The word rings sweet in our ears. Women scream for it in the delivery room. It has made previously-unthinkable surgeries routine. It keeps us from living our lives in fear. It is more indispensible than air conditioning. And it leaves us with this question: How did civilization manage for millennia without it?
Napoleon’s military surgeons had an advantage in the winter that they did not have during the warm months, and particularly in Russia: the anesthetizing effect of frigid temperatures and snow. Surgeons packed snow around doomed limbs to numb them before amputation. Women, including camp followers such as prostitutes, cantinieres, vivandieres, and actresses, plied men with brandy when it was available before surgery, but it was the cold that did the most to render amputations bearable. Surgery without anything to numb the affected areas, such as during the warm months, must have been indescribably horrific. Sometimes the patients were mere youths, too: drummer boys or civilian children caught in the crossfire. It’s not something most of us care to think about. If you ever suffer surgery without anesthesia, you will not soon forget it.
I have done many things for the sake of the experience, sometimes so that I could write about it. I have had many experiences for reasons of necessity. I wouldn’t volunteer to undergo surgery without anesthesia just to know first-hand what it was like, and not so that I could write about it. But I would do it in order to continue living.
You cannot expect doctors to be square with patients when doing so would mean inciting terror, and I wouldn’t hold that against them. I had a tracheostomy recently, and not only did the surgeons avoid telling me what I was in for, but they lied, for which I am grateful. They did let me know I would have to remain conscious during the procedure. Breathing on my own was crucial, at least until the aperture was made. If I were knocked out, I might stop breathing and suffocate. The lie came when the head surgeon told me the anesthesiologists would inject me with a cocktail that would send me to heaven, figuratively speaking. She said she’d never known a patient to remember the operation.
If that last part was true, then I ruined her streak, but I’m reasonably sure it wasn’t. My first clue that something bad was in store came when they flopped me onto the operating table and started putting my arms into restraints. I told myself this was surely just an emergency precaution. (I would hear later that surgical team members sometimes had to lie across a patient to keep the poor sap in place during a tracheostomy.) The crew fitted a strap around my head and installed a mask over my face so that I couldn’t see. The anesthesiologist announced that he was now injecting me and I would soon be happy and at one with the universe. I looked forward to that. Just the same, that Zen-like tranquility never came. The words were a placebo. The doctors told me lots of placebos. (I now notice that placebo has the same root as placate.) The doctor said that if by any chance I felt pain, to let them know and they would administer a local anesthetic.
If by “let us know” she meant scream, then we were on the same page. And if I was at one with anything, it was with a tiny buzz saw. I couldn’t see the critter, but I could hear and feel it. ZZZZ, ZZZZ, ZZZZ. Into my flesh it went. I gritted my teeth and clenched my sphincter; I didn’t want to be a baby about it. I could only make it a matter of seconds, however, before I called for that local. The anesthesiologist, or somebody, obliged me with a long needle to the sliced-up Adam’s apple. I felt fluid stream into the tissue, riding the current of pain that the needle generated. A numbing sensation—a welcome, appreciated, and wholly inadequate numbing sensation—followed. And the buzz saw followed that. ZZZZ, ZZZZ,ZZZZ went the implement. When you visit torture chamber museums, I was thinking, you see implements. I balled my hands into fists and squeezed my eyes closed. The mask, I realized, was to keep meat and blood from flying into my face. I imagined what was being flung onto the team as they stood around me.
The lead surgeon spoke to her assistant—her trainee—describing what they were seeing, what level they had reached, as she drilled. I asked as calmly as I could for another shot. Again the needle pierced my skin and plunged far too deeply into my neck tissue. Again the burn of fluid under pressure followed the pain of the needle. I felt the touch of air against the exposed nerve endings within the new crater. And then the buzzing resumed. The local gave me maybe a minute of arguably-tolerable pain before I was clenching and grinding and squeezing. The lead surgeon nudged her assistant for agreement that they were at the correct place in my throat. I couldn’t tell if the question was just part of the training, or if somebody was lost. The assistant agreed, but without the confidence in her voice that I longed for. And I asked for another shot. The routine had been established. That terrible blade whirled through me, its power-device producing resistance sounds, its RPMs slowing intermittently as it hit tougher material. I knew if I fought in any way that I’d make things worse. It burned me like a hot iron, but I had to take it. I thought of those soldiers in the tents losing their arms and legs to the stroke of a bone-saw. Again, I requested a shot, and I was lucky to have it, what good it did. I requested lots of shots before it was all over.
At long last—and I honestly don’t know how long it took, but I guessed about twenty minutes—I felt the sensation of fresh oxygen and nitrogen streaming directly into my lungs from my neck. I heard positive exclamations, reminiscent of the eurekas you might hear when gold or oil is struck. I was as relieved as a person could be under the circumstances. I’d thought for a moment I wasn’t going to make it, the pain having been so intense. But no one had secured me to the table with the weight of his body. That was something, anyway. After the surgeon asked the assistant to verify the hole had been drilled in the right place—which the assistant was pretty sure was the case—she told me I could now be drifted off to sleep.
And my trifling operation was nothing compared to a field amputation. Someone had discovered ether by the time the War Between the States came around, but I shudder to imagine life before that. The existence of anesthesia allows us to carry on without fretting over the likely event of an unbearable surgery. We, in our modern times, have no conception of what it was like to have such a thought lurking in our minds, the probability hanging over our heads. I’m surprised that that fear was not written about more often. I will forever feel a debt of gratitude for the people who worked so hard to bring anesthesia to the masses.