Apr 12, 2021
Hi folks! Here's the transcript from our Wondercon at Home panel, where we discuss Parks and Rec's "Emergency Response" and Bob's Burgers' "The Kids Run the Restaurant." Like the podcast, this transcript is not medical advice. If you catch any errors, let us know in the comments!
Johnny Kolasinski: 0:13 Hello WonderCon at Home, I’m Johnny Kolasinski. You might remember me from such podcast as Hi Everybody - A Bad Medicine Panel, The Snyder Cut. It’s just like this panel, but it’s four hours long and it has Jared Leto. This is, Hi Everybody - A Bad Medicine Panel. We’re going to be talking about what Hollywood gets right and wrong about medicine and how the body works. With me today are my co-host, Dr. Jackson Vane.
Dr. Jackson Vane: 0:36 Hi everybody.
Johnny Kolasinski: 0:38 And Dr. Courtney Nicholas.
Dr. Courtney Nicholas: 0:40 Hi everybody.
Johnny Kolasinski: 0:41 And Dr. Greg Winter.
Dr. Greg Winter: 0:43 What’s up! Hi everybody.
Johnny Kolasinski: 0:48 So, you can find this podcast online on Facebook, Instagram and Twitter at @hieverybodyMD or at www.hieverybodymd.com
Dr. Jackson Vane: 0:59 Or if you want to call us or leave us a message or text us, you can call us at 530-DOCTORB. That’s 530-362-8672. I guess, the B this week would stand for burgers. I guess it would tie in all the stuff that we’re talking about.
Johnny Kolasinski: 1:14 Yeah. Before we get into the two episodes of TV, we’re going to be discussing which is Parks and Recreation, Season 5 Episode 13, Emergency Response, and Bob’s Burgers, the kids run the restaurant, Season 3 Episode 20. I want to... Can you just introduce yourselves to people who don’t know the show and what you do?
Dr. Jackson Vane: 1:39 Sure. I’m Jackson Vane. I’m a pediatric emergency medicine doctor here.
Dr. Courtney Nicholas: 1:45 My name is Courtney Nicholas. My brother calls me a baby mechanic. So I’m a neonatologist. I take care of the babies in the ICU.
Dr. Greg Winter: 1:51 I’m Greg Winter. I am a hospice and palliative care doctor. I deal mainly with people at the end of life or people with severe symptoms that need managing.
Johnny Kolasinski: 2:01 And I’m Johnny Kolasinski. And I have no marketable skills.
Dr. Greg Winter: 2:06 You do so many podcasts.
Dr. Jackson Vane: 2:09 So much hosting.
Johnny Kolasinski: 2:12 Let’s talk about the elephant in the room really quickly before we get things started. And the fact that hey, you guys are there, I’m here. Why is that?
Dr. Jackson Vane: 2:23 Well, we’re all vaccinated. Since we’re all healthcare providers, we all have to get vaccinated, so we can work. So I mean, we’re still wearing our mask outside of our group of people and especially when we’re in public. But here, since, we’re all in the bubble, we are not wearing a mask right now. And that’s why we’re all here together. And you are unclean, so that is why you’re over there by yourself.
Johnny Kolasinski: 2:45 Exactly. Medical podcasters don’t get the same priority.
Dr. Greg Winter: 2:49 No.
Johnny Kolasinski: 2:49 And it just because we set up this great podcasting studio that we needed to immediately start recording remotely.
Dr. Greg Winter: 2:57 I also think it should be known like Jackson and Courtney both got their vaccines before I did, as they are more frontline than I am. I mean, there’s reasons for the rollout that they’re doing. And I’m glad that I can be in the same space with them. But also, we are following the rules. And you should protect yourself and protect your loved ones. It’s not a joke.
Johnny Kolasinski: 3:17 Yeah.
Dr. Jackson Vane: 3:17 We wish we could be there in real life, but this will be the second best thing we can do.
Dr. Greg Winter: 3:22 Third!
Johnny Kolasinski: 3:22 Exactly!
Dr. Jackson Vane: 3:23 Third best thing we can do.
Johnny Kolasinski: 3:26 So with that, let’s get into the first episode that we wanted to talk about today, which was the Parks and Recreation Episode. And quick synopsis of it is, at the last minute, Leslie Knope gets called into a disaster preparedness drill, where they are dealing with a fake outbreak of H5N1, which is the bird flu.
Dr. Jackson Vane: 3:54 Yeah. That one’s the avian flu. I think, we were watching this and I think, it brought back memories of when the hospital inspectors come to the hospital randomly and just surprise us. And we are all caught off guard and kind of forced into like a quick thinking situation. But H5N1 is actually a pretty scary virus. I think that was like the big hot virus a few years ago.
Dr. Greg Winter: 4:16 I mean, also I don’t think [that] in a real world scenario, they don’t come in and say, “Hey, here’s what’s happening.” It’s more like, “Are you doing things properly? What are your contingency plans in case something happens?” It’s less of a role playing scenario and more of a “Do you have your ducks in a row scenario?” Which is very different from a town council perspective, which is what they’re portraying. And actually, I think they do get this kind of testing, where someone comes in and runs a scenario with them. Actually Jackson, Courtney and I all lived in Long Beach. And part of my residency training there was doing this sort of running around with the government enforcement officials and kind of seeing what is going on, which means, “Are restaurants up to code?” Also, not just kind of penalizing people, but “Hey, here’s how you get your Grade A recommendation.” And one of the things I thought was really interesting when I was going through that particular rotation, in Long Beach, they have horse stables in the middle of downtown Long Beach, which is the thing you don’t know unless you have a horse. But part of that is they have bird cages there, where they are trapping birds, they’re also like taking blood from specific chickens and things like that to see if there is a spread of certain viruses and things like that. It was a very, very interesting rotation to just kind of see the things that are going on behind the scenes to make a city work and also make a city safe. So I mean, there’s that part of it, where it was like, “This is definitely for humor”, but also know that that’s happening behind the scenes in the city.
Dr. Jackson Vane: 6:02 And that also happens in the hospital too, where they’ll actually have like internal disasters.
Dr. Greg Winter: 6:07 Yeah. Oh, yeah. We definitely do that. That’s true.
Dr. Jackson Vane: 6:09 We actually have people with blood on their face, and just full makeup, and the ambulances would actually drive them into the ambulance bay and just drop them off going, “This one was an African and may have Ebola.” Like, racist. Yes.
Dr. Greg Winter: 6:25 Well, yes, Jackson is racist. I agree.
Dr. Jackson Vane: 6:27 How dare you?
Dr. Courtney Nicholas: 6:28 But in a very generalized sense, drills help you be prepared for these disasters that may come. And you tend to see them pop up more after significant storms, [or] things that may happen in the country, and we want to make sure that we’re prepared in certain area.
Dr. Jackson Vane: 6:43 Yeah.
Dr. Greg Winter: 6:44 I think the thing that’s kind of... I mean, this definitely happens. But the thing that’s fictional is that it’s out of nowhere. Whereas most of the time when your hospital is going to get tested for something, you know ahead of time, you’re preparing for it ahead of time. I mean...
Dr. Jackson Vane: 7:00 You basically don’t want it to be like Jerry.
Dr. Greg Winter: 7:02 Right.
Dr. Jackson Vane: 7:03 Where you just spring it on them and go, “Oh man, its...” Someone is gonna think it’s real, and everyone freaks out. And that actually happened when...
Dr. Courtney Nicholas: 7:10 I will argue with that. I think some people don’t know that it’s real. And yeah, the people the top may know it’s coming, but part of it is true.
Dr. Jackson Vane: 7:16 So that actually happened in my fellowship, where we actually had a drill where hot air balloons collided, and it was in the middle of our football field.
Dr. Greg Winter: 7:26 Kablammo!
Dr. Jackson Vane: 7:27 Yeah.
Dr. Courtney Nicholas: 7:27 Boom.
Dr. Jackson Vane: 7:27 And they had like down balloons and everything. And people on the sides like videotaping calling 911 and all that stuff, saying, “Something bad happened on the football field.” And we’re telling them, “No, it’s fake. It’s okay.” And they didn’t believe us, because everyone was super bloody. Well, also a bunch of ER doctors out there too, didn’t really help.
Dr. Greg Winter: 7:47 Right. Right now the place I’m working with is going through recertification. And so this is a thing that happens every couple of years, but it’s less. That’s very different from a disaster testing scenario, where... We’re getting recertified, which is the thing that you know about and you’re preparing for, but disaster preparedness is something where you can be tested, but I don’t... It’s not like suddenly you lose. It’s just like,” Oh, here are things you can improve on.” It’s not like, “You suddenly can’t be a hospital or something like that.”
Johnny Kolasinski: 8:18 Yeah, you’re suddenly no longer certified to deal with a disaster. So if there’s disasters happening, your hospital closes.
Dr. Jackson Vane: 8:24 And really they didn’t describe the penalty that would happen to pawning it.
Johnny Kolasinski: 8:29 Yeah, I don’t think there was a penalty, because they said they failed. Yeah. Can you turn Greg up just to touch?
Dr. Greg Winter: 8:38 Things no one ever says. I need a little more Greg in the microphone.
Johnny Kolasinski: 8:48 So let’s talk a little bit about what their plan was for H5N1. So is H5N1, first of all, is this something that’s going to be spread person to person or is it only animal to people contact?
Dr. Jackson Vane: 9:04 So it’s droplet and it is from person to...
Dr. Greg Winter: 9:06 Person to Birdman.
Dr. Jackson Vane: 9:07 Person to Birdman, yes.
Johnny Kolasinski: 9:09 You can only catch it from Michael Keaton. Got it. This is a good time to say what I should have said earlier, which is this podcast is not medical advice and neither is this panel.
Dr. Greg Winter: 9:18 The B stands for Birdman.
Dr. Jackson Vane: 9:19 The B stands for Birdman, Yes. The natural reservoir is in birds, poultry...
Dr. Greg Winter: 9:25 Also Edward Norton, so good. So good in birdman, Jesus Christ. So good.
Dr. Courtney Nicholas: 9:29 I think, I need to add that one to my list.
Dr. Jackson Vane: 9:32 Birdman? I got to watch that too. I haven’t watched it yet.
Dr. Greg Winter: 9:36 Oh,
Johnny Kolasinski: 9:37 That midsummer
Dr. Greg Winter: 9:38 And we just talked about Birdman. And we don’t have time. We don’t have time.
Dr. Jackson Vane: 9:42 No time. Not enough time. But yeah, it’s actually it started in birds and then it actually started in China. I believe, it was the first outbreak of H5N1. And it was in the live markets but also in hobby farmer. So you’re keeping chickens in your backyard for fun, or if you had cockfighting chickens, that’s actually how it spread quite a bit. I knew that was gonna get a snick somebody.
Dr. Greg Winter: 10:08 I mean, who had less than 10 minutes before Jackson mentioned cockfighting. Just... It could happen...
Johnny Kolasinski: 10:16 Moving on with this PG13 panel.
Dr. Greg Winter: 10:19 I said cockfighting. I know what I said.
Dr. Jackson Vane: 10:22 But it is spread from person to person. And there was actually a small outbreak at the end of last year of H5N1 as well.
Johnny Kolasinski: 10:29 At the end of 2020 or 2019?
Dr. Jackson Vane: 10:32 2020.
Johnny Kolasinski: 10:32 Okay.
Dr. Greg Winter: 10:33 There was also a significant... I’m sorry.
Dr. Jackson Vane: 10:35 I don’t remember where, but I know there was an outbreak of it.
Dr. Greg Winter: 10:38 There was a significant outbreak, probably, I want to say like six or seven years ago, also. And it was sort of the thing that was happening that you had to pay attention to.
Johnny Kolasinski: 10:48 Yeah. And that’s right around, I think, when the episode aired. It was like... If I remember it correctly, it was 2013.
Dr. Greg Winter: 10:54 From the headline.
Johnny Kolasinski: 10:54 Exactly.
Dr. Jackson Vane: 10:57 But it’s a pretty deadly one too. So we’ve all heard of like H1N1, which is like swine flu. That one is like pretty contagious. It spreads really quickly, but it doesn’t have a high mortality. However, this one, it’s spread slower, but it has a higher mortality in general.
Johnny Kolasinski: 11:13 In that situation, it’s kind of like COVID-19 then.
Dr. Jackson Vane: 11:17 Kinda yeah.
Dr. Greg Winter: 11:18 COVID-19 is in the... It’s in the [unclear 11:20] spot of fast spreading, also high mortality. And it’s more like the Spanish flu - another racist name. But it is one of those things where it’s like, it spreads slow enough to, or the symptoms are slow enough so that when it spreads, it’s not so bad, but it hurts you enough so that people die. And so that’s when things get scary when you can get a disease, and not know about it, and then spread it to other people, and then also everybody gets really sick and dies.
Dr. Jackson Vane: 11:57 Yeah.
Dr. Courtney Nicholas: 11:57 Something you can compare avian flu or H5N1 to is, maybe, Ebola. So something that has a high mortality rate, but doesn’t spread as easily.
Johnny Kolasinski: 12:05 Okay.
Dr. Courtney Nicholas: 12:05 Because it may kill the person who gets it before it’s able to really spread out. Whereas COVID 19 has spread easily and had a high mortality rate.
Johnny Kolasinski: 12:16 And let’s talk about some of the prevention methods that they put into place. One of them was that they were going to kill all the birds.
Dr. Greg Winter: 12:28 Kill all humans. I mean, I’ve been watching the drama.
Dr. Jackson Vane: 12:33 But he was very deliberate in how he wanted to kill all those birds. I mean, Greg actually has more experience in all of this, not the bird killing part, but actually tracking viruses and stuff like that.
Dr. Greg Winter: 12:47 So that’s part of it. It is like, “What’s happening? How is it spreading? How can we contain it?” And I think that’s one of the things that can often be overlooked by people that are sort of not in the scientific community. It is like, there are things that are happening behind the scenes. You can’t just be like, “Okay. We’ll put up a barrier. And that way it won’t spread.” If a diseases spread through birds, like you can’t really say, “Well, we stopped all the birds from flying out of our town.” This is a very fictionalized scenario. And so it’s a little bit different. These are really complicated scenarios. And so it becomes really important to listen to the people that know what they’re talking about, because otherwise you’re just kind of listening to opinions. So it’s very much mirrored in the things that are happening today. You just have to always consider your source. Like, make sure your sources are actually reputable sources of the information you’re getting.
Dr. Courtney Nicholas: 13:48 So one way to look at it is taking care of the vector or the thing that has the disease is kind of like quarantining.
Dr. Greg Winter: 13:53 Yeah.
Dr. Jackson Vane: 13:55 Basically you’re quarantine birds.
Dr. Greg Winter: 13:58 There’s a young joke in there somewhere taking care of business. TCYB, Country’s best yogurt. No.
Dr. Jackson Vane: 14:03 No.
Dr. Greg Winter: 14:04 Nobody?
Dr. Courtney Nicholas: 14:05 I’ve explained it.
Dr. Greg Winter: 14:05 Okay.
Dr. Jackson Vane: 14:05 Yeah. Take a laugh.
Dr. Greg Winter: 14:06 Jokes that you explained are the best jokes.
Johnny Kolasinski: 14:08 They are. Another step that they went through was, and this is one that they failed, was shutting down all the buses.
Dr. Jackson Vane: 14:21 And did they do that with COVID? I don’t remember.
Dr. Courtney Nicholas: 14:23 Well they shut down the planes. Remember?
Johnny Kolasinski: 14:25 That a couple weeks.
Dr. Greg Winter: 14:26 And that’s one of the... I mean, one of the big things was how do we keep this from crossing borders. I mean, borders in general are fictional lines on maps, but if you can stop people coming from an area where there isn’t infection to an area where there is an infection, then of course that’s going to help stop spread the infection. It’s harder to do that in a land based scenario. I mean, people have cars. You can drive around. And, and so then it becomes very difficult. Also when things can be spread by an animal flying away, it becomes very difficult to stop it. It’s not to say that taking those measures is wrong, it just means that it’s only just one of the things you can do. And so you really need people to really try hard in order to make sure that they’re doing everything they can to stop spreading something.
Johnny Kolasinski: 15:21 Because if I recall correctly, at least here, I don’t think buses were ever completely shut down. I mean, we’re all here in San Diego.
Dr. Courtney Nicholas: 15:29 They needed to keep things moving, at least. But in some counties in California, they have an ordinance that you can’t personally drive more than 100 miles away from the county.
Johnny Kolasinski: 15:38 Oh, wow.
Dr. Courtney Nicholas: 15:38 And if you do you have to quarantine yourself when you get back. That’s difficult to enforce. But that one those tries to follow the rules to keep your neighbors safe.
Dr. Greg Winter: 15:50 I think that’s really one of the things that’s really frustrating. It is because if you’re trying to follow those rules, and then you are around people that aren’t following those rules, and they are... Profiting is the wrong word. But their quality of life is nicer, because they’re not following the rules that makes things really difficult. And it makes it harder to enforce those rules for people that really do want to follow the rules.
Johnny Kolasinski: 16:14 Right. It’s like the people who will follow the rules don’t need the rules to be there, because enforcement is unnecessary, because you’re taking the steps out of good citizenship.
Dr. Greg Winter: 16:28 Yeah. The sign in the bathroom that says employees must wash hands is really like... Hopefully, the employees don’t need that sign. Hopefully, they’re washing their hands.
Dr. Jackson Vane: 16:39 But the ones that don’t.
Dr. Greg Winter: 16:41 Also they probably...
Johnny Kolasinski: 16:42 Probably don’t read signs.
Dr. Greg Winter: 16:43 Does that sign matter.
Dr. Jackson Vane: 16:44 The stern warning. Like hey, you should. You really should.
Dr. Greg Winter: 16:50 Pause! Hey, there’s a sign right there. You got to do it.
Dr. Jackson Vane: 16:52 Yeah. Can I talk about Chris’s symptoms really quick, too?
Johnny Kolasinski: 16:56 Yes, please.
Dr. Greg Winter: 16:57 No, I want to talk about poop hands.
Dr. Jackson Vane: 16:59 Well, I mean, this is a good...
Dr. Courtney Nicholas: 17:00 Is there just a possibility when you see someone not wash their hands.
Dr. Jackson Vane: 17:02 It is. It’s an irresponsibility.
Dr. Greg Winter: 17:04 All right, Karen.
Dr. Jackson Vane: 17:12 But I think poop hands is a good transition point to like how Chris eventually got sick because the buses didn’t get shut down. They said he just had diarrhea, diarrhea, some cold symptoms, and then he ultimately died of diarrhea.
Dr. Greg Winter: 17:24 Sounds more like dysentery.
Dr. Jackson Vane: 17:25 Yeah.
Dr. Greg Winter: 17:25 They’re confusing a lot of diseases. But also, we had to look up bird flu to make sure it didn’t include diarrhea.
Dr. Jackson Vane: 17:31 So it can but not to the point where you poop your brains up.
Dr. Greg Winter: 17:36 Yeah.
Johnny Kolasinski: 17:38 I don’t know, Chris Trigger’s diet probably is very, very fibrous.
Dr. Greg Winter: 17:42 It feels like he’s got a lot of loose stool to begin.
Dr. Greg Winter: 17:46 Swabbing
Johnny Kolasinski: 17:50 One of the things that they do that worked as a plot point for me, but wasn’t sure about the accuracy was they set up a triage point the plot that they were going to be using as a park. That was kind of the other a plot of the episode. What I... And Jackson, I know you’ve worked in smaller towns. Is that something that would happen where they would set that off-site away from a hospital?
Dr. Jackson Vane: 18:23 So usually, they’ll do that with kind of more disaster situations, as opposed to like viral illnesses. Because usually viral illnesses, you would expect them to have maybe a tent outside of a hospital, so that you can quickly triage patients and then put them where they need to go, whether into the clean or the dirty waiting room, which is actually what we’re doing in our emergency department. But usually when they do an off-site triage, it’s because like a bomb blew off or there’s earthquake balloons that crashed or an earthquake kind of situation.
Dr. Greg Winter: 18:54 How many hot air balloon emergencies have you had?
Dr. Courtney Nicholas: 18:56 A lot.
Dr. Jackson Vane: 18:57 Two.
Dr. Greg Winter: 18:57 It feels like more than one.
Dr. Jackson Vane: 18:58 Two, because where I used to live in Albuquerque, they had the Hot Air Balloon Fiesta, and crashes happen.
Dr. Greg Winter: 19:06 Yeah.
Dr. Jackson Vane: 19:06 And people really...
Johnny Kolasinski: 19:07 Thank god they had that drill.
Dr. Jackson Vane: 19:09 Yeah, so but that was the reason why would have that. And then we would do quick triaging, which we would go around with tags: black, red, yellow, green. If you have black that basically meant you’re dead or you’re gonna die soon. Red is like expectant. Also, usually what we’ll do is, if you need help, come over here. And then those are the people we immediately dismissed.
Dr. Greg Winter: 19:33 Now you guys are fine.
Dr. Jackson Vane: 19:35 You got up and you walk towards me, you’re fine.
Dr. Greg Winter: 19:38 I mean, that kind of brings us into the other episodes. I don’t want to get into it. But I remember in med school when we did these sort of triage drills, and part of it is like, you are determining where actual specialist care is needed. And so part of that is kind of this tag system of, at the bottom is green and then yellow, red, black and like sort of... The higher up you pull the tag; the more care you need. But if you are kind of that
Dr. Jackson Vane: 20:09 at the black,
Dr. Greg Winter: 20:11 that black tag person feels racist again. But I mean, it’s one of those ways where your resources matter and there are a certain group of people where in a mass casualty situation, you’re not going to be able to help them in a way that maybe you would help them in a different situation. And so if you’re trying to kind of do the most amount of good for the most amount of people, that’s part of weighing that responsibility. Most doctors never have to make that call. In fact, we’re lucky to be in a place where, even when things go really horribly, we’ve mostly don’t have to make that call. But still, it is a thing that we are trained to on doing.
Dr. Jackson Vane: 20:52 Yep.
Dr. Courtney Nicholas: 20:54 And then some things to remember is that as time moves on, those colors can change. And I don’t work in an emergency room, but I’ve read a lot about it after the Vegas disaster with the shooting at the concert. And it was really interesting to me that they see everybody and they tag them and the black group that you give them morphine and try to keep them comfortable. But then they would group together all the red tags, who needed help of all the providers taking care of them. And they group together the yellow tags knowing that if the yellow tags did not get help soon, they would become red tags. And so you have the amount of people taking care of them based on what they need at that time knowing that if you don’t get to them soon enough, they’re going to go down that cascade of colors.
Johnny Kolasinski: 21:42 There’s a video game reference that I’m... There’s like 15 games, I want a reference of like factorio and things like that, where as soon as you do one thing wrong, everything cascades. That’s where my brain is.
Dr. Greg Winter: 21:53 So you think people are like factorio.
Johnny Kolasinski: 21:56 Apparently I do.
Dr. Greg Winter: 21:58 I’ve been playing a lot of luck be a landlord tonight.
Johnny Kolasinski: 22:02 I don’t know that one. I play FTL.
Dr. Greg Winter: 22:04 We got a...
Johnny Kolasinski: 22:05 Fantastic but that’s not on topic here.
Dr. Greg Winter: 22:08 The luck be a landlord is amazing. There’s a lot of risk management.
Johnny Kolasinski: 22:17 So anything else specifically on Parks and Rec that we want to cover?
Dr. Jackson Vane: 22:24 Jones Hangover
Johnny Kolasinski: 22:26 Oh, yeah.
Dr. Courtney Nicholas: 22:29 That’s probably my favorite part.
Dr. Jackson Vane: 22:30 I think that was the part that we all were most excited to talk about was Jones Hangover. But that was her allergies is what she said. Because she wants Roos had a good time.
Dr. Greg Winter: 22:39 She went on a weeklong booze cruise that just ended in the morning.
Dr. Jackson Vane: 22:43 And her
Johnny Kolasinski: 22:43 Yeah.
Dr. Courtney Nicholas: 22:43 ... of COVID.
Dr. Jackson Vane: 22:47 But that her allergies started acting up, not COVID obvious. But I think when we saw the struggle with the coconut water, we knew pain was coming.
Dr. Greg Winter: 22:57 Yeah. And also part of a hangover is dehydration. And, I mean, Gatorade works, whatever that other Powerade works or any of those things that give you salt and some minerals, electrolytes.
Dr. Jackson Vane: 23:17 That’s what plants crave.
Dr. Courtney Nicholas: 23:20 Thank you.
Dr. Greg Winter: 23:20 God, that movie is amazing.
Dr. Courtney Nicholas: 23:21 I love it.
Dr. Greg Winter: 23:23 President Camacho. But those things definitely help with hangovers. I mean, what really helps with hangovers is maybe don’t drink so much. I mean, that’s really the main thing.
Dr. Jackson Vane: 23:34 Or getting allergies.
Dr. Greg Winter: 23:35 But I think probably all of us, I mean, and when I’m saying all of us I’m including anyone that’s listening has worked with someone who has overindulged.
Dr. Jackson Vane: 23:47 That’s a nice way of saying
Dr. Greg Winter: 23:48 And still come into work when they shouldn’t have. And so it was funny to see someone try to hold their-ish together and still do their job, but also not be able to. Just like no, you think,
Dr. Jackson Vane: 24:03 Hey, you tapped out.
Dr. Greg Winter: 24:04 You think you’re doing it. You’re not doing it. Also, someone else is propping you up. And I think, it’s in any field, you see that. And it’s also an unfortunate thing that’s exists in health. I mean, health care, people are still human beings. I think the consequences are greater when people do things like that, but it’s funny and also it’s sad.
Dr. Jackson Vane: 24:25 Yeah. But her planking was pretty nice.
Dr. Courtney Nicholas: 24:28 Okay. Thank you. I was just gonna say that.
Dr. Greg Winter: 24:30 Yeah, it was a good plank. It was a good slice of the early 2000s. Remember planking guys?
Dr. Jackson Vane: 24:36 It was hot names in the 2000s. I don’t even know if you would have body control enough to do plinking at that point.
Dr. Greg Winter: 24:44 Are you saying me?
Dr. Courtney Nicholas: 24:45 He is looking at you.
Dr. Jackson Vane: 24:46 The Royal we.
Dr. Greg Winter: 24:48 I’ve got body control.
Dr. Jackson Vane: 24:50 When you’re passed out.
Dr. Greg Winter: 24:51 I’ve got plenty body control. I can lay across two couches.
Dr. Jackson Vane: 24:58 We’re gonna try that after this.
Johnny Kolasinski: 25:01 Pay around level content right there.
Dr. Jackson Vane: 25:03 Yeah, but the other thing too is like Ron teaching the kid how to do a tracheotomy. That’s a really hard procedure. And We’ve talked about this on the podcast before too. It’s not a fun procedure, and it’s real bloody. And I’m surprised that kid called Ron instead of calling 911.
Dr. Greg Winter: 25:18 Actually, in that universe, Ron was the right person.
Dr. Courtney Nicholas: 25:21 Correct.
Johnny Kolasinski: 25:22 Yeah.
Dr. Jackson Vane: 25:22 That is true.
Dr. Greg Winter: 25:25 This is amazing.
Johnny Kolasinski: 25:26 What about his hangover cure? Which...
Dr. Jackson Vane: 25:30 Its steak cooked in butter with wet socks.
Dr. Courtney Nicholas: 25:34 Oh, yeah, that works.
Dr. Greg Winter: 25:35 Courtney likes her wet socks.
Dr. Jackson Vane: 25:39 Real wet. That’s how she likes her socks.
Dr. Greg Winter: 25:42 I mean, part of the part of any hangover cure is getting calories in your body, getting fluid in your body, and getting salt in your body. Any electrolyte solution is basically salts. And that’s what you need.
Dr. Jackson Vane: 25:56 And we all know you absorb the most salt through your feet.
Dr. Greg Winter: 25:59 Through your wet socks.
Dr. Jackson Vane: 26:00 Yep. That is where it all comes from. I mean, half of it seems, the steak part. I don’t know if you would want to eat a steak though. If you’ve been drinking a lot.
Johnny Kolasinski: 26:12 If you’re Ron Swanson, you would.
Dr. Greg Winter: 26:14 Yeah, but greasy food is always great. I don’t know if it makes... I mean, what is a hangover?
Johnny Kolasinski: 26:18 A lot...
Dr. Greg Winter: 26:19 Hangover is dehydration. That’s what a hangover is. I can’t say that a steak makes that better. But man does it taste good, huh?
Johnny Kolasinski: 26:29 I love country fried steak.
Dr. Greg Winter: 26:31 Johnny, we got to do some country fancy eating and talk about some sci-fi stuff.
Johnny Kolasinski: 26:36 Yeah, we do. So that was first episode that we wanted to cover. Second episode is the kids run the restaurant, which is in the third season of Bob’s Burgers. And there’s just really two or three scenes that stuck out at this one.
Dr. Jackson Vane: 26:56 Boy, were they scenes.
Johnny Kolasinski: 27:00 The premise of it is, obviously, the kids are running the restaurant. The reason is that Bob cut his finger and had to go to the ER. He cut his finger crotch.
Dr. Jackson Vane: 27:09 I don’t understand how he cut there, though.
Dr. Greg Winter: 27:11 That’s an official name.
Dr. Jackson Vane: 27:12 But finger crotch, not the webbing. I think we call it the webbing. I mean, that’s how I refer to it. But I have also told when my residents have presented to me with patients with a cut there, I’m like, “Oh, the finger crotch.”
Dr. Courtney Nicholas: 27:23 The finger crotch.
Dr. Jackson Vane: 27:24 I actually do call it the finger crotch. But how do you cut there if you’re cutting tomatoes? I’m still not understanding that as I’m gesturing.
Dr. Greg Winter: 27:33 I would say that Bob is maybe not an ice trained chief, if you would.
Dr. Jackson Vane: 27:40 Okay.
Dr. Greg Winter: 27:41 He does not have an internet,
Dr. Jackson Vane: 27:44 a formal training
Dr. Greg Winter: 27:45 Culinary Education.
Dr. Jackson Vane: 27:47 Fair.
Johnny Kolasinski: 27:47 I feel like there’s a couple episodes where we’ve seen his knife skills close up. And I kind of want to watch those and compare and see if this is an injury that could actually happen.
Dr. Jackson Vane: 27:56 I mean; he was a little distracted though. Like his kids and his wife were going completely nanners in the restaurant.
Dr. Courtney Nicholas: 28:02 Look, its was always an injury that can happen to you. Look at something you’re like, how did that work out?
Dr. Greg Winter: 28:09 When Jean says stitch please, that may be like there is [unclear 28:14] I mean, Pat, like see, there is something to be said for a specific group of people that see their own blood, even if it’s not a significant injury. And we’ll pass out from it, even if it’s like getting a blood draw or donating blood, that happens. It doesn’t make you a bad person. It’s not something wrong. It’s just...
Dr. Jackson Vane: 28:36 The first time I actually saw blood in an emergency department when I was volunteering in hospital, I passed out
Dr. Greg Winter: 28:41 And sounds about right. I see the plaque on your wall. Jackson passed out for the blood the first time.
Dr. Jackson Vane: 28:45 It’s over there. It’s my teaching award over there. But I remembered it was exactly like how they kind of portrayed it was, I saw them starting a line and some guy’s neck, but the doctor missed and it started spreading out and I said, “Was that supposed to happen?” Like, I can feel my voice slurs.
Dr. Greg Winter: 28:54 Was that supposed to happen?
Dr. Jackson Vane: 29:05 Like why is everything black and white? And then the doctor just looked at me like, “You’re gonna pass out soon.” And I’m like, “You need to sit down.”
Dr. Greg Winter: 29:13 cool.
Dr. Jackson Vane: 29:14 And did not sit down. He’s like, don’t pass that onto my sterile field; pass out backwards. So I did.
Johnny Kolasinski: 29:20 And did you?
Dr. Courtney Nicholas: 29:21 Like your head on the floor.
Dr. Jackson Vane: 29:22 I did. Luckily I’ve passed out right into a chair.
Johnny Kolasinski: 29:26 Okay. So now [unclear 29:26].
Dr. Courtney Nicholas: 29:27 Somebody pull a chair behind you. They saw it coming. And they knew. We are trained to see. Medical students go down.
Dr. Greg Winter: 29:33 Another medical student about to passed out.
Dr. Jackson Vane: 29:34 Here’s the worst part. I wasn’t even a medical student. I was just some little like kid.
Dr. Greg Winter: 29:38 They had a chair following you around when you walked into the ER.
Dr. Jackson Vane: 29:42 Yeah, pretty much. But that was a lot of blood and I fell and passed out.
Dr. Courtney Nicholas: 29:47 Oh, that was a [unclear 29:48] too.
Dr. Greg Winter: 29:49 I was not.
Dr. Jackson Vane: 29:51 Brag.
Dr. Courtney Nicholas: 29:52 I woke up. And one of my charge nurses had smelling salts under my nose.
Dr. Greg Winter: 29:56 Oh wow.
Dr. Courtney Nicholas: 29:59 Get that away from me.
Dr. Greg Winter: 30:00 Like we haven’t used these in forever.
Dr. Courtney Nicholas: 30:01 Exactly. My favorite joke in the Nikko is now don’t pass out. We don’t do adults up here.
Dr. Jackson Vane: 30:07 We’re gonna cram you in that little incubator.
Dr. Courtney Nicholas: 30:09 Exactly.
Dr. Greg Winter: 30:13 One of my favorite parts about this episode was after they, I mean, this is getting in the weeds, but I’ll do it. But when Tina gets asked to be the babysitter, they have board games out. And so they have surgery, Sam, which is clearly operation and then they have torpedo, which is clearly battleship, but also, as someone who loves board games, there’s a board game called Torpedo Run, which is like a rubber band disc shooting board game where you physically shoot discs across a flat plane to physically blow up people’s... Like the boats actually explode. They’re on little like rubber band like target. I don’t know how to explain it. But if you have the means, you should play Torpedo Run. You should immediately play. It’s one of the best games ever. I was hanging out with my friend Jeff earlier today. He just had a baby shower. Congratulations, Jeff. But that’s a game we used to play at his house. And it is like one of those games where everything is happening physically. And I saw that Torpedo thing and plus the ship theme, and I was like, “Oh, really Torpedo Run, and then later it’s clearly battleship.” But also, you should play Torpedo Run.
Johnny Kolasinski: 31:31 If you play Torpedo Run, you should watch midsummer.
Dr. Greg Winter: 31:34 And you should watch midsummer.
Dr. Jackson Vane: 31:36 This will all make sense if you listen to our podcast. The one thing I did notice that was kind of gross was when Bob cut his hands and he was trying to comfort Tina and just kept patting her on the head. I mean, this is one of the few times in this episode where there was not enough blood.
Dr. Jackson Vane: 31:52 That’s at the end of the episode, Jackson was like, “I think there was just too much blood.”
Johnny Kolasinski: 31:57 Yeah.
Dr. Jackson Vane: 31:58 It is always my complain.
Johnny Kolasinski: 31:59 I’m running theme of the podcast is that there’s not enough blood in any movie or episode of television that we watch.
Dr. Jackson Vane: 32:05 There is a lot of blood later on in this episode.
Johnny Kolasinski: 32:12 And the reason for that is that when Bob goes to the hospital, he is
Dr. Jackson Vane: 32:18 I think it was cute that they said, “Oh, we’ll be back in an hour going to an emergency department.”
Dr. Greg Winter: 32:22 That’s funny. I mean, if you went to an emergency department where you were the only patient, maybe then you would be. It maybe you’d be back.
Dr. Jackson Vane: 32:30 That’s still pushing.
Dr. Greg Winter: 32:31 Yeah, that’s how I thought.
Dr. Jackson Vane: 32:32 You got registration. You got to get those discharge papers.
Dr. Greg Winter: 32:36 But it was sort of a good view into... Like the emergency room is for emergencies. And did Bob cut his hand? Yes. Was it a bad cut? But I mean, even if it was a bad cut, like, is that actually an emergency? And it maybe. I don’t want to say it wasn’t. But often what we see, especially in the US is that the things in the emergency room are things that are certainly hurting you and not great. But is it an emergency? And part of an emergency room doctors job is to like sort of triage that and say, “Is this actually an emergency? Like, is this something that’s going to kill you? Is this a thing that you can go home with and figure it out later?”
Dr. Jackson Vane: 33:19 Thank you for describing my job.
Dr. Greg Winter: 33:21 Oh, Jackson is here. I’ll let him talk about it.
Dr. Jackson Vane: 33:23 What Greg said, basically....
Dr. Greg Winter: 33:25 That’s right. I said it better. I think that’s a really big problem, or that’s a really big issue with where we’re at in US medicine, which is, most people don’t have access to the type of care that they need, where like these things happen, where you have a thing that acutely happens, and all you can do is go to the emergency room. At the same time in the emergency room, someone has been shot, someone has been stabbed, someone is really, really sick with some sort of communicable illness. That’s the guy...
Johnny Kolasinski: 33:55 That’s all just one guy.
Dr. Greg Winter: 33:56 Yeah. Right. That’s like all that stuff can happen. And it’s like, is your cut on your hand really an emergency. And it may be an emergency to you, but is it an emergency in the grand scheme of things, which for a doctor is easy to say for someone that’s going through it it’s a little bit harder to evaluate. It’s just...
Dr. Jackson Vane: 34:15 And it’s one of those really hard things to explain to families is, “Hey, I got here before that person, why are you seeing that person before me?”
Dr. Greg Winter: 34:22 Because that person has an emergency.
Dr. Jackson Vane: 34:24 And we try to explain that all the time that it’s not based on time, it’s based on acuity. And I find it surprising how fast Bob got in with his little cut, because he went in before...
Dr. Greg Winter: 34:35 And most of the people just had coughs though.
Dr. Jackson Vane: 34:37 No, there was dangle arm guy. Dangle arm guy should have went in real quick
Dr. Greg Winter: 34:41 But you know he’s going to the OR. They’re waiting for the orthopedics to come in.
Dr. Jackson Vane: 34:45 They’re gonna cast that in though.
Dr. Greg Winter: 34:46 And they are not casting a double 90-degree angle, dangle arm.
Dr. Jackson Vane: 34:54 We do that all the time. We set it under sedation, and then cast it.
Dr. Greg Winter: 35:02 I mean, that guy’s going to the [unclear 35:04].
Dr. Jackson Vane: 35:06 Fair enough.
Dr. Greg Winter: 35:08 Also not an ER doctor. I think I’m going to come this before.
Dr. Courtney Nicholas: 35:11 We literally have a sign and a labor and delivery waiting room that says, “This is a triage situation. People will not necessarily be seen in the order of arrival. Get us posted up in the waiting room.”
Johnny Kolasinski: 35:23 And I’m guessing people read that sign just as frequently as they read the “Please wash hands in the bathroom.”
Dr. Jackson Vane: 35:28 Correct. I also made this other note, this happened at noon and we know this happened at noon. Because it was right before the lunch rush.
Dr. Greg Winter: 35:39 Just before gambling, it gets real busy.
Dr. Jackson Vane: 35:41 It is. That is the busiest ER I’ve seen at noon on a random day. I know it was fleet week. But still, I did not see all sailors in there.
Dr. Greg Winter: 35:51 What is [unclear 35:52] Week?
Dr. Jackson Vane: 35:55 North Chicago.
Dr. Greg Winter: 35:56 I’m just giving you ish, that is all right.
Dr. Jackson Vane: 35:59 I can say “ish”, right?
Johnny Kolasinski: 36:00 You can say “ish”.
Dr. Courtney Nicholas: 36:03 Johnny, I’m so glad you’re here.
Dr. Jackson Vane: 36:05 You’re wrangling all of us and keep aerating us all. And I should say. I do want to talk about like the reason why we picked this episode was newbie doctor. But I’ll let you set that up.
Johnny Kolasinski: 36:18 So the doctor that they’re seeing was a baby doctor, but the doctor that we were seeing was a baby doctor, but not like Courtney’s a baby doctor, but a doctor who was a baby.
Dr. Courtney Nicholas: 36:30 I have had to make that distinction before as well.
Dr. Greg Winter: 36:32 No, I mean, baby doctor.
Dr. Jackson Vane: 36:34 Do you know...
Dr. Courtney Nicholas: 36:34 I mean, I’m a doctor. I do baby stuff.
Johnny Kolasinski: 36:38 Yeah. And so he was a resident who had...
Dr. Jackson Vane: 36:40 I do for work, not for fun.
Dr. Greg Winter: 36:44 Okay.
Johnny Kolasinski: 36:44 Moving on. So he was a resident that was without his attending for the first time that day, correct?
Dr. Jackson Vane: 36:56 I mean, that’s how they saw that. Yes.
Dr. Courtney Nicholas: 36:58 Is that accurate?
Dr. Jackson Vane: 37:00 No.
Dr. Greg Winter: 37:00 Yeah, no, you are incorrect, Jackson. All of us had a day where we no longer had an attending,
Dr. Jackson Vane: 37:06 We still have to sign off in the emergency department or you still need to have an attending sign off, if you want to get paid for that patient.
Dr. Greg Winter: 37:13 That’s very different.
Dr. Jackson Vane: 37:15 It is a different thing. But there is...
Dr. Greg Winter: 37:17 Johnny, I’m sorry. I will be honest with you. Yeah, you know what the doctor that you have, at one point, had somebody immediately supervising them, and then another day they didn’t. And so that is a very real thing, where at some point, that doctor had a first patient where it was their responsibility completely for the first time.
Johnny Kolasinski: 37:39 Are they generally young enough to be texting their mom about it.
Dr. Greg Winter: 37:43 People still ask me what my age is, and I don’t think I look young. There’s some other issues wrapped up in there. But it’s one of those things where like, you know what, as you get older, and you get sicker and have more health problems, the people taking care of you are younger and younger. I mean, it’s just the nature of the...
Dr. Jackson Vane: 38:02 Have someone offered to breastfeed your face.
Dr. Greg Winter: 38:05 I would let Tina Boucher breastfed my...
Dr. Courtney Nicholas: 38:07 Is that happen to you?
Dr. Greg Winter: 38:08 No, but that’s happen to Tina Boucher.
Johnny Kolasinski: 38:09 Linda, Linda Boucher.
Dr. Greg Winter: 38:10 Not Tina. Oh, no, don’t cancel me. Linda, I meant Linda. But I mean, like, yes, you know what, just like any other profession, those people are being trained. Not everybody starts out as an expert. In fact, doctors are going to get things wrong. The good doctors are the people that are going to be able to admit that and also work through those solutions with you.
Dr. Jackson Vane: 38:32 The good doctor?
Dr. Greg Winter: 38:34 Not the good doctor. The doctors that are good people and can understand how to communicate are the people that are going to be like, “Hey, this was wrong. I did something incorrect, or we didn’t have all the perfect information.” I think that this show sort of did it in a way that was very human because like that doctor was not trying to play it up. That it was his first day, but Linda called him out on it. And also Linda is a mom and can appreciate like, “Oh, this is a huge milestone for somebody. I’m trying to celebrate it. But also this person is trying to be professional. Also, this person who’s in the ER should know how to sew finger.
Dr. Jackson Vane: 39:12 If you don’t know how to sew and your attending is out there, that attending let them go to sew.
Dr. Greg Winter: 39:18 Yeah. Oh, also Jackson. You don’t look that up in the room with the patient.
Dr. Jackson Vane: 39:23 No.
Dr. Greg Winter: 39:24 You’re kind of outside of the room.
Dr. Jackson Vane: 39:25 Yeah. You go to your desk, and you pull it up on YouTube at your desk. And then you come back and go, “I got it. Let me have my nurse get all my supplies. And I’ll be back.”
Dr. Greg Winter: 39:34 Yeah.
Johnny Kolasinski: 39:35 You go to the restroom. You look it up. You wash your hands.
Dr. Greg Winter: 39:38 You flop sweat and vomit. And then you go back and you go sow it up.
Dr. Jackson Vane: 39:42 You don’t just go randomly, “I’m gonna go inject it you a [unclear 39:45] and then I’ll figure it out afterward.”
Dr. Greg Winter: 39:47 I mean, I think in a very real way like all of us have done a lot of these things that we are called upon to do. We don’t necessarily have done them many, many times, but I think that in a situation like this, if it was something that you didn’t feel comfortable with, you always feel comfortable with going to your colleagues and being like, “Hey, there’s a thing I need to do. Can you help me do it?” And I mean, that really happens. And part of medicine is kind of having those relationships with people that you can ask to be like, “Hey, this is my patient, but I can’t do the thing that’s being asked. Like helped me do it.”
Dr. Jackson Vane: 40:23 That’s a constant thing in the emergency department too. Because like, it’s really rare when you’re like the sole provider. And there’s always someone else. And I’m actually working in a very tiny emergency department. So bouncing ideas off, “Hey, can you look at this x-ray? Hey, I don’t know how to do this one thing.” That’s a very common thing to do.
Dr. Courtney Nicholas: 40:41 No, basically, it prepares you to interpret what you see on Google. I’m serious. Like you can’t remember all of it.
Dr. Jackson Vane: 40:49 No, you’re never gonna remember I have.
Dr. Courtney Nicholas: 40:51 I used to have my residents and fellows, YouTube, any procedure they were gonna do before and I want them or watch a video before they did it. And if I haven’t done a procedure in several years, I ask a little bit of time than I absolutely will.
Dr. Jackson Vane: 41:02 But up to date is for?
Dr. Greg Winter: 41:04 Several, a little bit of time.
Dr. Courtney Nicholas: 41:06 Several years, but they’re really several years.
Dr. Jackson Vane: 41:10 From a medical critiquing standpoint, his suturing was horrible.
Dr. Greg Winter: 41:14 Yeah.
Johnny Kolasinski: 41:14 Why is that?
Dr. Jackson Vane: 41:15 Well, A) He wasn’t wearing gloves. B) He was just kind of using a straight needle and sewing a bunch. Usually, if I ever saw a finger crotch laceration, I glue those.
Johnny Kolasinski: 41:27 Yeah, it needs a little bit think you’re cracking laceration is my mouse rat cover band, by the way.
Dr. Jackson Vane: 41:32 That’s a good name.
Dr. Greg Winter: 41:33 But that’s a great name that a mouse wreck.
Dr. Jackson Vane: 41:35 That is a great name. But yeah, usually what I’ll do is I’ll put like a steri strip, which is almost like a band aid, and then I’ll glue over it just to give it a little bit more tensile strength. And that’s it. That’s all you really need to do to hold it together and most cuts on your finger, unless it’s massively deep in, or there’s exposed bone or whatever, you can get away with suturing.
Dr. Jackson Vane: 41:55 I’m sorry, what gluing?
Dr. Greg Winter: 41:57 I think part of it... I mean, that’s maybe the takeaway of the episode is like, if you don’t really know what’s going on, or especially if something goes wrong with your medical management, that’s when you have somebody else step in and be like, “Hey, give me another opinion.” What do you think I should do?
Dr. Jackson Vane: 42:16 There should be an attending in the house.
Dr. Greg Winter: 42:18 Right. And I mean, but also, he’s an attendee... At some point. You’re the attendee.
Dr. Jackson Vane: 42:22 Yep.
Dr. Greg Winter: 42:22 But that doesn’t mean, you can’t ask for help.
Dr. Jackson Vane: 42:26 Yeah.
Dr. Greg Winter: 42:26 And there are hospital systems where asking for help is not good. I think that sort of thing is shifting differently because people are more used to working in teams and more used to not feeling bad if they don’t know something, because information is available.
Dr. Jackson Vane: 42:42 Yeah.
Dr. Greg Winter: 42:42 So like, why just put your foot down and be like, we’re doing it this way when you can literally look on YouTube and be like, “Yeah, I can use superglue. And this maybe would come out better.”
Dr. Jackson Vane: 42:54 I had former trainees that still call me.
Dr. Greg Winter: 42:56 Don’t use superglue.
Dr. Jackson Vane: 42:57 No.
Dr. Greg Winter: 42:58 Please don’t.
Dr. Jackson Vane: 42:59 But also have former trainees call me at my hospital asking for advice when the other hospital.
Dr. Greg Winter: 43:05 Who calls you?
Dr. Jackson Vane: 43:06 How dare you?
Johnny Kolasinski: 43:10 So what is the difference between a resident and attendee and a fellow?
Dr. Jackson Vane: 43:19 Technically July 1.
Dr. Courtney Nicholas: 43:20 My family used to ask me this question and I’d compare myself to different characters on Grey’s Anatomy, but... basically, everyone does medical school in this country does medical school and you kind of learn everything and then you pick which area you want to you’re interested in and you do a residency. So that’s one step above medical school and it specializes you and get you certified into an area like internal medicine, or pediatrics, or general surgery. From those areas. If you want to specialize further you go into a fellowship. So my fellowship was neonatology, Greg’s was hospice care.
Dr. Jackson Vane: 43:42 Mine was pediatric emergency.
Dr. Courtney Nicholas: 43:57 Jackson was pediatric emergency. And so it’s basically a fellowship is a specialization in your general area of medicine. And then from there, you become an attending, which means you’re in charge. And if bad things happen, you’re in trouble.
Dr. Greg Winter: 43:59 I mean, you can become an attending before specialization.
Dr. Courtney Nicholas: 44:13 Yeah.
Dr. Jackson Vane: 44:14 Scholarship is an optional step.
Dr. Courtney Nicholas: 44:16 Absolutely.
Dr. Jackson Vane: 44:17 So that’s the big thing.
Dr. Courtney Nicholas: 44:18 And it used to be even a residency with an optional step. I think you could be a general practitioner, straight out of medical school.
Dr. Greg Winter: 44:31 I think, that’s right.
Dr. Jackson Vane: 44:41 I was like 20 years ago.
Dr. Greg Winter: 44:27 It is important to understand that it is called a practice of medicine. And also things are done differently in different areas of the country, despite the fact that there is like a, hey, this is what you should do. It’s not always the thing that is done everywhere. And also it’s not always the thing that is appropriate to be done everywhere. There is some I don’t want to say art to it. I just want to say there is a stylistic approach and part of that is also on the patient side, it doesn’t matter what your doctor says. If you don’t listen to what your doctor says so you have to have a relationship with your doctor that matters in a way that you’re going to act on. I mean, somebody can be the smartest doctor ever. I mean, look at house, right? I mean, that’s what the entire house show is based on it is this guy that is always right. But also he’s a jerk. And no one ever listens to him, because he’s a jerk. And so you have to be able to present that information about, I mean, maybe not necessarily being right. But say, Hey, this is the direction we’re going to go in working something up or looking something up. And you have to go along with me on that kind of journey, as opposed to just being like, Hey, you do this. And if you didn’t do that, well, then you’re wrong. And you’re gonna die. I mean, we’re all gonna die. So you got to find someone that’s going to help you not die in a horrible way. Or today, which is my job.
Dr. Courtney Nicholas: 45:54 Building the trust.
Johnny Kolasinski: 46:00 Got it.
Dr. Jackson Vane: 46:05 Can I mention the drive home?
Johnny Kolasinski: 46:07 Yeah.
Dr. Jackson Vane: 46:08 [Unclear 46:08]
Johnny Kolasinski: 46:10 So they leave the hospital. And then he’s bandaged everywhere.
Dr. Jackson Vane: 46:14 Yeah.
Johnny Kolasinski: 46:15 And shaved everywhere.
Dr. Jackson Vane: 46:16 Yeah. Because they wanted to look for more cuts which...
Dr. Greg Winter: 46:20 I mean, look I appreciate. She’s...
Dr. Jackson Vane: 46:23 She’s really trying to back them up.
Dr. Greg Winter: 46:25 She’s just very proud. She’s a proud mom.
Dr. Jackson Vane: 46:28 She is a very proud mom.
Dr. Greg Winter: 46:30 She wants Jean to be a doctor one day and he’s not gonna...
Dr. Jackson Vane: 46:32 He is not. It’s just a girls being girls.
Dr. Greg Winter: 46:37 Jean makes me laugh. So...
Dr. Jackson Vane: 46:38 Jean is probably my favorite one on that show. But him looking under... there was already too much blood oozing out from using the whole roll of gauze on his hand. And then when they opened it up and just sprayed everywhere, there’s no, I don’t think there’s any high pressure artery in a finger crossed.
Dr. Greg Winter: 46:57 There is... but it wouldn’t be a sudden, like it would have been bleeding like that before.
Dr. Jackson Vane: 47:01 Yeah.
Dr. Greg Winter: 47:02 Unless he nicked it while he was sewing it, which would have been bad.
Dr. Jackson Vane: 47:05 But also, it should have been bleeding during that time, too. Right. But he sprayed it all over the place, and then ultimately decided to use that hand to play rock paper scissors too, that was a good scene. That was when I think I looked at Greg and I said, you know what? Too much blood?
Dr. Greg Winter: 47:23 A little too much.
Johnny Kolasinski: 47:24 Even if he had reopened that injury...
Dr. Jackson Vane: 47:28 It wouldn’t spray. It was drip.
Dr. Greg Winter: 47:31 I think you see it when it first happens. You see kind of losing it could be it’s the hand. The hand has a lot of it is very vascular.
Dr. Jackson Vane: 47:39 I will say this, his hand should bleed just as much as when he had his initial injury.
Dr. Greg Winter: 47:43 Right. That’s what I was saying. Yeah. So shouldn’t suddenly be spurting out unless the doctor did something weird, which is possible.
Dr. Jackson Vane: 47:51 I mean, he was not doing anything. Right. And as Linda said, it looked like the 70s bush.
Dr. Courtney Nicholas: 47:57 If the injury extended.
Dr. Jackson Vane: 47:58 Yeah. If the injury extended, it would explain why he was in the whole role of gauze. Just...
Johnny Kolasinski: 48:07 What do you mean by extended?
Dr. Jackson Vane: 48:08 Like if he cut down deeper.
Dr. Courtney Nicholas: 48:09 Deeper.
Johnny Kolasinski: 48:10 Okay.
Dr. Jackson Vane: 48:10 He made those tiny cut into a much bigger cut. Which could happen? [unclear 48:15]
Dr. Greg Winter: 48:16 Especially if you’re gonna throw them scissors.
Dr. Jackson Vane: 48:19 Yeah. But sometimes you do need to actually extend the cut to get information. Yeah. Cut undermining. So it happens sometimes, but it’s rare. It’s a really rare thing to do. Usually, it’s like super jagged. And you can’t approximate while so you actually cut a little bit to tension off and then you’re able to reattach or re approximate the cut well. But it’s very rare when you need to do it.
Dr. Greg Winter: 48:45 I would agree that it’s very rare, if you are not a plastic surgeon, you should not be extending a cut in order to sew it up.
Dr. Jackson Vane: 48:52 No. I did it once.
Dr. Greg Winter: 48:55 That sounds about right.
Dr. Jackson Vane: 48:56 With the plastic surgeon right next to me. But that’s the rare situation.
Johnny Kolasinski: 49:04 Is there anything else we want to cover on this episode specifically?
Dr. Greg Winter: 49:10 I was gonna ask. Do you guys remember your first patient?
Dr. Courtney Nicholas: 49:14 First patient as a real doctor? After residency?
Dr. Greg Winter: 49:19 After residency?
Dr. Jackson Vane: 49:20 Yes.
Dr. Courtney Nicholas: 49:22 19 minutes into my being a doctor. They brought my first patient in getting chest compressions as they were running towards me in the room.
Dr. Greg Winter: 49:31 Courtney has a real job.
Dr. Jackson Vane: 49:34 My first real patient was a three-year-old that the mom said that he had seizures. It was in a clinic. And then I went back and I was so excited saying like I have a kid who’s really sick has seizures. And the first thing my attending goes was did he hit his head or get his toy taken away and then started crying. I’m like, it’s not a real seizure.
Dr. Greg Winter: 49:54 It’s not a real seizure.
Dr. Jackson Vane: 49:55 And I was real bummed about it. It was a breath holding spell. That was my first patient.
Dr. Greg Winter: 49:59 I don’t remember my first patient. I remember my first patient that I had like a sit down long discussion with because I no longer was being charged by, or I was not billing by the patient. I was salaried. And so this lady was explaining to me, she had brought her mom with her and her mom had all these weird ideas. And her mom watched Dr. Oz all the time. And I was just like, what, let’s just sit down and talk about Dr. Oz. And that’s what I remember being able to sit down and explain what it means to be a physician also what it means to be a snake oil salesman.
Dr. Jackson Vane: 50:35 It’s a good game.
Dr. Greg Winter: 50:36 It was also just like a nice conversation and it’s also what that lady needed. She didn’t really have anything wrong with her. It was more just hearing nonsense that was sort of against what a reasonable thinking person would think. Except for it. That’s what she listened to all day long. So it was just a very interesting, like, I remember specifically her daughter being like, Oh, well, you have to leave in 15 minutes. And I was like, actually, No, I don’t. And I pulled up to the chair out and just sat down. And we chatted for like, a half an hour.
Johnny Kolasinski: 51:08 And so that situation changed because you were salary. And so you weren’t kind of held to the same level.
Dr. Greg Winter: 51:14 I mean, in truth, I’ve never been in a situation where I felt that I was like, Oh, I better I have to leave it just like that was a very specific, like, I can leave this room, or I can sit here and talk to this person, because that’s the thing that they need. They need to actually like...
Dr. Jackson Vane: 51:30 Okay.
Dr. Greg Winter: 51:32 They really need to work out this thing that they’re going through. And if I dismiss them, it will only reinforce the things that they already think. So it was nice to just be able to sit down and talk with them.
Johnny Kolasinski: 51:49 With that, we’ve just got a couple minutes left, but we generally end the podcast with the same important question. And that’s the Human Centipede...
Dr. Jackson Vane: 51:59 We all made scrunchie face at that time.
Dr. Greg Winter: 52:03 [unclear 52:02] the Human Centipede builds itself as 100% medically.
Johnny Kolasinski: 52:07 We should.
Dr. Jackson Vane: 52:08 I mean one day.
Johnny Kolasinski: 52:09 The horror film “The Human Centipede” marketed itself as 100% medically accurate and ready to go episode by episode. If that’s the case, and if that’s our baseline, how medically accurate first was Parks and Rec, Season five, Episode 13, emergency preparedness? We’ve just got a couple minutes on this.
Dr. Greg Winter: 52:17 I would say 150. I mean, it’s more accurate than the Human Centipede. It’s also not super accurate. I don’t think they would do that type of scenario in a government building, but I’ve seen similar, I definitely saw that scenario in med school, but med school doesn’t matter. But...
Dr. Jackson Vane: 52:51 I mean, I’m gonna say 120 solely based on Jones hangover.
Dr. Greg Winter: 52:57 No planking.
Dr. Jackson Vane: 52:58 No playing but still more medically accurate than the Human Centipede. Yeah.
Dr. Courtney Nicholas: 53:03 I’m gonna go with 127.
Dr. Jackson Vane: 53:04 Okay.
Johnny Kolasinski: 53:08 All right. Same question different network.
Dr. Jackson Vane: 53:11 Yeah.
Johnny Kolasinski: 53:13 How medically accurate if the Human Centipede which bills itself as 100% medically accurate is our baseline how medically accurate was Bob’s Burgers, Season three, Episode 20, the kids run the restaurant.
Dr. Jackson Vane: 53:29 This one’s tougher.
Dr. Greg Winter: 53:31 I actually recall those awkward moments as you’re sort of trying to figure out how you are going to be a doctor.
Dr. Jackson Vane: 53:40 Yeah.
Dr. Greg Winter: 53:42 And also, I’m still going through those awkward moments. So I mean...
Dr. Courtney Nicholas: 53:47 Get a t-shirt with that on it.
Dr. Jackson Vane: 53:47 Doctor Puberty.
Dr. Jackson Vane: 53:46 Doctor Puberty.
Dr. Greg Winter: 53:51 The name is Dr. Puberty. Call me doctor. Mr. Puberty is my dad.
Dr. Courtney Nicholas: 54:02 180%
Dr. Jackson Vane: 54:03 180, I think that’s good. I was gonna say 200.
Dr. Greg Winter: 54:08 I’m gonna say 187.
Dr. Jackson Vane: 54:10 There we go?
Dr. Greg Winter: 54:11 Why not?
Johnny Kolasinski: 54:12 For those who don’t listen to the podcast, Bob’s Burgers is actually currently our highest scoring series with 450% for the episode where everyone gets pinworms.
Dr. Greg Winter: 54:23 Yeah.
Dr. Jackson Vane: 54:23 I mean, that was real legit. Like those, there were some itchy itchy people.
Dr. Greg Winter: 54:29 Did they do the tape [unclear 54:30]
Dr. Jackson Vane: 54:31 They didn’t.
Johnny Kolasinski: 54:33 It came up and like not quite a 400%.
Dr. Courtney Nicholas: 54:37 I’d make it five%.
Dr. Greg Winter: 54:38 Yeah.
Dr. Jackson Vane: 54:38 You don’t need to do the scotch tape test. You just need to see things crawling out.
Johnny Kolasinski: 54:43 Alright, well, with that we kind of have to wrap it up because I’m grossed out.
Dr. Greg Winter: 54:47 [unclear 4:46] Jackson.
Johnny Kolasinski: 54:50 So thanks, everybody for checking us out. If you want to learn more you can find us like I said at www.hieverybodymd.com or at hieverybodyMD on all your favorite social media platforms as long as their Facebook, Instagram or Twitter.
Dr. Greg Winter: 55:07 Also, you should call the doctor number.
Johnny Kolasinski: 55:10 Yeah. 530-DOCTORB.
Dr. Jackson Vane: 55:11 530-DOCTORB.
Johnny Kolasinski: 55:13 Give us a call. And thanks everybody for joining us for this. Thanks everyone who’s watching at home. Hopefully, we can see you at San Diego Comic Con or at wondercon 2022.
Dr. Jackson Vane: 55:26 Thanks so much.
Johnny Kolasinski: 55:27 Bye, folks.
Dr. Courtney Nicholas: 55:28 Bye.
Dr. Greg Winter: 55:28 Thanks. Bye.