This Is a Thing: People Are Choosing to Stay Awake During Surgery

I enjoy watching surgery shows.

I'll watch a show about the removal of a massive tumor or a show about the quest to create the perfect new nose and not squirm at all when they show the more graphic surgery shots. Those types of shows kind of relax me.

That being said, the idea of watching surgery being performed on me—as it's happening—is probably the most panic inducing thought in the world. And that is exactly what some people are opting to do.

According to a recent report in The New York Timesthere is a growing group of people choosing local anesthetic instead of a general anesthesia so that they can observe their own medical procedures.

People choose to be awake during surgery for a variety of reasons. Many relate to the patient autonomy movement, in which patients are pushing to be more deeply involved in their own medical treatment instead of just blindly accepting physician's orders and recommendations.

And if you don't think too hard about it, it seems like a good idea. Not only is local anesthesia less dangerous than the general option, it's also less expensive and has a shorter recovery time.

These factors—coupled with a few studies that suggest the idea of being awake during surgery (even with the blood and guts you might then see), makes people less anxious than the idea of being under general anesthesia—means the trend is likely to continue to grow.

But beyond these pros, some patients are choosing to stay awake simply because they think it'd be cool to see their procedure performed.

The only problem with this is most surgeons are not used to being watched. And as The New York Times explains, that can lead to some uncomfortable moments:

"Patients can become unnerved by a seemingly ominous silence, or put off by what passes for office humor. Doctors are only beginning to realize that when a patient is alert, it is just not okay to say: 'Oops!' or 'I wasn’t expecting that,' or even 'Oh, my God, what are you doing?!'"

One patient who had an "awake" procedure told researchers from the University of Chicago, "The surgeon told me he was going to get a sharper knife, and started laughing."

Yeah, that is unnerving. To say the least.

But so far, patient satisfaction for these types of procedures tends to be high.

"If I want sedation, I’ll have a beer," said David S. Howes, an emergency physician in Chicago who's had several awake procedures.

Apparently, he's discussed fly-fishing with his gastroenterologist during an awake colonoscopy, and read The Economist while undergoing two total knee replacements with only regional nerve block anesthesia.

"It’s not for the faint of heart," he said. "They have to cut the capsule of the knee, which is quite thick. I could feel the vibration of the saw cutting through the leg bones. Then they hammer, and it sends a shock wave slamming into your knee. It doesn’t hurt, but you feel the pressure. And you smell burning flesh."

But, as the Times reports, some patients who elect to stay awake during their procedures feel a bit of a letdown, as it's nothing like the choreographed drama of the surgeries they see on TV. In fact, they find the whole thing rather quiet. Too quiet, even, which means a lot of doctors are having to start making small-talk during procedures.

While the idea of having some measure of autonomy during surgery is appealing, I think I'll stick with the televised choreography. I want my surgeon to focus, not talk to me about the weather.

H/t: The New York Times