Three weeks ago, Bob Dick toughed his way through a 90-minute total knee replacement without the aid of anesthesia, choosing to stay awake through the chisel and the buzz of the electric saw.
When he reached Duke University Hospital, he started breathing deeply, a signal for his body to relax. Next he held his thumb and forefinger together, imagining a walk around the pond at his Chatham County home. Then he told himself, “Now it’s safe to go into a comfortable learning trance.”
So began Dick’s surgery by hypnosis, which he describes as being so trouble-free that he hardly realized it happened. He had nerve-blockers reducing the pain throughout the surgery, but his deep relaxation techniques made “going under” unnecessary.
“It’s the closest thing to magic I know,” said Dick, a 72-year-old psychologist. “I knew it was there. I just wasn’t paying attention to it.”
Dick’s self-administered treatment is a rare but increasingly common alternative to general anesthesia, in which a patient is made unconscious through inhaled gases and intravenous drugs.
In 1957, Dr. William Saul Kroger demonstrated hypnosis on a breast cancer patient in New York, gaining notice in Time magazine.
In 2006, British television broadcast a patient having hernia surgery without any drugs, lulled into his inner peace.
In April, Guinean singer Alama Kante sang her way through throat surgery to keep doctors from damaging her vocal chords – a feat aided by hypnosis.
While anesthesia is widely considered safe, it carries the small risk of stroke, heart attack and death, especially in older adults or those with a serious medical history, according to the Mayo Clinic.
With this in mind, and knowing that anesthesia can mean a longer time in the hospital and in recovery, Dick decided to try the method he’s long employed in his own practice.
“And I wanted to show off a little,” he said.
The key comes from understanding what hypnosis is and isn’t. Popular culture typically portrays the procedure being conducted as the patient watches a metronome or a watch, listening to a heavily accented doctor chant, “You are getting sleepy ...”
But to Dick, hypnosis is something practiced every day. A person engrossed in a movie or book is actually in a sort of trance. Someone meditating, praying or “zoning out” at work is using the same techniques that go into hypnosis.
As a young psychologist in the early 1970s, he studied for a week in Arizona with Milton Erickson, a psychiatrist who specialized in medical hypnosis. Rather than instructing patients with a direct order, Erickson would offer suggestions, much like Dick’s own: “Now it’s safe to go into a comfortable learning trance.”
In his own practice, he refers to it as an altered state of consciousness, an intense form of concentration that can change what the mind perceives. Also, he stresses that a patient can’t be forced into a trance, only willingly led.
“I don’t hypnotize people,” Dick said. “I can’t. I can’t hypnotize anybody but myself.”
He tried it during a colonoscopy, which didn’t work as well because the doctor asked him if it hurt, which focused his mind on the pain.
But hypnosis worked well for the cataract surgeries on both eyes, in which he was able to focus deeply enough to avoid seeing the knife.
But knee replacement took longer, and Dick practiced for two weeks ahead of the procedure, 30 to 45 minutes at a time. He also watched a YouTube video showing the operation, so he knew what noises to expect.
With surgery, “The anxiety is just as bad as physical pain,” Dick said. “I didn’t even know they’d started.”
Three weeks afterward, Dick had shed both walker and cane, recovering quickly. He hopes to be driving in a week and back to his semi-retired practice, encouraging his clients to relax.