Sawbones: A Marital Tour of Misguided Medicine - Sawbones: The Bends

Episode Date: July 13, 2018

In honor of the rescue of 12 boys and their coach from a cave in Thailand, we're discussing the history of dive medicine research that helped make it possible. 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. Hello everybody and welcome to saw bones a Merrill tour of Miss guy of medicine. I'm your co-host Justin McElroy and I'm sitting back right I had to get a breath in between

The middle of the intro that's never happened Are you okay over there? I am okay. I'm having as it's the anxiety is bad today About to leave town for like two weeks. I'm feeling very like stressed out right now. How much time of the? Well, the second week is for our beach week. I know that will be nice, but I still feel kinda stressed out about it.

I'm sorry. It's just being away from home. This is where I thrive. This is where I grow. This is where the deals get done here in the house. I meant to ask you before we... Inside the house. Right. I meant to ask you before inside the house. Right. I'm meant to ask you before we started recording, but did you pull up the nest came of our daughter?

Yes. I got her. I got the Charlie show or sorry, the Cooper show is pulled up here. Okay. Enjoying it immensely. It's a kind of slow episode. She's just sleeping. So and it's in black and white, which I stylistically is not my favorite. That's what we'd like her to do, at least for the duration of this episode. Well, what is this episode about? Well, Justin, maybe this, maybe this will be good for your anxiety right now. Usually when we cover, I feel like when we cover current events or topics that are relative to things that are happening today, it's usually bad. I don't know if that says a lot about a lot of the current events that are happening these days.

But since we're talking, since we cover a lot of misguided medicine, if we're talking about current events, then naturally it would be somewhat just this concerning. Well, this is a current event that I thought would lend itself to kind of a more positive story. A happier story. Did you hear about the soccer team in Thailand that got stuck in the cave? Well said, that's, I'm assuming you're speaking rhetorically, that was a very difficult

story to miss. A lot of chatter about that on the web. I never know. Sometimes you go Twitter dark for a while and I don't know what you need. And you don't know what's happening. Indeed. Yes. Correct. That's true about you, period. Yes. Spiritically, yes. So as many people have heard, there was a group of 12 kids in Thailand who were, they were out with their coach exploring like some caves and then their flooding happened and they got trapped in these caves. And as you already know, they're out, they're out. They're out.

They're out. Yeah, that's why this is a good story. That's good. But a lot of, a lot of what people started talking about as they were trying to figure out how to rescue this team was the logistics of, of diving and the dangers of cave diving. One of the people who went in and actually helped assist with the rescue was a doctor who happened to be... Are you a friend?

No. All doctors don't know each other. An Australian doctor who happened to be there on vacation, Dr. Richard Harris, and came because he was also a diving expert. So when anesthesiologist diving expert, and he went and assisted. And so I feel like this Australian anesthesiologist diving expert, I know everything I need to know about him. I feel like I've written this entire biography in my head.

I think it looks great. Really super handsome, right? Yeah. Of course. I hate this guy. I don't care how many kids you're asking. I hate this guy. No, he's a good guy. No way. A lot of a lot of people worked really hard to use their particular skills to get these kids out and and the coach and and it's really kind of I mean it's it's a wonderful story because do you know how hard that is?

I mean, I think I took a course in diving when I was in college. And the most diving I did was in the swimming pool in the gym at our college. And I do remember you taking that. Yes. And I found it very scary at the bottom of the pool, the physics and the medicine and the science that goes into this. It's really incredible. So I thought a little bit about where diving and medicine intersect and the history of hyperbaric

medicine, I thought it would be a good topic for a show and relates to this. Now as much as we love science, I know that this topic you were mentioning frustratedly to me last night does cross over into a different class of science, of physics, and you weren't necessarily thrilled about it. I am a biologist and a minor chemist because I have a minor in chemistry.

She's, I mean, she's a very notable chemist. I'm a major biologist and a minor chemist. Okay. I am, physics was something I took and I did fine in and then forgot about because it was not my strong suit. I don't have good spatial reasoning, honey. It's just not, it's just not the way my brain works. Okay.

Okay. So is cynic physics wrong? Just keep your tweets to your pocket gas like the physics of gas and stuff that like the Principles of anyway. So let's talk about diving medicine. Yes, this could also be called undersea in a hyperbarric medicine And it's basically the study of humans underwater, right? Right all the things that happen to your body under pressure and trying to pressurize gases to, you know, put them in your lungs so you can breathe underwater. What risks there are, how do you prevent and diagnose and treat illnesses that can occur

while diving and how your own fitness, how you can do different things to your body to try to make you a better diver. That's the whole study. And it's its own thing altogether, because it's, I mean, everything changes when you put the human body underwater. Kind of like we talked about with space medicine. Everything changes when you put the human body in space. Right, we're designed to be there, folks.

Well, but that's what's amazing. We are in space, we are in the ocean for a long period of time, in defiance of God of the Father. And we all need to accept it. It's a sin. There, I said it, you all won't. We are in the ocean for a long period of time and defiance of God the Father. And we all need to accept that it's a sin. There, I said it, y'all won't. I'm in the house, I'm staying here. I'm not gonna go in space.

I'm not gonna go to Barber'sville. I'm not gonna go to the ocean, okay? I'm fine here. Why did Barber'sville get to be on the list of space? The ocean and Barber'sville. There's many places that I cannot go right now and they are all of them that are outside of the walls of this Thomasile we're gonna go to my parents and have a chill time in the pool in a little bit here

I'm gonna I need it All right a lot of a lot of this has to do with the effects of gases under pressure and then as they're not as they are no longer under pressure as you leave the underwater environment does that make sense? Yeah, your under pressure and then you have to go back up to the service and you're not under pressure. And you have to also understand the various mixtures of gases that you could put in a tank to breathe. Oxygen done next.

It's not pure oxygen. There are problems with that. No, not your agent. 80% nitrogen, 20% oxygen. Sort of. 21% helium. Because once you get to the rescue, you can crack everybody up with this great voice you could hear. Helium's actually a really great choice.

We'll talk about why. But the mixes of gases in the tank actually are a little different than the mixture of gases in the air we breathe. Because we need different stuff. Because we're not absorbing air through our skin. Let me get through it. Let me get there. No, but well, no, no we're not absorbing our thirst again. Let me get through it. Let me get there. No, but well, no, no, that's not a, hmm, okay.

All this changes as you go up and down through the water, and especially to different depths, and not to belabor the point, but do you know with cave diving, how much more dangerous that is than open water diving? I mean, I know that cave being is a lot more dangerous than non cave being, so I can kind of just, like yeah, I can extrapolate.

Oh, because a lot of with cave diving, there's no surface to go to, right? Right, it's not like you imagine like you pop up out of the water and there's the cave ceiling up above you. Like the ceiling is in the water. This comes up in Tomb Raider a lot. You are swimming down through a chasm. You know that there's something else on the other end because the game is made by people and you think like should I pop up and get some air but you can't because you're kind of like in a tunnel. So maybe you need to go. Only people do this in real life. Yeah, I'm just my

experiences with Tomb Raider. You don't need to be crappy real life. Yeah, I'm just my experiences with Tomb Raider. You don't need to be crappy about it. No, I'm just saying like that as wild as that sounds in a game, like people do this in real life. And so like I read like you have to, if you're going cave diving, you have to conserve two thirds of your air to get back because you'll probably breathe a little faster.

Yeah. And you'll use up your air faster. And you don't ever want to, if you, they say, if you use up half your air on the way into the cave, then you're already dead and you don't know it. It's terrifying. K-diving isn't incredibly dangerous. Which is hilarious because it's like, is it?

If you, no, I'm saying it's hilarious because it's like, save two thirds of your oxygen because you're gonna be real freaked out coming out. And if you don't say two thirds of your oxygen, you're dead. And it's like, well, is there anything we could do to maybe not make me just burn through all the oxygen instantly?

Is there anything you're gonna say that's not gonna trip me out more than I already am tripped out? I mean, don't cave dive. I guess, yeah. It's, I will not be doing it. And for those of you who do it, I salute you because it would scare me. The pool scared me.

So some common illnesses with diving, just to kind of get into these before we go into the history. The most common that most people have heard of. The bends. There you go, the bends, decompression sickness. Do you know what it's named for? You asked me this way you're researching and I said, from bending over and you

look somewhat deflated as though that was the last thing I would have guessed. Well okay you didn't know that you didn't know the whole thing. So the bends, okay this is this is what the bends are. So you're inhaling a mixture of gases, compressed gases, right, in the tank. Nitrogen is in there, and you're inhaling more of it because it's under pressure. And this is because of boils, long. We'll get into who Robert Boyle was

and how he came up with this. But basically, the volume of gas is inversely proportional to the pressure that it's under. So more pressure, lower volume, less pressure, higher volume. So there's nitrogen that you're inhaling. It's dissolved in your tissues until you start coming up for air. So you start rising through the water up to less pressure. That volume of gas starts to expand and it bubbles back into your circulation. Okay. And you can get air bubbles, different places. In the, I guess, best case scenario, you just get air bubbles different places. In the, I guess, best case scenario,

you just get air bubbles in your tissues and joints and things that cause a lot of like pain and your knees and your hips and your shoulders and that kind of thing. And that pain will cause you to kind of stoop over. And that's where the name, the bends, comes from because you're bent over. And it's actually named for the Grecian bend.

What do the Grecian bend is? It was a silhouette of the female body that was popularized around 1820. You'll know what I'm talking about. It's like the female figure that's kind of stooped over and she's got the big bustle in the back. So the back of her butt area is kind of hooked out and she's usually carrying a teeny little umbrella Yeah, like carousel on the front and that that curvature of the body Okay, that was greatly exaggerated and in art

That is the Grecian bend and it was named for stooped Grecian figures that were found that were beautiful for that reason So most people have heard of that part of the bends where you feel really sick and you hurt all over. You can also actually get those little bubbles of gas that can imbalize or break off and kind of go in your blood vessels and can block blood flow to different places. So this can be very serious. This can be very serious. It sounds very bad. In my layman's brain, that sounds very bad. It can result in paralysis. It can result in death. It's a big deal. These are two of the worst things.

There's a wide range of presentations and it can be very bad. There's also a couple of other things that can happen when you're diving. You said inhale all oxygen. No, you don't want to do that. It's not good to inhale too much oxygen. I mean, like our air is like 21% oxygen. It's not like a lot. Why do we call it oxygen?

Well, honey, we call oxygen oxygen. We don't call air oxygen. Air is air. Okay. Okay. Well, that's fine. It's mostly nice. Yes, oxygen gets a lot of the... You have to have oxygen because if you don't have it, you'll die. But if you have too much of it, you could also die. So you want two of those and not like three O's because three O's might be too many. Well, that was ozone.

We did that last week. Right. You don't want three O's because that's too many O's. You want just the right amount of O's, O2. Too much oxygen can result in, it can damage cells. You can have vision problems, lung problems, seizures, or the biggest worst presentation. Oxygen toxicity, again, could be fatal. So you have to have just the right, you, the inhaled gases in like a, in a diving tank,

sometimes have more oxygen in them, but you don't want too much. Okay. A little more, but not too much more. Nice blood. Also, the reason you don't want as much nitrogen, in part is the bins that we just talked about. That's largely from nitrogen. But it's also nitrogen and narcosis. So pretty much all inert gases, all gases, except for helium and possibly neon,

but helium is the important one here. It can make you drunk at high enough doses. Okay. Like if you inhale them, narcosis for the narcotic effect, it makes you loopy and, you know, out of your mind. Why am I spending all these calories on old fashions then? You just inhale some nitrogen. There you have it.

There you go. Inhale enough nitrogen. From your favorite medical podcast. I mean, don't do it. Podcasting's favorite doctor, Sidney Maggore, I says. But basically you inhale too much nitrogen and you feel out of it. And that's not good because you're diving, you're underwater and you're doing something dangerous. And especially cave diving, you really can't be suffering from that. So that's actually why you'll see

there are different diving mixtures that have more helium in them to prevent this because helium doesn't do this. Okay. But again, you've got to get just that right mixture of everything. There's also barotrama, just pressure from the pressurized gases that we know this can happen outside of diving to. This can happen in like people who are on a ventilator and that kind of thing where you can damage lung tissue that way either from like pressure or from a vacuum applied to the lung tissue that can cause bleeding. So there are lots of things that can happen to the human body while diving. That sounds terrible. Yes, but that's why there's this whole field of science and medicine where

they have sought to find ways around all these issues. Okay. Now all of this kind of goes back, as I mentioned, I was going to tell you a little bit about Robert Boyle. Robert Boyle was an Irish chemist and a physicist and an inventor, and he did a lot of different experiments on gases in the 1650s and 1660s along with Robert Hook. And a lot of what he was interested in was how gases behaved in a vacuum. This would all become very important as we sought to understand diving medicine and everything down the road. He was also, I just think this is an interesting side note.

This was part of the time when, and Justin, I think you were really recently reading about this around the new philosophy of science. Yes, yes. He was part of the new philosophy. He formed what was originally called the Invisible College, but later became known as the Royal Society. Scientists who believed, instead of just kind of been like the tradition of Aristotle, you would argue your scientific point, like how does something work?

You argue it and whoever comes up with the best argument for it is right. Right, you're really talking about this sort of transitional phase between science being an accurate recounting of the phenomenon that we can perceive in between science being an accurate recounting of the phenomenon that we can perceive in the world and an accurate grounding of why that phenomenon actually occurs. He was interested in experimenting, testing, observing things, testing those things, and then figuring it out based on that as opposed to just this sounds logical, I'll argue it.

My argument makes more sense than years I win. Yeah. So anyway, he was part of that. And a lot of the experimentation he did was on gases and he came out with boils law, which is that the volume is inversely proportional to the pressure of a gas. And this is how you figure out how to pressurize gas

in a tank and give to diversion all that. Anyway, he also wants to a viper into a compression chamber and then decompressed it. Why? I'm not sure. But he did, he did note that he saw a bubble form in the eye of the viper as he decompressed it. There's nitrogen. It was decompression. He was, he was witnessing decompression

illness. I don't do this, please. I'm not a snake fan, but do not do this, just snakes. In 1662, so this is recently after we're starting to understand compression and decompression of gases, right? Boyle has just done all these experiments and published all this stuff. A British physician, Henshawaw tried to treat people with compressed air. Like, hmm, this is interesting.

Let's compress some air and put it around people. So he built something called... That's getting the dust out of people, actually, is fine, but just don't turn the canister upside down because it becomes very cold. That's very unpleasant. What are you talking about? Compressed air?

Like the canister. Okay. Press air. It's like in a candy. Yes, I got that. So you can clean off your computer. And he wasn't doing that. He built the domicillium, which was a big sealed room that was attached to some hand-operated bellows.

Okay. So you put people in the room and then just kind of like use the bellows and either compress the air or decompress the air. And you would want the air pressure in the room to be higher for acute stuff and lower for chronic stuff. You could also just spend some time in there for your general wellness. Sure.

This is not compressed oxygen, by the way. This is like a precursor to hyperbaric oxygen we'll get into. Because this was just high pressure air. Okay. Not oxygen. Just this was just high pressure air. Okay, not oxygen. Just oxygen, it was all air. This probably was not very effective either way. It probably wasn't very dangerous either just because how much compression

were you getting with a sealed room that had a hand operated bellows attached to it that you're pumping on your own? This is basically what you're describing as the machine from the pit of despair, right? Yeah, it kind of is. He was sucking away one year of their life. Oh.

But there wasn't really other than this one physician who was like, oh, I wonder if all this compression stuff could be good for medicine. There wasn't really much interest in it until the 1800s. Okay. What happened then? Well, I'm gonna tell you, Justin. Oh, yeah, I walked right into that one.

But first let's go to the billionaire. Let's go. The medicines, the medicines that I skilled in my car before the mouth. So it was the 1800s and people were getting really into compressed air for some reason, Sydney. That's right. I'm assuming it was for the family offer.

No. No. But please, no, I'm trying to cover kind of like two things at once here. I'm talking about the history of how we figured out a lot of diving medicine. And also, like in order to figure out how to diagnose and prevent the bends and decompression sickness was the biggest thing people were trying to understand.

You also were trying to figure out how to treat that and all this kind of goes hands in hand and hand. So I'm telling you the history of like this, how we figured out how gas is work and then also hyperbaric oxygen treatment for decompression sickness. It's all tied in here together. If it seems wandering, that's why. So in the 1830s, a French physician, Emil Tabare began treating patients using a hyperbaric chamber of his own device. So he made this compressed air chamber. Let me add a big house. Mainly to treat respiratory illness. That was the big use for it at the time, like any kind of asthma or tuberculosis or pneumonia or anything that's wrong with your lungs.

This led to interest in France and other French physicians building their own chambers, especially Juno who built this big round copper chamber that could reach much higher pressures. Right. So he was actually like, these early attempts maybe weren't doing too much. This was probably the first time that like, we were probably doing something. And he noted that people who spent time in there, he thought he was increasing their well-being, like their general wellness.

This is time of like, I don't know, can we do something just to make us feel better all the time? And people who spent time in this chamber would feel better, which may have actually been a little bit of that nitrogen in our cosses we talked about. Like a little bit high. Yeah, they're getting a little bit high. This is also by the way, have you heard of the rapture of the deep? No. So it's Jacques Cousteau called it? No, I mean, I've put by a shock, which is set in rapture underneath the water. Is that something? The rapture of the deep is what Jacques Cousteau called that feeling you get when you're breathing too much nitrogen in your underwater. When I need to get baked.

That's the same thing. In 1837, the contemporary of these other doctors provost built a giant air bath that could accommodate 12 people at once in the home. So you get 12 people compressed all at the same time. Just wish them all together. And like a lot of new treatments that we cover, it became a cure-all for a while. Okay, of course, yes.

Yes, of course. Everybody wanted to try it for everything. And in the use of these chambers were spreading all throughout Europe So everybody was wanting to go spend time especially for things like tuberculosis Which nobody was sure what to do with yet spend time in one of these compressed air chambers for that or just to make you feel better in general There's a doctor Fontaine who built a mobile one in 1879 That you just you know take around. I'm assuming you had a big car

1879. Yeah, you know, take around. I'm assuming you had a big car. The county fairs or whatever, spend some time in the compressed air chambers. That's kind of like how escape rooms just sort of popping up everywhere. Exactly. Same idea. Describe it for everything. It could hold more people and they even started to do surgeries inside this. They thought that the pressurized air helped surgeries inside this. They thought that the pressurized air helped reduce hernias better. No, but just got the doctor's bank to the job, everybody. There was even Fontainehead plans for a 300 seat hyperbaric surgical theater. So like a big giant, like the whole room would be pressurized. In addition to the operating area, like you could sit in your pressurized comfort. I want to see a wizard of Oz in there with dark side of the moon synced up to it and then fired up the hyperbred chamber. There was actually like some kind of injury that occurred

that he that Fontaine sustained while building this thing, which is why it was never realized because he died before he got to see its creation and then it never happened. Yeah. But, but so they never built that, but they were using these all over Europe. Now, of course, in the US, we had to get in on that, right? We need it. We need it. So, a doctor cutting him was one of the biggest proponents of this kind of therapy because he observed during the Spanish flu epidemic that patients in higher elevations he thought faired better. And so based on that idea, he thought that hyperbaric therapy would be helpful for the Spanish flu.

So he treated all his patients with it despite the fact that one night he had a bunch of patients and he would put them in these compression chambers for a long time. And one night he had a bunch of patients and he would put them in these in these compression chambers for a long time and one night he had them all in a chamber and they lost power and everybody died. Everybody decompressed instantly. Oh Sydney. Yeah. But he only saw this instead of seeing it as like a a danger of this therapy because nobody understood why this was problematic. Yeah, but instead of seeing it, there's a bunch of people died that were problematic.

What he thought was, ah, my therapy was the only thing keeping them alive. God, people. So he went on to expand, especially once the Spanish flu epidemic went, he went on to expand, especially once the Spanish flu epidemic went, he went on to treat every, I mean, like you had to find another reason to do this. So syphilis high, high pretension, diabetes, cancer, everything in Cleveland in 1928, he built a five story, 64 foot diameter chamber. It was basically like a nice hotel. So radical. That was all like a like a compression chamber,

like a compression decompression. Because you could do both. I'm calling it compression, but you could do both to people depending on there was some belief that that pressurizing the air was helpful for some conditions and then what they call rarified air or the decompressed air lower pressures were helpful for other illnesses. So you could do either. But he built, it was like a hotel that he built. It's awesome. So just put a bunch of people in and they could sleep there and stay there

and be under pressurized air. It might be slightly more exciting if it weren't for your previous anecdote. Like this hotel had the possibility of just becoming a huge coffin at any time. Exactly. Like that's fair. Undetard this cat, huh?

Just like, one more again. My, maybe the problem was, I didn't get enough people in there. What if this is what H.H. Holmes, what if that was his big play? He, why did he waste so much time building a hotel and then serial killing, why do people in there? He could have watched him all out. It was just, just pull the plug and then,

I remember he said, I was reading as I was reading this story I was like, please tell me this place to look this I have to go visit this place It's not they tore down the the AMA was always on this guy's case They kept saying like if this works, where's the evidence present us with the evidence? Surely you have evidence at this works and I mean he didn't so he was discredited in 1937 and it was converted to like a regular hospital briefly and then just torn down. So anyway you can't visit the Cunningham Chamber as much as

I would very much enjoy that. All of this comes together not with diving actually but with coal mining. Okay. Okay. So the industrial revolution brought along the demand for coal, right? Because we're building a bunch of things. We need coal. We need energy. And in France, coal was found beneath a river, the Loura River, okay? And flooding left it hard to mine all of this coal. So we had to get people down to where this coal was so that we could use it for energy. So a mining engineer, Jean Triger, developed a system of casons.

Casesons, what's a cason? Well, okay, I had heard of these, but I had to look at a lot of diagrams to really understand what was happening. So if you're going to build something, if you're gonna mine coal underwater, or this is the same thing if you're gonna build a bridge, if you're gonna build something underwater,

you have to get people down under the water. You have to displace water with pressure and then get people down there, right? Right. So you would lower these pressurized chambers underwater and then or lower these chambers and then pressurize them and force out all the water and mud and everything and then put people in them. Look at diagrams, they're like big boxes underwater. They're pressurized. Okay. And so that's what they started using to to mine the call. But in order to do it, like the chambers are pressurized to keep water and mud and everything out of them and you're putting humans in them. So you're making them inhale pressurized gases,

much like a diver would. Does this make sense? Yes. This is why all this ties together because people would work there and they'd be fine while they were down there working in these pressurized environments, but then when they would come back up to the surface at the end of the day of work, about 12 hours later, they would all get really sick because they were getting the bends and some of them even Suffered from paralysis and death and I mean

Obviously, there were major problems with this so Because so many people were getting ill. They started bringing in doctors to try to study like what what is happening here? What why you know, they're not they pretty quickly realize it's not being in the the case on that's not the problem It's when you come out something that's happening to your body when you come out. And so this physician, Paul Bert, began to study this issue and he would eventually be, he would eventually come to be able to describe decompression sickness, what was happening in the body and, and, you know, why this was the problem, but not quite how to fix it yet, but starting to understand what they may be able to do to fix it. But because words spread pretty slowly back then, we didn't to fix it yet, but starting to understand what they may be able to do to fix it.

But because words spread pretty slowly back then, we didn't have the internet yet to tell us everything right away. We were still seeing one of the most famous cases of this was actually the building of the Brooklyn Bridge. While the Brooklyn Bridge was under construction, a lot of workers were claimed by what they began to call Kesson's disease. Oh, okay. Yeah, because people were working down

in these pressurized areas and then getting decompression sickness and dying. Before word spread, like, hey, we figured this out. And by the time actually the Holland tunnel was finished, it had been started and then there was a funding problem and it was put on pause for a long time and that was probably good because then by the time it was restarted,

we understood this. And there was actually a decompression chamber on site to slowly decompress workers so that people weren't dying from this. They still had problems with it, but they were beginning to understand how to do this. And as we did more projects in the future, like things where people had to be deeper and we had to have higher pressures and we started to see that like, we're going to need to, we had to have higher pressures and we started to see that like, we're going to need to, there's not a one size fits all solution to this. That's where we see the British physician, how Dane come up with tables of how, if you are under this much pressure for this much time,

here's how long it takes you to decompress. These are diving tables. These are the precursors to diving tables, which is what a diver would use today. If you're going to go this deep in the water for this much time, here's how long and how slowly you need to ascend to the surface or how long it would take you to decompress so that you don't get decompression sickness. Because did you know that about diving that one way you can avoid the bends is by slowly coming back to the surface? I did actually know that. Yes. And that's how diving tables help you to do.

Figure that out. I did not know that the second half of the sentence about diving tables. I always wondered about that. Yeah, that's what they're all about. And these were the first ones that were made. There are different ones now that we use. They've gotten more precise over time. They're probably apps.

I mean, oh, I'm sure there's an app. They're passb time. They're probably apps. I mean, Oh, I'm sure there's an, they're passbana. There's probably apps. I'm certain there's an app. So, all of this was understood for all of these, by the way, how like humans are wild. Here we are underwater, building bridges. It's crazy.

Let's drop these tanks and pressurize them and force all the water out and then put humans in it. We want a bridge here. We want a bridge here. We're going to build a bit crazy. Let's drop these tanks and pressurize them and force all the water out and then put humans in it. We want a bridge here. We want a bridge here. We're going to build a tunnel here. We're not going around human control. Yeah, we're awesome. Quick question about this, because I don't know

that we're necessarily. What do you do? Okay, so you can go up slowly, right? But what if there's going to be a shark or something, whatever. And you go up too fast. Yeah. So that's where all this, this is where it all comes together. That's where hyperbare oxygen comes in.

So we had been, we had been toying around with ways to pressurize air and could it make humans healthier, right? Well, eventually people realized that pressurizing the air wasn't as important as pressurizing the oxygen. Applying high pressures of oxygen to humans was there some advantage to that. As we talked about, you had to be careful with this because of oxygen toxicity, but applying high pressured hyperbaric oxygen to people after they, if they've come up too quickly, or if they've been on great enough, enough been great enough depth where they just couldn't,

that can actually treat decompression sickness and prevent, well, treat the bends at that point. You've already got the problem, so you're treating it. Hyper-Beric oxygen chambers are now standard at a lot of diving facilities, where if you've come up too quickly, you can go spend some time in the hyper-Beric oxygen chamber. It'll just slowly repressurize you pretty much. Yes. And prevent the nitrogen from bubbling up

into your circulation. Maybe next, you know, I don't know, probably. Could you spend a while that way? How long are we talking? Days, minutes. Not minutes, but hours. OK. Yeah.

Usually not days. I hope you get some, a TV, a Game Boy something. The tape, it used to be days that you would spend in decompression chambers and things, slowly rising your pressure. And that was part of why the diving tables and all these pressurized tables changed over time was to shorten the length of time that you needed.

And hyperbaric oxygen helps with that too. But that is one of the uses of time that you needed. And hyperbaric oxygen helps with that too. But that is one of the uses of the main use, probably, of hyperbaric oxygen today, is to treat the bends and help with that problem. And then all these other issues that we've come up with, like the nitrogen and arcosis and the oxygen toxicity, a lot of this has to do with using the right blend of gases in your tank, which we were better and better at, not that it can't still happen, but it's more much better at it than we used to be.

So from the 1930s on, we found ways to address all these issues with divers, and we've just really advanced since then. Now, in addition to using hyperbaric oxygen to treat decompression sickness, which is probably the main thing that it's used for, we can also use it for some other, like actually we use it at our wound care center here. It helps with some wound healing, specifically like wounds from radiation or wounds from lack of blood flow or like diabetic foot ulcers, gangrene

for skin grafts or a skin flap. It can help with healing, brain abscesses, different infections. And chamber, carbon dioxide poisoning. So you have one? Like personally? Not on you. Not on me.

Yeah, that's what I work. Yeah. Do you, they ever let doctors like go in there and get like chill? Just relax a little bit? No. No. No. The patients No. No.

The patients that I've had that have used it don't, and they say it makes them feel very claustrophobic. They feel very trapped and they don't particularly enjoy it. Y'all should get a bigger one. We should get a 300 seat. Yes. No, or a five-story high. And then we'll book some shows at it. So I say all this again to just underline that all of the Thai Navy seals and this Dr. Harris and all the different, the, the diving structures, all the different people who went in to help rescue this team. I mean, our heroes because not only do they do it, which is incredibly dangerous. People die cave diving all the time. It's incredibly dangerous. People die cave diving all the time. It's incredibly dangerous,

but they also got these boys to do it. Yeah. That's amazing. There's a dear kid who never, they never dove before. And another hero is, I would say, science. Thanks again, science. You've saved the day once more.

Thank you for always being there for us. Even when we're being there for us even when we're not there for you. Well thank you to you city for that delightful discussion and thank you to you the listener home for hanging out with us for another program as long as we've got gratitude. Wait can I thank all those amazing rescuers? I thought you did Well, I didn't know if I actually said thank you. All right, Sydney. Thank them Thank you, and I didn't name and Samon Gunaan was the Thai Navy seal who died while he was helping to rescue the boys

If you remember our heroes both living in past absolutely Sidney. I want to say while we're saying thank you to folks I think and this is not as kind as it was for people to send things to our peopobox not quite a level with Giving your life to rescue Thai children, but still very nice Brooks and a sepurs Sarah blanket Amy said lovely cross stitch and Brad sent a big 20 dice roller So thank you to all of you for those kind gifts. That was an awkward transition, but There was nothing to be done for it. I think Thank you to taxpayers for the use there's all medicines is the intro and outro of our program and thank you to you at home for Listening of course, we we sure appreciate it.

Hey, if you got a second, do two things. One, go to bit.ly-fordslash-the-saw-bones-book and check out art from our forthcoming book that comes out October 9th from Weldon Owen. We wrote a whole book and you could pre-order it there, see some art that Taylor Smurl, Sydney's sister, and the illustrator of the book did, and pre-order it, and we really appreciate you doing that. And if you could also go to the iTunes store and give us a review,

we would very much appreciate that too. So, you know, that's two favors, but if you could do one or both, it would just be the top. So, thank you so much. And that's gonna do a fresh for this week, so... I'm just a backer. And as always, don't drill a hole in your head. Alright!