3 - THINGS YOU FIND IN THE ER
This Won't Hurt A Bit
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Full episode transcript -

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way gonna get this thing started. We're gonna do this. Yeah. Yeah, we're gonna do it. You know why we're gonna do it? Because this this this

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this viscous this way haven't incredibly fascinating topic.

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I'm excited. No one has told me anything.

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Actually, we haven't told you anything.

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I know. Obviously. Let's show, Doc.

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So what we want to dio is we want to talk about things you didn't know were in. Annie

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are OK. Nice. Nice. Did not know that were in the

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that I might not expect to find there. Yeah, it's not necessarily medical equipment. Or maybe it's just really unexpected.

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That's good, because the e r Doc's always seem pretty MacGyver like D I y and yes, go. So let's start us off. Just give us something that the average person Mrs Jo in the street wouldn't expect there to be in the hopper. Don't say live, alligator, cause that's just silly. No, wait. Hold on before we start. Okay? Am I gonna get a blindfold and you're gonna pass me the object? Have to guess what

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it is. We say the object and Dave has to guess the use. Okay, Dumb. Okay.

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Ready, David? Yeah. Object one. It's in my hand. It feels

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its e t tell you the object. Okay, Get your hand out of the water bowl. Water bowl. Okay. Okay. The first object is a metal detector.

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Okay, Um, like a metal detector at, like, t c A. He s a t s e t. I got you down the wrong path. Transportation Security Administration.

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That's right.

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So it's like a handle one. Yes. Okay. I'm guessing bullets. Um, shrapnel.

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That's maybe a good guesses. Thes air. Good guesses.

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Swallowed like a ring. Somehow got something metal in

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me, and it should be there. Yeah. Okay. Well, I mean, the obvious other one is someone who may or may not be sketchy. A sketchy individual who needs We need to make sure don't have weapons on them, right? Oh, Okay. Well,

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that's the obvious. I don't go there,

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but that's, you know, that's what they're Therefore, that's metal detectors in the e. R. Four. So we just go and borrow it from security. And if someone comes in who has swallowed something metal, then we can scan them to see if we can locate

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it. Okay, But it is it like a special medical metal detector. Or it's just like when those Garrett like gold finding park Ranger kind of metal detectors. If it was a special medical one, the only difference between it would be it would be incredibly expensive for exactly the same materials.

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Yeah, this is the one from security. Okay, Mel, but we don't use them. Usually if someone's been shot. If someone's got shrapnel in them, were usually not using that way

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because we kind of need to know a little bit more accurate than that puts him an enemy of the top. So we just take an X ray. X ray is a great and you can see with the Baltic and kind of, you know, say, Oh, it's in your heart. The coin isn't as dangerous, obviously, is the bullet so

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fast that coin is going? That's true. All right. You ready, Daisy?

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Still wet? No. Get the bull away from me.

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Why your gutters?

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Um, I would say Thio cut metal. Why? Why? Um, cut rings off of fingers. No,

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that's That's pretty good.

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Oh, if it's something like if something is piercing on the other side Well, um, like a fish hook like a barb.

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Yeah, yeah, yeah. I definitely got some of them right there. Eso were anything that you need to cut off of someone. So, like you said a fishhook, if you're cutting off a barb, if you're cutting a ring off someone, sometimes there's a little bit more specialized tools for doing that. Certain types of like a Dremel and there's like a little stroll. Metal

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piece has used a Dremel to Trammel

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Trammel. There's a very good for everything, actually, there's some really cool ways to get off a ring that's stuck on someone. One of them is just a piece of string. There's a really cool method for doing that. She's with the string.

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That sounds like a magic

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trick, but But with the Dremel, there's like this little metal piece that slides under between the ring and their finger. And then the Dremel goes on tops. That way it doesn't, you know, cut them or hurt them. And then there's another use of wire cutters. What?

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Okay, we're not cutting metal.

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No, it's also for cut. This would be a pretty terrifying situation. Hasn't happened to me yet, but someone comes in who has had their jaw wired shut.

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Oh, from like a surgery after surgery that got broken, Juror. It's all wired together, but they come and they got some problem that can't breathe. And I gotta get in there and help him breathe, but they kind of in the jewels. So you gotta go in there and start Snip, snip, snipping away. Um, you've got a look of disbelief. Well, no, it's I'm actually like it's a question that I've always wanted ask. And now that I'm in the room with two doctors, it's a little off topic.

What is wiring the jaw when someone gets their jaw wired? What does that mean exactly? Like? Are they putting parts of it holding it together? Yes. Are they closing it so you can stay non function, understand what's happening? So let's say I will win it. You with a baseball bat like kind of the show is very upset with You could get my hand out of the water bowl

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and I stashed

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up your face and you got this juror on all these moving parts. Bone can't heal if it's moving all over the place, so they put all these plates in to put the bone back together, and then depending on where the brake is, if you are opening and closing your mouth, the bone can't heal because it's moving all the time. It needs to be stationery. So they've got a wired the bone together and then stop you moving your mouth open and closed. Coming with all the fractures are so you're really wired shut. Okay. Bones of words. So they don't move your drawers wide. So you can't do normal Jor activity, which is open and close. It's a pain in the butt for this, but you can imagine that the diet for these people is basically through a straw. Yeah, So is it Do they want I'm sorry.

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Were sort off right now. No haywire.

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They wire the Josh up basically because you can't put a cast like

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like a cast. Yes.

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Yeah, because you just keep falling off the cast. You put it on, you been growing that they just let up. Next trap for the back of the Let's get over here. We've got to put accounts in this man's face job. I've never heard that.

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So maybe you could imagine how terrifying if that person needed a breathing tube. Yeah. Okay, so snip, snip, snip nips. Okay, ready for the next one. Fun are you having? I like it. I like. I like this too. Okay, the next one is super glue.

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Okay, well, I use that commonly in the garage to heal wounds back together. Ugo, I have, like, a bag of superglue little mini one. You super go, toots. I buy from eBay. And if I'm sitting there in the garage and get a cut, your genius for We have all medical superglue for cuts, obviously. And it's exactly the same material.

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Yeah, that's what we use it for. Certain certain types of lacerations. We

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close that way. But they can also use superglue in other ways too, Which is kind of fun. How else much use superglue India mints happened, Dave, the non air Doug toe. Hold something onto you? No. Sure. Like a porcelain vase for helmet china dough.

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Okay, But you're right about the sticking things together, Bart. I don't know. Okay, Mel, both. Let's

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dive. Imagine Picture this for a second, if you can, Uh, you're a kid. You like plastic round things and you like to stick him in your nose or in your ear bulls. One of the ways you can use superglue under those circumstances get like a little Q tip a little superglue on the end of it. And if you're very carefully, go in there and just dab it against the little plastic thing and then let it stick. You stick her and then you can pull it out. They're gonna be careful with that because you know what a dripping 11 plus if you're practicing, you're good. You can use superglue thio, take things out of people's noses and able stat. Seems like the aroma of superglue. It singe the inside of my science. And maybe, just maybe, he's. I've never actually used to believe in this way, but it's

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well described. I've done it for the ears. It failed, but there was a lot of earwax on the kid. Shoved a bead on his ear

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to

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ear wax. Not so well, Not

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so well. Nothing. Bones to Alexis. I'm gonna try it again. Well, nothing really binds the superglue better than human skin.

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No. What

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is it about that no matter what you're gluing together, doesn't matter matter what it's rated as to stick steel plastic. Gus skin is but more attractive

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to see if it will

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jump across the table and to your suit fingers. Isn't that what super glue was invented? It was invented for like on the battlefield. Surgical on.

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That was one of the first uses of it. It was one of the first uses. Yeah, superglue

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or Sino Accolate was actually first test on the battlefield in Vietnam. That World War Two was accidentally discovered by Dr Harry Coover, but he didn't realize its potential is an adhesive until working at Eastman Kodak in 1951. The original name of the glue was Eastman Number 9 10

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and another thing that is being studied about another potential use for Sino

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correlate fingerprints, right? Not like a whole MacGyver thing, I think. Yeah. In the movies, though, I feel like I need to find you'd get this fingerprint and then they'll put a little bit of super glow underneath the cup, and the view mes will expose the oil on the fingerprint, and then they take some tape and lift it up, and then they use it on the secret key pad to

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get into the special But that's exactly use it. Yes, that's how we get into the hospital. You know, another thing it's actually being used for is to secure I V s, which seems a little odd. But, you know, you put in an I V, and then you put some tape over and you hope it doesn't move, doesn't only where they pop out, and then you gotta poke the patient again. So people are looking at this idea of just gluing it in place.

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Sure. And sometimes we do things like stick needles in people to take fluid out of their belly, for example, that a certain circumstances come up. There's some fluid in this person building. We take a nice

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long needle, slowly put it in there

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like a very well controlled stab wound to the abdomen, and we go in there. We drained all the fluid out, and then one of the things you can do at the end is seal it off. So you dropped some superglue one there and it seals the whole Supergirl is great. It's great. Super glue is great. Now that's crazy. Crazy, strong, crazy, fast, crazy. Here's something for you. So this thing you like to do in the evenings in a nice glass. Well, having a nice steak,

what would that thing be? You'd put wine whole. So alcohol, There's alcohol in the air. And and not just, you know, in the waiting room where the patient's drinking or in the doctors for after hours are actually using my Nicholas in the immense department. Now, why would we do that? Any idea why we'd use alcohol? The different uses for alcohol in the men's department. Okay. Um, what kind of alcohol?

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That is a great question. Do

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you think of my mind's going flammable? Right? So I'm just thinking, How what proof alcohol are we

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talking about? I thought you meant Are we talking about I So Bobo are You know,

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I was assuming drinking alcohol. I mean, we like 80% proof, for example, of different forms of alcohol. We his name. It's about different proofs. So just give me one use. Come on. One use for alcohol. Immense problem, you know. Come on, you can do it Well. The only two things to come ahead are somethingto light on fire. If the proof is high enough or this might sound crazy but, like,

hair of the dog, like get somebody over hangover. Just give it back. You just give us a more outgoing get some teenager. Got drug really sick in there. Hungover? Yeah. He just gives work here with an egg in it. Some Tabasco sauce in your way. Don't do that. Okay, What about cleaning wounds? So we use alcohol as a sterilization method. Boy, didn't we talk about this? Do we talk about this?

Another episode, like you're gonna use alcohol like, Yeah, it's a last resort, but it's got sugars and other things in it. So it's not the best for cleaning wounds, right? We don't put them in words, been cleaning skin. So let's say I'm gonna put an I V in you. 70% alcohol, swabs, air all over the place and 100% for some reason. 70% alcohol is better Sterilizing your skin than 100% of these little swabs and you swap the skin and you put him in one way. Another way is you sort of brought up before people who drink alcohol. So let's say you've got somebody who's,

uh, Doug wasn't it? Let's say you're an alcoholic. in the street. You've run out of money, and the only alcohol around is wood alcohol. That's sort of the alcohol's you find underneath the sink. There's a lot of bad alcoholism today that you shouldn't drink. So we humans drink ethyl alcohol, but is isopropyl alcohol rubbing alcohol? And then there's metal alcohol, which is really dangerous. So if people come in particular the methyl alcohol, I drink a little bit as they metabolize that they produced these really bad toxins and they get really sick from it. So we can actually give people normal alcohol to stop the metabolizing the bad alcohol, and that prevents them developing the bed toxic effects of advising the method.

I think we talked about a little bit last season, but that's another way could be used. You can either drink it. What? We have it in these nice, shiny bottles. You can put it into somebody ivy. So if myself, I drink too much methyl alcohol, would l go on alcohol and I'm being poisoned from it and you give me ethyl alcohol. My body will default to start processing vessel first. That's why it s so the ends on which breaks down. Alcohol likes ethyl alcohol. Normal drinking alcohol much more than that likes the meth a local.

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But it'll

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it'll metabolize anything right at the local. There's no don't do that first like that. So if you give them enough of that, it will stop the metabolizing the other way. How and then your body will start to get rid of the wood alcohol, using other methods that aren't so toxic. So, do you have just a generalized ethel alcohol? Or do you like here's some bourbon or what would you like tonight, like a Manhattan?

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Or I mean, do you like it depends on where you work and how desperate you are to get this. So if you work in a major hospital and you want to give someone ivy ethanol because they have a methanol toxicity, then that's gonna be a special formulation of ethanol that the pharmacist sends E that you can put in

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intravenous like triple to spill like aged at all. Okay, but I need a 12 aged fo alcohol in a bag.

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But if I work in a very like rule environment and I don't have access to a lot of things and my patient is conscious, and then they're not gonna choke. I'm not gonna kill them by giving them something by mouth. Would I go down to the nearest liquor store if that's all I had and just get some ethanol? Yeah.

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Yeah, totally. And that's so interesting. I

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have you really

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make your run for a patient? Well, not really. It's a great story. So we had a patient who came in with metal alcohol, wood alcohol poisoning was getting very sick, and we had no medical alcohol. They used to be a lot of medical alcohol in the hospital. I used to work it, which is just like the normal alcohol you'd buy, but much more expensive Way had this patient and we didn't have any ivy form. So we decided that we're just gonna get this guy basically drunk on normal alcohol. And so we sent one of their reasons to go and get some alcohol, Say, went down to the liquor store and he bought of thing of tequila just like the troopers to kill you. Got me went aboard. The best part about this story.

It was Muslim residents who've never bean into a liquor store. Never bought alcohol, Man born, and he thought it was the most funniest thing ever to go. D'oh! Beer run.

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But really,

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it's not from a patient goes Sure it worked.

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Crazy s. So you made a joke. You guys made a joke earlier about the What is it? The hair of the dog. Okay, but in reality, if we have a patient who is alcohol dependence patient and they're admitted to the hospital, you don't want them to go into withdrawals. There are some hospitals, and that will just give you Ah, beer with your meal tray. OK? Yeah,

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Australia. It was the weirdest thing as a new medical student going into a hospital and seeing because I don't know if they still don't. Now this is 30 plus years and you go in there and there'd be this scene a crusty old world or two bit alcoholic who with lunch, would be ableto have to be. It's where dinner could have beers with breakfast would have to be. It's likely it's just prevents them going to withdraw. Yep, that's pretty funny thing. Well, I want to be an alcoholic veteran because I'll get freebie. So what? What does wood alcohol. What products does wood alcohol appear in? Well, where would I find this? It's it's used to, you know, to remove stains. And that kind of turpentine elective in time for the Rangers would stain this. Better make your own sort of ran. That has kind of the things I don't

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drink it. The common one that's always taught in medical school is if someone is trying to distill their own moonshine. Oh, and they don't do it properly. Right? Then you can add methanol. Exactly. Yeah. Yeah. So Okay. Right. Saved by alcohol. Interesting. Okay, You ready for another one? This one's pretty weird.

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Okay, nobody out there and podcast. Lan's gonna get this

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right. No, you have to be a doctor or watch a lot of TV e r shows Thio, football helmet. Every e r has a football helmet. Why,

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Um, just for head and neck stabilization,

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that's against it means All right, that's a good answer. I like, I like, I like where you're going with that because you would think that's what a helmet would be. Four.

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Yeah. All right. Well, that's

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what it's for, but that's not what we use

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it for. Okay, What do you use it

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for? Because we have We have, like, fancy or stuff to stabilize the neck. So what we what we use it for is a really rare procedure that happens sometimes where someone's having a catastrophic bleed from their esophagus. Okay, so you inflate. There's a special device. It inflates a balloon and their esophagus. So you've got this to basically coming out of their mouth and you got a balloon in their stomach and in their esophagus. Okay? And we want to secure that in place so it doesn't wiggle around or get pulled out. Okay. All right. And you want a little bit of tension pulled on it because there's a balloon in the stoker. So the face mask on the garden? Yeah. The little wire that goes across. We basically pull little tension and secure it to the football helmet so that it continues to hold tension. And no one has

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to stand there. Can you secure other things? Use it for not just the gas drove balloon, but would you use it to secure other tubes

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in place? You could you could directly, But we don't. That's the only thing we use it.

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And you know the difference between a medical football helmet and face mask and a normal price. You're getting it. Excellent. Excellent. I got one for you. Um, Now, this is something that you would perhaps put in your coffee or your tea to reduce the bitterness. Um, well, you've got one of these is a tooth. A sugar, sugar, sugar s o. See if you can think of some medical uses for sugar in the emergency department. And this is a little weird. Yeah.

Um, no, it's a little weird. It's crazy. Weird. Okay, well, isn't sugar hydrophobic?

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No, it's hijo. Fill,

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it looks like. Okay.

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Yeah. Looks water draws water. It's hydro filic. Hydrophobic means it doesn't like water

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and oil. Yeah. Um okay, so then use it to dehydrates something. Yes. Like in a wound, maybe. Or could be, But no, um, I want something. I guess you'd need some sort of blister like a blister. And you put sugar on it and it pulls the water. That's a great idea, but no,

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But maybe

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I'll try that next. It's just a spoonful of sugar. Helps the medicine go down. That's all. I was way too. hard about it. Well, actually, one of the uses is in things that prolapse. Let's say, for example, your uterus falls out of you. That

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would be so tragic for you, Dave.

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Which way? And then you just pour sugar all over it and climbs back up. Well, anything with that pearl. It's our prolapse is when an organ sort of fools out of its proper place. Okay, your rectum can full and be hanging out of you. Your uterus can have. Sure. Out of the fridge and no circumstance that get really swollen. And the blood supply isn't sort of count. Drain away. Avery Wilson gets lots of a demon, which is just fluids. And so one of the way to shove that thing back in where it's supposed to be is you pull sugar all over it. That sugar absorbs all of this extra A de metis fluid, which is just water.

Dries it out a bit. Shrink. Sit down. You just pop it back in. Hi, Mrs Smith. I noticed that your uterus is outside of one moment. Please, me Just get some sugar and we sugar it'll up. And then after a while we brush sugar off and shove it back. Is there a particular time? Like the rush over there is a white sugar is a very specific type of medical sugar, which is just like no motion for expensive.

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Yeah, Yeah.

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Isn't that weird? Well, can't you salt want salt? Do the same thing or salt would hurt. I think our their feelings are their feelings in prolapsed organs or it does it. It's a sort of a deep, uncomfortable sensations, not usually a ship. This is like, Oh, I feel weird that my organs are on the inside.

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Yeah. You think salt would probably

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work? There's probably some problems. Must have, Like a big, like £1 bag of sugar. You don't sit there and open up 1000 packets and portmanteau a bull, not second.

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You could have sugar. Yeah, you know what also use sugar for, but this is a slightly different formulation. This is like in a little sugar water type of thing. We give this to kids if we're gonna start an I V on a kid or we gotta do something that's upsetting or uncomfortable for them. If you give them a little bit of sugar, I don't know if it more distracts him or takes away the pain, but it's sort of like it makes them tolerate something uncomfortable.

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Okay, A spoonful of sugar. Is the medicine great? Just making the medicine go down into a 1,000,000 little yet little kids. Maybe it releases their endogenous more fiends, but you give him a little sugar, and then you they like, uh, that's where I'll take it. When I said sugar. All right, let's we probably time for one more. Give us another good one to finish this off.

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Come on, just one more

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way. Pound Torto? Yeah, we'll come back for Well, come back.

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Okay. I'm gonna go with cocaine. What?

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We like actual drug cocaine. Cocaine now, Medical code. It's just a lot of really expensive. Okay, well, it's an upper.

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Yes, right? Uh huh.

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Um, no, no, no. It's like a constrictor.

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Yes. Is it? Is it really a constrictor of ah,

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vessel? Yeah. Of blood. Yeah. So if so, if somebody's, like bleeding from their eyeball,

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you just make

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a snort, a button or no, from there knows you make him snort a bunch of cocaine. And then it all dried up

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again. Yes, actually really, really good at that. Is that true? Yeah. Yeah, Someone has a really bad nose bleeding, and we can't get it to stop by other means. Then this is one potential use or one potential thing we can do is in. Both constricts the vessels down, and it also helps relieve pain.

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Yeah, right. Because that's how the cops in the cop shows they put in their mouth and it numbs. It's like, this is high quality. Now. The cocaine we use actually is not really this executive, same street cocaine I was gonna ask one is powdered form on the streets, and we haven't usually more in a gel form that we can put it in their noses. So that is more expensive to reduce that to reduce that constriction, to give him some anesthesia. And people say you're using it to reduce nosebleeds. But I heard that when you use too much cocaine, you start to get nosebleeds. You see that in every movie, and so that's true. So where if you use a lot of cocaine doing lines of cocaine out there in the world over time because you're constricting,

you're actually starting to get in a crisis or death of the of the septum that holds your nose up and you get these big, crusty, bleeding things and even your nose can collapse. If you do enough, you're pulling those so we don't do it like that. We just use a little bit. Stop the bleeding and mental anesthesia just once. Not every day at parties. Is your rock staring way before you nail the furniture to the ceiling? When When you order down to the pharmacy for this, what's the You don't just write cocaine, right? It's got I got some name to it, right? Like some science E creek speed bag of coke. A.

I mean, I need a gram, I think very medical. Like we need four mils of 4% cocaine. Jill. So you do say cocaine? Yes. So can the actual name. Not a brand name.

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Okay. Okay. You know, was this fun way? Have so many more. Wouldn't even get

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no come back visit.

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I think we're gonna have to do apart. Let's tease one. Okay. All right. The teaser is gonna be, um what would you use a magnet for our

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many uses for a magazine. You'll never know unless you beckon. Listen or look it out, but come back and listen. That's better for us. I thought you did. Fantasy. Thank you, Genius. You. That's like a solid Jean minus.

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Yeah, Pretty well. Passing

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score. Yeah, we're out. Thanks to just Mason day. Mason. My name's mill. Herbert. This one hurt a bit is a production of fool Ibou Incorporated, produced by C. C. Herbert. Bill Connor. The information you here on this one hurt a bit. Should not be taken as actual medical advice. If you have actual medical questions about actual medical things, you should see an actual medical practitioner even though we are actually doctors were not your actual doctor. Soon be sensible and keep it real. And this Oh, this this this this force, this viscous.

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