My Hour of Memoryless Lucidity | Hacker News Reader

My Hour of Memoryless Lucidity

ericneyman.wordpress.com

135 pointssurprisetalk103 comments

This is what my grandfather was like for several days after he had a stroke.

No short term memory, but he was very lucid and sharp. When the nurses asked their standard questions ("do you know where you are", "do you know why you are here") he would use logic to guess the correct answer. The fact that I was in the room (and I live 8 hours drive away) lead him down a logic chain that whatever happened must be very serious and he must have been transferred the larger hospitable that was a few hours closer to where I live.

He would reliably repeat the same conversations based on whoever was in the room with him, and use the same jokes.

> and use the same jokes.

Pete and Repeat were sitting on a fence. Pete fell off, who was left?

Of course I can't speak for phire, but maybe this is not the right time.

Maybe it isn't the right time, but it IS the right joke. ;)

This is basically everyone I know when they're drunk. Being an experienced alcoholic is comforting in this sense: If you get hit in the head or you're coming off general anasthesia, if your memory cuts out and you're operating entirely in the present, with no ability to record anything, it won't feel particularly startling and you'll probably just pull out some of the greatest hits. Several vodkas will show you that our ability to analyze our own behavior is remarkably fragile.

People I know who have PTSD and other forms of dissociation do this regularly without any drugs at all. Consciousness is all a gradient.

I believe it's mistake to read too much into what happens in the immediate aftermath of anaesthesia. It's a different you.

Of course those reddit videos of undying love are sweet. But, people are often very very very inappropriate. It doesn't mean much, it doesn't mean they are unbridled sexist pigs, or heading there. Post-operative recovery Nurses have good stories.

That said, older people come out of Anaesthesia a bit differently. I am told by anaesthesiologists, that older people don't always come back the same even 6 months later. If you're old you need to be prepared for this, and it can acellerate decline in cognitive function (so I am told. I am not a health professional)

> That said, older people come out of Anaesthesia a bit differently

Wow, I hadn’t heard this before, a little scary:

“Among patients aged 65 years and older, up to 65% experience delirium and 10% develop long-term cognitive decline after noncardiac surgery. “

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807795

I have had limited experience of this, helping seniors with computing problems as a volunteer. One of my mentees had double-hip replacement. He definitely wasn't as sharp afterward. In his eighties.

My own cognitive state under anaesthetic, I am told was lucid but entertaining. I was interviewed by a doctor about some research project in wisdom teeth, post operative. It's 30 minutes of my life I have no recollection of, or even awareness. Another time after a colonoscopy I was told I was on a 30 second delay loop, replying well after the normal interval to any question. Slow.

Why have general anesthesia for a colonoscopy? It seems that's an unnecessary risk for a procedure that can easily be done without.

It was the classic double of gastro and colon. Rather than a full general I may have been given what is called twilight. Beyond not having intubation, you still don't recall the procedure and afaik it's the same drugs and brain effects. Also if they do find polyps, and burn, or take biopsy I am told it's not exactly easy. They have to move you around. Asleep or dozing may be simpler. You're inflated.

I ask because I've done colonoscopy a few times (I have IBS plus family history of colon cancer) and not once did I get general anesthesia or anything that impacts my brain. It hurts a bit (mostly from the gaz they use to inflate the colon) and yes taking biopsy is a quick sharp pain but it's really not that bad.

Likewise for endoscopy (that's significantly more uncomfortable than colonoscopy though). At least in Europe and in Japan, general anesthesia is not part of the sop.

I lost my grandpa (80+) a year ago to suicide. He had surgery for a minor GI issue, then came some complications, another surgery and then another one. He ended up very weak and couldn't walk properly, but his biggest complaint was that his body just didn't feel right after the surgeries. He'd often say that his GI tract felt as if it had been "disconnected," but also that the anaesthesia did something really bad to his head. He'd complain that he was seeing the world "like on a TV screen," as if he wasn't really sitting on the couch with us, living, but just watching things from a distance. Whatever it was, it made life unbearable for him, and he was gone in a few weeks.

I'm in my 30s and even after mild procedures it takes me months to feel normal again.

Medicine has a long way to go before it can deal with the qualia of post treatment life.

This is pretty terrifying to me. As someone who messed around a fair bit with altered states in my younger years I can remember feeling very similar to whats described here and being stuck like that is terrifying.

It's called De-realization, De-personalization.

Not fun.

"The psychotic drowns in the same waters in which the mystic swims with delight."

Anyone who has trained in a mystic tradition knows that it too feels like drowning, it’s just drowning on purpose, but no less painful and terrifying

Not to be rude, but it is not possible to know what all other people have experienced. This is but one of many things you can learn from a deep study of mysticism.

Is it impossible to don't afraid of anything?

Or maybe even scarier / more powerful: is it impossible to simulate it, adequately?

You quoted a general statement on the psychotic vs mystic, but when I respond to that generalisation you accuse me of unjustly generalising. According to your statement here, we should also dismiss your quote, since “it is not possible to know what all other people have experienced”, so how can you generalise them?

Be wary of applying double standards here.

Im pretty sure everyone, "even here", applies double standards. It's human nature. You fail by your own criteria. Fwiw, I upvoted both generalizations, yours and waterlovers, but want to point out that not all generalizations are equal.

In this case the generalisation is identical though

This is so?

Mine was a ~famous quote, and I put it within quotation marks.

Also, note that it says "the" mystic, whereas your claim is "anyone who". You also made broad negative claims.

Mysticism is often counter-intuitive, and imho "woo woo" isn't genuine mysticism.

Absolutely.

I consider myself a bit of a "psychonaut" and occasional practitioner of meditation.

But I had to cultivate this appreciation. I believe the DR/DP was a manifestation of my self's resistance to a new way to see the world and a new way to relate with my self - or lack thereof.

I stopped resisting, DR/DP went away... easier said than done though, I know. And I'm sure my experience was unique to my own.

There is a big difference between someone who studied computer science and then worked for one year in the field before quitting, and someone who devoted their life to it.

So too with DP/DR.

> seeing the world "like on a TV screen," as if he wasn't really sitting on the couch with us, living, but just watching things from a distance

I have this happen at times; I associate it with tiredness.

I've also noticed parts of my mind switch off suddenly when tired — one annoying and unfortunate thing I've inherited from my father is a tendency to get stuck in metal loops about imaginary arguments, sometimes involving people who died a decade ago, and one time this kept me awake… until just suddenly switching off like it was a part of my brain that fell asleep.

My understanding is that different bits of the brain do fall asleep separately than the whole, and that this happens at incresing scope and frequency the longer one has been awake, and knowing this means it wasn't scary to experience such a sudden change of mental state.

I’ve definitely experienced that last part in a short burst here or there. Having it permanently would definitely be catastrophic. I’m sorry this happened to your grandpa, you, and your family. Thank you for sharing.

Doesn't this imply that there _is_ some sort of damage caused or something, but younger brains are able to work around it easier? General anesthesia should be avoided unless absolutely necessary imo (particularly egregious is doing it for wisdom teeth).

> It's a different you.

I think some inhibitions or blockers fall off, and you kind of run on dream logic. I had some major surgery and my sister was supposed to come in and help out right after it. She came right as they were bringing me back in to the room, and apparently I was commandeering the doctors to give her space and make her a coffee cause "Im a fucking queen, and you will do as I tell you"... I don't remember any of it.

Would you say your behaviour that day stemed from underlying insecurities?

That’s a very good question. It seems likely that behaviour during that period reveals the unconscious

Thank you.

Why would that be likely?

Because events in such states often are, they are similar to jokes, dreams, and mistakes (to evoke the Freudian trio)

Freud has been debunked. Where is the evidence of similarity in such states?

> Freud has been debunked

That’s news to me and my insurance company

After decades working in healthcare I've never seen an insurance company take an official position on Freud. How is that even relevant?

Why would my state health insurance support a treatment with no efficacy? Actually there are many meta analyses showing the efficacy of it

The efficacy of what? I don't know which treatment you're referring to. If you mean Freudian analysis, that's not a specific billable procedure.

> If you mean Freudian analysis, that's not a specific billable procedure.

It is here in Germany

I think I've told this before but here goes. I was put under multiple times, but in this instance for nasal surgery I believe.

When I woke up, the nurses were half laughing and half pissed that I tried to get up mid surgery and fought them, so much so they had to get 6 nurses to restrain me(I'm a huge guy, no surprise here).

She said 'You kept saying you needed to take care of Charlotte, whoever she is, she must mean a lot to you.'

Charlotte was the location of our data center. Apparently even in my delirium I dream about work.

According to my family and nurses I was shouting "I am a fly! I can fly!" all while trying to reach the ceiling (by piling tables & chairs). That was until they could stop laughing long enough to restrain me (30 years ago things were different). So I just wouldn't put too much thought on these things. I have absolutely no memory of the event.

It's really bizarre isn't it?

Every single time I've been put under, I have absolutely zero memory of the event. When I wake up, I cry for about 30 seconds for absolutely no reason, then puke or dry heave. I'm not a cryer, which is so odd to me. I don't put much stake in it, just another oddity.

You know it's true... https://xkcd.com/705/

Yes, I wish families understood this more. My father, 70, had no health conditions, then had two completely unrelated medical emergencies within a couple of months, pulmonary embolism and testicular torsion, requiring GA. 3 years later, he’s still not the same person.

My father was in his late seventies when he underwent surgery for back pain. Unfortunately, they discovered that the cause of the pain was that his multiple myeloma had spread and that there was really no turning back. When he woke from surgery he couldn’t remember who his children were. He was a completely different person.

Definitely experienced this with my father, after two cardiac surgery (cardiac ablation), he became much more radicalized. Politically, he went from someone who was left wing closer to the center to being very much anarcho-left wing, repeating that the poors are exploited and getting very angry whenever someone disagreed with his new views. The change was rather startling. He did also experience some cognitive decline (lower working memory), had a hard time reading (he was a voracious reader before that) and experienced wider mood swings.

It was rather scary how much he changed in so little time.

This makes me wonder if there is a relationship between cardiac surgery and personality changes. I remember reading something similar about Lee Holloway[0].

[0] https://www.wired.com/story/lee-holloway-devastating-decline...

The last time I had a colonoscopy, I asked the attendant if it would be OK for my wife to video record my post-surgical conversation with her so that I could later have the odd experience of seeing myself having a recent conversation I had no memory of. I explained I don't have any social media account, we'd record only me, and it was just for my own personal use. They didn't hesitate to say no.

> They didn't hesitate to say no.

Did they give a reason?

HIPPA

No, but I didn't ask. I assumed that it was that there was no upside to them, which only leaves unspecified downsides, even if unlikely.

This completely sucks. Was it about liability?

Not the OP, but with my wife's ultrasounds during her pregnancy 11 years ago multiple technicians cited liability as the reason I was not permitted to record.

Liability of whom exactly? I'm really curious.

They can get shut down for not following HIPPA regulations.

But if the patient films himself, this is not by itself a HIPAA violation

I was and am, too. I've always assumed, very cynically, bans on recording medical practitioners come from attorneys' and insurers' concern about hard evidence of malpractice ending up "on the record".

My cynical take is that if they mess something up they don’t want to end up with video evidence of it.

Ignore them and record anyway. They won’t (and can’t) throw either of you out.

I did this while my daughter was in my wife’s womb. They tried to say that we couldn’t make any recordings of the ultrasounds. I made recordings of the ultrasounds. They asked me to stop, and I didn’t stop, and that was the end of it.

Admittedly you have to be willing to break social norms for this to even be an option, which is immensely difficult for most polite people. My solution was to remind myself I wasn’t being rude, and that I was a paying customer. (Unlike most people who say "I’m a paying customer," I always treat everybody well and respectfully; it still boggles my mind how awful most people are to e.g. support reps who are only doing their job. But this isn’t that situation, and it’s useful to remember that sometimes it’s true that you’re a paying customer and deserve to get your money’s worth when the only obvious downside is "they’ll be slightly annoyed for a few minutes.")

> My solution was to remind myself I wasn’t being rude, and that I was a paying customer.

Maybe I have a different definition of “rude”, but I feel that openly ignoring someone’s request is at the very least disrespectful, if not rude.

I’m not saying you’re wrong for continuing to record, but to your point of:

> you have to be willing to break social norms

I think this also means you have to be willing to be rude.

But it sounds like you’re arguing that being “correct” by definition makes it “not rude”.

But I’d argue whether you’re rude has little to do with whether you’re right, and more to do with how others think of your actions, especially when you’re knowingly doing something that might offend others (i.e. ignoring someone’s request).

I think a less “rude” approach might be to, for example, do an audio recording of the post-anesthesia conversation without the nurse’s knowledge.

Again, this is my take, but maybe I’m the one that’s off here.

It's not a matter of disrespect as much as of disobeyance. If there isn't (or shouldn't be) any subordination, disobeyance may not imply disrespect. The problem arises when people differ about whether there's subordination.

Regardless of hierarchy, responding to a request by ignoring it is pretty rude.

You can’t be rude ignoring a request that is both dumb and wholly a product of bureaucracy. Such requests are themselves rude, in a kind of weird impersonal way.

Of course you can. For instance, if you would reply to the request by insulting the physical appearance of the one making the request, that would be rude.

I disagree. Being rude is about being offensive; this is different from someone being offended.

For example, I was mugged at gunpoint once. The person very politely asked for my walled (it turns out when you have a gun pointed at someone you can afford to be polite). When I asked if I could keep my wallet and just hand over the cash, he responded (again surprisingly politely) in the negative.

If I had just ignored his request, would that have been "pretty rude"? [Ignoring whether or not this course of action would be advisable.]

And for a second hypothetical example. If I asked you to respond to me agreeing with everything I said, would it be "pretty rude" for you to ignore it?

In both cases the answer has to be no. The nature and intent of the request have to be considered when determining whether or not ignoring it is rude. And in this context (recording a medical event), they almost certainly want you to not record in case they do something wrong and the recording is used to prove it. It's a self serving request and it potentially works against the best interest of the patient in events where they believe their care is not sufficient.

I would respond to your request with "no" instead of ignoring it.

Saying no isn't rude. Ignoring that someone has spoken at all is, in most cases.

> Maybe I have a different definition of “rude”, but I feel that openly ignoring someone’s request is at the very least disrespectful, if not rude.

The problem is an asymmetric social contract. The business has no problem making a disrespectful request ("do not record this thing you're paying for") and this puts the client in the uncomfortable position of having to break social norms by ignoring said request.

This is often a problem when dealing with assholes and is why I absolutely refuse to work with them. They have no qualms about doing unreasonable things and they put you in the unenviable position of then having to violate social norms by pushing back.

I'm going to assert that a key component in being rude is being offensive. And I think that being offensive needs to be separated from someone being offended.

Here's what I mean. I've got some distant relatives who think I'm being rude because unlike them I don't get into an escalating argument with my wife over trivial things at family events that cumulates in a shouting match.

I'm absolutely breaking their social norms by having a positive relationship with my wife and they're definitely offended by it. However, to say that I'm being offensive or rude robs those words of their meaning.

I wonder if that's an IP issue ("we own the scan and might want to sell it back to you") or a liability thing ("we don't want you to have a copy of a scan video in case the sonographer didn't do it perfectly and you sue us").

In the US, HIPAA grants you the right to access your own health information [0]. I recommend asking providers to burn the DICOMs to a DVD (or send your images to you via an online portal, if they and you prefer) whenever you have medical imaging done.

[0] https://www.hhs.gov/hipaa/for-individuals/right-to-access/in...

I'm also interested in why they said no.

Is this specific procedure particularly unpleasant? I had all my wisdom teeth taken out with only some local anesthesia. I didn't care for people hovering their instruments real close to my face, but the pain wasn't that bad.

Are you for real? What was that like? Holy moly, my skin is crawling just thinking about that.

I have two bottom wisdom teeth, and am terrified of the day that I’ll have to get them removed. I plan to be fully knocked out; it’s hard to imagine someone literally cutting out my teeth. Even if you couldn’t feel any pain, how did you stay calm?

Maybe I’m just a wuss when it comes to teeth…

To answer your question though, at my recent colonoscopy, this type of procedure was awesome. They roll you into a room, and then you see white liquid go into your IV, and they say "you’ll be out in a few seconds." I remember asking "really?" in surprise, and she nodded yeah. Then my next memory was waking up to my wife. She said I was snoring and sleeping well post-op. I didn’t have any memory loss, but reading this post I wish I’d had that experience. It sounds interesting.

I had three wisdom teeth taken out over the years also with only local anesthesia. That was in Singapore and Australia.

They didn't even bring up the option of using more drastic steps to put me under.

It was all fine. I remember the most painful part was when the needle went in for the anesthesia. Afterwards, the rest was a bit weird, but not painful.

Global anesthesia has the potential for more side-effects and things to go wrong that more localised options. So it's generally preferred, when possible.

Well I don't want to make it sound too easy; indeed the whole waving metal things in your face wasn't pleasant. I think in my agony I gripped the chair pretty hard, and I grunted to ask them to give me a little break once. (That's also me because I can't stand people getting too close to me).

Anyway, reading into it, there might be some culturally set expectations going on? I never knew but apparently there's a lot less sedation-by-default in Europe. Childbirth, and dental procedures, seem to be more of a "yeah it hurts but you'll get over it" thing.

Must be a regional thing. Where I live, wisdom teeth extraction is usually done without general anaesthesia, sometimes even when it's all four in one go (AFAIK this isn't recommended for some reason).

Colonoscopy is another example. I had one a few months ago, The nurse injected me with a bit of midazolam, and apparently that was all I needed. I lay down with a stupid smile and began watching the video feed. I remember some bloating and some bubbling sounds, and the slightest bit of pain (comparable to having eaten something bad), but mostly the cool video and how chill it all was. Two minutes after the procedure I was able to walk to my clothes, get dressed, and five minutes after that I was having a completely serious conversation with the doctor about the results and my regime.

I strongly prefer how it went to getting put under for such a non-event.

The only surgical treatments I have had so far were all related to teeth: complicated extractions (including 3 of 4 wisdom teeth), a sinus lift, and 4 implants in total.

Everything done in local anaesthesia only. Unpleasant, but zero pain during the operation proper.

Yeah, in Europe it's pretty standard to extract wisdom teeth under local anaesthesia only (and perhaps mild sedation). You're pretty lucid throughout.

As a (former) neuroscientist I'm a lot more terrified about going under general anaesthesia with the risks and the long-lasting cognitive changes that sometimes occur afterwards!

That said it's pretty fun to watch all those videos of Americans with all the symptoms described in the article after going to the dentist...

Why? General anaesthetic is fun! The last time I was under for 6 hours. For a few days afterwards I saw the most incredibly interesting, detailed persistent hallucinations whenever I closed my eyes. They completely vanished when I opened them.

Harmless recreational side effects of anesthesia, or mild neural damage? Who knows!

I live in Europe and I even had a filling without local anaesthetic

As others have said, around here it’s entirely SOP to do wisdom teeth removal under just local anesthetic. I guess you can get a GA if you pay from your own pocket. My own experience was not that different from a more routine dental op, though they did use a "curtain" so I was spared the sight of the gory details.

I keep reading stories like these from Americans, and it seems that it is more common to do this.

Most of the people I have spoken to in my (Scandinavian) country use local anaesthetics unless the procedure is really complex.

I had one taken out earlier this year. The tooth had to be cut into tiny bits to be extracted. No pain. Not really that different from a regular dental check, aside from the sound of the tools they used, and the fact it took 20 minutes. Tell them you want a radio on and focus on the music.

In France, it's done with only local anesthesia. I don't remember it hurting much during the actual teeth extraction. On the other hand, I had some bleeding afterwards and that was particularly uncomfortable. I did all 4 at once

Yep that also sounded weird to me. I had, IIRC, three of my wisdom teeth removed as a teenager, I was living in Italy back then. I think two of them in a single session. General anaesthesia wasn't even an option, the whole thing happened in a normal dentist cabinet with a local anaesthesia to the relevant half of the mouth. I distinctly recall the dentist complaining that for one of the teeth my roots were particularly strongly attached to the bone, and he had to push and lean on it, _hard_; it didn't really feel painful, except that my jaw was aching on the opposite side (the mostly-non-sedated one) due to the pressure he put on it.

In fact, I think people and doctors alike tend to sedate much less in Italy - maybe not completely unjustified from a few things I've read in this thread. Back then, the normal drilling & filling tooth cavities mostly happened without any anaesthesia at all, local or otherwise. Frankly, that was quite painful, whenever the drilling happened to touch a nerve, and I really don't feel like experiencing it again :-) and I think at least this changed since.

> due to the pressure he put on it.

This is logical and within my experience.

Once an old dentist lady told me that she noticed patients complaining about pain on the other side in this situations. She didn't have an explanation then.

Had yours erupted? Mine were impacted and warranted an oral/maxillofacial surgeon. They usually won't administer local anesthesia with a vasoconstrictor to me because of hypertension.

I can see how local would be fine for what amounts to an uncomplicated extraction, though. Just make sure they don't bill you for an OR and anesthetist, anyway!

The memory loss aspect reminded me of the Sleeping Beauty toin-coss problem[0]. Might've been a good opportunity to try out a real variation of it.

[0] https://www.scientificamerican.com/article/why-the-sleeping-...

I wasted a few minutes trying to think of an anagram for W,A,M,O,R,T,Y (uses every letter exactly once) instead of a pangram (uses every letter at least once).

Tram, yow!

Mary Two

Mort Way

Interestingly, there's already some research about how bad people are at generating random numbers, so if the author tests that at the follow-up, I'd expect him to be both repetitive and predictable.

I haven't looked at the paper in a couple decades, but iirc, if asked to pick a random number between 1 and 20, almost a third of the answers will be either 7 or 17.

Anesthesia is spooky. Whenever I go under I try very hard to stay conscious and internalize how I feel and then I wake up when, to me, I was already awake. It's like time warp. I imagine that's what death is except without waking and that's even spookier.

A quick little zip to the end of the universe. Exactly as fast as the beginning to your earliest memories were.

Neat, I never knew this math trick before! Kind of seems obvious now... 2769=27710-27

And it works for "N1" too, 2771=27710+27

I'm not good enough at mental math to do 277 or 2707 so I don't think this will be too useful to me, but a good trick to know still!

You can decompose it further. 27 times 7 is 20 times 7 plus 7 times 7.

You can also multiply by 100 and 30 and subtract the latter, and then another 27.

In general the method is just about finding which calculations are easy enough to you to decompose the operations into.

For those confused, pard68 actually meant to write

    27*69=27*7*10-27

which is rounding up one of the numbers and subtracting the multiplicative difference.

You need to escape those *s with \ or put spaces around them.

This kind of method works much more generally. E.g. 58×33 will be close to 60×30 = 1800, so 58×30 = 1800 - 2×30 = 1740, so 58×33 = 1740+3×58 = 1740+3×60-3×2 = 1740+180-6 = 1940-20-6 = 1914.

Similarly 27×7 = 30×7-3×7 = 210-21 = 189, 270×7 = 10×27×7 = 10×189 = 1890, etc.

Another interesting one - 8% of 25 = 25% of 8

Isn’t that just 8/100 x 25 = 25/100 x 8 = (8 x 25)/100

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