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Reviewed in Australia on 17 August 2017
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
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