In Reply.— My personal experience (234:24, 1975) may have relevance to some of the preceding letters and to Dr Blacher's article. A few months ago, I underwent the phenomenon of being awake and paralyzed during surgery. The fact that I later had none of the psychiatric symptoms of Dr Blacher's patients may be in part because I had insight into the occurrence—at least to an adequate degree. I knew that my inability to move or communicate was the result of a muscle relaxant. I assumed incorrectly that my awareness indicated an anesthetic error; in fact, the operation was performed in an extreme emergency, and my condition was so poor during the early stages of surgery that the anesthesiologist judged that full anesthesia would be fatal. At variance with the theories in Dr Larson's first paragraph, there is no question that my experience occurred during the surgery itself. I awoke after
John D. Archer (1976) studied this question.