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Yet another weird SF fan
 

Thursday, May 26, 2005

The Effects of Bad Philosophy

During the Terri Schindler Schiavo controversy, many anti-tubists were convinced that Terri had no mind. They had a little bit of evidence: Much milder cases of brain damage can stop the formation of episodic memories. By the standard of “if you don't remember it, it didn't happen” nothing was happening to Terri.

The above standard has had horrible effects in the past. In the early 20th century, an alleged anesthetic called “Twilight Sleep.” It was a combination of morphine and scopolamine. The effect was to erase memories of the pain of childbirth but not the pain itself. For example:

Clinical improvements in the management of obstetric analgesia/anesthesia within the last five decades have included new equipment (e.g., pencil-point spinal needles) and new drugs (e.g., ropivacaine); none has been more impressive than those leading to a "new look" in childbirth, that of "family-oriented" obstetrics. Prior to this event, most vaginal deliveries and preceding labor periods were conducted either with no pain relief or under twilight sleep, the combination of morphine and scopolamine.

Eventually, the potential hazard to mother and/or fetus of both methods was recognized. The adverse effect of untreated pain was confirmed experimentally in pregnant ewes; a brief, minor stress such as a bout of loud noise, movement of personnel or application to the skin of mild electric stimulation decreased uterine blood flow secondary to release of norepinephrine.4 Maternal hyperventilation, often a reaction to pain, was shown to harm the fetus in two ways: 1) by the development of an oxygen debt in the mother and 2) by a shift of her hemoglobin-oxygen dissociation curve to the left, i.e., in the baby's disfavor. The sequelae of twilight sleep were even more pertinent. In addition to the potential of producing neonatal narcotic depression, the drug combination rendered the parturients amnesic and incoherent. Although screaming with every contraction, the women were unaware of their plight as were their husbands who, banned from the labor-delivery area, were pacing up and down in a distant room.6 (This author clearly remembers a young lady who climbed over the bedrail, delivered the baby on the floor and did not realize for the next 24 hours that she had become a mother.)

and:

[Old-timers please correct me -] I was told by my professors at Jefferson
(Phila, PA) that some women in labor given scopolamine would be
'screaming and hanging onto the light fixtures on the ceiling'
(metaphorically) or running down the halls at times.

However, when asked a few hours later (post-delivery) how their labor was,
they would say "beautiful".. they had no residual memories of their
feelings or behaviors....
The amnesia was great - the uninibited behavior could be a management problem...

as well as:

It was German doctors who offered controlled dosages of Twilight Sleep. Two American journalists went to Germany in 1914 to report on it, and one of them, in fine journalistic tradition, used it during delivery of her own baby and raved about it in a magazine. Early feminists, often society women interested in health issues, formed the National Twilight Sleep Association, which campaigned to ''relieve one-half of humanity from its antique burden of a suffering which the other half of humanity has never understood.'' The New York Times, The Ladies' Home Journal and Reader's Digest ran articles praising the removal of ''the primal curse,'' and increasing numbers of patients demanded Twilight Sleep.

But the small dose of morphine only disinhibited the patients and didn't actually prevent pain, so patients had to be strapped down and could be heard screaming several floors away. Doctors worried about the drug also causing hemorrhages, slowing contractions and depressing the baby's breathing. The campaign eventually died out after one of its leaders died hemorrhaging in childbirth, but Twilight Sleep continued to be used until the 60's, when it was finally killed off by antichemical sentiments.

In other words, the philosophy of “if you don't remember it, it didn't happen” not only caused unnecessary suffering but, once the effects of a chemical prescribed by the then male medical establishment became known, probably contributed to both environmentalism and feminism.

It's a bit disconcerting to find that the early feminists and anti-chemical activists were not completely insane …

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