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Sorry, you experienced that distress! Colonoscopies are done under sedation typically. This means that you may wake up a bit here and there. It’s not a general anesthetic. The person giving you your anesthetic titrates more in based on your breathing, level of awareness. I find that occasionally there isn’t an explanation going into it that you may wake up a bit during the procedure. As a brief summary: We know about different stages of sleep. We know some things that happen while we sleep (blood-brain barrier permeabilization and enzymatic and mechanical clearance of some chemicals, long term memory maintenance, etc.).We have a great many ways of telling if surgery is becoming “stimulating” (our term we use, meaning that the patient’s body seems to be feeling what is happening). If you had paralytic drugs on board, which we often do, but let your other drugs wear off, you could end up with a Billiard Where’s The Cue Ball Going Vintage Retro Shirt paralyzed but aware patient.

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We know that some things occur more while we sleep, others only occur while we sleep, and others occur only during specific stages of sleep. There are still in all likelihood many other things that happen which we don’t know about as well though. We have a tentative grasp on some small things (this chemical goes up, this chemical goes down, these neuron activities change), and know about a couple of medium things (eg long term memory), but there’s a no bigger picture. We can’t relate the small pictures to each other, nor the small to the medium and the big is just right out. There’s no framework that any of this fits into, nothing to explain why any of these things require and/or cause somewhat shutting off senses (and it’s still unclear exactly how to shut off the senses are), paralyzing skeletal muscles, and telling consciousness to go take a hike (or perhaps it doesn’t take a hike, we just don’t form any memories for an unknown reason).

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This statement makes it seems as if we don’t know way more about most other drugs and their mechanism of action. We know tons about many drugs, yet know almost nothing about anesthesia, one of the most used drugs. Like, yeah it’s a philosophical point that we don’t know everything about anything— like we really only know or have observed a small fraction of things there are to know or observe. But focusing on that in this context actually prevents us from being able to talk about anything. If we always look at the biggest picture and say “Well we only know like 1% about this,” then how can we have a meaningful conversation about it. Some VERY painful breaks that took time to get to even, I live on a Billiard Where’s The Cue Ball Going Vintage Retro Shirt island and it took all day to get to a hospital, then get a doctor. While I do have some recollection and faint memories of very uncomfortable physical sensations, even from times when I should have been unconscious, I never remember the pain. It’s not impossible, but it’s extremely rare in modern anesthesia.

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