Into the Gray Zone:

A Neuroscientist Explores the Border Between Life and Death

by Adrian Owen

Scribner

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Anesthesia has been around for over 170 years, and in spite of its inherent drama it’s impressively nonlethal. Current estimates place the death toll at about one in two hundred thousand or even one in three hundred thousand, which means—according to the earnest nonprofit the National Safety Council—that you or I are more likely to die from insect stings, “excessive natural heat,” or “contact with sharp objects” than either of us is from being put under. Properly supervised anesthesia is not only exceedingly safe but also ubiquitous, and necessary for a slew of lifesaving and life-improving procedures. Yet in these heady days of organic, “toxin”-free lifestyle goals, wariness of medical convention abounds. People rush to point out that we (“we” meaning doctors, which “we” usually aren’t) don’t really know how anesthesia works, thereby implying that it’s fundamentally suspect. There are movements in opposition to advances like vaccines and hormonal birth control, so it makes sense that anesthesia, too, with its murky chemical magic, would be a source of unease.

Because anesthesia is unlikely to cause death outright, the case against it goes more or less as follows: It’s mysterious and it’s scary. The former is posited as the reason for the latter, but even if there were a flawless explanation for how anesthesia works, we’d still be disconcerted—it strips us of our awareness, movement, speech, and senses. It’s very rare for people to unexpectedly wake up during surgery; rarer still that they register pain; even rarer that they spontaneously wake up, feel pain, and remember

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