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Those Doctors Are Trying to Kill Me!

May 31, 2011

Be careful what you say before going under anesthesia.

I had reached the age when my internist required me to get a colonoscopy, and I was not looking forward to it. I got gowned up in one of ridiculous back open gowns, for obvious reasons, but had a darkly funny thought when the nurse attached an I.D. bracelet to my wrist. I joked to the nurse, and to my wife, about the bracelet saying DNR, “Do Not Resuscitate.” Haha. See how I make joke when I nervous?

I know, I should have known better than to joke about a DNR, because it is after all a serious, and usually anguish-filled end-of-life decision someone has to make, at some point. It really wasn’t suitable for a joke, But hey, I can kid about my own mortality any time I want. Right?

Well, the joke was on me, because my timing for the joke was really bad. A couple of minutes later I was given an intravenous cocktail of Versed, propofol, and fentanyl. I was out.

In medical parlance, that form of anesthesia is called a MAC – Monitored Anesthesia Care. Which, for me, meant I didn’t care, or know anything at all, for a few minutes.

But when I woke up, things had changed. While I was unconscious, having my body invaded, someone had placed a DNR band on my wrist. And I was not happy about that, not at all. Who gave them permission?

I voiced my complaint to the nurse and my wife who were helping me get off the gurney and walk me to the car. But they didn’t seem to care! They wouldn’t even look at that blasted wrist band. Why was my wife so uncaring about my obvious distress?

At one point as my wife was driving me home, she started laughing at me. Of all the nerve! All I did was try to tell her about the DNR wrist bracelet. And she thought it was funny!

But I still remember my comeback to her. “Laugh jackass, laugh!”

 Boy, I sure had her number! That shut her up; until she started tucking me in bed for a nap.

But I didn’t want to sleep. I was mad as Hades! Did you know, someone had put a DNR bracelet on me while I was unconscious?

And then something clicked in her, born of years of raising toddlers and preschoolers. As I was trying to climb out of the bed she held my shoulders down, put her face right in front of mine, and said forcefully,

 “No. It does not say that! Now go to sleep.”

She later said I got a very hurt look on my face. And then I laid back, and was out, again.

When I woke up, all was right with the world.

But while I was sleeping that darned DNR wrist band had been cut off my wrist and the evidence destroyed. My wife still claims no knowledge of it.

If I may opine about what happened to me: I believe this is an example of idea fixation brought on by anesthetic agents. It was as if, on induction, a particular mental state was captured, which was in fact a mixture of dark humor regarding my bracelet, which obviously was not a DNR bracelet, and some anxiety over the procedure. Perhaps those anesthetic agents caused the emotional content to morph into something of its own creation, some paranoid delusion which was not abolished until the last vestiges of the drug were eliminated.

If you look up the term “idea fixation” you’ll see, oddly enough, repeated mention of nitrogen narcosis, a diving induced mental state of which I am all too aware. From a scientific perspective, there are qualitative parallels between the narcosis of nitrogen and the narcosis of certain anesthetic agents.  But I don’t know how many events such as the one I experienced have been recorded in the medical literature. If you know, please share with me.

In the meantime, I plan to maintain a tight grip on even the most humorous impulses I might have before undergoing anymore medical procedures requiring sedation. The next time, my wife may not be so understanding.

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