You know how you can’t pinpoint the exact moment you fall asleep? For me at least, there’s always a phase that comes right before NREM hits that has me dancing around the line between awake and asleep; my eyelids slowly lowering but then snapping open again, my thoughts drifting into dream territory then darting back to reality only long enough for me to think to myself, “that didn’t make any sense”. Eventually, after a few cycles of this, I fall asleep, and it’s not until I wake up, usually quite abruptly, that I realize I can’t remember exactly when.
Anesthesia is quite similar, in my limited experience. My first encounter with it was in 2000: I was an 8-year-old boy with an appendix ready to burst, and after being wheeled into the operating room, my parents by my side, the doctor tilted the overhead light to shine into my face and held a respirator up to my nose and mouth. Dazed and in pain, I can’t remember what my expectations were, but I remember the last words I heard being, “I’m going to count backwards from 10, and before I hit 1 you’re going to be asleep”. After that there was a countdown, but I couldn’t tell you which of the numbers I was awake for.
Five hours later I woke up in a recovery room. My immediate reaction was to call for my parents, whom the nurse promptly fetched for me. I didn’t feel that different, and I almost didn’t believe anything had happened, until I looked down and saw a small tupperware container with a tooth inside it, sitting on my lap. “Your tooth was loose, so they went ahead and took it out during the surgery. They didn’t want it to fall into your throat.” My tongue felt around in my mouth and confirmed the nurse’s explanation.
My other anesthesia story involves dental extraction as well. In the summer of 2015, after nearly a year of putting it off, I finally scheduled a visit to an oral surgeon to remove my wisdom teeth, two of which had grown in quite horizontally. Ever optimistic, I was more nervous about being novocained up before the operation began (always the most painful part of any procedure) than the extraction itself, though I was warned that with wisdom teeth there’s always a risk of semi-permanent nerve damage. Also on my mind was my experience 15 years ago. I was told outright I would fall asleep and still wasn’t able to remember exactly when it happened. Would it be different now that I was conscious of the fact?
The day came and I was lying back in the chair wondering about what it would feel like to be sedated again while the dentist, in a commendable effort to keep me informed about what was going on, told me that I would feel a pinch in my arm, promptly fall asleep, then wake up and be done. Half surprised because I expected delivery via gas-mask instead of IV, I nodded my consent, and he stuck the needle into my outstretched arm and began to make small talk.
“It says here you have lots of food allergies.”
“You don’t have asthma, do you?”
“I do, actually.”
“And skin problems?” He observed more than asked, his eyes tracing a clear liquid flowing from his syringe into my arm.
“Oh boy, you got the trifecta.”
He gave the needle a few taps and set it down, walking around the table to prepare the rest of his tools.
“Is it already working?” I inquired curiously. I don’t remember what his answer was.
About an hour later I can feel the nurse trying to get me off the chair and into the lobby like a college freshman hopelessly trying to prop up her blackout drunk friend so he can just get back into his dorm.
Strangely, I don’t have a memory of falling asleep. I remember getting IV’d, and I remember standing up after I was done, but almost nothing in between. Crucially, I didn’t have an abrupt waking up moment, mainly because unlike my surgery as a child, I didn’t come to in a completely different room. Was I ever asleep? Was I collecting memories the whole time, pain and all, and simply discarding them milliseconds afterwards? When I try to look back on that time now, it’s opaque. I have small fragments of sensations but not full ones; a jab of pain here and there, a cracking sound, perhaps a question I was asked but do not remember answering.
Perhaps I didn’t actually fall asleep, and those shards of memory are real experiences, albeit incomplete ones; ones that weren’t recorded properly, that didn’t make it through the complete process from sensory input to recollectable memory. But if I did in fact fall asleep, then those sensations are dreams. Influenced by real events that were happening to me, but just as equally processed by my imagination. Or perhaps there’s a third way, a middle ground, neither asleep nor awake, conscious nor unconscious. Perhaps then these incomplete experiences are palimpsests, there but not there, faded remnants on a page otherwise blank, barely visible but still having left their mark.