This is an off-the-beaten-track, thought provoking article. From Madhava Setty, M.D. at collective-evolution.com:
When patients ask anesthesiologists what we charge for putting them to sleep, we often say we do it for free. We only bill them for the waking up part.
This isn’t just a way of deflecting a question, it also serves as a gentle reminder to both parties regarding the importance of “coming to.” If we couldn’t regain consciousness, what would be the point in having the surgery in the first place? Nobody wants to experience pain and fear if it can be avoided. If the only way to avoid the pain of an operation is to temporarily be rendered unconscious, most people will readily and willingly consent to that, as long as we can return to our natural state of being alert and interactive with the world around us. We are awake and aware and that–rather than any particular conception of health–is our most precious gift.
How does Anesthesia work ?
From an Anesthesiologist’s point of view, we really shouldn’t charge for putting someone to sleep. It’s too easy. With today’s medications, putting someone to sleep, or in more correct terms, inducing general anesthesia, is straightforward. Two hundred milligrams of this and fifty milligrams of that and voilà: you have a completely unconscious patient who is incapable of even breathing independently. The medications we administer at induction are similar to the lethal injections executioners use. Unlike executioners, we then intervene to reestablish their breathing and compensate for any large changes in blood pressure and the patient thereby survives until consciousness miraculously returns sometime later.
In addition, those in my field have to contend with the reality that we really don’t know what we are doing. More precisely, we have very little if any understanding of how anesthetic gases render a person unconscious. After 17 years of practicing Anesthesiology, I still find the whole process nothing short of pure magic. You see, the exact mechanism of how these agents work is, at present, unknown. Once you understand how a trick works, the magic disappears. With regard to inhaled anesthetic agents, magic abounds.