Full transcript: Dr Marc Barton on London Real
0:15 Oh my god, welcome to London Real. My name is Brian Rose and with me is my co-host and cohort, Mr Nick Gabriel. And joining us in studio today is Dr Marc Barton. Welcome. Thanks very much for having me guys.
0:28 No problem. I first want to thank our sponsors at onit.com for their wonderful stuff, AlphaBrain, that’s now doctor approved because Marc has just taken his first AlphaBrain. So if you have any problems with it, you know that it’s been studied and taken in clinical trials here.
0:50 Please forward all correspondence to Marc Barton at… Is there going to be a disclaimer on the website? You might have to do one. But as you guys know, we’re on AlphaBrain right now. We love it.
1:01 And you can get some if you go to onit.com and use the code LondonReal. You’ll get 10% off or if you go to our website at LondonReal.tv, there’s a cool ad there and you can click on it and then you can be razor sharp and lucid and checkmate. And you might even become as good looking as Brian. Oh man, you’ve been on it for years I think. I’ve been on it now for maybe three months.
1:24 I usually do five days on and two days off. That way I think I kind of rejuice it up on Monday and I kind of feel it. That and a little cardio and a little caffeine does me well. But I just wanted to thank everyone that came out to the wine tasting this last week. I don’t know if you saw some of the pictures, but it was fun. And Nick, we didn’t see drunken Nick, did we?
1:40 That was pretty close. Buzz Nick. But it was fun, right? It was a great room. And I think we had a lot of London realers that came along and I just want to shout out to everyone. Thanks to James as well at Humble Grape. That was fun. Yeah, that was really good. And we just wanted to mention a couple fans that are just being really awesome. One of them we met at the wine tasting, which is Diego Ferreira. And he’s just a cool dude and a big London Real supporter.
2:03 And I just want to shout out to Diego and also to Rabia Mamoud. She’s another girl. We just, she found us somehow, I think on Facebook or on Google and she’s just really supportive. And so we just want to send her a shout out. But as usual, I will say again to you, Nick, who is this doctor in my house?
2:20 So I call him Dr. Mark, right? Okay, that’s like Dr. Phil. Yeah. Dr. Marks, he was originally a jujitsu student of mine and now he’s become a good friend of mine. I’m actually the godfather to his daughter.
2:36 Oh, wow. Okay. I saw those pictures. Very cool. Yeah. She’s so cute. Right. And besides being a very, very friendly and awesome person, Mark also has a very interesting job, which is he works in A&E, which is for those who don’t know accidents and emergencies. And, you know, I was so excited to have him on the show because sometimes we’ll sit in chat and some of the perspectives he gives me about dealing with people who are on their deathbeds. It’s just, I don’t know about you, but I’ve never even seen a dead body. No, I’ve never seen anyone die or never seen a dead body. So hopefully you have some pictures you brought with us. Yeah. Loads of photos on the phone.
3:15 So Mark, I know, and man, I know this theme keeps popping up because we’re supposed to do it. There’s some weird spiritual thing in another dimension that keeps bringing this theme up. I know it, Brian. I was talking to Mark this morning about DMT. Okay.
3:32 And he’s got a friend who has done it a few times. And then I was mentioning Kawa when you’re born with this two times in your life, when you’re born and when you’re about to die, that your body releases a massive dose of DMT. Okay. Right. Because when people have those visions, when they come close to death, some people attribute it to DMT.
3:51 And then Mark was about to say something to me about that. And I was like, no, no, stop. Save it for the show. Save it for the podcast. Yeah. You said you, I think you started saying you’ve seen so many people die.
4:01 Yeah. I’ve seen a lot of people die. Hundreds. Probably. Okay. Probably hundreds of people die.
4:08 I spent a long time this year working in intensive care, actually. So I took some time out from A&E and worked in intensive care. What’s the difference between those two? A&E is kind of the first four hours of your stay in hospital. Okay.
4:19 So you come in, you know, you get mangled in your car accident or whatever, and then we try and stabilize you then move you to, you know, a high dependency area or somewhere where you can get nursed. How important is that first hour? Because I read something about like soldiers in Afghanistan with the US and they’ve cut the time down from like two hours to 30 minutes where they go from the battlefield to treatment. And it makes such a huge difference.
4:39 It’s what we call the gold now. I mean, it’s crucial. I mean, the whole story behind how that this whole trauma life support thing came about was a, he’s an American guy, I think in the late 70s, who was involved in a light aircraft accident with his family and they crashed a plane in a fairly remote area, sort of in the Midwest of America, I think. And I think the treatment that his family got was poor, the way that the emergency services responded. And I think basically the old died apart from him. And then he took away his experiences from looking at what they did. And he felt he was an orthopedic surgeon, I think. And he felt that he could create a sort of a pathway or a way of caring for people in the trauma scenario, that he could have done better on his own without them there than they provided. He could have done better with no medical services available to him.
5:27 And he created what’s called the advanced trauma life support courses, which we all do now. It’s an American thing, but it’s been incorporated by the Royal College of Surgeons in the UK. And the golden hour they preach, this is the time that you can save lives in that first hour. I mean, you get three peaks of death in trauma. The first peaks in the first few seconds, and this is usually due to some sort of trauma to one of the great vessels, the aorta, you may perforate your heart, your ventricle, or some sort of major airway problem where you basically obstruct your airway and stop breathing. And he decided that there was, you know, this whole ABC principle, I don’t know who heard of the ABC. So I find this really fascinating.
6:16 So, you know, our first priority, the first thing that’s going to kill you is your airway. Okay. So you have to the first, the first thing you do if you have a trauma patient is you stabilize the railway, you know, and a good way of assessing that is if a patient can talk to you, they’ve got a patent now, you know, if not, you need to do something to assess that further. So you look, if they’re struggling to communicate via speech, you can look at different noises that they make, you know, patients, you know, they can, when you, when you get involved in trauma, things can block the airway teeth, vomit, blood, you know, these sort of things. You have to clear that out. You may have to what we call intubate a patient, which is introduce a tube into the trachea, and then you can plug someone into a ventilator. You can bag them and then you can breathe for them. It’s dangerous if someone does that on their own. I mean, you always hear, take the pen and you get the tube and then cut, you know, the trachea and stick it in.
7:02 I mean, you kind of need to have some knowledge of what you’re doing probably. So I wouldn’t advise you guys to go. Is it a horizontal cut or a vertical cut? Maybe we shouldn’t be saying this. You can actually do, this is what you’re describing is a cricothyroidotomy. And there was a, there was a paper published not too long ago that showed that it probably doesn’t work with a biro.
7:19 A biro? Yeah, I never read this paper. It’s a British wrote for a pen. So the sort of famous story of, you know, some doctor being on a plane with a coat hanger and a pen, you know, and it won’t work because of the airways. And also you need some sort of supplemental oxygen. You need to be able to ventilate the lungs, you know, your, your tidal volume, the amount of air that’s going in and out of your lungs. We’re looking at you would probably be about five, 600 mils. You can’t deliver that through that per breath. You can’t deliver that through a biro or a pen. That’s intense.
7:50 What do you, Mark, like when you, when you watch people die, is there any common thread like that you’ve noticed or any common reaction that you’ve you’ve seen in people on the deathbeds? You know, you know, when someone’s died, I mean, you know, I can tell when that moment’s passed. I mean, in the, I mean, there’s definitely something different about someone who’s about to die and the way that their body is and the way they are immediately after death.
8:20 I mean, there’s something gone, you know, to tell that in the, in the emergency department, the A&E setting, most of the people that I see who, who die have already stopped breathing or their heart stopped beating in the community and they’re brought in by ambulance. We, you know, we managed that as a cardiac arrest and try and resuscitate them. So you don’t actually get to see that kind of moment as often, but you do, you do see people, you know, you do see their heart stop beating or them stop breathing. In intensive care setting, it’s much more common to watch people die because you have patients for a long period of time, you nurse them for, you know, for maybe sometimes weeks. And then you, you know, you, you then actually, you’re more often around at that point of death.
9:02 Do they ever talk to you and say, I don’t want to die and this kind of thing? Or no, I mean, you know, a lot of the patients in intensive care, they’re ventilated, so they’re asleep, we sedate them, kind of make them comfortable. I think the most important thing really is to make someone comfortable at that moment, give them some dignity, you know? I mean, the barbiturates and opiates and stuff, how important is that for these people? Okay. These drugs are, you know, a huge part of what we do. I think, you know, dignity in death is something that’s very close to my heart. Very, very important thing, you know, you know, my, one of my, my, I have a goddaughter. Her name is Kitty Ann and she’s nine years old and her father died from cancer about two years ago. And I got to, we got to watch him die and it was hard, but he was on a lot of pills at the end and he stayed at home. And man, I think they really helped him. I mean, those last three months, because he’s been a lot of pain before that and he was taking the pills and he used to text me. He’s like, dude, I know this is the pills, but you know, I just want to say I love you and all this stuff. And it was just made a big difference, man, especially because his daughters had to watch him and, you know, when you say that, I took ecstasy earlier this year, like, you know, and for you guys know, I had that huge issue with that ex-girlfriend and then I was carrying
10:16 A lot of shit around that. And, you know, when I took that, that, that ecstasy tablet, like when it kicked in, the first thing I wanted to do was crazy. I just wanted to pick up the phone. I mean, things ended really bad. I wanted to pick up the phone and call her and say, you know, everything’s okay. You know, I know we both loved each other and even though it didn’t work out, I don’t care, just everything’s okay. And I could really feel like on a spiritual level that that chemical, the way I was explaining it to a friend the other day, I could feel it did something to my heart chakra, you know, it like literally changed the spiritual polarity of my whole being was absolutely incredible. So when you say that, I mean, how the guy texted you and said, I know it’s the polls talking, I can, I can totally believe that very interesting.
11:01 What do you think about that? Yeah, I mean, you know, you talk about your heart and how different drugs make you feel. And obviously, you know, the heart, as we think of it is actually, you know, a small portion of your brain, you know, and an area that’s basically processing that the information and the feelings that you have, and drugs can powerfully affect that. And it’s just a chemical shift, isn’t it really in the way that you’re thinking and a difference? Drugs have very powerful effects, you know, every drug we take, whether it’s something that’s prescribed, whether it’s something that you take illicitly, you know, a drug for recreational purposes, or a drug for prescription purposes, they’re all poisons. It’s just in the quantities that you take, you know, even poisons, why do you say that? If you know, if say, say, for example, you’ve got a headache, and you go and take a couple of paracetamol Tylenol. Yeah.
11:53 It’s great, get rid of your headache, you go and take 100 of them, it’ll kill you. Okay, you know, it’s just a perspective that you have. So, you know, you have to be cautious with everything that you prescribe, everything, you know, that I every time I write on a drug chart, I have to think to myself, you know, what’s this going to do? What are the side effects and cost, cost benefit kind of, you know, cost benefit, I suppose becomes an issue within the NHS, because it’s so what I meant is the physiological cost versus the physiological benefits. Yeah, yeah, for sure. Now, you’re on the front lines, and you must see a lot of alcohol related. I mean, I’m curious what you say. And a lot of people, like, you know, in California, you know, marijuana is legal, and it’s used for medical purposes, and used for a lot of recreational purposes. But, you know, people talk about the injuries that people do to themselves from alcohol versus other drugs. And I was just wondering what you see.
12:46 I mean, alcohol is 40 to 70% in the UK of patients that we see in the emergency department, coming with an alcohol, alcohol related problem. Can I just imagine the story that that’s related to that. I asked Mark once we’re sitting in his car, we’re driving somewhere and I said, you know, Mark, he’s Mark’s got three young kids. I said to him, from from your experience, from what you’ve seen, if there was one drug that you could guarantee your kids would never take, what would it be? And he said to me alcohol. And that that really blew my mind when you said that, you know, you have to, you have to realize that I spend night after night, you know, working in an emergency department with, you know, dudes pissing in the corner and fight the nurses and, you know, just behaving atrociously. And, you know, you get a very negative feeling about I mean, binge drinking in this country is a huge, huge issue for us, you know, on the front line in the A&E department.
13:38 Is that just a British phenomenon, in your opinion? Well, I’ve only worked in the UK. Okay. I’ve done my elective in Japan, it didn’t seem to be as big a problem over there. Something I think we do particularly well over here.
13:49 We spoke about the repression in British culture, and it could be like one of the outlets, right? It’s a thought, a theory of mine, you know, that so you know, socially, the British is always, as in Japan, it’s more of a repressed your feelings, there’s not a lot of hugging, a lot of kissing, like you would see in Italy. And they seem to vent their anger. So I find that when the British get their drink on, then it all comes out. And then you guys drop in their trousers and running around, which, you know, you wouldn’t necessarily see a lot of other cultures.
14:16 And I mean, I love England, I’m an English citizen as well. And but it’s something you notice by being here. I mean, I can’t think of another drug that has such a detrimental effect on society, in my opinion. And I know that’s legal. Yeah, if I want to go and kill myself a paracetamol, I can go to one shop and I can buy eight tablets. Okay, so then I have to go to another shop by eight more, and then I want to go to another shop by eight more. And eventually, I’ll get enough that I can give myself a fatal dose. If I want to kill myself with booze, I can go to threshers, I can buy enough just in one city, you know, I’ll go in there, give me the top shelf, and he’ll give me the lot and I can go and I saw him. He wanted why I mean, what else he’s jagged herself to death.
14:51 And you know what, that’s just one of the reasons I I know that the government doesn’t have our best interests, doesn’t always have our best interests at heart. And I don’t want to, not speaking as a conspiracy theorist, but think about this, you know, like marijuana is illegal, right? And I’m not some crazy pot activist. Like, that means nothing to me, you know, I don’t think it should be legal, but I’m not going to go out, like protesting about it. But if you bought 10 kilos of marijuana and sat there and tried to smoke yourself to death, you couldn’t do it. Literally, you couldn’t do it. But I could walk down the street to the nearest liquor store, buy three bottles of whiskey, come home and drink myself to death in a couple hours. It’s legal and sanctioned by the government completely. And you know what it is?
15:35 So culturally entranced, though, it is. Yeah, yeah. It’s a social issue. I mean, this is a drug that’s been, you know, used socially for hundreds of centuries, hundreds and hundreds of years, thousands, right? You know, thousands, and you know, and it’s become a big part of life. I honestly, honestly believe that if, if alcohol were invented today, we went into a different reality that there’s no way that it would be legal. I mean, this drug has the worst effects on your body, such as I mean, you know, you name any organ system, it’s going to affect it, you know, you’re going to give yourself liver failure, okay, you can give yourself it can affect your peripheral nervous system, give you peripheral neuropathies, we can’t feel your feet, you know, you’re going to have, you can get a condition called vernacus encephalopathy, where basically, you know, you get forgetful, you can fabulous stories. And, you know, you, you know, you can’t function properly on a higher cerebral level. It’s, you know, it’s a risk factor for loads of cancers, it’s, you know, it’s, it causes cardiovascular problems, not to mention that in the immediate term, it causes you to fall on your head, you may,
16:36 Make bad, bad judgments on alcohol, you know, people do things that would not otherwise do and I see that all the time, complete loss of inhibition, right? Yeah, loss of inhibition. I mean, you know, people get into fights, they hit each other, they become aggressive, you know, people, you know, sleep with people they wouldn’t otherwise sleep with, get pregnant, you know, you know, has wide ranging sociological effects. Mike, Mike Skinner has a really funny song. He’s from the streets, you know, and it’s from his original lab, I think original pirate material. And he’s, he’s, he’s the weed guy, and he’s doing this talk. And he’s like, I just smoke my weed and play my video games. And it’s illegal. And then the drunk guy’s like, I drunk drinking is legal.
17:11 I like getting drunk. So what if I beat people up in the next, like, you know, I never hit anybody when I’m on weed, but it’s illegal. And it’s just as funny, speaking, speaking of the streets, have you heard that track blinded by the lights? No. Oh, dude. I love those guys. They are so good. It was one of their big hits off original climate pirate material. I must, I must have heard it. If anyone out there is listening, and they haven’t listened to this track, it’s called blinded by the lights. It’s all about this guy. It’s like a narrative in a song. And he’s taking it, he’s taking an ecstasy tub. And it’s all about what happens as he goes into the club and takes it and as it hits him. It’s absolutely incredible.
17:47 I’ll check it out. Definitely. Don’t do drugs. I have to really say that as well. I can’t condone any illicit drug use at all.
17:54 Yeah, we just we just put up with Nick because he’s funny. You name a drug and I can tell you some bad stuff about it. Yeah. So do you see a lot of alcohol related incidents? Also, it’s the most most we were, we had a rare quiet moment Monday night. And I was talking to the other rich draws on and we were talking and neither none of us could remember a night in it that we’ve done a night shift in A&E and we hadn’t seen someone who was drunk and hit their head. Okay, literally. So, you know, we’ve been doing it between us maybe 20 years of experience, you know, so all those night shifts, not one night has gone by that we’ve not seen someone who’s drunk in their head. I’ve literally had to, when I was working in intensive care, I’ve had to like ventilate patients, like put them on a ventilator, you know, intubate them because they’re so drunk that they can’t protect their airway and they aspirate and they would die if I didn’t intubate them. And then admit them into intensive care for the night. That’s three and a half thousand pounds for a night stay because they got so drunk that, you know, they couldn’t basically support their airway anymore.
18:51 Man, you know, when I think about getting drunk, tell me, I really would appreciate your thoughts. I know you’re not a heavy drinker and neither are you, but for me, I just don’t understand why, you know, I’m all for having a couple of drinks and now I’m into that red wine thing, you know, have a couple of red wines and start to chill out and feel that awesome feeling of loosening up and get a little bit of buzz. But there’s been a few times in my life and I’ve gone out and gotten proper drunk, right? And goddamn, the next day, you know, you can just feel that your body should not be going through that. And I don’t understand how some people, some of my friends even, they go out two or three nights a week and get blind, fucking drunk and you’re destroying yourself. It’s just, well, why would you do that? Why? Like you’ve been given this vehicle to get you through this experience, right? Why would you actively go out and try to fuck it up?
19:40 Because everyone else is doing it. It’s culturally ingrained here, you know? It’s just the young people and that’s just what you do. You don’t go out for a few drinks, you get fucked up, you know? And I don’t know. They talk about how cheap alcohol is and whether that’s a solution. I don’t know if that is, but, you know, you watching that day in and day out must do things to you.
20:00 Well, I don’t drink much anymore. Okay. I mean, do you lose your empathy after a while when everyone’s coming in and you’re like, okay, right? These guys all get good treatment, you know, but I believe you, but at the same time, you know, you do get fed up a bit, you know, and, you know, is it dealing with them while they’re drunk too? And you’re like, okay, behave. I mean, you know, some, you know, some guys that come in and they’re just drunk and they sleep and you need to babysit them so they can wake up and that kind of thing. And then there’s some guys that come in a really aggressive, you know, they’re swinging punches at the nursing staff and have you had to use a jujitsu on a, on a drunk patient yet?
20:37 Or can you not answer that? I mean, I’ve had to help restrain patients and it seriously helped. Yeah. I mean, definitely it’s helped, you know, I’ve had a guy that was trying to, he was biting a nurse, you know, so, you know, we, you know, people, you know, that’s out of order, you know, you can’t, you can’t go in and get drunk and then, you know, someone’s trying to put a cannula in you or something to help you and you bite them. Can you sedate them or is that something you’d only do as a last resort?
21:02 You know, they pretty much sedate themselves, you know, most of the time, but, you know, yeah, you can some, you know, sometimes these, you know, the sedation is required. It’s a, it’s a, it’s a fine line because you’ve already got someone who’s got a lot of a drug on board, which is, you know, taking away their higher cerebral function or whatever and their ability to, you know, to protect their airway and that kind of stuff. And then you start giving them other drugs on top of that and then you end up having to ventilate them. And, you know, and, you know, that’s not a road that you want to go down. Right. Mark, tell me, you, how have you managed to, I’ve always like known you as a pretty upbeat cut, you know, you’re pretty relaxed, pretty friendly, pretty optimistic.
21:41 How have you managed to retain that when all day you’re surrounded by sickness and death? Yeah, I mean, it can be tough sometimes, you know, and, you know, I felt it sometimes in the ITU intensive care job. I mean, it can be a pretty dark place. You know, like a third of my patients probably die, you know, in the course of this day. And I think it can be difficult to be, but you do become a bit detached from it. You know, you don’t, you can’t take it all home with you. You have to leave some of it at the front door of the hospital when you go home. And do you think that that ability to detach, it’s just something that I mean, you didn’t practice it. It just kind of happened. Tolerance, I think, you know, it’s like anything you become tolerant to teach you any of this, like, is there a psychology when you get your, your degree? I think no, I didn’t get taught it. But I think the medical students now they have a, it’s a big part of the training. I think they have sociology is heard about that implementing that now.
22:32 And I think it wasn’t really something that, I mean, when I, you know, when I qualified, the system was a bit different. And it was still, you know, it was before the whole European working hours thing where doctors used their hours and that kind of stuff. So it was this kind of, you kind of get on with it, you know, just get on with it, go and do it, you know. What do people say when you tell them you’re a doctor and why did you want to, when you were five years old, do you, were you like, I want to grow up and be a doctor?
22:57 I didn’t want to be a doctor at all until, you know, late teens really. And what do people say when I tell them a doctor? I mean, I don’t know. I mean, do they look at you with like this ray of sunshine and like, oh, maybe it’s the circles I work in. Every girl wants to, wants to tell her mom, she’s getting engaged to a doctor, right? I mean, seriously, I don’t know. I mean, maybe I just don’t meet many people anymore, you know.
23:25 It’s quite a, it’s quite a burden of responsibility, man. It’s quite, I mean, I hate, I’m probably wrong here, but it’s quite, you know, I still think it was a noble profession. Tell me about it, right? You know, but then you probably, you probably don’t think that. I mean, I think, you know, I can go to work and I can, I can do my job and I can come home and feel pretty good about what I do a lot of the time, you know, and I think that, you know, and I think I do do it because I know it sounds corny, but I want to help people, you know, that was why I wanted to do it. And, and I try and, you know, you have to try and remind yourself of that. And that’s the reason that you’re there. You’re there to try and, you know, do something good for people and, you know, help them out when they need it.
24:00 And I’ve always met with the doctors I’ve had experience with, whether it’s in an emergency room or going in, they’re always super cool. They’re always in control. You know, I don’t know. I could never keep that up. I think it’s dealing with patients on a regular basis, but they all seem to have this kind of a higher plane that they’re on and they’re there to help you. And they just calming you down seems to be like 90% of their job. You’re in good hands.
24:23 Doctor Bedside Manor is just one of the most vital things as well. It makes a huge difference to have people respond to you. And it’s something that I’ve learned on the job over the years. I think, you know, I interact better with patients now than I did when I first qualified, for sure. I don’t know about you, Brian, but like for me, just, you know, I haven’t had anything really serious happen to my, to my body. Like during the course of my life, I had one or two mind operations, but man, hospitals, you feel so vulnerable, right? You know what I mean? It’s completely not in your hands.
24:49 Do you think that you, this is going to be a strange question, but look, we’re all going to die one day, right? It’s pretty, it’s pretty straight. All going to be seriously injured someday and have some major surgery someday. We’re all going to get prostate cancer too, because we’re dudes. The, the question I was going to ask him is, um, Ken, do you think that, that when that time comes when you’re an old man and you, you’re going to hospital for the end, you know, like if that’s the way you go, do you think it will be an easier process for you then the average person is not used to that or? No, I’m, you know, I’m well adapted to the idea that I’m mortal and I’m going to die. Do you know what I mean?
25:27 I have a huge understanding of that, you know, um, a huge awareness of that. So I think perhaps, you know, it’s not going to be, it’s not going to be a big surprise when that day comes, but you know, you know, no one wants to die. Do they, you know, I’ve never seen anyone, you know, who really, you know, desperately on their death bed wants to, wants to, wants to, you know, other than to alleviate suffering or they’re suicidal, perhaps. Do you think you want to go in a bang?
25:52 I mean, I hear a lot of people that get diagnosed with cancer and it’s a horrible way to go, but I also think that they have, it’s not a good thing, but you have three months or six months to kind of wrap things up as opposed to I’m just crossing the street one day and I just get nailed by a bus and that’s it. I can’t reflect. I can’t talk to people. Do you, do you ever think about that? So the conversation you have in medical school, you know, how do you want to go?
26:11 We have a top 10 list of things we don’t want to go with, you know, horrible diseases we don’t want to get. And then there’s a few things. I think for me, I want to be like, you know, 85, 90 with all my faculties and then just go quietly, massive heart attack in my sleep, you know? Okay. So that’s a good way to go.
26:25 I want to jump out of an airplane without a parachute. And that would be awesome when you’re 85. Yeah, dude. I’ve started to feel myself becoming like decrepit and forgetting like my friend’s names and stuff. Dude, I’m going to go out with a bang.
26:37 Yeah. You know what I’m going to do? I’m going to plan my funeral and I’m going to, and I’m going to have video messages and it’s going to be a big fucking party and everyone’s going to show up and, and, uh, and, uh, we’re going to have ecstasy for Nick and everyone’s going to party. And then every half hour I’m going to come up on the screen and I’ll be like, Hey motherfuckers, rock on. And they’ll be like, here’s the entree. It’s going to be stakes. And then I’ll come off the screen and then some people will be disturbed, but that can be really fun.
27:00 Right. But I have to plan it. I plan it in months in advance, but maybe it would bump some people out. You know, I think, you know, you, you just got to kind of live each day as it comes in and make sure that you’re enjoying it at the moment because I’m really, really aware that it’s pretty fragile. Was medical school very difficult and like the first time you had to dissect a human cadaver? I mean, at any point did you want to say, I don’t want to do this anymore because there’s a lot of school.
27:28 And, you know, I, I’d love medical school and that was the best, best times. I mean, you know, that’s just cause you were working up with the nurses. You best I met my wife in the first year of medical school. So, uh, and we’ve been together pretty much the whole way since then. So, um, but we had a great time and yeah, the exams were tough and it’s exam after exam and you have to study hard, but you have a lot of fun.
27:49 People get back and they really enjoy it. And I played a lot of sports and met a lot of great people. Friends have had, you know, the friends that I’ve kept for, you know, all these years since and, um, I love medical school. How long was medical school? I was there for six years because I did a, an extra year to do a, uh, like a BS, a bachelor of science in, um, physiology as well.
28:07 So you can integrate and do a degree in the middle. Okay. You know, what’s amazing is, um, if I’m teaching a jujitsu class or if I’m teaching a private lesson or something, and I’ll be like trying to describe a certain technique and I’m saying, Oh, you want to put this, you want to put this part of your body in like marks, like, yeah, that’s the radial bone or that’s the, you know, it’s, there’s knowledge of anatomy is just, it’s incredible. It’s nice. Okay.
28:30 Test me on, on the internet now, you know, so that’s pretty cool to know all that stuff from a physio standpoint. So this, this is your chosen track. Are you going to stay in any intensive care for the rest of your career? I mean, I think, um, my, that’s young man’s work, right? It’s tough work actually, but you know, the night, the night shifts and everything, they, they wear a bit thin sometimes, you know, is it all night?
28:52 Yeah. I mean, when, I mean, I do, I work a shift pattern. So, um, you tend to do day shifts, um, twilights or nights really. So, um, like I’m doing weekend nights this weekend. So, um, there’ll be like 12 hours overnight.
29:07 Wow. And that’s where the action is. Yeah. I mean, it’s pretty busy. Yeah.
29:11 Weekends can be busy. Again, a lot of it’s alcohol, you know, it’s, you know, just sort of sifting through that. I want to know something cool. Mark went and worked in Japan as a, when you were a med student. Medical student, I went, yeah, we do what’s called electives where you get an opportunity to go to a different country for a few months.
29:26 And I went over to Japan for how long were you there? Four months. What was, uh, like, what was some of the major differences in the way, um, the medical community or the medical establishment has run in, um, what operates in Japan compared to UK? I mean, yeah, the, the, the underlying structure of the system is a bit different. I think it’s like a sort of semi-private system over there.
29:43 So that has a different feel to it. Um, it, it was almost like being transported back in time to like the sort of 1950s. Cause all the nurses wore their little nurses hats and the, and the little old fashioned skirts. And they were really deferential to the doctors. Do you know what I mean?
29:58 If I was, you know, if I was to speak to the nurses, you know, in the A&E department, like these dudes spoke to their nurses. I’ll get my ass kicked by them. You know, they, they, and rightly so. Do you know what I mean? And, um, and they’re very well respected.
30:10 I think the respect of doctor, doctors in the culture over here, people still respect doctors. It’s degraded, you know, I think over time. And people understand that we’re more, we make mistakes. We don’t get everything right. And, um, yeah, that’s, that’s, um, in the States, you know, you always hear about like, uh, litigation stuff like apparently doctors, or if someone falls down in the street and hurts themselves, doctors like don’t want to get involved because if you try to treat the guy and you do something wrong, then you get sued.
30:37 I think the malpractice insurance in the States, the premiums are very, very, very high because it’s a very litigious country, but there still must be some litigation, uh, threats here on litigation. Yeah. And I think, um, but not as much as the States, not as much as the States. No, but it’s getting worse. Uh, I think the primary care sector, GPs get a pretty tough time of it.
30:53 I mean, you know, they’re on the frontline, um, are they insured? They’re insured. Yeah. They pay a lot of money. Are you insured?
30:59 I’m insured, but I, I’m also somewhat protected by the fact that I’m, uh, I’m, I’m like not at consultant level. So I’m a registrar. So my consultant takes some responsibility for my actions and also the trust that I work for the hospital. They work for sort of indemnifies me to a certain degree as well. So my insurance is my, in fact, my monthly payment is, is like, like a sixth of my annual payment is like a sixth of what a GP would pay per month.
31:24 So it’s much, much less. Have you ever seen a doctor doing something wrong and you had to be like, what are you doing and you had to stop them? Part of my job is to supervise junior doctors. Okay. And they’re there to learn, you know, as well as to, to, to perform a service provision type role.
31:40 And yeah, they do things wrong and you have to educate them, you know, you have to watch what they’re doing. And sometimes you have to literally watch what they’re doing. You know, if you, if you see a doctor who’s senior to you doing something that you know is wrong is, and that could cost the patient their life. Are you allowed to point that out? Are you allowed to like, it’s like an interview question, isn’t it?
31:57 But yeah, of course you have to, you know, the first part is patient care and patient safety. You know, if someone’s doing something that’s going to cost them their life, you stop them and you worry about, you know, the social interaction with your boss later, but I’ve never had to do that. I’ve never seen, you know, that the guys that I’ve worked for have all been pretty competent guys and, you know, I’ve learned a lot from them. So it happens, you know.
32:18 On a slightly, or coming back to the, the Japan thing I know, did you, were you telling me that you and Claire, and Claire is Mark’s beautiful wife, the mother of my beautiful goddaughter, by the way. How’s that feel being a godfather? It’s powerful. Yeah, it’s fun. I was over at Mark’s house the other night for like the bath time, dinner time, bedtime, kind of routine.
32:39 You regretted that ritual. Man, I was there for two hours, right? Maybe two hours in a bit. And, you know, I like, my goddaughter’s older sister, Emily, like I had to read her a story and, you know, then I had to hold Lucy and like rocker while Mark and Claire made dinner. And by the time I walked out, man, like I was shattered.
33:00 Three days, I’ve heard three days where it gets tough because you don’t have that third pair of arms. I mean, I guess that’s why you have Nick over. Okay. What are you doing on December the 16th? Claire’s going out.
33:10 I need someone else to come help. The thing is, my son’s nearly seven now. So he’s pretty good help as well. You know, he’ll come and, you know, he, I don’t need to, you don’t need to, you know, get him dressed anymore. He’ll dress himself.
33:24 He, you know, he sort of, he’s a, he’s a little person there. He, you know, he, he knows what’s going on. He knows he wants to help out. So it’s not like having three babies who are newborns who are totally dependent on you. So, and it’s not like you wake up one day with a seven year old, a three year old and a three month old.
33:39 It sort of happens gradually and you adapt to it over time. You know, that’s pretty cool. That’s funny, bro. It was like running a business, isn’t it? As clear as the CEO.
33:48 Okay, that’s good. You know how you and I, like, we, we enjoying the bachelor lifestyle. Um, you know, Where are we? I was sitting there with our little goddaughter and man, it was flicking some weird switches in my brain, bro. Your testosterone drop, by the way.
34:05 Testosterone dropped for sure. It’s been shown in studies. I can see it drop. He didn’t have to shave. Then he was like, come on, let’s do some jujitsu.
34:13 Like we got me down, right? But man, it’s, and that’s not even the kids not even related to me by blood, you know, and already I was feeling that kind of it’s powerful. It was a nice thing actually watching you interact with it just to sit back and, and, and you know, it was, it’s kind of special actually to see like a monkey with a coconut, right? You kind of get used to having a baby in the house and, you know, and all the different things they do. And I could just see Nick really soaking it in and, you know, really enjoying it.
34:39 It was nice to see. It’s very carnal, isn’t it? You know, just interacting with young, young humans. So what I wanted to ask you is, uh, I remember you telling me, I can’t remember the exact story, but you and Claire went either to Hiroshima or Nagasaki. We went to both actually.
34:56 Yeah. Okay. Yeah. I went to, um, It’s quite a trip from Tokyo, isn’t it? Yeah.
34:59 You’re out of your way. Yeah. I mean, we basically spent like sort of, you know, two and a half, three months in the hospital and then we had, we bought a Shinkansen pass and then, you know, just did as much as we possibly could. That’s a bullet train. Were you in Tokyo?
35:10 I just was the same. The hospital I was in was a Tokai Daigakubyoi, which is about an hour outside of Tokyo. So I went into Tokyo a lot. It’s a huge city, isn’t it? What’s the population?
35:19 20 million or something? 25. It’s felt like double that. I couldn’t get my head around that city because there’s like, there’s not like a downtown or a midtown. It’s like, there’s all these like, skyscraper cannot wait to go to Japan.
35:33 I cannot wait. I have to go. It’s like number one. You need some locals to show you around. It’s the most important thing because you can feel otherwise really alienated when you’re there.
35:43 I find just because if you don’t speak Japanese, which I think you don’t, it’s just, and they’re culturally, they’re, they’re quite, I mean, I went, I went, I was there when I was 12 years old and I spent six weeks there, live with a family and I, I met some really nice people and I went back for a pride fighting championship like five, six years ago. And I went to go hug this girl that I knew when I was 12. And like, she was just like, what are you doing?
36:05 You know, we don’t play that. And I was like, Misako, I haven’t seen you in ages, you know, and she was just like, we don’t play that. She’s like, get off me. There’s definitely some differences in the, in the culture, you know, there’s some huge differences and, um, how did you find the people? The people, uh, they were extremely friendly and polite and polite, um, with the sort of undertone of, you know, I could always tell Japanese tourists.
36:27 Like when I see Asian tourists and in London, someone will be like, Oh, look at those Chinese people. They’re not Chinese, they’re Japanese. How do you know the difference? By the, by the kindness and respect the way they treat people, you know, and they’re very, um, very polite and very respectful. And funny enough, we went from Japan to Hong Kong after that.
36:44 And I was in Hong Kong and my brother and I were bargaining for electronics. We were like 13 years old and this Hong Kong guy was tired of us because we were like, no, give us two calculators in one video game. And he went off on us and he was just like, get the fuck out of my store. And we were like, we’ve never had an Asian person yell at us like it cause when Japan, no one would ever do that. And we were like, where are we?
37:01 We’re in China, motherfucker. Well, I can give you a good example of how, how, um, friendly and, you know, and welcoming they are because, um, when we went to Nagasaki, it was the Nagasaki lantern festival. And, uh, the whole place was just heaving. It was busting. What, what is that about Mark?
37:16 To be honest with you, I don’t know, but there was a whole load of, you know, colorful lanterns. Oh, lantern festival. Okay. Yeah. Um, and it’s not to commemorate the, the, no, it wasn’t to do, to do with that.
37:25 And, um, and we booked this room. Um, all my friend, my Japanese friend had booked this room for us in, in this kind of, um, it was a ryokan, um, like a, like a traditional Japanese homestay type type place. Or the paper walls and stuff. Yeah, yeah, yeah. And they, they double booked the room.
37:42 Uh, so instead of just, you know, two fingers out, these guys, the guy that owned it, just like let us live in his house for that, for our stay there. They just, they just said, right, here’s the spare room. You stay with us. You know, that’s pretty, that’s pretty cool. No, this is a very just generous people.
37:58 I stayed with their family and I stayed with their family the second time. And I made a mistake. They said, what’s your favorite food? And I just didn’t pass in. I was like, I guess pizza.
38:05 And then for four nights afterwards, I kept giving me pizza and figured it out. And I was like, wait a second. I just want some Japanese food. You know, they were just out of their way to help, but it’s a crazy place. I don’t know if I could live there, but, um, you should definitely go check it out.
38:19 You know, the samurai spirit is you can feel it. They’re just like when that tsunami happened, I saw some people, I think I was with you in Covent Garden. They were asking for money to help the Japanese. And the first thing I thought is they don’t need your help. A and then they don’t want your help.
38:33 You know, they’re not a society that looks for charity. They’ve been through some crazy shit, as we know, from World War II and the bombings and, and they have a pride and a spirit in them. That’s, it’s almost unparalleled in a culture. And you know that, um, the whole, the bombs like Nagasaki and Hiroshima, just, if you just think about what that, that event actually was, you know, What was it like being there? I mean, is this the city, is the city all about where the former bomb inside of the second atomic bomb or is it each place is a bit different.
39:05 Um, Hiroshima, there’s a, there’s a big monument and there’s a, like a museum that you can go around. It takes you through it, but I wept the entire way around. I mean, it’s just one of the most, you know, harrowing experiences in my life. You probably saw pictures of the surviving victim. Absolutely.
39:20 And you know, just, there’s like a sort of TV program playing for you there and you just walk around and it’s just, it’s just not, it’s just an awful, awful feeling. Okay. Man’s is humanity demand, right? Yeah, that’s, um, Nagasaki, um, there’s a, there’s an interesting book actually called the bells in Nagasaki. Um, and it’s written by a doctor who, uh, what, what happened when the, when the bomb dropped, it was, I think it was supposed to land on a munition site and it, the winds took it off course and it landed on a hospital.
39:47 Really? And this dude was a radiologist, so he was in this lead lined box, basically when the bomb hit and he was protected from it. And, um, uh, he then set up a camp on the, cause it’s, it’s in a, it’s in a basin, um, Nagasaki. So it’s like surrounded by Hills. And that’s why they chose it as a target, right?
40:03 Yeah. And, uh, he set up this camp on the, on the, on, in, on the hills on the side of Nagasaki and then basically help people through the different phases of radiation poisoning and, and, you know, through their illnesses. Uh, and then he wrote this book, the bells in Nagasaki, which is, it’s a really difficult read. It’s a short book. Um, and it just in absolute sort of clinical detail describes each stage of radiation poisoning, what happened to, to, to all the patients that he was seeing and, um, uh, from a medical perspective, it’s fascinating and really, really interesting, but also I don’t think you’d get it like an American or a British doctor writing it in this style.
40:38 I don’t, you know, I just, I think there was no emotion. It was just, you know, descriptive and, um, this guy then gave up all of his possessions and lived in a shack. Um, and then just, you know, just basically helped radiation survivors. He died of leukemia, I think about 10, 15 years later. Radiation related.
40:54 Yeah, of course. Yeah. And this has been, there was no, um, medical experience with any kind of radiation before that. Right. And a lot of what, what I think we do is based on experiences from Hiroshima and Nagasaki now really descriptive experiences of doctors that work there.
41:09 So how close do you, I mean, Brian’s questions primarily ended you because you have, um, I like to think you have a pretty good knowledge of politics and, uh, global issues. So how close do you think we could, what’s the likelihood of that kind of thing happening again in the world? Like one nation initiating like nuclear, I think it’s high. Do you think so? And we get nation like Pakistan, you know, okay, that, you know, there’s a government there and then there’s the ISI, which is, is the intelligence agency there, which really runs the country.
41:41 Kind of a good parallel would be like J. Edgar Hoover when, um, Kennedy was elected. The J. Edgar Hoover ran the FBI at the time. Right.
41:49 And he had more power than the president. You know, he had files on the president and so he, and he had been around for 15, 20 years and JFK gets elected in a year. And he’s like, you think you run this country? You know, I know what you’ve been doing with Marilyn Monroe. So I run the country.
42:03 It’s kind of a strange thing to understand that the ISI in Pakistan really runs a country and they’ve got the nuclear weapons locked down, but I just think it would be so easy for someone in a terrorism related thing to, to just set one off in a major city that we couldn’t go into again. And I’d be surprised if it doesn’t happen in the next 20 years. I just would be, but, um, maybe I’m wrong now. Stratfor, which is the website I talk about a lot, they talk about actually having a nuclear weapon is one thing.
42:29 Having one that can be shot in a missile is a completely different scenario. So like Iran right now is probably 10 years away or maybe even 15 from being able to actually launch one. But as far as detonating one, that’s a different story. So that’s the, that’s my that comes into the likelihood of them. The way they’d initiate attack like that is to get an actual to get the bomb into the place they wanted to.
42:53 I mean, Iran’s always talking about let’s, let’s go to the fire one into Israel or something. Maybe they’re crazy enough to do it. I don’t know, but I don’t think they have the technology to launch them right now. But you look at states like Pakistan and it just makes you wonder. And there’s a lot of tension with India who are also armed.
43:07 It’s that doesn’t even need to be a nuclear thing. I mean, we do these CBRN training days with chemical, biological, radiological, nuclear. Okay. What do you guys do to prepare for that? We sit around a room and, you know, hope and hope and pray it doesn’t happen, I think, you know, but we have certain there’s certain things that you can do for each particular, particular, particular threat.
43:31 So there’s certain diseases that you want to work out. We watch out for anthrax and that kind of thing. You can wonder about, you know, chemical weapons that could affect, you know, we’re trying to recognize what’s going to happen. I think the important, I mean, I think when it happened in Tokyo with the sarin gas, it was up there 15 years ago. Yeah, it was the subway, right?
43:48 There was so many health care workers, you know, were hurt or died because they didn’t recognize what was happening to start off with. So I think the first, I think if you see something weird happening once, okay, something weird. If you see another patient comes in, you know, it should really raise your awareness. And I think if you see three people coming in with the same weird symptoms, you need to think this is kind of some sort of impending major. Who do you call them at that point?
44:12 Did you see the movie Contagion by the way? Yeah, we have the health protection agency in the UK. So I think we activate those. I mean, I call my consultant and I activate the health protection agency. And then we have a major instant alert, like for each hospital.
44:24 Okay. And there’s like a gold, silver and bronze command. And we all have action cards. So like, if something bad is to happen, there’s some sort of major instant. Basically, we pull out the action card, we’re all supposed to be aware of this.
44:35 And we have training drills and everything. And then we all have our own set roles. So the likelihood is if I’m the A&E registrar on that, you know, I’ll have a, you know, pretty key role at, you know, sort of entry point triage and that kind of thing for, you know, trying to try to designate tasks and trying to run the thing on a sort of frontline basis. Okay. What did you think of Contagion?
44:52 You haven’t seen it yet, have you? I mean, it’s, it’s, it’s pretty heavy. Yeah, it’s an outbreak. Yeah, that was good. Contagion just goes and like, there’s like 20 million people dying and it’s, it’s going all around the world on planes.
45:04 And it’s, I think, you know, it’s pretty scary. It’s possible these things can happen. It is right. You know, and, you know, think of the, you know, think of the black plague. It has happened.
45:11 It has happened. It eliminated like the third, a third of the European population. Something like that. I mean, you know, the way that genetics work, there’ll always be a tiny percentage of people that, you know, have some sort of innate immunity to something. So the human race will go on, but, you know, it’ll have some pretty far reaching effects on just watching the movie and it’s like, it’s not 2000 people dead and then it’s 20,000 and it’s 20 million and like that people are fighting to get food.
45:35 And then when the vaccine comes around, people are fighting to get vaccinated. And it’s like the people in power are trying to get vaccinated first. And then I think they do a lottery system and they choose 365 days a year when you were born, when you get the vaccine. Some people are waiting like six months and it’s just the contagious behavior that’s going on is scary. I wanted to shift the conversation away from all this morbid stuff.
46:02 I love the morbid stuff. I know you do.
46:08 So Mark, can you recall any really uplifting moments in your career working with the sick and the dying and just anything like human beings banding together? Oh, so many. Anything that comes to mind? I mean, there’s so many good things, people that have, tough dates, survived illnesses. When you’re a medical student, when I was in, for example, when I was in Japan, there was a kid with, I was on a pediatric oncology ward and it was a kid that pulled through his chemo and all his radiotherapy for his leukemia and that kind of stuff.
46:43 I mean, simple things make people happy. Just putting someone’s shoulder back in and they can go home that night in a sling, that’s a job well done. That’s something great. All the way to people, patients when I was in intensive care who were on death’s door, were in the unit for 60 days and then you decanulate their tracheostomy and then you discharge them to the ward and they get physio and they go home. I mean, what an amazing thing.
47:09 That is incredible. To sort of come back from the brink. So all the way through the spectrum, from stitching up head wounds and doing a good job with that all the way to the other extreme. I mean, there’s so many good things and so many uplifting moments and seeing relative spaces when they’re patient. Young guys and I’ve had a young guy on ITU who had meningococcal sepsis and we all thought this guy was going to die and he lost fingers and toes and his wife was coming in and his skin was sloughing off because of the way it was affecting him and that guy, he went home and brought us in a box of chocolates a couple of weeks later.
47:47 I mean, what an amazing thing. Do you have to detach yourself personally from these patients? Do they want to get in touch with you? I’ve never had anyone because they’re normally asleep for the vast majority of their time that they’re in with us. Yeah, you do.
48:00 I mean, you have to detach yourself. I think it’s more of a problem. My wife’s a GP and I think it’s more of a problem in the primary care sector. I’ve done some general practice as well and people just want to come in and talk to you. They just want to be part of your life and just have someone to talk to if they’re lonely.
48:15 That’s what my GP said. He said, I get a lot of people that come in here. They’re the hypochondriacs or something. They don’t need any help. They just want to complain or to talk to someone.
48:25 I don’t know. And it’s an important job as well. It’s a pastoral role, I suppose. Yeah, it is. But it’s not for me.
48:30 But, you know, it’s… Did you make that choice not to go down that road? I worked as a GP for a little while for a couple of years and then I decided that I preferred the, you know, acute setting and, you know, took that step back in, you know. Do you like the buzz of a busy A&E? Yeah, definitely.
48:45 I believe that. How close is it to, like, ER? Like the movies. Not that close. I mean, you know, you see the same stuff, but it’s less, you know, it seems less dramatic to me.
48:55 Maybe it would seem dramatic to, you know, to the people in the department. I mean… Have you ever had to do the thing with clear… It’s really disappointing now because about… We need a bouncer to get you out of here.
49:10 10 years ago, we created these gel pads. So you just have this sticky gel pad that conducts electricity and you just put it to their chest and you stand up, you know, 10 feet away and press a button. So it’s no… No more paddles. Have you ever had to, like, hammer fist a dude in the chest to get his heart started again?
49:24 Well, I’ve had to… I’ve had to percussion paste somebody actually. What is that for? So basically, when someone, their heart rate drops below a certain level, they can’t, you know, their circulation can’t be sustained by it. And, you know, you can externally pace people and you can actually pace someone by just delivering electricity to their chest wall by just giving them 10 joules over and over again and dropping your hand on their chest.
49:45 Okay. While you get… Just by a physical. Yeah, just literally do that. And you can do that for a little while until you can get an external pacing system set up.
49:51 Really? Last question on this team. Have you ever had to give a really hot chick mouth-to-mouth resuscitation? No. You’ve ever had to give a really ugly chick a mouth-to-mouth resuscitation?
50:01 I’ve had to give mouth-to-mouth resuscitation to a horrible junkie in the street that could overdose. Really? Never to a hot chick, yes. You did? Yeah.
50:09 Did you ever even have a split second of, oh, this is going to be gross or does the doctor pick gross? It was gross. It was gross. It was gross, dude. I went home and I…
50:17 He was out, I guess. He was just… It was a she, but yeah, she was just unconscious. Just having, I mean, I think it’d taken opiates, heroin or something. And I just had to…
50:26 She was apnea and I just gave her rescue breaths intermittently until the ambulance arrived, but it was pretty grim. Wow. So I went home and got the vodka out and had a squill round. You said no drinking. No drinking.
50:38 I’ll just do that. Wow. And I mean, what are some of the crazier things that you’ve seen? Besides the usual drunken things, you know? In what sort of way?
50:48 In an A&E perspective where you’re like, wow, I can’t believe that just happened or I can’t believe… I can’t be able to take an ax out of a dude’s head or something like that. I mean, there was…
50:59 All sorts of crazy stuff that happens. Everyone loves a good foreign body story, you know, moving… Foreign body? You know, like something that’s been inserted into an orifice or something. Okay, you gotta tell us.
51:11 Have you ever heard a ridiculous story that’s been made up to cover up the fact that some guy was getting a thrill over putting up something up his orifice? I mean, everyone seems to have slip and fall, you know? So, you know, slip and fall, you know? I slip and fall on the pool cue doctor, you know? I don’t know if this is an urban legend, but when I was at China Crossing Medical School, apparently there was a guy that inserted an unexploded World War II shell up his backside and then they had to take into theatre and get the bomb squad in and everyone had to gear up with, you know, with bomb gear and protection gear.
51:46 I don’t know if that’s true or not. At what point do you think that that’s a good idea? Like, Also, you gotta wonder what they tried before they went to Italy. They’re like, the hours they spent at home trying to undo it. That’s crazy.
52:00 Do you see a lot of like sexual related emergency stuff? No, not a lot of sexual related. I mean, you see, you do see some, but not a huge amount, but you see some arguing couples and, you know, it was his idea and that kind of thing. It’s his idea. Wow.
52:15 Okay. You know, it’s human life, isn’t it? People try different things and do different things. Crazy game we’re playing, right? Yeah, especially when the country gets too wealthy and too bored and start doing crazy stuff.
52:26 You know, we only got a few minutes left. I was wondering if there’s anything you want to wrap up with. That was fascinating. I know we can go out. We’re going to turn this out and then we’re going to, we’re going to ask you some more questions for another hour.
52:37 I had to go into my kids’ school a couple of years ago and I got asked more sensible questions about the sexual kids. I did. As opposed to the Nick questions. Have you ever had? They were similar.
52:51 What did the kids ask? Most of them wanted to know, you know, can I fix bones? They all seem to be obsessed with, you know, can I fix bones? Yeah, they all seem to be really, really interested in that. I actually took some, it was a fun afternoon, actually, that my kid was like four at the time or something, actually, and I took some plaster in and plastered their teacher’s arm and then got them putting slings on and stuff and it was quite fun.
53:13 They all seem to, can you fix this bone? Can you fix that bone? That’s crazy. Maybe that was just a stage of development they were at. They understood, you know, I think maybe a couple of the kids had fractured some bones around that time and they’re coming in plastering out and stuff.
53:26 Okay, I get it. Maybe it would have stimulated that. That’s cool. I keep thinking of that Alec Baldwin movie where he’s at the doctor and he has this God complex. Which one was that?
53:34 I forgot the name of it, but there’s a scene where they’re like, when they’re in the hospital and they go to the church in the hospital and they’re praying, he’s like, who do you think they’re praying to? They’re praying to me. He’s like, you think I have a God complex? I am God. He’s like, you know, I is the one that saves your kids.
53:50 I’m the one that saves your wife. So I was just wondering if you’re God. No, man. Do you meet doctors with God complexes? Or is that just?
53:58 I mean, you used to be the old sort of old school surgeon, you know, those guys have got to be pretty confident. If you’re going to stick a knife in someone’s belly and, you know, open them up and, you know, you’ve got to have pretty powerful belief in what you’re doing, you know. Is that the highest level of that game? I mean, I mean, you know, it’s it’s a it’s an aspect of the game, you know. I mean, you know, when there’s different things that I do that, you know, you know, if you, you know, if you do what’s called a rapid secret deduction where you have to intubate somebody, you know, you give them a you give them a paralytic agent, you know, they can’t breathe themselves.
54:27 If I don’t get that shooting, they will die. You know, you can’t ventilate them. So, you know, but you’re not playing God because you’re dealing with sick people, you know, and you have to remember that these guys, they need your help. They’re going to die if you don’t do something. So you’re not playing God.
54:41 You’re just trying to help. And, you know, a lot of the junior doctors get worried about running cardiac arrests and that kind of thing. And I think I always say to them, you know, you can’t make it any worse. This patient’s dead. So they can play panic on cardiac arrest.
54:52 And you said just something that’s fearful about, you know, trying to resuscitate, you know, someone who’s just recently died or, you know, has had an arrest. And I think you have to you have to have faith in the system. You have to have faith in the training that you’ve had. And, you know, you have to understand that, you know, you can try things because you can’t make it any worse in those circumstances, you know, and you have to be bold and you have to you have to believe in what you’re doing.
55:14 You know, I don’t know if that answers your question. No, it does. I just I’m thinking about how, you know, like trading on a city trading floor on being a doctor at A&E and just like, I don’t know, it just pushes your mind to just like do these things and make these hugely critical choices. Yeah, I’ve asked them like a similar question before, but the thing is, I think your response was that your your threshold will just raise, you know, according to the stimulus that you or the stimuli that you’re exposed to.
55:39 So, I mean, for you now, going on and doing a 12 hour shift and seeing people die and doing a track up to meet the track yard. How do you say an intubation or I mean, I’ve already done one track and put one track in and that was and that was in intensive care and it was an elective procedure, you know, so it’s not like we’re doing this all the time. No needle crikes and like crocothoid ottomies and that kind of stuff. These happen very rarely. Okay, but, you know, intubating someone and actually sort of visualizing a cord, you know, cheap going to the vocal cords or something that, you know, I do occasionally and that’s heavy.
56:11 Do that pretty much wraps us up. Dr. Marks, that was awesome. I think our viewers are going to love that, you know, it’s just a nice little snitch. I’ve never even had this kind of conversation with a doc.
56:25 So, thanks for coming in. I was proper London Real, right? Yeah, that was super real. So, yeah, we should get you back sometime next year and we’ll get you more questions, more Nick questions. Nick’s going to be on Wikipedia the night before next time.
56:39 Have you ever? What do you do in case of a zombie invasion?
56:46 That’s all good. Alright guys, thanks much for coming on. It’s about the journey. It is. Alright guys, take care.
