Book review—Anaesthesia: The Gift of Oblivion and the Mystery of Consciousness, by Kate Cole-Adams

Text Publishing, 2017, ISBN: 9781925498202

This is the book that I was planning to write, and the book that I could never have written. As an anaesthetist and a writer, I’m fascinated by the subject of consciousness and the concept of how anaesthetic agents work on the brain to alter it. I’ve even toyed with the idea of writing a book about it. However, I know that if I attempted to write such a book it would veer too close to becoming an impenetrable tome of academia. Perhaps I would be silenced by the fear of putting my profession offside. And, of course, years of training and experience have coloured my view of the subject and rendered me immune to the foreignness of the everyday business of anaesthesia. Simply speaking, I’m too close to the subject matter to really see it as others do, which is why I was so interested in reading this book when it was released earlier in the year

Kate Cole-Adams is a journalist and novelist and, as a layperson—albeit a very well-researched one—comes at the topic with fresh eyes and a very different perspective. The book is a detailed popular science investigation of how anaesthesia works to bring about unconsciousness and what happens when it doesn’t succeed, resulting in awareness. Indeed, the impetus for writing the story was apparently meeting a woman who was aware under anaesthesia for a caesarean section, a story which is both moving and horrifying. Yet, this is only a part of this meandering tale which is also a meditation on the meaning of consciousness, and a very personal and lyrical memoir of the author’s personal health, anxiety, family and her own experience of anaesthesia.

Cole-Adams has admitted that the book had a very long gestation period, and makes reference, at times, to editors’ suggestions to cut some sections which deviated from the central subject and towards the poetic for the sake of it: ruminations on her own dreams, for example, which appear from time to time and seem to have little bearing on the subject matter. For me, the book did seem to struggle to make a point at times. The scientist in me wanted a more linear path through the subject of consciousness and a clear conclusion, yet I knew that this would be virtually impossible. To wrangle a topic like this towards a firm conclusion would be like raking autumn leaves: as soon as you arrange them into a manageable pile, a gust of wind scatters them in every direction and you’re back to square one.

Overall, this book is a gorgeously written and thoughtful meditation on the science behind general anaesthesia, consciousness and awareness. When an excerpt was published in the Sydney Morning Herald, one of my medical colleagues expressed concern that this sort of article about awareness would raise anxiety in the community. He may have a point, but I’m a firm believer in knowledge being power. We clinicians need to respect patients’ intelligence and answer their concerns with empathy and evidence. Kate Cole-Adams’ writing is lyrical, personal and engaging, and if it raises community interest in the profession of anaesthesia, in my opinion it’s a good thing.