Were you to be the unfortunate victim of a limb removal of any sort, you could take hope. Here in the 21st century, doctors have gotten pretty handy at reattaching arms and legs, replacing thumbs with toes, rebuilding breasts, all to great success thanks to microsurgery techniques.
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Had I been problems inspire us to push the world forward. That's why so many people work with us on everything from city traffic to ocean plastic. Smart loves problems, IBM, let's put smart to work, visit, IBM dot com, slash Smart, to learn! More welcome to teach me something new, a new high cost from my heart. Radio in Britain come I'm your host bright morning. They show as about inspirational thinkers, scientist, artist and fears and the things they ve learned that transformed
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I heard radio apple podcast or were you get your podcast everyone's me Josh him for this week's as waste his legs
chosen, so your limb is torn off now. What it's? A great classic episode filled with neat stories about things like exposed innerds in sewing MA
so together is a good one, and it has a really great intro, if I do say so myself from January, two thousand fourteen so enjoy welcomed. Establishing now
action of Iheart radios have stuff were welcomed. The progress on Josh clergyman of each a bright in this is that we should know because Jerry's, if they dont, worry besides sick, I'm not sick
I've got a little bit of bug. Banana had met with your sick. I know you think, that's the first step, and yet in being sick is saying, I'm sick. I definitely believin psychosomatic.
Sure effects of mine has an impact on the body. Will if you can be a hypochondriac, surely you didn't do the opposite right here? You will yourself in not being anyway people. The show must gone, and I just want to point out how dedicated my part
here's to his craft row. I also want to say on a promise that it's not gonna, be like the great six week myself. Now you don't get to that. That was back in the old days. The unhealthy days I smoked in everything else. Your body didn't had a heel, ices enjoying nicotine. Now I'm dislike, I'm I'm not getting sick. I said to myself ass night, and here I am better than ever just two points. I think you are let's do this. Ok, he read it yeah. I got a story for you, but I know it I'll bet. You do too that he knows
yeah you saw his name is ever knows junior, but his everybody call them Eddie two days in a why I find the unwholesome
yeah and I didn't know Eddie could be short forever. It never heard that. I don't think it is. I think he just didn't like his name. Ok cause, it seems like each come. Every yeah, every Ebby III of the big
seventy two biggie so use a little either he's Lodi tiny like a little. Oh, that's right! Well, Eddie all calm Eddie, because that's what he preferred to be calm sure he was walking home from school one day in Somerville Massachusetts
he's a suburb of Boston and whose walk along the railroad tracks- and there just happened to be a train loaded with travel,
calling out of the area very slowly while his walk alongside he said. You know what I'm gonna have a little thrill you right now.
And grab onto this train any did he successfully grabbed onto the train, was
being with the I believe, his right arm and was having the time of his life to dangling there when he misjudged the distance between the train side of the train and the sight of a tunnel, and he was pulled into the tunnel support, smacked it and hung on for a second before he was dropped
off the train. The train going through the tunnel leaving Eddie can a crumpled and in a little shivering mass pain at the mouth of the tunnel.
Ends up any grabbed. His arms, like, oh, doesn't, feel very good and he starts walking toward town and apparently
talked about a hundred yards a pill. Winsome workers saw him and said: grab that kid:
because he was covered in blood you staggering. He looked like he was out of his clearly in shocks the grabbed raining
a woman, because at the time this is nineteen. Sixty two, a woman was the only one who could provide any kind of initial emergency care and a clerk. I believe some sort of warehouse. I'm came out and started to apply pressure to his boys moons, but she had a little bit of trouble when she tried to close the wound with
Tourniquet she found that his arm was an attempt to his body any longer it he's gonna holding it there,
very likely he was wearing a jacket, or else his arm would have been back at the mouth of the tunnel. Man can you hatch and like
the guy's holding his arm, basically to keep it from falling out of his jacket. Although he didn't know that
No, he didn't eras in shock. Luckily, he was still lucid enough to like tell everybody who he was where he lived and they called the hospital and the hospital scrambled some surgeons, but it wasn't until Chuck he got to the hospital and they started. Cutting is Jack off. They realize the extent of the damage this kid's arm was torn clean off yeah, but the operative word is clean. Yeah right
because Eddie Everett knows Junior of Somerville Mass on what may twenty third nineteen sixty two became the first recipient of a full, successful limerick, attachments, first, human recipient right, that's a good point. They had done that before dog successfully and they have.
They had done all the different surgeries that are required to
we attach a lamb but then
ever done all of them at once, like they re attach nerves, they re attach bone right. They re attach blood vessels, but
never had a full amputation than a human being successfully reattached and um. What I read the doktor was about excited, but they had been looking for a case housing as they thought like. I think we can do that
We need the right case where, exactly like all those budding he's like, I think we got one get in here. They got the they they like. You said they'd successfully, reattached arteries nerves bone. That kind of thing
never all never the whole should bang so they said we know how to do this. If somebody
come along and present us with an armful cleanly off, especially twelve Europe, because they definitely worked at his advantage purely an artery when severed the will plug itself up, especially in younger kids. That plugging is way more successful and happens more quickly.
So this kid. This basically presented like the perfect case, the main artery, I guess his Bracky artery, leading
shoulder was a full like two inches out of the wound is so like they had a lot to work with.
And work. They did yeah. They the arm was on ice
and they began working immediately. This is mass general by the way
damn they started with the arteries and veins, and then the nurse felt while they all sort of saw,
color they cannot, as a glow can occur.
I can do the arm. This kid hop. The train had his arm pull off and with
two and a half hours. They had gotten circulation back here.
And the nurse grabbed the hand and said hey: it's warm that's good spending in warm. She shook it. May.
Do the metal sign everybody in the operating there's laughing
the bone and muscle in the nerve in the skin happening and later
trees and the think the nerve they made it pretty important decision. The time was to wait on that altogether and let it he'll some were first, which is, as it turns out. Actually as it turns out. Most of this was sort of how they do it today, yeah like they propose
did the the process from that point through the seventies and eighties, when they really started like humming, with memory attachment
The only difference that I saw was will get into a little more, but they re attach the arteries first to get circulation. I guessed to keep from more more tissue dying.
And then they re attach the bone by driving a screw and using a hammer. These being now,
the screw into the marrow Agnes and its re attach the arm bone, that what is that FEMA no favours in the lay of the land? You think I would have liked this up already
the upper arm bone than the they put, they drove that into the other end of the screw.
Normally. Now, though they do, they re touchstone for to provide stability guess so when you re attach the arteries and veins and stuff they want,
away yet and he it was a success story because he ended up. He was he couldn't use.
Hand, as is dominant hand any longer, which says, there's a good pitcher yeah, but he was able to eventually get enough, you sort of it to where they said about. Like a left hand, her would have use of his right hand, so he disorder had to switch that up, but for nineteen sixty two, this pretty successful, especially considering in nineteen sixty, was the very first micro surgery performed just two years previously at the University of Vermont, oh yeah,
catamounts but there's dedication, so micro surgery, that's really what we're talking about here is the use of a microscope to perform surgery,
and when you are attaching you're, simply sewing together little nerves and blood vessels like
a millimeter in diameter. Yet you you need a microscope in a tiny, tiny, little needle right, an you're using tiny, tiny little suture thread which is about, as is as big as a hare. Yeah, that's the stuff using the two suture, these blood vessels back together that cat got now and it's in extremely involved surgery, as you can imagine, but it step by step like first you do the blood vessels than you do the arteries. Then you do muscles ligaments, tendons, all this stuff and you're doing it in this
process, but each each see surgery each part of the procedures like an enormous surgery in and of itself here so like,
a limb re attachment, which is called a replant nation. Fellows me cold, like literary or something he had. Some people call it that
First, the saucy, your doctors call Limerick, but, as usual,
If I go on a whole, the repatriation surgery can last like an entire day. Yet its intensive ma am,
a red too, that the whole micro surgery
concept of using a microscope for surgery was not accepted at first like be doctors and surgeons like now. Are we can't do that to look with her
and so ass, to be perfected, sort of on the fringe by doktor, by surgeons, who are willing to like, except this might be the future and environment and their basement. I guess apple unhappiness victim, maybe or dogs yeah. I didn't get Thea and I didn't look it up rating
the impression from this article one way or the other how dogs lost their lives to begin with
like was an accidental and there like, ok. Well, this will it order. Were they
dogs limbs often henriot it, because I'm guessing it was probably the ladder. Probably there I mean we ve taught plenty about
That kind of topic, because I mean think about it. Why would dogs limbs be pulled off in any more frequency than humans limbs and hence present more cases to practice on? I think there are cutting off togs limbs and then re attacking, which is messed up
It is so you're talking all micro surgery. What I saw with some replacing toes flat, alms, got big
exceeds. That was a big one. So you had a thumb on your foot earn big toe
There have been your hand
Apparently fifty to seventy percent of all the utility, in your hand, is in your thumb and if you're missing a thumb you might as well do not have your hand. You don't need a big toe quite as much you can use a cane or something like that you're to your new toe thumb, and that that became perfected in the sixties till
that's good bad name and then, in the seventies, free flat tissue transfer became a big thing with it, which is basically going to a part of Europe.
De harvesting, an area of your body like under your thigh, your abdomen. I think you're back lower back and then just basically taking the gap in sewing back together right. You see, I have a scar, but you also have a air. A portion of your body is diminished in size and in taking that in using it to basically do what we understand as Askin. Graft yes river, which requires micro surgery, is well I'm, MRS basically taking this part here and putting it back over here where there's a bunch of damage and re attaching all of the nerves and the blood vessels in everything yeah. I saw it when I was
upper photos of this kind of thing, I came across something that I had never seen before and I didn't I didn't get the story, but you could almost I mean I a sort of,
what's going on just from the photo series, but someone was D gloved on, though on their fingers. Basically, for MIKE that the hand knuckles forward, all the fingers had no skin.
And from the looks of it, they inserted it into an arm like into a bicep the fingers and like
They lived there for a while, like insert
under the skin of the arm and that that skin
they later would remove the fingers and came off as like a big flat skin graph likes. It
your hand, an envelope, crazy and eventually formed like webbed fingers and then fingers that is crazy. But, like
I don't know man. I just saw these photos, I shouldn't I mean I don't really having to do with us, but it was just remarkable
see someone with their fingers stuck in their bicep under the skin, like I'm having trouble visualizing this, I need to see these photos idea
I'll. Take a majority here. If you want to see some really grow stuff, you can just Google micro surgery, oil
Replanting nation is another way out in its nasty step at yeah, but amazing, like the arrogant and I looked at so many of them
Gonna get to that point out like all this is a gross. This is what the body looks like without skin, sometimes and which is now it's. I wouldn't go stout bodies without Skinner, girls, and I think so I think it's the beauty inside you become the central tyres. My friend ass before we get any further
What's your message: brick, they got some good stuff, come here's. The thing say:
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swine escape so check, we understand micro surgery is Frankenstein
the aid, basically to sewn up together yeah, because I mean like let's say you have a dead person or as a great hand, and you have alive person, who's got a poor hand. You cut off the lie, present hand, cut off the dead persons hand and attach the live where the depresses ended alive person. As that's that's Frankenstein, that's what they're doing in its pretty cool. It is critical. But if this ever happened to you, if you say you have a poor hand in that, its no longer attach too
her wrist, he can subscribe and it's all crushed in damage or whatever. I know not what say intact. Ok,
You say you know what I think, through my shock, that I might be a good candidate for RE plantation of my hand. What do you do?
Well, you want to call one one immediately, because it's just the first thing you do you get go and get folks on the way you or you can ask someone with you to call nine when one that's not putting any one out yet that's true. If you can't die of maybe I've hands, you could tell serious online when one year thumbs
yeah actually change. My theory to dude sits on a her anymore. Oh yeah, the Englishman. Actually ants can often Reginald. I don't know what his name is actually but he'll say stuff, like you know, said, call Josh and will say ringing: Josh, oh yeah. Instead of calling a classic kind of
anyway, you want to download one one get them on the way and then immediately we, u wanna, just try stabilize the patient. You want to stop the bleeding great, either with heavy pressure or tourniquet above the wound, like a nineteen, sixty female yeah, exactly
and once you get the patient stabilize and they're, not gonna,
led out there in the kitchen or wherever it is. You want to get the digit or there
and or the lamb and put it on ice, but not directly on ice
I put it in a bag and then put that bag on ice. Yeah, Yonah Pack packet in nice is much
as you can find, but you want to make sure that in the bag that you put the the hand or the digital whatever in there's, no, I
there's no water, because water causes it dishevel yeah, and that means you. You won't be able to re attached yeah an icy can. Actually, if I put if I cut off my finger and I threw it in a bucket of ice, it could actually get frostbite. Yet that's crazy. That is crazy, but it's also pretty cool yeah. Anyone frostbite on your because you know you will Be- will use anymore now. Frostbite is just dead tissue brought about by exposure to it,
We called the trade so after the teacher is after you, ve got it on the ice in the back.
On the ice.
Common one one! You ve got the bleeding stopped you want to cross, but whatever
yours, you have remaining and hope that you ve gotta get hospital nearby with some surgeons that aren't doing much at the moment.
Or who are willing to cancel their schedules and say: let's go do this yet get off the golf course. So when you get to the hospital or some things you can expect, if all of your surgeons have come in from the golf courses should be ready and waiting for you- and I M, like we said first they're going to re, attach the bone to provide stability for the rest of the surgery and there's probably still gonna, be a little bit of a gap there because they need to get in. There
and then they start re attaching near your blood vessels, the tried and just like with Eddie Knolls that just gets. You know the blood flow going and essentially makes that limb alive once more right. Well, I m it also keeps it from further dying here.
Because Chuck it turns out that, like there is a finite amount of time, which is understandable, but we we
are aware of how much time a limb
to sit around in the hot sun starting date to go. You know it and there's so. For example,
if you ever up whole arm or a whole leg, cut off a murmur death proof, yet they geyser leg
like sticking out of the window and mad MIKE is everything Carousal Tamar when he hit em in her legs goes here. If she had survived and her legs is laid their out at room temperature, it could have been
good for six to twelve hours. I imagine you really pushing at twelve hours yeah, but if say you had somebody who's like this. Like needs
put on ice and does everything right. He could say refrigerated for four days and still be reattached yeah.
Point out, though, in this article ideally you're having that surgery that day. But if you are then our here within minutes
yeah. I dearly basically the sooner the better it as soon as they are ready to go. You should be ready to go yet, but you are right. If that is not the case, and you have some good refrigeration going on, you can last for about four days. Yet an apparently is not even a surly, the skin tissue that that leads to problems in re attachment after being exposed to room temperature, muscled degradation area
interesting, so you you get there you're getting near surgery done. You probably are going to expect to go through that first long surgery, boundary attachment blood vessel, maybe some muscle fibre and an ill and action may be sure, and then they ll say
the nerves offer later and then later on down the road will be a skin grafter. Some kind like a free, flap surgery like I was talking about and the free refers to this. The free, like this part of this tissue from your body, has been removed the donor site outside the cost of the surgery, video, ok, it's it's been cut free right and they had make sense, and then it really is simpler than you think it's re attaching and hopefully everything takes and
you fight the infection off and you start the rehab process. Wisdom takes a long time in its ruling and not fun.
Can be weird at first, they point
article B, weird to look down and see her army attach, but imagine no weirder than looking down it's in your arm, not attached in. Oh, they probably
a comfort to Syria that Vietnam, you jerk, if you like odds kind of crooked, but it apparently
times, it kinda feel different, and that can be a little strange and off putting sure it's not like. Oh just like I was before fried in better than ever at and tumor this one life, my good friend Tom Chief. He said he also talked about something called cross transfer. This was mine blowing, which is basically like if, if just re plantation is Frankenstein in this is
even more so yeah haven't quite get the purpose of the hand, basically you're, getting a
a hand on your right arm. Let's say so your thumb in your pink
would be an weird places, great palm still facing them.
Direction, but let me really autonomous will steer yeah, but what's what's the point of that? If you
a bad hand in a good here I don't know if it's the only had like away
and available at the time. I don't know that when I got the other one were: basically they take your lower leg,
beneath your knee so like if your upper leg is damaging your Laurie, I guess fine was to say your upper leg is wasted, for whatever reason by your lower leg is fine. They'll cut it off the lower leg and basically turn it around
right now and then your knee becomes locked. Your calf muscles then serve the function that you're thigh muscles used to
and your new joint is now in your ankle. Then
also going to be wearing a prosthetic, obviously because you have no time muscles and your turned around foot
which is now backward. Where is extra support for that prosthetic foot or leg or limb, while it's pretty cool is basically saying like? How can we take this
and use it to even better utility. Now it it's a regional purposes, been destroyed, yeah, it's pretty cool. I tried Van photos of a cross transferred hand, but I couldn't find any photos and weirdly pictures Madonna kept popping up. Does she have something so no dude like I had tried all sorts of Google searches and she images of work at popping up so maybe get to Le Feeder, some
she does not set in the waiting forgotten. He literally had to her feet. There's gotta be dumped, you wasn't. I thought it was a messenger. Hasn't shown, you suggest that one where we talked about microbes
three men. There is perhaps another even better way which will cover right after this message.
some time ago, one of the greatest painters and most tortured souls of all time, there's something truly magical about the fact that he pulled out of this life of misery. This joyful images of flowers and rolling hills,
right colors? Would Albert Einstein be diagnosed with attention deficit disorder today he was a very good student and math and science, and he was in mediocre to decent student in other areas. Some of that is lack of interest that it also lack of talent, was Harry Houdini predestined to become the greatest scape artist, based on
families great escape. All of these things can function is sort of a metaphor for
his own genesis and
story, which seems to be again
series of escapes, I'm doctor gales,
and all my new podcast personality I'll be joined by amazing experts to delve into the minds of famous historical figures:
you want to know what really made exceptional people take then take a listened, a personality, fine personality on March, ninth on the eye heart, radio, app on Apple podcast or wherever you get your broadcasts. Are it so we discuss how you can have surgery, but there may be an actual way to regrow things, notices far by far them more preferable to yelling fingers, but not like you know, you can't lose a whole finger in regrow. It's gotta be above the bone like let's get the Tipp of your thing,
like your fingernails cut off right, any cant find it an even better. This is involved, like dumping, a magic powder on that that wound here. So if you, if you have
your finger cut off below the nail right below the nail, which happened to a guy in Cincinnati in two thousand five who owned a hobby shop. I used to love those place now meet you man,
when on be like. I just want all the model, airplanes and everything Eddie strict up in a land. It was my go to oh nine, which are just discovered, still exist, not too far from my house. Is it a magic shot? It's like everything else, dead models, Ed MAGIC kits, they head, you know what be cushioned
sort of like a catch all guys like both of those that I never went to one that was the same year anyway. This guy is hobby shop
owner. As far as we know, he sold no magic items here.
Lemon straining why a motor was very dangerous and in our sea plain he did a good job. I guess and cut his finger off and apparently is brother was had something to do with finger with tissue regeneration and said tat. He is in the best yeah. I think I went to the doktor. The hospital and doctors like will give your skin grafted, can cover this weirdness. But you know you lost your finger, ts, yeah and
His brother is like donkey. The skin graft just yet come over I'll, give you beer and I'm going to put some put some something. That's called extracellular matrix on your wound and, let's see what happens, and they did and magic happen
and it regroup the guy not only regrew his finger. He regrew, apparently not the bone, but very surprised
only the nail bed and fingernail edge, apparently like you, don't grow a nail bed back like even if you cut off just the Tipp of your finger like that nail beds, never growing back this guy's mailbag grew back. That's awesome! An cellular matrix is awesome. It's basically
the glue that holds ourselves together and not just us plants and animals and trees and now have it and it does its functions outside the body cells. That's what's called extra. So so you are obviously right and it's college, and we talk a lot about college in the protein that some in a super good for all kinds of things, especially growing skin air like
since can cream and stuff like that soap, so typically what they uses. This was a powder from pig bladder, but I've seen
I saw a video in New York Times site that showed how they do. It today
is mainly for I'm, like let's say you got, you didn't want to skin graft for some reason, or it was impossible to get a skin graft in you. You ve lost all the skin on your thoughts
they would get a pig water and they they spread it out,
and they remove all the cells basically is the step. Does it have pig
cells, no dynamic is harvested from pig body yeah, but they saw him
cells and all the dna with like a chemical bath and basically, what's remaining as the matrix in it.
Drawing it out and it looks like a cut it into sheets and looks like a sheet of like parchment paper
and then they will put that on your leg in it immediately to starts going to work. Yet they used to think the extracellular matrix was just something that provided structure for cells to grow around like a futile and the fetus yeah, because in if you
here in the feed us in, like something happens, you lose a town in the feed as if you are afraid of fear in the fetal position here in the womb. Yes, and you lose a toe the toes grown back there, you know you grow vestigial tale that goes away
your feet enhance start out being whether, through your growing, a lot of stuff and then getting rid of it, you can also regrow stuff that you're not supposed to lose up to the age of about two
and then I think, the general ideas that the extra chauvinist matrix disconnect goes dormant in humans right, but they thought that it was
just structure and then they realise that no, this is actually creating some sort of signal to the rest of the body to say: hey, don't scar regrow instead and it goes and recruit stem cells and says come over here and let's rebuild this finger. Yes, this hobby shop accident was to IRAN
let's reward this man with a regret finger and don't forget the nail Ben, that's what extracellular matrix says: everything
air and it's it's pretty cool. The problem with why you can't normally just regrow a finger is because, when some,
like that happens, the trauma happens. Your body says it recognizes it in the immune system kicks in, and it's gonna
swell up and get inflamed and scar tissues, gonna start the form and the extracellular matrix prevents the inflammation, prevent scar tissue from forming and basically tells the body like now. I'm just gonna grow like normally right now,
our tissue just regular old cells, but, like he said after a certain age, it is goes away. Like we have
the extracellular matrix still, but its function or its ability to trigger re growth is just becomes dormant or something happens to it, and with this picked later,
Stuff there they're starting to wonder who is there a way that we can just trigger this naturally in body? And if that's the case then
hello to re growing a whole head? I mean you never know because they pointed out that, like dear, can regret,
antlers and things like that in their own lives are different than us site, seller, cellular really right gives as bone cartilage skin church
All those things are, in your hand, your arm your leg
and you would need to regret all those two first, something really be considered. Re grown sure you Kansas, regrow the leg, but not the boat. It still be impressive, but you're like kind of flop, and they have you seen the picture that you have seen fighter
kicking, the guy any breaks his own leg in its dislike, almost like a cartoon year, Aura Miguel, he oh yeah. Well as we get here yet Stefan triggers the older mariner on yeah big time. Let me
week so that basically emanate they ve been experimenting with war veterans, erect
actually the New York Times, video us, although it was at war veteran who was analysed, unto his thigh yeah, he's a great success and I think it was scan and tendons in air, and it was you know it look at an early, but it was functioning and accounts you getting out nothing, there's literally
nothing else to say, but I agree, Sir well, then, if you want to learn more about re plantation, you can type that word into the search bar has suffered that camp and it'll bring up a couple cool things at the very least. Also I'm typing extracellular matrix, which is pretty cool
and then bring up another article two and since I said those things it's time for the same, it is right to call this direction. You get these from time to time we like area
from time to time. He guys and Jerry led the work you do. I love listen to the show. I wanted to write in, though, with a correction regarding Lewis and Clark, I'm working towards my Phd in art, history, and I am particularly interested in the history of medicine and disease.
In the middle, the show Josh mentioned that the Adventure Party inadvertently discovered syphilis had not been under Europeans. Up to that point
This is actually not the quite the case. Syphilis goes back pretty far in european history was first documented in late to think century. After conflict between France and ITALY,
and remained an issue for Europe peeking around the mid nineteenth century nineteenth century rather sir,
Josh did have part of it right, though, when he said that the party blamed on native american groups.
Early on everyone wanted to blame the disease on everyone else. No surprises here, but after that initial conflict, the French referred to syphilis as the neapolitan sickness, while the Italians named it the french sickness, a trend that continued as the stuff spread you
in our view, if your interested, it's really fascinating stuff, especially the cures that became popular mercury was really nasty. One history of syphilis by Claude Cartel is a pretty good reference. She read a book called with history of surplus. Somebody wrote a book.
Cover his roots anyway, just one in that was Claude Q. You ye accent of good Theo. These french lies in that what that's gone
member anymore anyway, just our normal person, that is from Catherine, I M sorry Kathleen Pierce nice. I think she was into disease fixed in paintings about disease. I get so thanks a lot for letting us know that Kathleen. I feel, like I've been said three. If you want to set a straight, we like to be corrected, and
better. All you have to do is three to us sure to initiate content. You can t tourists using our handle as why escape. I guess you can go on Facebook. That's another great way to contact us ache and complain there. We people love doing that, whereas Facebook that complex that we should now you can send us an email to Stuff Podcast House, therefore to come, and although you can't complain,
you can enjoy our website step. You should know that stuff, you should know, is pretty
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Transcript generated on 2020-03-06.