Metaphor and anesthesia

Abstract

Metaphors and related tropes, explicit or implied, are ubiquitous in our daily lives. Rereading the first paragraph of this article will demonstrate how pervasive metaphors are in our ordinary language (e.g., 'world of anesthesia,' a 'fueled' debate, 'medicine' has a 'fringe element'). Metaphors are not merely ornamental; metaphoric thinking is integral to how we perceive our environment and process our experiences. Anesthesia patient care, monitoring, research, subspecialties such as pain management, and the economics of anesthesia care are examples of areas replete with metaphors. Because language affects our perceptions, phrases such as 'under anesthesia,' which evoke vast metaphoric relationships, have profound implications. Some metaphors can be harmful or pointless. For instance, metonymic references to patients and other jargon provide a verbal shorthand, but may be unintentionally hurtful. Metaphors, such as those in scientific theories, can hide truths as well as reveal them. Unlike literary metaphors, scientific metaphors need to be consistent with observation and measurement. Although we need not return to Lockean distrust of tropes, over-adorned or flowery phrases are usually inconsequential or self-mocking. We are a species that can think metaphorically; it would be artificial, and indeed impossible to ban metaphors from the practice of anesthesia. Instead, we must recognize that metaphors exist in anesthesia and acknowledge their implications. Metaphors are powerful tools. By transforming the intangible to the tangible, metaphors may enhance and direct our understanding of anesthesia. Elucidating the metaphors that underlie difficult and multifaceted concepts can help clarify those concepts. Furthermore, creativity, whether it be in patient care issues or research, may be enhanced by a conscious effort to conceive new metaphors or combine existing ones in novel ways.