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After simple dental surgery, a man lost his ability to form new memories (bbc.com)
333 points by smoyer 61 days ago | hide | past | favorite | 189 comments

I ended up on a several hour car ride with an anesthesiologist, he mentioned that Dentists are often grandfathered in, and often end up doing serious procedures without an anesthesiologist involved. So while they are focusing on the procedure heart rate, breathing rate, O2, etc aren't monitored nearly enough.

Apparently getting panicked calls from dentists was not unusual. In one particular case a 18 year old woman wouldn't wake up, he helped as much as he could, but she was never the same.

Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved.

Which is why a dentist in Germany can give you only a local anesthesia (i.e. you loose feeling in your mouth area but nothing more).

If you need a full anesthesia you need to go to a dentist clinic which has a anesthesiologist.

Or at last that's is the idea, in practice things might not always be that clean cut.

This story took place in Germany.

But probably on the British military base, with military dentists.

Also it says the patient only had local anesthesia, not general.

Yes, but 15 years ago. I suspect parent comment means that is how currently things are done

Well, I'd say monitoring is the minor issue in such cases. The real issue is that when something happens, and something will happen someday over the duration of a career, anesthesiologists are basically the only ones who can really help. Unfortunately, you have to pay for anesthesia and they will want to do things their way so that's very annoying for other specialists.

So I guess what might be going on here, is partial brain tissue death from lack of oxygen, or something like that? Holy fuck.

Yeah, after reading this I'll never go under without an anesthesiologist.

They used local not general.

Interesting fact, locals are sometimes not effective. One case is when there's an infection, somehow the bacteria can interfere with dental anesthetic. I learned this during a root canal. The driller gave a little more local, apologized, and said we needed to keep going to get relief. Not pleasant.

It's not due to the infection itself. Locals are less efficient in acidic environments (such as infected/poorly oxygenated tissue) and if they can't reach the target nerves (such as when one injects in an abcess).

One way to improve this is to mix with a base to increase the pH.

I had a root canal once, and the dentist couldn't get me numb enough. He filled things back in and referred me to a specialist. The specialist cut open the top of the tooth and stuck a needle directly into each root of the tooth... that got me numb. It was a completely painless experience.

Local does nothing for me. Everything feels like an incredible electric shock when dental work is done. I now pay several thousand dollars extra for every damn procedure because my dentist is also an anesthesiologist.

Wait she completely passed out with long term damage from a local anesthesia?

This is not true in the United States.

I work almost exclusively with dentists, many of whom offer general anesthesia in their offices.

> Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved.

An anesthesiologist says anesthesiologists are indispensable? How shocking. There are plenty of horror stories when anesthesiologists are involved as well. The moral of the story is whenever possible, try and not to be put under.

Sure, but if you need it, stack the odds in your favor by having an expert involved.

Not indispensable. They just are the only ones who can react efficiently in case of problem. The complications linked to anesthesia itself are another matter.

Theoretically it’s possible for a dentist to have the exact same knowledge as an anesthesiologist though.

It’s like when people assume I don’t know anything about databases because I’m currently classified as front-end developer.

In medicine, experience is everything. Theoretical knowledge is good to have, but it won't save you in a crisis. It's like asking of Joe Schmoe to make furniture better than a carpenter without having access to either the tools or the timber to train.

Anesthesiologists are the ones who practice the skills most closely related to crisis situations in their everyday job. They will on average do massively better than anyone else, just because they're used to it.

Modern medicine, especially interventional, is still more a practical skill than it is science. You can't "know it better theoretically". If I had surgery and something happened, I'd trade an anesthesiologist or CRNA vs. Pretty much any other specialist anyday (except some ER/ICU guys, but not all of them by far).

Knowledge and experience, however, are two different things. If something goes terribly south, I'd rather have someone managing that who does it daily.

> If something goes terribly south, I'd rather have someone managing that who does it daily.

This depends heavily on what "it" refers to. If something goes terribly south, I really don't want to be handled by an anesthesiologist who handles terrible anesthesia-related screwups every day. He's almost certainly causing those screwups.

And if someone hires you to migrate their database and ends up losing data in the process, they deserve what they get.

A perfectly migrated database?

Is everyone really missing the point?

It's a funny effect of lacking experience. The less you've seen, the less you think there is to see. Having been told nothing about this database except the fact that you are to migrate it, you immediately assume that you can do it perfectly.

Is it Postgres? SQL Server 2012? Mongo? Oracle? Sybase???

Is it one DB or a cluster? Is it replicating, and by what methodology? How much downtime is acceptable, if any?

That's a pretty limited set of possibilities because, you see, I'm also not a database expert. Maybe you think you can handle all of those situations, but I know I can't. So yeah, one of us is definitely missing the point.

Not to mention, what if things don't go according to plan! Have you ever even dealt with a situation where you have unreconciled data?! The more I think about it, the angrier I get about your insouciant ignorance!

But it's ok, at least I'm not the one hypothetically dealing with a database migration gone totally fucked :)

What's your point, then? It seems you're supporting the idea that someone having knowledge and practicing once in a career can be better than someone practicing every day.

Possible, yes, but hard for a patient to tell.

But keep in mind even if they both have the same knowledge, when a dentist is concentrating on the procedure, handling any surprises, bleeding, and other difficulties they might well not notice that your breathing rate or heart rate have gone too low, or too high.

That’s also true. I’m inclined to believe a seperate anesthesiologist is a lot better for a host of reasons not necessarily related to experience.

Theoretically they could have the same knowledge as a rocket engineer but that doesn't mean I would trust something they designed. Specialties exist for a reason.

To me, the most disturbing part of this story came at the very end, where it says that he has just relearned, for the thousandth time, that his children are now in their late teens and early 20s -- whereas his last memory of them was as little kids.

If that were me, and I were just informed that my own little children had essentially disappeared, I would likely go catatonic. I mean, in a sense, even though they're still present as young adults, it's as if your children have died. I don't know how a person could cope with being told that even once, much less a thousand times.

I find raising kids to be this constant low-grade form of grief. They change so fast that I am always noting the passing of the little person they used to be, replaced by the similar but slightly different person they are now. I've grieved the passing of their infancy, toddler years, and now most of their early childhood.

Sometimes I ache with the desire to go back and time to visit those past selves, to cradle them as babies or hear their goofy mispronunciations one more time.

I cannot fathom the pain of having to experience all of that grieving in fast forward, every day.

While I can definitely relate to this feeling, at the same time there is constant exhileration because I get to go through all of the stages of childhood again (this time as an adult, but really, I’m just as excited as he is about his first day in kindergarden).

> Sometimes I ache with the desire to go back and time to visit those past selves, to cradle them as babies or hear their goofy mispronunciations one more time.

Yes, I understand the feeling. You will get that chance when you have grandchildren!

I never understood why grandparents were so into their grandkids until my kids started getting older. Then it clicked.

In many ways, parenting is like a video game where you only get to play each level exactly once before you're dragged to the next one. As soon as you master one stage of your kids' development they've outgrown it and you're back to fumbling your way through unexplored territory again.

Having the chance to play "Human: Level 1" again sounds pretty amazing. Not to mention getting to hold and snuggle a baby again. Babies are amazing, especially when you only have to take care of them part-time.

If you have several children - you get to play each level several times.

With the others acting as NPC's in game for bonus fun!

True, but the problem is that now you're replaying level 1 but also trying to play level 3 at the same time.

I have felt this quite strongly but never quite articulated it. Thank you for the clarity.

It took me a really long time to understand what I was feeling. I could sense this bittersweet thing whenever the kids accomplished something new but didn't know where it came from.

Then it clicked for me one day: I miss their younger selves. Every new milestone is the end of a phase that I'll never get to see again.

FWIW, I metaphorically went though that myself, by being overly focused on grad school and professional development while they were young. I would give almost anything to undo that mistake.

If you don't mind a suggestion, take lots of video and get lots of audio recording of them. Their little-kid voices don't last forever. And once they're past the obnoxious teenage years, you may find you can't even remember their earlier voices.

(AFK to dry my eyes and go give my kids a hug.)

> If you don't mind a suggestion, take lots of video and get lots of audio recording of them.

Totally agree. The firsts are a source of joy and the lasts make me melancholy.

This is probably the best part about ubiquitous smartphones. Making a video is almost always possible.

At the same time, I don’t think we should ignore the experience in the moment just to take a video for later.

That is the part that got to me as well. To see your children, but effectively not know the people they've become as they've grown must be devastating.

> I don't know how a person could cope with being told that even once, much less a thousand times.

I suppose the good news is that it's like the first time every time.

At least he had a family before it happened.

Consider it happened to someone currently (and normally temporary) alone.

Now you are close to guaranteed to be alone for the rest of your live ...

That part was absolutely heartbreaking.

> it's as if your children have died.

Or you did.

For another incredible case of retrogade amnesia, check the story of Clive Wearing, the men with a few seconds of memory.

Short clip: https://www.youtube.com/watch?v=Vwigmktix2Y

Extended documentary: https://www.youtube.com/watch?v=k_P7Y0-wgos

I learned of him through neuroscience classes. That was plenty of years ago, and I still think of his condition every now and then.

One thing that amazes me is that he keeps stacks of diaries where he keeps erasing the previous entry, adding the current date and time, and writing "first entry I made consciously" (https://youtu.be/k_P7Y0-wgos?t=1113). But also, it seems that over time he does learn something new, somehow. For example, he can now reliably "predict" the ending of movies he has seen a great amount of times after the amnesia started, without remembering of having ever seen the movie. And, of course, it's touching to see the relationship with the wife.

My memory took an absolute nosedive, not quite this severe but I have tremendous trouble, after being knocked out for a colonoscopy. I've lived in "brain fog" ever since, and my memory is a shadow of what it once was.

I've gotten extremely rigorous at writing notes for myself, doing sketches which I never used to need, and otherwise compensating. I hold it together on a professional note, but personal relationships have suffered badly. I guess I need to take better notes about them, which I don't currently do.

As horrific as this story is, I guess it's good to know that I'm not alone?

My father-in-law died of Lewy body dementia (famously the thing that Robin Williams had). One interesting (read: horrifying) aspect of DLB is that anesthesia can cause an immediate and permanent degradation in cognitive function for people that have it.

Before my father-in-law was diagnosed, he had had a couple of unrelated surgical procedures. Each time, he came out of anesthesia a changed man. We had no idea what was going on at the time, but the difference before and after was striking. He came out short-tempered, easily confused, and less mentally present.

Only years later did we realize it was probably because of the DLB. I don't know your age or if it is at all likely similar for you, but it's something to be aware of.


I've had the exact same experience following minor surgery, for which they 'kindly' offered to do under general anesthetic. And now rely extensively on notes like you (anki, in fact). Never needed to jot stuff down before that. Learned entire libraries of piano music by heart just by hearing. Used to be able to be able to hold the positions in my brain to calculate 5-6 moves ahead in chess within seconds; now I can barely do 3, regardless of how much time I try to spend on it. Thing is, I'm still very academic, so nobody would believe me; if I'm already good at something and I complain that it feels half-capacity, people don't take too kindly to that. Plus, people are always too quick to put things down to ageing etc. So I guess I've learnt to live with it; extensive notes it is.

> I'm still very academic, so nobody would believe me; if I'm already good at something and I complain that it feels half-capacity, people don't take too kindly to that.

YES! Nail on the head.

It's like if I take a car to the mechanic and they say "Well, its performance hasn't fallen below that of a '93 Escort, runs 0-60 in 12 seconds just like it should", and I say "But it's not an Escort, it's a Taycan Turbo S and it used to do it in 2.42, and there's something severely wrong with it!" and they say "Sorry sir, our diagnostic criteria only allow us to work on it when it's no longer roadworthy"

What a crap mechanic.

I never played enough chess to have that sort of comparison, but at work, there's a machine I built several years ago, in an afternoon, didn't bother writing anything down because it all went together in my head with room to spare. Recently I had to build another identical unit, and even with the first one to look at, I spent a day and a half tracing it out and writing things down to try to figure out how it worked. My brain just wouldn't do the thing. I constantly feel trapped in a fog, some deranged medley of Comfortably Numb and Keep Talking.

I never would've consented to anesthesia if I'd had any idea this could happen. Fuckit, I'll live with weird digestive issues, just give me my mind back.

I had the same issue with sleep apnea, which also affects your memory and ability to concentrate. Because I was already operating at an extremely high level, I went from one of the top of my field to above average -- but still quite good, so on the surface, when I tried to get jaw surgery for correcting my small airway, people looked at me like I was crazy. I ended up getting it anyways, and now I feel my health recovering to the point where it was at before. Skeptics are even noticing the difference, too.

Sleep deprevation is no joke. Parents of newborns will see a massive cognitive decline. It took me 6 months to recover from my first child who didn’t sleep through the night until she was 2.

I still have not recovered my abilities from before having a kid. I’m just tired all the time and can’t think at nearly the speed I used to. Kid is 2.5 now so hoping we find some balance when Covid is “over” (haha yea right).

Sleep deprivation had gotten to me this year (for unrelated reasons). I remember at one particular, my AC had died and I was waiting for someone to replace it and I hadn't slept in few days. By mid day it was so hot and stack with the sleep deprivation it was incredibly disorienting. I remember laying in bed hoping I could catch an hour of sleep but never fully falling asleep, just sweating and unable to think straight. The combo made it feel almost comparable to some moments from a bad trip.

Shit. Now I need to find out about that surgery. I’ve had surgery for deviated septum but only helped so much. I have a tiny airway and very asymmetrical jaw. If you’re in the US and have any resources handy about specialists or what I even tell my doctor I’d love to hear :)

You're looking for MMA surgery. Try to find someone who understands sleep apnea. Ignore anyone who tells you to get UPPP which only has 25-50% effectiveness. The best surgeons are at Stanford in Northern California. It will be a year long process with wisdom teeth extraction and orthodontics. Be patient, and good luck!

I am so ready for this. I am literally miles from Stanford, already wear a really uncomfortable orthodontic, and have a crown I just would prefer to remove and live with a gap - I will let anyone do what ever they want with my mouth - I think that speaks to how helpful this is - really, sincerely, wow. Thanks.

> Used to be able to be able to hold the positions in my brain to calculate 5-6 moves ahead in chess within seconds; now I can barely do 3

Yeah, I see what you mean. This definitely sounds like some form of humble brag :)

I skipped the drugs for my colonoscopy and I highly recommend considering that option.† It was a lot less discomfort than I expected--I get more discomfort from my abs routine at the gym, and I don't work out very hard. It was also extremely interesting to be able to watch the procedure on the screen. How often do you get to see your own appendix? And it was nice to have zero recovery time and be able to drive home.

†I recognize that everyone is different and this option may not work for everyone. I also think that I got a talented doctor. So your pain mileage may vary.

I think it is reasonable for anyone to try this, but would recommend that they have an IV placed and sort all the paperwork for the anaesthesia anyway just in case—I tried this and had the opposite experience to yours.

Yes, you are absolutely right. Not because of discomfort which is more of an inconvenience, but because having any kind of procedure without an IV in place is DANGEROUS! If you don't have an IV, this makes it very difficult for the anesthesiologist to act in case of problem, i.e. you're in deep sh_t.

Many people died on the table in minor anorectal procedures in the past due to bad parasympathetic reactions.

> bad parasympathetic reactions.

for example?

for example, circulatory arrest.

From having a tube shoved up your ass? I’m really curious how that can happen.

Could be a consequence of accidental stimulation of the vagus nerve.


Even certain routine procedures risk doing this.

Yes, this is a classic in things such as anal abscess drainage

I have no idea how you managed that. My sigmoidoscopy (they do not give you anything beforehand) was one of the most unpleasant experiences I've ever had.

The strange thing is that I also had a sigmoidoscopy 25 years earlier and it matched your experience of being very bad; I was about ready to confess if it would help. But the drug-free colonoscopy was pretty smooth. I think the second doctor was a much better "driver". But maybe endoscope technology also improved, smaller diameter perhaps? (One might also wonder why I went ahead with a drug-free colonoscopy after my sigmoidoscopy experience. I guess I don't learn from experience.)

I mean, it’s definitely unpleasant, but I have a hard time justifying any form of sedation for it. The sedation (especially full) seems more risky than the procedure in such case.

I had a sigmoidoscopy ... and that's done without drugs ... was definitely not an experience I wish to repeat. But, different people, different pain tolerances :)

After having the colonoscopy without any sedation the first time around, I find it hard to believe people would need sedation for it in the first place.

I even had an endoscopy without drugs. That’s the one with the scope down your throat. It wasn’t a fun experience, but certainly doable!

I'd recommend Cologuard as an alternative to colonoscopy - a lot of insurance is covering it now.

I did the same thing. Was an interesting experience, I’ll insist on the same next time.

Had similar after being exposed to prolonged natural gas.

My memory and cognitive function were completely crap.

Eventually figured out I had a genetic disorder that got activated by the gas. “factor 5 “Leiden” which is fairly common and usually not an issue, but environmental toxins can trigger it.

Result is my blood went very “sticky” So I was suffering micro clots / minor strokes multiple times week.

Went on blood thinners and my cognitive problems resolved.

Was an insane road to figure this all out.

I never had long-term consequences, but one thing I learned from my one surgery, is that general anesthetics are absolutely brutal.

You aren't (or shouldn't be) put under general anesthesia for a colonoscopy. They use "conscious sedation", in the USA typically achieved with intravenous propofol. You are technically conscious, but very sleepy and unable to form memories while sedated.

But yes, general anesthesia is really wild stuff. Even more wild when you learn that we don't know how they actually work, other than that they work.

They gave me a "sedative" for my colonoscopy. They just said it will make me really relaxed and maybe sleepy. I wasn't sleepy at all but boy was I relaxed! I remember laying on my left side, the doctor behind me controlling the scope, and the nurse in front of me but not obstructing the views of the monitors that were also in front of me. I was getting an awesome inside view of my guts! At one point I was feeling some pain and making some noises about it and the nurse told the doctor to hold on, apparently there was a pretty tight turn and she kneaded my guts so they could negotiate it. They did find a polyp and showed it to me on the monitor, TBH you have to have a trained eye to recognize those, so they biopsied it right then an there. The results came back a few days later saying it was benign. Unfortunately since they found a polyp they have me on a five year colonoscopy schedule instead of ten.

For those fretting about getting a colonoscopy, like I was, let me tell you it's no big deal. I've had dental cleanings that were more uncomfortable. In fact, there was nothing about my colonoscopy that was uncomfortable. Getting your guts cleaned out in preparation for the colonoscopy? Yeah that's a different story but the actual procedure itself is a big nothing burger.

I don't know how common the different methods are but in my case I was certainly out and that was the intent. They did use propofol and it was like the time I was out just didn't happen. I have memory issues that seem to be related to sleep issues but they were not affected by the sedation any way I could tell.

It could still be sedation only. Sedation for colonoscopy is usually done with propofol.

Patients don't always notice they're semi-awake, and most don't remember the procedure. It's perfectly normal. I you had an airway in place and were mechanically ventilated, then that's general anesthesia.

While my memory isn't 100% clear, I'm fairly sure I had a mask and I clearly remember the anesthesia person saying I would be out in a few seconds (which is what happened). There were three people doing the procedure, one just on the anesthesia (nurse anesthesist I think), and it was done in a hospital complex. When they woke me up I first thought they must want me to move to a different position before they start but it was done (I don't remember how long it took but it wasn't that quick even though they didn't find any issues). While convenient to not feel any pain (not even any discomfort that I can recall), it is unsettling to have a hole in my life like that. I can see how those drugs could be misused, although at least I can remember everything before I was out and after I woke up at least as well as I can remember anything (maybe better since I was worried about what they might find). The time I was out didn't feel at all like sleep. And the haze managed to fully clear not long before I went to bed that night so it didn't even help me get to sleep faster :/.

It also made me giggle right before my colonoscopy, so that’s nice if not embarrassing.

I'm in Australia, and I get top and tail done at the same time (ie endoscopy and colonoscopy) and maybe due to that I get general anaesthesia?

They use conscious sedation for both. It's unlikely you got general because there are significantly greater risks involved with administering and recovering from general anesthesia. For conscious sedation, all they have to do is give you an oxygen mask (or the tube that sits under your nose, aka "nasal cannula").

My takeaway from general anesthesia is that I think I know what it feels like to die now. When you go to sleep and wake up, it feels like there was some passage of time. You can tell if you've been asleep for 1 hour or 8, or really just that some time has passed. Maybe the whole night wasn't filled with dreams, or you don't remember them, but something was there. With anesthesia, there is absolutely nothing. You wake up and you know that time has passed because someone told you it did, but it feels like you just came out of a black hole. There is just pure nothing in between going under and coming back out. I found it really weird and somewhat enlightening.

Strange... I have this problem also and it started getting worse after surgery on my neck (decompression on cervical spine), but I chalked it up to other unknown neurological issues I've been dealing with over the years. I didn't know anesthesia was a contributor to poor memory. Sometimes it makes me severely depressed because I had the sharpest memory of anyone I know and I'm not exaggerating that; I could remember the most granular details of the most insignificant event. Now there are days where I can barely remember my kid's name. I'm in my 30s btw

This effect has been known for some time, but more commonly observed in the elderly, particularly those who already have some cognitive decline. Basically, clinical studies have show a measurable long-term cognitive decline post-anesthesia. Here an example of a paper reviewing the data[1].


Also interesting that long term use of sleeping pills / over the counter antihistamines are associated with memory loss.

Temporary or permanent?

Interesting. Sounds like my brain after getting sleep apnea.

(pre-rant: Why do people post medical articles on HN? If you say anything in response to them, you get downvoted because you're not a scientist/doctor/yada yada.)

Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia:



It's funny, most people, even doctors, don't yet seem to know anything about MTHFR, but my son's dentist knew this (he has heterozygous mutations on 677 and 1298; I am homozygous 677) - so when I brought up MTHFR, she knew what to do - give him kiddie xanax rather than nitrous. I thought I was going to have to fight her about it, but nope.

(also: i know this article is about local anesthesia, i'm making a more general comment about anesthetics and complications)

Anything MTHFR-related has become a minefield of bad science on the internet. The amount of misinformation around the MTHFR gene is staggering, not to mention the droves of websites trying to sell various supplements and ebooks to people who are concerned about their MTHFR gene mutations.

> Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia:

That's not exactly what those studies are saying. The latter is a single case report of an isolated incident which the authors hypothesized to be related to her rare homozygous MTHFR mutation. The former paper cites the latter paper as one of only two references.

Needless to say, the evidence is quite weak. Moreover, the first paper recommends alternative methods that have their own downsides.

It's remarkable that people are so quick to assume entire professions have overlooked something so obvious as the MTHFR mutation based on a pair of linked papers. In fact, the latter paper even goes so far as to say they are not advocating for removal of nitrous oxide nor for preemptive screening for the MTHFR mutation.

How did you find out about the MTHFR mutation? Does it present with some visible symptoms such that a diagnosis will likely be made?

Try a consumer genomics company like 23andme or nebula

What would it take for you to be convinced after you wake up this morning that you had this condition and the year was actually 2035 right now?

Rot13 after you've thought of an answer:

Abj nfx lbhefrys, ubj uneq jbhyq vg ernyyl or sbe gung gb or snxrq?

When I was younger I lived with my grandparents and young uncle. My uncle and I pulled an all-nighter playing video games. I had work the next evening at 5 a bar/restaurant. I went to bed exhausted about when the sun came up.

The next thing I knew, my uncle was waking me up frantically, telling me I’d be late for work. It felt like I’d barely slept. I looked at the clock and it said 4:30. I jumped out of bed, grabbed my uniform, brushed my teeth and glanced at a different clock, kind of in disbelief and wondering how I was going to make it though this shift so tired. It was 4:40. I ran towards the kitchen ready to go and looked for my keys, glancing again at yet another clock to make sure I was leaving in time. 4:45. I was going to just make it.

That’s when I noticed The Price is Right playing on the television. I don’t know what time it’s on now, but then it had been running from 10-11 am as long as I had been alive. My uncle had changed every clock in the house in preparation for this prank. I wanted to kill him but instead just collapsed in bed, uniform and all.

Once in a prior life I collapsed into bed, exhausted, around midnight. Woke up feeling refreshed. Glanced at my (analog) watch, saw that it was about 07:10. Got up, got dressed, shaved. Glanced at my watch again: It was now about 01:50. I'd been asleep for just a couple of hours. Back to the rack.

>What would it take for you to be convinced after you wake up this morning that you had this condition and the year was actually 2035 right now?

Looking in the mirror? Even getting out of bed? I mean seriously, it seems straight forward, albeit with a minor complication. On the simple side, well 15 years quite a while right? A mirror and the feeling of moving around and my own body alone would drive home it wasn't 2020 quite directly. My significant other/kids/family will be changed (this may also be immensely painful, beloved pets will certainly be gone and maybe some family too). Friends, jobs, companies, all will be different. Not just the news but the environment in general will probably be pretty different in many places. And of course as this is HN, by 2035 there will be fairly massive technology changes one way or another too. Wearable displays, far more ubiquitous connected stuff, etc., or if not only because of devastating societal changes which themselves would be fairly obvious.

I guess one minor complication though is that an inability to form long term memories would mean that new things and tech couldn't be persistently learned either, and in turn there'd be direct reason to keep much of your home frozen in time to keep things more comfortable, which might slightly disrupt belief for a short period (before aging made it impossible to ignore). Anything that couldn't be relearned in a matter of minutes would probably be disfavored. Even in theoretical future shock type scenarios where somebody wakes up after being frozen or something, there is the inherent fact usually that they can at least start learning about what they missed and begin building a new life. Not being able to do that would be particularly painful, so much incredible cool stuff but not being able to hack on it. Future shock every single day. Somebody talked about checking their phone, but in 2005 we didn't have smartphones at all, and in 2035 we may not either (because they'll all have been obsoleted by advanced WDs or implants or who knows).

Far better AI assistants though could probably be a big differentiator. Full human quality natural language interaction, a full daily rundown and routine, explanations and handling advanced tech, it'd be a clear change that could be experienced and probed conversationally.

But my real hope would be that by 2035 neuroscience has advanced enough to be able to deal with it!

My phone's clock and going to Google.com and being able to load it. Assuming it's still around.

If not I doubt it'll fail with a cert error.

Imagine waking up and seeing an iPhone for the very first time. In 2005, the latest phone he probably had was some flip phone.

"Ah sweet, what else do we have? Are all cars electric? Did we make a manned flight to Mars? Have we cured cancer?"

"Oh, that's about it. We have iPhones now. And to be honest, they are kind of a problem."

Imagine you were me in 2005 with an HTC 8125 that had a sliding keyboard with actual QWERTY keys, and I wake up to find that all “smart” phones are black slabs of glass that I’m suppose to poke at with my paws like some kind of animal.

I’ve since come to terms with the glass keyboard of my iPhone, but I maintain that it was not progress. Besides, the person in the story was only two years out from seeing an iPhone for the first time, like everyone else at the time.

Yeah. I prefer a slab of glass all around, but I went straight to smartphones from flip phones.

I've yet to meet a HipTop user who thinks that the modern smartphone is an across-the-board improvement.

...and then going outside and seeing an orange sky and all the people wearing masks.

The article should have explained this in little more detail. Does he have a 2005 phone, probably Nokia Symbian? Or does he actually remember something and can use android or iphone. In the first case, a written note in his own handwriting would make more sense I guess.

So what would be the equivalent for 2035? Everyone using AR devices or neuralink?

We'll only know when we get there, but I'd hazard a guess it'll be more conventional as extrapolations on tech we have now, instead of more experimental stuff. AR doesn't seem to have much movement, and neuralink is still in that realm of promising way more than it's proving.

A blockchain 1438156 blocks tall with valid proofs-of-work.

> Abj nfx lbhefrys, ubj uneq jbhyq vg ernyyl or sbe gung gb or snxrq?

Vastly more money than anybody is going to spend trying to fool me.

See, all you HN crypto-haters, it's good for something after all! ;)

That was the plot of one of the Professor Layton games—the characters thought that they were brought into the future, but really it was an underground facility designed to fool people into thinking it was the future.

Professor Layton games have this thing where, the explanation seems to be supernatural (or involve far future technologies), but then you discover the truth, and it's always, always something completely unbelievable and incredibly unsatisfying.

A trip to https://time.gov/ on a device that I trust would convince me.

> on a device that I trust

How would you accomplish this part?

Go to a library, or Best Buy or the Apple store in the mall and use their computer.

"It's 15 years later none of those things exist, people never leave their house, and all deliveries are by robots, and people interact by AR."


But all your devices stopped working back in 2027 when <insert plausible reason>.

Good chance it will be related to encryption (assuming big sites like Google continue backwards compatibility with modern JavaScript for a long time). "This site no longer supports clients connecting over TLS 1.2" or something like that in 2035? Might we have post-quantum TLS by then?

"Hey Google, what is the date?"


I had a similar experience, when a friend got hit by a car and hit his head when falling. After all due checks were performed at the hospital and I was allowed to see him, his memory would reset every five minutes. He would stare blankly at the wall for a few seconds, then ask the same questions all over again: where am I, what day is it, and so on. After a while we just gave him a piece of paper with a brief explanation of what happened and some FAQs. I must confess, I had some (innocent) fun.

Now he's fine, as if nothing happened, and we laugh every time we remember this.

Happened to me during a soccer game, was gone next morning. I think it's not so rare symptom of concussion, i.e. quite different than what the article describes.

> he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist

That’s some real-life eternal Groundhog Day stuff right there. Hellish :(

> Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”.

This is more positive, and reminds me of the movie 50 First Dates with Adam Sandler.

Also, am glad to hear he has someone in his life that is by his side.

It could also remind you of Memento, though that brings you back to "hellish" ;)

50 First Dates... Much more fitting comparison, at least in terms of waking up to the "same" day over and over (as she too had some sort of amnesia).

To be fair, I haven't watched 50 First Dates so you might be right!

In Memento, Leonard also wakes up each day to the "same" day because he (arguably) has anterograde amnesia and cannot form new memories. He keeps tracks of new developments he wants to remember by writing on his own body and on the backs of polaroids (a bit like writing a note with his smartphone! Memento was filmed in 2000, and smartphones didn't exist yet).

50 First dates is the more romantic story about a guy who meets a girl who has ~~ante-rograde amnesia~~.

e: I forgot, in the movie she has a fictitious disease that's sort of like ante-retrograde amnesia, but wipes her memory when she sleeps.

I'm the reverse... I haven't seen memento.

I think the main difference sounds like... is 50 first dates involves someone else writing things down and using a VCR for when the Amnesia victim wakes up. Friends, family do the "heavy lifting".

Sounds like Memento is self descriptions? Doesn't sound like there's anyone else to write things down for him.

Memento was 2000. 50 first dates was 2004. So they are more comparable than someone with a smartphone - obviously.

But it sounds like the smart phone plot item is more of a twist on doing stuff for yourself - IE Memento.

Yes, in Memento the main character leaves notes for himself, because he wakes up each day with no new memories since his "accident", but he is trying to solve a crime!

Whether the notes and the character's understanding of his situation are accurate is the main gist of the movie (and as its tagline says: "some memories are best forgotten"). I can't recommend it enough: it's a great movie with some excellent acting, and it manages to be both cerebral and emotional.

In Memento, Leonard doesn't lose his memory when he goes to sleep, he just can't form long term memories. This affects his whole day, Leonard can start a task or conversation and not remember starting it by the time he gets to the end.

There's a scene that starts with Leonard in a hotel room, sitting on a closed toilet, fully clothed, with a bottle of alcohol in his hands. He wonders why is he sitting there and if he's drunk. He then takes a shower. Because he doesn't know why he's in the hotel, he doesn't know why he's in the bathroom, etc. He literally forgot he broke into the room to ambush a guy as he was doing it.

Whereas in 50 First Dates, it is how you described. Lucy replays the same day, she resets when she sleeps. But during the day, she can recall what happens. She can tell you what she had for breakfast, where she got her pineapple, who she met, etc.

You're right, Leonard has it worse: he doesn't just reset his day, he keeps resetting his last few minutes! Sorry I was unclear.

That scene you describe is brilliant, I still remember the monologue: "I don't... feel drunk".

It's one of my favorite movies. Even knowing it beat by beat, I enjoy watching it because it is so well told. Even the narrative structure feels integral to how Nolan wants the story told. So it doesn't feel as "gimmicky" as it could be.

It also gives a nice twist on a noir murder mystery. Because the story starts with a murder, then instead of making us guess who did it, it makes us figure out why he did it. With every step giving another piece to that puzzle. So the mystery unfolds linearly while the narrative goes both backwards and forwards to meet back at the beginning of the movie.

While I haven't watched Dunkirk or Tenet yet, Memento remains my favorite Christopher Nolan film.

> Also, am glad to hear he has someone in his life that is by his side.

Hard to decide who has it more hellishly. Can you imagine having a partner who will forget every single new experience you ever share together. Can you even be said to have a relationship in any meaningful sense then?

How does he know to look at his smartphone? How does he know how to look at his smartphone? My phone in 2005 was a flip-phone and I wouldn't have even known how to put notes in it.

If you start digging into amnesia, you start to see some really weird things about which memories are retained versus those lost.

Short term versus long term memories is one distinction (and seems intuitive), but you'll see things like selective long term memory loss - they might forget where they've lived for 10 years, but remember people they met back then.

It's really fascinating as it gives some insights into how memory is organized and stored within the brain. Things that you'd imagine are processed the same (what your home looks like versus your spouse's face), are actually very different memories and handled in different parts of the brain.

There were devices alike smartphones in 2005. Pretty popular in Germany too. Maybe he had one of these, or just has a dumb phone (most had note taking abilities and calendars and notifications) but the editor changed it? Sony Ericsson had some very powerful phones, and Nokia too, both very popular back then. You could even run apps (J2ME), I had one for public transit schedules and one for school grades and timetables.

This one was wildly popular in Europe, earlier models had similar functionalities: https://en.m.wikipedia.org/wiki/Sony_Ericsson_K750

I'm more surprised he can navigate a smart phone with memory from 2005

That this happened from a local anesthetic is very, very strange. Before reading the story I wondered what combo of drugs they'd used to knock him out, because those can be risky. While I don't see any direct relation, this article makes me recall another discussing gum disease prevalence in Alzheimer patients.

I have a friend who suffered permanent nerve damage from a simple local dental anaesthetic. Given a large enough sample size, I guess unlikely things will crop up?

Peripheral nerve, yes. But not brain damage I guess? Yes, that's a possible and well-known complication, although quite rare.

Toxic effect of an accidental intravascular injection? Who knows where that vessel went...

Why does everyone assume it's due to anesthesia? It's not stated like that in the article, I think. And it's also very unlikely pharmacologically speaking. Could be infection. Could be a random stroke that happened at the just the right time...

> Since then, he has been unable to remember almost anything for longer than 90 minutes. ... Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”.

I think it would be fascinating to read the "First thing - read this" file on his phone. I can see why they don't go into more detail it would probably be pretty personal info in there.

Still as a mental exercise, its interesting to think about what I would write down in that file for myself.

Recently I watched movie "Brain on Fire" sorry a big spoiler ahead, in it main protagonist a girl had auto-immune disease so one half of brain got inflamed. She was showing symptoms like she had schizophrenia. After fixing auto immune problems and brain inflammation everything return to normal with some after effects.

That being said and knowing that root canals can get inflamed and that inflammation can spread trough nerves to brain how lightly is the cause of his amnesia has a similar cause?

Neurologist among you what is the brain region that is most probably first to be affected if that would happen?

I remember Roger Penrose talking about the mystery of anesthetics, how they may target the vast "microtubule" network in the brain, itself a pretty surprising and unknown structure.

So little we know I suppose.

In this case, his dentist used local anaesthetic. Penrose was referring to general anaesthetics and their effect on consciousness.

He spoke last week about it at The Towards a Science of Consciousness conference (Univeristy of Arizona) Stuart Hammeroff and Penrose have the Orc OR Theory of Consciousness. Stuarts an anesthesiologist

I heard that the upper teeth are close to the brain and tooth infections can cross the blood-brain barrier so that was my first thought, but it doesn't seem to be the case here (the transition was instant, the damage doesn't appear to be local or getting worse).

This happened to my grandmother. One week she was sharp as a tack. Next week, lit her house on fire to clear a paper jam...

Doctor's claimed dementia, turned out to be a tooth infection.

teeth abcesses can degrade really fast (like, minutes). root canal infectious migration to the brain is actually the most likely cause here, in my opinion.

My cousin lost her sense of taste after a routine dental surgery, removing her wisdom teeth. My sister also lost hers while removing her wisdom teeth (different dentist) but recovered after a few weeks taking some vitamins prescribed by the dentist.

The front of my tongue no longer tastes, and barely feels anything, after dental surgery (probably local anesthetic from a root canal). I can still taste in the back of my tongue, thankfully, but my sense of taste overall has definitely diminished. I feel sorry for your cousin.

I had gotten the local anesthetic several times without issue, it was just that one time that I got unlucky. Supposedly if the sense of taste doesn't come back after two years it's not likely to, so I guess this is my life now.

The paper Profound anterograde amnesia following routine anesthetic and dental procedure [1]

> Anterograde amnesia caused by bilateral hippocampal or diencephalon damage manifests in characteristic symptoms of preserved intellect and implicit learning, and short span of awareness with complete and rapid forgetting of episodic material. A new case, WO, 38-year-old male with anterograde amnesia, in the absence of structural brain changes or psychological explanation... amnesia onset coincided with anesthetic injection and root canal procedure, with extended vasovagal-like incident.

> WO attended a routine dental appointment for root canal treatment at 13:40 hours. He was injected with the anesthetic, Citanest with Octapressin 3% just prior to the beginning of treatment. He wore tinted dental glasses, obscuring a view to his level of responsiveness. The procedure was completed at 14:30 hours, and at this time it became apparent that WO was pale and faint, and could not get himself up when re-positioned from the supine to the upright position.

So after the 50 minute dental surgery, the patient was still suffering from something similar to an extended fainting spell (vasovagal syncope). This resulted in permanent brain dysfunction isolated to the parts of the brain associated with forming long-term memory without any measurable structural damage.

A weird but fascinating puzzle. Question 1: does oxygen deprivation in the brain result in measurable structural damage? Question 2: can an anaesthetic selectively impact one artery servicing the brain?

[1] https://pubmed.ncbi.nlm.nih.gov/25978125/

Hopefully something can be learned from his experience, but what a tragedy. It seems like a waking nightmare.

Christopher Nolan did the screenplay for Momento which was one of my favourite films a few decades back about a guy who has anterograde amnesia[1].

[1] : https://en.wikipedia.org/wiki/Anterograde_amnesia

Christopher Nolan based the screenplay for Memento (which he directed, as well) on a short story[1], Memento Mori, written by his brother Jonathan.

[1] https://www.londonscreenwritersfestival.com/assets/Memento-S...

What a fascinating case - that he is even unable to learn procedural skills. Speculating wildly here, but with learning being at the very core of what neurons do, the issue seems "low level" enough that it might even show up if you put a tissue sample in a petri dish.

> Since then, he has been unable to remember almost anything for longer than 90 minutes. So while he can still tell me about the first time he met the Duke of York for a briefing at the Ministry of Defence, he can’t even remember where he’s living now; he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist. Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”.

This almost perfectly captures the premise of the movie Memento.

> Given the evidence, Burgess instead suspects the answer may be hiding in the thicket of tiny neural connections we call “synapses”. Once we have experienced an event, the memories are slowly cemented in the long term by altering these richly woven networks. That process of “consolidation” involves the production of new proteins to rebuild the synapses in their new shape; without it, the memory remains fragile and is easily eroded with time.

I was reading the other day about a study that's checking to see if injecting BDNF [1] into a patient's cochlea will help improve their hearing. In animal studies it helped rebuild broken synapses and led to better hearing. I wonder if injecting the brain with the missing proteins (or as the article refers to them, "ink") would help with the formation of memories? Though maybe this is too simplistic of a view.

[1] https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_fac...

That entire page and no mention of the Adam Sandler/Drew Barrymore film 50 First Dates, which came out a year before and covers a woman who wakes up every morning thinking it's the same day?

At the time of release it seemed to be a medical condition that wasn't real, however there have been a couple of instances diagnosed since then.

A year ago, after getting a nasal cautery (third one in a year in a nostril that kept being problematic) I started getting spasms between my neck and shoulder, it happens whenever I'm laying on the bed on that side. Massage makes it worse, but that's also my "bad side" when it comes to muscle knots, even before the little surgery. Stopped wearing a backpack since then to see if that was the culprit, cut down on caffeine, MRI & Angio show up OK, but still no go. Maybe the ENT messed up my nerves? Asking for a friend.

"Despite their necessity in modern medicine, scientists aren't sure exactly how anesthetics work. The best theory suggests that they dissolve some of the fat present in brain cells, changing the cells’ activity. But, the precise mechanisms remain unknown." Perhaps it works by stopping the protein synthesis... Permanently in his case https://www.livescience.com/33731-anesthesia-work.html

HM has been such a monumental case in neuroscience, that a case like this would mean a huge shift in the way people think about hippocampus and memory. We already know that his amnesia it was more severe due to parahippocampal areas being removed rather than just hippocampi. Still, he was only one case, upon which thousands and thousands of studies have rested on.

John Varley wrote a story about this kind of medical condition: "Just Another Perfect Day" [1].

[1] https://www.lightspeedmagazine.com/fiction/just-another-perf...

I’m curious since this happened in Europe, is that dentist liable for malpractice? Who has to pay for his subsequent medical bills / loss of employment?

Something I want to know, that no article seems to mention is, which tooth? If theoretically there is a memory mechanism external to the brain, wouldn't this offer a hint to where to look for one?

My guess is this is probably caused by the anesthetic. Maybe it somehow got its way to his brain and damaged his hippocampus. That they didn't find any brain damage, doesn't mean he didn't get any brain damage.


My guess as an experienced anesthesiologist is that the most likely cause is infection. Anesthesia is far behind in terms of probability, although not 100% excluded. Even a random stroke would probably be more likely.


    Somewhat interesting story


    More of the story


    Some more story


    Some more story


    (Scroll down to far)

If this is the future of the BBC (being in the 'future' category of the website), then I'll pass on that.

Firefox' reader mode helps a lot in such cases. Beloved and often used feature.

News sites just add random stock pictures. If a story is about airplanes, someone adds a random photo of a plane. Not a plane that has anything to do with the story. Not necessarily the correct type of plane. Or even a plane from the same manufacturer. But they want to show readers a plane.

Stories about construction projects will feature stock photos of people in hardhats, taken years ago and half a world away.

I guess people like pictures and it's expensive to go take relevant ones. My mind still boggles. Can you imagine newspapers doing this 30 years ago?

The thing is that everyone does this and everyone is paying to do this (as stock photos are not free). I assume it is passing A/B testing.

Apparently the BBC has a bulk deal with stock photo agencies where they basically get unlimited usage for £££ every year. I found this out when I asked them why they were using a Getty image of Broadcasting House (in a story about BBC office moves) rather than just stepping out into the corridor and taking one...

There's a time and place for this technique. I do it on my posts where I'm showing you something as it evolves - usually an electronics project.

Long running narratives are usually not the place for this.

If you're cheap there's unsplash though, nice quality for the pricetag (free)

TRWTF is that they still have a link to share an article on (long defunct) Google+.

Look deeper at the first photo. That isn't even a real dentist. Those are not medical/laser safety glasses. They look like they came out of a carpenter's toolbox. And look at the tool in his right hand (camera left). We have all been eye-to-hook with the various dental implements. That doesn't look like any tool i've ever seen. I think it is a prop, a blunt tool so that actors don't cut themselves.

If the BBC is going to use a stock image, at least use the one of a real dentist.

(I can forgive the faked scratches on the glasses. That was probably done so we don't see the reflected image of the camera lens.)

The tool in his right hand is a standard dental probe explorer, used for measuring gum depth, and the one in his left is a dental mirror. Pretty standard stuff. Safety glasses look legit too. (source: am retired dvm)

Counterpoints.They look like laser safety glasses to me and I don't presume to know all the dental instruments.

Why is this so concerning to you? Do you feel deceived? Most stock photos use actors and this shouldn't be surprising.

>> Why is this so concerning to you?

Because this is the BBC. I hold them to the highest standards. Everything they use should be legit, even stock images.

The tool on camera left is a dental pick, the tool on camera right is a mirror (held backwards).

I'd say those are some scultping tools.. Like those [1]

[1]: https://www.aliexpress.com/item/1827273916.html

@dang could we get rid of the clickbait title?

Something more like "Man suffers anterograde amnesia after routine dental surgery"

> Something more like "Man suffers anterograde amnesia after routine dental surgery"

"... he'll never know what happened next"

> clickbait

I considered changing the title when I submitted this but went with the HN guidelines that prefer the publisher's title. Admittedly the article's header might be a bit better than the slug in this case (but I was lazy).

It's not clear that there is any causal relationship between the dentist appointment and the resulting events.

Possibly this event was bound to happen and it just so happened that the subject was visiting a dentist.

At least I hope people won't get even more scared of dentists after reading this... but I guess BBC succeeded in that.

The gums are full of nervous tissue. It's a straight line to the brain.

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