For years, anesthesia awareness has been shrouded in mystery. Although extreme experiences like Donna’s are rare, there is now evidence that around 5 per cent of people may wake up on the operating table – and possibly many more.

By David Robson

It can be the smallest event that triggers Donna Penner’s traumatic memories of an operation from more than ten years ago.

One day, for instance, she was waiting in the car as her daughter ran an errand, and realized that she was trapped inside. What might once have been a frustrating inconvenience sent her into a panic attack. “I started screaming. I was flailing my arms, I was crying,” she says. “It just left me so shaken.”

Even the wrong clothing can make her anxiety worse. “Anything that’s tight around my neck is out of the question because it makes me feel like I’m suffocating,” says Donna, a 55-year-old from Altona in Manitoba, Canada.

Donna would not be like this if it were not for a small medical procedure that she had before her 45th birthday. She was working in the accountancy department of a local trucking company and had just celebrated the wedding of one of her daughters. But she had been having severe bleeding and pain during her period, and her family physician had suggested that they investigate the causes with exploratory surgery.

It should have been a routine procedure, but, for reasons that are far from clear, the general anesthetic failed. Rather than lying in peaceful oblivion, she woke up just before the surgeon made the first cut into her abdomen. With her body still paralyzed by the anesthetic drugs, she was unable to signal that anything was wrong.

So she remained frozen and helpless on the operating table as the surgeon probed her body, while she experienced indescribable agony. “I thought, ‘This is it, this is how I’m going to die, right here on the table, and my family will never know what my last few hours were like because no one’s even noticing what’s going on.’”

The lingering trauma can resurface with the slightest trigger, and still causes her to have “two or three nightmares each night”. Having been put on medical leave from her job, she has lost her independence. She suspects that she will never fully escape the effects of that day more than a decade ago. “It’s a life sentence.”

Donna tells me about her own experience, during a lengthy telephone conversation from her home in Canada.

She says that she had felt anxious in the run-up to the operation, but she had had general anesthetic before without any serious problems. She was wheeled into the operating theatre, placed on the operating table, and received the first dose of anesthesia. She soon drifted off to sleep, thinking, “Here I go.”

When she woke up, she could hear the nurses buzzing around the table, and she felt someone scrubbing at her abdomen – but she assumed that the operation was over and they were just clearing up. “I was thinking, ‘Oh boy, you were anxious for no reason.’” It was only once she heard the surgeon asking the nurse for a scalpel that the truth suddenly dawned on her: the operation wasn’t over. It hadn’t even begun.

The next thing she knew, she felt the blade of his knife against her belly as he made his first incision, leading to excruciating pain. She tried to sit up and to speak – but thanks to a neuromuscular blocker, her body was paralyzed. “I felt so… so powerless. There was just nothing I could do. I couldn’t move, couldn’t scream, couldn’t open my eyes,” she says. “I tried to cry just to get tears rolling down my cheeks, thinking that they would notice that and notice that something was going on. But I couldn’t make tears.”

The frustration was immense. “It felt like someone was sitting on me and holding me down and there was absolutely nothing I could do.”

Eventually, she tried to focus all her attention on moving one foot, which she managed to wiggle very slightly – and felt astonishing relief when one of the nurses placed his hand over it. Before she could move it again, however, the nurse had let go. She tried a total of three times, all with the same result. “It was very frustrating for me knowing that was the only way to communicate and it wasn’t working.”

I felt so… so powerless. There was just nothing I could do. I couldn’t move, couldn’t scream, couldn’t open my eyes.

Donna’s torment should have finished after the surgeon had ended his work. But as the neuromuscular blockers began to wear off, she started to move her tongue around the tube stuck down her throat; it was a way, she thought, of signalling to the staff that she was awake.

Unfortunately, the staff misread her attempts at communication, and began to withdraw the tube prematurely, before the paralytic agent had faded enough for her lungs to be able to operate on their own. “So here I was lying on the table and he took away my life support, my oxygen, I could not take a breath,” Donna says. She assumed she would die.

At this point, the operating room began to feel more distant, as she felt her mind escape in an out-of-body experience. A committed Christian, she says she felt the presence of God with her. It was only after the staff restored her oxygen supply that she drifted back into the operating room, to wake, crying.

That pain, the fear, the sense of absolute helplessness all still linger to this day – feelings of trauma that have led her to be put on medical leave from her job. And that has meant a loss of independence and confidence, and the abandonment of many of the hopes and dreams that she had built with her husband. “It’s hard to sit at home here and watch all the neighbours hurrying out of their house in the morning, jump in their cars, and go off to work, and I can’t.”

Having gained strength in the years following the trauma, Donna is now trying to remedy the problem, by working with Canadian universities to educate doctors about the risks of anesthesia awareness and the best ways to treat patients. “I want them to be prepared, because when things go wrong you need to know how you are going to react to the patient, because that is crucial to the patient’s recovery process.”

This is an excerpt quoting Donna Penner’s traumatic memories from the article first appeared on Mosaic and is republished here under a Creative Commons licence.

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