Silent screams, the invisible tears

“This is what I call invisible scars in the mind. The only injuries is what I call silent screams, the invisible tears.” That’s Douglas Hornsby’s dramatic description of the injuries suffered by patients who experience “anesthesia awareness,” which occurs when the patient awakes while still under the knife. Clearly, they aren’t awake in the fullest sense otherwise they’d sit up on the operating table and say, “Cut that out!” (haha!) However, they are awake enough to realize something is poking around inside them, and that can be traumatic, as you can imagine. Anesthesia awareness may soon become the new hotness in medical-malpractice suits:

Plaintiffs attorneys claim that in the past, people who awoke during operations rarely sued because they couldn’t prove it, and doctors ignored them.

But now, they say, these patients have new ammunition: an alert recently released by the Joint Commission on Accreditation of Healthcare Organizations. It says that anesthesia awareness happens 20,000 to 40,000 times a year, and that this phenomenon is an “under-recognized and under-treated” problem in the health care industry.

“Somebody has actually opened the door and said, ‘Hey, this does happen,'” said attorney William DeGarmo of San Jose, Calif.’s McCann & Logue, who is handling two anesthesia awareness suits.

“If someone had said to me 10 years ago, even five years ago, that someone had woken up during surgery, I’d say, ‘I can’t imagine that.’ … But it’s only recently that publicity has come out about this that people are saying, ‘I’m not nuts. This did happen.'”

The joint commission noted that while the 20,000 to 40,000 figure cited in the report represents only one to two cases in every 1,000, the experience is “traumatic for those people who do become aware,” and called on hospitals to do more to prevent it.

“I think there’s a concern that this kind of an alert could prompt more lawsuits,” said Karen Posner, an anesthesiology professor at the University of Washington who tracks medical malpractice claims for the American Society of Anesthesiologists.

You don’t say, Ms. Posner.

Apparently, anesthesiologists have done a pretty good job of keeping their malpractice rates down — good job, Dad! — , but the increased awareness of this unfortunate event may bump them up. And of course, anesthesiologists aren’t given a particularly easy job:

In defense of the anesthesia profession, Roger Litwiller, past president of the American Society of Anesthesiologists, issued a recent statement saying, “In some types of surgeries, awareness is the result not of error, but of the need to give the patient only as much anesthesia as his or her body can tolerate. In other cases, the sounds or sensations that patients become aware of are fleeting and not traumatic.” He added: “Awareness under general anesthesia is not common. The vast majority of surgeries performed under general anesthesia are accomplished with the patient unaware and pain-free.”

In the past, I’ve schemed of ways for the Barnett Family to make megabucks, but now I have my most brilliant plan yet. Dad keeps working how he is now. I actually finish law school. Dad puts Little Brother under for some routine surgery. Little Brother suffers some silent screams, invisible tears. I represent him. Dad throws the case (“I effed it all up, yer Honor!”). We take the med-mal insurance for all it’s worth. Dad retires. I take my 20% cut. Little Brother makes bank. And the cool thing about this is we can do this twice if Older Brother becomes an anesthesiologist too. The only flaw is the whole law school part.

(via Point of Law)

3 thoughts on “Silent screams, the invisible tears”

  1. :doh: Ha-Ha. Awareness under anesthesia is an extremely RARE phenomenon. In over twenty years of anesthesia I have never known it to occur in my or any of my co-worker’s patients. I’m not aware of any law suits involving it. A lot of patients think they were under general anesthesia when actually they were under sedation. They could possibly have some recall. Many trauma patients can only have minimum levels of anesthesia or they risk cardiovascular collapse. I would rather be alive with possible recall than dead with a lethal anesthetic. Most of this interest in Awareness Under Anesthesia today is being stimulated by a company that makes a special monitor that may detect this problem. They stand to make hundreds of millions if they “brainwash” enought people. However their monitor is very expensive and isn’t completely effective either. Overall anesthesia has become so safe in the past 20 years that very RARE and non-lethal issues such as awareness are getting alot of unwarranted publicity. Doctor DAD

  2. It’s true, the company that creates this “awareness” monitor is trying to make the monitor standard of care, which if it does, every single operation will then need this company’s monitor. So the company is pushing all this research into finding a problem that doesn’t really exist. And awareness isn’t an such aweful thing, almost every woman that has a C-section is paralyzed and aware, and they have no “mental trauma”. What does suck is if they’re also in pain, which shouldn’t be happening, because most cases are loaded up with narcotics unless the patient is starting to decompensate.

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