Sleeping Patients with Anesthesiologist Dr. Zach Antonov

KKH Trailer Wide


Will: [00:00:00] Knock,

knock, hi. Hello. Welcome to knock, knock. Hi. With the Glockenfleckens. I am Dr. Glockenflecken. I’m Lady Glockenflecken. And, uh, we are so happy to have you here. It is mid July and, um, we, this is an exciting time in medicine. It is. Because July 1st, actually, you know what? It’s not even July 1st now. Like a lot of, a lot of residencies are starting their interns like a week or two early.


Kristin: I’ve noticed that on social media. There’s a lot of people. Why 

Will: is that? That’s not fair. Yeah. Like give your, give, give your new interns a break. Like let them enjoy their, their last vestiges of life. 

Kristin: Well, I don’t know. Don’t you remember that? Two or three weeks in between like when med school was [00:01:00] over and residency hadn’t quite started yet And like the time off was kind of nice, but the financials of the situation get a little tricky for people Absolutely, you’re going a few weeks without any sort of You know, I do remember thinking or 

Will: loan or anything.

I remember like looking at Cobra once I think it was yeah I think I was like, oh, this is not possible, right? This is like three thousand dollars a month. This is insane. Yeah, and and I think I, I want to say we just kind of hoped for the best. We just let it go and hope for the best, which is terrifying knowing my medical history.

Uh, it all worked out. But anyway, so now interns and like the, the medical year is starting now a little earlier, but now A lot of interns have had about a month and 

Kristin: everyone’s at least a couple of weeks for people to settle in. Yeah. 

Will: And I just want to clear something up. There has been, you know, you always hear like people make jokes about this and this is actually something I never make a joke [00:02:00] about because I don’t, it’s not true.

And I don’t want to like, so any, uh, angst and, and fear, uh, regarding this issue of like, oh, you don’t want to go to the hospital in July. 

Kristin: Right. That’s when all 

Will: the newbies start. All the new doctors. That’s garbage. All right. Yes. There are lots of new doctors, but you know what, you know, who also recognizes that there’s new doctors, all the old doctors, they know, they’re 

Kristin: never paying closer attention.

Will: Then everyone is, is there’s, there’s lots of supervision. Everybody’s double checking things. And they’ve, I, I want to say there has actually been a study looking at like mortality and certain like health measures. Uh, you know, in July versus other times and, and this, it’s, you know, that, that’s, it’s an unfounded fear.

And, uh, and so to all of you people thinking about out there, thinking about getting something done, some surgery, some procedure, July, it’s fine. It’s fine. You know what? 

Kristin: [00:03:00] Maybe it’s even better because those fresh, you know, people fresh out of med school. They’re super smart. They have learned a lot. Or people fresh out of residency.

Those people are like, the most knowledgeable of everyone. 

Will: They come with a new perspective. They’re 

Kristin: up on the newest technology. It’s all still fresh in their 

Will: mind. And their attendings are vigilant. They’re hyper vigilant. They know, they know where the shortcomings are. Where, uh, where the, the new interns and new doctors need to grow and, and, and get the experience.

And so they’re on it, you guys. 

Kristin: It’s fine. Yeah, and and you’re a patient, just, you know, be patient. No, but really have a little bit of like understanding and compassion that they’re, they might be a little bit nervous. Yeah. Things might move a little 

Will: slowly. They’re in a new job. But you’re still going to get great care.

Yeah. Don’t worry about that. Uh, I’m, I’m more just like they’re right now. They’re all like super stressed. Yeah, 

Kristin: I know. I [00:04:00] feel protective over the new people. I don’t know why 

Will: I remember what it was like, you know, like being unsure of myself and, uh, you know, not, not, not. Uh, you know, knowing if I’m ordering the right dose of Tylenol, right, right.

And, uh, relying on the, the, the people around me, the pharmacists and the, you know, getting advice from them and physical therapists and nurses and all that, just like really. We’re, like, leaning on the team to just, like, you know, provide great care. Some checks and balances. 

Kristin: Yeah. Just making sure. And also, go check in on those people’s families, the newbies, you know?

They’ve all just moved to new places, for the most part, and, and they’re all starting new jobs, and they’re trying to get established, and, like. Don’t forget about the families. Of the new doctors. Yeah, yeah. Or new med students. That was you once upon a time. That was me. Yeah. But that’s a lot of people. And, um, people forget about, about the invisible support systems behind all of the [00:05:00] new doctors.

Will: So. I’m trying to remember what rotation I started on. I have no idea. Maybe an emergency medicine or I don’t know. I’ve blocked out a lot of that. Yeah, 

Kristin: I do remember taking a picture of you on your first day of residency. I’ll maybe have to share that like a first day of school picture. Oh, yeah. And then I also took a last day school picture on the day you were done with residency and you had like your lunch box and 

Will: everything.

I looked quite young. I did. Yeah, 

Kristin: that was a long time ago. We’re getting 

Will: old. I know. All right, let’s get going on this episode. So we have a special guest today, Dr. Zach. Antonov, all our guests are special, uh, Dr. Zach Antonov, uh, is, um, it’s his pen name actually. He’s an author and a practicing anesthesiologist, and he has, uh, written a fantastic book that 

Kristin: is…

I’m very intrigued by the title. Yeah. Yes. I really want to read it just to figure out what that’s 

Will: about. It’s called I Watch You Sleep, A Doctor’s Tales of Anesthesia and Chain Restaurants. Like, what do the chain restaurants 

Kristin: have to do with it? I love it. So what are you [00:06:00] watching me do in my sleep? I just have 

Will: so many questions.

So we talked a little bit about his book and just about, um, practicing anesthesiology. He, he pulled down the blue drape for us and told us a little bit about what his job is like. And I think it’s kind of fascinating for people in medicine, but also people who have. I’ve always wondered like, what is it that’s going on while I’m asleep?

Which is a question that Kristen asked. Yeah, it’s one I have all the time. So here we go. Here is Dr. Zach Antonov.

All right, we are here with Dr. Antonov. Zach, thanks for joining us. So excited to talk with you. Well, I’m, 

Dr. Zach Antonov: I’m honored to be here. You must really be kind of digging at the bottom of the barrel to have me on here. I think, uh, 

Will: yeah, we scraped, we scraped and scraped and, uh, and then we found you. And so, and you’re 

Dr. Zach Antonov: here.

Yeah. Am I, am I like the first non famous non influencer guest you have on? I mean, there’s not a single set of embroidered figs and fig scrubs in sight. 

Will: [00:07:00] Famous people are, are, are boring, like you’re probably going to be bored talking to, not that we’re famous, but I mean, uh, it’s, uh, you know, we, we like the bottom of the barrel people, if that’s what you prefer to call 

Kristin: yourself.

We are bottom of the barrel 

Will: people at heart. Just a couple of bottom, uh, cellar dwellers talking to each other. That’s all we are here. Uh, Zach, it looks like you’re in some sort of awful appearing cubicle right now. 

Dr. Zach Antonov: Yeah, so I don’t, I don’t know when’s the last time you’ve been in something called a call room before, but that’s where I’ve heard it I am going to be in the hospital on call working.

Um, but it’s this place inside the hospital where you can sleep the whole time or work the whole time, depending on what’s happened. 

Will: They got like prison issue sheets and blankets and 

Dr. Zach Antonov: pillows. Yeah. It says, you know, property of Rockland County prison across from it. I think they get like the third hand.

Third hand 

Will: sheets. Actually, this is a good question. When was the last time I was in a call room? It’s it’s got to be I didn’t use it in [00:08:00] in residency. It was all home call. That’s all home call. Oh, 

Dr. Zach Antonov: that’s nice Which 

Will: which home well home call is a scam. I don’t know it is It’s a scam because it’s an excuse to, to, to bypass work hour restrictions and residency so that you can still work all day the next day.

And to pay 

Dr. Zach Antonov: you way less of a salary too, because you can’t do anything anyway the whole day. You’re just like always on edge. Oh, I can get a call here. I can get a call there. I can’t go anywhere. 

Will: So Zach, I want to ask you a question. Uh, because you have a, a background in comedy, you’re, you’re a writer and, uh, you write very funny stuff and, uh, you’ve, you’ve dabbled in a little standup comedy.

Um, just as like a general question, are doctors funny? What do you, what’s your gut reaction? Are we funny as a, as a, as a field, as a 

Dr. Zach Antonov: vocation? As a field invocation, I think no, and I think overall we’re not really allowed to be, and I think you’ve probably gotten that [00:09:00] sense when you started off on your Glockenflecken journey.

Um, you know, you had to hide behind a nom de plume at first, and, you know, society just expects doctors to… Have a certain, uh, demeanor to present themselves a certain way, you know, lives are in their hands. You can’t be saying like, okay, I’m about to save your life, but then also check out this one liner I’ve been working on.

Uh, but, but the, the stuff that we do lends itself to a lot of humor. Um, and I think many doctors use humor as a way to process kind of all the… Intense stuff that happens in medicine that many people probably can’t even comprehend Or they might even say how are you making fun of that? And you say well, I mean gallows humor, you know It’s some of the yeah some people’s defense mechanism Um, but i’m glad you found me at least here to liven up your show with humor has been a little too much serious stuff About 

Kristin: yeah, it’s not very funny.

So i’m glad that you’re here [00:10:00] 

Will: I struggle I I try I try my best with the jokes. No, it’s uh Um, I think, I think we, I think in general, what do you think the answer is? Do you think doctors are funny? I’ve interacted with a lot of doctors that are not me. 

Kristin: Yeah. Yeah. Uh, I think when they’re being doctors No, they don’t tend to be funny whether they are funny as humans I don’t know because it’s like he said I don’t think you guys are allowed Quote unquote to be funny like it’s it’s considered Unprofessional I 

Will: think we’re maybe not as not as funny as we think 

Kristin: we are There’s that too.

I think you guys are pretty good at like dad jokes. Like that’s nice, safe humor. I’ve encountered a lot of dad 

Will: jokes. Yeah, that’s, that’s, that’s my go to with patients. You know, you talk about like, I get asked this question a lot as, as what, what do you tell jokes to patients? Like, is, are you like this?

Are you doc? I’m like, no, I’m not like a comedian, like in my day to day [00:11:00] life. I’m sure you, you feel the same way, but. But when you, when you bring jokes in, it’s, uh, it’s very dad jokey, very kind of like corny. humor, right? Do you, as an anesthesiologist, as, as, as you’re pushing the propofol and you’re, you’re, you’re sending patients off into sleep, do you have, uh, any, any, what do you tell them?

What do you tell people? Do you try to make them laugh or is that a dangerous proposition, right? As people are about to go into unconsciousness. Well, 

Dr. Zach Antonov: hopefully when I’m pushing the propofol is not the first time that I’m speaking to the patient. If that is, that’s a very traumatic, really bad thing where.

Uh, if that happens, I might whisper into their ears some platitude because that might be the last thing they ever hear in their life, you know, uh, but in 

Kristin: a Hail Mary or something 

Will: as 

Dr. Zach Antonov: you’re Oh gosh, yeah. No, in a normal situation, no, uh, anesthesiology is unique because surgeons, all these other doctors, like, you’re a doctor, right, Will?


Will: I Technically, yes. Okay. I’m an ophthalmologist. 

Dr. Zach Antonov: [00:12:00] So, you build up somewhat of a relationship with patients before the actual you know, cutting into the eyeballs into the body anesthesiologist. We have maybe three to five minutes before the surgery to Establish who we are, establish rapport, uh, gain confidence in the patient to put their lives in our hands.

So it’s a lot of reading the room, uh, you know, if I walk into a patient’s room and they’re clutching some crosses and they’re saying prayers or something and the whole family is around them, I’m not going to be telling some dirty jokes there. As opposed to if you, uh, you know, you go into a young patient’s room, they’re…

You know, cracking jokes with me, I’ll, I’ll respond in kind. And I think that goes a long way with, uh, establishing kind of this intense trust in such a short amount of time, which is, I think, very unique to anesthesiology. 

Will: The last time I’ll just tell a quick story. The last time I received general anesthesia was when I had my, uh, I had a, um, my subcutaneous defibrillator placed and I actually, I didn’t, [00:13:00] I didn’t, uh, meet with the anesthesiologist.

At least I don’t remember it. They probably did come in. I’m sure to say something, but you know, the amnestic effects of all the things that you do, you know, it’s all hazy, but I, I, the first, the only thing I remember is, is being wheeled into the room, being scared to death. And, um, and the anesthesiologist just said, are you nervous?

And I said, I’ve never been more scared in my life. And then he pushed like 10 milligrams of Versed and that was the end of it. That was it. He’s like, okay, I’ll give you 

Dr. Zach Antonov: a little extra. I was done. You’re still, you’re still in a dream. I 

Will: was. Yeah. Yeah. And I, I. That’s 

Kristin: how come everything has gone so well.


Dr. Zach Antonov: still You’re gonna wake up. You’re gonna be a resident. 

Will: And I’m, I’m so thankful for that person. I don’t even know who it was. I don’t remember any other interaction, but it was, uh, he’s one of my favorite people. That is my 

Kristin: experience as well. Like with epidurals, I’ve had two kids. The first time I tried to do it without an [00:14:00] epidural because I didn’t know any better.

And oh man, when that epidural hit, it was like the best. This feeling I’ve ever had in my entire life. And then when the second one came, I was like, just hook me up right now. As soon as I came in, you guys. 

Will: How do you feel about doing epidurals? Are you, is that, what’s your favorite part of the job? 

Dr. Zach Antonov: Uh, you know, I’m in a community setting.

So we kind of have to do everything. You know, we do the epidurals, the labor stuff, the general ORs. We respond to codes and airways. If you’re in an academic place, then everything kind of ends up getting subspecialized. You have the people that only do. OB and epidurals. You have the people that only do general anesthesia, only do pediatrics, hearts, whatever.

Uh, but, and I think that’s the reason I went into community practice. Uh, I wanted to keep doing all the stuff that I used to do. Um, except, you know, the big things like hearts or transplants, those obviously don’t go to community centers and you wouldn’t really want them to, but otherwise I [00:15:00] do everything, you know, epidurals, regional blocks.

I even sometimes have to interact with. Ophthalmologists for their cases. Uh, no, 

Will: no, you don’t. No way. I do. I get the Versed ready though. That one milligram, that two milligrams, that must be very exciting for you guys. 

Dr. Zach Antonov: It’s, it’s very exciting, especially when you have 20 lined up in a day. It’s great. But anything we can do to help you.

Will: I always, I always feel bad. Like when I, uh, when I see you guys doing like eye rooms, because you don’t have any time for breaks. It’s it’s or I mean you do find time for breaks, but you know, it’s so fast paced We’re like constantly turning over and you’re yeah, you don’t I feel like I only get one Sudoku I feel like you enjoy like having a little bit of time to just check your portfolio.

Yeah That 

Dr. Zach Antonov: is true. It’s um, the, the hard part about it, the hard part about it is just the Requirements that we have to do there’s so many clicks and check boxes for every single [00:16:00] case You have to do if that weren’t an issue if it was just actual medicine that you had to practice That would be the easiest day in the world.

You say hi to the patient You ask what medical problems they have and then you say I don’t care because you’re just getting an eye done And then you bring them into the room and you give them a milligram of Versa and you sit back like that’s the easiest day But it’s the same amount of clicking for a five minute case as it is for a four hour case We lose a lot of time there.

Kristin: I have a question because I’m not in medicine at all 

Will: We got lots of questions for the anesthesiologist here. 

Kristin: I think this is A common fear, right? Or, or at least a common concern, which is what are you doing to me while I’m asleep? I mean other than the surgery like obviously that’s happening or whatever the procedure is but like when someone is under like are y’all in there making fun of us or No, you know like that’s the that’s the concern is like that’s your 

Will: concern or everyone’s concern 

Kristin: I think some people have that concern 

Will: self conscious [00:17:00] about being asleep in front of Strangers.

Kristin: Because it’s so vulnerable, right? Like, you have no way to know what is happening to your body, and then you just wake up and everybody’s gone, and I don’t know. There’s just a large gap in your imagination of, you know, what could be happening during that time, and people feel it in all sorts of ways. So tell us, clear it up for us.

What’s going on while we’re all asleep? 

Dr. Zach Antonov: Well, you had two kids, so it sounds like that could be the most vulnerable place you’ve ever been with your legs splayed open and 40 people in the room. Looking at all the stuff. You know, I don’t feel 

Kristin: vulnerable in that Situation honestly, which is kind of funny by that time.

You’re like, I don’t care who’s in here I don’t care what they see just get this kid out, right? Like I feel like you’re more it feels more powerful than vulnerable 

Will: if anything I think maybe what Kristen is saying. What are you doing behind the drape Zach? Sure. What are you 

Dr. Zach Antonov: doing back there? I can pull the curtain and You can see the puppet master and what we do here.

[00:18:00] Um, in terms of what we do to you, uh, there’s a lot of things that go on depending on the case. There’s a lot, you know, after you go to sleep, there’s a lot of things that have to happen. We have to secure your airway with a breathing tube or not. We have to start all the medicines to keep you asleep. Make sure you stay asleep.

A lot of medication management, you know, for blood pressure paralysis. All of that. Sometimes we have to put other things, uh, inside you, so to speak, uh, you know, temperature monitors, suction things down your mouth or throat to suck out your stomach, other IVs that can happen while you’re asleep. Um, so those are all the things we do to you.

While you’re asleep, maybe if you have a really super cool tattoo, that’s super visible. We might go. Yeah, that’s pretty cool 

Will: But they have a lot of syringes a lot of medications, that’s what I remember 

Dr. Zach Antonov: from it Yep, a lot of medications, but otherwise, you know that mantra is pretty accurate where it’s you know, 90 99% boredom and 1% sheer terror So hopefully you always fall into the [00:19:00] 99% boredom category, which means everything is going okay, where we’re just kind of, the pilot’s on cruise control, the ventilator’s doing its thing, it’s breathing for you, our medicines are turned on, they’re going in, keeping you asleep, um, I mean, Sudoku is such a, like a, such a trope, you know, I mean, it’s Candy Crush now, because we have cell phones, like, we don’t need a pen and paper there.

So that’s it. That’s right. It’s pretty old 

Kristin: fashioned. It is. That was 

Will: an oversight on your part. Well, I, I, I, I have my, the character holding the Sudoku book just because I needed a prop. Yeah. Yeah, yeah. 

Dr. Zach Antonov: Like, I can’t, I can’t hold Candy Crush. The Del Sudoku Extravaganza? You got 

Will: it. Yeah. That I found at my local, uh, gas station one day.

That’s where, that’s where most of my props come from very, um, you know, just. 

Kristin: Disreputable. Yeah. No. Like dollar 

Will: stores and stuff. But, but I want to, I want to talk about just anesthesiology as a career because I, in the, in the scheme of like work life balance, [00:20:00] uh, you got like ophthalmology, so you got me like I’m always running my mouth off all over social media about how great my work life balance is and making jokes about it and everything.

But I, I always say anesthesiologists, you guys, you fly under the radar a bit. People don’t realize. Like you, you got it nice. Like it’s, it’s not bad. You know, the, you got to get up crazy early in the morning. That’s really the only thing. And, and, and you mentioned that 1% of the time when things are, um, absolutely terrifying, uh, so could you speak about what, where do you think you fall on the work life balance spectrum?

Am I correct in my, in my, my, uh, assessment of this? 

Dr. Zach Antonov: So I think anesthesiology has always been a part of that classic ROAD you know, radiology, ophthalmology, anesthesiology, dermatology. Um, I think that would 

Will: be, let’s be honest, like dermatology, [00:21:00] that’s, that’s the, 

Dr. Zach Antonov: yeah. Uh, I think that was maybe the case back in the day, the good old days.

But now I think every specialty has its share of, you know. lifestyle issues. Um, we as anesthesiologists, like you said, we, we basically have to always be on unless you’re working at a surgical center where you’re just, you know, business hours Monday through Friday, you get all your holidays off. But otherwise you need people to do the surgeries, to do the traumas, to do the emergencies, the open globes, the appendectomies that come in, things like that.

So one negative is that. You just, you never know when you’re going to be on, you never know when you’re going to be off, as opposed to someone that knows I’m going to be home at 5 p. m. every single day, I’m going to sleep in my own bed every single night, I’m going to eat dinner with my family every single night, um, so that’s really a very big rough aspect of that, um, that I don’t think people appreciate.

We’re basically, we’re basically always concurrent with the surgeons. Um, except we have to probably get in even earlier than them because we’re the ones that have [00:22:00] to do everything first. You know, they just show up and sign a paper and start cutting after everything’s already been done. Oh, 

Will: that’s all.

What set you on the path to anesthesiology? 

Dr. Zach Antonov: You know, I was… Everyone thinks in medical school kind of angels would sing and trumpets would blare whenever you did your first day of whatever rotation you’re meant to do, right? And you’re going to be like, yes! Just like every time I ask someone about their mother, I get this high and I want to go into psychiatry and you know, things like that.

But that’s rarely the case. It’s more of a, I think, practical decision. People have multiple interests, multiple dislikes. You can say, oh, I like dermatology and I like pediatrics. And then you kind of just have to. Analyze yourself, analyze the realities of things, the financial prospects, what you want out of life.

So, I did that. I was interested in urology at first. That makes sense. Yeah, I do like being in the surgical space, the [00:23:00] procedures, the fast, uh, fast paced nature of it. And 

Kristin: urologists have a really good sense of humor. Oh, 

Dr. Zach Antonov: yeah. Oh, yeah. Yeah, that was a big thing a urologist told me Well, you know what? The only difference is between Urologists and anesthesiologists is he says urologists play with other people’s dicks during the case, right?

But then I did anesthesiology It wasn’t a required elective. I don’t think it is required in many places. So you have to actively seek it out And I just like being behind the drapes, kind of the puppet master that sort of pulls the strings. You know, we’re not in the limelight, but we do a lot of things to make the surgeons in the limelight.

be able to do what they do. And I like the blend of medicine, the medicine aspect of it, because I really do like, you know, thinking about all aspects of things as opposed to just, okay, here’s my one problem that I have to concentrate on. And we’re really kind of throughout the whole hospital, like you said, we’re in labor and delivery, helping ladies, we’re in the operating rooms where the emergency departments were throughout the whole hospital, if [00:24:00] someone stops breathing, or, or has a code.

So I really like that aspect, because I can just go through any door in the hospital with my badge, and no one else can see that. 

Will: I did a two week elective. I don’t know if you remember. Probably not. I did a two week elective in anesthesiology. Um, and it was one of those classic, you know, like, I was done with everything else.

I just had to do something in med school. I think it was my fourth year. And, uh, um, I, I, I just remember the sputum. There’s just, there’s so much of it, and it’s, I just like, this is not for me. I cannot, I, no. 

Dr. Zach Antonov: You have to pick your specialty based on which bodily fluid you need to boost. That’s what I’m learning with this 

Will: podcast.

And I did, I did, I attempted one intubation. And I did it successfully and I was like, that’s it. I’m Lee. I’m done. Like I’m I’m out. I’m 100% on my intubations. That’s it. 

Kristin: Yeah, I have to ask [00:25:00] you something that I would have to ask any, you know, self professed comedian, which is. Who hurt you? Who 

Dr. Zach Antonov: hurt me? Oh, everyone.

What happened to you? Everyone in my life. Have you ever been hurt? Where did he touch you? Show me. Yeah. No, I wasn’t a stereotypical class clown. I was always the kind of good boy straight A student that parents loved having over always telling their own kids, why can’t you be more like him? Um, but I was always drawn to the comedy and absurdity of in the mundane and every day.

And you know, it would occasionally show. One traumatic memory I have was in elementary school, um, when I and another classmate, uh, who was actually very curiously gifted as well, we just, like, wrote some kind of witty but kind of crude, dirty poem just for fun. And the teacher found it and, you know, we got in big trouble.

They called our parents. Typically, you know, elementary school boy stuff, you know, penises, things like that. And I’m like, Jesus, come on. This is clever, like clever and funny. So [00:26:00] it was all downhill from there. Um, 

Kristin: I recognize that response. That’s a good joke. I stand by it. 

Will: I may have said that once or twice.

Um, and so you, you kept doing, I know you, you, you, you did, you dabbled in a little standup comedy, you know, in college and med school and And what, um, what are the types of things, because what I’ve learned is that, cause I used to do a little standup comedy as well. Um, there’s a big difference with medical audiences versus just a general audience.

And I still say to this day, like I’ve been just doing strictly medical comedy for so long. I don’t think it would translate to like a general audience very well. Um, and so when, when you were doing a lot of standup, what was it that you were talking about? Were you incorporating a lot of your medical education and training or in your job into those, those sets you were doing?

Dr. Zach Antonov: At the time that I was doing it, I wasn’t like [00:27:00] exclusively medical humor. Um, because like you said, we can be pretty specific. I wasn’t making jokes about, Oh, I was doing a subtenance block for this ocular case. And then he had a hematoma. Um, so a lot of my ass off at that. What are you talking about? I would mix just, um, my, my experiences throughout college and residency, and you kind of have to pick and choose what you think would be funny to the average audience.

You know, anything with sensitive subjects always lands. You know? Rectal exams, penile exams, just, you know, all of that, because people can relate, that’s people’s kind of fears or, uh, anxieties about the doctor. Um, if you start making jokes about, oh, I, you know, I had a patient die on the table, it might not really land as well.

So, you gotta pick and choose. 

Will: Thanks. I think that’s, that’s now we’re up to three, uh, penis references, already. 

Kristin: Well, he did say he almost went into 

Dr. Zach Antonov: urology. Yes, that’s true. It’s still there. It’s just still there. That can be 

Will: forgiven. It’s still there. You can’t get rid of it. Um, [00:28:00] and so, I, you know, I want you, you actually, you sent us a number of little stories here and I know that you, you, you’ve written a book.

Right. I want to make sure that you talk a little bit about this book, because, uh, as what’s a big part of this podcast is, is stories and everybody in medicine has so many stories. So could you, uh, tell us something from the world of, of anesthesiology that you think, uh, is, was interesting or funny or embarrassing?

Give us something. 

Dr. Zach Antonov: Sure. You know, um. You know, I think anesthesiology is a pretty mysterious field to many people, you know, surprisingly even to surgeons judging by the way they act sometimes, uh, I guess I got to do it. Well, they don’t care about anybody but themselves. Exactly. I have to deal with patients who don’t know anything or they focus on the wrong things.

Um, when I ask about, you know, personal or family problems with anesthesia. Or I’m, you know, I’m looking for major life threatening reactions. Uh, they, you know, they tell me their second cousin, twice removed, got nauseated [00:29:00] once after a colonoscopy. And I’d be like, I don’t really care, but, but thank you. Or a common thing that they say is…

I woke up during surgery once. You know, I always have to act really shocked, really empathetic, when I know 99. 9% of the time they’ll say it was like during a colonoscopy or a heart, or a cataract surgery. Or a cataract surgery. Those aren’t full general anesthesia, you know, colonoscopies can be done awake.

Now, I had a guy come in for his colonoscopy who refused anesthesia because he had to drive his wife home after her colonoscopy that day. You know, it sounded like a really roundabout way to incorporate butt stuff into their sex lives, but who am I to judge? Um, I don’t know, you know, patients often say things like, after I list all the complications that can happen, they say.

I don’t care. Just make sure I’m asleep. And I always say, you mean, make sure you wake up, right? That’s, that’s the hard part. People don’t understand the risks. Um, a patient doesn’t care that you manage this ejection fraction of 10% severe pulmonary hypertension while they’re [00:30:00] exsanguinating on the table.

Although remember is, you know, feeling the tube in their mouth for one second at the end, or, oh, my, my lip is a little bloody. And that’s a kind of a drawback of our field having advanced so much in patient safety, that perfect outcomes. Or to be expected. Yes. I always say that anesthesiologists are like hockey goalies, they, we can’t, we can’t win the game, but we can definitely lose it for people.


Will: Absolutely. 

Kristin: That’s terrifying. I’m not sure I want to, I’m, I’m very curious about, you know, what we should be worried about, but then at the same time, I don’t think I want to know. Yeah, 

Will: I think that there’s probably a, there’s certainly a spectrum because I, I do a lot of informed consent as you do as well.

Yes. Absolutely. And there are some people that really ask you, they, they go through a line by line and, and ask about all the, the different things. And, and there’s some people that really don’t want to hear anything. Uh, same thing with like during a, a conscious surgery. So cataract surgeries, you know, people are awake.

Some people [00:31:00] want me to, they’re asking me questions like, what, what are you doing now? What’s what, you know, what’s, what’s the next step. And then some people I’ll, I’ll start talking to them. About what I’m doing, they’re like, please don’t talk, doctor. 

Dr. Zach Antonov: Is that what your wife says, or the patients? Yes.

Will: Exactly. Just in general. It’s so interesting, you know, the spectrum. You know, that you’ll see, uh, you know, whenever you’re talking about these. Sensitive things and these, these difficult things that you’re going to be doing to, to patients. Absolutely. 

Kristin: Well, because we’re not, we’re not awake for it, obviously.

Yeah. So we, we don’t, I don’t know, I guess ignorance is bliss. We don’t know the things we should be afraid of, but what we, what we are afraid of is… We know we’re going to be cut open, so we just really don’t want to have to experience that. 

Dr. Zach Antonov: Well, you know, sometimes 

Kristin: that’s not Just make sure 

Dr. Zach Antonov: I’m asleep, comment comes from me.

Yeah, and you know, I totally understand that, but it comes to situations where I’m like, listen, going to sleep is really not safe, and you could die, and here’s this alternative where we can do a nerve [00:32:00] block, where we can make your arm basically a limp dead fish for a few hours, where you literally feel nothing, and I don’t have to give you anything at all, and they still say, nope, just put me to sleep.

You know, I have to document, okay, you have all these increased risks of death, heart attack, stroke, and they just say, okay, I accept that and, you know, as patient autonomy, we got to, uh, do right by that. And as long as they understand everything, then we do it. 

Kristin: I’ve had a nerve block before. I’m a big fan.

Yeah. What did you have? I don’t know why you were confused. Uh, well, that was part of the, uh, my epidural cocktail. Oh, okay. I guess. Remember for kid one? It was an epidural and a block. Oh, okay. I don’t remember much about why and what kind, but I remember it was magical. Very good. I was going from like, making mooing sounds trying to get this child out to immediately taking a nap.

I mean, like 

Will: that. I do remember that. Yeah. Yes. It was 

Kristin: amazing. 20 hours 

Will: in And then I asked if I could have one. Yeah. [00:33:00] And, um, but that wasn’t allowed, so… But Zach, I have one more question before we take a quick break. Um, can you help me with my anesthesiology content? I could use, I’ve exhausted all of my anesthesia jokes, I feel like.

Like, I’ve already done a joke about malampadis and, uh, and, and breaks. Like, I’ve done all the things. I need some more. Can you help me out? 

Dr. Zach Antonov: I can certainly be your, um, your reference, your, your advisor for anesthesia related content. Um, you got to let me sit down and think about it because I mean, you already used the breaks in the Sudoku.

That’s 95% of the stereotypes. So we got to start digging. That’s true. There’s my, there’s my tip. 

Will: There you go. That’s right. I got to do that. All right, let’s take a quick break. We’ll be right back with Zach Antonoff.

Hey, Kristen, I have a PSA for you and all of our listeners from our friends from Tarsus. You know how sometimes you can get red, itchy, irritated eyelids? Okay. Well, do that [00:34:00] might be? What? Eyelid mites. Yeah, it’s true. No! It’s a disease. It’s called demodex blepharitis. That’s disgusting. It’s pretty common.

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All right, we are back with Dr. Antonoff. So Zach, uh, uh, we are gonna play a game that’s called, um, annoyed Anesthesiologist, , I’ve, which is a, [00:36:00] a name I, I literally just came up with the second, um, because what this is, is a game where, I’m going to play the surgeon and I’m going to say a thing, a few words, a phrase, and you are going to give me on a scale from one to ten how annoyed that thing I said made you feel.

With ten being the most annoyed? 10 being the most annoyed, like you’re like seething with rage, but it’s all underneath because anesthesiologists, you guys are so cool and calm. You’re like straight. You don’t, you never lose your cool. That’s what I like. Surgeons do. They lose their cool. Like they, they freak out at things.

Uh, but I have never seen an anesthesiologist like. Like really lose it. Cause you can’t, because you’re like, things could like turn on a dime. Right. And you got to like, be able to handle things. So I feel like that’s part of the personality with anesthesiologists. I’m excited. So anyway, what annoyed anesthesiologist?

Okay, here we go. [00:37:00] The first thing, Hey, anesthesia. That’s it. That’s it. That’s it. That’s it. Surgeon says, Hey, Anastasia. What’s, how does that make you 

Dr. Zach Antonov: feel? Let’s say during residency that would have made me feel an eight where I was more Proud and culture and you know all confident and indignant, but nowadays maybe a two or a three Um, mostly, 

Will: there’s a, you don’t mind when the surgeon doesn’t know your name, it doesn’t bother you too much?

So, it, it really depends. You’re just 

Kristin: so identified with your profession that now that is your 

Dr. Zach Antonov: name. I, if it’s a surgeon that’s literally seen me day in, day out for years and they still call me anesthesia, then, then yeah, sure. Or if there’s just so much turnover where it’s impossible to learn everyone’s names, I’ll give them a pass, um, you know, but otherwise, not too bad.

Not too 

Will: bad. Okay, but still surgeons. If you’re a surgeon listening, learn. Learn the anesthesiologist’s name. All right? If you don’t know the name, make one [00:38:00] up. Okay? At at least then you could say, oh, I thought you were somebody else. 

Dr. Zach Antonov: Sorry. I also know all the breaks make it hard because we’re coming in and now you can take like 20 breaks in one case.

Like, wait, are you John? Wait, now you’re frank. I don’t even know. 20 

Will: bricks, . It’s like, like every five minutes. Uh, man. Okay, here’s another one. Anesthesia bed up, please. 

Dr. Zach Antonov: Um, that I would say just a one. I’m really not annoyed because they need doesn’t bother. The surgeon needs the bed at a certain way to get the surgery done.

Honestly, if it makes you operate even 1% faster to get the bed at a certain place, please, by all means, tell me to go up, down, left, right, side to side. I’ll make it happen. 

Will: Perfect. Perfect. Okay, good. So that’s a one. All right, next one. Five minutes later, bed down, please. 

Dr. Zach Antonov: Yeah, uh, now how annoyed are you? That would, that would creep up to a four and five now.

I’d be like your anesthesiologist [00:39:00] that just makes a noise and say, how’s that?

Will: Surgeons can be a little finicky, a little, a little picky, a little particular about, uh, about things like that. Okay. Next thing. Let’s have our med student close the incision. 

Dr. Zach Antonov: Oh man. Um, I would say 

Will: I don’t know if a community hospital where you’re at now. Do you have med students 

Dr. Zach Antonov: that come in? We don’t have med students.

Um, I think they sometimes have like PA students or kind of PAs that may not have as much surgical experience as an actual surgeon. So, you know, we still, we still get that, but 

Will: look, you’re, this is, this is also the end of a, um, let’s say four hour case, uh, open of colon resection. 

Dr. Zach Antonov: Oh man. Let’s have our 

Will: med student 

Dr. Zach Antonov: close the You’re going to see the, you know, we’re just calm, cool, and collected, man.

I would also say maybe a five at that because I’m not too far [00:40:00] away from residency in med school. Everyone needs their training. I totally understand that. And as long as I actually know, then I can tailor it. You know, if, if they say that, I’m like, okay, I got another half an hour left. I know exactly what to tailor as opposed to, you know, all of a sudden, okay, we’re done.

You can wake the patient up. That, okay. 

Will: What is that? That was my next. Ah, I gotcha. Okay. Where are you? Where are you on the annoyance scale? Yeah, nine or ten. Okay, we’re done. Nine or ten right there. Yeah, that’s like… That’s peak. Why? What is that? What? Well. Tell us 

Dr. Zach Antonov: why that’s so awful. Well, sure. Like, as, as Will has shown in his skits, we don’t have an anesthesia on and off button where we just press a button and then magically they wake up and everything is all done.

Sometimes we can do that depending on the anesthetic, but most times it’s a process. You know, everything has to start. Dissipating and coming off and it’s kind of a, the whole landing process of an airplane. You know, you don’t just snap your fingers in the middle of the air and you’re departing on the ground.[00:41:00] 

Uh, that all takes skill, finesse, time. So if a surgeon says, okay, we’re all done. You can wake him up. We got another case to go. I’ll be like, you just screwed yourself over, you know, and then it makes me look bad because everyone’s standing around for 10 extra minutes waiting for the patient to wake up glaring at me.

I’m like, blame the surgeon. You know, he could have given me a 10 minute warning. 

Will: Okay. All right. Next one. Uh, anesthesia, the patient’s moving. 

Dr. Zach Antonov: Oh, uh, I’m, okay, I’m going to say a two or three, but if you worded it as the patient is waking up, then an eight or a nine, there’s a big difference. All right. He’s not waking up just involuntary reflexes.

Okay. If you say they’re waking up, it makes me look like I’m just doing a bad job or keeping the patient awake. Um, but, 

Will: oh, okay. That’s a good distinction. All right. Waking up versus moving. Exactly. And, uh, and then. What do you do then? What do you do if when the, when the surgeon, what do you do back there when the surgeon says, Oh, patient’s moving?

And you’re like, Oh, it’s, it’s a reflex 

Dr. Zach Antonov: thing. [00:42:00] I’d probably just give a little more anesthetic or more paralysis. Um, sometimes you have surgeons that are just like patients a little tight. Are they fully paralyzed? And you’re like, they. They got zero twitches on the twitch monitor. What more do you want me to do?

Like, well, they feel tight here. And then you just say like, okay, I’m giving something. And same thing as the bed height going up. Patient’s a little 

Will: tight. Right. What does that mean? The 

Dr. Zach Antonov: patient’s a little tight. Like their muscles are tight when they’re operating in them. They just have a subjective feel that the patient is a little.

Tight and not paralyzed enough to their liking. And then, and 

Will: then you give the the 

Dr. Zach Antonov: placebo. I give the placebo and 70% of the time it works 100% of the time. That’s us. 

Will: That’s the surgeon placebo. Yeah. And also you mentioned another thing, a twitch monitor? Is that, was that? 

Dr. Zach Antonov: Yes. Is that a thing? Yeah, yeah, it’s when we stream live on Twitch during the operating room and just like do comedy.

No, no, it’s uh, We have, uh, like basically two electrodes that we can place on like either the face or the arm and it [00:43:00] sends us electrical stimulus four in a row and you kind of see how many twitches they have on their arm. And if you have four out of four twitches, then you’re not paralyzed. And if you have zero out of four, you’re probably totally paralyzed.

And somewhere in between is a, you know, a scale of it. And that tells you kind of how much paralytic 

Will: to give. Gotcha. I had no idea you could monitor twitches. That’s cool. Um, I, see, this is another thing, like, I, this is the reason why, like, neurosurgeons and general surgeons, they say that ophthalmologists are not surgeons.

Because I have no idea what some of these things are. 

Dr. Zach Antonov: Well, they have no idea what some of those things you do are. 

Will: That’s true. That’s true. They don’t know what it’s like to pull on an eye muscle and, um, you know, have the, the heart rate. Okay. Moving on. Moving on. Alright. Alright. Alright. I got, uh, we’ll do one more.

Anesthesia. What is taking so long to wake this patient up? Wow. 

Dr. Zach Antonov: That, that would probably be a 10 for me. You hit a, you hit a nerve [00:44:00] there. Just because you really gotta have some balls on you to say that. You know. After doing an eight hour case and then waiting until the last minute to say, okay, we’re done.

Um, and then having the boss to say, what’s taking so long? Cause there’s just so many things that can happen. Oh, I don’t know. Maybe the patient just had a stroke from, you know, the massive blood loss you gave them. There’s just so many reasons. There’s, there are a lot nicer ways to 

Will: say. Yes, that’s absolutely true.

You should never say that, that’s never something you should say. Um, is it true like the longer the case is, like the longer it takes to wake the patient up from, is that, or do you type, you have to start that process of waking them up? a little sooner, right? So that it doesn’t take too long. Is that your goal?

Dr. Zach Antonov: Yes, it depends too. There are some drugs and some anesthetics where you could be infusing them for three days and they’ll still come off, you know, within three minutes, but the vast majority, yes, the longer you go, the longer it takes to kind of wear off. So it’s always nice to have. A lot of, uh, a [00:45:00] lot of warning ahead of time and also just, you know, occasionally looking over the drapes and just seeing what they’re, what they’re doing, because if they’re already starting to sow skin and they haven’t said anything.

You can probably start waking them up. 

Will: There you go. Um, did I miss any, did I, did I miss any major annoyed 

Dr. Zach Antonov: anesthesiologist? Oh, maybe, oh, can we just do this case under a little sedation as we’re trying to cancel a case? That’s always a, 

Will: oh, that’s true. We didn’t even talk about canceling a case, which I, I recently learned is part of the Residency curriculum actually 

Dr. Zach Antonov: that’s part part is like words for anesthesiology.

Will: Is that that? Oh, okay. That’s what it is That’s something you actually like you have to like when to cancel 

Kristin: a case you have to know 

Will: or even like how to communicate it With 

Dr. Zach Antonov: this search. There’s usually one scenario where they say, okay, here’s the scenario of the case You’re canceling it. You have to talk to the surgeon about this and that’s always a very because they always get an actor He’s just the biggest a hole [00:46:00] talking to you 

Will: Right.

I that is that is so funny that uh, that that that’s like a something that you’re tested on 

Dr. Zach Antonov: Oral boards or no. 

Will: Yeah, we do oral boards. Yeah. Yeah But we don’t, we don’t have like, how would you respond to an anesthesiologist telling you that your cataract surgery is cancelled? 

Kristin: Have you ever, I wonder what GPT would say to answer that question.

They pass the boards, right? 

Will: Yeah, so what is your strategy for broaching this subject with the, with the surgeon who has no idea they’re about to get their case cancelled? 

Dr. Zach Antonov: It’s always best to frame it in a patient care and patient safety aspect and always frame it as in like our patient and, you know, I think the safest thing would be to do this because if you just say, hey, Potassium’s too, we gotta cancel.

Uh, that doesn’t really come across well. And you always want to make it seem like, as you said before, it’s the surgeon’s idea to cancel. And that’s truly, anesthesia doesn’t cancel cases. You know, it’s the [00:47:00] surgeon that listens to us and says, okay, I guess I’m listening to anesthesiology and cancelling the case.

You know, we, we, we always suggest things. Cause the, the surgeon can always say, I don’t care, I’m calling this case an emergency, and we have to do it. And in that case, we say, okay, I’m gonna write that down. And we’re going to do it. There you go. 

Will: There you go. Annoyed anesthesiologist. Thanks for getting annoyed with it.

It’s okay. It doesn’t, 

Dr. Zach Antonov: it doesn’t take, uh, I’m pretty cool. 

Will: Let’s let’s take, let’s take one more break. And we’ll come back with a couple of fan stories before we wrap up.

All right. We are back with Zach Antonoff. So we’re going to, one thing we do, Zach, is, uh, is we read a couple of. We read a fan story, so people send stories to us about their time in health care, uh, and I, I don’t read these ahead of time, uh, and so this, we’ll be experiencing this together, uh, and this will be very exciting.

So our story today, we just have [00:48:00] one story, it comes from David. David says, I tore my ACL about a year ago and had to have surgery. When I went in for the surgery, the nurse who put my IV in was, uh, struggled a little bit. I’ve always been praised by phlebotomists for how present my veins are, and after not drinking anything since midnight the night before, I knew it wasn’t my fault.

My so that means so when you’re when you’re dehydrated your veins are not as like notable and prominent and so it can be right They’re not as engorged. We’re talking to an anesthesiologist who puts IVs in all the time. Yeah, tell us Is it difficult when patients are NPO and haven’t had anything to eat or drink?

Dr. Zach Antonov: Yeah, it’s certainly I don’t know if it’s one of those thing is actually true or something We say to kind of put the blame on the patient instead of us not being good enough. Make yourself feel better 

Will: Gotcha. All right. So this, uh, so David, uh, had flat veins and it wasn’t his fault. Uh, so, um, uh, my wife was in the room for this.

So she recounted [00:49:00] this for me a few times. The first time the nurse tried to stick me, they missed the vein. Not a big deal. I know that happens, but I think it riled them up a bit. They tried a second time, but didn’t. Pinch me, pinch, pinch me how you were supposed to, and I gushed blood onto the floor and the blankets until they taped the IV in place.

That’s the only time I ever heard a healthcare worker say shit. I’m sorry. I’m sure the ortho bro loved including the puddle of blood on the floor. And his estimated blood loss numbers. 

Dr. Zach Antonov: Oh yeah. I always make that joke too. When we make a bloody mess for IVs or A lines. Yeah. Hey man, it happens sometimes.

Sometimes messes happen. But as long as the IV gets in there one way or another, that’s 

Will: uh. As long as it’s in, right? That’s what counts. You get more, you get more with uh, the, the, the art lines, right? You can get more, a lot, a lot more 

Dr. Zach Antonov: bleeding there. Shooting geysers if you’re not careful. Geysers. Blood [00:50:00] geysers.

Kristin: That’s delightful. All in 

Will: a day’s work. The veins a little, uh, uh, like an IV is just, is more using. Oh, okay. Yeah, there you go. Do you, do you put in all the A lines? 

Dr. Zach Antonov: Uh, it’s a, it’s a mix between, you know, CRNAs and the attending anesthesiologists. So, we kind of… Have a crack equally at it. Uh, so yeah, I, 

Will: I do.

Here’s, here’s another one. Here’s another one from a surgeon. Uh, Hey, let me try it. 

Dr. Zach Antonov: I have never heard that. I think surgeons just want as little to do as possible with that. Uh, that’s honestly almost as bad as what’s taking so long for you to do everything. It’s like, here, let me just do it. 

Will: I don’t know.

If a surgeon has ever said that in the history of surgery, um, How about the med student? The, having the med student try, I, I tried a couple of art lines. They’re actually harder than you’d think. I, I found them quite difficult. They’re very humbling. Yeah, you would think it’s easier because 

Kristin: you can, What is an artery?


Will: in an artery? Yeah. Putting a, like a, [00:51:00] I don’t know what you call it, catheter, but you put a catheter in, uh, an artery. A lot of times it’s in the wrist. It’s like the radial artery, right? That’s what you’re using. And the, the, the thing is like, you can feel it, you can feel the pulse and it’s like, it’s right there.

It’s right. Why is this so hard? And then but then like you just miss it and and then you get bleeding and then it like Collapses and you can’t I don’t know from what I remember see I’ve only done this like once or twice and it was traumatizing And so I remember every part 

Dr. Zach Antonov: of it for you I wonder how the patient with a giant hematoma and swiss cheese artery felt 

Kristin: That’s what I’m thinking.

I’ve had one of those giant 

Will: hematomas. I felt, I did feel really bad. It’s, it’s, I, you know, but, um, I don’t know, I guess. For 

Dr. Zach Antonov: some reason, they’re just hard. I don’t know why. 

Will: They are. Yeah, they’re hard. Arts are hard. Okay. So thank you, uh, David, for that story. You can send us your stories, knock, knock, high at human content.

com. Zach, thanks for joining us. Uh, just a [00:52:00] pleasure to talk with you. Let’s, um, uh, tell us about this. I, I want to make sure we, we talk about your book here. So tell us about it. Uh, what is, what is it? What’s about, you know, 

Dr. Zach Antonov: who’s it for all the things? Well, uh, I did write a book called, I watch you sleep, a doctor’s tales of anesthesia and chain restaurants.

It’s, it’s kind of a, it’s not your when breath becomes air, you know, you’re not going to be shedding copious tears here, maybe a couple, but it’s kind of an unfiltered humorous, meaningful memoir of sorts about a life in medicine and anesthesia. So kind of giving a cross section of my life. Through that lens and you’ll kind of think maybe David Sedaris if he were an even more vulgar Person and a physician if I may afford myself That compliment so, you know I touch on a lot of things that we kind of talked about here and I kind of mix it in with Kind of wild stories that may or may not be true So basically take everything with a grain of [00:53:00] salt when you read it.

It’s kind of half entertainment half educational. Yeah, it’s aimed, I think, towards a lay public, you know, I don’t get too technical in there. It’s for people that are interested in getting kind of a glimpse of that world, you know, similar to the, the worlds of like, I don’t know, house of God, or this is going to hurt kind of that kind of irreverent style.

It’s kind of less common. I love that. Because as we said, doctors have a certain Reputation and image to uphold but we are people, you know, at the end of the day. Yes So that’s out there on that’s great. Bezos is favorite marketplace. You can find it And check it 

Will: out. That’s Amazon in case you didn’t know Jeff 

Dr. Zach Antonov: Bezos And you can’t see it for anyone listening, but there’s just giant pallets of my books behind the Flannery’s there They must be real big fans.


Kristin: yes We bought them in 

Dr. Zach Antonov: absolutely I had a question for you. Like, how do you handle the inevitable kind of criticism and negativity when it comes to like criticisms towards the [00:54:00] art and the humor aspect of things that you do? 

Will: Oh, yeah. Um, you know, if it’s like one or two comments, like one or two, that’s all it takes.

Well, if, if that’s it, I kind of ignore it for the most part. If it’s like, I’m getting a lot of the same types of criticism, then there probably is something there to that. And I need to at least take it seriously. Think about it. Like, where’s that coming from? Did I word something the wrong way? You know, do I need to, you know, take the content down, whatever it is, um, which very rarely happens.

Uh, and so, but you’re always going to get like one or two, like kind of strange, you know, negativity or people that are just really upset about what you said. 

Kristin: But that’s always about them. Not about you. When it’s those one offs, you know, like that’s an unhappy person having a bad day or they’ve had something very specific happen to them that that touched in some way.

And [00:55:00] I don’t know, I think it’s easy to, to write off the, the one offs, right? Because you can’t be on things to all people. So that’s just not someone that’s. 

Will: I think people that the valid criticism will be apparent because it’s going to come from, especially if you have a large platform, it’s going to come from lots of different places.

Dr. Zach Antonov: think people that aren’t in the creative sphere don’t kind of the don’t appreciate the vulnerability that comes with releasing a creative endeavor. Into the wild because I’m sure when you were doing it what you know when I was doing it Um, you know, I don’t need the piddling royalties that Jeff Bezos ekes out to me from this book You know, I do it as a creative endeavor.

I had something I wanted to say I put it out there I’m sure you were the same and it is very vulnerable You know You put it out you get people that like you get people that don’t you get people saying one thing or another And I, I think it’s just the nature of art, you know, you’re not doing something to please everyone you’re not making, you’re not making a car that you want every single person to buy you’re making a piece of art that you hope just resonates [00:56:00] with the audience you want, and with enough people to make an impact, even if it’s positive or negative, you know, I’d almost rather have an average five out of 10 score and have it all be filled with 10s and ones.

Rather than just all being filled with fives because you at least know you right spark the discussion you Yeah, 

Will: you made a lot of truth to that that that’s actually a really good point Yeah, 

Kristin: if you’re not ruffling a few feathers as a comedian, then you’re boring 

Dr. Zach Antonov: But if you’re ruffling feathers as a doctor, then you’re fired 

Will: Well, you could be, yeah, I mean, that’s, you know, absolutely, but, you know, also because a lot of what I do is satire and, and so you, you gotta evoke a reaction and, uh, there’s gotta be some truth to it and you gotta like have, uh, uh, kind of, uh, an underlying message and some people are going to agree with that message and some people are not, but, um, I think the message is still important.

Uh, and you gotta kind of take a side, you know, that’s, that’s, that’s kind of the nature of. Yeah. Comedy and 

Dr. Zach Antonov: satire is your one low negative comment Jimmy T [00:57:00] from United healthcare or something commenting on your videos 

Kristin: No, it’s me

Will: You know, actually, you know, it’s so funny that because the United healthcare stuff You think I’d get the only people that would disagree with what I say about United healthcare is 

Dr. Zach Antonov: United health Well, they’re busy sailing their mega yachts. They don’t really care. I don’t 

Will: think They don’t care. I mean, I do know that they see my stuff because I’ve talked to people that have been, that are in the UnitedHealthcare that, that, that have, um, uh, said that they, they see it and a lot of them secretly laugh at it and agree with it and all this stuff.

But, um, and maybe, or maybe I’m just trying to sow discord within the UnitedHealthcare organization by saying this. I don’t know. Uh, but I’m okay. There’s some, some people you’re just okay with. 

Kristin: Yeah, I think if you believe in what you’re saying, you know, and there’s some substance to it and a reason for sharing it, then, you know, naysayers, whatever, it’s easier to write them off when, [00:58:00] when you believe in what you’re saying, I 

Will: think.

But Zach, keep doing what you’re doing. I love seeing people, uh, show, you know, have creativity in medicine. We need more creativity, more people showing their creative sides. And so I think it’s awesome. It’s 

Dr. Zach Antonov: been an honor talking to you for free when other plebeians have to pay 250 on Cameo to do it. So, could you just wish me a happy birthday real quick so I can save it for next year?

Yeah, happy birthday. 

Kristin: Uh, yeah. Um, happy graduation to you, and nephew. Uh, 

Will: yeah. Yeah. Happy birthday, Zack. Merry Christmas and happy new year. And uh, congratulations. Congratulations on the thing that you did. Thank you. Well done. I love it. Uh, again, your book is called, I watch you sleep a doctor’s tales of anesthesia and chain restaurants.

Get it on Amazon. And are you on social media? Uh, 

Dr. Zach Antonov: no, you know, as I kind of alluded to, I just put, I wanted to put something out there. My goal is not to just become a. media personality. So I’m not on social media. I am just on the cover of books. 

Will: [00:59:00] That’s all. There you go. I actually that’s that’s uh, I’m very impressed in fact So it’s probably makes your life a little bit easier than they have to promote yourself on social media So where else where else 

Kristin: do you write?

Do you have anything you’re working on? 

Dr. Zach Antonov: Uh, not currently I I’ve always loved writing fiction as well, but that’s kind of on the back burner I got some some kid a kid on the way a third kid on the way. So I’m busy with all of that Uh, maybe, 

Will: maybe later. Maybe during those big, uh, colon resections, you can, you know…


Dr. Zach Antonov: do you think I wrote most of this? There’s a chapter or two. That’s right. 

Will: All right, Zach. It was good talking to you. Thanks for joining us.

All right. Thank you to Zach for joining us. And I just had a, I loved being able to ask all of my anesthesiology related questions. Uh, I, I think they got a, a, a great job. of[01:00:00] 

pressure. It’s a lot of pressure. Yeah. Even like the routine. Uh, uh, um, intubations. I mean, they have to get that tube in. Yeah. Because the patient’s like, not breathing. I guess 

Kristin: I never realized. It’s gotta get in there. Before, like, are you, Stressful. You’re always intubated if you’re under general anesthesia?

Will: Yeah, cause you’re, cause you’re, you’re, you’re um, You’re paralyzed. Right. Yeah, so you can’t, yeah, you can’t breathe on your 

Kristin: own. So, does that mean you’re on a ventilator? Is that the same thing? 

Will: Yeah, yeah, I mean, Yeah, basically it is. Yeah, you got a machine that’s breathing for you. Yeah, so that’s scary Anyway, and uh, and thank you all for sending in your stories Let us know what you thought of the episode if you have any other suggestions for Doctors, I think Zach might have been a suggestion to us from we get a lot of yeah People have a lot of great ideas for guests.

And so we love hearing that so [01:01:00] send us your guest suggestions Uh, we definitely have a few guests coming up in, uh, uh, some future episodes that were recommended to us. And, um, let us know what you thought of the game. Did you like the game? Annoyed 

Kristin: anesthesiologist. Seems like a little bit of an oxymoron now that we’ve gotten through it.

Turns out, not much can 

Will: ruffle those feathers. It’s hard to ruffle their feathers. That’s true. 

Kristin: I guess that’s good if you’re in such a high pressure occupation. You want somebody that can keep 

Will: their cool. Even keeled, level headed type of person. Lots of ways to reach us. You can email us. Knockknockhigh at human content.

com Visit us on our social media. All the social medias. We’re there, uh, kick it with us and our human content podcast family on Instagram and TikTok at humancontentpods. Uh, thanks to all the listeners leaving feedback and reviews. That really helps. Go out there, like, if you like the show. If you don’t like the show, just never listen to us again.

See ya. Uh, it’s fine. No hard feelings. But if you really like it, please leave a review. [01:02:00] Uh, if you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shout out. Like today, at Matthew Doye. Doye? On YouTube said, came for the lols, the lols, stayed for the eyeballs. I see what you did there.

That could, uh, that could apply to a lot of things, uh, that I say and do in my, in my life. Uh, so thank you for that. You’ve converted. 

Kristin: An eyeball fan. 

Will: I, I did. Yeah, I love, I love

making eyeball fans. Maybe that’s a future ophthalmologist. One can only hope. Uh, of this podcast are on YouTube, on my YouTube channel at DGlockenflecken. You can also help join our Patreon. Uh, lots of cool perks, bonus episodes, where we react to medical shows and movies, hang out with the Knock Knock High community.

We’re there, we’re active in it. Uh, early ad free episode access, Q& A live stream events, a lot more. Um, we got a hangout coming up pretty soon. Patreon. com slash Glockenflecken or go to Glockenflecken. com. Speaking of Patreon community perks, new member [01:03:00] shout out to Baseball Rob, Sarah M, Ann P, and Kristen N.

Oh, we got 

Kristin: another Kristen. It’s even spelled the same way. It is, yeah. The correct 

Will: way. The correct way. Uh, you’re going to, you’re going to hear it from, I 

Kristin: know wrong. We Christians have some strong opinions about that. 

Will: Shout out. Thank you for joining us. Everybody. Shout out to all the Jonathans as always a virtual head nod to you all.

Uh, Patrick, Lucia C. Sharon S. Omar, Edward K. Steven G. Ross Fox. Jonathan F. Marion W. Mr. Granddaddy. Caitlin C. Brianna L. Dr. J. Chaver W. Jonathan A. Leah D. KL. Rachel L. And Anne G. Thank you to all the Jonathans. Patreon roulette, random shout out to an emergency medicine tier patron. Shout out to Rebecca O for being a patron.


Kristin: it’s moving into more of a cat purr. 

Will: What is it?

Kristin: Everyone has left now. 

Will: [01:04:00] That’s a cat purr, right? Can I do, am I doing a good cat purr? I don’t know. Yay. This is, uh, this is, we’re turning this into an ASMR channel. Let me purr into the microphone for you all and call it a, a, uh, drumroll. Thank you for listening! We’re your hosts, Will and Kristen Flannery, also known as the Gawkomplagons.

Special thanks to our guests today, Dr. Zach Antonoff, our executive producers, Will Flannery, Kristen Flannery, Aaron Corny, Rob Goldman, and Shanti Brooke. Our editor and engineer, Jason Portiza. Our music is by Omer Binzvi. To learn about our Knack Knack Highs program, disclaimer, and ethics policy, submission, verification, and licensing terms, and hip release terms, you can go to Gawkomplagons.

com or reach out to us. Knock, knock with any questions, concerns, or jokes if you have them. Puns also work. Knock knock High is a human content production


As adults, I think it’s 

Dr. Zach Antonov: obvious that we all stop sometimes and 

Will: think, as much as 

Dr. Zach Antonov: I love my job, what other options are out there? What would it be like as a professional cuddler, 

Will: a real life 

Dr. Zach Antonov: zombie, a horse breeder, or a scuba diving 

Will: pizza 

Dr. Zach Antonov: delivery person? My name is Sidney Razkine, or as I’m known around the internet, Sidney Raz.

You may know me as the guy who discovers all the things we wish we knew by our thirties. 

Will: But, the one thing I’ve always 

Dr. Zach Antonov: wanted to know is, how do you get the world’s most obscure jobs? And how do you even do them? Join along as each week I sit down to understand what makes these people tick and question to myself if I should have taken a different career path all along.

Let’s find out. Internet on explain like I’m 30. Catch new episodes each Thursday wherever you get your podcast. And on my YouTube channel at Sydnee Raz. Subscribe now and let’s learn how to milk a goat 

Will: clean 

Dr. Zach Antonov: when a porn gets St. Stir. 

Will: What [01:06:00] should I use to still, where could I

explain like I’m 30.