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"Real Nightmare," the article about awareness under general anesthesia, contained exaggerations and misleading statements that serve no purpose other than to frighten people facing surgery.

Awareness under general anesthesia is rare. The article cites thousands of cases each year, but fails to mention that only a fraction of these cases are actually unexpected awareness, and fewer still are traumatic. We are very sympathetic to this small but important group of general anesthesia patients who might experience awareness.

The quote by Dr. Michael England that "anesthesiologists don't really want to acknowledge they have issues like that" is a grossly inaccurate portrayal of our profession. In addition to the training anesthesiologists have been receiving in residency programs for decades, the American Society of Anesthesiologists has been educating our members about this phenomenon for more than 10 years, and is devoting substantial resources to a task force examining this issue.

Furthermore, we encourage anesthesiologists to discuss any concerns patients have about awareness ahead of time, and to be available to talk to patients who may recall events surrounding their surgery when making rounds postoperatively.

Rather than sensationalizing highly unusual cases, it would be far more appropriate to celebrate the 90,000 uneventful anesthetic victories made possible every day by the modern advances of safe anesthesia practice.

Mark J. Lema, M.D.

First Vice President

American Society of Anesthesiologists