The movie "Awake" has just been released. It dramatises the rare phenomenon known as "awareness during anaesthesia", basically distorting facts and portraying certain situations in a totally untruthful manner. I've copied below a recent press statement from 'Ontario's Anesthesiologists' (anesthesiologists being the North American term for what the Brits/Aussies/Kiwis call anaesthetists). All the statements about standard of care equally apply when anaesthesia is administered by a trained professional in any country I'm familiar with.
Ontario's Anesthesiologists Criticize the Film Awake
TORONTO, Nov. 30 /CNW/ - Ontario's Anesthesiologists expressed their
disappointment in the movie Awake, which was released nationwide in Canada
today.
Dr. Stephen Brown, Chair of Ontario's Anesthesiologists, a section of the
Ontario Medical Association, criticized the film, stating, "The film highly
distorts the practice of anesthesiology and the condition known as anesthesia
awareness, in a manner that is irresponsible and that could jeopardize the
ability of medical professionals to properly treat patients in need of
anesthesia care."
Said Brown, "While we appreciate the fictional nature of the story, the
movie gets the science completely wrong. The greatest problem with this is the
effect it may have on patients, many of whom may become unnecessarily fearful
about necessary medical procedures. As doctors, we encourage patients to take
an active role in their care. I believe that this sort of misinformation will
impede patients in playing an educated role in their care."
Among the inaccuracies of the film, Ontario's Anesthesiologists noted:
<< - The film and its publicity materials indicate that anesthesia
awareness occurs to 1 out of every 700 patients undergoing general
anesthesia. The actual incidence of the condition is likely closer to
1 in 15,000 for routine surgeries. Further, the incidence of
anesthesia awareness is much rarer in the vast majority of cases, and
only approaches the 1 in 700 ratio if one considers very high risk
cases such as in some traditional cardiac anesthesia and trauma
surgery.
- The film indicates that anesthesia awareness is a condition in which
the patient is fully paralyzed and fully awake. This is not usually
true. While in the very rarest of cases this can occur, most forms of
anesthesia awareness involve a slight sense of awareness of the
surgical procedure, including possible memory of sound as well as a
general awareness that the surgery is taking place - but not an
experience of pain.
- The cardiac surgery conducted in the film was not conducted according
to standard modern anesthetic procedures. More modern procedures
lessen the incidence of anesthesia awareness and increase the ability
of the anesthesiologist to detect and remedy any possibility of
anesthesia awareness.
- The patient in the film (played by Hayden Christensen) was described
as "paralyzed", but was in fact only partially immobilized, as
evidenced by eye and facial movements These movements are indicators
to the practising anesthesiologist which allow the anesthesiologist
to detect the possibility of awareness.
- In the movie, anesthesia was apparently provided in a single, initial
dose. In reality, for a general anesthetic, the anesthesiologist
would administer an initial dose, but would continue to administer
anesthetic during the entirety of the procedure, and would monitor
the treatment throughout.
- The movie presented an anesthesiologist who was inattentive and
intoxicated. This would obviously not be an acceptable level of care
in Ontario hospitals.
- The pre-operative assessment of the patient in the movie was
completely missing. Ontario's Anesthesiologists conduct a thorough
interview with patients who are to undergo anesthesia. And, for
complex surgeries, such as cardiac surgery, the anesthesiologist
further assesses the patient at the time of surgery. This assessment
allows the anesthesiologist to determine whether the patient is
within a group that is at a higher risk for anesthesia awareness and
to properly determine the form and amount of anesthesia to be
provided. >>
Ontario's Anesthesiologists believe that patients and their families
should be involved in their treatment and should be well informed about their
medical options as well as any risks associated with treatment. However,
Ontario's Anesthesiologists are disappointed that the movie Awake has failed
to accurately portray anesthesia treatment and, as such, may have a negative
impact upon the proper treatment of patients.
