Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Burns

Episode Date: July 2, 2015

This week on Sawbones, Justin and Dr. Sydnee celebrate their wedding anniversary by rubbing cow manuer in a burn. Music: "Medicines" by The Taxpayers

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We pushed on through the broken glass and had ourselves a look around.

Some medicines, some medicines, the escalant macaque for the mouth. Wow! Hey everybody, welcome to Salbo, a Demental tour of Misc Scott medicine. I'm your co-host Justin McElroy and I'm Sydney McRoy Happy belated anniversary said Thank you honey. I told you yesterday happy anniversary But I'm telling you again because this is the podcast didn't hear it So now I want to improve and podcast proof happy nine year anniversary dear. Well, thank you I mean you put it on Facebook, which is like, it's real once it's on Facebook.

Yeah, but I don't have any randos on Facebook. It's just close, my 500 closest friends and family. Okay, well, that's never how I would refer to our, our dear listeners. Our dear randos. Our dear. Our dearest randos. Well, thank you.

That's very sweet of you too, in this public forum of a podcast, wish me happy anniversary. And I would like to extend that same happiness to you as well. How cordial, thank you. I love you. I love you. But I have a question for you. Tell me the question, Sid. Would you say that after nine years that you still have like a burning passion for me. Yeah, yeah, absolutely. I love you just as much I did the day I met you. I mean, that the flames of our love still burn as brightly as they did nine years ago.

Yeah, I mean, yeah, for sure. But do you think you still have a burning desire? What are you doing? What are you doing? It's a burn thing. It's gonna, our show's about burns. It's gonna, I don't know. We already did sunburn last week and now it's just burns. I got nothing. Okay. Well, do you have information about burns? Yeah, I mean, I got lots information about burns. I just don't have you have information about burns? Yeah, I mean, I got lots of information about burns. I just don't have any clever intro about burns. That burns better.

Let's just do that then. Well, okay, we're gonna talk about burns. I wanna thank a couple people who suggested this topic. Trisha, Jimmy, Carson, Laura, thank you all very much. We already talked about sun burns, but why don't we talk about all burns? Yes, yes, let's include our, let's increase our scope. Yes, so first of all, before we get into the history of burn treatment, because there's some pretty interesting and crazy and stupid stuff we've done with burns through the years,

I want to tell you a little bit about skin and burn skin. Tell me about burn skin. So first of all, who's hungry? I think everybody knows this, that our skin is our largest organ. I think everybody's favorite piece of trivia, because it sounds like it's not, but it is. Yeah.

And its primary function is to protect us. Our strongest muscle is the tongue. Is that true too? I've heard about that. I don't believe that that's true. Okay. I'll I'll do some research later Although I don't remember a time in medical school where they like ranked all of our muscles Muscles by strongest in the order of strongest two weakest you would think that would be a class and No to get the full scope of understanding of the human body. I do remember I do remember writing for individual muscles. I do remember them saying that the so-as muscle in our body is sort of like the the filet mignon Like the most like the most tender muscle in our body the most delicious cut. Yeah, I remember them telling us that anatomy class

And going like oh, why do I know why I look around class at that moment and just look for the one guy is like, mm, go on. That's why they tell you that is for the one guy who has that look on his face. They're like, security. They were mad. They were moving from medical school. There's always one. You didn't know that in every medical school class, there's one cannibal that we have to find. Why don't we hear more about cannibal doctors? There's your answer.

Our medical system is working to weed them out. Instead of Waldo, find the cannibal. Find the cannibal. Get him out of medical school. So skin, mainly protects us from the elements from bugs and dirt, water, and all that. It also does some other stuff. It regulates our temperature and makes vitamin D. And there are three layers to your skin.

You may know this. There's the epidermis, the dermis, and then there's the hypodermis, all the stuff underneath. You're getting deeper. And when we talk about burns, what we're really talking about is the depth of the burn. Like the extent of the burn is rated by the depth. And then there's other classifications based on like what caused it and how much of your body is covered by the burn. But when you think about first degree, second degree, third degree, we're really talking about how deep.

So, a first degree burn is like a sunburn, it's the epidermis, the top layer of skin. A second degree burn involves some of the dermis or all of the dermis, the next deepest layer. And a third degree burn is one that extends below the dermis into the connective tissue, or the muscle, or the bone, or whatever. And obviously, they get worse as you go. Right. We also, I think this is an interesting little thing for everybody to know. When we're talking about how much of a person is burned,

because the total body surface area of a burn helps us determine how sick they're everybody to know. When we're talking about how much of a person is burned because the total body surface area of a burn helps us determine like how sick they're going to get and also helps to calculate their chances of surviving a burn. We use something called the rule of 9s and it's basically like dividing your body into 9% of like each section is like 9% of your total body surface area. So like the front of your right leg is 9% of like each section is like 9% of your total body service area. So, like the front of your right leg is 9% and the back of your right leg is 9%. The front of your torso is divided into 2-9% sections and the back is 2-9% anyway. So it's all divided into these 9% and then you can just look at what's burned and then multiply your 9s by that and figure it out.

And then there's also the palms and the perineum, which is another one percent. Perineum? The area between your front butt and your back butt. Oh, you need the taint. You can't say that. It's not a curse word. It's medical name.

It's the area between whatever's up front and whatever's in the back. Got it. That back. Got it. That area. Got it. So, perennial. So, that part. Rebranding. I conveniently rebreeding from Sydney, Macri, refuses to use the clinical medical term.

Tane. No, it's perennial. Well, great to disagree, Doc. I'm impressed because I thought when I brought up the fact that when we talk about, like, the perennial and the genitalia in general general that that's only 1%, I thought you would be forced to make a joke here. No. But you're leaving it alone.

That's low hanging fruit. I'll leave that for those common medical history podcasts. This is an area diet medical history podcast for a discerning listener who isn't afraid to hear the word taint three times in a minute. Moving on. Burns obviously are a problem because, you know, burnt tissue is destroyed, whether it's tissue, nerves, capillary beds, you know, teeny little blood vessels. That's all part of the problem. But there's a lot that else that goes into burns that we learned over time. You lose a lot of fluid mainly because you're losing skin layers.

The hydration is a big problem, infection obviously because you've lost what protects you against infection. Inflammation and organ damage, the biggest problem historically has been infection. And actually, there's a long time in human history where if you had a burn, the last thing you would do is go to the hospital. Because of the why? Because hospitals were known to be places where people got infections. Like before we knew how germ theory worked or after that. Yeah, well that's pretty incredible. We didn't know how germ theory worked. We didn't really know what an infection was. We just knew that a hospital was a place you got sicker and probably died, so stay away. You know what, it's funny, even though, even though, like, even if we didn't understand

germ theory, I would think that, like, you would be able to put together, like, the hospital, that's where a bunch of sick people are. Right. Well, they knew that, but they didn't, I mean, but you really wouldn't have understood that, because they didn't know that, like, dirty hands. Yeah, right. It was largely the problem. Yeah.

So they just knew that, you know, our cousin got burnt and went to the hospital and they died. So when I get, you know, I'm not going to burn, he's not going. That kind of thing. Historically and now, burns are really managed by surgeons. I don't think most people know that.

Just because there's not a lot else you can do for them, like there's not a pill you can take. Well, there's not a pill you can take, I mean, other than like pain control, but there are some other things you can do other than surgery, but yeah, one of the most important initial and we'll kind of talk about this, treatments for burns, often as surgery, depending on the depth and the extent of the burn, but most of the time is surgery. And so a lot of the time, and certainly now, if you go to the hospital with a burn or you go to a burn unit, it's all managed by surgeons.

I don't think most people knew that. But as far back as the Ebers papyrus, we have been talking about burns and what we need to do about them. In that document, in particular, what they recommend is a five, so let's say you got a burn. Okay.

You're an ancient Egypt. Okay. They're going to prescribe you a five day treatment of a couple different things, some black mud to coat all over you, some incantations. Sure. And then a mixture of some cow dung, beeswax, barley porridge, and ram's horn covered with a dressing made out of the Acacia tree with some red ochre and copper. Oh, well, that seems very, very bad and dangerous and harmful.

It's interesting because I don't know, yeah, that's really bad. That's so worse. The beeswax probably wasn't a terrible idea to try to like, see a lot. Yeah, but like, but the cow dung, I think. It only takes one fly to spoil the soup. Like it only takes like a teaspoon of cow dung to ruin your beeswax. I think when we're talking about infection.

Yeah. Yeah. So that probably, I don't know what the success rate from this treatment was, but I'm gonna guess it was not. Right. Successful. No, I would think not.

They also mentioned you could try breast milk okay so you're in luck you have a burn except no no you're not why not because only from moms of male babies oh well that makes of course I mean naturally so my breast milk is useless. Useless to me. So don't even try to squirt my breast milk on your wound, on your burn. I was all about to, it was so I'm glad you stopped me. Hippocrates weighed in on burns later. His advice was to get some melted pig skin.

You mean pork rinds? I don't think they're melted. If your pork rinds are melted, you're doing them wrong. Yeah, they've gotten the stale. And mix it with asphalt. And you've got yourself a burn treatment. Do you? No.

No. Remember Paraselsis, we talked about him. Oh sure. Yeah, he weighed in on this as well. He had a whole sav that he created. Which I think sounds like, as I wrote, as I was writing this down, like Parasels' recipe for burns, this sounds like something you would order at, like, I don't know, like some kind of like hip-story restaurant.

And what are the ingredients? I have the SAV made of hog and bear fat, soaked in red wine, with a side of the roasted earthworms and some moss from the skull of a dead man. Okay, so I think the last thing there, I think the last thing the analogy sort of falls apart. I've, like, are those free range earthworms? That's a crazy, that's a crazy thing to put in your ingredient list of like,

here's what would help, like, I've never seen that in my life. Was this a locally sourced dead man? Okay. All right. No, I've never either. I don't know. I don't know how you come up with that.

That's like a great thing if you're trying to like fake people out like, well, you know what would work? This and this and this and then a bunch of grounded up Faberger eggs. It's like, well, I can't get those. Well, yeah, but like, if you could, woof, that would be really helpful to you. I don't know if this is like, sometimes you read things like this

and you think it's just the greatest joke somebody ever made. Sure, yeah. Because it's gonna echo throughout history and it's nonsense. From, for two millennia, medicine has basically been an extended hazing. It's humanity's hazing. It's humanity's hazing.

It did. I tried not to now. Yeah, I appreciate that. You best of got. Yeah. After we made gunpowder burns, and of course wounds in general became much more complicated. In the 15th century, that's when we see that, like that's when we first start class fine burns, the first through third degree is made by Wilhelm Fabri,

who was also known as Fabricius Hildanes, which if that's your name, why are you going by Wilhelm Fabri? I don't know. You would refer to me only as Fabricius Hildanes. I mean, if that was me, is it because Haneis is in the second name, is that you think you got tired of the school yard ribbing?

Well, I don't know, because it could be Haldannas or Haldannas. And I'm pretty good. Hey, hold Anus. Hey, hold Anus, right? I don't know. He was German. I think they're too sophisticated to make those kinds of jokes. Let's hope.

And also, that would be English. So, fair enough. Yeah, well, I mean, you, but you heard the accent. I could tell you that was that was that a German accent moving on In the medieval period we actually had some advances made with a if you can believe it with burn treatment from a French barber surgeon Who we've kind of talked about a little bit before Ambrose I kind of talked about a little bit before Ambra's parquet, who was, he considered one of the fathers of modern surgery in general,

and he cared for a lot of war related wounds and burns and that kind of thing. And at the time, the predominant treatment for a burn was to cover it in boiling hot oil. Let me say that again, if you came in with the burn, your doctor in that evil period would cover it in burning hotwood. Oh, that makes perfect sense though. It's like attracts light, a lot of attractions, the secret.

I actually think it was like the, remember we've talked about this, like the love similar and the doctrine of signatures and yeah, that kind of thing. I think it was based on that. And also the idea that you could purify the wound somehow, that way, which, I mean, you'll kill bacteria. Sure, right. I mean, yeah, it's like everything else. You're basically just starting it over at Square One.

It's basically like re-breaking the arm because it didn't set right. Exactly, exactly. And he saw, Paray saw that people did not do well with this treatment. And so he kind of thought it was a bad idea. So he was revolutionary in that when you came in with a burn, he did not burn you further.

Instead, he tried like emolience, which are like moisturizing soothing kind of saves and lotions and bandages, which does not sound groundbreaking, but was at the time and people did better. And people, we continue to get better about like not treating burns with burns. And by the 19th century we're actually doing some experiments to try to figure out what the best, what the best treatment for burns was. Dr. Jacob Bigelow, who conducted a lot of rabbit experiments.

Okay. So, I don't know, you may not want to listen if you like rabbits a lot. Yeah, if you like a big animal lover, maybe just get back in. Not that we're not. No, we're not. I don't know.

We're just, we got to look this dead in the eye, right? Yeah, and we just got to talk about it. Just get ahead like 30 seconds, go. So he basically burned rabbits, not to get graphic, but and then he would treat them with different things. He would either like, don't come in ice water, put turpentine on it. And he published these findings in the very first issue

of the New England Journal of Medicine, which I think is pretty interesting. Yeah, cool. Like the burning rabbit experiment. Around the same time, so that's it, the rabbit's. You nailed that, 30 seconds, good job. Around the same time. I zoned out too, so.

Dr. Lure who was a surgeon, a very fancy surgeon, to a lot of Napoleon's officers, was advising honey and wax for the treatment of burns, which isn't terrible, terrible one. And then Dr. Dupatrin, of course, you know of the contracture fame. No, sure. Everybody knows Dupatrin's contracture. Yes, Dupatrin's contracture. We talked about this before. This is one of my favorite, of contracture fame is one of my favorite things to say. Yeah. But he expanded on this by saying maybe you should debris the area, meaning kind of clean out the dead tissue. Again revolutionary idea,

good idea, and some silver nitrate, which is still a good idea. But however we were treating the burns, infection was still a huge problem. And of course as we go into like the Civil War era, the best thing we knew to do was just amputate the limb that was burnt. So, you know, because we knew that we knew people were gonna die of infection. We knew it, like, oh my gosh, you've got a hole in you. We don't really understand what exactly is gonna happen, but it's gonna be bad, so let's cut off your leg

or your arm or whatever. Doesn't that just make another hole? It's like a bigger hole? Yes, which is why a lot of people died of infection. Got it. More unfortunate. We tried other ways died of infection. Or war, unfortunately. Got it. We tried other ways to avoid infection.

There was a solution that we used of cocaine, carbolic acid, linseed oil, and lime water that you would then put like a rubber dressing over to like seal it. That's like half like to a nice, pretty nice cocktail. You don't want to put carbolic acid in your... What's lime water? I'm thinking, from what I read, the recipe was spelled lime like an actual citrus fruit,

like a lime, but I'm wondering if they mean lime like, you know... Lime stone? Lime stone. Water. And then you could also use picker acid, but both that andiroleic acid are highly toxic and would be very damaging and you do not want to use them on your skin ever. Although they probably did kill bacteria. Hey.

Again, they would kill everything else. Got it. What's next? What about, let's see, the next one, I guess, I guess, World War I. Well, before we talk about World War I, let's head down to the billing department. Let's go. World War One. Alright in World War One.

Friends Ferdinand has been assassinated. That's great. The scene hit by the black, Archduke France Ferdinand has been assassinated by the black hand. I've set the scene. Sydney. Powder keg of the Balkans powder keg I'm burnt I'm burnt by the powder keg of the Balkans Sydney What am I gonna do about it? Oh, it's I know it seems weird that we're kind of going through history by wars, but A lot of think about it. Like it makes perfect sense the way it does make perfect sense

See the matter we give you by like kitchen fires. Like history of grease fires. Well, and it really is a lot of the advances we've made on Burns throughout history have been thanks to the military and research that's been done there. War. Helping people out since time immemorial. I don't know that that's a great tagline for war.

Helping rep butler and burn victims. Causing, causing problems and then solving them. Yeah. So during World War One, we developed something called number seven paraffin, which was basically just wax and some paraffin and some oil. But I wanted to mention it because it's called number seven paraffin, which sounded to me like something from like a dystopian future buck. It's cool name.

Yeah, I liked that a lot. And then also you have to apply it with a camel hair brush. No, thank you. So, hugely unpleasant. To your burn. Ugh. So I just thought that that was kind of cool.

You do start to see some like antiseptic technique used in World War One. Of course, we don't have antibiotics yet, but we are understanding like, keep things clean, you know, wash your hands. That kind of thing is starting to catch on or washing your hands. They still used cold water immersion at this point. So as soon as you get burned, they would just like dunk it in really cold water as soon

as possible, which isn't really a great idea. And as well as tanning, not tanning like sun tanning. No, tanning like hide. Like apply tannic acid to it. Ooh, this is horrible. Yes, the idea was that this would somehow seal the wound. And this continued for a while, the idea of tanning a wound.

This was replaced later by gension violet because it would also kind of seal the wound but then the idea was that it would also kill bacteria because it does, kills some grand positive bacteria. And doesn't upholster you at the same time, which is great. They both do, are gonna color your skin though. Perfect.

Which is interesting. You'd have a burn that, if it healed, I guess, you'd always have a brown spotter, like brownish yellow or Genshin Violet, I think would probably die you purple. I don't think that'd be permanent though. The tanning would though. Man, this episode's rough on animals.

I'm gonna have to, if you're okay, if you didn't listen to the rabbit part, there's gonna be a dog part. So just don't listen to this. For 30 seconds starting now. Okay, so we understood at this point that fluid loss is a big issue in burns like dehydration losing a bunch of fluid. So a doctor named Alphablaelok to prove this did some experiments where he burned half of a dog like multiple dogs just burned them on one side and then he cut them in half and then weighed them to prove that the

half that was burnt laid west weighed less and the half that wasn't. Lotsy, mochi. To prove fluid loss. That's terrible. That's real, that sucks. But that's how we prove that. Okay, great. Moving on.

Thanks for enlightening me. Are 30 seconds. Yeah, you didn't miss anything. Welcome back. All right, we're up. 30 seconds are up. Okay, then I'll talk about new things. Let's move on from that pretend it never happened.

During World War II, antibiotics came around. Yay, yay, I bet you cheer for antibiotics. And this made things a lot better for burn patients because then we could treat infection, but the dressing issue was still weird. We were still doing things like tanning burns. So we still didn't quite understand what to do. The big turning point for burns is actually

the coconut grove fire in Boston in November of 1942. I never heard of that. I had neither until I read about this. So there was a nightclub called the coconut grove in Boston and it was a very popular nightclub in November of 1942. A lot of civilians went there as well as soldiers who were on leave. And we're talking about around like Thanksgiving time,

there was a lot of people in a lot of family, the place was packed, it was decorated with lots of paper decorations all over the place. And all it took was, I believe there was one waiter who was lighting like a candle or a lantern or something, and a match caught one of the paper decorations, and the whole place went up very quickly. The nightclub was packed, so 300 people actually died on the scene. A total at the end was around 500 people lost their lives in this terrible, terrible fire.

Doctors were called in from all over the city to help care for the burn patients. And so nobody really knew exactly what to do for these burns. We were still kind of just all doing different, weird things. And there were actually some younger doctors who had been- And the latest 1942. Yeah.

It's wild. Who were trying some things with some greaseier, like saves, like petroleum jelly-based saves. And so some of these, like they kind of actually compared. They would try some of the older methods and some of the newer methods because they didn't know what was better and see what patients did better. And so we learned a lot from this, how to dress wounds and what to use on them. We learned about smoke inhalation injury, a great deal from this.

Smoke detectors are probably in part due to this fire. We learned a lot about fluid loss again from this and how to replace fluids and how to keep people from getting dehydrated. So although it was a terrible, terrible thing, we did learn a lot. We made the best of a bad situation by learning a lot about burn treatment and burn therapy and how to take better care of unfortunate victims of these these awful kinds of disasters. There was also a lot of research done in the wake of World War II, especially in the UK. I just thought this was really interesting. There was something called the guinea pig club. Oh, is that? It was a club that was formed. There was some like royal air force survivors like who

had had burns and wounds and stuff. And then there were other civilians who were cared for for burns and they basically all joined this club where they were kept track of where they were monitored by You know doctors in the city and like Their burns were cared for and they tried different things to help them and they just kept track and they were called the guinea pig club because They were guinea pigs. Oh, yeah, I mean you get it't. We didn't. I'm with you. They're experimenting on them. But that club persisted. Their magazine was published until 2003. I think that's fascinating. By the end, I was just reading it for the article, so it wasn't a lot to talk about. Well, we fixed burns. Well, we did. Yeah, we're still learning about burns. I thought though, before I tell you some real some real burns, I'll give you a little bit info on how we really treat burns now. As I

was as I was looking for weird burn cures from history, I found this internet cure for burns. Got it. So one thing that was recommended was potato peels that that and this isn't an old thing, this is something that people like right now But one thing that was recommended was potato peels. And this isn't an old thing. This is something that people like right now are telling you to do. So if you have a first or second degree burn, what they recommend is that you just get a potato, peel it, sterilize the peel. I guess boil it.

I guess boil it to just say sterilize it. They just say make sure it's sterile. Don't try to fry it because it'll be delicious. Then you're just going to want to eat it. So sterilize the peel. I'll make it my treatment. Then you're going to dip your burn in icy water. Nope.

And then put the peel on it and then you're fine. That may work. Well, I mean, if you have a first degree burn, I guess go for it. If you have a second degree burn, I'd go get it checked out. That's what I would do. If you have a first degree burn and you're not sure,

go get that checked out too. Yeah, because what do you know from first degree, second degree? If you got a thumb burn, you're probably cool. But, but this is what I think is great. So they say like for a first or second degree burn, our potatoes are excellent. Just get the peel sterilize it, put it on your burn. No problem. Forget those doctors. But for a third degree burn, they're a little more careful with their

instructions. Okay. So this is the order. This is the actual order that I found for if you want to use a potato peel to treat your third degree burn, Here is your here your instructions. Step number one, call 911. Okay. Step number two, move the burn victim away from heat and smoke. Got it? Done. Step number three, leave the burned clothes on them. Don't try to remove them. Is that good? Yes. Yeah, that's good. Okay. So far, we're okay. These are good. These are good advice. Good. Number four, don't immerse the burning cold water. All right. Okay. Good. Don't number five stars CPR if needed. Okay. Number four wasn't really a step Nor was number three really if you think about it. Just some do's and don'ts. Yeah. Well just things that you might flutter through your mind right in this awful situation. So you've started CPR if needed.

That's done. So you're done with CPR. I'm assuming they're still breathing. Got it. Number six, elevate the burned part above the heart. Good, okay. Okay. And then number seven, get a potato.

Peele the potato. Sterilize the potato peel. And then place it loosely on the burn skin. Just lightly on there. And then number eight, get a tetanus shot. Great, excellent. So, can you imagine that scenario? No, I can't.

Actually, I can because I just visualized it very clearly. You were very detailed and I imagined that exact scenario. Did they teach you that in basic life saving? You finished CPR, you rolled a victim on their side into the rescue position. Get the burn, get the potato. And then you run upstairs and grab the potato. in basic life saving, like you finish CPR, you roll the victim on their side into the rescue position. Get the burn, get the potato. And then you run upstairs and grab a potato. Are you cool here?

Because I need to go to the store. I go get a potato, I gotta peel it, sterilize it, put it on your skin, and then go get a tetanus shot. I have some more rhodochrancal cuts. I hope we're gonna try it, I don't know. How about just move the, just call me a one. Okay.

Also, at McDonald's, if you work there, there was an article recently they might tell you to use butter, ketchup, or mustard, and don't go to the hospital so we can keep you working. That was a recent issue. Cool, that's not great. And they were telling their employees to do that. Don't do that, go to the hospital.

Can I ask you real quick, like, what should we do? Like, if it's not a terrible burn, like, first aid for burn, like, what should you do? You said, no, cold You said no cold water? Not cold water? No, no, just keep the burn. I mean, no, you don't need to, you don't need to dunk it in icy cold water. No, don't do that.

And certainly, if you're not sure of the depth of the burn, go get it checked out. If this, here's what I would say. If you got a sunburn and you're just red and you hurt, treat it like you just want it. We covered that last set. Yeah, we treated it separate. If you're not sure, if it's deeper than that, or if it hurts more than a normal burn, just go get it checked out.

Go to the doctor. Don't stay at home and try to do weird things from the internet. Go get it checked out. The worst case scenario is they tell you to take some IV profan and put some aloe on it, and it's no big deal. Great. And certainly if you're burned by anything other than the sun, because who knows?

You know, because those burns can go deeper than you know. So go get them checked out. Don't do anything else. If you do have a second or third degree burn and you go to the hospital and you have to be admitted and cared for, we do have burn units now where we know how to care for burns very well. Like I said, initial surgery can be really important, so like, excision of the burn tissue and grafting, so skin grafts are critical to burn management nowadays. Fluids, nutrition, it prevent infection, treat infection when it occurs, physical therapy,

so you don't get like stiff scar tissue, forming and stuff. We use like petroleum gauses. We still use silver nitrate and then antibiotic appointments. I think it's interesting that they'll take now, they can take skin grafts from your own skin. Did you know they did that? I did know that. They can take it from your thigh and then they mesh it.

Meaning? They put it through this thing to, it's like making slits in the piece of skin, but they can also do a machine can do it and it'll make it look like a piece of mesh. So it stretches further. Whoa. Yes. And it's kind of gross. So it stretches further. Whoa. Yes. And it's kind of gross. But it stretches further over the barn.

This has been quite the episode. Sorry. But it covers more, that's so cool. It covers more surface area. They taught me that once at Kosa, Kosa immobile. Like when they came to our school. That is cool. Yes, very cool.

And we're working on growing skin and petri dishes. Well, I'm not. I'm not working on that. But somebody is to replace it for burns. So yeah, don't, don't, if you have a second or third degree burn, go just go see doctor. Thank you so much for listening to our show.

Sorry about the parts that you might have had to scan through this surprisingly pretty upsetting. Sorry. Wow, you just put a grape in. You couldn't even, we're 30 seconds from the home stretch. Tell me, I'm really hungry. I'm really hungry. Thanks for the maximum fun. Or a great network of podcasts.

Here's my special recommendation. A couple weeks ago, we hung out with our, I will say friend John Hodgman, our buddy John Hodgman. I think he's our pal. I think he's our pal. And if he doesn't listen to this episode as far as you guys, now he's our friend.

He's our friend. He's our good friend. He's got a show on Max Fun called Judge John Hodgman, where he passed his judgment on decisions of everyday life. It is hosted by Baylor Jesse Thorn, who runs Max Fun Fun. And it's a great show. It's really funny.

And he's a great guy. So go listen to Judge John Hodgman. That's my Max Fun recommendation of the week. And I agree. So now you can trust it. If you get a second, as an anniversary gift to us, will you go rate and subscribe to our show on iTunes until everybody you know to do the same?

I mean, only if you were gonna rate it good. Like what kind of anniversary present it is? It's bad. Yeah, that would be a shame. I understand that really. But if you could do that, maybe share the show with a friend, say like just like my dear friends Justin and Sydney, who are not randos to me, we're all friends friends I'm sorry I said randos we're friends now that

I'm asking for something please go just tell everybody you know to listen we really appreciate it thanks so much to you for listening thanks to Taxi Patreos for letting us use your song medicines is our intro and outro and thanks again to you until next Wednesday I know it's Thursday, but you know, life, life, life, it's fine. We'll be better at promise. We'll be better. Until next Wednesday, I'm Justin McRoy. I'm Sydney McRoy. So don't drill a hole in your head. Alright!

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