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Anaesthesia: The Gift of Oblivion and the Mystery of Consciousness
You know how it is when you go under. The jab, the countdown, the—
—and then you wake.
This book is about what happens in between.
Until a hundred and seventy years ago many people chose death over the ordeal of surgery. Now hundreds of thousands undergo operations every day. Anaesthesia has made it possible.
But how much do we really know about what happens to us on the operating table? Can we hear what’s going on around us? Is pain still pain if we are not awake to feel it, or don’t remember it afterwards? How does the unconscious mind deal with the body’s experience of being cut open and ransacked? And how can we help ourselves through it?
Haunting, lyrical, sometimes shattering, Anaesthesia leavens science with personal experience to bring an intensely human curiosity to the unknowable realm beyond consciousness.
Kate Cole-Adams is a Melbourne journalist. Her novel Walking to the Moon is published by Text.
What really happens to us when we are anaesthetised? By this I mean not what happens to the pinging, crackling apparatus of our nerves and spinal cords and brains, but what happens to us—to the person who is me or the person who is you—as doctors go about the messy business of slicing and delving within us?
‘The prose is quite gorgeous—simultaneously tough and tender.’ Adelaide Advertiser on Walking to the Moon
‘A work of splendid richness and depth, driven by a curiosity so intense that it hazards at times the extreme boundaries of the sayable.’ Helen Garner
‘Kate Cole-Adams has been fascinated with our funny non-being during surgery for a long time, and Anaesthesia feels like a book that’s taken over a decade to write, which it is. It also feels like you’re having a decade’s worth of conversations with a dogged, but generous and resourceful thinker, with someone (she is both a journalist and a novelist) who can crack open a complex idea, and then run with it.’ Readings
395 pages, Kindle Edition
First published December 5, 2017
133 people are currently reading
1712 people want to read
About the author
Kate Cole-Adams
3 books22 followersKate Cole-Adams is a writer and journalist. She lives with her family in Melbourne. Walking to the Moon is her first novel, and was shortlisted in the Victorian Premier’s Literary Awards (Prize for an Unpublished Manuscript) in 2006. It was published by Text Publishing in 2008.
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January 27, 2018
Kate Cole-Adams’s book is ostensibly about anesthesia—the kind you typically undergo for surgical procedures. In fact, the first half of the book, give or take a bit, really is mostly about anesthesia, albeit with an almost obsessive focus on awareness/waking up during anesthesia. The second half of the book, starting with chapters entitled “Dreams” and “Ghosts”, however, is largely about the author’s preoccupation with her own psychological processes. More about that later.
Eighteen years ago, Cole-Adams states, she knew and cared nothing about anesthesia, but all of that changed when she heard Rachel Benmayor’s story. Benmayor’s general anesthetic failed during a caesarean section to deliver her second child: she was conscious, paralyzed, and in agony, and experienced a near-death encounter with “a great, implacable consciousness.” This compelling story, along with the author’s own overwhelming fears around much needed surgery--deferred over and over for years (until middle age)--for worsening spinal scoliosis apparently fueled Cole-Adams’s investigation into anesthesia.
Early in her book, Cole-Adams briefly addresses the first successful medical anesthetization. In 1846, American dentist William Morgan demonstrated how ether could be used to render a patient unconscious in order to facilitate removal of a painful lump in the jaw of a 20-year-old patient. News of ether’s miraculous powers quickly spread. In no time at all, it was being employed in London and Paris. Nowadays, other less odorous, less flammable gas anesthetics (related to ether) are employed, and the twentieth century ushered in the use of powerful intravenous anesthetics (such as midazolam and propofol). In 1942, Canadian anesthesiologists recognized the value of curare, a chemical extracted from a species of South American tropical plants, traditionally used in hunting by the indigenous peoples of that continent. By incorporating curare in anesthetic protocols, anesthesiologists could ensure that patients would remain completely still during surgical procedures. In short, patients were paralyzed. This meant that less anesthetic was used and that deaths due to anesthesia dramatically declined. In fact, anesthetic mortality dropped by a full 1/3 within ten years.
The third key element in modern anesthesia is analgesia—chemical pain control. According to Cole-Adams, who interviewed numerous medical specialists for her book, many anesthesiologists continue to administer inhaled gas anesthetics with little or no intravenous painkiller, often only providing small, incremental doses of pain medication as the patient emerges from general anesthesia. This is highly problematic because anesthetic gas provides no pain control, and there is evidence that the central nervous system still registers pain (even though the patient isn’t conscious of it at the time) and can be “sensitized” to it. Chronic pain that lasts months, even years, after the surgery can ensue.
To my disappointment, Cole-Adams is not terribly interested in the physiological effects of anesthesia—the impact of powerful sedating drugs on various organ systems, nor does she spend any time discussing how anesthetic complications occur. As the subtitle of her book suggests, she is almost exclusively focused on psychological aspects of anesthesia. I think it is fair to say that her interest in waking during anesthesia borders on the obsessive.
Recent studies suggest that the number of patients who awaken during general anesthesia may be higher than the “1 to 2 in a 1000” figure that is typically quoted. It may be as high as 4 to 5 %. It appears that women, the obese, redheads, and drug abusers are more likely to wake up and that some people may have a genetic predisposition to awareness while under anesthesia. Patients undergoing caesarian sections, heart, and trauma surgery tend to have lighter anesthesia, and their risk of being aware may be ten times that of patients undergoing other procedures. Waking and experiencing pain is apparently far less detrimental than waking to absolute paralysis. Patients who are aware of their paralysis are predisposed to being troubled by mental health issues afterwards. PTSD can even result.
Cole-Adams has certainly done her research on awareness during anesthesia. She provides details of a multitude of studies on the topic, many of whose conclusions are suggestive and speculative rather than definitive. I wish she had been more judicious in her selection of studies to present in her book and more restrained in her reportage of study details. It all becomes overwhelming quite quickly.
While I learned a lot from Cole-Adams’s book, I can’t deny that it was pretty hard going at times. The main problem is that the author is very concerned with her own psychological processes. Why, she asks several times, has the topic of anesthesia taken hold of her, a journalist, in this manner? What is that feeling of grief—the constriction in the chest and throat, the physical unease--that lingers just beneath the surface of her everyday self? Will undergoing hypnosis help her understand where that sense of loss comes from? Why do tears flow when the author tells a therapist the story of herself, at age two, being left behind with kind family friends while her parents vacationed? The thoughts that flit through her head while she swims, including observations about dappled light and grungy pool-bottom ceramic tiles, are recorded. The poor reader is mercilessly submitted to endless quite personal details--about failed romantic relationships, the author’s anxiety and self-loathing, her writing process, her artist mother’s paintings, and her elderly parents’ illnesses. Even excerpts from an unpublished manuscript on consciousness by her grandfather are included because . . . well, consciousness is sort of related to anesthesia, isn’t it? It goes on and on. I must admit that towards the end I regularly wondered if she would ever stop.
Yes, in the second, mostly autobiographical, half of the book, there are occasional nuggets of interesting material about anesthesia, but it is hard work indeed wading through the sometimes ostentatious writing and self-absorption to get to them. I don’t mind an authorial aside, a relevant anecdote or two, but too much of this book read to me like therapeutic journalling.
An Australian psychiatrist, an expert in hypnosis, upon first hearing Cole-Adams’s research interests tellingly comments to her that it all sounds a bit like “gobbledygook”. “I’m not certain,” he says, not unkindly, “whether you’re trying to sort yourself out, or whether you’re trying to sort out other things.” Amen, I say.
“You think too much,” the author’s son says to her, but that’s not quite accurate. What seems closer to the truth is that the author really just talks too much (and writes too much) about matters that no one but herself should be expected to be interested in. That is the main failing of a book which I commenced with the understanding that it was about anesthesia. It far too frequently is not. Ms. Cole-Adams’s editors would have done a great service for potential readers by urging the author to slash at least a third of this unwieldy tome. Huge amounts of the biographical stuff—the endless ruminations, the family history, the recounting of dreams (oh, dear!)—just needed to be cut. Some ruthless revising would have allowed the author’s research findings to really shine.
Eighteen years ago, Cole-Adams states, she knew and cared nothing about anesthesia, but all of that changed when she heard Rachel Benmayor’s story. Benmayor’s general anesthetic failed during a caesarean section to deliver her second child: she was conscious, paralyzed, and in agony, and experienced a near-death encounter with “a great, implacable consciousness.” This compelling story, along with the author’s own overwhelming fears around much needed surgery--deferred over and over for years (until middle age)--for worsening spinal scoliosis apparently fueled Cole-Adams’s investigation into anesthesia.
Early in her book, Cole-Adams briefly addresses the first successful medical anesthetization. In 1846, American dentist William Morgan demonstrated how ether could be used to render a patient unconscious in order to facilitate removal of a painful lump in the jaw of a 20-year-old patient. News of ether’s miraculous powers quickly spread. In no time at all, it was being employed in London and Paris. Nowadays, other less odorous, less flammable gas anesthetics (related to ether) are employed, and the twentieth century ushered in the use of powerful intravenous anesthetics (such as midazolam and propofol). In 1942, Canadian anesthesiologists recognized the value of curare, a chemical extracted from a species of South American tropical plants, traditionally used in hunting by the indigenous peoples of that continent. By incorporating curare in anesthetic protocols, anesthesiologists could ensure that patients would remain completely still during surgical procedures. In short, patients were paralyzed. This meant that less anesthetic was used and that deaths due to anesthesia dramatically declined. In fact, anesthetic mortality dropped by a full 1/3 within ten years.
The third key element in modern anesthesia is analgesia—chemical pain control. According to Cole-Adams, who interviewed numerous medical specialists for her book, many anesthesiologists continue to administer inhaled gas anesthetics with little or no intravenous painkiller, often only providing small, incremental doses of pain medication as the patient emerges from general anesthesia. This is highly problematic because anesthetic gas provides no pain control, and there is evidence that the central nervous system still registers pain (even though the patient isn’t conscious of it at the time) and can be “sensitized” to it. Chronic pain that lasts months, even years, after the surgery can ensue.
To my disappointment, Cole-Adams is not terribly interested in the physiological effects of anesthesia—the impact of powerful sedating drugs on various organ systems, nor does she spend any time discussing how anesthetic complications occur. As the subtitle of her book suggests, she is almost exclusively focused on psychological aspects of anesthesia. I think it is fair to say that her interest in waking during anesthesia borders on the obsessive.
Recent studies suggest that the number of patients who awaken during general anesthesia may be higher than the “1 to 2 in a 1000” figure that is typically quoted. It may be as high as 4 to 5 %. It appears that women, the obese, redheads, and drug abusers are more likely to wake up and that some people may have a genetic predisposition to awareness while under anesthesia. Patients undergoing caesarian sections, heart, and trauma surgery tend to have lighter anesthesia, and their risk of being aware may be ten times that of patients undergoing other procedures. Waking and experiencing pain is apparently far less detrimental than waking to absolute paralysis. Patients who are aware of their paralysis are predisposed to being troubled by mental health issues afterwards. PTSD can even result.
Cole-Adams has certainly done her research on awareness during anesthesia. She provides details of a multitude of studies on the topic, many of whose conclusions are suggestive and speculative rather than definitive. I wish she had been more judicious in her selection of studies to present in her book and more restrained in her reportage of study details. It all becomes overwhelming quite quickly.
While I learned a lot from Cole-Adams’s book, I can’t deny that it was pretty hard going at times. The main problem is that the author is very concerned with her own psychological processes. Why, she asks several times, has the topic of anesthesia taken hold of her, a journalist, in this manner? What is that feeling of grief—the constriction in the chest and throat, the physical unease--that lingers just beneath the surface of her everyday self? Will undergoing hypnosis help her understand where that sense of loss comes from? Why do tears flow when the author tells a therapist the story of herself, at age two, being left behind with kind family friends while her parents vacationed? The thoughts that flit through her head while she swims, including observations about dappled light and grungy pool-bottom ceramic tiles, are recorded. The poor reader is mercilessly submitted to endless quite personal details--about failed romantic relationships, the author’s anxiety and self-loathing, her writing process, her artist mother’s paintings, and her elderly parents’ illnesses. Even excerpts from an unpublished manuscript on consciousness by her grandfather are included because . . . well, consciousness is sort of related to anesthesia, isn’t it? It goes on and on. I must admit that towards the end I regularly wondered if she would ever stop.
Yes, in the second, mostly autobiographical, half of the book, there are occasional nuggets of interesting material about anesthesia, but it is hard work indeed wading through the sometimes ostentatious writing and self-absorption to get to them. I don’t mind an authorial aside, a relevant anecdote or two, but too much of this book read to me like therapeutic journalling.
An Australian psychiatrist, an expert in hypnosis, upon first hearing Cole-Adams’s research interests tellingly comments to her that it all sounds a bit like “gobbledygook”. “I’m not certain,” he says, not unkindly, “whether you’re trying to sort yourself out, or whether you’re trying to sort out other things.” Amen, I say.
“You think too much,” the author’s son says to her, but that’s not quite accurate. What seems closer to the truth is that the author really just talks too much (and writes too much) about matters that no one but herself should be expected to be interested in. That is the main failing of a book which I commenced with the understanding that it was about anesthesia. It far too frequently is not. Ms. Cole-Adams’s editors would have done a great service for potential readers by urging the author to slash at least a third of this unwieldy tome. Huge amounts of the biographical stuff—the endless ruminations, the family history, the recounting of dreams (oh, dear!)—just needed to be cut. Some ruthless revising would have allowed the author’s research findings to really shine.
May 31, 2017
4.5★s
Anaesthesia: “Most of us can barely pronounce it. Yet it has allowed the body’s defences to be breached in ways previously unimaginable except during warfare or other catastrophe. Through the use of powerful poisons, it has enabled entry into the secret cavities of the chest and the belly and the brain. It has freed surgeons to saw like carpenters through the bony fortress of the ribs. It has made it possible for a doctor to hold in her hand a steadily beating heart. It is a powerful gift. But what exactly is it?”
Anaesthesia is the second book by Australian journalist and author, Kate Cole-Adams. This book explores what happens when we go under. The impetus to write it came when Cole-Adams heard the story of a woman who went under for a caesarean birth. Except she didn’t. Go under, that is.
During her exploration of this intriguing topic, Cole-Adams looks at consciousness and unconsciousness, at hypnosis, at amnesia, at hallucinations and dreams, at awareness, at explicit and implicit memories. She looks at the effects of the different types of anaesthetic drugs used. Apart from asking the obvious questions such as “what is consciousness?” and “how does an anaesthetic work?”, she poses the ethical conundrum “Is it acceptable for the patient to be awake during surgery, paralysed and perhaps, even probably in pain, if they don’t recall it afterwards?” What might the psychological, emotional and physiological impact of that be?
The many years of research that Cole-Adams has done on her topic is apparent on every page, and evidenced by sixteen pages of notes on the chapters (references), thirteen pages of sources and eight pages of comprehensive index. And while she includes a wealth of information, her background in journalism allows her to present it all in a form that is easily digestible even by those with only the most basic medical knowledge.
As well as talking to many, many anaesthetists, attending conferences and doing extensive reading, Cole-Adams shares her own experiences and those of family, friends, acquaintances, work colleagues and total strangers, in first-hand accounts and stories told second- or third-hand. The impression she gets is that is it much an art as a science.
This is a must-read book, not just for those who have undergone or will undergo anaesthesia, but for anaesthetists and any staff working in operating theatres and in the pre-op or post-op situation, for whom the overriding lesson might be “Always assume your patient can hear what you are saying about them”. This is an utterly fascinating read.
Anaesthesia: “Most of us can barely pronounce it. Yet it has allowed the body’s defences to be breached in ways previously unimaginable except during warfare or other catastrophe. Through the use of powerful poisons, it has enabled entry into the secret cavities of the chest and the belly and the brain. It has freed surgeons to saw like carpenters through the bony fortress of the ribs. It has made it possible for a doctor to hold in her hand a steadily beating heart. It is a powerful gift. But what exactly is it?”
Anaesthesia is the second book by Australian journalist and author, Kate Cole-Adams. This book explores what happens when we go under. The impetus to write it came when Cole-Adams heard the story of a woman who went under for a caesarean birth. Except she didn’t. Go under, that is.
During her exploration of this intriguing topic, Cole-Adams looks at consciousness and unconsciousness, at hypnosis, at amnesia, at hallucinations and dreams, at awareness, at explicit and implicit memories. She looks at the effects of the different types of anaesthetic drugs used. Apart from asking the obvious questions such as “what is consciousness?” and “how does an anaesthetic work?”, she poses the ethical conundrum “Is it acceptable for the patient to be awake during surgery, paralysed and perhaps, even probably in pain, if they don’t recall it afterwards?” What might the psychological, emotional and physiological impact of that be?
The many years of research that Cole-Adams has done on her topic is apparent on every page, and evidenced by sixteen pages of notes on the chapters (references), thirteen pages of sources and eight pages of comprehensive index. And while she includes a wealth of information, her background in journalism allows her to present it all in a form that is easily digestible even by those with only the most basic medical knowledge.
As well as talking to many, many anaesthetists, attending conferences and doing extensive reading, Cole-Adams shares her own experiences and those of family, friends, acquaintances, work colleagues and total strangers, in first-hand accounts and stories told second- or third-hand. The impression she gets is that is it much an art as a science.
This is a must-read book, not just for those who have undergone or will undergo anaesthesia, but for anaesthetists and any staff working in operating theatres and in the pre-op or post-op situation, for whom the overriding lesson might be “Always assume your patient can hear what you are saying about them”. This is an utterly fascinating read.
June 1, 2018
‘Should be compulsory reading for all anaesthetists, others responsible for the care of surgical patients, and medical students who wish to achieve a true perspective of today’s anaesthesia.’
medicSA
‘Kate Cole-Adams’s Anaesthesia propelled me towards new ways of thinking about thinking itself: experience and consciousness and how we make in and make up this world.’
Ashley Hay, Australian, Books of the Year 2017
‘A work of splendid richness and depth, driven by a curiosity so intense that it hazards at times the extreme boundaries of the sayable.’
Helen Garner
‘Kate Cole-Adams has been fascinated with our funny non-being during surgery for a long time, and Anaesthesia feels like a book that’s taken over a decade to write, which it is. It also feels like you’re having a decade’s worth of conversations with a dogged, but generous and resourceful thinker, with someone (she is both a journalist and a novelist) who can crack open a complex idea, and then run with it.’
Readings
‘Comfortably numb. A close-up look at anaesthesia is equal parts social history, popular science and report on experience.’
NZ Listener
‘Anaesthesia is not just an account of medical research but a poetic exploration of the mysteries of the human mind.’
Australian
‘Cole-Adams’s prose is sinuous, at times intoxicating, and witty.’
Sydney Morning Herald
‘A troubling, anxious subject that most of us would rather avoid or deflect with dark humour. Cole-Adams has illuminated it in a memorable way. The book is a gift not of oblivion but of awareness.’
Inside Story
‘For the interested reader, it’s an outline of the science, with an emphasis on the unknown. For the practitioner, it’s a patient experience, eloquently expressed. There’s much more the anaesthesia than meets the eye, and this book provides a glimpse into the depths.’
Conversation
‘Anaesthesia is mesmerising…This rich and thorough study looks more deeply into questions about the nature of consciousness than many of us who undergo an anaesthetic are likely, or willing, to ponder.’
Australian Book Review
‘A fascinating mix of historical background, moving—sometimes shocking—surgical stories, interviews with experts and case studies. Surprisingly, it seems relatively little is really known about exactly how effective and affective anaesthetic is. Despite that, I found this book an oddly reassuring study.’
North and South
‘A fascinating mix of historical background, moving—sometimes shocking—surgical stories, interviews with experts and case studies. Surprisingly, it seems relatively little is really known about exactly how effective and affective anaesthetic is. Despite that, I found this book an oddly reassuring study.’
North and South NZ
‘Kate Cole-Adams has written a book that defies familiar categories. It is a personal memoir, a history, a scientific study, and a philosophical enquiry into the unconscious, and by drawing all these strands together the author has delivered a masterpiece.’
Jamie Grant, head judge, Waverley Council Nib Literary Awards
medicSA
‘Kate Cole-Adams’s Anaesthesia propelled me towards new ways of thinking about thinking itself: experience and consciousness and how we make in and make up this world.’
Ashley Hay, Australian, Books of the Year 2017
‘A work of splendid richness and depth, driven by a curiosity so intense that it hazards at times the extreme boundaries of the sayable.’
Helen Garner
‘Kate Cole-Adams has been fascinated with our funny non-being during surgery for a long time, and Anaesthesia feels like a book that’s taken over a decade to write, which it is. It also feels like you’re having a decade’s worth of conversations with a dogged, but generous and resourceful thinker, with someone (she is both a journalist and a novelist) who can crack open a complex idea, and then run with it.’
Readings
‘Comfortably numb. A close-up look at anaesthesia is equal parts social history, popular science and report on experience.’
NZ Listener
‘Anaesthesia is not just an account of medical research but a poetic exploration of the mysteries of the human mind.’
Australian
‘Cole-Adams’s prose is sinuous, at times intoxicating, and witty.’
Sydney Morning Herald
‘A troubling, anxious subject that most of us would rather avoid or deflect with dark humour. Cole-Adams has illuminated it in a memorable way. The book is a gift not of oblivion but of awareness.’
Inside Story
‘For the interested reader, it’s an outline of the science, with an emphasis on the unknown. For the practitioner, it’s a patient experience, eloquently expressed. There’s much more the anaesthesia than meets the eye, and this book provides a glimpse into the depths.’
Conversation
‘Anaesthesia is mesmerising…This rich and thorough study looks more deeply into questions about the nature of consciousness than many of us who undergo an anaesthetic are likely, or willing, to ponder.’
Australian Book Review
‘A fascinating mix of historical background, moving—sometimes shocking—surgical stories, interviews with experts and case studies. Surprisingly, it seems relatively little is really known about exactly how effective and affective anaesthetic is. Despite that, I found this book an oddly reassuring study.’
North and South
‘A fascinating mix of historical background, moving—sometimes shocking—surgical stories, interviews with experts and case studies. Surprisingly, it seems relatively little is really known about exactly how effective and affective anaesthetic is. Despite that, I found this book an oddly reassuring study.’
North and South NZ
‘Kate Cole-Adams has written a book that defies familiar categories. It is a personal memoir, a history, a scientific study, and a philosophical enquiry into the unconscious, and by drawing all these strands together the author has delivered a masterpiece.’
Jamie Grant, head judge, Waverley Council Nib Literary Awards
August 25, 2017
An often fascinating look at consciousness and memory via a detailed look at the mysteries of anaesthesia. The scientific parts of the book are wonderful, but it got a bit bogged down when Cole-Adams explored her personal fascination with the topic - basically I think as soon as you're writing about your dreams you're walking a tightrope, and there were sections of this that didn't work for me.
January 22, 2020
After a childhood accident, I was in a coma for more than six weeks as a young child. I subsequently had quite a few operations under anaesthesia, and one awful experience of half-waking up while still on the operating table. My memories of the experience – the lights, the hooded faces, the flashing knives, the agony, the strange sensation of being out of my own body – have made me curious for many years about altered states of being.
So I bought this book on a whim at the Sydney Writers Festival last year. I dipped in and out of it over the following months, as I often do with non-fiction. Then I had the most strange and profound experience while undergoing a routine procedure in day-surgery (ok, ok, if you must know I was having a colonoscopy!)
I had been working on a new poem about labyrinths for a few days and had decided to write it as a Fibonacci sequence (i.e. syllables of 1,1,2,3,5,8). A I lay in my hospital gown on the trolley, waiting in the chill, bare hall, I thought about my poem. Reciting poetry to myself has always been one way I deal with the rising whine of anxiety I feel once I smell that awful hospital smell and hear those awful hospital sounds.
When I drifted into wakefulness some time later, I had the poem in the palm of my hand, a perfect marvellous spiral. I wrote it down when I got home, and needed to change barely a word.
This experience was so eerie I spent my convalescence reading Kate Cole-Adams’s book, Anaesthesia: The Gift of Oblivion & The Mystery of Consciousness. On the one hand it’s an examination of the history of anaesthetics, and some of the mysteries and problems associated with it. To my relief, it was written in such clear, limpid and often lyrical language that I had no problem understanding it. The other aspect of the book was personal histories of those who have suffered and survived and been saved because of anaesthetics, including that of Kate Cole-Adams herself. These stories lifted the book out of the ordinary, along with her utterly beautiful prose:
‘Anaesthesia … Most of us can barely pronounce it. Yet it has allowed the body’s defences to be breached in ways previously unimaginable except during warfare or other catastrophe. Through the use of powerful poisons, it has enabled entry into the secret cavities of the chest and the belly and the brain. It has freed surgeons to saw like carpenters through the bony fortress of the ribs. It has made it possible for a doctor to hold in her hand a steadily beating heart. It is a powerful gift. But what exactly is it?’
An astonishingly intense and personal book about a science we now all take for granted.
So I bought this book on a whim at the Sydney Writers Festival last year. I dipped in and out of it over the following months, as I often do with non-fiction. Then I had the most strange and profound experience while undergoing a routine procedure in day-surgery (ok, ok, if you must know I was having a colonoscopy!)
I had been working on a new poem about labyrinths for a few days and had decided to write it as a Fibonacci sequence (i.e. syllables of 1,1,2,3,5,8). A I lay in my hospital gown on the trolley, waiting in the chill, bare hall, I thought about my poem. Reciting poetry to myself has always been one way I deal with the rising whine of anxiety I feel once I smell that awful hospital smell and hear those awful hospital sounds.
When I drifted into wakefulness some time later, I had the poem in the palm of my hand, a perfect marvellous spiral. I wrote it down when I got home, and needed to change barely a word.
This experience was so eerie I spent my convalescence reading Kate Cole-Adams’s book, Anaesthesia: The Gift of Oblivion & The Mystery of Consciousness. On the one hand it’s an examination of the history of anaesthetics, and some of the mysteries and problems associated with it. To my relief, it was written in such clear, limpid and often lyrical language that I had no problem understanding it. The other aspect of the book was personal histories of those who have suffered and survived and been saved because of anaesthetics, including that of Kate Cole-Adams herself. These stories lifted the book out of the ordinary, along with her utterly beautiful prose:
‘Anaesthesia … Most of us can barely pronounce it. Yet it has allowed the body’s defences to be breached in ways previously unimaginable except during warfare or other catastrophe. Through the use of powerful poisons, it has enabled entry into the secret cavities of the chest and the belly and the brain. It has freed surgeons to saw like carpenters through the bony fortress of the ribs. It has made it possible for a doctor to hold in her hand a steadily beating heart. It is a powerful gift. But what exactly is it?’
An astonishingly intense and personal book about a science we now all take for granted.
June 4, 2021
I didn't finish this...
I got to page 70, and it just wasn't what I expected. It was:
Some people achieve the paralytic portion of anesthesia without loss of consciousness!
They feel pain!
I have a fear of this!
Lots of anesthesiologists are in denial this happens!
Just couldn't jump into that phobia with her for another 400 pages.
I got to page 70, and it just wasn't what I expected. It was:
Some people achieve the paralytic portion of anesthesia without loss of consciousness!
They feel pain!
I have a fear of this!
Lots of anesthesiologists are in denial this happens!
Just couldn't jump into that phobia with her for another 400 pages.
September 4, 2017
You know how it's really dull to listen to people talk about their dreams? About half of this book is literal recounts of dreams (both the author's and other people's) and those parts are not particularly interesting nor do they seem relevant to the advertised central premise of anaesthesia. That's probably because parallel to the topic of anaesthesia, the author is really writing a book about her own hang ups. At one point, a psychiatrist who the author interviews makes a very pertinent point: "'And I'm not certain,' he added, 'whether you're trying to sort yourself out, or whether you're trying to sort out other things.'" This exact thought had definitely occurred to me in the previous chapters. I hope after the years of writing this book, it had a therapeutic effect for the author and she can find some peace.
However, the parts of the book on anaesthetics are very interesting. There's a lot that the average person (or even anaesthetist) doesn't know about anaesthesia, and this book gives a broad, occasionally scattered introduction to the topic, with an obsessive focus on anaesthetic awareness, or patients accidentally becoming awake or aware during surgery. It also delves in the world of consciousness/unconsciousness, hypnosis and dreams (where the book becomes much more vague and even airy fairy). Unfortunately at times, research is disregarded in favour of the author's own 'feeling' on an issue (the purpose of dreams, for example).
I can't help feeling that this book would have have more clarity if it had a reduced focus on the author's anxiety-ridden journey through her subconscious, but it did seem like it was written as a personal journey more than anything, despite the 'sciencey' motives expressed in the introduction.
However, the parts of the book on anaesthetics are very interesting. There's a lot that the average person (or even anaesthetist) doesn't know about anaesthesia, and this book gives a broad, occasionally scattered introduction to the topic, with an obsessive focus on anaesthetic awareness, or patients accidentally becoming awake or aware during surgery. It also delves in the world of consciousness/unconsciousness, hypnosis and dreams (where the book becomes much more vague and even airy fairy). Unfortunately at times, research is disregarded in favour of the author's own 'feeling' on an issue (the purpose of dreams, for example).
I can't help feeling that this book would have have more clarity if it had a reduced focus on the author's anxiety-ridden journey through her subconscious, but it did seem like it was written as a personal journey more than anything, despite the 'sciencey' motives expressed in the introduction.
November 10, 2017
I received this book from Goodreads.
Did not finish.
In my defense, I somehow made it halfway through the book before quitting.
Anesthesia is a astoundingly boring book of debatable non-fiction written by a oblivious, hyper phobic woman who spent a decade writing about her biggest all consuming fear.
If you, like me, are curious about this book because you'd like to read an engaging novel about anesthesiologists, anesthesia's history, anesthetic drugs and their different uses, proven cases of accidental awareness, and ultimately how the common use of anesthesia in medicine has improved healthcare for the better... then you better go find another book.
I spent months slogging through most of this book and I hated every minute of it. I should of known not to read a book about anesthesia that wasn't written by an anesthetist- or someone even in the medical field.
The only thing I took away from this book is that the author Kate Cole-Adams has a seriously alarming phobia of anesthesia and surgery. Having a fear of a surgical operation is common and perfectly healthy, but the lady that wrote this book takes it waaay out of proportion.
She is undeniably scared to death. It consumes her thoughts and her life.
I'd never judge anyone harshly for a fear they can't control, but when you write a book that's only goal is to scare everyone and make them fear anesthesia and surgery as much as you do, then I have a problem with it.
The way the author wrote this book is so obviously meant to terrify- not to inform and educate. That is NOT okay.
Did not finish.
In my defense, I somehow made it halfway through the book before quitting.
Anesthesia is a astoundingly boring book of debatable non-fiction written by a oblivious, hyper phobic woman who spent a decade writing about her biggest all consuming fear.
If you, like me, are curious about this book because you'd like to read an engaging novel about anesthesiologists, anesthesia's history, anesthetic drugs and their different uses, proven cases of accidental awareness, and ultimately how the common use of anesthesia in medicine has improved healthcare for the better... then you better go find another book.
I spent months slogging through most of this book and I hated every minute of it. I should of known not to read a book about anesthesia that wasn't written by an anesthetist- or someone even in the medical field.
The only thing I took away from this book is that the author Kate Cole-Adams has a seriously alarming phobia of anesthesia and surgery. Having a fear of a surgical operation is common and perfectly healthy, but the lady that wrote this book takes it waaay out of proportion.
She is undeniably scared to death. It consumes her thoughts and her life.
I'd never judge anyone harshly for a fear they can't control, but when you write a book that's only goal is to scare everyone and make them fear anesthesia and surgery as much as you do, then I have a problem with it.
The way the author wrote this book is so obviously meant to terrify- not to inform and educate. That is NOT okay.
November 4, 2017
Described as a mix of philosophy, science and questioning, this book delves into the mystery that is modern anaesthetic. Convention has it that you go in for surgery, an injection puts you to sleep, gas keeps you that way, you feel no pain, and then you wake up.
Trouble is, no one knows exactly how these drugs work. You're not "asleep" that much is known. It's a disconnect between pain and your brain, awareness and unconsciousness, or else it's just that you're there all the way but you don't remember. Cole-Adams seeks out the stories of those who were awake, or who remembered afterwards what went on and tries to make sense of it in medical, scientific and philosophical ways.
Twenty years ago, I worked as an anaesthetic nurse. I saw hundreds of patients slide off to oblivion and wake promptly at the end. I also heard first hand from patients who recounted what they heard in theatre--conversations between the theatre staff (secret: it's definitely not all solemnity and concentration. Theatre staff are just as likely to be talking about golf, singing opera, flirting, or debating last night's TV. But back then, we took for granted that the patient whose guts we were manhandling would not be in anyway traumatized by the experience,
Apparently not so.
I enjoyed this book, but I suspect that the main reason I was so caught up in it was my experience of years in theatre. The book was probably 20% longer than it need be and fairly repetitive.
Still a good read.
Trouble is, no one knows exactly how these drugs work. You're not "asleep" that much is known. It's a disconnect between pain and your brain, awareness and unconsciousness, or else it's just that you're there all the way but you don't remember. Cole-Adams seeks out the stories of those who were awake, or who remembered afterwards what went on and tries to make sense of it in medical, scientific and philosophical ways.
Twenty years ago, I worked as an anaesthetic nurse. I saw hundreds of patients slide off to oblivion and wake promptly at the end. I also heard first hand from patients who recounted what they heard in theatre--conversations between the theatre staff (secret: it's definitely not all solemnity and concentration. Theatre staff are just as likely to be talking about golf, singing opera, flirting, or debating last night's TV. But back then, we took for granted that the patient whose guts we were manhandling would not be in anyway traumatized by the experience,
Apparently not so.
I enjoyed this book, but I suspect that the main reason I was so caught up in it was my experience of years in theatre. The book was probably 20% longer than it need be and fairly repetitive.
Still a good read.
August 17, 2017
‘The gift of oblivion and the mystery of consciousness.’
What is anaesthesia and what impact does anaesthesia have on us? I’ve experienced fifteen or so general anaesthetics over the past fifty years, and I also worked (as a student nurse some forty years ago) in both the operating theatre and intensive care environments. A lot has changed over that period, but the intention of anaesthesia is surely broadly the same: to alter consciousness and reduce pain. Well-trained (and empathetic) anaesthetists are critically important to success. Why empathy? Because patient confidence is also important, and an empathetic anaesthetist is far more likely to inspire confidence.
As Ms Cole-Adams writes:
‘This book explores perhaps the most brilliant and baffling gift of modern medicine: the disappearing act that enables doctors and dentists to carry out surgery and other procedures that would otherwise be impossibly, often fatally, painful.’
This book is about both anaesthesia in general and about Ms Cole Adams’ own journey towards major surgery for scoliosis. It includes accounts from those who were conscious under anaesthesia (where this was not intended) as well as referring to studies investigating situations where people have become aware under anaesthesia, but don’t have conscious memory of this occurring. I’m interested in how those studies were conducted. Some of the accounts had me shaking my head, and remembering advice I was first given in 1974: never assume that an unconscious person can’t hear what is being said.
‘It is odd where the mind goes, when it is off the leash.’
Two of the main objectives of anaesthesia are to ensure that the person is unaware of what is happening to them and that they will have no memory of it. Ms Cole-Adams focusses on these objectives and on the complexity of consciousness. Do we need to form a memory of an experience for it to be harmful? And what about those (thankfully rare) cases where people become aware during surgery, and remember the experience? How should such cases be identified and managed? If consciousness is a continuum, then managing it through anaesthesia is surely both an art and a science.
There’s a lot of detail in this book, but it is presented in a way which makes it accessible to an interested non-medically trained reader. It is clear, from the references and sources noted at the end of the book, that Ms Cole-Adams has done a lot of research. The book is both an explanation of anaesthesia and an account of patient experience.
If you’ve ever had an anaesthetic and wondered about the experience, you may find this book interesting. I certainly did.
Jennifer Cameron-Smith
What is anaesthesia and what impact does anaesthesia have on us? I’ve experienced fifteen or so general anaesthetics over the past fifty years, and I also worked (as a student nurse some forty years ago) in both the operating theatre and intensive care environments. A lot has changed over that period, but the intention of anaesthesia is surely broadly the same: to alter consciousness and reduce pain. Well-trained (and empathetic) anaesthetists are critically important to success. Why empathy? Because patient confidence is also important, and an empathetic anaesthetist is far more likely to inspire confidence.
As Ms Cole-Adams writes:
‘This book explores perhaps the most brilliant and baffling gift of modern medicine: the disappearing act that enables doctors and dentists to carry out surgery and other procedures that would otherwise be impossibly, often fatally, painful.’
This book is about both anaesthesia in general and about Ms Cole Adams’ own journey towards major surgery for scoliosis. It includes accounts from those who were conscious under anaesthesia (where this was not intended) as well as referring to studies investigating situations where people have become aware under anaesthesia, but don’t have conscious memory of this occurring. I’m interested in how those studies were conducted. Some of the accounts had me shaking my head, and remembering advice I was first given in 1974: never assume that an unconscious person can’t hear what is being said.
‘It is odd where the mind goes, when it is off the leash.’
Two of the main objectives of anaesthesia are to ensure that the person is unaware of what is happening to them and that they will have no memory of it. Ms Cole-Adams focusses on these objectives and on the complexity of consciousness. Do we need to form a memory of an experience for it to be harmful? And what about those (thankfully rare) cases where people become aware during surgery, and remember the experience? How should such cases be identified and managed? If consciousness is a continuum, then managing it through anaesthesia is surely both an art and a science.
There’s a lot of detail in this book, but it is presented in a way which makes it accessible to an interested non-medically trained reader. It is clear, from the references and sources noted at the end of the book, that Ms Cole-Adams has done a lot of research. The book is both an explanation of anaesthesia and an account of patient experience.
If you’ve ever had an anaesthetic and wondered about the experience, you may find this book interesting. I certainly did.
Jennifer Cameron-Smith
July 6, 2017
Disclaimer: I know the author and I appear in this book.
I've had several anaesthetics for medical procedures in my life. Most went well- one (which you can read about in the book) did not. But I'd never thought about what happens to "me", where "I" go while under the influence of the cocktail of drugs that is anaesthesia.
This is a fascinating book that covers a range of topics around consciousness, unconsciousness and what it means to trust in medical professionals by handing over our bodies to them to treat with surgical implements. Cole-Adams has woven an intricate tale that explores her own experiences alongside those of many others, as well as investigating the world of those who administer and research anaesthetics. Her skill as a journalist is evident both in the access she had to medical professionals and the willingness she had to get into the nitty gritty of the topic, including witnessing operations.
The book does not so much answer questions as open them up. There is a lot to think about, and I often found myself putting the book down for a few minutes to reflect on what I'd just read. Questions about what makes us who we are, how anaesthesia may change us, what memories form us, and whether or not memories can be formed under anaesthesia are all laid bare and picked apart.
Well-researchedand though-provoking with a good balance between personal stories and professional insights, Anaesthesia is a book that goes deep into this mysterious and somewhat elusive subject. Highly recommended.
I've had several anaesthetics for medical procedures in my life. Most went well- one (which you can read about in the book) did not. But I'd never thought about what happens to "me", where "I" go while under the influence of the cocktail of drugs that is anaesthesia.
This is a fascinating book that covers a range of topics around consciousness, unconsciousness and what it means to trust in medical professionals by handing over our bodies to them to treat with surgical implements. Cole-Adams has woven an intricate tale that explores her own experiences alongside those of many others, as well as investigating the world of those who administer and research anaesthetics. Her skill as a journalist is evident both in the access she had to medical professionals and the willingness she had to get into the nitty gritty of the topic, including witnessing operations.
The book does not so much answer questions as open them up. There is a lot to think about, and I often found myself putting the book down for a few minutes to reflect on what I'd just read. Questions about what makes us who we are, how anaesthesia may change us, what memories form us, and whether or not memories can be formed under anaesthesia are all laid bare and picked apart.
Well-researchedand though-provoking with a good balance between personal stories and professional insights, Anaesthesia is a book that goes deep into this mysterious and somewhat elusive subject. Highly recommended.
September 24, 2024
I tried hard to like this book, but it was no page turner. There are many interesting historical bits that I enjoyed but the personal search left me cold. The premise of memories while under was interesting but laboured to extreme. Mind you, I was reading this in the company of a retired consultant anaesthetist, with whom I discussed aspects. My experiences with anaesthetic have been blissful. Thankfully. They have some pretty good stuff these days. If the book focused more on the history with a chapter on suppressed memories, and a third to half the length, it would have been better.
July 7, 2017
Anaesthesia and its attendant mysteries are definitely fascinating, and the questions posed in the blurb seemed as promising as they were ultimately unanswerable – so I was expecting to really enjoy this book. Unfortunately, and without wanting to diminish the decade-plus of hard work and undeniable passion that have clearly gone into this project, I found that the book suffered from trying to be two things at once. Goodreads lists it as a science/nonfiction/psychology title, but a more accurate categorisation would be something like ‘half science, half wannabe-memoir’.
I enjoyed and was even gripped by the parts that discussed anaesthesia on scientific grounds; I was interested to hear about anaesthesia and consciousness studies from years past; I was even on board for reconstructed conversations between the author and various anaesthetists and psychologists… But all too often this book crossed the line between science and personal reflection.
The intermittent musings about the author’s personal circumstances and even dreams seemed out of place in an otherwise pretty interesting treatise on anaesthesia and consciousness. Isn’t the first rule of writing that nobody wants to hear about someone else’s dreams? I was similarly disgruntled by the author’s assertion that an anaesthetist she spoke to, who she dubbed ‘Mr Anaesthesia’, all but literally sedated her with his words – in my opinion, fluffiness like this is inexcusable in a book that positions itself as scientific.
If Kate Cole-Adams wants to write a memoir, I say by all means write a memoir, and include her fascination with anaesthesia within it. But if I’m going to read a memoir, a) I want to know that that’s what I’m in for when I pick up the book, and b) I want the author-narrator to be a fleshed-out character that I care about, not an extra with only snippets of tangential information to support her existence in the narrative. The latter parts of the book seem to build up to the author’s back surgery under anaesthesia, but this doesn’t seem a logical or satisfying culmination of the story, since it didn’t seem like the book was about her back surgery to begin with, especially since she admits to previously having had several general anaesthetics with little drama.
I enjoyed large parts of this book, but tacking disconnected and lyrical musings about barely-connected autobiographical events onto an otherwise interesting exploration of anaesthesia does not do justice to either project. I’d still recommend this book for the parts that are grounded in science, but you’ve got to be willing to read past the rest.
I enjoyed and was even gripped by the parts that discussed anaesthesia on scientific grounds; I was interested to hear about anaesthesia and consciousness studies from years past; I was even on board for reconstructed conversations between the author and various anaesthetists and psychologists… But all too often this book crossed the line between science and personal reflection.
The intermittent musings about the author’s personal circumstances and even dreams seemed out of place in an otherwise pretty interesting treatise on anaesthesia and consciousness. Isn’t the first rule of writing that nobody wants to hear about someone else’s dreams? I was similarly disgruntled by the author’s assertion that an anaesthetist she spoke to, who she dubbed ‘Mr Anaesthesia’, all but literally sedated her with his words – in my opinion, fluffiness like this is inexcusable in a book that positions itself as scientific.
If Kate Cole-Adams wants to write a memoir, I say by all means write a memoir, and include her fascination with anaesthesia within it. But if I’m going to read a memoir, a) I want to know that that’s what I’m in for when I pick up the book, and b) I want the author-narrator to be a fleshed-out character that I care about, not an extra with only snippets of tangential information to support her existence in the narrative. The latter parts of the book seem to build up to the author’s back surgery under anaesthesia, but this doesn’t seem a logical or satisfying culmination of the story, since it didn’t seem like the book was about her back surgery to begin with, especially since she admits to previously having had several general anaesthetics with little drama.
I enjoyed large parts of this book, but tacking disconnected and lyrical musings about barely-connected autobiographical events onto an otherwise interesting exploration of anaesthesia does not do justice to either project. I’d still recommend this book for the parts that are grounded in science, but you’ve got to be willing to read past the rest.
May 28, 2019
I’ve never thought about whether, apart from death, it’s possible to switch off who we are. I’ve always assumed that this is what anaesthetists do. I read this like a wide-eyed child and sped through it in a few days. It freaked me out quite a bit and I pretty much bombarded everyone around me with weird and frightening stories about anaesthesia (or should that be amnesia?) Only I kept saying Anastasia like it was about the Romanovs – and then I would just say look, it’s about going under (or should that be not going under?) In trying to understand anaesthesia, you have to try to understand consciousness/the self so the personal aspects and dreams made perfect sense, especially when Mashour (in talking about sensory organs and older brain structures) says, ‘you have the information that you need for the experience but you don’t have the tools to assemble that information’. Cole-Adams is clearly a writer-writer so this is not pop science. Top-notch non-fiction with enough aliens and hypnotists to keep you intrigued
September 16, 2017
I loved this exploration of consciousness and anaesthesia. I'm an anaesthtics nurse so there was a lot about the patient experiences reported in the book that was familiar and sometimes troubling. Kate Cole-Adams writes so well and it really is one long extended patient journey or memoir which I enjoyed a lot. I also studied philosophy in my BA before nursing and I felt like this book tied together so many different bits of my own experience, it's so much more than an exploration of anaesthesia.
September 27, 2017
Liked it til about page 200 but then got tired of hearing so much about her. I felt that she brought too much of her own personality into the book. And I found myself having to look up things I thought she could use better words for, not technical terms, but things like "Simpson's sky" or "spell bag". But still quite fascinating in parts....
April 4, 2018
This is a wonderful combination of memoir and social history of medicine, and also a truly horrifying slap in the face of how little we actually know about anaesthesia. I guess surgery is good and important but I really wish we understood more about this specific part of it.
November 29, 2017
I understand the world differently from reading this book. It is not often a book can do that.
January 3, 2019
It took me a few attempts to finish this book. While I found the sections on the history and science of anaesthesia interesting, I felt there was too much focus on the author's own experiences, particularly her recurrent references to her fear of waking while under anaesthesia, which became repetitive. I also have to admit to skimming the second half of the book where the author talked about dreams (her own and others). Possibly therapeutic for the author, but all just a little too self-absorbed for me. A good editing to remove much of this as well as the repetition would render this book much more readable.
January 21, 2018
I liked that Kate Cole-Adams mentioned people's personal experiences and also spoke at length to practitioners and researchers. She discusses important advances in anaesthesiology and different anaesthesiologist’s practices and preferences/views. In addition, she talks about the very interesting, but also disturbing, topic of patients waking during anaesthesia, some of these patients’ experiences and the repercussions. Kate Cole-Adams also discusses other altered states of consciousness, such as hypnosis, regression, and questions that scientific research has so far been unable to answer, which was also very interesting to read. It made me think back to the operations I had to undergo and general anaesthesia I received (five in total!) when I was little, to alleviate problems with my inner ears. While not as ‘scientific’ as I would have liked, I did enjoy the book. Thanks to NetGalley for providing me with this ARC in exchange for an honest review.
January 13, 2018
This book is intense. The author got interested enough in the subject to write a book after talking with a young woman who was, due to undetected anesthesia failure, awake, paralyzed, and able to fully feel the pain of her Caesarian. Quite the horror story, with lasting psychological damage. So one main question in the book is, how often does this happen? Another is, how often is a person under anesthesia awake, with or without pain, but doesn't remember it afterwards due to amnesiac drugs that are part of the anesthesia cocktail?
These are interesting questions, and the author interviews a number of anesthesiologists, other medical professionals, and lay people about them, with an wide range of responses. Opinions, personal experiences, theories, experimental data, interpretations of the data, re-done experiments that invalidate previous ones, questions of ethics, etc. All this, and a smattering of neuroscience, made the book well worth reading for me.
But, for my taste, the book has major flaws. It goes back and forth in time and subjects, sometimes leaving a scene and picking it up, or adding an observation to it, later. This made it seem scattered and disorganized. It is most obvious in the story of the author's own surgery, with her fears of anesthesia on center stage, which she spreads out mostly over the later half of the book, with almost cliffhanger-like abrupt changes to another subject. I was exasperated; just finish your story! I also didn't like the constant self-examining. It was fine with me that she injected her own life, experiences, and family into the book. But I could have done with fewer of those details and less of her agonizing about the writing process and her own fears. She even mentions that her son told her "You think way too much." I read the book because I saw it reviewed in the NY Times and the New Yorker. They love these literary conceits, so I guess I could have expected it. Personally, I would have liked the book to be more about the science and experiences of anesthesia and less about her adventures in her own mind. And I think it could probably have been half the size and organized more by topic.
Basic and intriguing questions about consciousness and identity came up. She also touched on post-anesthesia delirium and dementia, which I'd like to read more about (they basically ended my father's life).
I had general anesthesia (for wrist surgery) just a few weeks ago. For me, as for most people, it was fine. I don't remember the 10 or 15 minutes just before the anesthesia; after that, the first thing I remember is waking up. I don't know if I carried on conversations during those lost minutes, but it's likely. I don't know (but doubt) if I was awake at all during the actual surgery. It's an interesting question, and one at the heart of the book, about what kind of consciousness do you have when you are awake but not able to form memories. And, if you are awake and in pain but not forming memories, is it really pain and does it affect your psyche? And if you're not awake, how do your body and mind experience the pain? I know that I didn't feel any pain, because I had a nerve block that cut off all feeling to my arm. But I still wonder, as does the author, where "I" was during that time.
My ex, on the other hand, had an experience where he was still awake when the paralytic took effect and stopped him from breathing. As he lost consciousness, he was in a panicked state, sure that he was dying, and and woke up in the same panic. How many people going into surgery know that anesthesia includes being paralyzed and on basically a respirator? Not so many. He didn't.
So all in all, the book is a pretty good look at a fascinating subject.
These are interesting questions, and the author interviews a number of anesthesiologists, other medical professionals, and lay people about them, with an wide range of responses. Opinions, personal experiences, theories, experimental data, interpretations of the data, re-done experiments that invalidate previous ones, questions of ethics, etc. All this, and a smattering of neuroscience, made the book well worth reading for me.
But, for my taste, the book has major flaws. It goes back and forth in time and subjects, sometimes leaving a scene and picking it up, or adding an observation to it, later. This made it seem scattered and disorganized. It is most obvious in the story of the author's own surgery, with her fears of anesthesia on center stage, which she spreads out mostly over the later half of the book, with almost cliffhanger-like abrupt changes to another subject. I was exasperated; just finish your story! I also didn't like the constant self-examining. It was fine with me that she injected her own life, experiences, and family into the book. But I could have done with fewer of those details and less of her agonizing about the writing process and her own fears. She even mentions that her son told her "You think way too much." I read the book because I saw it reviewed in the NY Times and the New Yorker. They love these literary conceits, so I guess I could have expected it. Personally, I would have liked the book to be more about the science and experiences of anesthesia and less about her adventures in her own mind. And I think it could probably have been half the size and organized more by topic.
Basic and intriguing questions about consciousness and identity came up. She also touched on post-anesthesia delirium and dementia, which I'd like to read more about (they basically ended my father's life).
I had general anesthesia (for wrist surgery) just a few weeks ago. For me, as for most people, it was fine. I don't remember the 10 or 15 minutes just before the anesthesia; after that, the first thing I remember is waking up. I don't know if I carried on conversations during those lost minutes, but it's likely. I don't know (but doubt) if I was awake at all during the actual surgery. It's an interesting question, and one at the heart of the book, about what kind of consciousness do you have when you are awake but not able to form memories. And, if you are awake and in pain but not forming memories, is it really pain and does it affect your psyche? And if you're not awake, how do your body and mind experience the pain? I know that I didn't feel any pain, because I had a nerve block that cut off all feeling to my arm. But I still wonder, as does the author, where "I" was during that time.
My ex, on the other hand, had an experience where he was still awake when the paralytic took effect and stopped him from breathing. As he lost consciousness, he was in a panicked state, sure that he was dying, and and woke up in the same panic. How many people going into surgery know that anesthesia includes being paralyzed and on basically a respirator? Not so many. He didn't.
So all in all, the book is a pretty good look at a fascinating subject.
March 16, 2018
Anesthesia, hard to pronounce even harder to spell. Since it's invention over 150 years ago it has made surgery much less risky and more readily available for pretty much anything including a c-section to a facelift. However do we really understand the science behind what happens when people go under its influence, well no we don't really.
The lengths that Kate Cole-Adams has gone to research this topic is evident with every page she has written on the topic. Which has someone who is a scientist themselves it's very much appreciate that someone has gone to this length of care to research a topic to make sure what they are writing about is accurate and informative to a wide range of people no matter their scientific knowledge.
The mixture of scientific information and personal experiences from the authors themself and friends, family and colleagues make for an interesting and insightful read especially for someone who has not experienced anesthesia firsthand. Some of the stories of people 'waking up' during the anesthesia only makes it more evident the need to understand the topic and the workings of anesthesia to prevent the potential of mental injury from the patients miss hearing something during surgery.
Well worth a read
The lengths that Kate Cole-Adams has gone to research this topic is evident with every page she has written on the topic. Which has someone who is a scientist themselves it's very much appreciate that someone has gone to this length of care to research a topic to make sure what they are writing about is accurate and informative to a wide range of people no matter their scientific knowledge.
The mixture of scientific information and personal experiences from the authors themself and friends, family and colleagues make for an interesting and insightful read especially for someone who has not experienced anesthesia firsthand. Some of the stories of people 'waking up' during the anesthesia only makes it more evident the need to understand the topic and the workings of anesthesia to prevent the potential of mental injury from the patients miss hearing something during surgery.
Well worth a read
November 24, 2017
The author goes on a personal quest to piece together the history of anaesthesia and what we know of it now to make sense of the experiences she and others have had. This is more of a story, a journey, than an entirely scientific accounting, despite the numerous references to studies and interviews with professionals in a few fields. I adjusted my expectations as soon as I realized what kind of book this was going to be. I learned quite a bit.
I read this book courtesy of NetGalley.
I read this book courtesy of NetGalley.
November 11, 2017
It was really profound. The author has profound ideas that cross link medical science and psychology, with metaphysics, philosophy and spirituality. But the book was odd in the sense that I kind of got lost in the brain fog (both metaphoric and literal) that the writer described. Parts were scientific but parts were mish mashed with her own experiences (and obsession with learning about anaesthesia), psychological musings, and thus it was part scientific, part memoir. I know that the book is the author's own personal explorations of these things, but as a scientist I was left with a sense of incomprehension about what I had read. Perhaps that was the point. I definitely recommend it though.
December 11, 2018
This is not a book about anesthesia. It is a navel-gazing book by a self-absorbed author, whose only interest in anesthesia is the occasional phenomenon of awareness during anesthesia. She is terrified of it, and she thinks everyone else needs to talk about it. Over. And over. And over.
Talk about it, though—not learn anything about it, or about anesthesia in general. The book mostly revolves around anecdotes from people who claim to have had awareness. At one point a doctor suggests to the author, Kate Cole-Adams, that perhaps trolling Google bulletin boards for scientific data isn’t the best idea. That seems to have had no effect on Cole-Adams. It is self-reported anecdotes all the way down.
But we do learn tremendous amounts about the author’s personal life, personal struggles, panic attacks, and every minor psychological problem or event that has created her frustrated, middle-aged self. If you’re interested in that sort of thing, go ahead and read this book. What you won’t learn is anything insightful or interesting about anesthesia.
Talk about it, though—not learn anything about it, or about anesthesia in general. The book mostly revolves around anecdotes from people who claim to have had awareness. At one point a doctor suggests to the author, Kate Cole-Adams, that perhaps trolling Google bulletin boards for scientific data isn’t the best idea. That seems to have had no effect on Cole-Adams. It is self-reported anecdotes all the way down.
But we do learn tremendous amounts about the author’s personal life, personal struggles, panic attacks, and every minor psychological problem or event that has created her frustrated, middle-aged self. If you’re interested in that sort of thing, go ahead and read this book. What you won’t learn is anything insightful or interesting about anesthesia.
December 25, 2017
I got up to page 230 of this work, but really can't be bothered going any further.
Interesting when it was looking objectively at the science and scientific facts behind anaesthesia, but it worked way too hard to draw any evidence about hidden memories as a result of being under.
And when Cole-Adams started to recount her dreams in great detail .... well, let's just say she lost my attention.
With way too much in the way of personal thoughts, feelings and fears inserted into it, this book is not objective enough to be a lucid look at the art and science of anaesthesia, nor is it really a memoir.
Interesting when it was looking objectively at the science and scientific facts behind anaesthesia, but it worked way too hard to draw any evidence about hidden memories as a result of being under.
And when Cole-Adams started to recount her dreams in great detail .... well, let's just say she lost my attention.
With way too much in the way of personal thoughts, feelings and fears inserted into it, this book is not objective enough to be a lucid look at the art and science of anaesthesia, nor is it really a memoir.
November 26, 2017
This was a very interesting topic. The book was well written and obviously soundly researched. The book read very quickly; as the author did a great job humanizing the issues and historical figures of anesthesia. My only criticism is that, in parts of the book, the author injected too much of her personal thoughts and it became a little too "Dear Diary" for my tastes.
I was provided a free copy of this book in exchange for my honest review.
I was provided a free copy of this book in exchange for my honest review.
December 17, 2024
DNF at 49%. I find anesthesia fascinating, but this book is less about anesthesia and more about the author’s fear of possibly having some awareness while being anesthetized. I can only imagine how frightening it would be to “wake up” during surgery and being in excruciating pain and not being able to let the surgeon or anesthetist know, but most of the stories related here were about later psychological effects even when the patient didn’t recall any pain during the episode. Anyway, it was interesting but much too long (and that is a criticism I almost never make about a book!). IMO it could have used some judicious editing.
December 13, 2018
How anesthesia works is a fascinating subject, but this book doesn't cover the subject well at all, and the author's lack of medical/scientific background really comes through as a negative. While a memoir about anesthesia awareness could, maybe, have been interesting, the personal anecdotes are woven clumsily through the work and ultimately it's not really a good book about anesthesia, consciousness, the practice of medicine (especially anesthesia) and its issues, nor is it a compelling memoir.
June 7, 2018
Not what I was expecting when I picked up this book! It was much more narrative and personal, filled with interesting accounts of experiences with anaesthesia mixed with academic research. Overall, very enjoyable.
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