Yeah, I posted it after I was reminded about it from your question.

Your comment about amnesia is very insightful. In fact, if you don't remember it, it didn't happen. I always tell my residents that when I'm training them. Good story......We give a brief dose of IV anesthetic for cardioversion of the heart, when they try to get someone back in a regular heart rhythm. Sometimes we do them in our anesthesia recovery room. One day I was doing a great big guy. I had the resident give him the dose, he quit responding to me, so I told the cardiologist, "shock away". They hit him with the paddles and he sits bolt upright and yells, "shit, you goddamn motherfuckers" at the top of his lungs. All the nurses and patients recovering from anesthesia look down our way wide-eyed. The guy lays right back down, goes back to sleep for 2 or 3 minutes. When he wakes up I say, "you alright?" "Fine" he says. "Did we bother you at all?" I ask. "Don't remember a thing," he says.

So, if you don't remember it, temporary discomfort does one no harm.

The benzos, like versed (midazolam) are potent amnestics. The wild thing about them is, once you give it, the majority of patients appear awake, conversant, cooperative, but later they don't remember a thing. When patients hear that, they worry "what did I say that might have been inappropriate?" It worries them. I've had a few with loosened inhibitions, but not many.

No, general anesthesia is not like physiologic sleep, the latter being a complex and active function of neurons located in the brain stem, in and around the thalamus. If you are unlucky enough, a small stroke in this area, while not damaging a significant portion of the brain, can result in permanent coma.

For an interesting sleep disorder, look up fatal familial insomnia. It's rare, and one you don't want to get.

The mechanisms of the some of the general anesthetics are still unknown. For instance, we don't know how the most widely used ones, the halogenated hydrocarbon gases, (halothane, isoflurane, sevoflurane, etc.) have their effect. Their potency is significantly related to their lipid solubility, which suggests they get in your neural cell lipid membranes, and alter them (temporarily) such that they can't carry on communication with other neurons. They've been used for 150 years now, and we still don't know exactly how they work!
Many of the IV anesthetics inhibit specific receptors and antagonize specific neurotransmitters, such that we do know how most of them work.

Cheers,

In reply to this comment by schmawy:
No, I don't have that kind of depth of knowledge. Sleep and dreams are so mysterious and fascinating, though. Is anesthesia anything like sleep, or nothing at all? Does a patient have REM under the gas?

In reply to this comment by snoozedoctor:
Watched this last night and forgot to upvote. I was diverted by looking for video of the goats with the myotonia, undoubtedly a similar phenomena. Alas, there was already a similar sift, so I dropped it. You ARE going medical on us.

I had a southern dialect dictionary one time. It referred to okra as a "rot-slick vegetable" "Rat-cheer" as in, put that chair rat-cheer. etc. I wish I could locate it. It was great.

Is this instantaneous action stuff still a total hangup for theoreticians? I don't see a graviton as necessary if the local geometry of space is what it is due to concentrated mass in the vicinity. Because space/time is not an electromagnetic force, why does it have to be tied to the velocity of electromagnetic radiation? That's another one I've never really understood. But, as I've pointed out, to practice good medicine you just need a good memory and good common sense. Not many of us can solve a quadratic.
In reply to this comment by jonny:
No, I'm not a physicist either, though occasionally I pretend to be one. I do have some background in it and try to keep current, but I'm definitely no more than a layman when it comes to understanding stuff like quantum mechanics.

I might have misinterpreted your first comment to mycroft. I thought what you were saying is that while it might be mathematically interesting, it doesn't necessarily have any connection to reality. Afaik, the mathematical framework of String Theory is able to account for everything General Relativity and the Stanard Model predict. But GR is also a mathematical model. The comment about gumbo recipes was a philosophical one. The difference between a recipe for gumbo and a bowl of gumbo is that I can't actually eat the former. The recipe may be an accurate description, but it's not "real" in the sense of being able to fill my belly. So, if I have two recipes for gumbo, my only preference for one over the other is personal taste.

It's not the best analogy. And in some sense, String Theory would be like a recipe that you can't actually cook. String Theory predicts a number of things which apparently can't be tested (currently? or maybe ever?). So, I guess the question is, do you like okra in your gumbo?

In reply to this comment by snoozedoctor:
Jonny,
I'm not a physicist and don't pretend to be one. I worked my ass off to get through introduction to calculus. Conceptually, as I interpreted what I've read about the strings, it seems like trying to squeeze a square peg thru a round hole. If we mathematically cut off the corners we can make it fit. Though, no doubt, theorists scored big last century. But, I'm just skeptical on this one. Are you in physics as well?

Jonny,
I'm not a physicist and don't pretend to be one. I worked my ass off to get through introduction to calculus. Conceptually, as I interpreted what I've read about the strings, it seems like trying to squeeze a square peg thru a round hole. If we mathematically cut off the corners we can make it fit. Though, no doubt, theorists scored big last century. But, I'm just skeptical on this one. Are you in physics as well?
In reply to this comment by jonny:
Mind if I jump in here? I'm curious what it is that you don't buy. I mean, General Relativity is a mathematical model as well, right? To me, they are both like a recipe for gumbo, but they are not gumbo, if you get my meaning.

[edit] Just noticed mycroft's response. A specific testable prediction would be nice in the mathematical model, and I think it's being worked on, but afaik, it can't be tested with current tech? possibly with any tech? That would make it a bit of mental masturbation ultimately, unless it can be used to predict something.

In reply to this comment by snoozedoctor:
Hey, this has little to do with the sift, but, as a physicist, what do you think of all this string theory business. Is it just mathematic manipulation? I recently read another book about it. So far, I'm not buying it.

Didn't notice you were no longer in Tar Heel land. Are you from NC?

Where do you find all this neat stuff?

Snoozedoctoring is a great job, I wouldn't trade it for anything that I'm otherwise capable of. How's that for a qualifier?

Although you probably won't find any video, kd lang's first "Angel With a Lariat" is high energy cow-punk. Her "Shadowland" disc was produced and arranged by Owen Bradley, Patsy Cline's arranger. It has some soaring moments.

Keep finding that obscure stuff. It's great.


"Yea i found that out reading the wiki, made me interested in looking for Lang's earlier stuff.

Mind checking this out? http://www.videosift.com/video/Hotel-Ngyuen6805
and this http://www.videosift.com/video/60s-Girls, I think you might like it.

Oh and my dad is a snoozedoctor as well"

With your wealth of music info, you're probably aware, but kd lang, early in her career thought she was channeling Patsy. Thus, kd lang and the "reclines", her early band.

In reply to this comment by Farhad2000:
Patsy Cline (b. Virginia Patterson Hensley September 8, 1932 – March 5, 1963) was an American country music singer, who enjoyed pop music crossover success during the era of the Nashville Sound in the early 1960s. Since her death at the age of 30 in a 1963 plane crash at the height of her career, she has been considered one of the most influential, successful, revered, and acclaimed female vocalists of the 20th century. Her life and career has been the subject of numerous books, movies, documentaries, articles, and stage plays.

Cline was best known for her rich tone and emotionally expressive voice, which, along with her role as a mover and shaker in the country music industry, has been cited and praised as an inspiration by many vocalists of various music genres.

http://en.wikipedia.org/wiki/Patsy_Cline

Jonny,
I can't seem to drum up any interest in Victoria's songs and they languish in my personal queue. I was hoping that a more conventional voice, like Maria McKee's would get across the brilliance of Victoria's songwriting. Thanks for your support. It's good to know a few out there share my zeal. It was a huge thrill to meet her several weeks ago. She was playing in a band called "The Thrift Store All-stars," in a tiny roadhouse in Joshua Tree. She came over and talked a while. For me it was SWEET RELIEF.

In reply to this comment by jonny:
oh no - was it a dupe? why not just let it slide into your personal queue?

In reply to this comment by snoozedoctor:
*discard

Can't help but noticing buddy, you're accompanying me to my personal queue on a regular basis. What's wrong with these people? Obscure is where it's at. If it ain't different, chances are it's the same.

You talkin' about Bill Clinton's patented humidor?

"I'm big into, y'know, sticking things in body cavities."

Thanks,
I appreciate having a really good science guy to back me up when some of this IV chelation, touch therapy, paranormal mumbo-jumbo starts floating around.
I pass gas most of the day and when I'm not, I'm usually sticking needles in things. As they told us in med school, there's not a body cavity that can't be reached with a strong arm and a 14 gauge needle.

You are right, those kids show open for Alison Krause. Here is Sierra, in the 6th grade, on stage with Alison and Union Station.
http://www.youtube.com/watch?v=4GU5hWdaQfY
What a talented girl!

Sofa,
What indeed is wrong with these people. I guess I'm getting too old and jaded. I long for bygone days of real musicians playing real songs with real instruments. Anyone can set a loop to play over and over and monotone some poetry over it. On the other hand, very few can make smoke rise from the frets of a Tele as it screams the blues of a lonely and neglected heart. Am I waxing too poetic here? I think I'm off the deep end in despair over this.

Finger-pickers are it. Nice playlist.