I Don't Know About That - Anesthesia

Episode Date: February 28, 2023

Jim knew a bit about anesthesia, but now how to spell it. Dr. Christopher Lancaster, MD teaches us the correct spelling and also a lot more! Our friend Sean Marquette (@seanmarquette) joins us in the studio and will be on our Patreon at the end of the week! Jim's new special "High & Dry" is now available on Netflix! Subscribe to our Patreon at patreon.com/IDKAT for ad free episodes, bonus episodes, and more exclusive perks! Tiers start at just $2! ADS: ATHLETIC GREENS: If you’re looking for an easier way to take supplements, Athletic Greens Is giving you a FREE 1-year supply of Vitamin D AND 5 free travel packs with your first purchase. Go to athleticgreens.com/IDKAT. That’s athleticgreens.com/IDKAT. Check it out.

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Good. Yeah, I forgot the name Of our show for a bit The sun The moon Which one has man stood on Neither It's a conspiracy theory Theory Not even a theorist

A theorist is like Talking about us Not doing it Good morning Hello everyone Welcome to the i don't know about that frame what's that it doesn't matter no one watches this okay um hello everyone welcome to the i don't know about that podcast uh i'm jim jeffries uh my special is out thank you everyone for who is right nice messages and what type of stuff i appreciate that i'm here uh with

forest shore how are you i'm good You're about to go to England. Kelly Bear. Hello. Jack Hackett. And Sean Marquette. I was going to say your name, but I always say Marquez. It's Marquette. Marquette's a made-up name.

It's Rodriguez. Oh, I didn't know you were one of them. So you really are more Marquez than Marquette. Did you change that for acting reasons so you would get more work I bet you wish you could change it back now yeah we had that conversation yes we did my my wife's uh my wife's stage name is uh Tasey Lawrence but she her real name is Tasey Danraj and she changed it because she thought Danraj wouldn't get her any acting work and And now I'm like, let's get that. I'm thinking of taking on her name. You're going to hyphenate yours?

Yeah, yeah. Jim Danradge Jeffries. There we go. I've got a bit of something. That would work. A bit of flavor to me. Very nice. Yeah.

Very nice. Very nice. You just got back from your casino gigs in the East. Well, those both sold out. Thank you for coming. They did. We haven't actually done the gigs yet, but I'm going to theorize that they went okay.

People showed up. You had a good laugh. I put a bit of effort in. Are you going to be there? Yeah. Oh, Forrest put effort in? Yeah. I'm here by where the Goldbergs are set.

Pennsylvania. Yeah, Pennsylvania. Close. Outside of Philly. yeah ah forrest put effort in engineer by the jj where the goldbergs are set um and salem pennsylvania yeah pennsylvania but they live in uh jankin town jankin town the jankin town posse my roommate in college is from jankin town so that's why yeah all right because sean is off the goldbergs i actually saw one of the guys the short one from the Jankintown Posse and I did yell out JTP yes I did and he just sort of looked at me okay mate alright like that deal with it that's what fame is

get a catchphrase anyways you're about to go on tour in England give them what they want England Scotland Ireland give them what they want tour give them what they want give them what they want give them what they want. England, Scotland, Ireland. On the Give Them What They Want Tour. Give them what they want. Give them what they want. I forgot that.

Yeah, the Give Them What They Want Tour. And then Europe and then a bunch of other stuff. Go to jimjepers.com. We're going all over the UK. We're going crazy on the UK and on Europe. And the UK dates are all but sold out. There's been some added shows. There's been a show added in Manchester and and a show added in london um but there's like there's a few tickets at the other gigs but i think like like like there's a there's

like um brighton's completely sold out and part of is completely sold out you had a show in warsaw poland so the first one sold out i don't know what happened there the first one didn't sell out but they're they're optimistic the polls so and i've got so many polish jokes that they want to they want to hear them all i'm like i'll just like if the show's half full i'll just be like oh you all bought tickets but you were too dumb to come polish people that's that's the thing you didn't know that that's an american thing American things yeah yeah the rest of the world does the Irish

yeah the rest of the world makes fun of the Irish but in America growing up I remember we would make fun of Polish people for being stupid

in the Truly Tasteless joke book yeah yeah how do you get into a Polish submarine through the fly screen the screen door

yeah see it's even different fly screen fly screen yeah the old Polish submarine bloody Polish people alright See, it's even different. Fly screen. Fly screen. Yeah, the old Polish memory. Bloody Polish people. All right.

Let's start the podcast. Well, go to IDCAP podcast on Instagram. Go to IDCAP. Come and see the Patreon. The Patreon, we did a whole Patreon with Sean. He was wonderful. Great laugher. Had a whole lot of stories. If you want to hear some goss about the Goldbergs.

Yeah. Oh, yeah yeah he knows it all he knows every bit that's going on down at the goldbergs yeah so that's at patreon.com slash idcat and our instagrams at idcat podcast johnny atkins man before the diet ads ads our next partner is Athletic Greens I take AG1 In the morning Before I start my day And it makes me feel Like I'm doing

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athleticgreens.com slash IDKAT. Can you just do that one last line again? athleticgreens.com slash IDKAT. Check it out. Please welcome our guest, Dr. Chris Lancaster. G'day, Dr. Chris. Now it's time to play... Yes, no.

Yes, no. Yes, no. Yes, no. Judging a book by its cover. All right, Dr. Chris. If I could get the camera angle back on him. There we go uh hello mate okay so hello he's either he's either uh is it you're are you an anglophile chris a bit a bit

yeah maybe just a little bit uh is are we talking about the premier league no no that's a good idea but no oh not even close even close. Make a note. I'd like to talk about, okay, so you've got a snooker. Are we talking about a snooker? Nothing in that room that I can see is going to help you. Oh, okay. Are you a doctor, Chris, or are you like a medical doctor? Are you one of these ones that you have a doctor of philosophy or something like that? Medical doctor.

Medical doctor. Okay, so are we talking about the human body. Well. Yes. Yeah. Okay. That's how that works. Yeah.

It might be. Okay. Are we talking about a part of the human body, not a virus? Like, are we talking about an appendage? No, really, we're talking about the whole body. Oh, the whole body. The whole body. Are we talking about COVID?

No. We should do that. People haven't heard enough about that. Yeah, I'm sure you've experienced this before. Oh, when your muscles are so tight from working out in the morning. Yeah, he gets that every day. He's a doctor of that. Yeah, he's a doctor of that.

Is it hemorrhoids? I've experienced it nine or ten times. I think four is. I was thinking maybe six or seven. Are we talking about anal sex? Okay. That's my specialty. Nailed it.

This is something that would be done to you to have something else done to you oh so we're talking about sleeping pills for anal sex very close but not the anal sex oh anesthesia Dr. Christopher Lancaster MD attended medical school at

New York Medical College and Dr. Lancaster is also board certified in four specialty areas of anesthesia. He trained for these at Pediatrics at Valley Children's Hospital, CA and Pediatric ICU and Anesthesia and Pediatric Anesthesia at John Hopkins Baltimore. He currently works for USAP Florida, that's United States Anesthesia Partners, in Orlando, Florida as a pediatric cardiac anesthesiologist. So thanks for being here, Dr. Lancaster. Thanks for having me.

How do you get into anesthesia? Is that something you've always wanted to do or when you were a kid? I actually went into pediatrics out of medical school. I was going to be a pediatrician. into pediatrics out of medical school i was going to be a pediatrician but i quickly learned that or discovered that office-based practice wasn't probably for me so i looked for another specialty and i went into pediatric intensive care and almost kind of fell into the anesthesia by accident they they called me up and said we have a combined program in icu and anesthesia if you're interested i said okay i'll do that so it was almost by accident why why does america have pediatricians and other countries don't i remember like watching an episode of friends where ross goes to his

pediatrician and i couldn't understand the episode now that i have kids and i live in america we have a pediatrician for the for the children and Maybe the question is, why don't other countries have that? It makes sense to have them. It's just people are people, right? Little people different? Are they that different? Yeah, I would think so. I don't know. They've got different developmental milestones you would want somebody to be an expert in.

No, they're just little adults. Yeah, I have the same doctor that I had since I was born in Australia. He might be dead. I don't know. It's been a long time. Completely different for kids and adults. Yeah, just the height chart, though.

Like, can you treat a dwarf the same as a child? Is that the same medical thing? Is it just height-based? No, I'm joking, everyone. everyone i'm joking i don't have the answer anyway i would like support from my people i don't need i don't need a laugh just a smile just don't leave me with my balls hanging out as i say the word dwarf and then just go no it's waiting for the answer um all right uh dr lancaster i'm going to ask Jim a series of questions about anesthesia. And at the end of that, you're going to grade him on his answers, 0 through 10, 10 being the best.

Kelly's going to grade him on confidence, 0 through 10, I'm going to grade him on et cetera. And we're going to add those together. And 21 through 30, anesthesia. Anesthesia. 11 through 20, Johnny-sthesia. 0 through 10, Ricky-sthesia. I'm tired. I didn't get enough sleep.

Question one, spell anesthesia. He liked them. Actually, that is the second question. Is it really? I threw that in there. I have no fucking clue. I couldn't do a spell in me. That was a bonus question.

How do you spell anesthesia? Okay. I've seen it written. Yep. Yeah. A-N-S-T-I-G-H-E. Okay. What the fuck

What What A N S T E I

G H E Anesthesia You got zero points What is A What is

What is anesthesia And what does the word mean I didn't even know Okay Anesthesia Is when you When you get Anesthesized You can't use the word In the definition Yeah I didn't even know it was... Okay, anesthesia is when you get anesthetized.

You can't use the word in the definition. Yeah, it's when you get... They put gas over your face, right? And that knocks you out so that they can perform surgery on you. Do you know what the word means? To sleep. Okay. To sleep in measured amounts.

This accent's weird. All right. When did anesthesia start being used and by whom? Well, the invention of the hammer was the first anesthesia. That was the first bit and that was used by, I'll say, Jesus. Okay, I was going to say by whom and what was his profession. Jesus Carpenter. Carpenter, small cult leader.

What was the first? I have Sean on all the time. I'm a lot funnier than him. Dr. Lancaster, we have a guest in the studio. He's an easy laugh. Yeah, yeah, yeah. Sean and Eric crying. What was the first used, some good energy there.

What was first used as surgical anesthesia? Like, what was... You said hammers. That's your answer. No, that was my fun answer. Okay. My real answer was whatever killed Michael Jackson. That stuff.

All right. Who should not go under anesthesia? Michael Jackson. That's the answer? Michael Jackson. That's the answer? Michael Jackson. He shouldn't have gone through it. At least that last time. Okay.

I'll say people Kanye West's mom. She was another one. Didn't enjoy the process. Wait for the hate comments. Instead of naming people that died from it, instead of naming people, who's at risk, let's say?

People with, they block noses, because then you wouldn't know. And then, I'm going to say, small people with respiratory problems. How long does general anesthesia last? As long as they want you to last for depending on the surgery some surgeries forest if you've watched the er they take these

surgeries take 24 hours there's doctors sleeping in the corner and shit like that you have to keep topping it up and then other surgeries like my vasectomy was all done in about 15 minutes so i had a short anesthesia who Who administers anesthesia? It was a girl called Sally. What's the name of a person? An anesthesiologist. Okay. How common is it to wake up during surgery?

Too common. One time is enough. You don't want to... That must be hell. You wake up, they're cutting into you. Is that pretty common? No, I don't think it's very common. I think it's one in 500. One in 500.

What is the mortality rate? That would be one in a million. One in a million, okay. Can you breathe on your own under anesthesia? Yes. Okay. Why can't you eat before anesthesia? Because you could vomit and choke on your vomit also if they're

doing stomach surgery they don't want to find food yep what are the four types of anesthesia sleepy dozy that's what your doctor said i'm giving you sleepy anesthesia wakey upy wakey upy uh no there'd be local local locals locals just uh like i like i love when you get excited about that it fucking came to be local local anesthesia can just be an injection that numbs the thing yeah locals one general uh which is what you do for the military. Yeah. And then there would be casual. Casual.

And Fridays. Fridays. Risks. We'll talk about that somewhere. What does the difference between anesthesia and sleep? Like what does anesthesia do? Like you said it just puts you to sleep, but what's the difference between that and sleep? Anesthesia not only puts you to sleep,

but it also knocks out your nerve system so you can't feel pain. So that's the difference between that and sleep? Well, yeah, if you were sleeping and someone got a scalpel out and cut you in the stomach, you'd wake up and go, oh, that's no good. But it takes away the pain as well. So it numbs and knocks you out.

And sleep is just... If you had anesthesia and you were in a at a rock concert you wouldn't wake up but if you're sleeping you would yeah solid sleep who delivered the first baby with anesthesia it would have been a woman any idea so it was either you mean doctor person yeah um i'm gonna go i'm gonna go that would have been uh l ron hubbard okay no it was it was a woman it was a prominent woman in history oh mrs l ron hubbard no they're a prominent woman in history geez there's only a few to pick from um uh there'll be meryl monroeences? What are the differences between anesthesia for children and adults?

You give less to children and more to adults. See, I remember like there was, I watched the Andre the Giant documentary and they just couldn't figure out how much anesthesia to give him without killing him because the guy used to drink like four bottles of vodka to get drunk. So they were like, we don't know. We'll give him four times the regular amount. So they weigh you they give i've got a cup of i i've been knocked out twice hemorrhoid surgery

yeah i told you that story i was going under and the nurse just as i went under went my boyfriend's your biggest and then i went under and i was in i was i was in turmoil the whole time because i was like she's gonna fucking talk about my asshole when she gets home. And then I got knocked out recently for my vasectomy, and they're the only two times I've been knocked out. Who was Jon Snow? And that refers, I'm assuming, to anesthesia because I don't know the answer to this.

Oh, well, I know Game of Thrones. It's not Game of Thrones. Jon Snow, he would have been the man who invented the practical use for anesthesia. Okay. Why don't we use general anesthesia for deliveries anymore? It probably wouldn't be good for the baby. You'd probably have more stillborn babies than you want.

Not that you want any, but just more than you'd like. Okay, and here's a couple more questions. What is fentanyl? Fentanyl. Oh, I know. Fentanyl is an opiate. It's from the heroin family, which is an opiate. And it's used for pain, and it's meant to be for cancer patients and stuff like that.

But people in the Midwest use it for a snack. Okay. This is a name one celebrity that died from it bonus points oh uh february oh i i know some non-celebrities well let's stick to the celebrities um yeah i've heard of some nonsense oh um he used to be used to date ariana grande well i know someone really famous oh yeah he's famous yeah he's been more famous than that yeah cashy d or whatever his name was mac miller that's the one cashy d yeah yeah mac miller he died and then and then pete davidson swooped in with his big dick yeah i'm pretty sure prince did as well but oh yeah prince what is propofol propofol?

Propofol is the drug that killed Michael Jackson. Okay, so there you go. That was another bonus point. Are propofol and fentanyl safe for surgery? If administered correctly, yes. So they're safe. Okay. Okay, Dr. Lancaster, how did Jim do on his knowledge of anesthesia? Zero through ten, ten's the best.

Lancaster, how did Jim do on his knowledge of anesthesia? Zero through ten. Ten's the best. He had some solid answers and he was right on half the stuff so I'll give him a five. Five. Confidence, Kelly. All right. It wasn't strong

until you realized you knew local. I'll give you a seven. Seven, twelve. All right. I'll give you a five. You're Johnny steser um so what is anesthesia and what does the word mean um good drag name that anesthesia does it mean to sleep and measured amounts anesthesia what does it what does it mean dr lancaster so anesthesia really the ana means no and anesthesia means pain so really anesthesia is no pain okay no pain and uh one of the ways we have we we lessen pain is when patients are having

surgery we put them to sleep but there are other ways we do it as well and jim named some of them and some of them he didn't name but uh so anesthesia when most people think of it they think of going to sleep okay and so that is like the general gist of anesthesia we're just putting a patient asleep for surgery i'm going to add another one into my four is anesthetic and it's antiseptic does that mean what does septic mean like no infection no infection no septic means infection no infection yeah but antiseptic. Like dead old. What are you adding this to? To my four.

Rabon. Antiseptic. Rabon. Antiseptic. Doesn't change your score. No, septic. No, those are anti-infective. Damn.

Yeah, he's got a point off. Yeah, so my job entails more than just putting patients to sleep. There's other parts of it. First part, I have to make sure patients are ready for surgery. I have to review their background, review their history, see what medications they're on, so I can come up with a plan to prescribe the right medicine for anesthesia. And it's not a one-size-fits-all kind of situation. There's different anesthesia for different surgeries, and there's different types of medicine combinations

for different patients. So that's the first step. And then the second step, if it's a surgery, we would put them to sleep and then wake them up, obviously, at the end, recovery, and then some sort of follow-up afterwards. And do you wake them up with another chemical or do they just naturally wake up because the anesthesia is timed?

Typically all the medications are temporary and there would be bad medications if they were permanent. So all the medications are temporary so basically what we do at the end of a surgery is turn them off and the patient wakes up. Do you ever, like, I'm not saying So basically what we do at the end of a surgery is turn them off and the patient wakes up. Do you ever, like, I'm not saying you look at them naked or anything like that, but with the body, do you ever do anything fun, like wave at people? Yeah, you take their hand and wave. Yeah, take their hand and wave.

Or do you ever just morph right past their face and fart and then giggle for yourself? I mean, at some point, body parts is body parts, you know, especially when the patient's asleep and you're focused on a job. Yes, I see naked people every day, but I might have an awake baby in my hands, holding the baby, taking him to the operating room, and I might make the baby wave or something like that. But no, we don't write on asleep patients. My baby had a small hernia, my oldest boy when he was a baby,

and he had anesthesia. And when I came and I saw him afterwards and we were waiting next to bed for him to wake up, I felt it was really sad. There was nothing sadder than a baby just sort of passed out from anesthesia. I didn't like the look of it yeah i haven't yeah same thing with pets yeah i mean it's different than kids i know but whenever i've picked up an animal from there all drugged out i'm like no i felt terrible for farting in his face um that's a very common uh thing that parents tell me yeah they sometimes will come back with

us while we're putting the kids to sleep and then a lot of times to get a very emotional response from the mother or the father and they put a little oxygen on the face what is it you're what is it you're crying about and the mother said i think that's what he would look like if he was dead i was like oh wow wow, that's the same reason I was cheering. No, I'm kidding. You know you didn't spell it correctly, right, Jim? I don't know I didn't. He was so close, though. I mean, I could tell you how to spell it,

but I don't think it's going to stick. So A-N-E-S-T-H-E-S-I-A. H? And what did I say? You said A-N-S-T-E-I-G-H-E. I reckon if you put that into your phone right now, it'll autocorrect. I reckon I was close enough. Yeah, actually, let's find out.

That means I'm in the ballroom. That sounded like the Irish spelling to me. It actually autocorrects to a struggle. Okay. That's perfect. Wait, did you say it's the Irish spelling or you're making a joke? struggle. Okay. That's perfect. Wait, did you say it's the Irish spelling? Or you're making a joke?

I'm making a joke. Sorry. No, no, no. Go ahead and do that. I thought he actually got it. How cool. Is that your room in your house or are you at a pub? No, it's a little pub room we made in our house. I'm telling you what, man, that's banging, that room. That's cool.

Anyone would love to have that room. That's fantastic. The stained glass windows like an Irish pub, the English Premier League stuff, the Chelsea sign. Who's your Premier League team? Chelsea. Yeah, I thought you might be. I support Fulham.

Oh, that's nice. And I support Fulham because I couldn't afford to go to Chelsea because not a lot of people know that Chelsea and Fulham are basically the same suburb. They're like right on top of each other. It's like, it's nice. And I support Fulham because I couldn't afford to go to Chelsea. Because not a lot of people know, Chelsea and Fulham are basically the same suburb. They're like right on top of each other. It's like, it's nothing. It's like Sherman Oaks and Studio City are playing each other. Yeah. I lived in London in 1989,

and that's before they had the Premier League. And I got to go to a bunch of Chelsea games because they were shit, and the tickets were dirt cheap. Yeah, yeah, same reason. So that became my team yeah they came around for my father was was there in the 60s and same thing he supported chelsea because they were cheap um when did anesthesia start being used by whom what was

the profession was it jesus was it a hammer was the carpenter i'm thinking not yeah i don't know about Jesus, but they've been using opium and hashish and alcohol for as long as those things have existed. But the first official demonstration in a public place of anesthesia was in Boston in 1846 and a guy named William Randolph, William Morton. 1846 and a guy named uh william randolph uh william uh morton and he did it in mass general hospital in this place called the ether dome and he anesthetized a patient with ether and um he was a dentist and they did a dental procedure and what year did you say um 1846 okay so what happened before that no surgeries before 1846 you never seen a western there drink some stuff and bite on a piece of leather yeah so civil war era that's literally what they would do they had they had some opium and they had some laudanum which is basically a form of opium and they had alcohol and they would put a stick or a bullet in between their teeth and they would just uh and the surgeons were renowned for their speed

and being how quickly they could do an amputation so i could take off a leg in 12 seconds so the patient didn't have to suffer that's what they had on their billboards yeah 12 seconds or your money back well and surgery was like a spectator sport back then wasn't it like they it was like a actual dome where audiences would come in in street clothes like everybody's just wearing shit off the street. I still find it weird that there's seats you can watch surgery. You called it the Ether Dome. I thought you were just kidding. That's an actual place

people watched? Yeah, they did wear masks. They didn't wash their hands. They were clueless. Yeah, they all sat around in top hats and gentlemen's suits and they watched the surgery being done. Did he stumble across using ether, or was someone else said, like, this stuff might work,

and then he gave it a go? Yeah, there's reports of people using it before this guy did it. And he tried to do it once before in a public space, and the ether didn't work, and the patient never went to sleep, so he was really embarrassed. So he wanted to go back and prove that he could do it, so he did it a public space, and the ether didn't work, and the patient never went to sleep, so he was really embarrassed. So he wanted to go back and prove that he could do it, so he did it a second time, and it worked. He must have tried it out on himself, like a la The Hulk or any of those, like, origin stories where he must have, if no one's going to do it, he'll put the mask on his face. What was first?

Also, my answer was correct because Jesus is God and God created everything. I think it was a caveman with a rock. Ah, Korag. Korag, the anesthesiologist. So what was first used as surgical anesthesia? That's the same answer? The ether? Yeah, that was the first publicly displayed one.

And who should not go under anesthesia besides Michael Jackson, Kanye's mom? That was a great answer. That was a great answer. You got extra points for that one. That's correct. He said people with blocked noses and respiratory problems is what Jim said. Okay, so the answer is it depends on the urgency of the surgery. There are some surgeries where we can't wait.

Emergency surgeries, we can't really choose who's going to have anesthesia and who's not. We have to go, and we have to have ways to deal with that, and that's where the mortality is really high because we're not properly able to prepare anybody for the surgery, and they're at very high risk because of what's going on. But in general, we don't do elective surgery on pregnant women unless you know unless there's an absolute medical reason we don't do elective surgery on newborn babies because we're worried about it affecting their brain development all that's never been proven and that's never been shown but what if a newborn baby wants new tits i was literally just thinking like it must have come up once But what if a newborn baby wants new tits? I was literally just thinking that.

Like, it must have come up once. And then we don't do, you know, if somebody's too sick for their procedure or has a new medical problem that we didn't know about, then we would postpone it until we deal with those issues. And we cancel surgeries all the time because of that. Do people ever shit themselves underneath it? Like, if you've got the runs and then you go do it or because i found after both times i did it i was a bit backed up is that a thing yeah so babies do and kids do and um some people with bowel problems do but in general if you're going in you're having your

nose job done or something it's not it's probably not going to happen i imagine if you came back from your nose job how did it go doctor went all right for you the rest of us we have to clean our smocks or whatever they call it our scrubs how how long does general anesthesia last uh jim said as long as they want some surgeries take 24 hours it's spot on there as long as we want. Some surgeries take 24 hours. It's spot on there, as long as we want. I've been involved with surgeries where I've been in the operating room slash operating theater all day and gone home, got a good night's sleep, come back, and the surgery's still going. I take over again.

So there are some surgeries that are just so long. Do you ever come back from a surgery like that and go, oh, fuck that dentist. There's bloody shit everywhere. Do you ever come back from a surgery like that and go, oh, fuck, they had Dennis. There's bloody shit everywhere. Do you ever do that? Or go, I've been asleep for eight hours and you cunts have done nothing. That's four stitches. Do I have to be here all the time?

A little bit of both, I think. Yeah, the thing about what has Dennis done here with all of his shit? That's for sure. I think there's really somebody named Dennis. Well, when you're in the pediatric anesthesia game, you have to be very detail-oriented. So for me, it was sort of my channel for my OCD tendencies.

You know, I can pay attention to those details rather than have to worry about washing my hands 17 times a day. Here's one for you. In surgery, do you ever listen to the radio? I think that would make everyone a bit more comfortable. I'm not saying music. There's a bit of talkback, like Rush Limbaugh. We do listen to music, and we often let the patient choose the music,

especially if they're kids. What do you want to listen to while you're going to sleep? I've heard that damn Frozen Let It Go song probably 2,000 times because every little kid wants to listen to it. Well, this is the thing. So my wife's giving birth, right? And we go in, and she had the epidural and all that sort of stuff. And then the doctor went,

they went, what music do you want to listen to? I'm holding her hand, and she goes, P.F. Twigs or something. F.K. F.K. I still don't know who this Twigs girl is, right? do you want to listen to i'm holding her hand and she goes pf twigs or something okay okay okay i still don't know who this twigs girl is right fk twigs or something yeah and i think i went like this who's fk twigs you want the beatles or something like that and then like all the nurses looked at me like okay i guess i'm not giving birth i have no say in the music selection just something we could all enjoy.

Alright, well listen to the twigs. And then halfway through the birth, my wife went, can we change the song? Now I don't want to say that childbirth isn't hard. But I've had shits where the last thing on my mind would be changing the music in the room. I'd be in no position.

I'm in too much pain to worry about the song. She was thinking of a playlist we're back to that okay i don't want to say this thing i said on the podcast for um who administers anesthesia anesthesiologists and what is their role you talked a little bit about that is there anything else you want to say about that yeah there's actually more than just anesthesiologists at least in this country, we have certified registered nurse anesthetists, CRNA, and we have anesthesia associates. Those are people who work with the physicians, and they can administer anesthesia, and they're trained, and they go to graduate school to learn how to do anesthesia, and they have clinical practice as well and so they we work with them in this country and i don't know if they do that in australia or england but um that allows us to run more than one room at the same time where we have a nurse anesthetist who could be

in the room and i could be supervising them and taking care of more than one room no in australia we just have the one room. In the whole country. And we get everything done in that. One day, you'll be fixing a car in there. And someone will do a bit of surgery. I'll come in for a dance class in the evening. Yeah, and they just have a kangaroo come kick you in the head. Yeah, yeah.

That's the anesthesia, isn't it? How common is it to wake up during surgery? Is it 1 in 500? That's what Jim said. It's not far off. It's about, they say it's about one in a thousand. And that doesn't just mean,

Hey everybody, I'm awake. So there's degrees of that. And any of those degrees would count towards that number. So you might, you might recall hearing a noise or you might recall uh recall uh somebody moving you or something like that um most people who have those memories don't have any pain associated with it do you uh do you ever chat to them because because i at the times i've gone under they say count to 100 or whatever it

was or count down from something and i can vaguely remember counting three or four digits and then going down but i assume i counted way more than that but my memory doesn't until i got to the thing is anyone ever said anything very weird to you or interesting or can you chat to them yeah yeah yeah uh i had one lady uh she was a young lady and i was just doing small talk with her. I killed Kennedy. So trying to take her mind off it. And I said, what do you do? You know, when you're not in the hospital hanging out with us and she says, I do so-and-so and she's, and I was pushing the medicine at the same time. And she says, what do you do? And you, and she goes to sleep. And then we took her to the, did the surgery,

took her to the recovery room and she woke up and like she hadn't missed a beat she said when you're not in the hospital i haven't like she picked up right where she left off which i've never seen before yeah that's that's because i i always think i'm going to enjoy the anesthesia because you know you get a bit of sleep and then you don't remember anything you're like but you wake up feeling so well rested. No, I feel groggy. I've always really enjoyed it. After I had the hemorrhoid surgery, they said I had to have a piss or I had a catheter. I had to have a catheter shoved in. And they put the catheter in because I couldn't pass a urine. And I've never begged my penis more for anything.

I was like, come on, man. And I needed the piss. I said, come on, you've got to do this. Otherwise, they're shoving a rod down your hole, dude. Didn't happen. I've seen it. It's not fun. No, not fun.

Were you saying something else about when people wake up, some people are in pain? Was that what you were about to say? Well, yeah, so a little bit about that. So if you're having a painful surgery you're going to need pain medicine so the anesthesia itself will um will decrease the pain or deaden the nerves as jim said while you're while you're under it but at some point you're going to wake up and you're going to need something for the pain when you wake up that's where we have drugs like narcotics

morphine fentanyl um dilaud, other medications that are for the pain, because you need pain, your body can still respond to pain even if you don't feel it. So your heart rate can go up, your blood pressure can go up. Those things are what we call autonomic processes. Those can happen even if the patient's not feeling any pain. So we have to make sure the blood pressure, the heart rate, all those things are normal throughout the surgery as well. So if you wake up with some narcotics on board, some morphine, if you've ever taken any narcotic pills, codeine or something like that,

you know that they can make you sleepy. So if you wake up with those on board, I'm sorry, Jim. You can be more sleepy. With pain. And I'm sure that when you Oh, sorry. No, go on. You could be more sleepy. With pain. And I'm sure that when you had your hemorrhoids that you had some pain medicine. Oh, no. I was loving it. I skipped out of the bloody place. Pain's pointless, isn't it?

Pain's... I know what everyone's going to think. Oh, it's our body's way of telling us that something's wrong. But why? Why does it have to be pain? Why can't your finger just twitch and you're going, oh, a kidney infection right you know what i mean well why can't you ejaculate and go it's a heart attack you'll ignore that yeah i think it's got to be something because you you ignore things all the time i think everyone should just have one illness in their life and

that's the one that kills you well you should write the rest of it because every time i have every time i have a bad like the influence every time I have the flu really badly and my body's aching and I've got snot coming out of my face, I always think to myself, how fucking pointless is this? If you're not going to kill me, fuck off. There are some inputs to your body that are not pain. So, like, there's something called a spinal reflex where it goes from your say you grab a hot pot you it goes from your your hand to your spine

and your spine says that's bad and it goes right back to your hand and makes you open your hand and drop the pot right right right then the signal also goes up to your brain and then you feel the pain oh good good it works both. I've already dropped the pot. Yeah, I've got to feel the pain as well. I've got fucking boiling water all over my feet. What is the mortality rate? Is it one in a million? It's about 0.6 per 100,000. That includes all groups, including the really, really high-risk groups of older people.

People over 70 years old are high-risk. They can be between 20 and 50 that's pretty close that's pretty close yeah not bad so yeah it's not far off it's about you know pretty close to one in a million um can you breathe on your own under anesthesia jim says yes absolutely yes uh it depends on the type of medicines that we give there are some surgeries where we don't want the patient to breathe, and we breathe for them. And there are some surgeries where it's okay if the patient breathes, and we let them breathe.

So the answer is it depends on the situation and what type of anesthesia. So if they're working on your lungs, maybe they don't want you breathing. If they're working on your toe, they probably don't care if you're breathing or not. Inevitably, you would have had to anesthetize some people who very well might die in surgery. What do you say to them? You might be the last person to talk to them. Do you ever just go, all right, well, good luck?

Yeah, that's a hard conversation to have. I would say to somebody, you are at extremely high risk of having a bad outcome. You are at extremely high risk of dying. I try to be honest. I try to be direct. What song would you like? Without using... Yeah.

Twigs. I try not to minimize it. No? But sometimes it does happen. It doesn't happen very often, thankfully. It's very safe to go under anesthesia. I tell patients every day, it's safer to have anesthesia

than it was for you to drive here on the freeway. Does anyone ever wake up and, like, you've had to amputate, like, a leg or something like that, and then the first words out of their mouth is, wrong leg! Oh, man, that's bad. Yeah. That happens.

That hasn't happened to me, but that is bad. Do you just tie a bow around the toe of the happens that hasn't happened to me but that is bad do you just tie a bow around the toe of the leg that you meant to do and then another doctor comes in fucking dennis was just in here i thought it was the one that wasn't had the tie on no we all agreed on the tie bow system yes we we have a tie the surgeon puts his initial his or her initials on the on the part that they're going to be operating or a happy face or something that signals it and then everybody who meets that person says what's what side are we operating on what side are we operating on and then before the patient goes to sleep we say what side are we operating on that's the good thing not what's that's the wrong side surgery that's the good thing about hemorrhoid surgery. No mistakes.

I like that. He probably drew a happy face on your anus anyway, though, right? Yeah. I like that that's a term for it. Wrong side surgery. It's not even technical. Wrong side surgery. It's called a whoopsie surgery. You wake up, you got tits on your back.

Wrong side surgery all your surgeries involve tits look i've only i've only ever had two surgeries myself but i've paid for a few more um why can't you eat before anesthesia jim said you can vomit choke on on your food is that the correct answer? Yep, that's right. In your stomach, to help digest the food is hydrochloric acid. If you get food mixed with hydrochloric acid and you throw up and it goes into your lungs, very, very, very bad for lung tissue. So you could literally die from that.

So patients take that very lightly sometimes, and they'll be eating in the lobby waiting for their surgery and we're like oh sorry you got to go home go back um that's something we stick to and unless it's an emergency now if it's an emergency we we have ways to deal with that that make the patient not vomit but uh those are a little more risky so we don't use those for elective surgeries yeah you're thirsty i always remember each time being... I also had my chin done. I had three. But I also, yeah, I

had lipo on my chin. Bit of fact. That's all I had. That's why I got rid of the jowls one time. Movie star. Oh, no, I also got the thing for my teeth. I've always needed a size for that as well. Veneers. Yeah, I've been knocked out four times.

Woke up with tits on me back. What are the four types of anesthesia? First he said sleepy, dozy, wakey-uppy, then local, general, casual Fridays. Are those the four? Yeah, pretty close. Local is where you can block the pain in a specific spot. like if you go to the dentist and they numb your tooth or if you're going to have your finger worked on and they numb up your finger and then there's something called regional anesthesia where

if you're going to have your elbow worked on we can numb up the whole arm or numb up your whole leg or numb up your ankle or whatever and then there's's what we call anorexia, and that includes epidurals and spinals, where we kind of block the lower half of the body or something like that. And then there's general anesthesia, and there's different degrees of anesthesia. There's anything from sedation, like you might have for a colonoscopy. That's kind of a lighter form of it. And then we call that, they used to call it conscious sedation, but we don't call it that anymore because you're not conscious.

But we call it monitored anesthesia care or sometimes twilight sleep and then there's general anesthesia where you're all the way out all the way asleep you don't hear anything you don't feel anything and um so that's kind of the the range anything from local to uh to general anesthesia and when we do cardiac surgery we take it even further we cool them down and we stop their heart and put them on a heart lung machine so we can operate on their heart and they're really anesthetized now is is can you be anesthetized too many times because there was a talk with Joan Rivers when she died they said she went underwent this was a rumor this was just a rumor but they said that she went under too many plastic surgeries or something like that, and that's why her heart failed or whatever like that.

Is there too many, or can I get anesthetized once a week? You can get anesthetized once a week. I mean, I wouldn't recommend it, but there are some patients where we have to take them to the operating room every single day for some problem, and there's no long-term issues that we know that we've ever been proved i mean there may be something we don't know about but right now we don't know of any problems for being anesthetized or anesthetized every day can i be put in a coma um just like to lose weight for like for like 10 like three weeks or something like that, and then I wake up and I'm going, all right.

For your next special, you want to do this? Yeah, yeah, yeah. Or just to get through my children's childhood. Just like 18 years and like, I've got enough money. They'll still pay for the school bills. That'll be a direct debit. Right, but I'll just be passed out, and then I'll wake up and go, how'd you turn out?

Good. And then I wake up and go, how'd you turn out? Good. No, I had an idea of starting a center for super, super rich celebrities and detox them under anesthesia and charge them like $100,000. And then I don't know how to set that up. I'm not a business person, but it seems like a good idea. Well, I know a bloke, and I don't know if I've already mentioned this this on the podcast but i've been telling a few people this because i just found this out um i know a bloke who went into a coma in january of 2020 and then he woke up three months later at the height of covid

and he uh he didn't know that covid was happening and his wife was standing by the bed in a fucking hazmat suit and everything it was like the walking dead. Bit of fun, isn't it? I'll tell you, that COVID was no joke. That was probably the scariest time of my life that has to do with medicine, or maybe not to do with medicine. It was frightening to go to work every day. Especially before we had the vaccine, every day I didn't know, am I going to get the COVID?

Am I going to be dead in a week? Like, every single day I was scared. I've never had that feeling before. It was very, very, very frightening. All you people in the front line who went through that, we watched on the news, you all weren't getting the supplies and you were wearing masks and stuff

and gloves from the Mets baseball team. I watched all these. And mate, thank you. Thank you very much because you know what I did in COVID? I had a wonderful time. I watched so much TV and I didn't have to go on the road. It was the most relaxing time of my life.

But I always had to remember that other people were going through a living hell during the time. So I appreciate that, mate. You're welcome. When they first shut down the state, you know, everybody, all elective surgeries were canceled. So we weren't really doing a lot of surgeries. A lot of us stayed home because there was nothing to do so i got a new dog i learned some philosophy i took long walks those first couple weeks were great and then i had to go back to work what's it what's the best what's the best bit of philosophy you learned that time oh um i alluded to this whole history of philosophy course on audiobook, and it went from like the Greeks up through modern day.

I don't remember any of it. It's good you spent that time wisely. Yeah, yeah, definitely. What is the difference between anesthesia and sleep? Anesthesia and sleep look the same to someone observing that person, but there's a couple differences. You have some changes in your

heart rate and changes in your blood pressure and changes in the strength of your heart under anesthesia that doesn't happen during sleep. You can't be easily aroused from anesthesia as you can from just a regular sleep. Oh, so you don't wake up with an erection from anesthesia.

I don't see it very often. It's not common. Oh. And you don't have REM sleep. Sounds like a challenge for Jim. You don't have REM dreams. You don't typically have dreams during anesthesia. It's just kind of black.

You go to sleep, black. You wake up, no time pass, it feels like 30 seconds, you're, you know, it could be five hours. But people dream in comas though, don't they? The only exception to that is when they, sorry, Jim. In a coma, people dream in comas, don't they? Yeah, if they're under anesthesia for the coma, maybe not, and it depends on what they're under. There are some drugs that we use in anesthesia.

You can still dream when they first started testing propofol is back in the 1980s. They reported people having erotic dreams, specifically erotic dreams under propofol. Then you wake up with a boner. Who did that? That's possible. Who delivered the first baby with anesthesia?

Jim said, Mrs. L Ron Hubbard. So I actually screwed up this question i thought you were asking this question below and somebody reworded it so the queen one is the one that i was saying notable oh the queen did it did she well this question wasn't asked that's why she always wears like white gloves okay well i could i can summarize both of those so So there's a Scotsman named Simpson.

He was an OB doctor, a baby doctor, and he used chloroform. So he was the first one to use chloroform, and they delivered the baby with an anesthetized mother under chloroform. That was a year later than the guy in Boston. So it was 1847. And then the question that Kelly was getting to was about what famous queen had a baby delivered under anesthesia. And that was Queen Victoria. But that was a couple years later.

She wasn't going to be the first one to try it out. All right. And differences between anesthesia for children and adults? Is it just you give less to children, more to adults? Is it that simple? Yeah, you do. You give less to children more adults is it that simple yeah you do you give less to children but based on the size of their weight and their height and their age it probably works

out to be pretty close um some ages and it changes throughout your life you need less when you're at one age you need more when you're another age and it peaks and then it goes back down as you get older again so it depends on what age you are and um and then in in children typically if we're um able to we would put them to sleep with a mask so we put the mask on their face and they breathe some gas and they go off to sleep so we don't poke them with an iv while they're awake we put them them to sleep first. I had the mask once and the IV another time and all that type of stuff. Yeah. We don't do that for adults. We don't do that for adults.

Adults always get, usually adults will get the IV. And that's because the mask doesn't work very well for adults. They kind of get stuck about halfway asleep. So what we do, everybody who goes to sleep gets a mask, but for adults it's usually just oxygen. about halfway asleep so what we do when you everybody who goes to sleep gets a mask but with for adults it's usually just oxygen and with kids it's it's it's anesthesia gas how do we put them to sleep and then we put the iv in after their sleep if you can do it every day why did why and how did michael jackson die uh okay so first of all they weren't using proper monitoring

to monitor his breathing if you give too much propofol it can affect your breathing that can even make your breathing stop and if you have monitors you would know that right away so you could take steps to fix it and then uh the real answer is the guy who did it was a cardiologist not an anesthesiologist so he had no business uh messing around with that stuff and uh he did it in a in a non-medical setting without the proper monitoring and probably without the right rescue equipment uh is a setting that i would never attempt anesthesia could you could you anesthetize yourself uh i know i couldn't you could do it once you said yeah i could do it once i wouldn't i wouldn't

want to take the chance if i stopped breathing i you know there'd be no one there to to give me oxygen or to to breathe for me but you've never had like a hard night out on the gear and thought i'm never getting to sleep and then you sort of looked over at your little bag no but there was a time in in in mexico the next morning when i went and got a bunch of bags of of water fluid saline hooked them up to my buddies and i gave us some ivs now they have these iv bars so that oh i'm a big idea i had too i'm a big fan of the iv bars i uh several times i've been uh i have had a cold or something like that and fell under the weather and had to get up on stage. And I remember I'd be in the room and Colonel Tom Parker came in

and said, get that boy on stage. And I got the IV in and I've done it. I've spruced up for a bit. They just pump you. And then your piss is fluorescent. Wonderful. Yeah. Just jumping ahead because you mentioned propofol. bruised up for a bit. They just pump you. And then your piss is fluorescent. Wonderful. Yeah. Yeah.

Yeah. Just jumping ahead because you mentioned propofol. So propofol and fentanyl are safe for surgery as long as they're like. Oh, yeah. We use them every day. So the answer is yes, we use them every day. They have things pop up in the media and the news, you know, and people get worried. But propofol, I use it every day.

Fentanyl, I use it every day. Fentanyl, I use it every day. You have to know what you're doing. You have to know the right dose. You don't have to know how much to give and it's perfectly safe. Yeah. My mom used fentanyl for pain management. They had patches, you know, when she was sick. So I know that. Used correctly. It was a time release patch and stuff. Yeah, we still use those time release patches. Who was Jon Snow? Was it the man who invented the practical use for anesthesia? Who was Jon Snow?

The dude who gave the chloroform to Queen Victoria. And then was Jon Snow? Yeah. And was the Game of Thrones guy named after him? It feels a little bit too coincidental. It is a coincidence. I don't know that. He also happened to be what we call one of the first epidemiologists.

He thought there were, during certain plagues and during pandemics, he was like, there must be an invisible particle going around from person to person that we can't see that's transmitted this disease. Everyone's like, oh, you're full of it, Snow. But he was right. We have germs, bacteria germs bacteria viruses other things uh he he was one of the first reason to people to call that and to um and to try to minimize contact with people when they were sick that that would have been the biggest conspiracy theory of its day oh yeah how we sick? There's things in the air that fly through the air. I mean, look at the response to COVID.

And then they get into your mouth. Happened again. And then that makes you sick. Don't come near me. There's air things. They'd say, you know nothing, Jon Snow. Alright, thank you guys. I'll see you next week. Why don't we use general anesthesia for deliveries anymore? Is it not good for the baby? It's not good for the baby. That's not good for the baby. It makes them,

it can affect their breathing. It can affect how vigorous they are when they're, when they're delivered. And it's honestly, it's not fun for the mother. The mother wants to be there for the birth. Not my experience. Both the women I had babies with would have been happy if I just brought it home 17 years later.

All right. Now is the time of our show called Dinner Party Facts. We ask our guests to give us some sort of fact, interesting or obscure, that our audience can use to impress people about the subject. What do you got for us? All right. So one of the side effects of anesthesia that we try to avoid but it still happens occasionally is people who have general anesthesia can have an upset stomach get sick

throw up we call it nausea and vomiting and the people who are at risk for that are young women who have a history of motion sickness and who are non-smokers so you can say that smoking cigarettes the only medical thing it does for you is reduces the incidence of post-op nausea and vomiting after you've had anesthesia that makes you look cool but i don't recommend people take up smoking just for that we have medicines for it uh oh i forgot to ask you this, too. I think you told Kelly in the answer. Somebody told me that redhead or redheaded people need more anesthesia. But you said that. Yes.

That is true. My oldest son was a redhead. And I looked up the studies. It is true that you need more anesthesia. But the amount is very small. So we call it uh we call it clinically significant but not uh i'm sorry statistically significant but not clinically significant meaning if if it fans out and it pans out in studies but it doesn't it's not true in

real life like basically we give redheads the same amount of anesthesia that we get non-redheads but it is true you can say that as a fact did you did you see that other thing i said about andre the giant how they they couldn't pick how much anesthesia have you ever had that issue with someone who's so giant that you're just sort of going what the fuck do i do with this coat no but people who use a lot of recreational drugs or drink a lot of alcohol definitely have more tolerance for anesthesia i remember there was this i kept on waking up the whole time when i was in baltimore uh one of these baltimore junkies came in for surgery and uh he's like no man you got to put me to sleep you got to put me to sleep i'm like just hold still we'll give you some local it'll be fine he's like no you got to

put me to sleep i'm like look you hold still i will make you as high as you've ever been and i pushed like a huge amount of drugs in the sky fentanyl and he's like oh that's good but it's not as good as my first high sounds like an episode of the wire as good as his first one all right dr chris laster, thank you again for being here with us today. That was very interesting. Thank you, Dr. Chris. I really enjoyed that. That was a lot of fun.

Thank you. Ladies and gentlemen, if you're ever at a party and someone comes up to you and goes, I'm eating because I have surgery tomorrow, you go, I don't know about that, and then walk away and then just pray for them. Good night, Australia.