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Education  |   May 2013
Counting Backward
Author Affiliations & Notes
  • Vincent J. Kopp, M.D., F.A.A.P.
    University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. vkopp@aims.unc.edu
  • Accepted for publication August 16, 2012.
    Accepted for publication August 16, 2012.×
Article Information
Education / Mind to Mind / Gastrointestinal and Hepatic Systems / Infectious Disease / Ophthalmologic Anesthesia / Pediatric Anesthesia / Respiratory System
Education   |   May 2013
Counting Backward
Anesthesiology 05 2013, Vol.118, 1224-1226. doi:10.1097/ALN.0b013e318273e290
Anesthesiology 05 2013, Vol.118, 1224-1226. doi:10.1097/ALN.0b013e318273e290
SOME weeks or months after the doctor’s house call — at six it is hard to keep track of time—my parents brought me with my older sister to a hospital near our home. It was not a large hospital, not by modern standards. Neither was it intimidating or especially welcoming. It was a hospital, the first I remember entering. It felt authoritative and no-nonsense but accessible if not particularly friendly, like a church or a school, a serious place where children behaved. As we climbed the broad steps out front to enter we knew whatever else it was, the hospital was a place that would change our lives.
Entering the hospital lobby, we stopped at a quiet receptionist who told us to turn right and walk down the hall. As we walked—father, mother, sister, and me—down the long hall with a high ceiling, I noticed wooden doors with glass transoms at regular intervals. I remember being very impressed by how our collective footsteps echoed with different pitches on the marble terrazzo floor. The chorus of footsteps seemed to augment our purpose with great importance, even my small contribution. Aside from our steps, the hospital hall was quiet. The many doors, however, hinted at hidden rooms—out-of-view chambers that honeycombed the bulk of the building, where important but unseen things were occurring.
It was through one of these doors that we soon entered right into a large, bright room full of children and nurses in white uniforms. There were tall windows along the room’s outside wall. The flat light of late winter or early spring blanched the glass panes free of any outside details I can remember.
The room had the same high ceilings as the hallway but none of the quiet. It was full of nurses wearing white winged hats and tending to children in cribs and chairs, all left behind by their parents. The sounds were of murmuring and stifled crying. It was from there my parents exited, leaving behind my older sister and me.
I do not recall what happened in that room to separate me from my sister after my parents left. Somehow we were cut from the herd. Nor do I recall seeing my sister again until we were both home some days later. I do remember, however, being dressed by a nurse in a light, open hospital gown, of feeling a draft down my back, the odd sensation of nakedness patients have despite being clothed. I do not remember being embarrassed or frightened or even particularly bewildered. My main memories are of being wide-eyed, observant, never in danger, never threatened, or feeling close to harm.
The transition from changing room to induction room is a blank but my recollection of anesthesia induction is vivid in every sense, even now. It was as if I had been expertly conducted through a series of locks, like a ship about to cross from the Pacific to the Atlantic through the Panama Canal. Isolated, alone except for my attendants, all I could do was lay still on the gurney upon which I had been placed.
I was wheeled into, head first, a pale, green-tiled room, through a door at the far corner of the room. There was a window on the wall opposite but it was translucent only. No one could see in or out except God, I thought. My head made a leftward turn as the gurney was brought into position under a searchlight that had not yet been turned on. A white sheet covered me up to the neck. A snug strap was firm against my legs so I could not move. I lay at attention like a stiff soldier, arms and hands straight by my sides, still under the thin white sheet. I did not feel cold; nor did I shiver, cry, or writhe to free any part of myself from captivity. I do not remember anyone placing any monitoring equipment on me nor anyone trying to start an intravenous line at any time while I was still awake.
What I remember, though, was a sweet, warm pair of eyes set in a face covered by a white gauze surgical mask peering over and down at me from the upside of the gurney once it was in position. Deep into her eyes my eyes peered. Imprinted indelibly into my mind then were her two black pupils; her two irises of indeterminate color; and her two clean, white sclera, forever. I would have obeyed any flick of her eyes on the simple merit of their beauty; completed whatever silent command she beamed at me, followed to death’s edge her gaze on a simple nod, gone in whatever direction she asked, based solely on the kindness I found in them at that moment. Mesmerized as I was, when her equally sweet but soft and disembodied voice told me to start counting backward from 100, I could not resist. I was warm and felt love for her; I would have done whatever she told me to do.
As I began to count …100, 99, 98…a black conductive rubber mask cupped in her womanly small hand came gradually down on my face to cover my mouth and nose. By 97 I could taste the first pungent sickly-sweet tang of ether on my tongue, smell the indescribable in my nostrils. By 96, my lungs were full of the cloying thick gas; I breathed as if I’d inhaled a bit of strong toothpaste. My hearing soon became disengaged from recognizable sounds. I felt the room lift and fall away in a slow whirl from my bed and body simultaneously. By what should have been 95, I felt I was falling through that speeding swirl into the middle of a progression of widening circles, white into black, black into white. A chemically induced tintinnabulation built and burrowed into my ears. But I didn’t struggle or resist but compliantly accepted the inevitable sense of loss and disengagement from living the drug induced in my six year-old body.
Certain now there was no 94, the same hiss-full high pitched ringing that marked my lapse into general anesthesia also heralded my emergence but this time as a decrescendo. I woke, aware of myself again, in a cold high-barred hospital crib, retching, staring at the floor.
The rest of my recovery from ether and tonsillectomy remains a blur. The details of then revisited now are seen as by a swimmer swimming underwater, eyes wide-open, breath long held, head rising up only to breathe. There was the razorblade filleted throat; crying eyes that burned with unwanted tears; ears that roared with loud sounds; spasms of deep involuntary and unfamiliar retching that made breath impossible; and a deep unchildlike loneliness that made me curl in a ball in the crib with cold white metal bars, against which my head pressed and through which I could only see the hospital’s ubiquitous green floor. Where were the kind eyes, I wondered. How could they have betrayed me so easily, so beautifully?