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How Triage Works · Stuff You Should Know

• 0:00
  Speaker 1: This episode of Stuff You Should Know is sponsored by
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  Speaker 1: squar Space. Whether you need a landing page, a beautiful
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  Speaker 1: gallery of professional blogger, an online store, it's all possible
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  Speaker 1: with the square space website. Go to squarespace dot com
• 0:13
  Speaker 1: and set your website apart. Welcome to Stuff you Should
• 0:17
  Speaker 1: Know from House Stuff Works dot com. Hey, and welcome
• 0:26
  Speaker 1: to the podcast. I'm Josh Clark, and there's Chuck Bryant
• 0:30
  Speaker 1: and there's Jerry and it's Stuff you Should Know. How's
• 0:34
  Speaker 1: going pretty good? Do you like my Scotland shirt? That's great.
• 0:38
  Speaker 1: You're gonna wear that in Scotland. Yeah, that's why I
• 0:40
  Speaker 1: got it. Okay, I got a shirt for each city
• 0:43
  Speaker 1: nice country. Well Edinburgh, yeah, yeah, that's the city. Yeah.
• 0:49
  Speaker 1: I think they'll be behind the Scotland shirt. And they
• 0:51
  Speaker 1: will too. They're gonna stand up and do that Arsenio like, yeah,
• 0:57
  Speaker 1: because they're living in the eighties. Yeah, about a shirt
• 1:00
  Speaker 1: for each city on our UK tour because I'm just
• 1:04
  Speaker 1: you know, I can write it off and that's just
• 1:09
  Speaker 1: the very mean thing to do. I'll keep the Manchester
• 1:14
  Speaker 1: shirt a secret. Oh I know what it is, do you?
• 1:18
  Speaker 1: I think? So? All right, Well, we'll talk later. Okay.
• 1:22
  Speaker 1: In the meantime, Chuck, let's talk about trias. Let's talk
• 1:26
  Speaker 1: about the French language. Okay, tree a okay means too short?
• 1:33
  Speaker 1: Did you know that? Which means that Lars von Trier's
• 1:36
  Speaker 1: name is Lars Vaughan. To sort, Yeah, sort or sift.
• 1:39
  Speaker 1: I saw another meaning, but everywhere else said sort, and
• 1:42
  Speaker 1: apparently it was originally used exclusively in reference to sorting vegetables. Yeah,
• 1:49
  Speaker 1: a little known fact. But the pre industrial French society
• 1:54
  Speaker 1: was a grarian, so they would say, and that means
• 2:00
  Speaker 1: and they snapped their fingers and point and pile of vegetables,
• 2:04
  Speaker 1: sort of veggies, root veggies in France. Yeah, they have
• 2:09
  Speaker 1: those everywhere, but but they they're bonkers for root veggies
• 2:13
  Speaker 1: in France. They have good, clean, simple food in that country. Yeah,
• 2:17
  Speaker 1: good good food. Yeah. What's it called the French food?
• 2:23
  Speaker 1: It's not not the trinity that's like a Cajun, but
• 2:25
  Speaker 1: the mere poix. Oh I've not heard that before. Is
• 2:30
  Speaker 1: it the same thing? No? I think mere poise carrot onion,
• 2:34
  Speaker 1: and one other thing parsley, celery, celery. Jerry's the celery Jerry.
• 2:41
  Speaker 1: I think you're right? Are you right? You know you're right, okay,
• 2:44
  Speaker 1: in Cajun Land, it's like Bell Pepper onion and what
• 2:48
  Speaker 1: and uh garlic it would meet garlic. I was trying
• 2:54
  Speaker 1: to think of something funny and I failed my brain
• 2:56
  Speaker 1: just like, yeah, well it's late in the day, trying
• 3:02
  Speaker 1: to think of something about like an angel Heart reference. Man,
• 3:06
  Speaker 1: that movie is crazy. Still holds up. I saw it
• 3:10
  Speaker 1: really well. Actually I can't say it holds up because
• 3:13
  Speaker 1: I never saw it as a kid. I saw it
• 3:14
  Speaker 1: as an adult recently. I think it's still on Netflix.
• 3:18
  Speaker 1: You know, Lisa Bonet is in the season of Ray
• 3:21
  Speaker 1: Donovan and she looks exactly the same vampire perhaps very
• 3:29
  Speaker 1: pretty lady. I was crushed on her big when I
• 3:32
  Speaker 1: was a kid, and she's super laid back. Um, what
• 3:36
  Speaker 1: was it Lisa Huxtable? Yeah, for sure they didn't. Her
• 3:42
  Speaker 1: name wasn't Lisa Huxtable. It was something huxtable. Well probably
• 3:47
  Speaker 1: not because the real names Lisa. Yes. You know, sometimes
• 3:49
  Speaker 1: shows like used the actor's first name as the character's name,
• 3:53
  Speaker 1: even though they're not playing themselves. I always thought that
• 3:56
  Speaker 1: was weird. Yeah. I always wonder if it's because they
• 3:59
  Speaker 1: have a hard time I'm remembering their characters right, or
• 4:02
  Speaker 1: the writers like I just can't come up with a name.
• 4:05
  Speaker 1: Just call him the real name, okay, sue me. And
• 4:07
  Speaker 1: I know people get so tired of screaming at us
• 4:11
  Speaker 1: about like, oh, what was the name of that? And
• 4:14
  Speaker 1: they're like her name was this? I do that to
• 4:17
  Speaker 1: other podcasts, so I feel your pain. I heard one
• 4:20
  Speaker 1: just the other day. I think Judge John Hodgement he
• 4:22
  Speaker 1: couldn't think of something, and I was like, no navy blue. Anyway,
• 4:28
  Speaker 1: I apologize for all the things we don't know. Uh.
• 4:32
  Speaker 1: Treer to sort was to sort vegetable foundation of the
• 4:38
  Speaker 1: term triage. Yeah. And the reason why the French got
• 4:42
  Speaker 1: to got naming rights for this process that will describe
• 4:45
  Speaker 1: in a minute is because it was basically invented by
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  Speaker 1: a French person. Pretty remarkable guy from what I can tell.
• 4:54
  Speaker 1: He had a great name. He was Napoleon's surgeon, the
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  Speaker 1: chief surgeon of Napoleon's Imperial Guard. His name was Baron
• 5:01
  Speaker 1: Dominique Jean Larrey. Yeah, and he was, uh, he was
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  Speaker 1: a bad dude in all the best ways. He was.
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  Speaker 1: And this was at a time when warfare was getting
• 5:14
  Speaker 1: pretty serious. Um, I mean it was already serious, but
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  Speaker 1: people were dying and massive amounts of people soldiers dying
• 5:23
  Speaker 1: on the field and great, great numbers. And so he said,
• 5:27
  Speaker 1: you know what, we need to come up with the system,
• 5:30
  Speaker 1: a way to take care of these dudes. Uh, so
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  Speaker 1: they're not waiting over there with a bone sticking out
• 5:35
  Speaker 1: of their leg waiting for attention. Well this dude also,
• 5:39
  Speaker 1: I mean he came to this conclusion because he was
• 5:41
  Speaker 1: running around battlefields like performing amputations and um, just in
• 5:46
  Speaker 1: a sea of bodies. Like bite, bite on your gun
• 5:49
  Speaker 1: barrel while I cut your leg off. Yeah that kind
• 5:53
  Speaker 1: of thing. Yeah, um, and he barrel but stuck. Sure
• 5:58
  Speaker 1: could bite on yourn, but be really, they needed up
• 6:01
  Speaker 1: needing new teeth. Um, the wood is much more comfortable
• 6:05
  Speaker 1: when you're having your leg amputative without anesthetic, I would
• 6:08
  Speaker 1: say so. Um, but while he's running around performing these
• 6:11
  Speaker 1: battlefield amputations, he realizes quite quick quickly that some people
• 6:15
  Speaker 1: are in need of help more urgently than others. And
• 6:19
  Speaker 1: he decided it would be pretty awesome if you could
• 6:22
  Speaker 1: figure out a way, like you were saying, to devise
• 6:25
  Speaker 1: a system of arranging people very quickly so that, um,
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  Speaker 1: you could give aid to the people who needed it most.
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  Speaker 1: And Uh, to do that, you would need to sort
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  Speaker 1: through the people, hence triage as if they were root vegetables.
• 6:43
  Speaker 1: Uh so what he did initially, and it's gone through
• 6:46
  Speaker 1: some changes that we're going to talk about, but the
• 6:48
  Speaker 1: initial incarnation of triage was only based on severity of injuries,
• 6:54
  Speaker 1: no other factor. Well even before that, and this is
• 6:57
  Speaker 1: another reason this guy is awesome when he like, there
• 7:01
  Speaker 1: was a very vague form of triage before, but it
• 7:04
  Speaker 1: was based on your social standing. Oh really, so yeah,
• 7:07
  Speaker 1: I was reading that, like, if you have a of course,
• 7:10
  Speaker 1: a guy who's like, uh, an aristocrat with a broken leg, yeah,
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  Speaker 1: and just a grunt whose bowels are hanging out, you
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  Speaker 1: fix the broken leg first, which is senseless. And laure
• 7:22
  Speaker 1: was like, no, we're not gonna do that anymore. It's
• 7:24
  Speaker 1: going to be based on severity of of injury, yeah,
• 7:28
  Speaker 1: their need for help. And Napoleon was like, that's great,
• 7:31
  Speaker 1: but you know, I'm at the top of the list
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  Speaker 1: no matter what. Right, Hey, have you heard people calling
• 7:36
  Speaker 1: me the anti Christ behind my back? Because I could
• 7:39
  Speaker 1: hear rumblings about this and it's bugging me. You know,
• 7:41
  Speaker 1: I'm not really short, I'm average. Yeah, that's true. Uh.
• 7:45
  Speaker 1: And the process went on to change a little bit more.
• 7:47
  Speaker 1: With British surgeon naval surgeon John Wilson in six he said,
• 7:52
  Speaker 1: you know what, let's refine this a little bit and
• 7:55
  Speaker 1: let's put some focus on people who can be successfully treated,
• 7:59
  Speaker 1: so not necessary early. That guy's got all his bowels
• 8:02
  Speaker 1: hanging out, he's the most severely injured. He thought, well,
• 8:06
  Speaker 1: you know what, that guy might not make it, so
• 8:08
  Speaker 1: maybe we shouldn't spend so much time. It's harsh, but
• 8:11
  Speaker 1: it's war, it is. And that was a huge shift
• 8:13
  Speaker 1: because it up to that point, if you were a
• 8:16
  Speaker 1: medic um like you just treated people. Now you have
• 8:20
  Speaker 1: a decision to make with each person. Do you let
• 8:23
  Speaker 1: that person die? Um, because they're probably going to die
• 8:28
  Speaker 1: and you could be saving other people rather than wasting
• 8:31
  Speaker 1: your talents and resources on this person right here, Make
• 8:34
  Speaker 1: them comfortable, maybe throw some morphine their way, and then
• 8:38
  Speaker 1: you know, go about your business. That was a big
• 8:40
  Speaker 1: big shift in in triage, in battlefield triage, and in
• 8:44
  Speaker 1: the US it didn't um, they didn't, We didn't. We
• 8:47
  Speaker 1: didn't catch up very quickly by the Civil War. So
• 8:51
  Speaker 1: that guy uh Laura was was working on triage, inventing
• 8:56
  Speaker 1: it in the seventeen nineties. Um, John Wilson refined it
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  Speaker 1: in the eighteen forties in the Civil War. Still we
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  Speaker 1: were doing like first come, first served. Whoever was closest
• 9:08
  Speaker 1: to the medic was who got worked on first in
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  Speaker 1: the Civil War in the eighteen sixties. Still, it wasn't
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  Speaker 1: until um, I think the late eighteen sixties or early
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  Speaker 1: eighteen seventies that the US first started adopting even basic triage.
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  Speaker 1: So Britain led the way in this case, well, France
• 9:26
  Speaker 1: and then Britain. Yeah, yeah, France led the way in mercy.
• 9:30
  Speaker 1: Britain led the way in um saying like, no, we
• 9:33
  Speaker 1: gotta let some people die here. Well, I would say
• 9:36
  Speaker 1: efficiency in saving lives overall. Yeah, I mean it's a
• 9:40
  Speaker 1: very utilitarian way of looking at and like they're they're
• 9:44
  Speaker 1: like gotta be gotta have nerves of steel, gotta have
• 9:47
  Speaker 1: a kung fu grip. World War One things changed again. Uh,
• 9:53
  Speaker 1: they tweaked it and now they said, all right, maybe
• 9:56
  Speaker 1: we should treat and you know, if this was what country,
• 9:59
  Speaker 1: this was just generally this is a US Army manual.
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  Speaker 1: It was, but apparently the US wasn't alone in this.
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  Speaker 1: It was like a it seems like a worldwide movement
• 10:12
  Speaker 1: shift in in triage, which was to treat, uh, how
• 10:18
  Speaker 1: many people can you treat in the shortest amount of time,
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  Speaker 1: So like maybe people that don't need as much. But yeah,
• 10:24
  Speaker 1: and the basis of this is even more steely nerved
• 10:28
  Speaker 1: than than um John Wilson's shift, because this is saying
• 10:34
  Speaker 1: not ignore that person, they're probably going to die. It's
• 10:38
  Speaker 1: this person is going to die, you could probably save,
• 10:42
  Speaker 1: but it's gonna take up too much time. And the
• 10:44
  Speaker 1: time that it takes to save this person's life and
• 10:46
  Speaker 1: you probably could save it. You could have fixed up
• 10:49
  Speaker 1: twelve people who weren't going to die but can get
• 10:52
  Speaker 1: back out and fight the war a lot faster if
• 10:54
  Speaker 1: you work on them. And that was I think the
• 10:56
  Speaker 1: thinking behind it, patching up people who are more likely
• 10:59
  Speaker 1: to be a will it returned to battle, rather than
• 11:02
  Speaker 1: saving lives of people who UH might not be able
• 11:05
  Speaker 1: to or who would take up a lot of time,
• 11:08
  Speaker 1: hard choices. Yeah, that's super utilitarian. That was, like you said,
• 11:12
  Speaker 1: a surgical manual out of the military at the time
• 11:15
  Speaker 1: said this quote, a single case, even if it urgently
• 11:18
  Speaker 1: requires attention, may have to wait for in that time
• 11:21
  Speaker 1: a dozen others almost equally exigent but requiring less time
• 11:26
  Speaker 1: might be cared for. And four people died while I
• 11:28
  Speaker 1: read that on the battlefield it could have really sum
• 11:33
  Speaker 1: that up quicker. Uh, should we take a little break? Sure? Man, No,
• 11:56
  Speaker 1: all right, my friend, Uh, there are we've been talking
• 12:00
  Speaker 1: about the battlefield so far in its history. That was
• 12:03
  Speaker 1: the origin of it. But uh, if you go to
• 12:07
  Speaker 1: the e R. And actually I haven't been to the
• 12:10
  Speaker 1: e R much at all in the last jeez much
• 12:15
  Speaker 1: at all in my life. That's good. But since I
• 12:18
  Speaker 1: was a kid, but I did go in New York remember,
• 12:20
  Speaker 1: Oh yeah, that's right. When I got sick. I went
• 12:24
  Speaker 1: to the emergency room in New York City, Beth Israel.
• 12:29
  Speaker 1: And it was, man, it was a little a little scary,
• 12:35
  Speaker 1: just the scene there. Sure, yeah, it wasn't like I'm
• 12:38
  Speaker 1: sort of used to the hospitals around here, kind of nicer,
• 12:41
  Speaker 1: like it had seen its better days, the e R
• 12:45
  Speaker 1: room and the waiting room, and it was it's sad
• 12:49
  Speaker 1: to see the people that are in there that need help,
• 12:51
  Speaker 1: you know, in a big city like that. It's um,
• 12:54
  Speaker 1: it's not like you know, my kid fell down and
• 12:55
  Speaker 1: bumped his head. It's like, you know, it was disturbing.
• 13:00
  Speaker 1: I'll just say that. Yeah, but I was triaged when
• 13:03
  Speaker 1: I first got there. And that's what will happen to
• 13:06
  Speaker 1: you when you go to a er there. There's gonna
• 13:08
  Speaker 1: be a triage nurse. Somebody runs up to you and
• 13:10
  Speaker 1: throws glitter in your face and said, you've been triaged.
• 13:17
  Speaker 1: That's after someone already threw molasses on your face. That
• 13:20
  Speaker 1: glitter would sticks. Yeah, So triage nurse is gonna come
• 13:24
  Speaker 1: by and that that dude to that lady is gonna say, hi,
• 13:27
  Speaker 1: welcome to Beth Israel. Sorry about the mess. Um, let's
• 13:33
  Speaker 1: check you out. I'll watch your step. There's some blood. Seriously,
• 13:37
  Speaker 1: it's kind of like that. Um and uh, they will
• 13:41
  Speaker 1: do an assessment. They're gonna look at you and say,
• 13:44
  Speaker 1: you know, deep, this guy has a spoon coming out
• 13:47
  Speaker 1: of his ear, so I can make a snap judgment
• 13:50
  Speaker 1: that you need quick help. Yeah. Or this dude in
• 13:54
  Speaker 1: my case was just holding his belly and so he
• 13:57
  Speaker 1: looks like he can wait, Yeah, he looks like he
• 13:58
  Speaker 1: was shooted duck. He can sit here and hold that
• 14:02
  Speaker 1: for a little while. She said, here, let me pull
• 14:04
  Speaker 1: your finger. Everything will be all right. And there's what
• 14:07
  Speaker 1: you're describing this e er triage that's done by a
• 14:10
  Speaker 1: triage nurse, right, the first person about the first person
• 14:14
  Speaker 1: you see when you come to an e er when
• 14:16
  Speaker 1: they're doing triage. It's not constant necessarily they have been
• 14:21
  Speaker 1: trained to do this, but they're also following float charts.
• 14:23
  Speaker 1: There's there's triage protocols, different ones, and there's one from Manchester,
• 14:29
  Speaker 1: UK and it's from what I understand, the international gold
• 14:33
  Speaker 1: standard for triage, the Manchester Triage system And it's a band. Yeah,
• 14:39
  Speaker 1: it is like Manhattan Transfer. Um. But it's like it's
• 14:43
  Speaker 1: a flow chart and it basically says like, um, are
• 14:45
  Speaker 1: they breathing? No, get them immediate help, like stop right
• 14:49
  Speaker 1: now and immediately get them into a place where a
• 14:53
  Speaker 1: lifesaving intervention can be carried out right. Um. And there's
• 14:56
  Speaker 1: some other ones, but it seems like breathing is the
• 15:01
  Speaker 1: focus of it. That's good, Yeah it is, but but
• 15:04
  Speaker 1: I mean you think about it, you would think there'd
• 15:07
  Speaker 1: be some other ones too, like as are there is
• 15:09
  Speaker 1: their blood coming out of their ear or something like that. No,
• 15:12
  Speaker 1: it's mostly breathing. Like if if you're breathing, there's a
• 15:16
  Speaker 1: pretty good chance you're you're gonna make it, especially if
• 15:19
  Speaker 1: you have a normal breathing pattern, right. Um. And but
• 15:22
  Speaker 1: then there's some other ones like if if the person
• 15:24
  Speaker 1: is not responsive or if they're drooling. Apparently it's another one. Um,
• 15:29
  Speaker 1: there are a couple of jewelers in the r Israel.
• 15:32
  Speaker 1: They should have been seen immediately according to the Manchester
• 15:35
  Speaker 1: UM triage system. So, um, there's like a float chart.
• 15:39
  Speaker 1: You don't have to It's not necessarily just the nurses
• 15:43
  Speaker 1: subjective judgment. It's not supposed to be. I'm sure it
• 15:47
  Speaker 1: is in like high stress situations and with really highly
• 15:50
  Speaker 1: trained triage nurses they can just be like, yeah, this
• 15:53
  Speaker 1: move that person there, you go sit down, you go home. Um.
• 15:58
  Speaker 1: But for the most part, it's supposed to be a
• 16:00
  Speaker 1: UM an objective system that you can just consult and
• 16:04
  Speaker 1: be like, okay, well here here's where you fit paper.
• 16:09
  Speaker 1: You're so smart, why don't you just treatage everybody yourself?
• 16:12
  Speaker 1: Well beyond the initial UH flow chart to they're also
• 16:15
  Speaker 1: going to take some vitals. Um, here your complaint in
• 16:18
  Speaker 1: your medical history, allergies, all that good stuff, medications you
• 16:22
  Speaker 1: might be on, and then take your vitals, blood pressure, temperature,
• 16:25
  Speaker 1: all that good stuff. Yeah, if if you're not in
• 16:28
  Speaker 1: that group where they're just like to send them right back. Yes,
• 16:31
  Speaker 1: And by the way, I'm not knocking beth is reel
• 16:33
  Speaker 1: because Nurse Eddie there, this dude, the guy who didn't
• 16:37
  Speaker 1: believe that you were sick. Yeah, a little bit. He
• 16:40
  Speaker 1: was amazing and took wonderful care of me and was
• 16:43
  Speaker 1: like the typical New York nurse that you might think
• 16:46
  Speaker 1: of this sort of like he had the accent, and
• 16:49
  Speaker 1: he was like a very kind of cool customer dude,
• 16:52
  Speaker 1: like I would have felt very comfortable walking into his
• 16:55
  Speaker 1: arms like a gunshot, because I'm sure he could have
• 16:58
  Speaker 1: like totally taken care of me. But he did get
• 17:00
  Speaker 1: a little like like I couldn't figure out what's wrong
• 17:04
  Speaker 1: with me at first, and then after I got better
• 17:07
  Speaker 1: and they knocked me out and gave me fluids and
• 17:09
  Speaker 1: I woke up. I had a I was like, all right, great,
• 17:12
  Speaker 1: and you know, I'm out of here. And I felt
• 17:13
  Speaker 1: this lump, remember that, I felt a lump behind my
• 17:16
  Speaker 1: ear the size of a golf ball. And I walked
• 17:18
  Speaker 1: back in. I was like, Nurse Eddie, dude, I got like,
• 17:21
  Speaker 1: what is this? And he kind of gave me one
• 17:24
  Speaker 1: of those looks like, oh, you're one of those guys.
• 17:27
  Speaker 1: And I was like, I'm not a hypochondriac. I'm never
• 17:32
  Speaker 1: at the doctor. I've never been to the e R hardly, like,
• 17:35
  Speaker 1: please don't look at me those eyes. Nurse Eddie and um,
• 17:39
  Speaker 1: he felt it and I was like, see, it's like
• 17:42
  Speaker 1: it's huge. And I think he determined that it was
• 17:44
  Speaker 1: some kind of like he had a doctor come over
• 17:47
  Speaker 1: and they determined it was just a swelling of lymph
• 17:50
  Speaker 1: node from hypochondria brought on by my sickness. But anyway,
• 17:56
  Speaker 1: big shout out. It turned out to be you had
• 17:58
  Speaker 1: snakes in your belly. Yeah. If I passed out on
• 18:02
  Speaker 1: the subway, woke up two days later in Coney Island,
• 18:06
  Speaker 1: I had thirteen snakes in my belly, no more, no less.
• 18:11
  Speaker 1: So weird. So um. They gather these details in the
• 18:19
  Speaker 1: triage didn't take long. They use the color coded system
• 18:23
  Speaker 1: in some hospitals. Numbers and some were both things on
• 18:27
  Speaker 1: where you are. Yeah, what's this is astounding to me?
• 18:31
  Speaker 1: It's not universal, Like the colors aren't universal. Numbers seem
• 18:36
  Speaker 1: to be like nobody does it backwards, but the color
• 18:39
  Speaker 1: should be the exact same too. So for example, like
• 18:42
  Speaker 1: in Manchester's jam Like the worst of all is red.
• 18:47
  Speaker 1: See red? Making sense? No another trio system blues? The
• 18:51
  Speaker 1: worst code blue. Yeah, I think you hear that a
• 18:54
  Speaker 1: lot on American TV, but it's a It's a real thing,
• 18:57
  Speaker 1: at least in the States. So I I think that
• 19:00
  Speaker 1: everybody should get together and agree on a color system
• 19:03
  Speaker 1: because the whole point of triage is rapid fire. Let's
• 19:07
  Speaker 1: get this done. Not oh, well, which system did you
• 19:09
  Speaker 1: triage them? Because I'm I'm I enjoy a spotted t
• 19:13
  Speaker 1: so I'm a fan of the Manchester system, so this
• 19:17
  Speaker 1: this red is completely odd to me. Yeah, but you
• 19:20
  Speaker 1: know the one your hospital uses, so you're probably not
• 19:22
  Speaker 1: getting confused as the triage nurse. Yeah, I guess it's true,
• 19:27
  Speaker 1: But I mean, I know what you mean. There's just
• 19:29
  Speaker 1: you should you should go out of your way to
• 19:32
  Speaker 1: um take out any possible you get transferred to another hospital. Yeah,
• 19:37
  Speaker 1: there's just I think there should be universal colors. I
• 19:40
  Speaker 1: have a strong opinion on that. I totally agree. If
• 19:43
  Speaker 1: you're a kid, you may get sent to closer to
• 19:46
  Speaker 1: the front of the line um or if you have
• 19:48
  Speaker 1: a history of illness or like you have cancer or
• 19:52
  Speaker 1: something like, if you have an outstanding condition already, you
• 19:56
  Speaker 1: may be shuffled to the front um or. And this
• 19:59
  Speaker 1: makes a lot of sense to me. A lot of
• 20:01
  Speaker 1: times now they have what they call it a different track.
• 20:03
  Speaker 1: They have two tracks. Um, if you're in severe distress,
• 20:06
  Speaker 1: you're in one gets you right away. But if you
• 20:09
  Speaker 1: have another one doesn't necessarily mean you're gonna wait eight hours.
• 20:12
  Speaker 1: They'll just put you in a different track, right for
• 20:14
  Speaker 1: the less severe cases. Yeah, you go see the doctor
• 20:17
  Speaker 1: who's been caught drinking on the job. You know that's right.
• 20:20
  Speaker 1: All right, Well, let's talk about those color codes since
• 20:23
  Speaker 1: you mentioned it. Okay, here in the US, code blue,
• 20:27
  Speaker 1: like you said, is the most that means come right away.
• 20:31
  Speaker 1: I understand the use of blue. It's um like they're
• 20:34
  Speaker 1: turning blue, yes, cyanotic? Okay, right, that it makes sense.
• 20:39
  Speaker 1: But again red makes sense too. Yeah, you hear code
• 20:42
  Speaker 1: red and that doesn't sound great. It doesn't make me
• 20:45
  Speaker 1: think like, oh, they'll be fine. Well code red it's
• 20:48
  Speaker 1: category too though, so it is serious. That means they
• 20:52
  Speaker 1: require immediate attention. But they're just not blue, right, they're
• 20:57
  Speaker 1: still breathing. Uh, then what he got got an orange
• 21:01
  Speaker 1: mid level Okay, you got gray, which means you're sick,
• 21:05
  Speaker 1: but it's like a bad cold. Really, gray should be
• 21:08
  Speaker 1: the worst. If you're gray, you've already passed blue. That's true,
• 21:13
  Speaker 1: you're uh. And then the least urgent is green, which
• 21:18
  Speaker 1: just means you want someone to love you. Yeah, it
• 21:21
  Speaker 1: means you're you're med seeking. Yeah, you shouldn't be in
• 21:23
  Speaker 1: the er basically, right, and that's not a joke. That
• 21:25
  Speaker 1: literally means you don't have an emergency, right they they
• 21:28
  Speaker 1: if if you are deemed code green five, do they
• 21:32
  Speaker 1: send you home? Yeah? Or else they'll be like, there's
• 21:35
  Speaker 1: a minute clinic down the street, go there. Yeah, you don't,
• 21:38
  Speaker 1: you're wasting valuable resources here, go away. So then across
• 21:43
  Speaker 1: the pond and then under the Manchester scale, the worst
• 21:46
  Speaker 1: is code red, followed by code orange, then code yellow,
• 21:51
  Speaker 1: then code green, then code blue, then code earl gray. Wow,
• 21:59
  Speaker 1: code blue is the least Yes, yeah, see you got
• 22:02
  Speaker 1: a point like that's you can't have one color be
• 22:04
  Speaker 1: the worst possible thing and one color be the the
• 22:08
  Speaker 1: least dangerous, especially in an increasingly globalized world. I don't
• 22:14
  Speaker 1: like it either, Um, what can we do? Should we
• 22:18
  Speaker 1: start a movement? Yes? We should online petitions. How does
• 22:22
  Speaker 1: that get done? Or just yell about it on Facebook?
• 22:25
  Speaker 1: I think the Facebook wanna that's that's the best shot
• 22:29
  Speaker 1: we have. That's how you accomplish things. Um, triage if
• 22:34
  Speaker 1: there's I mean, we talked about battlefield, we talked about
• 22:37
  Speaker 1: regularly er. But then there's of course, like when bad
• 22:42
  Speaker 1: things happen, like in New York when that building exploded. Yeah,
• 22:45
  Speaker 1: those are called incident triage. Yea, like a natural disaster
• 22:49
  Speaker 1: or something. Yeah, uh that Harlem explosion, right, it was
• 22:52
  Speaker 1: a gas explosion in Harlem. Yeah. Um, so triage works
• 22:57
  Speaker 1: anytime there's a scarcity of resources in a high demand
• 23:01
  Speaker 1: of for medical care. It's a good way to say.
• 23:04
  Speaker 1: It's just it's healthcare rashing. It's it's it's saying like,
• 23:07
  Speaker 1: we don't have enough resources for all you people, so
• 23:09
  Speaker 1: we're gonna have to figure out who's worse, right, and
• 23:11
  Speaker 1: you're supposed to do it very quickly. But yeah, with
• 23:13
  Speaker 1: incident triage. Um, there's actually a really clever thing called
• 23:18
  Speaker 1: the met tag. Then that article you sent was awesome
• 23:22
  Speaker 1: and it was a fast code design article, and there's
• 23:26
  Speaker 1: basically a triage code system that's used out in the
• 23:30
  Speaker 1: field Um that you'll see people who are victims of
• 23:34
  Speaker 1: like an explosion or a plane crash or something like that,
• 23:37
  Speaker 1: and they'll have tags around their necks with the color
• 23:39
  Speaker 1: code attached. And that was invented by a guy named
• 23:43
  Speaker 1: Robert bludgett Um in Jacksonville, Florida, in the early nineteen sixties,
• 23:48
  Speaker 1: in response to the Cuban missile crisis. Yeah. I thought
• 23:50
  Speaker 1: that was so interesting. It did not exist. Um, he
• 23:54
  Speaker 1: was a civil defense director and America was super scared,
• 23:58
  Speaker 1: especially Florida at the time time, because the Soviet Union
• 24:01
  Speaker 1: had nuclear missiles pointed at us right off the coast,
• 24:06
  Speaker 1: what ninety miles off the coast of Florida, and people
• 24:09
  Speaker 1: were freaking out. And um, he was one of him.
• 24:13
  Speaker 1: He wasn't freaking out, and he seemed like a cool customer. Yeah,
• 24:16
  Speaker 1: but he was definitely worried. But no, he doesn't seem
• 24:20
  Speaker 1: like he was freaking He wasn't running around going like
• 24:22
  Speaker 1: oh my god, oh my god. But he had a
• 24:23
  Speaker 1: bomb shelter at his house. Sure don't you think anybody
• 24:27
  Speaker 1: who was anybody had a bomb shelter back then? I
• 24:29
  Speaker 1: told I think I mentioned before my dad went to
• 24:31
  Speaker 1: build one after the day after movie, and um it
• 24:35
  Speaker 1: was his obsession for a month, like you know, every
• 24:39
  Speaker 1: Saturday for a month. I don't remember. Did he complete it.
• 24:43
  Speaker 1: He got about a third of this dirt room dug
• 24:47
  Speaker 1: out behind the wall. Like my brother and I basically
• 24:51
  Speaker 1: were the was We were the cheap labor, you know,
• 24:54
  Speaker 1: we were carrying buckets of dirt out in the woods.
• 24:56
  Speaker 1: He'd come down with like a high left and be like,
• 24:58
  Speaker 1: how's it going down here? How my project coming? He
• 25:01
  Speaker 1: didn't drink, but yeah he would come down with his
• 25:04
  Speaker 1: his buttermilk and corn bread I know, right, Um yeah,
• 25:10
  Speaker 1: he know. Of course he didn't finish any didn't because
• 25:12
  Speaker 1: you guys went on strike or something. Uh No, he
• 25:15
  Speaker 1: just like a lot of people that probably saw the
• 25:18
  Speaker 1: day after a month later, they're like, yeah, not so scared.
• 25:23
  Speaker 1: That's an awesome story. Um So anyway, this guy has
• 25:28
  Speaker 1: uh Mr Blodgett definitely had completed shelter. Oh yeah, there's
• 25:33
  Speaker 1: no way he bailed. He probably swept it like every
• 25:36
  Speaker 1: couple of days. Even well, his deal was he made it.
• 25:39
  Speaker 1: It was really pretty brilliant. It was a two sided
• 25:41
  Speaker 1: laminated card on lanyard and he said, you know what
• 25:44
  Speaker 1: this thing needs to be kind of universal. Um, so
• 25:47
  Speaker 1: I'm gonna put pictures and colors and things of uh,
• 25:52
  Speaker 1: like you know a symbol that represents blood pressure in
• 25:55
  Speaker 1: your sex and what time it is. Imagine those little
• 25:58
  Speaker 1: clock on there. Um, So anyone can read this thing
• 26:02
  Speaker 1: no matter what happened. Right. And then, um, you would
• 26:05
  Speaker 1: be assigned a color code depending on the severity of
• 26:08
  Speaker 1: your injury, your illness. Right, um, just like in an
• 26:11
  Speaker 1: e er. Um. But this this lanyard around your neck,
• 26:17
  Speaker 1: they would tear off the colors that you weren't. So
• 26:20
  Speaker 1: it was progressive, right if you had one, I think
• 26:23
  Speaker 1: it was green, You're fine, no problems. Uh. And then
• 26:28
  Speaker 1: it got progressively worse. And like you said, there were
• 26:30
  Speaker 1: some pretty clever symbols, including, um, I think on the
• 26:33
  Speaker 1: green one, there's an ambulance with a circle with a
• 26:36
  Speaker 1: slash through it, Like, don't even put this person on
• 26:39
  Speaker 1: an ambulance. They're fine, they can probably, they can probably
• 26:42
  Speaker 1: help you out if you need assistance in like applying
• 26:45
  Speaker 1: pressure to a wound. Right, Green's fine. Um, it went
• 26:49
  Speaker 1: all the way to black, and the black said morgue
• 26:53
  Speaker 1: on it, and it's said in this article, it's really
• 26:56
  Speaker 1: unsettling that if you had uh met around your neck
• 27:01
  Speaker 1: and the only tag that was left was a black
• 27:04
  Speaker 1: one because they ripped them off one by one, right,
• 27:07
  Speaker 1: or they could rip off like three if like they
• 27:09
  Speaker 1: just knew it meant you're a goner. You might still
• 27:12
  Speaker 1: be alive right now, you're looking you're about to die
• 27:14
  Speaker 1: where you're laying right now, and that awful because it
• 27:17
  Speaker 1: said Morgan it too, so you could look and be like, oh,
• 27:22
  Speaker 1: I imagine if you're in that kind of condition, you
• 27:23
  Speaker 1: don't need that black tag to let you know that
• 27:26
  Speaker 1: time is near. Yeah, probably not. But if you're holding
• 27:30
  Speaker 1: out hope, it does not help. No, Yeah, no, that's good.
• 27:34
  Speaker 1: You give up the ghost. But again, the whole idea
• 27:37
  Speaker 1: of disaster or a battle battlefield triages. It's a necessary
• 27:44
  Speaker 1: kind of sad thing that you have to do to
• 27:46
  Speaker 1: save more people. It's the mercilessness of a compassionate um profession.
• 27:51
  Speaker 1: Yeah all right, well let's take a break and we'll
• 27:54
  Speaker 1: talk a little bit more about these tags right after this.
• 27:59
  Speaker 1: So oh alright, So this guy Mr Blodgett, he actually
• 28:22
  Speaker 1: sold these through I don't know if he got the money,
• 28:25
  Speaker 1: that's what I was He didn't. I think he found
• 28:27
  Speaker 1: somebody who was like, we can distribute these widely. Your
• 28:31
  Speaker 1: your idea will be set in stone. But we're keeping
• 28:33
  Speaker 1: the money. The American Civil Defense Association is who he
• 28:38
  Speaker 1: gave them too to sell. That's the impression I have.
• 28:40
  Speaker 1: All Right, Well, good on him, you know, hero hero,
• 28:44
  Speaker 1: anybody who gives up intellectual property rights as a hero. Agreed. Um.
• 28:50
  Speaker 1: So it's said here in the heyday that they were
• 28:52
  Speaker 1: selling about a hundred thousand of these a year, two agencies,
• 28:57
  Speaker 1: which is uh no small number. And um I didn't
• 29:02
  Speaker 1: see how much they sold them for though. Yeah, they
• 29:05
  Speaker 1: were in bulk, so like scantron sheets or something, probably
• 29:08
  Speaker 1: not a lot of money. But um they went on
• 29:11
  Speaker 1: to be refined years later in when was this? This
• 29:15
  Speaker 1: was after the Oklahoma building explosion, right, yeah, the bombing, Yeah,
• 29:21
  Speaker 1: the Alfred P. Murrah building. Is that pronounced right, Murmur?
• 29:26
  Speaker 1: I think I'm pretty sure it's Maura. I just see
• 29:28
  Speaker 1: out of the corn mon Jerry nodding and shaking her head.
• 29:30
  Speaker 1: I don't know what means. What's speaking circle? Um. There
• 29:35
  Speaker 1: was a l A. P. D Fire department. Um. Well,
• 29:38
  Speaker 1: two guys actually, Dennis Ortiz and his brother, and they
• 29:43
  Speaker 1: were working that, like I said, at l A County
• 29:45
  Speaker 1: Fire Department and when when were they on the scene
• 29:49
  Speaker 1: in Oklahoma at the time or were they think they
• 29:52
  Speaker 1: were moved by it? They were like, uh, if something
• 29:55
  Speaker 1: happened like that in l A, would we do we
• 29:58
  Speaker 1: have like the resources we need. That's pretty amazing. So
• 30:02
  Speaker 1: he went to get these tags from l A County
• 30:06
  Speaker 1: and these MET tags, he said, we're basically disintegrating in
• 30:09
  Speaker 1: my hand, I guess because they were just so old.
• 30:12
  Speaker 1: And he said, there's there should be a new tag
• 30:15
  Speaker 1: and this is sad but also necessary for terrorist disasters
• 30:21
  Speaker 1: and terrorist attacks, and it was pretty great idea. So
• 30:25
  Speaker 1: he now included this new tag with things like biological contamination,
• 30:31
  Speaker 1: radioactive contamination, UM diagrams for blast injuries, personal property receipts,
• 30:39
  Speaker 1: stuff like that. Yeah, it's like a trifold package. It's
• 30:43
  Speaker 1: it's got everything all the bells and whistles you need, right,
• 30:47
  Speaker 1: including basically a revised, improved MET tag. So a MET
• 30:52
  Speaker 1: tag for the new Yeah. I think they're called smart
• 30:54
  Speaker 1: tags now, really smart everything. Yeah. Well, another thing they
• 30:59
  Speaker 1: can do too is UM, a lot of times you
• 31:02
  Speaker 1: might not have these tags, so they'll literally right go
• 31:05
  Speaker 1: around with sharpie's and write on people. Uh in in
• 31:08
  Speaker 1: the case of a disaster. I wonder if people can
• 31:10
  Speaker 1: feel you writing write the word on your forehead or something. Yeah,
• 31:15
  Speaker 1: I can feel you're writing morge on my forehead. I
• 31:17
  Speaker 1: know what you're doing. That's not good. Did you ever
• 31:19
  Speaker 1: play that game when you're a little word You would
• 31:21
  Speaker 1: draw on someone's back and you would try to guess
• 31:23
  Speaker 1: what they were. I was. That was terrible at that
• 31:26
  Speaker 1: I was bad too, but it felt so good. Yeah,
• 31:28
  Speaker 1: I love back scratches. So it was always like, draw
• 31:31
  Speaker 1: something really elaborate, Jah Lawrenz attractor, that'd be wonderful, but chuck.
• 31:37
  Speaker 1: Whether it's in an incident triage or e ER trias
• 31:40
  Speaker 1: or something like that, it's um well, I should say.
• 31:43
  Speaker 1: And an e R triage. There's a spectrum of triage, right,
• 31:48
  Speaker 1: and e R is about the most calm, stable version
• 31:52
  Speaker 1: of it, even a chaotic, crazy e ER in a
• 31:54
  Speaker 1: big city, compared to on the other end, the site
• 32:00
  Speaker 1: of a massive disaster that's not just impacted a bunch
• 32:04
  Speaker 1: of people, it's probably affected like the health care infrastructure
• 32:07
  Speaker 1: as well. Within within that spectrum, there's different types of triage,
• 32:11
  Speaker 1: and usually the worst it is the faster your assessment
• 32:15
  Speaker 1: has to be. So like out on a battlefield. Um,
• 32:18
  Speaker 1: they've come up with basically a two two point um
• 32:23
  Speaker 1: triage assessment. It's called the field triage score. It's part
• 32:26
  Speaker 1: of the technical combat casualty care methodology, right where they
• 32:31
  Speaker 1: feel your pulse and then they give you a rating
• 32:34
  Speaker 1: of awareness on the Glasgow Coma scale, which we covered
• 32:38
  Speaker 1: in our comma. Yeah, and apparently if you put those together,
• 32:42
  Speaker 1: it's a pretty good predictor of whether somebody's going to
• 32:45
  Speaker 1: survive their injuries or not. So like, if you're out
• 32:48
  Speaker 1: of it and your pulse is low, move along, that
• 32:50
  Speaker 1: person is a goner in that situation. Whereas if that
• 32:55
  Speaker 1: person came into an e R in the suburbs um
• 32:59
  Speaker 1: or or trauma center or something like that, they might
• 33:01
  Speaker 1: have a really good chance of making it. But depending
• 33:04
  Speaker 1: on the situation along that spectrum of triage, UM, you're
• 33:09
  Speaker 1: you're going to depending on where you are on that
• 33:12
  Speaker 1: spectrum physically literally, Um, you may just get passed over
• 33:17
  Speaker 1: or you may have your life saved. Man, You've got
• 33:19
  Speaker 1: to have nerves of steel to be a first responder. Yeah,
• 33:23
  Speaker 1: and we should also say to once you're given a code. Um,
• 33:27
  Speaker 1: but you're like, that's not it's not static, like it
• 33:30
  Speaker 1: can change, You're you can deteriorate over right, switch tags
• 33:35
  Speaker 1: that person next to you, right, But no, you're absolutely right,
• 33:38
  Speaker 1: like to to to say, like I want to save
• 33:41
  Speaker 1: your life, but I can't. I've got to leave you
• 33:45
  Speaker 1: there to die. You're absolutely right. I mean it's metal,
• 33:50
  Speaker 1: not for me. That's metal in both spellings, two D
• 33:55
  Speaker 1: s and a T, you know, two teas and an
• 34:01
  Speaker 1: L E. Oh, it's M E T T L E.
• 34:04
  Speaker 1: Why do I think it was emmy D D L E.
• 34:05
  Speaker 1: Because it's like meddling. If you went and rearranged everybody's tags,
• 34:13
  Speaker 1: that would be meddling. It's amazing metal and like metal.
• 34:17
  Speaker 1: I know, it's amazing the amount of dope things I
• 34:19
  Speaker 1: say on the show, and people still think I like
• 34:21
  Speaker 1: have anything to offer the world. I've got you beat
• 34:24
  Speaker 1: by like four or five times. I think I don't
• 34:26
  Speaker 1: think so, I think so. Um, all right, well let's
• 34:29
  Speaker 1: talk a little bit about what's well, we've talked about
• 34:32
  Speaker 1: what's good about it, um, pretty much everything because it
• 34:35
  Speaker 1: will say ultimately more lives, yeah, but has its critics
• 34:38
  Speaker 1: well yeah, and a lot of times you know when
• 34:40
  Speaker 1: you go to the e er. We're not talking battlefield
• 34:42
  Speaker 1: or disaster, but when you go to the er, you
• 34:45
  Speaker 1: want to get seen as quickly as possible because it's
• 34:48
  Speaker 1: the worst. My thumb hurts, Yeah, and so long you
• 34:52
  Speaker 1: look around and you're like, well, that person doesn't look
• 34:55
  Speaker 1: so bad off, why are they going in? Or I've
• 34:58
  Speaker 1: been here for an hour. This guy just came in
• 35:00
  Speaker 1: and he got seen and he didn't look too bad
• 35:02
  Speaker 1: that the kids breathing, Yeah, why is he going ahead
• 35:06
  Speaker 1: of me? Yeah? I mean they hear a lot of
• 35:08
  Speaker 1: I mean e ers have to feel a lot of complaints,
• 35:11
  Speaker 1: yeah about wait times. And there's a lot of people
• 35:13
  Speaker 1: who end up in what's called the l w B
• 35:16
  Speaker 1: S category. Is that where they send complainers left without
• 35:19
  Speaker 1: being seen. Some people just give up there, like forget it,
• 35:22
  Speaker 1: I'm not sitting around here any longer. I could see
• 35:25
  Speaker 1: me doing that. Yeah, you just become indignant or you're
• 35:28
  Speaker 1: like I feel like eating some cereal. Well, I just
• 35:32
  Speaker 1: don't like to wait. And maybe it would have to
• 35:36
  Speaker 1: be something where it's subsided enough to rouse like I
• 35:38
  Speaker 1: think I'll be all right, right, not like an injury, right,
• 35:40
  Speaker 1: Unless I thought I could set it up myself or
• 35:43
  Speaker 1: Rambo style, which Emily's dad did once. What did you
• 35:48
  Speaker 1: like soda cut in his arm himself one time with
• 35:51
  Speaker 1: needle and thread? Did he put gunpowder in it and
• 35:53
  Speaker 1: light it on fire? He should have that would have
• 35:57
  Speaker 1: done it. Uh. And apparently that they interviewed someone from
• 36:01
  Speaker 1: for our House to Works article from our great children's
• 36:04
  Speaker 1: hospital here Scottish right, and this doctor said, especially at
• 36:07
  Speaker 1: children's hospitals, a lot of upset parents that don't really
• 36:13
  Speaker 1: get the triage thing. Well, um, there's been studies actually
• 36:17
  Speaker 1: that there was. There was one very famous study from
• 36:21
  Speaker 1: the nineteen nineties I think actually, and then it had
• 36:25
  Speaker 1: there was such an outcry against it as far as
• 36:29
  Speaker 1: criticism of the study went, because the study, the studies
• 36:32
  Speaker 1: findings were very critical the trio triage as a whole,
• 36:35
  Speaker 1: like the concept of it. Um that the authors actually
• 36:38
  Speaker 1: wrote another study responding to the criticisms of their original study.
• 36:43
  Speaker 1: And I was reading that and they're basically in the
• 36:46
  Speaker 1: original study they found that triage when it's actually done,
• 36:52
  Speaker 1: leads to longer wait times for the people who need
• 36:54
  Speaker 1: the most immediate care, like gets in the way, and
• 36:58
  Speaker 1: that it didn't have any impact patient satisfaction, meaning people
• 37:02
  Speaker 1: didn't feel like they were being cared for better than
• 37:06
  Speaker 1: when they weren't exposed to triage. So um, they the
• 37:12
  Speaker 1: the people just said this is what we found. A
• 37:14
  Speaker 1: lot of people were like, this is a B S study,
• 37:17
  Speaker 1: but it does make sense. There are critics to triage
• 37:20
  Speaker 1: saying like, no, this is unnecessary. Uh, it's clumsy, it
• 37:24
  Speaker 1: gets in the way. It's an extra layer, a barrier
• 37:26
  Speaker 1: between a patient and treatment. Um, like someone's gotta say
• 37:33
  Speaker 1: this guy's got a spoon in his ear. I think
• 37:35
  Speaker 1: for the most part, the critics don't have an alternative
• 37:41
  Speaker 1: and that you know, triage can help. But I think
• 37:45
  Speaker 1: there's a it's almost a cult of triage, where like, yeah,
• 37:48
  Speaker 1: of course triage helps. You're an idiot for saying anything different.
• 37:51
  Speaker 1: Scientists are saying like, it's not it's not perfect. Um,
• 37:56
  Speaker 1: but I don't know what an alternative would be in
• 37:58
  Speaker 1: the case of really scarce resources. Well, here's one, not alternative,
• 38:03
  Speaker 1: but one other way of doing things. And they did this,
• 38:06
  Speaker 1: uh at the Kaiser Permanent South Sacramento Medical Center Kaiser Permanente.
• 38:12
  Speaker 1: They forgot the e oh they did Kaiser Permanent. What
• 38:15
  Speaker 1: they said here, Um, what does permanente? I mean either
• 38:19
  Speaker 1: what does what does it think? It means permanent in Spanish? Okay,
• 38:22
  Speaker 1: who's kaiser? Uh? That means permanent in German? So the
• 38:28
  Speaker 1: permanent permanent. No, that means a role, A delightful type
• 38:32
  Speaker 1: of role that's permanent, a German role forever. Uh yeah
• 38:41
  Speaker 1: yeah four times. So. Um they employed something from the
• 38:46
  Speaker 1: l e A and the lean thinking principle in Japan
• 38:49
  Speaker 1: and their businesses. Is this like when they have people
• 38:52
  Speaker 1: do like calistinics and that kind of thing. Now, I
• 38:56
  Speaker 1: don't know, I want to look into what that is.
• 38:57
  Speaker 1: It sounds interesting. Well, it's like a cutting down on waste.
• 39:02
  Speaker 1: But I'm sure that the Japanese probably figured out a
• 39:04
  Speaker 1: way to insert calisthenics into it. Um are Actually I
• 39:09
  Speaker 1: might be thinking of China. No, Japanese are into too, okay. Um.
• 39:15
  Speaker 1: So they used this lead methodology and what they would do,
• 39:19
  Speaker 1: and this makes a lot of sense. It was sort
• 39:21
  Speaker 1: of like the two track thing. But if you have
• 39:24
  Speaker 1: the minor injury, you actually have a doctor come out
• 39:27
  Speaker 1: to the waiting room and treat you in the waiting room,
• 39:32
  Speaker 1: or at least see you at first in the waiting room.
• 39:35
  Speaker 1: And I think that definitely would give someone a sense
• 39:37
  Speaker 1: of while I'm being tended to, at least I'm not
• 39:40
  Speaker 1: just sitting over here holding my belly in pain. But
• 39:43
  Speaker 1: it's also not like, uh, you're on track to go
• 39:47
  Speaker 1: sit over there and wait for a bed to come
• 39:49
  Speaker 1: open so you can see. It's like, you there, you
• 39:52
  Speaker 1: don't have to wait for a bed. The doctor came
• 39:54
  Speaker 1: to you instead. Yeah, that's a great idea. And they
• 39:56
  Speaker 1: found it reduced the left without being seen rate from
• 39:59
  Speaker 1: four point five percent to one point five percent. Uh,
• 40:02
  Speaker 1: and the wait times fell by half. Yeah, that's right.
• 40:07
  Speaker 1: Wait times are one of my biggest complaints with modern medicine. Sure,
• 40:12
  Speaker 1: it's the worst. Your appointments at one, you get in
• 40:15
  Speaker 1: there at two. Oh man, boy, oh boy, you want
• 40:20
  Speaker 1: to see me get mad? Stick me in the waiting
• 40:23
  Speaker 1: room with bad magazines. But if you got some mad magazines,
• 40:27
  Speaker 1: you're like, this is delightful. The other criticism of triage
• 40:31
  Speaker 1: is that it shouldn't be done at all, That withholding
• 40:34
  Speaker 1: care under any circumstances is unethical. So I just have
• 40:38
  Speaker 1: like eight times as many doctors and nurses. I guess
• 40:41
  Speaker 1: it's come on. Uh, if you want to know more
• 40:43
  Speaker 1: about triage you're sorting. Um, you can type those words
• 40:47
  Speaker 1: into the search part how stuff works dot Com. And
• 40:49
  Speaker 1: since I said that it's time for listening mail, I'm
• 40:54
  Speaker 1: gonna call this lighthouse follow up. We've got a lot
• 40:56
  Speaker 1: of really great pictures and emails from lighthouse enthusiasts. Yeah,
• 40:59
  Speaker 1: it's pretty cool. Uh, including ones that were for sale
• 41:03
  Speaker 1: so I could live about my fantasy. Yeah. Are you
• 41:05
  Speaker 1: going to know how much are they didn't see? Um,
• 41:09
  Speaker 1: I don't know. I didn't. I don't remember any crisis
• 41:12
  Speaker 1: looking up on Zilo. I bought like two of them
• 41:14
  Speaker 1: and I didn't catch the price. You're just like, here's
• 41:17
  Speaker 1: a bunch of money. Bring me those lighthouses. Hey, guys,
• 41:20
  Speaker 1: I listened to your lighthouse episode and it was so
• 41:23
  Speaker 1: excited to hear this. Last year, I visited every lighthouse
• 41:27
  Speaker 1: on Oregon's coast her state. Uh, such a good year
• 41:33
  Speaker 1: long goal, That's what she said. I agree. Anyhow, I
• 41:37
  Speaker 1: wanted to tell you about one of our coolest in
• 41:40
  Speaker 1: my opinions, is Terrible Tilly. She was built on a
• 41:44
  Speaker 1: rock a mile off shore and see pictures is really neat.
• 41:47
  Speaker 1: That's what I needs. It's like just out there in
• 41:50
  Speaker 1: the middle of the ocean. Many men died trying to
• 41:52
  Speaker 1: construct in eighteen seventies, and many men died while keeping
• 41:55
  Speaker 1: the light that was decommissioned in nineteen fifty seven and
• 41:57
  Speaker 1: was sold after her sale, until he became a graveyard
• 42:02
  Speaker 1: so to speak. Sailors would be cremated and had their
• 42:05
  Speaker 1: ashes stored in the lighthouse. During the seasonal storms, when
• 42:08
  Speaker 1: the waves break into the lighthouse, the ocean chooses who
• 42:12
  Speaker 1: she takes back with her to be buried in her bosom. Well,
• 42:16
  Speaker 1: it's very poetic. It's pretty romantic in a Victorian or
• 42:19
  Speaker 1: Gothic way. I totally agree. Thanks for all you guys do.
• 42:22
  Speaker 1: I look forward to listening to your podcast every week.
• 42:25
  Speaker 1: And I evangelized stuff you should know, the stuff you
• 42:27
  Speaker 1: should know gospel to all my friends. And that is
• 42:30
  Speaker 1: from Kendra, and Kendra used the word evangelizing bosom in
• 42:34
  Speaker 1: the same email and Gothic, so that means straight to
• 42:38
  Speaker 1: the top of the pile. Thanks a lot, Kendra, that
• 42:40
  Speaker 1: was indeed to create email. Uh. If you want to
• 42:43
  Speaker 1: get in touch with us, you can tweak to us
• 42:45
  Speaker 1: a S y S podcast. You can join us on
• 42:47
  Speaker 1: Facebook dot com slash Stuff you Should Know You can
• 42:50
  Speaker 1: send us an email to Stuff podcast. The House suff
• 42:52
  Speaker 1: works dot com and has always joined us at our
• 42:54
  Speaker 1: home on the web Stuff you Should Know dot com.
• 43:02
  Speaker 1: For more on this and thousands of other topics, visit
• 43:04
  Speaker 1: how stuff Works dot com.