Going under: The history and mechanisms of general anesthesia

Daniel and Kelly explore the history of general anesthesia, and what we know (or don't know) about how it works.

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Episode Transcript

Speaker 1 (00:00):
Hello, friends, just a heads up that on today's episode,
we're going to be talking about the history of anesthesia.
We'll also be discussing medical procedures in the pre anesthesia era,
and we'll touch on triggering topics like mental health crises
and suicides. Since one of my best friends is a

(00:24):
physicist who likes to get philosophical from time to time,
I sometimes find myself in discussions about time travel, which
inevitably bring up the question of when in space and time.

Speaker 2 (00:35):
I'd like to be alive.

Speaker 1 (00:36):
If it were up to me, it would be amazing
to see early human species create complex tools, or communicate
complicated ideas to each other for the first time, or
sit at a table with Antoine von Lewinhook and ask
him how to pronounce his name correctly while looking through
his microscope, to see microscopic creatures swimming around in a

(00:57):
drop of water, or to sit in the hall at
the Royal City Society when Charles Darwin and Alfred Russell
Wallace's theory of natural selection is shared publicly for the
first time. Any of those moments would be amazing to
witness firsthand, But my answer is way more practical. I
want to be alive in a time and place that
has good sanitation, antibiotics, and critically anesthesia. Doctor Lindsay Fitzharris

(01:22):
is a medical historian and author, and the prologue to
her book The Butchering Art makes it incredibly clear why
living in the age of anesthesia is super awesome. Here,
I'm going to recall a story from the beginning of
her book. It was December twenty first, eighteen forty six,
and the crowd of medical professionals and spectators were settling
in to the operating theater at London's University College Hospital.

(01:45):
In the middle of the room was a blood soaked table.
The floor was covered in sawdust to soak up the
anticipated forthcoming pools of blood. Surgery on that day would
be performed by the famous doctor Robert Liston, who was
well known for completing surgeries in thirty seconds or less.
And we know that it took thirty seconds or less

(02:05):
because he often started his surgeries by proclaiming time me, gentlemen,
time me. Now, if you have a limb that needs
to be amputated, you can be forgiven for wanting to
get it done by the guy who does.

Speaker 2 (02:17):
It in under a minute.

Speaker 1 (02:18):
But speed sometimes came at the cost of accuracy, as
Liston once coupled a like amputation with an accidental testicle ectomy.
Most people avoided surgeries at all costs. Not only was
it an absolutely miserable experience to be held down by
surgeon assistants while you were cut into, but if that
experience didn't kill you, subsequent infection often did. As this

(02:42):
was in the era before sterile technique and antibiotics, and
it was gruesome to watch too. Physician James Simpson once
fled an operating theater because it was too much for
him to watch a breast removal surgery. After escaping the theater,
he proclaimed that he would instead study law. He did, however,
go on to complete medical training, and we'll hear more
about his pioneering work on anesthetics for childbirth later in

(03:04):
the episode. But anyway, on this day, in front of
a crowded theater, Liston was trying the anesthetic ether for
the first time. A thirty six year old butcher who
needed a leg amputation was laying on the bench and
the ether was administered, knocking him out. The leg was
quickly sawed off, the arteries tied off, and the flesh
closed up. All this was completed in just a few minutes.

(03:28):
When the groggy patient came to, he looked at Liston
and asked, when would the surgery begin?

Speaker 2 (03:35):
Amazing. Welcome to Daniel and Kelly's Extraordinary Universe.

Speaker 3 (03:52):
Hi. I'm Daniel. I'm a particle physicist, and my most
terrifying experience with anesthesia was having my ten year old
old son go under.

Speaker 4 (04:01):
Oh.

Speaker 2 (04:02):
Hi, I'm Kelly Waitersmith.

Speaker 1 (04:03):
I study space and parasites, and thus far, none of
my kids have had to go under anesthesia. I've had
anesthesia make me vomit and embarrass myself many times, but
I've never never been scared about it. What was so
scary about your kid going under.

Speaker 3 (04:16):
The fact that nobody knows what they're doing or how
it works. And they're like, there's a pretty good chance
he'll wake up, And we're like, what.

Speaker 1 (04:24):
Dan, you know it's more than just a pretty good chance. Like,
we've got a lot of experience with this by now.

Speaker 3 (04:29):
Yeah, we have played a resturan roulette with this many
many times, and mostly people survive, and that all is
fine scientifically, But when it's your kid going under, it's
an emotional decision and probabilities and statistics are irrelevant. Yeah,
it's just terrifying.

Speaker 1 (04:44):
Yeap, Have you ever said anything particularly stupid coming out
of anesthesia?

Speaker 3 (04:52):
That assumes I don't say stupid things when I'm not
under anesthesia, So I think my distribution of intelligence and
stupid doesn't change. How about you? Have you said absurd
stuff coming out of anesthesia?

Speaker 1 (05:04):
I don't remember, but Zach told me that after I
came out of a procedure, I just kept asking was
I polite to everyone? Was I polite to everyone? And
I just kept asking. I was really panicking about whether
or not I was polite to everyone, and Zach said
I was fine, and then I threw up. But I
didn't feel the procedure, which is great.

Speaker 3 (05:24):
Well, I'm sure you're always polite to even when you're
in pain or when you're out of it.

Speaker 2 (05:29):
Thanks. Yeah, apparently I really worry about that.

Speaker 3 (05:33):
And I'm sure that today you're going to give us
a very painless tour of the history of anesthesia, what
we know about it, how we've discovered it, and how
many humans have suffered unnecessarily through history.

Speaker 1 (05:42):
Yes, well, I am attempting today to politely answer a
wonderful question from our listener Eric, and let's go ahead
and hear that question.

Speaker 2 (05:50):
Now.

Speaker 5 (05:51):
Hey, there's a whole lot of important stuff that we
don't fully understand. Tangents as part of the plain episode
was my favorite part. I think I remember ones that
we don't really know how anesthesia works?

Speaker 3 (06:03):
Is that true?

Speaker 5 (06:04):
Seems like a cool episode idea history of anesthesia back
when getting someone really drunk was the best we could do,
to what we do now and if we actually understand it,
to the differences between anesthesia and sleep.

Speaker 3 (06:15):
Thanks.

Speaker 1 (06:16):
Oh my gosh, there are so many cool topics in
that question. I got to go down so many amazing
rabbit holes. And if you would like to submit a
question about whatever it is that keeps you up at night,
please send us those questions at questions at danieland Kelly
dot org.

Speaker 3 (06:32):
This question makes me wonder how much we do and
don't know about why things work in medicine. I actually
asked Katrina about this when I read this question, and
she was like, you should be less surprised we don't
know how tailent all works. I was like, I'm less
surprised now, but I'm more terrified. I guess all right, Like,
basically our bodies are huge Rube Goldberg machines, and we

(06:55):
don't know how they work, but we have discovered if
you press this button and pull this lever, that this
thing happens, and now we rely on that for all
of modern medicine.

Speaker 1 (07:04):
I think my scariest example of this, and I think
I've said this on the show before, so I'll keep
it brief. As I was talking to someone about why
deep brain stimulation works, where you essentially like stick an
electrode in the center of someone's brains and shock it,
which is usually to stop a seizure, and they were like,
we don't know. I was like, wow, we're shocking the
insides of people's brains and we're like it works, and

(07:24):
that's great, but why I know?

Speaker 5 (07:27):
I know?

Speaker 3 (07:27):
And the physicist to me wants to be like really
reductionists and be like, we have to understand how these
things work if we're going to do them right, like,
because who knows what other consequences there could be. And
also it makes me wonder like, how did we figure
this stuff out if we don't know how it works
or what it was going to do? Have we basically
just been experimenting on ourselves unethically on other people for millennia,
like this is terrible. On the other hand, like you know,

(07:50):
you've got to make progress. It's going to be a
long time before we have an understanding of the human
body that would satisfy a physicist. And we have kids
who need anesthesia when they go under.

Speaker 1 (08:01):
So yeah, yeah, well, and so that's actually a really
nice transition into a book that I used to do
a bunch of the research for this episode. It's doctor
Lawrence Altman's book, Who Goes First, And it's essentially trying
to figure out who should we test this stuff out
on first to make sure that it's safe. And this
book is all about self experimentation in medicine. Basically doctors
who decided I am the right person to test it

(08:22):
on first because I understand the risks and I'm the
one who has the idea, and so they tested it
on themselves. And there's a lot of self experimentation in
the history of anesthesia.

Speaker 3 (08:31):
Is that sort of on the down low? I know
that you're not allowed to experiment on people unless you
have all sorts of ethical reviews, et cetera. But are
there such reviews for experimenting on yourself. Can you basically
do anything you want to your own body?

Speaker 2 (08:42):
Why should I start here?

Speaker 1 (08:44):
So I got kind of interested in this question and
after World War Two, and I promise I won't do
like nearly one hundred years of history on this question.
But after World War two there was the Nuremberg Code,
and this was in response to the horrible experiments that
Nazi doctors did on people in their concentration camps. And
one of the things that they were encouraging was like,
if you're going to do a procedure on someone, you

(09:06):
need to be willing or actually you need to do
it on yourself, because that is a way to show
that like you think this is safe, you're invested, blah
blah blah.

Speaker 2 (09:13):
So for a while there it was encouraged for people
to do it on themselves.

Speaker 1 (09:17):
Now, you're not supposed to experiment on yourself unless you
were included in the permits and protocols that you submitted
to get permission. And so you can say I need
one hundred subjects and the first one is going to
be me. But yeah, you're not supposed to just willing
nilly experiment on yourself. Though I have heard of people
who do that anyway.

Speaker 3 (09:36):
And I wonder if once you do that, if you
break the rules, if that did is not allowed to
be considered in future questions, you know, sort of like
doctor Mangela's data, or if they're like, well, you have
this data, you did it already, so let's use it.
You know.

Speaker 1 (09:51):
I've also come a lot across a lot of examples
where people have experimented on themselves. They got the answer
they expected, and then they moved forward as so they
knew what they needed to know, but it's turned out
their sample size of one was completely misleading. And I've
seen this in like, you know, trials for vaccines. Yeah,
not anymore, these kinds of data would not fly anymore.

(10:12):
Just to be clear, okay, but in the past, people
have like tried a vaccine on themselves, been like this
worked great on me, and then distributed it widely and
turned out it works very different in different kinds of bodies.
So you can learn something from a sample size of one,
but then you need to follow it up with much better,
much more broad trials.

Speaker 3 (10:29):
So let's zoom in and talk about today's topic, which
is not how the whole human body works, but how
we put parts of it to sleep. Yeah, let's go
all the way back to very early history, like what
were people doing thousands of years ago when they needed
to have surgery?

Speaker 1 (10:44):
So I don't know many thousands of years ago, but
something like one to two thousand years ago. We were
just trying stuff out, which is maybe not so different
than what we do now, but we've got better evidence now.
But so there's evidence of Chinese and Arab positions inhaling
very kinds of drugs, mixing things in alcohol, and this
apparently helped with surgery, but we've sort of lost the recipes.

Speaker 3 (11:06):
The physicians were doing drugs and that helped them with
the surgery, or the patients are getting the truck.

Speaker 1 (11:13):
If I needed to amputate someone's limb, maybe I would
want to be not completely present for that process.

Speaker 3 (11:19):
But it's like past the pipe there, dude, when you're done.

Speaker 2 (11:21):
With this, that's right, that's right.

Speaker 1 (11:23):
But so we don't really have great data on what
it was that they were doing, but we do have
some fun stories from like French surgeons from a long
time ago who would knock people out, not with drugs,
but by putting a wooden bowl over someone's head and
hitting it with a hammer to like literally knock you out,
Oh my gosh. And then for a while, attempting to
mesmerize patients, you know, like hypnotizing them was popular. But

(11:46):
then it became clear that some people were saying this
worked and they were actually just like tricking a bunch
of people, so that fell out of favor. But then
what is kind of frustrating is that, around seventeen ninety
nine it was discovered that actuallyitrous oxide does make it
so that you don't feel pain. So Humphrey Davy was
he a physics guy?

Speaker 3 (12:06):
I don't know, I've never heard of him.

Speaker 2 (12:07):
Oh gosh. I heard his name before, and I just
assumed he was a physicist.

Speaker 1 (12:12):
Why did you assume he was a physicist, because people
don't care about old biologists.

Speaker 4 (12:19):
Uh.

Speaker 3 (12:20):
He sounds to me like a guy who would sit
on a wall and fall off.

Speaker 2 (12:22):
And crack yep, yep. Oh he's a chemist.

Speaker 3 (12:24):
Oh god, all right, yeah, knock him off that wall.

Speaker 2 (12:27):
That's right, that's right.

Speaker 1 (12:28):
So in seventeen ninety nine, Humphrey Davy had a job
where he was experimenting on various things, and one of
the things he was experimenting with was nitrous oxide. Which
is also called laughing gas. And he was experimenting with
his friends, who included the poet Samuel Taylor Cooleridge and
doctor Peter Roget who was the guy who compiled with Thesaurus.
But anyway, they were sort of like knocking themselves out

(12:51):
with nitrous oxide, and Humphrey Davy mentioned, oh, hey, when
I take this, my headaches go away and my wisdom
teeth don't hurt anymore, And so he noted it could
be used for surgeries to remove pain. But then he
goes on and does other stuff, like he gets knighted
for inventing the minors safety lamp, and he never pursues
this line of reasoning. So from as early as seventeen

(13:13):
ninety nine, we could have been using things like nitrous
oxide to knock people out in surgeries. But this just
sort of like disappeared into the ether and was an
idea that didn't get followed up on chemists.

Speaker 3 (13:25):
Oh my gosh, what are you doing keeping secrets of
painless surgery from the masses?

Speaker 1 (13:30):
Well, I mean no, he shared this result like in
a report, but then he moved on to other things.

Speaker 2 (13:36):
But you know, let's both agree that chemists could be
doing better.

Speaker 3 (13:39):
So before seventeen nine nine, before the discovery of nitrous oxide,
people would just like Grin and Barrett, you know, they
would like drink whiskey or smoke cannabis or pull from
the opium pipe. It must have meant that a lot
of people like avoided necessary surgeries because they were just like, yeah,
it's just not worth it.

Speaker 1 (13:55):
Yeah, So literally you would be you know, you'd take
a couple shots of some alcohol. Of big dudes would
be brought in to hold you down, and then the
surgeon would try to do things as fast as they could.
And so surgeons were often picked not for their skill
but for their ability to saw through things really super fast.
Lindsay Fitzharris has this great book called The Butchering Art

(14:17):
that included a bunch of stories of really horrible things,
like a surgeon who was trying to cut through a
leg and did it really fast and also took half
of a scrotum with the leg and no bonus, I
guess not for the guy who was under the knife.
But yeah, So there were a lot of surgeries that
they wouldn't do. Like maybe they had an inkling that

(14:38):
surgery would help in this case, but it was a
procedure that just would have been too hard to hold
someone down for they might have lost too much blood.
And so only the things that could be done fast
were done, and they were done by people who were
moving quickly, perhaps at the expense of moving carefully.

Speaker 3 (14:53):
Right, maybe it's more of a last ditch option.

Speaker 2 (14:55):
Oh god, yeah.

Speaker 3 (14:56):
Well, But as a research and nerd, I'm curious, how
do we know these things about the earliest surgeries, Like
do we have written records from China or you know,
the Islamic world, or what is the sort of earliest
record we have of medicine and surgery.

Speaker 1 (15:12):
So the earliest record that I came across while doing
the research was two hundred CE where a Chinese physician
was mixing alcohol with some other stuff. But the references
that I read never included and we learned this from
an ancient scroll that was found in such and such
tomb or something like that. So I don't know the
history of how this information came to be known, but

(15:33):
I do know that more recently, for example, some of
the stuff I'm going to be talking about next was
like in the news and in letters written from one
physician to another. But this was all much more recent fascinating.

Speaker 3 (15:44):
I wonder what they did in ancient Egypt, for example.
You know those guys are pretty advanced, especially in surgery,
or are They like took organs out and put them
in weird vessels and stuff, so they knew their way
around a body.

Speaker 1 (15:55):
Does it count as surgery if they're dead? Though, Like,
I mean, it didn't.

Speaker 2 (15:59):
I think.

Speaker 1 (16:00):
I think they were also unimpressed with the brain, for example,
and thought that, like the heart is where most of
the important stuff happened. So I don't know that i'd
want an ancient Egyptian surgeon to be working on me.

Speaker 3 (16:11):
All right, So let's fast forward back to the present.
You said, Humphrey Davy missed his opportunity to save people
from pain and just enjoyed hanging out with his friends
Sam Coleridge and Peter Rodgit. What happened next? When did
we actually start to figure stuff out and use it
to save people from suffering.

Speaker 1 (16:27):
Well before we were saving people from suffering, we were
allowing people to have a really stinking good time. And
so in the early to mid eighteen hundreds, there were
events called ether frolics or jags, where essentially people would
get together huff ether and appreciate how awesome it made
you feel. And there was no sort of surgical implication

(16:48):
or plans to understand how this would work in surgery.
It was just like, whoa, it's really fun when you
huff ether or huff nitrous oxide.

Speaker 3 (16:56):
And let's have a biology physics disentanglement moment here, because
physics ether refers to this concept that space is filled
with something for like to propagate through, famously disproven by
the Michaelson Morley experiment in the late eighteen hundreds. That's
not where people are snuffing at your biology parties.

Speaker 1 (17:14):
Right, No, a chemist would tell you that ether is
an organic compound. It's a mix of oxygen with alkyl groups.
And you know, we both know that I don't know
much about chemistry, but no, it's not a made up
idea it is.

Speaker 2 (17:28):
It's an actual chemical compound.

Speaker 3 (17:30):
And what happens when you sniff it, you just like
feel good or you pass out or what happens.

Speaker 1 (17:34):
Well, we'll go into more detail about what it's doing
to the brain a little bit later, but for the
purpose of these parties, it just sort of made you
feel kind of silly and anything that heard stopped hurting
and you'd laugh a lot more.

Speaker 2 (17:45):
And you know that all sounds fantastic.

Speaker 3 (17:47):
That sounds great. Why did you go out of fashion?

Speaker 1 (17:49):
Well, because it's also kind of dangerous. It can lead
to vomiting and death, and if you do it too often,
it can like impact your organs, and it's yeah, bad news.
And we will encounter worries about some people who are
thought to have maybe gone a little bit mad on
account of all the ether and stuff they were taken.

Speaker 2 (18:06):
Probably chemists, yeah, I know, right, almost certainly chemists. God guys.

Speaker 1 (18:10):
All right, so let's take a break here, and when
we get back from the break, we'll talk about the
four men who brought anesthetics to the medical world and
their downfall afterwards as they all fought for credit for
being the first to come up with this idea.

Speaker 4 (18:26):
Oh no, all right, we're back.

Speaker 1 (18:48):
We were talking about ether parties, which do sound fun,
but I would not engage in an ether party because I'm.

Speaker 3 (18:55):
A whimp and you're so wholesome, Kelly.

Speaker 2 (18:59):
Yeah.

Speaker 1 (18:59):
I work in this lab once where somebody said something
to me to the effect of you're really nice, and
it was like, in a condescending I've never had anyone
be like, you're nice and that kind of sucks. But
like anyway, so I have been told that I'm not fun,
but that's fine.

Speaker 2 (19:18):
I'm not fun.

Speaker 3 (19:19):
You're a lot of fun. You're a lot of ways.
Let me ask you a more personal question, which is
what is your drug of choice? Are you an alcohol drinker?
Do you chew on banana peels? How does Kelly unwined?

Speaker 1 (19:30):
Kelly does not enjoy chewing on banana peels at all.
It makes Kelly feel really uncomfortable. Kelly enjoys a glass
of red wine and caffeine. Kelly mostly lives a stimulant
free like you know what. Kelly's favorite stimulant is the
anti anxiety medication.

Speaker 2 (19:46):
She's hot. That's how eye roll.

Speaker 3 (19:51):
That's the modern day ether.

Speaker 2 (19:52):
What about you.

Speaker 3 (19:53):
I'm a big believer in caffeine as well, and I
enjoy red wine, and for many years I did also
enjoy banana peel. It helped to stimulate some creativity in
my research, but no longer.

Speaker 1 (20:05):
Ah well, we all have had youthful indiscretions.

Speaker 3 (20:10):
All right, So now let's talk about the indiscretions of
various men in history who brought us anesthesia.

Speaker 1 (20:16):
So the first person we're going to chat about is
doctor Crawford Long, and he was at one of these
ether frolics and he was really enjoying it, and he
noted to himself that when he or others did things
that should be painful, they didn't seem to feel the pain.
And he was a physician and this made him think, oh,
you know, maybe this could be used in surgery. And

(20:38):
so he was the first person to actually test it out.
So he had a patient who needed two small cysts removed,
and the patient was nervous about getting the surgery done
because it was painful, and he was like, look, this
isn't critical. I don't want these things taken out. And
the patient had also tried ether recreationally and really enjoyed it,
and so Long was like, look, let's try it.

Speaker 2 (20:56):
I'm going to put you under the ether.

Speaker 1 (20:58):
You know that you don't feel as much much pain
under the ether, so let's see how it goes. And
actually it went great. Wow, and Long started using this
gas for other operations as well. But the big thing
here is that he didn't share this information with the
medical profession widely, so he didn't like write a paper
or go to a surgery that was watched by a

(21:19):
lot of other people. So at the time, surgeries were
done in operating theaters where students of medicine were sort
of sitting in the same room. So now, like you know,
if you've watched Gray's Anatomy, you know that there is
like a elevated area and you can be behind glass
and you can sort of peek in.

Speaker 3 (21:33):
Like a splash guard there and make sure, you know,
get sprayed in the face.

Speaker 1 (21:36):
I'm wondering if maybe they're protecting the patient more than anything,
like you're you know, when you sneeze, they don't want
the germs settling into the patient's abdomen.

Speaker 3 (21:43):
But uh, I wonder if they used to pass around
raincoats the way they do it like SeaWorld in the
first few rows, you know.

Speaker 2 (21:48):
Oh so gross.

Speaker 1 (21:50):
I know they used to put sawdust under the operating
tables to absorb the blood. Uh yeah, intense, And I
don't think they always cleared the sawdust before the next person.
And I read some stories where the guy would like
take the saw where he had amputated a leg and
he'd kind of like wipe it off on his apron
and then get to the next guy, which we don't
do anymore.

Speaker 3 (22:10):
And who would come to these things anyway? Is it
just medical students or is this like, you know, an
afternoon with the family. What are we going to do?
This is before movies. Let's go see some legs get
cut off.

Speaker 1 (22:20):
I don't know if you bring little Susie with you,
but like, definitely the medical students are there. And this
isn't too far after people used to go to like
public executions for fundsies.

Speaker 3 (22:30):
Yeah, that's what I was thinking.

Speaker 1 (22:31):
Yeah, and so I do think some people did come
off the streets just to kind of watch. That's probably
not how I'd spend my day. What was Shakespeare around?

Speaker 5 (22:41):
Like?

Speaker 1 (22:41):
Were the options to go to the globe and see
a Shakespearean play or watch someone get their leg amputated
my timeline of history?

Speaker 3 (22:48):
Not a hard choice, I mean, geez, yeah, Shakespeare's a
couple hundred years before He's like early sixteen hundreds, late
fifteen hundreds.

Speaker 1 (22:56):
Oh all right, well, and maybe I would watch the amputation.
You know, what else are you going to do in London?
So anyway, Long gets the ball rolling but doesn't share
with anyone, so it stops with him. But then in
eighteen forty four, a dentist called Horace Wells goes to
a nitrous oxide demonstration. So there were people who would
travel around the country and they would essentially get up
on a stage and they'd be like, this nitrous oxide

(23:18):
stuff is great. Is there a volunteer from the audience
who would like to feel, you know, what nitrous oxide
feels like. So they'd have them inhale some nitrous oxide
and then they'd be like.

Speaker 2 (23:27):
I feel great. He he he would be so fun, and.

Speaker 3 (23:29):
People would watch this and they're like, let's amputate your leg. Sure,
he he he he.

Speaker 1 (23:34):
Well and so uh, so Wells was watching this demonstration
and one of the people who got sort of exposed
to nitrous oxide got a pretty big laceration on their leg,
but clearly didn't feel it while it was happening, And
so Wells afterwards goes to the guy doing the demonstration
and is like, whoa, hey, I saw that someone got

(23:54):
hurt and then they were totally fine. And I'm a dentist,
so can you like come with me to my dentist
off and we can try like knocking out my patients
before doing the procedure.

Speaker 3 (24:04):
This is a dentist who cares, who doesn't want to
cause his patient's pain.

Speaker 2 (24:08):
That's right, it's amazing.

Speaker 1 (24:09):
I miss oh you. This is a joke about dentists
in general. I didn't get it because I have an
amazing dentist. I love him so much.

Speaker 3 (24:19):
I hope he listens to the pod. And here's how
much you love him.

Speaker 2 (24:21):
You're the best doctor, Cayton.

Speaker 1 (24:26):
Okay, So before he started using it on his patients,
he decided he wanted to try it on himself. So
this is an example of self experimentation. So Wells calls
over a dentist friends of his. The guy who did
the nitrous oxide demonstration knocks Wells out, and the friend
dentist who came over pulled out a molar, and Wells
doesn't feel a thing.

Speaker 3 (24:45):
So we just like sacrifices a healthy molar to science.

Speaker 2 (24:49):
Yes, amaz, yeah he does.

Speaker 3 (24:50):
I like this dentist.

Speaker 2 (24:51):
Yeah, no, me too.

Speaker 1 (24:52):
He's willing to get his hands dirty for the arts.
I appreciate that.

Speaker 3 (24:56):
All right, So far I'm voting for Horace Wells to
get credit for this.

Speaker 2 (24:58):
I like Wells too.

Speaker 1 (24:59):
So Els does this on fifteen other patients, and he
decides this is awesome, right, Yeah, So in eighteen forty five,
he goes to Massachusetts General Hospital and they're doing one
of these big public surgeries, and he decides he's going
to remove a tooth from a volunteer. But he doesn't
give the volunteer enough nitrous oxide. Oh no, And so
now we know that, you know, some people require more

(25:21):
nitrous oxide to get knocked out, some require less, and
this guy just didn't get the right amount for whatever reason.

Speaker 2 (25:27):
And so the patient is clearly feeling pain during this.

Speaker 1 (25:30):
Procedure, and it is very embarrassing to doctor Wells because
he's got this whole audience and it's clearly not working,
and so this was sort of devastating for him.

Speaker 3 (25:40):
This is his big moment.

Speaker 1 (25:41):
Wow, this was his big moment. And we'll see that
he doesn't actually emotionally recover from this.

Speaker 2 (25:46):
Oh no, I know, I know some.

Speaker 3 (25:49):
Like emotional nitros oxide. He needs some of that antidepressants.

Speaker 1 (25:51):
He does need some antidepressants, as we'll see. So then
the next group that gets in on this at around
the same time is doctor William Morton and his chemistry teacher,
doctor Charles Jackson. Morton starts experimenting with ether instead of
nitrous oxide. And it turns out that ether sort of
works a little bit better. And at the time, the

(26:12):
professors and the students were playing with ether too, so
they were doing these ether parties and you'd get together
with your professors and like get high on ether.

Speaker 2 (26:20):
Times have changed and.

Speaker 3 (26:21):
So no, no, no, I do that all the time
with my classes. Yeah.

Speaker 2 (26:24):
Absolutely, Oh yeah, I don't. Uh, we're moving on.

Speaker 3 (26:27):
So if any administrators that you see or Vara listening, I.

Speaker 1 (26:31):
Was a joke, of course, good, yes, yes, So I
think Morton had been aware of what Wells was doing,
and he starts using ether instead of nitrous oxide. He
talks to his chemistry professor, He's like, can you get
me some ether? And to try out the ether, Morton
wasn't willing to test on himself. He extracted the tooth
of one of his assistants. Oh, but the ether he

(26:51):
was using wasn't pure enough and it was painful for
the assistant. So Morton's like, oh shoot. So then he
starts testing on himself because he can tinker with the
doses and the purity. And apparently his wife is like
super not excited that he's doing this, because he's like
I put sid a timer and I knocked myself out
for eight minutes, and she's.

Speaker 3 (27:08):
Like, no, that's not good.

Speaker 2 (27:11):
It's not good. What are you doing.

Speaker 3 (27:12):
You're getting drained brimage.

Speaker 2 (27:14):
Oh god.

Speaker 1 (27:15):
So later he tries it out on a patient who
has a toothache and it works great. So he also
goes to Massachusetts General Hospital in eighteen forty six and
there is a surgeon who is doing a procedure to
excize a neck tumor. At the time, Morton was a
second year Harvard medical student, and he gets permission to
administer ether well. The surgeon is removing the tumor, and

(27:38):
the procedure goes so well that when it's done, the
surgeon looks out at the audience and says, gentlemen, this
is no humbug.

Speaker 3 (27:47):
You have to translate for me. Is that good? Humbug
is bad? So no humbug is good?

Speaker 2 (27:52):
That's right. Yes, Yeah, the double negative threw you a bit.

Speaker 3 (27:55):
So if you're getting like comments from a reviewer in
the eighteen hundreds, and a reviewer too is like, this
paper is no humbug, then that's good.

Speaker 2 (28:01):
That's good. Yeah, you probably got past reviewer too. Good job.

Speaker 1 (28:06):
So it worked but Morton at this point sees a
cash cow, and so he doesn't want to tell anybody
what it is, and so he names it Lethion, which
is after the mythological river LETHI. I think it's pronounced
where the souls of the dead forget their earthly lives.
I don't know if I'd want to be taking something
that's usually associated with helping the dead forget things, like

(28:27):
I'd rather stay alive while I forget the procedure.

Speaker 3 (28:30):
Would you like to take a trip on the river sticks?

Speaker 2 (28:32):
Yeah, no, thank you, I'll pass. Can you just take
this moler out please?

Speaker 3 (28:36):
That's one big humbug for that idea.

Speaker 2 (28:38):
That's right, amen.

Speaker 1 (28:39):
But ether has a super distinct smell, and so Surgeon's
pretty quickly figured out what he was doing, and he
tried to get money some other ways. He tried to
make this like very particular device for administering the ether,
but other people figured out better devices, and so anyway,
eventually Morton realizes he's not going to make a ton
of money, and everybody now transitions to trying to figure

(29:01):
out who can get the most credit for it. So,
if you're not gonna get rich, at least you can
impress the whole world.

Speaker 3 (29:05):
Right here comes the dark side of science.

Speaker 2 (29:07):
That's right. Here we go.

Speaker 1 (29:08):
So Wells who was the first to do a public
demonstration of it, and if you remember, he's the one
where he did the public demonstration. It didn't work. He
was super embarrassing. So Wells is interested in this, but
he's trying out some other ways to maybe make it
work better because it was embarrassing when he did the
nitrous oxide thing. So he starts trying chloroform instead. But

(29:28):
he gets addicted to the chloroform and it seems to
have eventually like sort of messed with his mental health,
messed with his mind. So he goes to jail for
throwing sulfuric acid on prostitutes.

Speaker 3 (29:41):
Oh boy.

Speaker 1 (29:42):
Yeah, And while he's in prison, he had apparently managed
to smuggle some chloroform in and he commits suicide using
the chloroform and a razor blade in prison. So and
the worst well not the worst. The worst thing is
he died.

Speaker 2 (29:55):
That's awful.

Speaker 1 (29:56):
But his wife a few days later gets a letter
from the Paris Medical Society and they have concluded that
Wells is the one who should get credit for doing
the first painless surgery under anesthesia.

Speaker 3 (30:07):
Oh no, so that letter could have saved his life probably.

Speaker 1 (30:10):
Yeah, it seems like he was super concerned about the
credit anyway. So next up we'll talk about Morton.

Speaker 3 (30:16):
Well, that's a big humbug.

Speaker 1 (30:17):
That is a huge humbug. Humbug of the year maybe.

Speaker 2 (30:21):
Yeah.

Speaker 1 (30:21):
So Morton is the guy who was trying to make
a bunch of money off of ether and he had
kind of worked with his chemistry professor, and he and
his chemistry professor, it turns out end up in this
giant debate about who should get the credit. And Morton,
as I mentioned, he had this device that people stopped using,
and then he's frustrated because other dentists are using this procedure.
So now he's not even making money by having the

(30:42):
most patients.

Speaker 3 (30:43):
In the meantime, a lot of people are now having
surgeries and procedures without pain.

Speaker 1 (30:48):
So that's good, that should be huge, right, Yeah, But
that's not doing it for him. And in eighteen sixty eight,
a magazine article comes out saying that Morton's professor Jackson
is the one who should get the credit, and that
seems to drive Morton absolutely crazy, and he drives to
New York to confront the editors and dies of a
stroke in Central Park.

Speaker 2 (31:06):
Oh my gosh, at forty eight.

Speaker 3 (31:08):
This whole area is like cursed.

Speaker 2 (31:10):
I know, it's horrible.

Speaker 3 (31:12):
Or maybe it's just the product of all this self
experimentation with these crazy drugs.

Speaker 1 (31:16):
I mean, I do think that the fact that these
drugs are a bit mind altering and had been used
maybe way too often and at way too high doses,
could have had something to do with the mental health
problems these people had. But anyway, Jackson, the chemistry professor
is backed by the Academy of Sciences of the Institute
of France, so it looks like the medical communities in

(31:36):
France are sort of.

Speaker 2 (31:37):
Divided on who they're going to back.

Speaker 1 (31:39):
Jackson gets told that he's getting the credit, but he
becomes an alcoholic and he's found screaming at Morton's gravestone.
Like even after Morton dies, he's still angry enough to
like go to his gravestone and yell at him. He
ends up in an asylum where he stays for twelve
years and dies at seventy five.

Speaker 3 (31:56):
I hope to never be found yelling at gravestone.

Speaker 1 (31:58):
Yeah, Like wow, you know, that seems that's pretty high end,
Like at the point where your enemy has passed on,
I feel like.

Speaker 3 (32:05):
You can move on.

Speaker 2 (32:07):
But I guess it's not always that easy.

Speaker 3 (32:10):
On the other hand, gravestones are kind of there for
you to like visit someone who's passed and talk to
them and connect with them. And so if Yellen's what
you gotta do, I guess that is the place for it.

Speaker 1 (32:20):
Yeah, I guess, sure, sure, but maybe i'd want to
like smoke some banana peels to chill me out before
I get there.

Speaker 3 (32:26):
Yeah, But I'm also intrigued by this facet of history
where like societies are deciding who gets credit for something. Yeah,
you know, that's not the way we do things these days,
at least not on physics. Like if you make a discovery,
you argue about the paper, or you argue about who
gets prizes. But it's never like the American Physical Society
decides Daniel gets credit for this idea or Sally gets

(32:47):
credit for that idea.

Speaker 1 (32:49):
I mean, I feel like the Nobel Prize has just
like that is the ultimate arbiter of who gets credit
for the idea, and maybe nobody else minds. I guess
I don't or nobody else feels like it's worth weighing in.

Speaker 2 (32:59):
I don't know.

Speaker 3 (33:00):
Yeah, yeah, I guess this is all pre Nobel Prize stuff,
so m M, maybe that plays a role. Fascinating all right, So,
so far three folks have tried to take credit for
it and either died or gone mad. Who's up next?

Speaker 1 (33:12):
I saved the best for last, so remember the No,
this is actually the best. So the first person who
we talked about who didn't share his results publicly and
was just like, oh, this is great. I'm going to
make sure that all of my patients are well taken
care of from here on out. He continues his medical practice,
owns a pharmacy in Georgia, and has a happy life.

Speaker 3 (33:33):
Oh my gosh, I was waiting for the disaster there.
But no, I'm glad he lives happily.

Speaker 1 (33:38):
Ever after he does well, he dies at sixty two.
He dies well prepping to give ether to a woman
in labor. So that wasn't great for her. I'm sure
she was like no at first, give me the either.

Speaker 3 (33:48):
But that's not a good sign if your doctor drops
dead during labor.

Speaker 4 (33:53):
No.

Speaker 1 (33:54):
No, But actually, before we go to a commercial, I
want to real quick tell you this story about chloroform
in the UK. So the UK was more interested in chloroform.
We were more interested in nitrosoxide and ether. And a
very important time when you can use ether is during childbirth.
So there was the Scottish obstetrician James Simpson. We talked
about this guy in the intro. He ran out of

(34:15):
the operating theater and thought about becoming a lawyer because
it was so upsetting to watch surgeries without ether. But anyway,
around eighteen forty seven he's experimenting with different gases, decides
chloroform is best. But there was this idea at the
time that women needed to actually go through the process
of labor and that the pain was sort of part
of it, and taking the pain away was unethical or like,

(34:36):
wasn't okay on religious grounds, and so he wasn't able
to start administering it widely until John Snow and any
epidemiology nerds out there are.

Speaker 2 (34:45):
Like John Snow with the cholera pump and the Broad
Street pump.

Speaker 1 (34:49):
But anyway, so he helped figure out the cause of cholera.
I think the pandemic was wrapping up by the time
he figured it out. He in eighteen fifty three administers
chloroform to Queen Victoria while she's giving We're to her
eighth child. That's high stakes, that's super high stakes.

Speaker 2 (35:03):
But it goes great. Queen Victoria is like, awesome.

Speaker 1 (35:06):
Everyone should have access to this, and now it becomes
super widespread. It has since been sort of superseded by
other methods because it is kind of nasty stuff, and
if you use it for too long it damages like
the liver, kidney, hearts, and eventually chloroform falls out of favor.
But Queen Victoria and obstetrician James Simpson helped bring some
pain relief to women in childbirth.

Speaker 3 (35:29):
Hurrah, Hurrah James and Queen Victoria. It's amazing how these
things are cultural, right have, Like, yeah, one person in
one country can turn a whole society in one direction
or another to use chloroform and not just oxide. It's
incredible how random history really is.

Speaker 2 (35:44):
Oh my gosh, yeah, it absolutely is. Agreed.

Speaker 3 (35:46):
All right, Well, let's take a break and when we
come back, we'll learn what we do and don't know
about how anesthesia actually works.

Speaker 1 (36:14):
All right, So let's chat about what we know about
how anesthesia works. And let's just clarify there's different kinds
of anesthesia. In this episode, we've been talking about general anesthesia,
where you breathe it in and it totally knocks you out,
you feel no pain.

Speaker 2 (36:27):
We're going to go into a bit more detail about that.

Speaker 3 (36:30):
Well, you don't remember feeling pain, right, Isn't There still
some debate about like are you actually feeling pain? But
then the experiences are wiped from your memory, and so
it's like you didn't feel pain.

Speaker 1 (36:40):
If you're taking a local anesthetic, you are awake, and
so like when I got an epidural when I was
giving birth to my second kiddo, I was awake, you know,
but I didn't feel any pain. I felt very itchy, right,
but I didn't feel any pain.

Speaker 2 (36:54):
And he was a ten pounder.

Speaker 1 (36:55):
And so I don't think that my memory was wiped
because if so, I would have been feeling pain in
the moment, right.

Speaker 3 (37:00):
But general anesthesia you're not conscious of right. So it's
possible that you are aware of the pain, you just
don't remember it, right because generalisty you don't remember the procedure.

Speaker 1 (37:09):
Yeah, I think there is a subset of people who
like will wake up sometimes and they can't move, Yeah,
but I don't think they feel pain. They're just like,
this is a very disconcerting experience.

Speaker 3 (37:22):
Well, let's hope not. But it strikes me that, like,
if I went through a very painful experience and then
somebody came and deleted those memories, I wonder how that
would be different, oh from the experience of general anesthesia.

Speaker 2 (37:32):
Right, yeah, I don't know.

Speaker 3 (37:33):
Anyway, Maybe that's more philosophy question. But tell us what
we know about how this actually works medically and neurologically.

Speaker 2 (37:39):
Not a lot.

Speaker 1 (37:40):
So. The Proceedings of the National Academy of Sciences is
a big, prestigious group of scientists in the United States,
and a twenty twenty paper started by saying anesthetics are
used every day in thousands of hospitals to induce loss
of consciousness, Yet scientists and the doctors who administer these
compounds lack am a lie secular understanding for their action.

Speaker 3 (38:02):
This is twenty twenty twenty. I'm talking about ancient history anymore.
This is basically today.

Speaker 1 (38:06):
That's right, that's where we are. But another thing that
was sort of interesting is that they mentioned in eighteen
forty six William Morton demonstrated general anesthesia with inhaled anesthetic
diethyl ether. So apparently they picked team Morton, Like, I
don't know if they you know.

Speaker 3 (38:23):
We're wading into this controversy.

Speaker 2 (38:25):
Yeah, that's right, that's right, but they're giving credit to him.

Speaker 3 (38:27):
Well, I hope that the descendants of these four gentlemen
are not like still battling it out. I hope they
get together and toast these guys and all of their achievements,
and I'll get along.

Speaker 1 (38:37):
I think it would be much nicer to just appreciate
the memory of people who took pain away for so
many of us, as opposed to like turning it into
a nasty fight for credit. But yeah, anyway, Okay. So
I ended up reaching out to two different anesthesiologists because
it was really complicated working through the literature and I
couldn't tell if I was reading sort of fringe idea

(39:00):
or the main idea, And so I ended up talking
to doctor Shannon Stem and doctor a Joa Botang Evans. So,
the main mechanism that we think is important here is
a neurotransmitter called gabba aminobeic acid or just GABBA. Your
neurons have receptors and these receptors are responsible for tinkering

(39:21):
with the electrical charge inside of the neuron, So let's
talk about why that's important. So our neurons are connected
to each other, there's like this open area in between
neurons called the synaps, and when chemicals are released into
that synapse, one cell has talked to another and a
message passes between the neurons. The way you get that
message into the synapse is that your cell needs to

(39:42):
pass a certain electrical charge to initiate what's called an
action potential. So usually your neuron has a little bit
of a negative charge and when it starts to accumulate
a positive charge, at some point it'll pass the threshold,
an electrical charge will pass through the neuron, the chemicals
will get released into the synaps, and the conversation between
neurons will happen.

Speaker 3 (40:01):
This is fascinating to hear about because I think about
neurons all the time, but from the point of view
artificial neural networks. They do a lot of machine learning
and AI, and we use neural nets all the time,
but we never think about them as neurons anymore. Where
we use the same language. You know, in our mathematical
model is that a neuron is like a little blob
and it has inputs, and if the inputs are high

(40:22):
enough that they add up to a certain amount, then
the neuron is activated and it sends like a pulse
to its output, which is linked to other neurons. Of course,
and my understanding of the brain basically is that it's
this big network of neurons that are all firing and
stimulating each other. And so you're talking about the bit
between the neurons, the sydnaps, the connection and whether that
thing is allowed to fire or is inhibited from communicating

(40:44):
with other neurons. Is that right?

Speaker 2 (40:45):
Yeah, pretty much.

Speaker 1 (40:46):
I mean we're focusing on the neurons too. So what
GABA does is it inhibits the action potential. So what
essentially happens is that your neuron has all of these
receptors on it, and it has three different kinds of
GABA receptors for them. When this chemical GABA binds, they
open up and they let chloride ions in, and so

(41:06):
these ions have a negative charge, and so the negative
charge in the neuron gets more negative, which makes the
cell less likely to hit that action potential point and
talk to the next neuron price. There is another kind
of receptor that when GABA binds to it, it opens
up and it lets potassium ions out, and these are
positive charge, so the positive charge is fleeing, and so

(41:29):
here again the cell is getting more negative, but just
through a slightly different mechanism. So in all of these cases,
GABA is making the cell more quiet less likely to
communicate with the next cell down the line.

Speaker 3 (41:42):
And it's just like a hypothesis or something we can
observe by taking like a single neuron and putting it
in an experiment and you know, connecting it to electrodes.

Speaker 1 (41:51):
So I can't say that I am an expert in
how we know this. One of the women that I
talked to did mention that there was some experiment done
in mice where they genetically tinkered with the mouse so
that their GABA receptors were kind of messed up. And
when you do that, anesthesia doesn't work the same way
in these mice. So that's pretty good evidence that GABBA

(42:15):
is somehow involved in anesthesia. But in terms of what
we know about what these neurons are doing in our
brains in response to GABBA, like, I don't know that
we've been able to observe that happening in real time.

Speaker 3 (42:26):
Yeah, although the system is so complicated, it's hard to
draw conclusions. Right. There's the famous example of the scientist
who trains frogs to jump when he says jump and
then it cuts their legs off, and he says jump
and they don't jump, and it's like, oh, see, they
can't hear me, so therefore they must hear with their legs. Yeah, right, Like,
you can obviously draw the wrong conclusion when you're dealing
with a complex system. Was that a ridiculous example?

Speaker 2 (42:48):
Yeah, what famous experiment does that?

Speaker 3 (42:50):
I've never heard it without a real experiment. It's a
famous anecdote illustrating how you can draw the wrong conclusion
from your data, even if it sounds reasonable. Right, So,
in this case, saying like it interferes with the gabba
and the anesthetics don't work the same way, and that
is suggestive, but I don't know how conclusive it is.

Speaker 1 (43:06):
Yes, absolutely, I agree, and further highlighting the fact that
we don't really know what's going on. We've looked at
the structure of the chemicals that are used as general anesthetics,
and based on the chemical structures. We've tried to predict
other kinds of chemicals that should also act as anesthetics
because we think we understand what's going on. In some
cases that works and other cases it doesn't, So there's

(43:28):
something we don't understand. Also, doctor Shannon stem was telling
me that xenon kind of has similar characteristics when you
give it to people, like it acts as an anesthetic,
and xenon is a noble gas, so it's not supposed
to be reacting with anything.

Speaker 2 (43:43):
So what the heck is happening there? We don't know.

Speaker 3 (43:46):
Maybe it just interferes. Xenon can also like kill you
because you can breathe it in and it can interfere
with you breeding oxygen, right, so maybe it just gets
in the way.

Speaker 1 (43:56):
Yeah, yep, maybe it does just get in the way.
And then it also seems like the function some of
the different kinds of anesthetics that we try is making
sells more excitatory, so more likely to talk to each other.
And so I saw what appeared to be a hypothesis
where the idea was just that it messes up communication.
So instead of having like a clear signal traveling from
neuron to neuron, there's just all kinds of things communicating

(44:18):
with each other at weird times, and it's more about
like the pattern of communication getting thrown off. But anyway,
I want to make clear that anything that I have
gotten incorrect is my fault and not the fault of
the anaesiologists who very patiently tried to explain this all
to me.

Speaker 3 (44:33):
And how terrified you think they are by not really
knowing how this works. Doesn't that make it something of
an art For every patient you have to really monitor them.
Maybe they're reacting differently because you can't always predict how
much anesthetics somebody is going to need.

Speaker 1 (44:45):
Yeah, so they both highlighted to me during our conversations
how amazing the monitoring equipment is now. So yes, you
do need to be careful. Some people need more, some
people need less. Some people have strong reactions, but they're
monitored very carefully, and as long as the people know
what they're doing, you know, and I'm sure hopefully all
certified anesthesiologists do know what they're doing.

Speaker 2 (45:07):
You know.

Speaker 1 (45:07):
They felt like it would be good if we knew
the mechanism, maybe that would help us become even better
at this stuff. But they felt like not knowing the
mechanism didn't keep us from doing a good and safe job.
And I feel like there's got to be all kinds
of physics stuff that you apply that even though you
don't understand it at a like atomic level or whatever,

(45:27):
you can still form predictions and you know, do amazing
new experiments.

Speaker 3 (45:31):
Oh for sure, there's so many cases where we don't
understand the microphysics. It's too complicated for us to model that.
We know generally how things behave and so absolutely you
don't need to know all the details. I'm just super
curious and oh yeah, you know, somebody's life is at
stake here, and so it seems pretty important. You get
a sense from them, like what is the cutting edge?
Are we gonna in ten years develop new amazing anesthetics

(45:55):
that are better or safer or transcendently wonderful or something.

Speaker 1 (46:00):
I didn't get a clear answer on that. They did
mention in passing again how great we are getting it
monitoring and how we're getting a better understanding of how
people from different backgrounds respond differently to anesthesia so that
we can try to make things even safer for everyone.
My conversations with Shannon highlighted that they are trying to
predict different compounds that would make good anesthetics, and they're

(46:21):
trying those out. So maybe we'll even have better tools
in the future. But if they were here, they might
give a much better answer, no surprise. So the final
question we got from the listener is going under anesthesia
different than sleeping or is it the same? And it's
definitely different than sleeping. So the anesthesiologists I talked to

(46:42):
said that it's more like a drug induced reversible coma.

Speaker 2 (46:46):
Whoa, yeah.

Speaker 1 (46:46):
So the main criteria or that you want the person
to be unconscious, not feeling pain, not moving, and making
no memories. So when you're sleeping, one you move, people
sleepwalk sometimes Two if somebody were to poke you, you
would feel pain.

Speaker 4 (47:03):
Three.

Speaker 1 (47:04):
As I understand it, the main function of sleep is
that it helps us consolidate memories and sometimes you even
remember the dreams that you had, whereas when you are
knocked out under general anesthesia, you don't make any memories. Additionally,
when you are sleeping, when you do an EEG, you're
looking at the activity in your brain and you'll see
that we alternate between two different kinds of brain waves.

(47:27):
So when we're in rapid eye movement sleep, our brains
are doing one thing, and when we get out of
rapid eye movement sleep, our brains are doing something different.
And we're going to probably go into a lot more
detail about this in a future episode because we're getting
doctor Gina Poe on the show to tell us all
about sleep and why we sleep, So more on that later.
But the point is that when we're sleeping, our brains
are sort of alternating between two modes, and when you

(47:49):
go under anesthesia, you are staying in the same mode
the whole time. And I believe it also just like
creates different sort of electrical patterns altogether, so there's really
no way in which it's sleep. And this is we
can sort of end on a moderately interesting story, which
is Michael Jackson used to take this drug called propofol

(48:09):
and it's an anesthetic. It helped knock him out and
it made him feel good, and so he was given
it by his doctor at night to help him sleep.

Speaker 3 (48:17):
Because he has sleep problems.

Speaker 1 (48:18):
Right, Okay, yeah, but it's not actually sleep. So all
of the important things that your body does while you're
sleeping are not getting done, or at least they're not
getting done as well when you're knocked out by something
like propofol. And so part of why it's thought that
he ended up dying was because he was laying down,
but he was actually over time.

Speaker 2 (48:38):
Being deprived of sleep.

Speaker 3 (48:39):
Oh my god.

Speaker 1 (48:40):
So it is different than sleep in a way that
is very meaningful and important.

Speaker 3 (48:44):
It's amazing how vital and how crucial all these brain
functions are, how little we understand them, and yet how
much we rely on all these medical advances to manipulate them.

Speaker 2 (48:56):
Yeah, it's incredible.

Speaker 1 (48:57):
And you know, despite the fact that we don't really
stand this at a mechanistic level, I am still on
team anesthesia. I would not want to live and any
time that didn't have it. And you know, in addition
to not needing to be like literally pinned down and
restrained while someone cuts into you for surgeries, Yeah, anesthesia
opened up much longer, much more complicated surgeries. And it has, uh,

(49:20):
i'd say, really changed our lives in a lot of
great ways.

Speaker 3 (49:22):
Yeah, and it's so recent right until Yeah, just a
couple hundred years ago, surgery was horrible suffering.

Speaker 2 (49:29):
M M.

Speaker 3 (49:30):
Makes me wonder what medical advances in a few years
or a few hundred years people will be unable to
live without or imagine what it was like before we
had them.

Speaker 1 (49:39):
Yeah, no, it's incredible. I mean I had to have
my wisdom teeth out. I can't imagine someone just yanking
those out with pliers without being knocked out. And clearly
that is one of the easier surgeries I've never I've
never had someone have to cut into my abdomen, for example,
So hurrah for living today.

Speaker 3 (49:56):
All right, Well, we hope that journey into the history
of anesthesia didn't put you you all to sleep numb.
Your brain couldn't have.

Speaker 2 (50:03):
It was fascinating.

Speaker 3 (50:05):
Some folks like to listen to the podcast to fall asleep,
so we hope that they're now asleep. Pleasantly. Have a
great night.

Speaker 1 (50:12):
Everyone sleep tight, And let's end by hearing what Eric
thought about our hour long episode on anesthesia.

Speaker 6 (50:20):
Eric, that definitely answered my questions. I went to college
in Atlanta, so I think I'm definitely gonna have to
be on Team Crawford Long in the Great Anesthesia Wars.
And I admit to a little disappointment that I was
born too late for ether parties and too early to
live in a city on Mars. But I do live
in the golden Age of podcasts. So thank you so
much and.

Speaker 3 (50:40):
Have a great day.

Speaker 1 (50:48):
Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio.

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