Hey there, everyone. Welcome back to Seeker Plus, a video podcast where we explore one topic across
three episodes. I'm your host, I'm Julian Huguet, and this week, we're doing surgeries. I mean,
we're not doing surgeries, we're talking about surgeries. Trust me, nobody wants me near a
scalpel. So even though surgeries are really common these days, it's still pretty incredible
to me that surgeons can cut people open and dig around. And afterwards, people feel better. I
mean, we've learned how to remove tumors, fix brain, stitch wounds, we can swap out entire body
parts. Over the next three episodes, we're going to talk about how we got here through a history of
trial and sometimes gruesome error and why anesthesia might be the greatest and weirdest
thing our species has accomplished in medicine thus far, then we'll get specific about a few of
what I think are the coolest surgeries out there. And then we'll cap it all off with the future
of surgery, how robots cameras, new technologies are shaping what medicine will become.
So my first question is, where did this all start? I mean, who was the first person to have a sick
friend and say, Hey, you know what's gonna make you feel better? Let me cut you open. It'll be
great. Don't worry about it. Well, archeologists have actually found evidence of surgery that goes
as far back as the Neolithic period in which five to 10% of the skulls found had holes
carved into the top of their skull. That's a huge percentage, if you think about it, five to 10%. So
what one in every 10 of your friends had a hole in their head back then this practice of carving head
holes is called trepanation. And evidence has been found in skulls throughout the world. Trepanation
was practiced in Europe, Asia, and both North and South America. The practice actually lasted
all the way up until the 16th century, which is not that long ago in the grand scheme of things.
The theories on why ancient people did this particular surgery very improbably differed
from culture to culture, it may have been used to actually treat head injuries or pain, or maybe it
was done to release spirits from the body. There's much of this early surgery that remains a mystery.
Much of early surgeries in general, that remains a mystery. But this is proof that
we've been carving up people for a long time. Some of these skulls even showed regrowth and healing,
which means that some of these people actually lived through it. So maybe we need to give these
ancient surgeons a little bit more credit. Besides trepanation there are many surgeries that can be
traced back to ancient Egypt and Greece. surgery in ancient India was especially advanced with a
legendary surgeon named Sushruta. In 600 BC, he performed skin grafts even facial reconstructions.
And he only had basic tools, a small level of success and no anesthesia. So I assume he also had
a lot of screaming patients. But more recently, in the second century AD, and on the other side
of the globe, one surgeon in Rome named Galen dominated the field. His writings became the
main source for Western medicine for more than 1000 years, he saw how arteries and veins carry
different colors of blood and proposed early versions of the circulatory system. I'm going
to take a sidebar here and say, I don't mean red and blue, I mean, bright red and dark red,
bloods is never blue, it's always red. Galen also figured out how spinal cord injuries worked
and pioneered concepts of the central nervous system. The problem with Galen is that all of his
knowledge of anatomy came from dissecting animals. Now, it's not his fault, it was illegal to dissect
or experiment on humans at the time. But as you may have guessed, the bodies of apes and pigs,
well, they're different than humans inside and out. As a result, he believed humans
had the womb of a dog, the kidneys of a pig, and the brain of a cow or a goat.
He even added some body parts that we don't have. In particular, he thought that human bodies had
an important cluster of blood vessels in the head, called the rete mirabile. because
he found them in sheep. The fact that his writings prevailed for so long led to many
misunderstandings as putting it nicely but misunderstandings in medicine. That and medical
schools believed it was more important to read Galen's work than to actually learn from exploring
the body during surgery. any discrepancies found during surgery on actual people,
well, that was considered an error with that person's body rather than Galen's work, which
is insane. I feel like it should also be pointed out it wasn't until the 1900s you would have been
more likely to survive a surgery than die from it. This probably had something to do with that. It's
really not great odds if I'm honest. All of this leads me to something that I don't think a lot of
us think about when it comes to something that was vital to improving the field of surgery. And that
is how we visualize the human body. For a really long time surgeons were just going in blind they
didn't know what our organs look like or how they connected to each other. They didn't have that
song you know the hip bones connected to.... they didn't have it. This of course, is where
scientists like Leonardo da Vinci had to be sneaky about where he quote unquote, found bodies
to dissect. When dissections were allowed, one of the greatest advances in the field was simply when
physician Andreas Visalius in 1543 published anatomical drawings of the body in his textbooks.
He was one of the people ridiculed for disagreeing with Galen and it took some time for his views to
take hold. In a lot of ways, having drawings not just written text about anatomy was a serious leap
forward. Even today, the advancements in being able to see inside the human body are key to
making surgeons better and better at their jobs. If a surgeon can 3d print a heart to explore and
practice on or practicing VR before ever picking up a real scalpel, their surgery will be much
safer. We'll save all this for Episode Three, it's safe to say though I'm pretty pumped about it.
Beyond the advances in visualization, there are two other things that really skyrocketed
the field of surgery, they changed it from an experimental field that was really positioned
as a painful last resort to a more commonplace miracle cure. These things are anesthesia,
and antiseptics. Anesthesia, the ability to knock somebody out while you cut them open and it made
everything so much easier. There were attempts to ease a patient's pain using alcohol or opium
or herbs. But eventually, ether was discovered. And even though it was great, a huge advancement,
it wasn't ideal. One thing is the dosage for ether isn't reliable, so it's easy to
accidentally use too much and kill the patient, which is counterproductive. ether also causes a
choking sensation. So patients had to be held down while it took effect. And oh yeah, it's
really flammable. But over time, other effective anesthetics were discovered like nitric oxide,
chloroform and eventually the modern mixtures that we use today. After all this time though,
we still don't really know how anesthesia works. I mean, we understand local anesthesia. It's
designed to numb specific areas of the body and it works by stopping nerves from delivering pain
signals to the brain, but general anesthesia that knock somebody out entirely it's not a question
of simply putting people to sleep. It needs to block pain turn off reflexes prevent the release
of stress hormones, keep the heart rate and blood pressure chill and needs to make sure that the
patient has no memory during an operation. How though, how does this work? Well, one recent study
on fruit flies found that anesthesia freezes a neurons ability to fire leading to a loss of
consciousness. They figured it out by dowsing cells in chloroform, and observing how clusters
of lipids in the cell membrane break apart in the anaesthetic kind of like a bunch of balls
on a pool table. The scientists think that these lipids are a sort of go between for a mechanism
related to consciousness, which that's so exciting because now we're starting to crack the code on
how consciousness works in the brain. It could have huge implications for sleep studies and
certain disorders and I'd love to talk about consciousness. But we're here to talk about
surgery so I have to focus. Even surgeries done with anesthesia, though, had a low success rate
until antiseptics were discovered. Surgeons used to wear the same clothes over and over and they
let them build up with dried blood and pus and vomit. I'm really sorry if you're having lunch
right now, one of my favorite stories from this period of medical history is about this
physician named ignaz Semmelweis. He was working in the maternity ward of a hospital in Berlin,
and it bothered him that 13% of women giving birth in his ward were dying slowly and painfully of
something called child bed fever. Around the same time, a doctor friend of Semmelweis got
a wound while performing an autopsy and he later died of a blood poisoning that mimic the symptoms
of child bed fever. In this hospital doctors were doing autopsies on cadavers, and then
delivering babies in the same shift, just poking around inside some dead guy and then
go in and touch in moms and their newborns without ever washing their hands or anything. Semmelweis
concluded that something from the cadavers was poisoning his patients. So before germ theory
had even entered the world of medicine. Semmelweis implemented strict hand sterilization practices,
and his mortality rate dropped to 0.19% by the end of the year, so from 13% to less than point 2% Way
to go Semmelweis. Later with the discovery of germ theory, medical staffs started scrubbing services,
washing hands and placing antiseptic barriers over wounds resulting in lower rates of infection
and death across the board, all leading to the hyper-sterilization of modern operating rooms.
Which brings us to today where we're operating on people's brains, hearts, feet, and all the stuff
all around it in between. So let's talk about how these surgeries are done, and some of the most
incredible surgeries of all time, which we'll talk about in the next episode of Seeker Plus,
thanks so much for tuning in. Make sure you subscribe so you can watch the upcoming episodes
on surgery and all the series that we'll have rolling out. By the way, if you want to let us
know in the comments, any topics that you think we should cover? Go for it, comment away we can talk
about anything really. We could talk about the intelligence of plants, or ants answer cool or the
science of dance. Let me know. Thanks so much for watching, and we'll see you on the next episode.