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Comment by helsinkiandrew | Hacker News Reader

> 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

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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.

> 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.

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."

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.

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.

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).

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.

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