Cover Image: Anaesthesia

Anaesthesia

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This book was like a does of anaesthesia in itself. It was so dull and boring that I could not get further than 100 pages in before I gave up. Maybe interesting to some, but not for me.

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"Anaesthesia" is a disturbing book.
As patients in a hospital, our self regresses: it is no longer us who lead our lives and make decisions, but we become dependent in every possible way. Especially on the operating table, we are absolutely vulnerable.
This book presents the concrete possibility that, during a surgical operation, our state of consciousness fluctuates to the point of becoming aware of what is going on around us, maybe in a moment of emergency for our lives. Unable to breathe on our own, to open our eyes, to move a muscle…we will live the experience of being absolutely paralyzed, on the verge of dying.
At our awakening, we would have no conscious memories of that, but we could have psychological after-effects even for a long time after the surgery.
This book touches on several other topics – consciousness, hypnosis, brain functions, psychoanalysis, dreaming…– but at its core is the possible awareness during anaesthesia.
This is a scenario that many anesthetists and researchers, armed with modern machinery and sophisticated cocktails, deny can happen. And yet... different professionals and various researches suggest the opposite.
But "Anaesthesia" is also a reassuring book, because all the information about anaesthetic procedures can play in our favor. Knowing what to expect in case we come back to awareness during anesthesia can help us to remain calm, to keep at bay the most primitive fears, to become active participants in that experience, in that important fragment of our life.
Do you want to be frightened? Read the first chapters of this book and you will not be disappointed.
Do you want to feel better? Read the whole book. It’s worth it.

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I wish this book focused more on the actual history about anesthetics rather than being a personal search story. I liked the chapter on suppresses memories and I wish the author has talked much about that. And actually, it would have been better if the book could be a third to half the length. It was unnecessarily long and that's why felt repetitive.

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A personal, scientific and historical exploration into what anaesthia is and the impact it has on people.

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It took me quite 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.

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I love medical books and true life memoirs from the medical profession. This one sounded just like the kind of thing I like! This book is about what supposedly happens in between the ‘counting backwards from 10’ and waking up. What really happens in that time? Can we hear what is going on around us, or can we feel pain?

The author has obviously researched Anaesthetics in great detail and it was interesting reading her view on things, but for me personally, I was interested mainly in the stories, facts and figures about anaesthetics and what really happens when you go under. Unfortunately the book was split between the two, with the larger half going towards the author’s opinions.

I did find that I was skipping through some parts of it but on the whole I did enjoy it.

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I really struggled with this. It sat partially-read, then mostly-read and looked doomed to be un-finished for quite some time before I picked it up and tried again. It's fascinating subject-matter, and Cole-Adams is clearly very invested (perhaps obsessively so) in its exploration. Her emphasis on the scientific unknowns and mysteries of unconsciousness is unsettling (and rightly so), but it was the strong focus on the author's own anxieties and fears that left me feeling most uneasy. I hope that the process of writing the book has eased some of these concerns.

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This is a book of two halves - the science of anaesthesia and the personal fascination of the author. Sadly I was more interested in the science and could have done with ending the book there.

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I thought this would be a fascinating subject, but I just couldn't get into this one. I made myself finish it, but kept falling asleep. The scientific info is repetitive and not well-organized, and any interesting stuff was quickly swept under a hypnotic wave of personal meanderings and other boring and unnecessary info. Unfortunately, I cannot recommend this book.

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An overall interesting look into the anesthesia, it's history and it's uses. Definitely worth reading.

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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

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Anaesthesia:
The Gift Of Oblivion And The Mystery Of Consciousness
By Kate Cole-Adams
Text Publishing, February 2018 (in UK)

If you have any worries about needing an anaesthetic in the near future, this is definitely NOT a book you want to read. Modern anaesthesia is generally very safe and very effective, but what frightened me most was the fact that nobody, not even the anesthetists who use these medications every working day, is entirely certain how they actually work...... and why, sometimes, they don't.

What exact part of our brain do they affect? Do they affect the entire brain and make it utterly impossible for your brain and body to retain any sort of awareness of trauma inflicted in surgery?
Does anaesthetic awareness happen more often than we think?
Does the lack of hard knowledge unduly worry some anaesthetists? Surprisingly not.
What constitutes consciousness anyway, and what makes us remember things? (And that really is a can of worms!)

Kate Cole-Adams is an Australian journalist with a long-term interest in anesthesia and its problems, who needed to undergo major surgery herself, and this book is the result of her researches and her own experiences. It is an interesting book, with lots of fascinating medical research introduced and referenced, but the large amount of speculation as to the nature of consciousness could perhaps have been more tightly edited as parts of the book did tend to ramble somewhat, making it a lengthy read indeed.

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I started reading this book expecting it to be about the science of how anaesthesia works and instead found it was more a psychology title. Gave up about a third of the way through as I couldn't get on with the writers style. Thank you to Netgalley for giving me a copy of the book in return for an honest review

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A bit meandering at times, but absolutely fascinating. I've always been terrified of general anesthesia (I've only ever had a brief IV sedation once), and just the thought of ever needing surgery makes me panic. This book didn't exactly help my fears, but now I feel so much more informed. It helped take some of the mystery out of it. Recommended!

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Fascinating and at turns horrifying, this book had me hooked from beginning to end. It was clearly an enormous undertaking, weaving together numerous interviews with anesthesiologists, psychologists, researchers, patients, and more, along with Kate Cole-Adams' personal narrative about her interest in and experiences with anesthesia. I imagine some in the medical community would find Cole-Adams' take a little too emotional or spiritual, but I found it to be an enthralling take on consciousness and the things we don’t understand about the brain. As Cole-Adams said in the introduction, I feel I may now know too much to undergo general anesthesia without immense fear of all the ways it could go wrong.

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This was a difficult book to read. I would get annoyed by the endless digressions, but still could not bring myself to put it down. Mind you, it's been (at least) shortlisted for a bunch of awards, so what do I know.

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A book covering a fascinating topic, anesthesia, wakefulness, and consciousness. Built partly on personal anecdotes and those of others, the book also provides details about aspects of anesthesia. Sadly, my review copy had file defects and I am unable at this time to provide a fuller review.

<i>I received a Digital Review Copy from NetGalley in exchange for an honest review.</i>

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Kate Cole-Adams takes you on a journey - one that is not just an exploration of the anaesthetised state but also of consciousness itself via an exploration of other altered states. The journey is a disturbing one at times, particularly when she evokes the experiences of patients who have been awake but paralysed whilst under anaesthetic.
A gripping and, at times, frightening book - it cleverly combines her personal journey and the experiences of patients she interviews with an exploration of the recent research and advances in anaesthesiology. It wasn't always an easy read but I still highly recommend it.

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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 Cole-Adams’s own overwhelming fears around much needed surgery--deferred over and over for years (until middle age)--to address worsening spinal scoliosis apparently fueled the author’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 his 20-year-old patient unconscious in order to facilitate removal of a painful lump in the jaw. News of ether’s miraculous powers quickly spread. In no time at all, it was being administered to patients in London and Paris. Nowadays, other less odorous, less flammable gas anesthetics (related to ether) are used, and the twentieth century ushered in 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 ensured that surgical patients would stay still during procedures. In short, they 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.

Along with gas and curare, a third element plays a critical role in the modern practice of anesthesia: analgesia—chemical pain control. However, 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 providing small, incremental doses of pain medication only 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. The number may actually 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 be placed under 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 lingering 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. This is a case in which less would have been more.

While I learned a lot from Cole-Adams’s book, I can’t deny that it was hard going at times. The main problem is that the author is overly concerned with exploring and explaining her own experiences and 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 a fairly commonplace story about her two-year-old self 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 seemingly 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? Cole-Adams goes on and on . . . and on. By the three-quarter mark, I was regularly wondering 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 tells her at one point—but that’s not the problem exactly. What seems closer to the truth is that Cole-Adams really doesn’t think enough about what her listener or reader might be interested in. Instead, she just talks (or writes) too much about issues that can matter to no one but herself. Ms. Cole-Adams’s editors would have greatly assisted future readers by insisting that the author 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 revision, including better organization (rather than a collage approach), would have made this a much better book.

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Absolutely fascinating! I learned so much reading this book.

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