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Awake & Under the Knife!

Aired December 12, 2007 - 21:00   ET


LARRY KING, HOST: Tonight, the worst nightmare -- awake and aware on the operating table, but helpless to stop the surgeon's knife.

UNIDENTIFIED MALE: Come on, open your eyes. No, no, no, no, no, no, no, no, no!


KING: It's not just the plot of a Hollywood movie -- it's a real life horror story.


UNIDENTIFIED MALE: There was a pain which you deal with. UNIDENTIFIED FEMALE: You're screaming inside your head.


KING: Out, but not completely under.


UNIDENTIFIED FEMALE: It just hurt so bad.


KING: Those who survived the shattering ordeal relive their experiences next on


Good evening.

We'll be meeting other victims -- if they can be called that -- throughout the program. But our panel throughout will be Carol Weihrer, the president and founder of Anesthesia Awareness Campaign. The Web site is Her dedication to this cause, by the way, stems from traumatic personal experience during 1998 eye surgery.

Dr. Donald Matthews, M.D. Is anesthesiologist with St. Vincent's Medical Center in New York and a board member of the Anesthesia Awareness Campaign.

And, of course, the well known Sanjay Gupta. He's here with us in L.A., which it's nice to have him aboard, CNN's medical correspondent, practicing neurosurgeon and an assistant professor of neurosurgery.

What is anesthesia awareness -- Carol?

CAROL WEIHRER, WOKE UP DURING EYE REMOVAL SURGERY, FOUNDER, ANESTHESIA AWARENESS CAMPAIGN: Anesthesia awareness is the phenomenon of supposedly being under full general anesthesia, but for one reason or another, the anesthesia that puts your brain to sleep does not work.

KING: And what...

WEIHRER: The paralytic works.

KING: What, Dr. Matthews, does the campaign attempt to do?

DR. DON MATTHEWS, ANESTHESIOLOGIST, BOARD MEMBER, ANESTHESIA AWARENESS CAMPAIGN: The campaign attempts to educate caregivers about this phenomena and it also acts as a forum for people who have experienced this phenomena to have a place to reach out to, to get information.

KING: How phenomenal is it?

MATTHEWS: The incidence is a little controversial, but it's estimated to be one to two people per thousand have the ability at some point after their operation to remember something that occurred during that surgical time.

KING: That's what it means, just that you wake up and remember something during the surgery?

MATTHEWS: It's a spec...

KING: Not screaming?

MATTHEWS: Well, there's a spectrum of experience. It ranges from actually fairly mild -- remembering certain voices and certain things that are said -- all the way up to these horrific type things that -- like Carol experienced, where you have prolonged awareness of what's going on and an inability to stop it.

KING: Sanjay, you operate, do you not?


KING: Ever had this happen?

GUPTA: You know, not that I know of, you know?

But it's one of those things as a surgeon and I have not -- a patient hasn't come to me and said I remember something from the operation. But I don't know if that's something they told their anesthesiologist afterward. But I've never had a patient actually say I was awake or I remember any part of the operation.

KING: Have you have heard of a patient waking up in pain? GUPTA: Yes. I mean certainly patients might wake up in pain at the time that they're supposed to wake up. And instead, their pain control wasn't adequate at the time that they were actually being awakened from anesthesia. One of the anesthesiologists in our hospital, Dr. Peter Sebel, has told me anecdotal cases about patients actually being aware afterward and saying that they remembered certain things or they even had pain.

KING: But not screaming jumping up in the middle of a surgery, yelling, whoa!

GUPTA: Never heard that. And keep in mind, as well, Larry, as even in some of those images, people have a breathing tube in. So they're not able to speak or, you know...

KING: They...

GUPTA: ...or do anything like that that. It's all sort of more internal.

KING: Now, anesthesia awareness happened to our guest, Carol Weihrer, who is with us tonight. Her nightmare story was re-enacted on a Discovery Channel documentary, "When Anesthesia Fails".




UNIDENTIFIED MALE: On the day of Carol's surgery, she has nothing to fear. From a peaceful cocoon of unconsciousness, Carol is rudely awoken.


WEIHRER: Disco music.

UNIDENTIFIED MALE: The music is the accompaniment to her surgery and the soundtrack to her nightmare. The hypnotic drug has not put her to sleep. She is awake on the operating table.


KING: Good grief.

OK, tell us what happened, what...

WEIHRER: Larry, I was awake for everything but the induction dose to put the tube down my throat. I can tell you every word that was said. I was absolutely paralyzed. There was nothing I could do. My head was screaming -- wait, stop, I'm awake! My brain was thinking and praying and plotting and cursing and trying to figure out how they could stop this.

KING: Were you in pain?

WEIHRER: I was not in the cutting pain, but I received two doses of paralytic drug while I was conscious -- which is, in fact, so cruel and unusual, it's the basis of the lethal injection controversy.

KING: Are there lawsuits involved in this?

WEIHRER: We did sue, but we were given a judge who said this would never be believed by anybody and it would not be taken to court.

KING: How did it stop?

How come they didn't go right through with it if they couldn't hear your plea?

WEIHRER: They had no idea that I was awake.

KING: So why didn't they do the surgery?

WEIHRER: They did the surgery.

KING: They did it?

WEIHRER: Oh, yes.

KING: So you had pain, then?

WEIHRER: Oh, yes. I was awake through the thing. I didn't feel the scalpel cutting my eye, but I felt this burning go through me.

KING: Why not?

Why not feel the scalpel?

Did you ask later?

WEIHRER: I probably had a local injection in my eye. But the paralytic drug going through you is just excruciating. And they were pulling on the tube in my throat and saying it'll take an hour to fix.

KING: You're an anesthesiologist, Dr. Matthews.

MATTHEWS: That's right.

KING: What do you guess went wrong?

MATTHEWS: In Carol's case, I'm not sure. Probably what happened was that the vaporizer that delivered the anesthetic gas to Carol was empty or ran dry during the procedure and the caregiver didn't notice it in a timely fashion. That would be my guess. But, however, obviously, I wasn't there, so I can't be sure.

KING: Is there a way the anesthesiologist can check that everything is OK before anything starts?

MATTHEWS: Sure. We have a whole checklist -- just like on an airplane -- that we go through before we start a case. And with our due diligence, we check our equipment, we check our machine, we make sure everything is in place that we need and we do this on a routine basis for every patient that we care for.

KING: Has anything like this happened to you?

MATTHEWS: Again, like Dr. Gupta said, I don't know of any patient of mine to whom this has occurred. But I know, from a statistical point of view, there may well be somebody out there who -- what happens sometimes is people don't have recollection immediately following the surgery. Research in this area has shown for some patients, it doesn't come back to them immediately. It comes back a week later, two weeks later. And that's why researchers who do work in this area, like Dr. Sebel, do a series of structured interviews following anesthetics to try to figure out who has this recall.

KING: Sanjay, do you -- when you start surgery, do you have total faith in the anesthesiologist?

GUPTA: Yes. Yes, we do. We have conversations ahead of time. The patients are examined ahead of time. Every patient is different so, you know, what -- an anesthetic that might work for one patient might not work for another. Your weight comes into play. Your age comes into play, medications that you're taking, all these sorts of things they talk about, that even people with red hair need more anesthesia, for example. That's something a lot of people don't know.

KING: Really?

GUPTA: Yes. It's something about the way that the body metabolizes anesthesia. If you're red headed, you're going to need more anesthesia. So, but, you know, it's interesting, Larry, to your other question. When put someone to sleep, you're giving them paralytics -- as Carol was talking about. You're also giving them sedatives so that they're sleepy. And you're giving them pain medications. It's a real combination -- a real art of all of those three things. If one of those three things don't work -- as in Carol's case, the sedative sound like it didn't work -- her pain may have been under control, she was paralyzed, but she was having this complete awakeness.

KING: As we go to break, another story that's hard to believe, but it's true.



KELLY HAAPALA, WOKE UP DURING SURGERY: I was screaming inside -- stop, I'm awake! This can't happen. Stop! Stop!. And nobody is hearing me.

KEITH OPPENHEIM, CNN CORRESPONDENT (voice-over): Eventually, Kelly could move. She began flailing her arms and legs. HAAPALA: I was in such terror, I needed to let them know so badly that they needed to stop what they were doing. They just dove on me and started screaming at each other that I was awake and put her back under, put her back under.





UNIDENTIFIED MALE: For Jeanette Liska, a routine hernia operation in October 1990 became an unfolding nightmare. According to records, Jeanette Liska's vital signs were also stable, despite her torture.

JEANETTE LISKA, PATIENT: I just continued to scream, yell, cry, pray. But there was nowhere to go. I was buried alive inside myself. I was no longer anything except this brain that was still alert, awake and alive on the table.


KING: Joining us now is Angela DeLessio, who was aware during an emergency C-section two decades ago that she was not completely under anesthesia.

What was that -- what was it like?

ANGELA DELESSIO, WOKE UP DURING C-SECTION, FELT EVERYTHING: I wasn't under at all. I was paralyzed. But both the pain medication that you're given and sedative was not working. So I was completely aware.

KING: You felt pain?

DELESSIO: I felt severe pain. And I was completely conscious at the same time. So, much like Carol, I had no sensation. When I was intubated, I'd have no recollection of that. But immediately after, when they began the surgery, from the very first incision, I felt everything.

KING: Were you trying to scream?

DELESSIO: Oh, gosh, yes. Yes. You're screaming, you're yelling, you're trying to move, you're trying to let somebody know that something has gone wrong and that you're feeling this, but you can't do that.

KING: And the tube prevents them hearing you?

DELESSIO: It's not necessarily the tube. It's because you're paralyzed. I really had no sensation of the tube. I only had sensation of the operation itself. KING: And have you had surgery before?

DELESSIO: I did, earlier, when I was a teen. And, again, at that time, they had an awful hard time getting me to go to sleep. They had to give me a lot of extra anesthesia. I suppose they gave me enough at that time that I didn't feel it, but they did need to use extra.

KING: Did you tell that to the anesthesiologist?

DELESSIO: I didn't. I thought that that was just something that happened at that time. I didn't wake up during that procedure, so I figured everything would be OK this time. But it certainly wasn't.

KING: What kind of brain activity did you have?

DELESSIO: Complete. I was thinking as conscious as I am now, I was then. But you know...

KING: You heard everything, everything (INAUDIBLE)...

DELESSIO: I heard everything. Recounted exact conversation from the procedure to the surgeons afterwards.

KING: And this was an emergency operation?

DELESSIO: An emergency C-section, which I required. And I also -- then they were giving me general anesthesia because they wanted to do this quickly.

KING: Did you have brain awareness -- Carol?

WEIHRER: Yes, I did. I can tell you every word that was said. And as Angela said, it's not the tube that keeps you from screaming, it's the paralytic.

KING: Because?

WEIHRER: Because you can do nothing. You can't move a whereas, a toe, an eyelash, nothing.

KING: In other words, you're totally paralyzed?

WEIHRER: Absolutely.

KING: So shouldn't you be paralyzed from pain?

DELESSIO: Well, I guess the doctors would be able to answer that.

KING: I'll ask them in a minute. But why...

DELESSIO: I was not. And I know that for a fact afterwards, when I spoke to the anesthesiologist, the body, I guess, responds in a funny way. I was doing what they called bucking, where your body is moving on the table. And they think that was the response because I was so desperately trying to move. And at that point, they just administered more paralytic -- not more anesthetic. So I just couldn't move more.

KING: Had you ever heard of anesthesia awareness?

WEIHRER: I had never heard of it before that.

KING: Can you explain why there would be pain if you're paralyzed?

GUPTA: Well, I mean it's a -- the paralytics basically paralyze the muscle, so the muscles simply can't move. And that's important for operations. You don't want your patient moving...

KING: Not the nerves?

GUPTA: Not the nerves. The nerves are actually -- as far as pain goes, it actually is a pain medication. Like morphine, for example, would be a pain medication, whereas a different type of medication would actually prevent from you moving.

And as Carol said, it is -- it is sort of that worst, awful kind of torture almost, to paralyze somebody while they're completely awake. They can't breathe on their own. They can't move at all. They're paralyzed, but cognizant.

KING: Why did you choose this specialty, doctor?

MATTHEWS: I found it to be very interesting in medical school -- the physiology, the pharmacology.

KING: Helping people out.

MATTHEWS: Yes, no. The skills that we bring to take care of people are really quite breathtaking. And what we can do for people when it works well is really remarkable. We get people through these unbelievably large, complicated tricky surgeries. People come to us with unbelievably terrible medical problems that, a generation ago, wouldn't have even come to the operating room. But -- and the skills that my colleagues and I have can really do a lot of good when everything works the way it should work.

KING: Are you a surgical nurse?

DELESSIO: I had been. I had worked in the operating room. And at that time I had worked in the operating room. So one of the things...

KING: So you were a veteran of the operating room?

DELESSIO: Well, I was. At the time I'm -- you know, I was lying there, one of the conscious thoughts I was having was oh my gosh, this is what people actually go through when we operate on them -- they feel surgery.

And then I -- of course, my next thought was no, we would know that. You know, this has got to be something gone wrong. But it was one of the things I thought about and it made it very difficult afterward, when I went back into the operating room. Every time I watched an incision, it was very difficult for me, you know, to watch an operation. And I would have to look away at that first incision.

KING: Do you think about it, Dr. Gupta, when you're operating?

Do you ever think about it?

GUPTA: You know, I've learned a lot, actually, just from preparing for your show, actually. I hadn't really thought about it, I'll be honest with you. I mean I -- you know, we have an anesthesiology team that I work with which -- they're cognizant of this and they actually do someone where they measure someone's brain waves during the operation so that they can actually get a sense of someone if someone is actually truly asleep. They don't rely on the anesthesia alone. They look at this monitoring.

But I hadn't thought about it, really. I think most surgeons sort of do leave it up to the anesthesiologist.

KING: Carol, is the memory horrible?

WEIHRER: The memory is such that for 10 years now, I have not slept in a bed. I sleep for an hour and 15 minutes at a time on a good night. I have startle...

KING: You can't sleep in a bed?

WEIHRER: No, I sleep in a recliner. I can't lie flat like I was in surgery.

KING: Because it brings you back to the surgery?

WEIHRER: Post-Traumatic Stress Disorder and all of the various forms of that. And I've spoken with over 3,000 victims and it's the same story...

KING: Three thousand victims?

WEIHRER: ...again and again and again.

KING: Anesthesia awareness affects more than just a few people. As we go to break, here's another compelling case that makes you think twice about surgery.




UNIDENTIFIED MALE: In 1994, Judy needed an emergency caesarian section for the birth of her youngest son. Her general anesthetic was less than effective.

JUDY: You know, it was a loud clang. I don't know whether a dish was knocked onto the floor and in the process the doctor was making the incision to do the caesarian. I could feel the pain of being cut. It was quite a horrific pain.



KING: Some of our scenes may be rather graphic, but this is a very important topic.

By the way, I failed to ask you, Carol, what was your surgery for?

WEIHRER: The removal of my eye.

KING: To remove the eye?


KING: The right eye?


KING: The left eye is OK?

WEIHRER: No, I don't see much out of it.

KING: Todd Whitlock joins us now.

He was awake during hip replacement surgery.

Todd is from Kansas City.

He shares his anesthesia awareness horror story, but we have a short explanation of how anesthesia is given.

Dr. Matthews gave our crew a walk-through of the process.



MATTHEWS: So this is our patient simulator. And I'll demonstrate using the simulator how we approach a patient when we administer general anesthesia.

We hook up monitors to watch the patient closely. And then we administer oxygen through a face mask and we have the patient breathe deeply for a couple of minutes to fill their lungs with oxygen. And what that does is it gives us a little margin of safety when we induce general anesthesia. And once we're satisfied that there's enough oxygen present, then we give a series of drugs to cause the patient to become unconscious and ready for surgery.

And the first drug that we usually give is a drug that causes unconsciousness. And this is a drug called propaphal (ph) that's used all the time around the world for this task. And this is given into an intravenous line. And within 30, 45, 60 seconds, a patient becomes unconscious.

After a patient is unconscious, then we usually also administer a second type of drug, which is usually an opiod type drug. And what that does is acts to blunt the stimulation that we're about to invoke on the patient and also that the surgeon later causes the patient to experience.

And the third thing we usually administer is a drug that causes muscle relaxation or paralysis. Now, as anesthesiologists, we do this because what we do after we administer these drugs is secure the patient's airway. So once we have that airway secured, then we're done with what's called the induction of anesthesia. The patient is asleep. And now we move to a maintenance phase of anesthesia. And we do that by putting the patient on a ventilator, by turning on an anesthetic gas and by maintaining the patient's -- by keeping the patient alive, essentially, while the surgeon goes about their business.


KING: And we're now joined by Todd Whitlock -- awake during his hip replacement surgery.

What happened, Todd?

TODD WHITLOCK, AWAKE DURING HIS REPLACEMENT SURGERY, "WORST EXPERIENCE" EVER: June of '06 I went in for hip replacement surgery. I had had a problem with general anesthesia back in '82 when I got a kidney transplant. I was kind of pukey coming out of it. So I had asked the anesthesiologist to use a block rather than general anesthesia. And so they said that they were -- they were going to try to use the block, but if they were not successful with that, then they would have to put me under. So they tried using the block.

KING: And a block does what?

WHITLOCK: A block is just -- it blocks the nerves from the area where they're going to be operating.

KING: You're not out?

WHITLOCK: Yes. But -- no, I was not out. I was going to be very sleepy, but I would still be conscious.

KING: So what happened?

WHITLOCK: They could not get my leg to stop twitching using the block. And so they said that they were going to have to go ahead and use -- put me under.

KING: And did you remember things?

Did you experience pain?

WHITLOCK: After they put me under, the next thing I remember is a pain that -- well people have asked me to explain the pain and the way I put it is, they give you that one to 10 scale when you go in the hospital asking you what zero is the -- one is the least pain, 10 is the most pain you have ever felt. I tell people the pain I felt was off that scale. I was -- I was aware of the pain immediately. I could hear the surgeons talking. I could feel them digging in my leg.


WHITLOCK: And I was -- I could hear them talking and I was screaming in my head, as Carol has talked about. I was screaming in my head. I was trying to move my whereas, bat an eyelash, do anything I could to let them know that I was awake.

I could feel them basically moving the tissue around in my leg.

KING: Did they complete the surgery?

WHITLOCK: At that point, from what I'm being told, my vital signs hit the dumper. My breathing became irregular, my heart went into V- tach.

KING: And they stopped?

WHITLOCK: And no. What -- apparently what they did was they lessened the anesthesia medication in order to try to finish the surgery. But I believe my body was trying to tell them that I was awake.

KING: Did they finish?

WHITLOCK: No, they stopped. They stapled me together and put me into the recovery room. And when I was in the recovery room and I was finally able to open my eyes and to make, you know, to say something, I grabbed a nurse rather violently and told her that I was awake.

KING: Did you get to talk to the anesthesiologist?

WHITLOCK: No, in fact, I did not.

KING: Did you ask to speak to him?

WHITLOCK: Yes, I did...

KING: But he -- he didn't come?

WHITLOCK: ...and he was unavailable.

KING: How do you explain this, Dr. Matthews?

MATTHEWS: Again, it's difficult, in Todd's case, to know what occurred. What we do know is that there are certain situations where we have difficulty administering what you would consider a full dose of anesthetic to patients. People who have particularly bad heart function -- all of these drugs cause some depression of heart function. So if someone comes into our operating room with very bad heart function or someone who becomes very unstable during the surgery, which requires us to potentially turn the anesthetic down a little bit to maintain heart function, there's the potential that we're not giving quite enough of this unconsciousness producing drug to the patient.

KING: But, obviously, standing there at the operating table, they were unable to know what was happening to Todd?

MATTHEWS: Again, I wasn't there. I don't know, but...

KING: But, obviously, or they would have done something.


Listen, the ability to detect conscious from unconscious states is an imperfect practice.

KING: Really?

MATTHEWS: And that's the real issue here. Obviously, with -- the people here can testify to that.

KING: Let me get a break.

And when we come back, we'll hear from a woman who was out for most of her surgery, but woke up for a scary 15 minutes.

Don't go away.



ERIN COOKE: I was startled awake because I could feel the doctor cutting me open.

DAVID MATTINGLY, CNN CORRESPONDENT (voice-over): Erin Cooke (ph) went in to have an ovary removed in March. She emerged with vivid memories of searing pain -- feeling trapped in her body, unable to move or speak. The experience left the young mother psychologically scarred and in need of therapy.

COOKE: I just kept praying, God, please, just knock me out. Just knock me out. Let somebody know that this hurts so bad.



KING: Welcome back. Are you afraid of anesthesia? That's the quick vote right now on our Web site, Head there now and vote and you can check out the results.

Joining us now in Sag Harbor, New York is Erin Cook. She was awake and aware during part of a three-hour surgery to remove an ovarian tumor. What happened, Erin?

ERIN COOK, AWAKE DURING OPERATION: On March 15th, I went in to remove the tumor that was on my ovary, and they also removed my whole ovary. And I remember going to sleep, which I now know was just temporarily to be intubated. And the next thing I remember is waking up to my doctor slicing me open. And I thought for a moment, I know this isn't happening to me. This doesn't happen to people. And then the pain just continued and I thought, this is really happening. And I need to do something to let them know you're awake.

KING: Did it feel like a knife cutting you?

COOK: Oh, yes. It was a knife -- it was just a burning sensation. It was as if I had just was laid out on a table, strapped down and somebody just cut me open.

KING: What were you thinking?

COOK: I was thinking, I need to tell somebody I'm awake. This is hurting me terribly. And so I tried to do sign language. I tried to sign the word help. So I lifted both hands to do so and I thought oh, they are strapped down - and not realizing at the time that my body would be fully paralyzed. It makes sense now to me that I would be. But at the time I didn't realize I was paralyzed so I was trying to move my fingers and spell the word "help," over and over and I thought my fingers are not moving either.

And at this time I thought something else has gone wrong. I can't move anything. So I thought, OK, let me just try to stop breathing and some type of buzzer or bell would go off and they will know I'm awake. But then I tried to stop breathing and, obviously, the machine took over for me and I didn't get a buzzer or bell or whistle to go off. And I thought OK, they are going see my blood pressure, my heart rate, something. My heart was just jumping out of my chest at that time. And nobody saw, and I could hear their voices. And their demeanor was not as if something were wrong, and all I did was pray to God, you need to do something to knock me out and to let me tell these people that I'm awake.

KING: So how did you get out of it?

COOK: I remember about 15 minutes to 20 minutes just praying and screaming, trying to move and all of a sudden, bam, I was in recovery. And I heard the nurse wake me up and I immediately, first thing I said, was I was awake during surgery and she just couldn't believe it.

KING: Boy oh, boy. Has this affected you psychologically since?

COOK: Oh, definitely. After this happened, I had a lot of people at my bedside asking, documenting my case. They said, you know, it must have been your body adversely reacting to the anesthesia. And it wasn't until two months later that I found out they actually knew that the vaporizer was leaking during my surgery. I was told I was getting about 5 percent of what I should have been getting. So for two months I slept for about 15 minutes at a time. It wasn't until I called them to see where I could send the counseling bill that they had told me they had found out what happened.

KING: Is it true you had surgery since? COOK: Yes, sir, I had surgery in October to repair some damage done during childbirth, and I was - I asked them to be awake, obviously, on purpose, with a spinal anesthetic. And they were very accommodating, thank goodness.

KING: Thank you so much, Erin. Thank you for joining us.

We have an e-mail question from Brenda in Austin, Texas: "Has the unbearable pain of conscious surgery affected your tolerance of pain now?"


WHITLOCK: Well I -- I have been on dialysis for 28 years so I kind of developed a high pain threshold just dealing with that from day to day. But the pain that -- the pain that you deal with when you go through this, it's words like unbearable or horrendous. They just don't fit -- there's no vocabulary for what you go through.

KING: No. Angela?

DELESSIO: Absolutely. I think that the same mechanism that doesn't work as far as how I metabolize anesthesia is the same for how I metabolize pain medication. It also does not work the way that it does for most people. They usually need to use a lot more. But, yeah, I think it does affect it.

KING: Carol?

WEIHRER: Larry, I don't fear anything. I have been to hell and back. There's nothing I fear anymore.

KING: Nothing you fear?

WEIHRER: Nothing I fear anymore.

KING: You don't fear pain?

WEIHRER: I don't fear anything because I have had the worst that can possibly happen to a human being.

KING: That's some state to be in. How many people have you counseled with regard to awareness, anesthesia awareness?

WEIHRER: I'm not a counselor, a doctor, a psychiatrist or anything. I'm merely a patient advocate. I have spoke personally with over 3,000 people for an hour or two at a time the first call. I have sent out over 10,000 packets.

KING: I have a cousin, Dr. Mathews, who had valve replacement surgery and he said he had a local anesthesia and he heard everything going on the whole way. Is that possible that would you have a local anesthesia in valve surgery or is this a misconception?

MATHEWS: Perhaps he misunderstood the situation. On the other hand, cardiologists can do a lot of non-invasive valve work with their catheters and things that are done with sedation. So it's possible he had valve procedures done by a cardiologist --

KING: Not a complete valve replacement.

MATHEWS: A complete valve replacement, you would need to have general anesthesia.

KING: We will take a break and be back with more. We will include your phone calls. Don't go away.


UNIDENTIFIED MALE: As their patients descend into unconsciousness, anesthesiologists must balance two competing risks -- hypnotic drugs to press cardiovascular function too deep, and they risk prolonged recovery or even heart failure. But too light a dose, and a patient could recover consciousness.



KING: With Carol Weihrer, Dr. Donald Mathews, Dr. Sanjay Gupta, Angela Delessio and Todd Whitlock. We are talking about tragedy and near tragedy in the operating room.

Did any of you, did you, Angela, have to seek counseling after this?

DELESSIO: I didn't. This was 20 years ago. Most of the medical professionals I spoke to about this really didn't believe it happened at all.

KING: Did they deny it?

DELESSIO: They didn't deny it. They said that I was either dreaming, I imagined it, I had an overactive brain. They really didn't believe. In all honestly, how can a medical professional want to believe this? Because they do this every day. So how could they want to imagine their patients feel it?

KING: Would that be your reaction, Sanjay, I don't believe it?

GUPTA: I don't think that I would say I don't believe it, but it would be hard for me to accept it, I guess, that a patient was awake while I was performing neurosurgery on them.

DELESSIO: Once they did believe me, once I expressed to them the words that were said in the operating room, the actual occurrences that happened, they certainly did believe it. But they were shocked. They made me really believe that I was a one in a million case, that this never happens.

KING: Did you need counseling, Carol?

WEIHRER: Yes, I did, for many years.

KING: Did it help?


KING: It did not help. Did you, Todd?

WHITLOCK: No. I consider myself a strong man of faith and I basically have been letting the lord take it through prayer.

KING: Adelanto, California. Hello?



CALLER: I had a similar experience 27 years ago with a C- section, emergency C-section, but I had a spinal. So I was able to tell the doctors that I could feel everything that was going on so they stopped surgery immediately and put a mask over my face.

My question is, though, how do you get a doctor to believe you later on in life that you had such a high resistance to medications? Because I have neuropathy now and I'm having a difficult time explaining this to the doctors, that I don't respond in the average way.

KING: Dr. Mathews?

MATHEWS: Well as part of our preoperative discussion with a patient, we talk about things like this, previous experiences with surgery, previous experiences with anesthetics and we try to tease out the people who may be a little resistant or who may need a little more than the average person through their history.

Also through what else they might be consuming, alcohol, drugs. We try to find in our head where these patients may sit in the spectrum of humanity in terms of anesthetic requirements.

KING: Sanjay?

GUPTA: Every patient is very different. In her case, she obviously had this experience. I think most doctors actually would listen to that. I obviously can't speak for her own doctors, but I think most doctors take that as part of the history and physical. Every patient has got to be individualized.

KING: You would think they would have a fear.

GUPTA: Absolutely. And that fear alone can sometimes keep people from seeking out treatment that they need because they don't want to go back to the operating room or get care. But all of my patients will see the anesthesiologist before surgery, unless it's an emergency.

KING: You see them usually the day before, right, the night before? GUOTA: Night before. Sometimes if I'm in the clinic, I see a patient for an outpatient type thing, I will send them to the anesthesiologist a week beforehand so they really can get a chance.

KING: And how much time should an anesthesiologist spend with a patient, Dr. Mathews?

MATHEWS: It depends on the patient's medical difficulties, history. A young, healthy person coming for a fairly routine operation, the visit can be relatively short because there's really not that much to talk about. Someone who is sick, lots of medical problems, lots to go over, a long exam can take 10, 15, 20 minutes, sometimes even longer to really go through the records and think about what you're going to do.

KING: What a situation. What a revolting development, as someone used to say. You're watching LARRY KING LIVE. Anderson Cooper will be with us at the top of the hour with "A.C. 360." Anderson, what's up tonight?

ANDERSON COOPER, CNN ANCHOR: Hey Larry, thanks very much. It was their last chance to debate before the Iowa caucuses. The Republicans squaring off one more time, throwing around a lot of fingers. Were they factual, however? We are keeping them honest tonight.

Also, we will tell you if Mike Huckabee continued to impress or is there now someone else who is creeping into the lead?

We'll also tell you about a surprise turnaround on the Democratic side. The race is now wide open, completely unpredictable.

Plus, Drew Peterson under suspicion for killing his wife Stacy makes a surprising move. And we'll talk exclusively to Stacy's sister. She says she knows who is responsible for her sister's disappearance.

All of that and more, Larry, at the top of the hour on "360."

KING: Wow, important viewing tonight on Anderson Cooper, "A.C. 360," 10:00 Eastern, 7:00 Pacific. Thanks, Anderson.

Hollywood, by the way, has a take on our topic tonight. As we go to break, here's how the popular show "Nip/Tuck" worked it into a story line.


UNIDENTIFIED FEMALE: My toes are cold. I can feel them. When does the anesthesia kick in? Wait, wait a minute! That burns! ``


KING: We had an e-mail question from Linda in Hatboro, Pennsylvania, that might lead right into the next question. She says: "Is it possible to have your reaction to anesthesia tested before you undergo surgery?" What, Dr. Mathews, is a BIS monitor?

MATHEWS: A BIS monitor is one of several different brain wave monitors that are available in the operating room now to anesthesiologists. What it does is it takes the complications from anesthetic and brains and gives us a number from zero to 100 which is related to how much us how much anesthetic is in that particular patient's brain. And what's been show, is that by titrating to mid- range number during surgery, we actually give a little less anesthesia to the average person.

KING: You put something on their head?

MATHEWS: It's a series of electrodes that gets stuck to the patient's heads, it's very easy to apply. And it also has been demonstrated to decrease the incidence of awareness in a couple of studies. At St. Vincents in Manhattan, we brought them in eight years ago and put them in all of our operating rooms.

KING: You use them routinely?

MATHEWS: We use them every day.

KING: Have you had it, Carol?

WEIHRER: No, and I believe that they should be a standard of care.

KING: Have you had it, Angela?

DELESSIO: I have. I had a subsequent operation two years ago doing this because Dr. Mathews informed me of this technology and I had no incident whatsoever.

KING: You had it, Todd?

WHITLOCK: No. The hospital I had that had my surgery had them but didn't use them.

KING: Unbelievable. That's a BIS monitor?


KING: You use them, Sanjay?

GUPTA: We do use them.

KING: Why doesn't everybody use them?

GUPTA: It's interesting. Dr. Mathews and I were talking about this on the break. Even the America Society of Anesthesiology Web site, they said that it doesn't always provide benefit to every patient. I mean still, the most important barometer.

KING: Is there a downside to it?

GUPTA: No, just cost, probably. I don't know how much it costs. WEIHRER: $4,000, not very much.

GUPTA: $4,000.

MATHEWS: It's a controversial area in our field.

KING: Because?

MATHEWS: Because it's relatively new technology. There are people like myself who have adopted it and use it. There are other people who have used it and don't see patient benefit when they take care of patients and that's fair enough. And there are some people who have not had the chance in their practice to really use the monitoring to see what they think about the care of patients.

KING: By the way, we mentioned earlier, Hollywood has made use of anesthesia awareness as a plot element. The recent film "Awake" gets inside the head of a terrified heart patient. Watch.


UNIDENTIFIED MALE: Wait, wait, wait. Something is wrong. Give me -- wait. I can feel that. Don't tell me that. I can still hear you. I'm still awake.


UNIDENTIFIED MALE: Do something, do something, please! Move a finger. Come on, open your eyes! No, no, no, no, no, no, no!


KING: You saw that film twice, Carol?

WEIHRER: Yes, several days apart. Once was a private showing, once was the premiere. In seven days, I repressed one third of that movie in my mind because it was so terrifying.

KING: We will be back with our remaining moments on this terrifying topic right after this.


KING: We were discussing how rare this is. Todd Whitlock had a good line, said "it may be rare but once is too many if it occurs to you, it isn't rare." But it is an unusual occurrence, right, Dr. Mathews?


KING: To have occur on an operating table.

MATHEWS: This is extremely rare. Most patients, obviously, are going to come from surgery and get through from one end to the other without having any incident.

KING: Is the industry working on it?

MATHEWS: Both the industry and our scientific community is working on this, trying to understand exactly what the mechanism of this -- whether there's some genetic component, which there seems to be. Some people seem to be a little more resistant to the memory- scrambling parts of anesthetics. So we are learning more every year about more and more information about this topic.

KING: Can you take something back from Atlanta with you from tonight?

GUPTA: I think hearing these sorts of stories, certainly, you can't help think, I had surgery, as you know, Larry, not that long ago on my hand. I had an operation and they put me to sleep and gave me medications to make me forget everything and it worked.

KING: You trusted them?

GUPTA: I did. I trusted them. And we had a long conversation ahead of time. But yeah, I think it's something that I will certainly be talking about with our anesthesiology team.

KING: Carol, do you think you will see it end?

WEIHRER: If I have anything to say about it, we will. I would like to hear from people to whom this has happened.

KING: They can do that at anesthesia awareness -- all one word.

WEIHRER: dotcom.

KING: You want to hear from people from questions.

WEIHRER: And we are also working with researchers about this.

KING: You do not seem confident, Todd? I gather that.

WHITLOCK: No, I don't. I don't have too much trust in anesthesiologists. In fact, I have actually switched hospitals in Kansas City because I found a hospital in Kansas City where the BIS monitors are used for every surgery.

KING: And you think they should be?

WHITLOCK: Yes, they should be used for every surgery, even if they are not 100 percent efficient. A little bit is better than nothing.

KING: They don't kill you, right? They don't bring pain?

MATHEWS: No, they don't kill you.

KING: Are you fairly confident, Angela?

DELESSIO: I'm a little more confident. I'm glad now we have the awareness, although the movie is uncomfortable for me to watch. I'm certainly glad that it has brought to light some of the new technology that is available. I just hope it's used more consistently, as well as the research. I'm very, very hopeful that that will lead to more discovery.

KING: It is not the highest paid field, is it, Dr. Mathews?

MATHEWS: No, I think neurosurgeons do a little better than we do, actually. We do OK, we do OK.

KING: You don't have private patients, though?

MATHEWS: No. We take who comes in our door and that's part of the issue. They don't really know us. We have to get to know them in a short period of time, establish trust and take very good care of our patients.

KING: It's a good idea to get to know your anesthesiologist a little?

GUPTA: Yes, absolutely. You know but the tag line for this movie that you've been showing was, this movie will do for the operating room what "Jaws" did for the ocean. That might be a little bit over the top, Larry, you don't want to scare people aware from the O.R.

KING: Thank you all very much, Carol Weihrer, Dr. Donald Mathews, Dr. Sanjay Gupta, Angela Delessio and Todd Whitlock.

A music legend died today. Ike Turner was 76. He had quite a life. He wrote was believed to be the first rock 'n' roll song, "Rocket 88." He made more history when he teamed with his wife, an incredible pairing that was as productive as it was violent. Here is Tina Turner talking about Ike on our show.


KING: What was Tina's break?

TINA TURNER, SINGER: Well, actually, isn't in Memphis, it was in St. Louis, Missouri, because that's where Ike was. That's where he lived in East St. Louis.

KING: You met him there?

TURNER: Yeah, I went to live with my mother after my grandmother passed and my sister was old enough to go to clubs and so I went along with her. And I heard Ike Turner for the first time, I saw Ike Turner for the first time. And I really wanted to sing with him for a long time. But I didn't look the part.

KING: You were a fan?

TURNER: Yes, I was a fan. Well I became a fan after seeing his show and a great musician. They really rocked the house. It was incredible. (END VIDEO CLIP)

KING: Ike had drug and alcohol problems, served jail time, but he died peacefully at his home in California.

And we're excited about a new member of the Larry King family. Cameron McManus, here he is. He's the just born son of one of our producers, Eleanor and her husband Mike. We wish them all the best. Welcome to the world, Cameron.

As always, head to our Web site, You can e- mail upcoming guests, send them a video e-mail, or download our Podcast. It's all at

T.V. judges give us their verdict on all the day's hot legal cases, but right now "A.C. 360" with Anderson Cooper. Anderson?