There's a number of competing theories as to why this happens, possibly an evolved response to help control bleeding or vestigial tonic immobility (feigning death to hide from predators).  Either way, it's kinda fascinating.
In my third week or so on the ward — three weeks after graduating from medical school — we got a man who'd been in a fight whose arm had been sliced open by a broken bottle down to the bone, the injury being about a foot long. The thing was, he was so drunk, he wasn't in any pain yet was perfectly conscious.
Me and a fellow intern spent 3-4 hours in the early morning suturing him up after copiously irrigating the wound with many liters of sterile saline. We'd NEVER done anything remotely like this in med school, so we simply did what we'd learned from watching and reading. We must have put in hundred of sutures, starting with deep muscle and then moving outward layer by layer. We worked from opposite sides of the surgical field. During the entire procedure the guy never complained of pain, but rather talked with us perfectly rationally.
When we were done, we were certain he'd become septic and require weeks of IV antibiotics, but darned if that wasn't the case: he was discharged back to the County Jail after a couple days, with no apparent infection.
I'd say it's very annoying rather than kinda fascinating. Cannot donate blood. Routine bloodwork can become a chore. Minor doctor procedures become gripping.
Doctors/nurses don't like it either, apparently they do not want you to pass out during these transacations.
And since it's a brain-based thing, thinking about the issue, "ok, I'm not going to let this bother me" actually just enhances how much it bothers me. ugh.
I live off grid, and barely a day goes by that I don’t cut myself and have blood dribbling out, somewhere - and it doesn’t bother me in the slightest - even some pretty gruesome injuries (like bifurcating my thumb with an axe) are just “well, crap, that’s going to need stitches”. Even when it was stitched up, the needle going “click” as it pushed through the underside of the nail, I just watched with fascination.
That all said, every time I have a phial of blood taken, I faint, like clockwork. I’m not convinced that it’s the sight or thought of blood, but perhaps a marginal drop in BP or available blood glucose triggering syncope - but I’m not a doctor, just confused as to why it’s triggered by blood being drawn, but never by accidental bloodshed.
Anyway, thanks for giving the phenomenon a name.
Any idea what you call the feeling in your belly/spine when someone describes a nasty injury?
I was totally not able to do that when I started having issues with it, the bare thought of touching it made me feel uncomfortable. But after like 5 or 6 different treatments under local anesthesia or involving ridiculous molded acrylic concoctions that _were not doing anything_ I got tired, bought a scalpel and grabbed some cotton and a napkin and spent like one hour carefully cutting and shaving the thing and using cotton balls to lift it around in a way were it looked like it will grow well after my massacre.
That was probably twenty years ago and I never had any issues with it since then.
Funny how different people are I guess.
 - https://www.amazon.com/Who-Goes-First-Lawrence-Altman/dp/052...
Self experimentation remains relatively out of reach of the ethicists and so should be kept in mind for the more creative researcher types.
See also, an old story by Scott Alexander: https://archive.fo/eSbZb.
Barry Marshall drank the bacteria Helicobacter pylori to prove it's involvement in gastritis and ulcers.
Before that everybody assumed bacteria wouldn't survive stomach acid and these sicknesses were causes by stress.
He treated with antibiotics afterwards and got the nobel-price.
Sounds like it’s only an Australian rule.
It feels like it's an overreaction to a specific event.
It's not incredibly prevalent, but it's a death sentence if not treated immediately.
There have been studies where a large percentage of cases of appendicitis were successfully treated with antibiotics (which is treatment of course, but not immediate surgery).
Sure, antibiotics don’t work for every case, but doing abdominal surgery just in case sounds risky.
Also, the PR is very bad, and while ethically that's no reason for a medic to recommend this surgery to their patient it might be enough reason for a government to make it policy anyway.
Of those who take antibiotics, 40% require it to be removed via surgery within 5 years.
The mind/body enters an interesting mode in my experience, where I become disassociated from the situation and can focus on what needs to be done. The pain strangely suppresses temporarily, until a sense of completion/achieving stability is restored.
Living things are inherently survival machines.
Pretty sure that's called shock.
To elaborate, I've had other experiences medical professionals assessed as shock. They were paralyzing, and usually involved uncontrolled involuntary shaking and tears.
This is something quite different. If I entered into such states of shock in the survival situations I'm referring to, I would have bled to death.
My assumption is it's a massive release of adrenaline and endorphins.
How fascinating, then, how despite this so many people manage to voluntarily give up their own lives.
>A natural death from kidney failure does not hurt. As toxins build up in your blood, you will start to feel sleepy.
It was anything but painless if her cries throughout the night, too weak to stand, until finally succumbing were any indicator.
As someone fertile who has managed to avoid reproducing for >40 years, I don't find that particularly fascinating.
But this… I swear, if I were born in an earlier century, I would have died long before now. I am soooo grateful for the medical technology we have in this age.
Objectively sedation would be the riskiest part of the procedure. And I wanted to see what it looked like. It was completely painless, but also quite unsettling. I'm pretty distant and cold about things in general, and I would imagine other people might find it distressing or even traumatic.
From memory, with anesthesia was better for the baby.
But being one of the many political biologies I'm not sure I'd trust the result.
When he was old and in the U.S. (late 1960s?) he chose suicide over surgery.
"I worked without gloves. It was hard to see. The mirror helps, but it also hinders—after all, it’s showing things backwards."
Fumbling around in your intestines backwards lying awkwardly on a table while you're already fucked up due to the appendicitis and fever. Pretty incredible.
> Opening the peritoneum, I injured the blind gut and had to sew it up.
Removing the appendix is relatively straightforward, and not too delicate (in a normal surgical situation!) Stitching damaged bowel is a lot more delicate. The idea of doing it mostly blind, via a mirror at best, to yourself... wow.
— Monty Python, 1974
And went back to work.
There have been times where, if I had the training and knew that self-surgery would lead to quick relief after only another few hours of excruciating sensation, I might have been willing to give it a go.
And I would have probably passed out from the pain and bled to death.
i've had similar thinkings about dental surgery during intense oral pain.
Tooth pain is pretty bad -- it's amazing that anything can make a human come to the conclusion of : "Well, if I ripped all the bad teeth out of my head..."
The lead in Darren Aronofsky's 'Pi' comes to a similar conclusion before self-trepanning due to intense migraines, although in that movie it is made intentionally unclear whether or not the peace the lead comes to is due to the hole in his head, or something else.
This case in particular is incredible to me, partially because I am freaked out (irrationally) by the idea of surgery at all. Being awake during surgery is impressive enough, but doing it on yourself is a whole new level of amazing.
For me personally, there's not a lot of things that I think would stop me, but I don't think I would operate on myself.
Possibly, if I had the skills I would feel differently, but honestly, I think I would feel the same way.
The typical person is not actively suicidal. So conditional odds suggest in most cases a person would prefer to live
Edit to clarify: There exist situations which would drive one actively toward death, I could understand a refusal to do surgery on oneself being a passive decision leading toward death.
The situations you allude to are almost exclusively mental situations. Having to operate on oneself, while mentally taxing, is a fundamentally physical dilemma. It produces fear and stress, but not existential ennui.
After having read the OP and the other cases people have linked, I no longer feel that way.
Thanks for the great conversation, it's caused me to think quite a bit!
> prepared to amputate his trapped arm at a point on the mid-forearm in order to escape.