For those of us who fall easily into worry spirals, one of the only things worse than knowing you have to go under the knife is knowing you’ll be awake for it. Surgery already lends itself to a chain of escalating what-ifs — listening to doctors cut through your skin and flesh can only add fuel to the fire.
And yet, as the New York Times recently reported, a growing number of people are choosing to forego general anesthesia, opting instead for a local anesthetic that lets them observe their own medical procedures. Patients make the decision for a variety of reasons: Some worry about potential complications from going under; others believe surgery will be less frightening if they know what’s going on; others still are just curious, or think it’d be cool to see their own tendons or bones (orthopedic surgery is the most common type to stay awake for, the paper noted, though “surgery in breast, colorectal, thoracic, vascular, otolaryngological, urological, ophthalmological and cosmetic specialties is also moving in this direction”).
It’s a good idea, in theory, if you’re the type that can stomach it — local anesthesia is cheaper and less dangerous than general — but it comes with a caveat: Doctors aren’t really sure how to act around their conscious patients. The Times explained:
[A]s surgical patients are electing to keep their eyes wide open, doctor-patient protocol has not kept pace with the new practice. 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 O.K. to say: “Oops!” or “I wasn’t expecting that,” or even “Oh, my God, what are you doing?!”
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