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My dad is an anesthesiologist and I've heard similar things from him. Anesthetics have three goals: 1. Elimination of pain; 2. Loss of consciousness; 3. Loss o

My dad is an anesthesiologist and I've heard similar things from him. Anesthetics have three goals: 1. Elimination of pain; 2. Loss of consciousness; 3. Loss of memory. Of these, he was saying that the most important is the last. If you have no memory of the pain, in some sense it didn't really happen. It does sort of make sense that they are okay with the patient experiencing some pain because anesthetics (at least those used for general anesthesia) are very dangerous drugs. There is a metric called the "therapeutic index" given to drugs, which is the ratio between the amount needed to get the medical benefit to the amount needed to kill you. Most drugs in medicine have a very high therapeutic index, like 1:100 or 1:1000. (Morphine is around 1:70 for instance.) But the drugs used for general anesthesia are closer to 1:2. So there's very little margin for error which means they try to provide lower doses if at all possible.

bscphil 4y ago
> Of these, he was saying that the most important is the last. If you have no memory of the pain, in some sense it didn't really happen. That strikes me as a very strange thing to think. When I am dead, I will have no memory of anything. I should not conclude on this basis that any pain I have during my lifetime "didn't really happen", or doesn't matter. On the contrary, it seems like the only thing that could matter is the pain I actually do feel, for as long as I feel it. Of course, given the choice, it would probably be preferable to not have to remember the pain later, but I wouldn't call the gap between the two an enormous one.
- antognini 4y ago
  I think that it is partly because the drugs generally have an amnesiac effect at lower doses, so if you don't give enough of the drug to cause amnesia, there will almost certainly be pain, too. But maybe there's a more cynical interpretation that it it "didn't happen" in a liability sense. If the patient has no memory of the pain then they have no reason to sue you for messing up the dosage. Incidentally I recently watched through Severance and I can't help but see the parallels to the show.

bscphil 4y ago

> Of these, he was saying that the most important is the last. If you have no memory of the pain, in some sense it didn't really happen. That strikes me as a very strange thing to think. When I am dead, I will have no memory of anything. I should not conclude on this basis that any pain I have during my lifetime "didn't really happen", or doesn't matter. On the contrary, it seems like the only thing that could matter is the pain I actually do feel, for as long as I feel it. Of course, given the choice, it would probably be preferable to not have to remember the pain later, but I wouldn't call the gap between the two an enormous one.

antognini 4y ago
I think that it is partly because the drugs generally have an amnesiac effect at lower doses, so if you don't give enough of the drug to cause amnesia, there will almost certainly be pain, too. But maybe there's a more cynical interpretation that it it "didn't happen" in a liability sense. If the patient has no memory of the pain then they have no reason to sue you for messing up the dosage. Incidentally I recently watched through Severance and I can't help but see the parallels to the show.