What anesthesia gone wrong is teaching us about consciousness


#1

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#2

If you’re going to link to the NYT, please use the ?pagewanted=all link; otherwise, lots of us will hit a paywall when we try to click through to the second page.


#3

I’m glad you’re not in the consciousness-is-an-illusion camp.


#4

Congrats on the Times piece Maggie!


#5

Nothing vindicates writing books that long and tedious.


#6

I’m sure it says something about my upbringing, but I can’t hear or read the name Kant without Monty Python’s Philosophers Song immediately popping into my head:

"Immanuel Kant was a real pissant
Who was very rarely stable.
Heidegger, Heidegger was a boozy beggar
Who could think you under the table.
David Hume could out-consume
Schopenhauer and Hegel,
And Wittgenstein was a beery swine
Who was just as schloshed as Schlegel.

There’s nothing Nietzsche couldn’t teach ya’
'Bout the raising of the wrist.
Socrates himself was permanently pissed…

John Stuart Mill, of his own free will,
On half a pint of shandy was particularly ill.
Plato, they say, could stick it away;
Half a crate of whiskey every day.
Aristotle, Aristotle was a bugger for the bottle,
Hobbes was fond of his dram,
And Rene Descartes was a drunken fart: “I drink, therefore I am”

Yes, Socrates, himself, is particularly missed;
A lovely little thinker but a bugger when he’s pissed!"


#7

I was hoping this article would go deeper into the fact that anesthesia is actually a combination of paralytics and what people traditionally think of as anesthesia. The drugs that “knock you out” or even just make you forget the pain are not what makes you feel paralyzed. They actually give you paralytics to do just that. Succinylcholine will render you completely paralyzed, unable to even breath, while still conscious. Interesting field though. Midazolam is weird. I once watched an ER doc set a teenager’s broken ankle using Midazolam. The kids felt the pain, that’s for sure! But was pretty much awake through it all. Five minutes later he had no memory of the event. The same doctor claimed that they used to Midazolam for childbirth, but they found it caused women to have a horrible type of post-pardum depression. The theory, he said, was that their bodies already did something to make them forget the true pain of childbirth (who would have a 2nd otherwise?!?) but not the birth itself. Whereas the drug made them forget everything. It also brings up the idea of memory-as-personality-or-personal-reality. So if your brain records no memory of the event, it never really “happened” to you in some way. I’m not talking about buried memory, but the shutting off of that recording mechanism of the brain. If you had no memory past the last minute, could you “be” who you are?


#8

Lovely article Maggie, well-informed and well written.

I’m an anaesthetist in the UK (Hence the correct spelling!). One of the issues that you didn’t really touch upon is that of paralysis- for many operations to work, the patient needs to be given a muscle relaxants which makes all voluntary movement impossible. This is necessary sometimes, but it makes the anaesthetist’s “awareness of awareness” all the more difficult - it can be impossible to know that the patient has become aware.

The future’s bright, but for the time being, the instruments we use are pretty blunt!


#9

Psychologist William James did a little personal consciousness exploration by putting himself under anaesthesia and came out of it with the proclamation: “everything is the smell of burnt almonds.”

Alan Watts - The smell of burnt almonds

Would also like to add that psychedelics could be a great tool in the study of consciousness. British psychiatrist David Nutt put their ban and lack of pursuit in these terms, “imagine if you were an astronomer in a world where the telescope was banned.”


#10

Another anaesthetist here (NZ this time). It’s good to see our specialty written about in an informed way.

The only thing I’d like to point out is that the 1 in 1000 incidence of awareness quoted in the article is that of recollection of auditory stimuli only —i.e. hearing things going on around you intra-operatively and remembering it after. That experience need not be disturbing if it is counselled for and not entirely unexpected, so all of my patients are explicitly warned that they might hear noises, voices or music; albeit rare for it to happen. The incidence of painful awareness —the nightmare for patient and anaesthetist alike, of the patient being wide awake in pain and unable to tell anyone— is considerably lower. Most commonly that sort of event is down to poor equipment or an emergency operation on the critically ill, where the first priority is keeping the patient alive rather than fully anaesthetised. Equipment standards in the UK/Oz/NZ environment are generally very good now, but we don’t have any control over how sick you are when you turn up on our door! :wink:

(Punctuation edit only)


#11

Maggie, thanks for a cool article!

I’ve been to a couple of Hammeroff’s conferences at University of Arizona (they alternate years between Tucson and non-US locations, either Europe or Asia.) David Chalmers, the philosopher who writes about “philosophical zombies” and “The Hard Problem - the gap between internally perceived experiences and externally measurable phenomena” is another major participant (and sings a mean “Philosophical Zombie Blues” as well.) It’s been an interesting mix of people, ranging from neuroscientists studying vision systems to people talking phenomenology to the types of people who Explain Consciousness to people who do FMRI studies of meditators or measure the neurochemical reactions to psychedelics. Some of the attendees are professionals, some are amateurs who’ve studied a lot of neuroscience (like my wife), some are random spouses tagging along (like me), some are grad students doing poster sessions, some are total cranks doing poster sessions about how consciousness is a Quantum thing.

At least one year there have been two “Science and Consciousness” conferences in Arizona - the academic one in Tucson and a Deepak Chopra woo-woo conference in Phoenix. (And a couple of years later Chopra kicked in some money to help fund the academic conference as well, which was … interesting.)


#12

I have found that sometimes ?pagewanted=all still hits a paywall. Adding ?pagewanted=all&partner=rss&emc=rss has every time (or ?partner=rss&emc=rss for one page articles).


#13

You are aware that Hameroff himself, along with theoretical physicist Sir Roger Penrose, have developed a hypothesis for the action of quantum consciousness, right?

And I have to say that if hylozoism/panpsychism are ever proved by science, and consciousness is proved to have a quantum component, I’ll have to ask you to eat your hat.


#14

Yeah - I’ve heard one of Stu’s talks about their theory. It seemed like lots of handwaving was involved, but I didn’t spend enough time researching to actually understand it. On the other hand, he is an actual scientist, so while his theory sounds rather optimistic, it definitely treats quantum physics from a scientific perspective rather than the usual quackery of people who don’t have a clue about what quantum even means*. He at least attaches the quantum stuff to the chemistry of some sets of molecular structures in neurons that are small enough for it to be reasonable to have a bit of quantum randomness that might be enough to flip a bit on whether a given synapse fires or not; it’s less clear how there’d be any quantum entanglement between microtubules in different neurons involved, or how there’s anything related to consciousness involved in it, as opposed to the same kind of uncoordinated randomness you’d get from a bit extra heat.

Meanwhile, I just got an email today with a call for abstracts for 2014’s conference, which will be in April in Tucson. Plenary speakers will include Susan Blackmore, Ned Block, David Chalmers, Karl Deisseroth, Daniel Dennett, David Eagleman, Rebecca Goldstein, Stuart Hameroff, Christof Koch, Henry Markram, George Mashour, Sam Parnia, John Searle, Petra Stoerig, Giulio Tononi and many more. And Deepak Chopra’s giving a talk :slight_smile:

* (There’s also a non-quackery reason for discussing quantum; it you philosophically want to have your mind have Free Will instead of being a deterministic (if incalculably so) side-effect of materialism generated by the meat in your head, and maybe even have a Soul involved, there needs to be some non-deterministic process attached to the biochemistry, and quantum effects are the only hook physics gives us to hang that on. It’s tough to get from there to a scientific theory of how the Soul knows which neurons to trigger, and most of the people who talk about quantum don’t actually try.)


#15

Ah, Heidegger. How could I forget this:


#16

i really like “Philosophers are fond of pointing out that, for all you know, you’re surrounded by people who appear to be fully conscious but who experience none of it subjectively.”


#17

I’m one of the unlucky ones who’ve woken up paralyzed but feeling everything during surgery. It was the worst experience of my life, by several orders of magnitude. I would almost rather they’d foregone the anaesthesia altogether and given me a pint of whiskey and a leather bit to chew on. But I was thirteen and it was oral surgery, so that wasn’t happening. And now as a result my mouth looks and smells like a rotting colonial graveyard due to phobia.


#18

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