Thursday, January 27, 2011

Experiment #19: Anesthesia

What constitutes pain? The discomfort of feeling, or the lack of feeling?

Earlier this week I had a decision to make. My four wisdom teeth, all impacted, needed to come out, and the sooner - the better. The first oral surgeon we consulted, supposedly the best in Ahmedabad, took one look at my X-ray and stroked his chin in a not-so-reassuring way. "Your case is a veeeeeery interesting one..." He suggested we schedule my surgery ASAP, under general anesthesia.

Judging from his reputation, I assumed he was the best, and began to prepare my mind for the procedure. I had never had any sort of surgery before, so I decided that this was a good baby step. And how bad could it be? After all, I was going to be knocked out.

But of course, things rarely go as planned. My parents wisely consulted another oral surgeon for a second opinion. Surgeon #2's diagnosis was the same - I was growing four sets of crooked wisdom, all which would have to be removed eventually. However, he offered to do the surgery for half the cost as Surgeon #1, under local anesthesia.

I'm not a fan of going to the dentist, but then again, who is? All that poking around in your mouth, the horrible scraping sounds against teeth that seem amplified thanks to the proximity of the ear, and the acrid, unsettling taste of blood. The thought of being awake to hear, smell, and taste each prod and yank of the teeth pulling, sent me into a nervous tailspin.

My father, who had his wisdom pulled a few years back, and my mother, who's wisdom has never caused her any dental problems, tried to explain to me how foolish it was to go under general anesthesia when the procedure could easily be done with local.

I tried to explain to them how horrified I was of having a drill put to my gums - while being conscious.

Finally, reason and rationale reluctantly prevailed over my emotions. Yesterday at 12:30 pm, I squeezed my eyes shut, said a prayer, and opened my jaw with a feeling of doom.

I won't go into the details of the surgery. (I am trying to push all that yanking, twisting and drilling out of my mind.) But I will say, it was not peachy.

The most unsettling part of the whole ordeal was my inability to feel my lips and tongue once the local anesthetic took affect. I felt compelled to touch my chin and mouth every few minutes, just to make sure they were still intact. My lower lip especially, felt like an inflated balloon attached to my face.

After the surgery was over and my gums were stitched up, the surgeon asked me, "Was it painful?"

How to answer that question? There was the obvious discomfort of having the teeth forcefully separated from my jaw, but I'm not sure I would classify that as pain. Really, the painful part was not being able to speak once the surgery was over; not being able to express how upsetting it was to feel like my mouth had been taken over by aliens, while I was awake to witness it.

There would have been obvious pains associated with general anesthesia as well: the IV drip, the intubation tube to monitor my breathing, and the post-operative soreness. But I think I would have preferred to be in a state where I could not judge the discomfort of the actual procedure.

After all, that is what pain stems from in any situation - our judgement. There is a Buddhist saying, pain is inevitable, suffering is optional. We choose to judge our pain - to associate certain sensations with discomfort and others with pleasure. But when does it start? At what point in our lives are we programmed to dread the stick of a needle?

Studies have shown that the extent of pain we feel has both a biological component, and a psychological one. We appraise each situation, insist on reacting rather than observing.

To respond to Surgeon #2, I could simply grunt and narrow my eyes. In that moment, my reaction was in check - though not by choice, since the lower half of my face was still paralyzed.

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