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