --> 0:04:06.920 he didn't. He was in shock. Luckily, he was still 0:04:07.000 --> 0:04:10.240 lucid enough to like tell everybody who he was, where 0:04:10.240 --> 0:04:14.360 he lived, and uh. They called the the hospital, and 0:04:14.680 --> 0:04:18.440 the hospital scrambled some surgeons. But it wasn't until chuck 0:04:18.640 --> 0:04:21.279 um he got to the hospital and they started cutting 0:04:21.320 --> 0:04:24.560 his jacket off that they realized the extent of the damage. 0:04:24.800 --> 0:04:28.799 This kid's arm was torn clean off. But the operative 0:04:28.839 --> 0:04:35.560 word is clean, yeah, right. Because Eddie Everett Noels Jr. 0:04:36.160 --> 0:04:42.120 Of Somerville, mass On what May two became the first 0:04:42.560 --> 0:04:47.640 recipient of a full successful limb reattachments, first human recipient. Yeah, 0:04:47.680 --> 0:04:50.760 it's a good point. They had done that before dogs successfully, 0:04:50.880 --> 0:04:54.560 and they had they had done all the different surgeries 0:04:54.839 --> 0:04:58.400 that are required to reattach a limb, but they had 0:04:58.400 --> 0:05:01.279 never done all of them at once, like they'd reattach 0:05:01.320 --> 0:05:05.479 the nerves, they'd reattach bone, they've reattached blood vessels, but 0:05:05.520 --> 0:05:08.800 they had never had a full amputation and a human 0:05:08.839 --> 0:05:12.039 being successfully reattached. And um. From what I read, the 0:05:12.080 --> 0:05:15.120 doctor was I don't know about excited, but they had 0:05:15.120 --> 0:05:18.400 been looking for a case. I was because they thought, like, 0:05:18.480 --> 0:05:19.920 I think we can do this. We just need the 0:05:20.000 --> 0:05:22.320 right case right exactly, you know. And he called his 0:05:22.360 --> 0:05:24.400 buddy and he's like, I think we got one. Getting there, 0:05:24.480 --> 0:05:27.640 they got the They like you said, they'd successfully reattached 0:05:27.839 --> 0:05:30.599 artery's nerves, bone, that kind of thing, but never all, 0:05:30.760 --> 0:05:33.159 never the whole shebang. So they said, well, we know 0:05:33.200 --> 0:05:35.919 how to do this if somebody will just come along 0:05:35.960 --> 0:05:39.760 and present us with an arm pulled cleanly off, especially 0:05:39.880 --> 0:05:43.200 twelve year old, because that definitely worked at his advantage. Apparently, 0:05:43.480 --> 0:05:47.919 an artery when severed will plug itself up, especially in 0:05:48.000 --> 0:05:50.919 younger kids that plugging is way more successful and happens 0:05:51.000 --> 0:05:54.159 more quickly. So this kid just basically presented like the 0:05:54.240 --> 0:05:57.680 perfect case. The main artery, I guess his brachial artery 0:05:57.760 --> 0:05:59.640 leading out of his shoulder was a full like two 0:05:59.640 --> 0:06:03.040 inches out of the wounds. So like they had a 0:06:03.040 --> 0:06:06.120 lot to work with, and work they did. Uh. Yeah, 0:06:06.160 --> 0:06:09.839 and they the arm was on ice and they began 0:06:09.920 --> 0:06:14.080 working immediately. This is mass general, by the way, and um. 0:06:14.120 --> 0:06:18.560 They started with the arteries and veins, and then the 0:06:18.680 --> 0:06:22.479 nurse felt well, they all sort of sold color and 0:06:22.480 --> 0:06:24.960 they described as a glow kind of came back into 0:06:25.040 --> 0:06:27.040 the arm. This kid hopped the train, had his arm 0:06:27.080 --> 0:06:29.479 pulled up, and within two and a half hours they 0:06:29.520 --> 0:06:32.440 had gotten circulation back. Yeah. And the nurse scrabbed the 0:06:32.440 --> 0:06:35.839 hand and said, hey, it's warm. That's good thinking warm. 0:06:35.960 --> 0:06:38.719 She shook it, made it do the metal sign. Everybody 0:06:38.760 --> 0:06:42.640 in the operating theories laughing. Uh. The bone and the 0:06:42.720 --> 0:06:46.640 muscle and the nerve and the skin. Um happened in 0:06:46.640 --> 0:06:49.880 in later surgeries, and the I think the nerve. They 0:06:49.880 --> 0:06:51.719 made a pretty important decision at the time was to 0:06:52.120 --> 0:06:55.320 wait on that altogether, uh, and let it heal some 0:06:55.360 --> 0:06:58.720 more first, which is as it turns out, actually, as 0:06:58.720 --> 0:07:01.440 it turns out, most of this was sort of how 0:07:01.480 --> 0:07:06.080 they do it today, Like they perfected the process from 0:07:06.080 --> 0:07:08.960 that point through the seventies and in the eighties is 0:07:08.960 --> 0:07:12.440 when they really started like humming with limb reattachment. The 0:07:12.560 --> 0:07:15.120 only difference that I saw was and we'll get into 0:07:15.120 --> 0:07:18.200 it a little more, but um. They reattached the arteries 0:07:18.200 --> 0:07:20.400 first to get circulation, I guess, to keep from more 0:07:20.400 --> 0:07:24.760 and more tissue dying. Um. And then they reattached the 0:07:24.800 --> 0:07:28.000 bone by driving a screw and using a hammer. They 0:07:28.160 --> 0:07:31.280 nailed the screw into the marrow, and then reattached the 0:07:32.280 --> 0:07:36.960 arm bone. What is that femur? Now? Femurs in the leg? 0:07:37.040 --> 0:07:41.160 You think I would have looked this up already. Yeah, 0:07:40.960 --> 0:07:44.680 the upper arm bone. Then they drove that into the 0:07:44.720 --> 0:07:48.080 other end of the screw. Normally now though they do 0:07:48.360 --> 0:07:51.760 they retach the bone for supervide stability, so when you 0:07:51.840 --> 0:07:55.720 reattach the arteries and veins and stuff, they won't pull away. Yeah, 0:07:55.720 --> 0:07:58.080 and he uh, it was a success story because he 0:07:58.240 --> 0:08:01.560 ended up he was uh, he couldn't use that hand 0:08:01.560 --> 0:08:03.840 as his dominant hand any longer, which just said because 0:08:03.840 --> 0:08:06.360 he was a good picture. Yeah, but he um was 0:08:06.440 --> 0:08:09.640 able to eventually get enough use out of it to where, 0:08:10.280 --> 0:08:13.120 uh they said about like a left hander would have 0:08:13.360 --> 0:08:15.600 use of his right hand. So he just sort of 0:08:15.600 --> 0:08:19.520 had to switch that up. But for nineteen two that's 0:08:19.520 --> 0:08:25.400 pretty successful, especially considering in nineteen sixty was the very 0:08:25.440 --> 0:08:31.400 first microsurgery performed just two years previously at the University 0:08:31.400 --> 0:08:38.000 of Vermont. Oh yeah, go catamounts. But um, so microsurgery, 0:08:38.040 --> 0:08:40.199 that's really what we're talking about here. It's the use 0:08:40.840 --> 0:08:44.360 of a microscope to perform surgery. And when you're attaching, 0:08:45.160 --> 0:08:48.640 you're essentially sewing together little nerves and blood vessels like 0:08:50.000 --> 0:08:53.439 a millimeter in diameter. You need a microscope and a tiny, 0:08:53.440 --> 0:08:56.400 tiny little needle, right, and you're using tiny, tiny little 0:08:56.640 --> 0:09:01.080 sutra thread, which is about is is is big as 0:09:01.120 --> 0:09:04.040 a hair. That's the stuff you're using to to suiture 0:09:04.080 --> 0:09:07.559 these blood vessels back together. It's not no and it's 0:09:07.600 --> 0:09:12.120 an extremely involved um surgery, as you can imagine, but 0:09:12.160 --> 0:09:14.200 it's step by step. It's like, first you do the 0:09:14.200 --> 0:09:18.400 blood vessels, then you do the arteries um and you 0:09:18.480 --> 0:09:22.960 do muscles, ligaments, tendons, all this stuff, and you're doing 0:09:23.000 --> 0:09:28.000 it in this this process, but each each surgery, each 0:09:28.040 --> 0:09:30.400 part of the procedure is like an enormous surgery in 0:09:30.440 --> 0:09:34.160 and of itself. So like um, a limbery attachment, which 0:09:34.200 --> 0:09:37.920 is called um replantation. I thought it was gonna be 0:09:37.960 --> 0:09:41.800 called like limbery or something. Some people call it that. 0:09:41.840 --> 0:09:44.720 I'm a limist, the saucy. Your doctors call it limbery. 0:09:45.120 --> 0:09:47.920 But um, it usually is like as on a whole. 0:09:48.240 --> 0:09:51.640 The replantation surgery can last like an entire day. Yeah, 0:09:51.679 --> 0:09:54.760 it's it's intensive. Um And I read too that it 0:09:55.040 --> 0:09:58.080 uh the whole micro surgery. The concept of using a 0:09:58.120 --> 0:10:01.319 microscope for surgery was not accepted at first, Like the 0:10:01.640 --> 0:10:04.920 doctors and surgeons were like, now, like you, we can't 0:10:05.000 --> 0:10:07.439 do that. We have to look with our eyes. And 0:10:07.679 --> 0:10:09.360 so it had to be perfected sort of on the 0:10:09.400 --> 0:10:12.760 fringe by doctor by surgeons who are willing to like 0:10:13.000 --> 0:10:16.520 accept this might be the future and experiment in their basements. 0:10:16.559 --> 0:10:20.480 I guess so on hapless victim maybe or dogs. Yeah, 0:10:20.559 --> 0:10:22.760 I didn't get the and I didn't look it up, 0:10:22.760 --> 0:10:26.360 but I didn't get the impression from this article one 0:10:26.400 --> 0:10:29.760 way or the other how dogs lost their limbs to 0:10:29.800 --> 0:10:32.720 begin with, Like, was it accidental? And they're like, Okay, 0:10:32.720 --> 0:10:35.440 well this we'll reattach it. Or were they cutting dogs 0:10:35.480 --> 0:10:38.280 limbs off and then reattaching them, because I'm guessing it 0:10:38.360 --> 0:10:42.360 was probably the latter in it. Probably Yeah, I mean 0:10:42.400 --> 0:10:45.400 we've talked plenty about that kind of topic, because I mean, 0:10:45.440 --> 0:10:48.240 think about it. Why would dogs limbs be pulled off 0:10:48.320 --> 0:10:51.880 in any more frequency than humans limbs and hence present 0:10:51.960 --> 0:10:54.200 more cases to practice on. I think they were cutting 0:10:54.200 --> 0:10:59.360 off dogs limbs and then reattaching, which is messed up. Yeah, 0:10:59.520 --> 0:11:03.200 it is. So you were talking about microsurgery. What I 0:11:03.240 --> 0:11:09.680 saw was replacing toes for thumbs got big sixties. That 0:11:09.760 --> 0:11:12.640 was a big one. So you had a thumb on 0:11:12.640 --> 0:11:14.880 your foot or a big toe on your hands, big 0:11:14.880 --> 0:11:18.800 toe on your hand, because apparently fifty to sevent of 0:11:18.840 --> 0:11:20.840 all the utility in your hand is in your thumb, 0:11:20.920 --> 0:11:22.679 and if you're missing a thumb, you might as well 0:11:22.760 --> 0:11:25.200 just not have your hand. You don't need a big 0:11:25.200 --> 0:11:27.400 toe quite as much. You can use a cane or 0:11:27.400 --> 0:11:30.319 something like that thanks to your new toe thumb and 0:11:30.559 --> 0:11:34.200 um that that became perfected in the sixties toethumb. That's 0:11:34.200 --> 0:11:37.920 a good band name. And then uh in the seventies, 0:11:38.200 --> 0:11:43.520 um free flat tissue transfer became a big thing, which 0:11:43.559 --> 0:11:47.080 is basically going to a part of your body, harvesting 0:11:47.120 --> 0:11:51.800 an area of your body like under your thigh, your 0:11:51.840 --> 0:11:56.920 abdomen um I think you're back, lower back, and then 0:11:56.920 --> 0:12:00.800 just basically taking the gap and sewing it back together. Right. Yeah, 0:12:00.840 --> 0:12:02.760 so you have a scar, but you also have a 0:12:03.800 --> 0:12:06.680 portion of your body that's diminished in size um, and 0:12:06.679 --> 0:12:09.079 then taking that and using it to basically do what 0:12:09.160 --> 0:12:13.520 we understand is a skin graft, which which requires microsurgery 0:12:13.559 --> 0:12:16.800 as well. Um, it's just basically taking this part here 0:12:16.840 --> 0:12:18.640 and putting it back over here where there's a bunch 0:12:18.640 --> 0:12:20.719 of damage and reattaching all of the nerves and the 0:12:21.240 --> 0:12:23.720 blood vessels and everything. Yeah, I saw when I was 0:12:23.720 --> 0:12:27.600 looking up photos of this kind of thing, I came 0:12:27.640 --> 0:12:31.120 across something that I had never seen before. And I 0:12:31.160 --> 0:12:33.760 didn't I didn't get the story, but you could almost. 0:12:34.160 --> 0:12:35.800 I mean I sort of gathered what was going on 0:12:35.840 --> 0:12:40.400 just from the photo series. But someone was degloved on 0:12:40.760 --> 0:12:46.079 the on their fingers basically from like the hand knuckles forward, 0:12:46.640 --> 0:12:51.440 all the fingers had no skin, and they, from the 0:12:51.480 --> 0:12:55.720 looks of it, they inserted it into an arm like 0:12:55.800 --> 0:12:59.760 into a bicep the fingers and like they live there 0:12:59.800 --> 0:13:04.760 for a while, like inserted under the skin of the arm, 0:13:04.800 --> 0:13:09.280 and that that skin. They later would remove the fingers 0:13:09.320 --> 0:13:12.240 and it came off as like a big flat skin 0:13:12.320 --> 0:13:15.600 graph like sticking your hand in an envelope and uh, 0:13:15.720 --> 0:13:21.040 eventually formed like webbed fingers and then fingers. That is crazy, 0:13:21.440 --> 0:13:24.480 but like, I don't know, man, I just saw these photos. 0:13:24.480 --> 0:13:26.000 I should have done. I mean, it doesn't really have 0:13:26.040 --> 0:13:28.520 anything do with this, but it was just remarkable. They 0:13:28.520 --> 0:13:32.880 see someone with their fingers stuck in their bicep under 0:13:32.880 --> 0:13:35.679 the skin. Like, I'm having trouble visualizing this. I need 0:13:35.720 --> 0:13:38.800 to see these photos. Yeah, I'll take about the show 0:13:38.840 --> 0:13:40.560 out to you. Yeah, if you want to see some 0:13:40.679 --> 0:13:44.360 really gross stuff, you can just google. Um. Microsurgery or 0:13:44.520 --> 0:13:49.640 replantation is another one. Yeah. Man, it's but amazing like 0:13:49.720 --> 0:13:51.880 that they can. And I looked at so many of them. 0:13:51.920 --> 0:13:53.360 I kind of got to that point where I was like, well, 0:13:53.360 --> 0:13:55.920 this isn't gross. This is what the body looks like 0:13:56.240 --> 0:14:00.360 without skin sometimes, and which is gross. Nuts. I wouldn't 0:14:00.360 --> 0:14:04.160 grossed out bodies without skin or gross, I don't think so. 0:14:04.520 --> 0:14:09.199 I think it's the beauty inside you couldn't desensitize my friend. Well, 0:14:09.240 --> 0:14:11.800 before we get any further, Chuck, let's do a message break, 0:14:11.800 --> 0:14:20.440 because I got some good stuff coming up. So Chuck, 0:14:21.200 --> 0:14:25.160 we understand microsearcherry. Now it's frankensteiny in right. Yeah, you're 0:14:25.200 --> 0:14:27.680 basically just sewing stuff together. Yeah, because I mean, like, 0:14:27.760 --> 0:14:29.960 let's say you have a dead person who has a 0:14:29.960 --> 0:14:31.760 great hand, and you have a live person who's got 0:14:31.760 --> 0:14:33.880 a poor hand. You cut off the live person's hand, 0:14:34.120 --> 0:14:37.040 cut off the dead person's hand and attached the live 0:14:37.240 --> 0:14:40.280 or the dead person's hand and a live person. That's 0:14:40.400 --> 0:14:45.280 that's Frankenstein and that's what they're doing. And it's pretty cool. Um, 0:14:45.320 --> 0:14:47.600 But if this ever happens to you, if if say, 0:14:47.760 --> 0:14:50.840 you have a poor hand in that it's no longer 0:14:50.880 --> 0:14:55.520 attached to your wrist, han sucks, right, and it's all 0:14:55.600 --> 0:14:58.560 crushed and damaged or whatever. No, no, no, let's say 0:14:58.560 --> 0:15:01.560 it's intact. And you say, you know what, I think 0:15:02.160 --> 0:15:04.800 through my shock that I might be a good candidate 0:15:04.800 --> 0:15:08.640 for replantation of my hand. Yeah, what do you do? Well, 0:15:08.920 --> 0:15:12.160 you want to call mine one one immediately, because that's 0:15:12.200 --> 0:15:13.760 just the first thing you do. You get go ahead 0:15:13.760 --> 0:15:16.120 and get folks on the way, or you can ask 0:15:16.320 --> 0:15:18.280 someone with you to call nine one one. That's not 0:15:18.600 --> 0:15:21.400 putting anyone out. Yeah, that's true. If you can't dial, 0:15:21.560 --> 0:15:23.520 maybe you don't have hands, you can tell Sirie to 0:15:23.560 --> 0:15:27.600 call nine one one. Yeah. I actually changed my series 0:15:27.640 --> 0:15:29.560 to a dude, so it's not a her anymore, but 0:15:29.640 --> 0:15:33.840 an englishman actually. Yeah, it's kind of fun, Reginald. I 0:15:33.840 --> 0:15:36.200 don't know what his name is actually, but he'll say 0:15:36.200 --> 0:15:38.720 stuff like, you know, I'll say call Josh and we'll 0:15:38.720 --> 0:15:42.040 say ringing Josh. Oh yeah, instead of calling it. It's 0:15:42.120 --> 0:15:46.280 classy kind of fun anyway. Um, you want to dial 0:15:46.320 --> 0:15:48.120 mine one one, get them on the way, and then 0:15:48.240 --> 0:15:50.840 immediately you want to just try and stabilize the patient. 0:15:50.880 --> 0:15:53.680 You want to stop the bleeding, either with heavy pressure 0:15:53.880 --> 0:15:57.200 or a tourniquet above the wound like a sixties female. 0:15:57.760 --> 0:16:01.120 Yeah exactly. Uh. And once you get the patient, UM, 0:16:01.440 --> 0:16:03.880 stabilize and they're not going to bleed out there in 0:16:03.920 --> 0:16:06.760 the kitchen or wherever it is. Um, you want to 0:16:06.760 --> 0:16:10.040 get the digit or the hand or the limb and 0:16:10.600 --> 0:16:13.320 put it on ice, but not directly on ice. Put 0:16:13.320 --> 0:16:16.360 it in a bag and then put that bag on ice. Yeah, 0:16:16.480 --> 0:16:18.960 you want to pack pack it in ice, as much 0:16:19.000 --> 0:16:20.400 ice as you can find, but you want to make 0:16:20.440 --> 0:16:23.040 sure that in the bag that you put the hand 0:16:23.160 --> 0:16:25.840 or the digit or whatever in there's no ice and 0:16:25.840 --> 0:16:29.440 there's no water, because water causes it to shrivel, and 0:16:29.520 --> 0:16:31.920 that means you won't be able to reattach it. Yeah, 0:16:31.920 --> 0:16:34.000 and ice you can actually if I put if I 0:16:34.040 --> 0:16:35.920 cut off my finger and I threw it in a 0:16:35.920 --> 0:16:39.400 bucket of ice, it could actually get frostbite. Yeah, that's crazy, 0:16:39.520 --> 0:16:41.840 That is crazy, but it's also pretty cool. And you 0:16:41.840 --> 0:16:44.960 don't want frostbite on your because you know you won't 0:16:44.960 --> 0:16:47.080 be able to use it anymore. Now. Frostbite is just 0:16:47.320 --> 0:16:51.880 um dead tissue brought about by exposure to extreme cold. 0:16:52.480 --> 0:16:55.840 That's right. So after the T shirt right there is 0:16:56.560 --> 0:16:58.680 after you've got it on the ice, in the bag, 0:16:58.800 --> 0:17:01.120 on the ice, you've call nine one one, you've got 0:17:01.160 --> 0:17:04.520 the bleeding stopped. You want to cross whatever fingers you 0:17:04.520 --> 0:17:07.160 have remaining and hope that you've got a good hospital 0:17:07.200 --> 0:17:10.800 nearby with some surgeons that aren't doing much at the moment, 0:17:11.560 --> 0:17:15.119 or who are willing to cancel their schedules and say 0:17:15.200 --> 0:17:17.320 let's go do this. Yeah, get off the golf course. 0:17:17.720 --> 0:17:19.640 So when you get to the hospital, there's some things 0:17:19.680 --> 0:17:22.800 you can expect. If all of your surgeons have come 0:17:22.840 --> 0:17:24.600 in from the golf course, they should be ready and 0:17:24.640 --> 0:17:27.520 waiting for you. And um, like we said, first they're 0:17:27.560 --> 0:17:31.520 going to reattach the bone to provide stability um for 0:17:31.560 --> 0:17:34.679 the rest of the surgery. And there's probably still going 0:17:34.720 --> 0:17:36.600 to be a little bit of a gap there because 0:17:36.600 --> 0:17:39.840 they need to get in there. Um. And then they 0:17:39.920 --> 0:17:44.760 start reattaching your your blood vessels. And just like with 0:17:44.960 --> 0:17:49.200 Eddie Knowles, um, that just gets you know, the blood 0:17:49.200 --> 0:17:54.440 flow going and essentially makes that limb alive once more well, 0:17:54.640 --> 0:17:58.640 and it also keeps it from further dying. Um, because Chuck, 0:17:58.680 --> 0:18:00.600 it turns out that like there is a a finite 0:18:00.640 --> 0:18:04.120 amount of time, which is understandable, but we we are 0:18:04.200 --> 0:18:06.800 aware of how much time a limb can just sit 0:18:06.840 --> 0:18:10.359 around in the hot sun starting to go you know, 0:18:10.840 --> 0:18:15.080 fit it. And there's so for example, um, if you 0:18:15.119 --> 0:18:17.480 have a whole arm or a whole leg cut off, 0:18:17.920 --> 0:18:21.760 remember death Proof, Yeah, that girl has her legs like 0:18:21.840 --> 0:18:24.240 sticking out of the window and mad Mike is that 0:18:24.359 --> 0:18:28.200 his name Russell when he hits him and her legs 0:18:28.240 --> 0:18:33.000 goes Um, if she had survived and her leg just 0:18:33.080 --> 0:18:36.760 laid there out at room temperature, Um, it could have 0:18:36.800 --> 0:18:40.120 been good for six to twelve hours. I imagine you're 0:18:40.200 --> 0:18:44.760 really pushing it at twelve hours. But if say you 0:18:44.840 --> 0:18:46.920 have somebody who's like this leg needs to be put 0:18:46.920 --> 0:18:50.080 on ice and does everything right, it could stay refrigerated 0:18:50.119 --> 0:18:54.440 for four days and still be reattached. Yeah. Um. They 0:18:54.560 --> 0:18:56.800 point out though in this article, ideally you're having that 0:18:56.840 --> 0:19:01.479 surgery that day, but if you within hours, uh, within minutes, 0:19:01.960 --> 0:19:04.800 they're talking. Ideally, Basically, the sooner the better. It's as 0:19:04.840 --> 0:19:06.960 soon as they're ready to go, you should be ready 0:19:07.000 --> 0:19:09.280 to go as well. But you're right, Um, if that 0:19:09.400 --> 0:19:12.080 is not the case and you have uh some good 0:19:12.080 --> 0:19:15.120 refrigeration going on, you can last for about four days. Yeah. 0:19:15.119 --> 0:19:17.840 And apparently it's not even necessarily the skin tissue that 0:19:18.040 --> 0:19:23.400 um that leads to problems and reattachment after being exposed 0:19:23.440 --> 0:19:28.119 or room temperature. It's muscle degradation. Oh yeah, interesting. Uh, 0:19:28.240 --> 0:19:32.320 So you you get there, you're getting your surgery done. Um, 0:19:32.400 --> 0:19:35.639 you probably are going to expect to go through that 0:19:35.720 --> 0:19:39.320 first long surgery phone reattachment, blood vessel, maybe some muscle 0:19:39.400 --> 0:19:43.520 fiber and then sure, and then they'll say we'll put 0:19:43.520 --> 0:19:46.879 the nerves off for later. Um, and then later on 0:19:46.960 --> 0:19:49.160 down the road will be a skin graft of some kind, 0:19:49.480 --> 0:19:53.480 like a UM free flap surgery like I was talking about. 0:19:53.960 --> 0:19:59.000 And the free uh refers to the the free like 0:19:59.040 --> 0:20:01.320 this part of this issue from your body has been 0:20:01.480 --> 0:20:04.080 removed the donor site. Oh, it's not the cost of 0:20:04.119 --> 0:20:08.800 the surgery, it's it's been cut free, right, And then 0:20:08.840 --> 0:20:13.359 you have makes sense and then um, it really is 0:20:13.400 --> 0:20:17.520 simpler than you think. It's reattaching, and hopefully everything takes 0:20:17.800 --> 0:20:20.760 and you fight the infection off and you start the 0:20:20.760 --> 0:20:24.600 rehab process, which um, it takes a long time, and 0:20:24.640 --> 0:20:28.040 it's it's grueling and not fun. Uh. It can be 0:20:28.080 --> 0:20:31.200 weird at first, uh, they point out in the article, 0:20:31.240 --> 0:20:33.640 And be weird to look down and see your army attached. 0:20:33.680 --> 0:20:35.880 But I imagine no weirder than looking down and seeing 0:20:35.920 --> 0:20:39.760 your arm not attached. You know, it'd probably be a 0:20:39.760 --> 0:20:42.399 comfort to see it reattached, But you're a jerk if 0:20:42.440 --> 0:20:46.160 you're like, oh, it's kind of crooked. Yeah, but apparently 0:20:46.200 --> 0:20:49.439 sometimes it can feel a little different, and uh, that 0:20:49.480 --> 0:20:53.680 can be a little strange and off putting. It's not like, oh, 0:20:53.720 --> 0:20:56.560 I'm just like I was before, right, you know, better 0:20:56.600 --> 0:20:59.760 than ever? Um and Tom wrote this one my good 0:20:59.760 --> 0:21:03.520 friend time chief. He said. He also talked about something 0:21:03.560 --> 0:21:07.280 called cross transfer. This was mind blowing, which is basically 0:21:07.359 --> 0:21:11.879 like if if just re plantation is Frankensteinian, this is 0:21:12.440 --> 0:21:16.600 even more so. Yeah, I didn't quite get the purpose 0:21:16.840 --> 0:21:20.720 of the hand. Uh, Basically, you're getting a a left 0:21:20.720 --> 0:21:24.040 hand on your right arm. Let's say, so your thumb 0:21:24.080 --> 0:21:26.640 and your pinkie would be in weird places, right, your 0:21:26.640 --> 0:21:31.080 palms still facing the right direction, but switched. Yeah, yeah, 0:21:31.119 --> 0:21:33.560 but what's what's the point of that if you have 0:21:33.680 --> 0:21:35.720 a bad hand and a good hand. I don't know 0:21:35.760 --> 0:21:38.200 if that's they only had like a left hand available 0:21:38.240 --> 0:21:40.560 at the time. I don't know that one. I got 0:21:40.600 --> 0:21:45.359 the other one where basically they take your lower leg 0:21:46.119 --> 0:21:48.639 beneath your knee. So like if your upper leg is 0:21:48.720 --> 0:21:50.479 damaged and your lower leg is fine, let's just say 0:21:50.520 --> 0:21:53.080 your upper leg is wasted for whatever reason, but your 0:21:53.080 --> 0:21:56.200 lower leg is fine. They'll cut it off the lower 0:21:56.280 --> 0:22:00.560 leg and basically turn it around right, and then your 0:22:00.640 --> 0:22:05.440 knee becomes locked. Your calf muscles then serve the function 0:22:05.480 --> 0:22:08.359 that your thigh muscles used to and your knee joint 0:22:08.400 --> 0:22:11.000 is now in your ankle, then you also are going 0:22:11.040 --> 0:22:13.800 to be wearing a prosthetic obviously because you have no 0:22:13.960 --> 0:22:18.280 thime muscles um, and you're turned around foot which is 0:22:18.280 --> 0:22:22.679 now backwards. Is extra support for that prosthetic foot or 0:22:22.760 --> 0:22:26.440 leg or limb? Wow, it's pretty cool. It's basically saying like, 0:22:26.640 --> 0:22:29.040 how can we take this and use it to even 0:22:29.040 --> 0:22:32.400 better utility now that its original purpose has been destroyed? Yeah, 0:22:32.440 --> 0:22:34.720 it's pretty cool. Yeah. I tried to find photos of 0:22:34.760 --> 0:22:39.679 a cross transferred hand, but I couldn't find any photos, 0:22:39.680 --> 0:22:43.560 and weirdly, pictures of Madonna kept popping up. Does she 0:22:43.640 --> 0:22:48.120