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When people would ask me what my father does for a living (particularly, when I was young), I would tell them he's an anaesthetist, and then I would spell it for them. It was quite impressive. Their next question was invariably: So he puts people to sleep?
Eventually I worked out that anyone can put someone to sleep - the skill comes from being able to wake them up again.

About ten years ago, my dad told me this story, which had occurred early in his career (about twenty years before his narration):

A patient in Recovery was not waking up after an operation. A young anaesthetist's worst nightmare. So he does the usual checks. He looks in the eye - the pupil reacts the way a conscious pupil would.
Hmmm - strange...
He raises the patient's arm above his face, and it falls to his chest.
Hmmm - okay, well, conscious enough to protect himself...
Check the arm's reaction to gravity again.
Ok, so now we all know he really is conscious, but still no response.
"NURSE! This is very serious! I'm going to have to use our special 'waking up' injection!"
Perplexed look from the nurse, but that's ok, because the patient's eyes are closed.
1 cc of saline. This will hurt only in the sense that a needle is being put into the body - no other real effect. The body readily absorbs saline.
2 cc of saline. Double the pain - no other real effect.
4 cc of saline. This should really hurt. Still no reaction in the patient.
8 cc of saline. Doh... ok we'll have to try something else... better tell the nurse, so the patient can hear.
"NURSE! This is even more serious than I realised! I'm going to have to use our extra strong waking up injection!"
1 cc of distilled water. Think of something exquisitely painful - this has no electrolytes for the body to easily absorb. And still the patient remains motionless.
"NURSE! I'm going to have to double the quantity!"
...And finally, the eyes open.

Now, I remember this story better then he does. Because there isn't a month that goes by that I don't wonder: WHY?

What is the motivation for the guy pretending to be asleep after the operation? What is he trying to achieve? He can't even laugh at his own joke. He isn't getting attention. Why?

And I keep wondering these things, until tonight... Well, actually, I'm no closer to the 'why' of things, but he tells the story again - only it's a shorter version.

He adds that yesterday, he had another patient do the same thing, but this time, when he tells the nurse he is going to the next injection (the 2 cc's of distilled water) into the thigh muscle, the patient's hand knocks his hand out of the way, as the patient's eyes open and he says, "NO!"

But then today, another patient didn't crack. The ability to wake up a patient, is the most critical thing for an anaesthetist. When a patient does not wake up for real, there are serious procedures that have to be followed. So when this guy didn't wake up, it meant he had to book in for a CAT scan and some other expensive check.

We talked about a rectal probe being used as an alternative in this instance, or maybe even an enema. But what really worked blew me away: My father 'fizzed' the patient.

In our family, a 'fizz' was used by pressing the two nerves either side of the kneecap simultaneously. (This doesn't hurt like hitting your funny bone does, but it does feel very strange). I don't think my dad added the verbal "FIZZ" that went with the action, but he did nonetheless, play with this guy's knee as he was being wheeled out for a CAT scan, and the patient reacted! It was too late to avoid the tests at any rate.

I'll remember these stories long after he begins to forget the detail. In truth, in all three cases spanning a career of more than thirty years, no one died or got hurt and no one got sued. Everybody woke up. So the details are less important to him. But for me - I'll always wonder:

Why?


LudditeAndroid says heh heh. Whenever a patient fakes unconsious at the hospital here, the doctor says "bring me the catheter, nurse!" Wakes 'em right up.
I forgot to say: usually when patients do that here, they're trying to avoid something (talking to relatives, being questioned by police, etc)

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