A KNOCKOUT!

Hamilton Morris collab when

Nope.

Missed opportunity for more analysis - obstetric pain relief was heavily opposed by the church due to the belief that women SHOULD feel pain during childbirth because it was Eve's inherited punishment. This went on until the literal head of the church Queen Victoria used chloroform for her births, administered by John Snow, that this religious opposition eventually failed. Historical anesthetists were completely appalled that women had to give birth without pain relief and even though this eventually swung into the horrors of twilight sleep it came from a place of deeply believing that obstetrical pain relief was a human right. Fun fact - for obstetrical epidural, nurses and midwives check to see if the epidural is working by putting ice on the skin every hour or so. Since the pain and temp neurons work on the same pathway, people don't feel the cold of the ice if the epidural is working up to that spinal level. You move the ice up the body until the patient can feel it as cold as on their arm, etc to document the spinal level (obviously we want to have it work on the uterus but not impede the diaphragm). The goal of modern obstetric epidurals is to take the edge off but not impede movement - some places even have "walking epidurals" but I haven't seen any. The really important thing to know is that the drugs affect pain neurons, but not pressure neurons. The feeling of a fetal head coming down and taking up 99% of the space in the pelvis is indeed something that triggers a lot of pressure neurons and can be quite intense - however the ability to feel pressure is something that really helps people push properly and control the pushing which helps with labour progress and preventing perineal injury. People who end up with a C-section don't feel the knives at all but for getting the baby out we warn people that it has been described like "someone doing dishes in your belly" (lots of pulling). We do skin to skin after checking baby so they can still cuddle behind the curtain during the repair. The other thing is that obstetric epidurals are patient-controlled - there is a lockout but instead of high levels of anesthesia the continuous infusion is run at a lower rate and when people want a little more they can press a button to give themselves a bolus to top it up. Research shows that patient-controlled anesthesia gives people a feeling of empowerment and control and people also end up using less anesthesia overall. The excellent thing about obstetrics is that the pain is "worth" something in the end if all goes well, and the postpartum hormones can go absolutely crazy and make the baby the only thing people can focus on (leading people to overdo it when they should be resting, frankly). It's wild.

Too lazy to check if it was this or another episode where they talked about Chinese cigarettes but figured y’all might appreciate this https://youtu.be/XDPY0QKKVQU?is=5yX1B6-1P3x_c-1d

HR Gieger making the workstation for my Brain Salad Surgery.

Someone please tell me I’m not the only one who finds a Dog post anesthesia hilarious. They’re so goofy. I foster for our local shelter so I bring home a lot of dogs fucked up post spay/neuter.

I fucking love whenever you lot do a medical one, but as a perioperative Registered Nurse with a deep interest in medical history (the only thing I still use my medical anthropology degree for these days) this episode was an absolute delight ❤️

I spent a significant amount of time as a medical novelty when I was a child/young adult, and I learned a lot about anaesthesia both from the receiving end as a way to take an enforced nap (while my pelvis was taken apart and rebuilt like a piece of furniture) and as a patient of pain management services run primarily by anaesthesiologists. I now work in healthcare experience and medical data in part because of my (often good, occasionally horrific) experiences as a young patient, and I’ve had to populate the data for posters like the ones in the video. Big thanks to Ali for coming on and giving a clinical/academic/historical perspective, and for especially advocating that people explore accessing resources and reassurance available in the public domain - active participation in our own care is something that can be difficult but incredibly worthwhile.

Alcohol sounds super useful for surgery - antiseptic, reduces pain and keeps the doctors hands from shaking!

:) Two. And. A. Half. Hours. Some surgeries (actual surgery time, excluding prep and anaesthesia and PACU) don't take that long 💜

there's a pretty decent movie about early anesthesia called "corridors of blood," where boris karloff plays a surgeon in the 1840s who is trying to develop and introduce surgical anesthesia (and christopher lee plays an evil body-snatcher!) that has these really great horror moments of karloff's colleagues lecturing him about how "pain and the knife are inseparable." also i do want to bring up that the robert liston 300% mortality rate operation story is apocryphal, there's no attestation of it from the time.

Thanks to this episode I have now read the sentence "The loud crack was in fact the release of air through the scrotum". I would complain, but I was warned o.o

Fantastic episode. It's fun to have an engineering success.

This is one of your absolute best episodes ever, and one of your best guests as well. I really hope the good doctor will be returning, because ironically my normal tactic of using episodes to relax me before sleep instead triggered an hours long deep dive on early surgery

Yay a fun podcast to listen to a week before major surgery! :3

40 yr ER registered nurse here- omg too right -The after action report on the missed intubation is brutal with regard to the patient injury. I have seen pneumatic injury like that but only in crush incidents. I was completely impressed at the report itself. Flawless setup of the scope and causation research followed by conclusion and improvement actions. RIP Mr. Ewing and peace to his loved ones. I am sorry that happened to you.

What a delightful guest! Thank you, Doctor. Also hope Liam had a good group session.

ymmv but this episode actually made me feel a lot better about my upcoming bottom surgery so, win!

As someone who knows nothing about aesthetics but works in aviation im remembering the story of Qantas accidentally filling up the pilot's oxygen bottle with nitrogen for the tires.

This episode of The Pitt goes real hard, especially the bit where Mel hits Santos with a chair.

he's not the lisan al gaib he's a very naughty boy

I like Ali bring Ali on the pod again

Apropos of nothing, "Green for Danger" by Christianna Brand would be a perfect episode for Be Gay, Solve Crimes.

Can anyone post the YT link? The patreon embeds don't work on any of my devices

Perfect for kicking back with a wee dram of oramorph! I've already drunk the laudnum I made last summer unfortunately...

As a former butcher, I am greatly enjoying the discomfort of Victoria and Liam. The things I have seen and done.

02:05:50 this is how Liz Truss found out about the Underground Transgender Mafia!

I am 16 minutes into this and I feel sick and squirming so much I won’t need to go to the gym for a week. This episode should be marketed as a weight loss aid.

I had an endoscopy when I was 18, they asked if the numbing agent for my throat should be mint flavour or strawberry. I love strawberry. Those foul bastards sprayed my throat with useless chemical, held me down, and choked me with the camera. And brilliantly, as I was fighting every survival instinct in my body, they complained that everything I was doing was wrong. Well excuse me.

I'm going to be 100% with you: I'm not listening to this one lmao

I think "twilight sleep" (early anaesthesia, specifically for child birth) is an example of "terrible time in surgery, but you just don't remember any of it", and if I recall correctly, it was stopped being used due to a combination of patients being difficult to deal with during operation, and psychiatric distress as hard to place/impossible to place memories and sensations bubbling up after time (making them difficult to process).

great episode to come out 2 months before i get top surgery i'm sure this will do nothing weird to my anxiety

We need the whippets episode. In fact yall could just start doing periodic elements

In this episode we discover that Nova has a medfet

Baseball dates to the 1860s or so, there must have been at least one or two early pro players who were also Civil War veterans.

not gonna lie I did get a laugh out of the youtube thumbnail just being black

21:00 Greatly appreciate the 19th Century Huffing and Whippet Parties

What a wonderful episode to come out the same day I catch the flu.

Listening to this before getting bottom surgery

Omg this is a topic I love and know soooo well. I’m so excited.

Tried listening but fell asleep.

Oh shit, I'm already scared as shit of surgery because of anesthesia, you're gonna make it worse? Fuck you, I'm not listening (because it's too late so I'm listening tomorrow... I'm never getting my dick chopped off now smh)

An eepysode

New episode! November! Y'all made my day

And a sudden email notif comes to me, on the eve of my emergency jaw surgery,,

Surely, of all the episodes of this show, this is the one you don't need visuals for

The episode that puts you to sleep instantly

That first slide has me rolling already