The Anesthesiologist
My left thumb propels the syringe, right index
finger reaching for the soft skin where ear
lobe meets neck. Before, opiates and alcohol
left ghosts behind, their lure not enough to quell
the nightmare of surgery. Dear patient, doctors
used to bleed you into submission, deliquium
animi, but now the symphony I orchestrate is
much more refined. First, the propofol: falling
blood pressure, dissipated breathing; then,
I give you a little push to make the lungs inflate,
the ventilator expanding and retracting the heavy
blooms inside your chest. Sevoflurane is such
a wonder, though no one can really say
how it manifests unconsciousness, crossing from
the lungs into the blood and from the blood
to the brain. But then what? Isn’t a little mystery
the price we have to pay to see the magic? Yes,
everything is a corrective to everything else.
But what makes this so different from daily
life? The avoidance of, or rush toward, the death
drive, the push and pull of consciousness—
exhausting, no, trying to be so goddamn present?
I’m never able to leave my own self behind,
to abandon this dull, known world where every
moment—each wavelength and spectrum
of perception—is mine alone, incomparable.
Descartes thought the pineal gland was the place
where all our thoughts were formed but still
insisted whatever kernel of light lived within
to be ineffable. And lonely. The knotted brow
of agony has been smoothed for ever, declared
Holmes after they pulled the gleaming tumor
from the sleeping patient’s neck in the Ether
Dome. And the only sacrifice you must make
is memory. What can link us then, if not brief
electrical impulse and synapse, bone and gristle?
Earth will outlast us—there’s no concern
about that. It’s everything else we’ll raze
in the process. But for now, patient, relent:
the miracle of anesthesia transcends pain.
Forget those fears, unfetter the sleek beast
of imagination within the deep bone
bowl of your skull. See what you can find
down there in your unconscious—you won’t
be able to bring it back, but you’ll be different,
changed in ways you’ll never realize. Perhaps
you’ll return to it in dreams, some great new
skein of sky for you to unfold. All I ask for
is the knowledge that keeps me awake
at night: when you sleep, when you dream,
dear patient, sweetheart: it’s me.
Italicized language is from Joshua Lang’s article “Awakening” from the January/February 2013 issue of The Atlantic Monthly