- I've officially finished watching The Last Of Us.
I played the game, really enjoyed it.
But there's a lot of medical stuff
that we have to talk about.
This is not just a live reaction.
I planned this out
into four categories of things we have to cover.
This is going to be a wild ride.
Let's get ready to have some fun, guys.
Be whoop.
All right.
There's first aid, but like I said,
this is the worst first aid.
We got a couple of scenes here pulled up
where I think there are just glaring examples
of problems, starting with the first episode.
- Sir, we are not sick.
(gunshots)
(man grunts)
(child gasps)
Okay, you're okay.
- All right, so she's breathing fast.
That means she's not getting enough oxygen.
So the body's responding by increasing the pulse,
increasing cardiac output, and trying
to increase the breathing rate
to try and get more oxygen.
- I know, I know, I know, I know, I know.
- So he's trying to apply pressure.
This is the right thing to do in a scenario like this,
'cause she is breathing, she does have an open airway,
but in reality, moving a person like this
is now creating more harm than good,
'cause you're not actually helping them in any way.
- Baby, baby, listen to me, I got to get you up.
- Getting her up is only going
to make the bleeding worse, faster.
Given how much blood has come out
in this short, 30-second interval,
you can already predict how much more
is going to come out and as a result,
you know that she's not going to make it.
That's why in a wartime situation,
if you were to see an injury like this,
it would be about getting the morphine out,
not helping the soldier.
Oh, this scene drives me up a wall.
My guy doesn't know yet that she's bit,
and he's trying to create some sort of ankle brace for her,
but he ends up wrapping her foot.
Like, what are you wrapping here?
Like, at least puts something stiff
on either side of the ankle, so it doesn't re-roll.
Instead he, like, double wraps the foot.
Like, it doesn't help anything.
You got to add the stability to the ankle,
because when you have an inverted ankle injury,
what ends up happening is, you can damage
the ligaments on the outside of your ankle,
usually the anterior talofibular ligament.
And as a result, your ankle is very loose and unstable.
What I would've done is find some piece of wood,
like, there's wood and materials all around them,
and take two little sticks, and put it on either side
of the ankle, so that the ankle gets extra stability.
In fact, some of the best braces that I recommend
to my patients are ones that have,
like, little metal inserts on the side
that literally prevent your ankle from rolling side to side.
It allows your ankle to have motion, like this.
Plantar flexion and Dorsiflexion,
but not Eversion/Inversion.
Boom, wooden bat gets hit, he pushes the guy,
but then he's going to realize the baseball bat
that broke off on the tree is now in his abdomen.
Potentially the worst thing you can do is, without thought,
pull out the object that's been stabbed into you.
Hey, this object is jagged.
So as a result, pulling it out
is going to create more damage.
Just like most knives,
and other things that get inserted into you.
On top of it, you don't know if it's putting pressure
on a blood vessel, and preventing you from bleeding out,
and my guy, right there, pulls it out.
Bad move, bad move.
A lot of blood's going to come out, he's going to pass out.
And the reason why he starts passing out quickly is 'cause,
due to the loss of blood, your blood pressure drops,
and you're not getting enough circulation to your brain.
So you lose balance.
Okay, she found some thread.
Very classic scenario here, okay, she has this,
first of all, extremely dirty towel,
which is bothering me so much,
'cause she's just festering that wound
with massive bacteria, and then she's going
to suture the wound.
This is what I find ridiculous in these shows,
because remember, he was stabbed internally,
so he's bleeding internally.
Her closing off the wound is only closing off
for the bacteria to be trapped inside of there,
and not really stopping any bleeding,
'cause he's bleeding internally from his intestines,
his organs being damaged.
So she's not helping him out at all,
with a situation like this.
She's closing a dirty wound, which is something we don't do.
Okay? She got her self some penicillin.
And she obviously doesn't know
how to give him the penicillin.
Also, this is an IV dose of penicillin,
or IM dose of penicillin,
so she just, kind of, ends up
spraying it at him, into his wound.
So there's basically four ways you can give a medicine.
You can give it orally,
you can give it topically, like skin coverage.
You could also give it IM,
which you inject it into a large muscle group.
Think about EpiPens.
And then, last but not least,
you could give it subcutaneously,
which is in the superficial portion of the skin.
Oh, and through an IV, obviously, directly into blood.
Like, if I was her, and I wasn't sure,
I would probably just stab it in his butt.
And I know that sounds funny,
but at least that's an IM form of the dosage
that you know it's going to get well absorbed,
and then travel systemically throughout the body.
Obviously doing it IV is the best way,
but that's, kind of, hard to ask, in a situation like this.
Joel is officially superhuman in this series.
It starts with this scene.
Yep, classic fight scene.
He's getting hit.
This is the worst place you want to find yourself
in a battle like this,
because all the other person's weight is on top of you.
You put pressure on these carotid arteries for just
a matter of seconds, the person loses consciousness.
In fact, here's a strangulation reference guide
from the city of New York that says only 11 pounds
of pressure, placed on both carotid arteries,
for just 10 seconds, is necessary to cause unconsciousness.
And just four pounds of pressure on the jugular,
for 10 seconds, is necessary to cause unconsciousness.
That's because the jugular vein actually
prevents outflow of blood from the brain.
And if you block it, you actually have a buildup
of blood in the brain, also causing a loss of consciousness.
All right, so this is the part where Joel's running away.
We're bringing this scene back.
Okay, he's fighting the guy.
Great, first of all, I already know he has a bat into him,
but the fact that he chokes this guy for three seconds,
and then, does this weird motion, this,
this does not destroy someone's neck.
He doesn't even position him in a unique way.
He moves his whole body around,
and somehow, they create a cracking sound.
What did he do?
Did he crack his vertebrae?
Did he crack his trachea?
Even then, the guy would be laying on the ground choking,
but instead, it looks like this guy
just cut off all circulation to his brain.
He decapitated him, with his ever mighty grasp
on his neck, and obviously, off his fresh wound,
freshly surgically closed by expert Dr. Ellie,
he's fighting, wrestling people.
My guy's hemoglobin hasn't recovered, he's still anemic,
walking, for patients like this,
they'll get short of breath,
and yet my guy is wrestling out here.
Like, literally, there's a level of deconditioning
that happens after an infection, after a blood loss,
that you're not able to do things like this.
- I don't know any girl.
- This was an interesting scene.
Basically, Joel sticks the knife, what looks like
through the guy's femur, and/or kneecap and/or tibia,
ladies and gentlemen, you cannot just,
after being sick and anemic, and going into shock,
with a knife, stab through someone's bone!
And first of all, getting stabbed into the quad muscle,
there's probably the most painful area to get stabbed.
There's so many nerve fibers, loss of circulation,
lots of blood loss.
But wow, the fact that he just
went right through his bone is impossible.
Stun grenade.
These types of stun grenades create
such a concussive effect on our brains
that they shake us up.
And in a scenario like this, where he was just injured,
falling on his wound, not being fully recovered,
he's not getting up from this for days.
It's like getting the second concussion in sports,
that I always tell you about, is the worst.
And now, he got hit again, in the head.
He's not waking up for weeks at a time,
not without major symptoms, at least.
Next section is called Cordyceps Is No Fun, Guys.
It's my little play on it,
because it is a fungi, but it's no fun, guys.
- And just to be clear, you do think
microorganisms pose a threat?
- Oh, in the most dire terms.
Fungi seem harmless enough.
Many species know otherwise, because there are
some fungi who seek not to kill, but to control.
- It's actually true that fungi exist
in the millions in our ecosystems,
and yet, there's only few of them that have adapted
in order to evade our own immune systems,
in order to tolerate the high temperatures
that the scientist is about to talk about.
- Fungal infection of this kind is real, but not in humans.
- True fungi cannot survive if it's host's internal
temperature is over 94 degrees, and currently,
there are no reasons for fungi to evolve
to be able to withstand higher temperatures.
But what if that were to change?
What if, for instance,
the world were to get slightly warmer?
Well, now, there is reason to evolve.
- I think it's important to think through these scenarios.
As scientists, I wouldn't present this as a leading threat
to our lives, because there are so many things
like these mutations that could happen,
in certain scenarios, that would be absolutely devastating
to the human race, that talking about it
on a daily basis would just yield so much anxiety
that would ultimately harm us, for sure,
as opposed to the chance of these things happening.
- Fungi can alter our very minds.
Fungus starts to direct the ant's behavior,
telling it where to go, what to do,
like a puppeteer with a marionette.
- It's also true that fungi, technically met,
most of them would be weeded out
by our own internal immune systems.
But there are situations where immune systems are weakened.
That's actually the majority of times
when fungal infections happen in humans,
at least the devastating ones.
And then, on top of it,
modern medicine has created some medications
that we actually need to treat certain conditions,
that also weaken our immune systems,
that allow for opportunistic infections.
- Puppets with poisoned minds, permanently fixed
on one unifying goal: to spread the infection
to every last human alive, by any means necessary.
And there are no treatments for this.
No preventatives, no cures, they don't exist.
It's not even possible to make them.
- I don't know why he says there are no treatments
for fungal infections, 'cause they do exist.
So I'm sure he is making a point
that I'm just not, sort of, wrapping my head around.
But we do have medications for fungal infections.
The one thing that I will say is accurate about this
is they show the bite here,
and then they show little red bumps far away.
These are called satellite lesions, and those are,
sort of, part of what we see on a fungal infection of skin.
So that is realistic.
- Take your bandage off.
- This is where we see her immunity.
- Joel, this is real.
- The question is though, how is she immune?
Is it her blood type?
Is it previous exposure, some medication that she got?
They have no idea.
Well, this is Ellie being born.
We fast forwarded quite a bit here.
This scene also didn't happen in the game, which is unique.
They, kind of, added a prequel of what happened before,
kind of, giving us some insight, potentially,
as to how Ellie is immune.
So you have a pregnant mom, delivering a baby,
by herself, in a really dirty, non-sterile environment,
while fungi-infected zombies are running around.
(grunts, moans)
- Ooh, brutal fight sequence here,
you're also fighting for the baby.
We see that the mama bear gave birth to Ellie
while fighting, probably from bearing down
during the contraction.
You also see simultaneously,
that mama bear here has been bitten by said infected zombie.
And mom is still connected via the umbilical cord to Ellie,
therefore potentially spreading a small amount
of particles of this infection to the baby.
She cuts it rather quickly.
But there is a possibility that Ellie was just
slightly exposed to this type of fungal infection.
So if you have a a mild, small exposure of fungi,
that can't hurt you.
Maybe you could build up an adaptive immunity to said fungi.
Not proven yet, but it's a theory.
Now we got to fact check the actual medicine
that we're seeing in the show.
- I'm exhausted.
Goddamn it, you're-
- Back in bed.
- I promise you, I'm going to stay up.
- Why?
- Because this is my last day.
- What he's talking about here
is basically medical aid in dying.
For example, in New Jersey, where I work, we have programs
that, after meeting all the requirements, making sure
that you've met with the proper mental health folks,
that you've been judged by doctors to make sure
that you actually have a short lifespan,
and that your condition is irreversible,
that you can receive medical aid in dying.
It's part of compassionate care, and end of life care.
Frank looks like he probably has MS,
maybe ALS, also known as Lou Gehrig's disease.
They're actually quite similar neurodegenerative diseases.
But the things that they attack
in our nervous system is different.
For example, in MS this is an autoimmune condition
where the body attacks the myelin sheets,
the protective covering of the nerves.
In ALS, you're actually creating damage
to the neurons, themselves.
So it's slightly different, in that sense,
but a lot of the symptoms look quite similar.
Oh, this scene here is very fascinating to me,
because, if Ellie believes this to be something
that she has in her blood, antibodies as an example,
she's essentially trying to do, like,
a convalescent plasma transfusion here.
The question is, is she going to create
a proper transfusion kit?
And, as we all know, given the lack of supplies,
and the circumstances, she's going to do
the classic blood brothers thing, or blood sisters thing,
where she's going to make an incision,
and try and bleed over his wound.
But as we know, while that can transmit some infections,
it's not going to transfer enough healing factors
for it to be beneficial.
And the reason we use convalescent plasma, by the way,
for these types of transfusions, like,
we use them with COVID, is because the plasma,
which makes up the majority of your blood,
it's that yellow portion of blood that I've shown you
in previous videos, that we desperately need donations of.
So donate your plasma, that's where the antibodies float,
and by getting that donation, you can actually
pass along immunity to others.
Now this is where we learn this.
This community of people
are actually involved in cannibalism.
- What is it?
- Venison.
- Many people will say,
oh, that must carry so much disease,
in reality, not to sound gross,
human flesh is not that much different
from eating animal flesh, in terms of risk.
You cook it well, the person's not sick in the moment,
it's very similar.
Obviously the human body has a weird distribution
of proteins and fats, in order for it to be nutritious.
So it's not very nutritious.
But then the brain, it can carry a disease known as kuru.
And this actually was a big problem
in the fifties and sixties in New Guinea,
where they actually, as part of their culture,
would consume the brains of other humans.
It's very problematic, 'cause it's lethal.
And we learned a lot
about Prion disease from that scenario.
And specifically a lot,
because the incubation period was so long,
that it actually allowed us to study it,
and see this develop in the native population.
So that's the one part of the body that's, like, a no-go.
- Just take me to her.
- I can't, she's being prepped for surgery.
- But why is she going for surgery?
What do they hope to do?
If they believe her blood has healing powers?
What is this purpose of the surgery?
Study her blood first.
See if that works, before putting her into surgery.
- Our doctor, he thinks that the cordyceps in Ellie
has grown with her since birth.
- Why is she in surgery?
- It produces a kind of chemical messenger.
It makes normal cordyceps think that she's cordyceps.
It's why she's immune.
- That makes no sense.
If it makes other cordyceps think
that she's cordyceps, they wouldn't bite her.
- He's going to remove it from her.
Multiply the cells in a lab, produce those
chemical messengers, and then we can give it to everyone.
- That's probably the worst theory of why she's immune.
Whoever that doctor is needs to be relegated
to the D-league, the G-league.
Where do doctors go?
I don't know.
- He thinks it could be a kilojule.
- Cordyceps grows inside the brain.
- How does he know that?
How does he know that cordyceps grow inside the brain,
not in the blood,
and then infect the brain through chemical messengers?
- It does.
- How does she know?
How have they become experts in cordyceps,
when I don't know she-woo about cordyceps.
The only thing I know about cordyceps is
there's something to do with caterpillars.
That's my knowledge of cor-
And some people use them, 'cause they think it gives them,
like, better athletic performance.
I understand if you fail doing all the initial tests,
and then this is your last thing, okay, fine.
But they haven't even tried sampling her blood.
Why not take a, like, a pint of blood from her?
Give it to someone who has a cordyceps infection,
see if it heals them.
This is a actually a great situation
to talk about the trolley problem.
Do we sacrificed one Ellie, in order to save the human race?
I'm curious.
Leave your comments down below.
'Cause I need to know.
- Unhook her.
- How did you get in here?
- All right, so we see the heart monitor,
we see good lights.
We see them wearing proper protective gear.
It looks like a very sterile environment, actually.
- Move!
- Oh my god.
- They're taking off the EKG leads.
They're pulling out the IVs.
That was a weird placement for the IV.
It was, kind of, in the middle of the forearm,
not antecubital.
I will say, they did create a nice, makeshift hospital.
I just don't know what they were about to do,
what medical procedure, surgically,
would help them find the cure.
I actually asked all sorts of ethical questions
just like that, to ChatGPT to see
if it's as smart as a real doctor.
It actually was a little smarter,
but also a little stupider.
Click here to check that out.
And as always, stay happy, and healthy, and fungi-free.
(synth music)