Where Do Our Minds Go?

After experimenting on a hen, his dog, his goldfish, and himself, dentist William Morton was ready. On Oct. 16, 1846, he hurried to the Massachusetts General Hospital surgical theater for what would be the first successful public test of a general anesthetic.

His concoction of sulfuric ether and oil from an orange (just for the fragrance) knocked a young man unconscious while a surgeon cut a tumor from his neck. To the onlooking students and clinicians, it was like a miracle. 

Some alchemical reaction between the ether and the man’s brain allowed him to slip into a state akin to light sleep, to undergo what should have been a painful surgery with little discomfort, and then to return to himself with only a hazy memory of the experience.

Monitoring patients’ brains still isn’t something that medical boards require.

General anesthesia redefined surgery and medicine, but over a century later it still carries significant risks. Too much sedation can lead to neurocognitive disorders and may even shorten lifespan; too little can lead to traumatic and painful wakefulness during surgery. 

So far, scientists have learned that, generally speaking, anesthetic drugs render people unconscious by altering how parts of the brain communicate. But they still don’t fully understand why. Although anesthesia works primarily on the brain, anesthesiologists do not regularly monitor the brain when they put patients under. 

And it is only in the past decade that neuroscientists interested in altered states of consciousness have begun taking advantage of anesthesia as a research tool. “It’s the central irony,” of anesthesiology, says George Mashour, a University of Michigan neuroanesthesiologist, whose work entails keeping patients unconscious during neurosurgery and providing appropriate pain management.

Mashour is one of a small set of clinicians and scientists trying to change that. They are increasingly bringing the tools of neuroscience into the operating room to track the brain activity of patients, and testing out anesthesia on healthy study participants. 

These pioneers aim to learn how to more safely anesthetize their patients, tailoring the dose to individual patients and adjusting during surgery. They also want to better understand what governs the transitions between states of consciousness and even hope to crack the code of coma.  READ MORE...