Surgery & Hypnosis

"When you tell a patient that only five out of 100 people ever have any trouble in an operation," says Dr. Fred T. Kolouch, "he isn't really listening to you. He's thinking. 'I'm going to be one of the five.' " So now, at his first interview with a person who needs surger, Dr. Kolouch (rhymes with solo) tells the patient that he will have an easier time in the operation, and get better faster, if he agrees to be hypnotized. Last week Surgeon Kolouch finished compiling the records of 100 patients on whom he has performed surgery with hypnosis, and concluded that in 81 cases the trance experience had saved patients anxiety, pain and money, and had speeded recovery. It also helped the surgeon, anesthesiologist and nurses.

Nebraska-born Dr. Kolouch, 47, was trained at the University of Minnesota's department of surgery, where he got a Ph.D. for a thesis on ulcers in addition to his M.D. He moved to Twin Falls. Idaho, 14 years ago to get more room for raising a family and to be closer to ski slopes. As chief of staff at Magic Valley Memorial Hospital. Dr. Kolouch had plenty of chances to observe patients being prepared for operations, was struck that so many of them had irrational fears.

Troubling Voices. Dr. Kolouch was as skeptical of hypnosis at first as most surgeons. But increasing use of it by reputable medical men, mainly in obstetrics and in special cases to reduce the amount of chemical anesthesia needed, persuaded him two years ago to give it a try. He read up on it, then worked for a while with a San Francisco expert.

Many people are hesitant when Kolouch first suggests hypnosis, and he does not press the idea. But by the second interview, most of them come around to accepting it, and the surgeon immediately sets about hypnotizing them. His attention-holding gimmick is a piece of gem quartz that the patient holds suspended from a chain. Dr. Kolouch arranges signals that will get the patient into a hypnotic trance promptly when needed in the future. He then assures the patient that he will feel nothing during the operation, that he will awake from the anesthesia with only minimum discomfort, and that he will soon be able to go back to work.

Equally important, Dr. Kolouch instructs the patient that while under anesthesia he will not listen to any conversation that is not aimed directly at him. Dr. Kolouch became convinced of the need for this after observing cases in which the operation was a success but the patient inexplicably made a poor recovery. Hypnotizing one such patient later, a colleague was startled to have her quote back to him verbatim a remark he had made while she was under anesthesia; she had misconstrued the remark as a bad omen for herself. Dr. Kolouch believes that even a sudden silence in the operating room upsets the unconscious mind of the fearful patient.

A Fast Recovery. Among his first 100 hypnotized patients, whose ages ranged from 4 to 83, were 25 who had only minor operations, usually under local anesthesia in outpatient departments. All but one responded well to hypnosis. The biggest group of 57 were hospitalized for surgery of medium severity. It was among these that Dr. Kolouch had his most satisfying success. All were more relaxed during anesthesia and on the operating table. They made fast and uneventful recoveries, with little need for pain-killing drugs. In cases of thyroid removal or hernia operations, the number of doses of opiates was half the usual average and the hospital stay was also cut in half. Hypnosis is less successful in operations such as removal of the gall bladder or part of the stomach. Dr. Kolouch suspects that, besides the severity of the operations, there are other reasons not yet clear.

Dr. Kolouch's prize case was a businessman of 46 who had had a mortal fear of surgery since childhood, capped by an unsuccessful operation for hernia repair at the age of 41. After this earlier operation he had needed seven doses of pain relievers and was hospitalized for five days. Moreover, the operation failed, and he suffered agony for five years because he could not face repeated surgery. Dr. Kolouch talked him into it and used hypnosis. With his unconscious anxiety and conscious fears at rest, the patient needed only one dose of an opiate and was up and about again the next day after a successful repair.

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