Nitrous at the Dentist's

From: ranjit@gradient.cis.upenn.edu (Ranjit Bhatnagar)

It started with the foul-tasting anesthetic spray. (Well, it really started with the panoramic x-ray, but that's boring. "Bite down on this, hold onto these, breathe in, and swallow...") By the time they asked me if I wanted nitrous oxide, it was already difficult to speak due to rubbery lips and tongue. I was reluctant, but decided to give it a try.

Lying down on the operating table. They strapped a tube over my nose, and I felt panic as I came close to fainting, and breathed through my mouth for a while until the world was visible again. Fading vision was replaced by a feeling of detachment, tingling and slight numbness in my arms and legs, and a loud buzzing-humming-rushing noise which soon either faded away or I learned to ignore it. I then spent almost the entire time of surgery planning how I would describe what nitrous consciousness is like.

It felt a lot like lucid dreaming, or like the half-dreaming state on lazy weekend mornings. There was a similar sense of distance from my perceptions. I could feel, hear, see everything, but it just wasn't my main concern. After I had been breathing N2O for a few minutes, the dentist came in to inject the deep anesthetics. He warned me that it would hurt (I could barely hear him through the haze) and it did, and I thought yup, that hurts.

My top stream-of-consciousness -- the talking-to-myself kind of consciousness -- was much more lucid than in a dream, pretty close to wakefulness... but not quite there. I felt that I could think almost as clearly as ever, though I was aware of being easily distracted (like when half asleep), and obviously the most important effect was the lack of interest in the physical world. Every once in a while I checked the clock (over the foot of the bed), partly to check my perception of time (usually about the same as normal consciousness, except when I got distracted) and partly just to make sure I could still focus my eyes. I couldn't converge the double image, though. I also wiggled my feet and fingers whenever they started to feel like they weren't attached any more.

At some point the surgeon removed my two upper wisdom teeth. I never noticed... it must have been easy, so I may have missed it in the much more complex process of smashing the two lower teeth to bits with hammers, drills, and levers. Whenever I smelled burning enamel or heard the sharp CRACK of another chunk being pried off, I thought "I sure am glad I opted for nitrous. This wouldn't have hurt much, but it would have scared the heck out of me. As it is, I just don't care." The surgeon frequently made requests... open wider... turn your head this way... that way... they seemed to drift into my consciousness from a distance, and though I was intellectually aware that he was right there, it didn't feel that way. I wondered what would happen if I refused to obey-- would he think I had fallen asleep?-- but I never refused. I wondered what would happen if I bit down on the drill-- but I never did. I wondered if people under nitrous would be more susceptible to suggestion--like hypnosis--because I had heard that people following hypnotic suggestions had similar thoughts: "I could refuse to obey... but I don't feel like it." I had all these thoughts and metathoughts--including this one--while under the gas, which is why I say I was nearly lucid the whole time. I was always aware that I was drugged, and that I felt lucid, and that it was possible that what I thought was lucidity at the time really wasn't. But on reflection, breathing plain old oxygen and nitrogen now, I don't think I was deceiving myself.

When I thought of it, I tried little tests of my consciousness. Could I recite pi to 16 digits? I could. Could I sing my favorite rounds to myself? I could and did, but one round got fixed in my mind and didn't go away until I'd been breathing atmosphere for fifteen minutes. I was also aware that I was having difficulty thinking of tests, and wondered if that itself was a symptom.

I wish now that I had thought of testing my visual and aural imagination, which is always much more powerful in a half-dream state. I thought, if they put this stuff in the air in long plane trips, they would seem to go by a lot faster! I wondered if I would seek out illicit nitrous trips in the future, and eventually decided that I probably wouldn't, because the chief attraction was in avoiding confronting a very unpleasant situation (oral surgery). It wouldn't be good for parties, and I couldn't imagine bringing it with me to wait in line at the bank or some such.

I was hoping to write more about that particular feeling -- which is what makes it such a good surgery drug -- but I'm having trouble figuring out how to describe it. Although I've said I was almost fully aware of everything that happened, that's obviously not really true. After all, I missed two extractions entirely. I felt very sleepy the whole time (a rather different feeling from the near-fainting when I first started the gas), and several times realized that the reason I was having trouble seeing was that my eyes were nearly closed. I fought against sleep; I didn't want to be unable to respond to the surgeon's instructions. I may have missed a lot during these episodes. I know from my clock-watching that I never lost self-awareness for more than 3 or 4 minutes at a time. I think the most useful thing I can say about nitrous consciousness is that my internal mental life became much more important than my physical state, like reading an absorbing book while the radio is chattering away in the background.

It took at least 20 minutes after being disconnected from the gas (and I felt a definite pang of regret when they took the tube off my nose... is it over already? Total gas time about 25 minutes) before I felt like I was mostly free of nitrous consciousness. Some of that may have been the influence of the anesthetics, though, which took over three hours to wear off completely. As I mentioned before, I tried to keep careful track of time, mostly to prove that I could. To my great regret, I forgot to ask in advance if I could keep the extracted teeth, and they were medical waste by the time I got around to it. Maybe they'll wash up on the Monterey coast sometime soon.

Later I took a codeine pill and spent the next few hours fainting and vomiting, but that's another story. No more codeine for me.


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