SummaryRetrospective surveys were carried out on two groups of patients who had survived a stay of at least 48 h in an Intensive Therapy Unit. One group had been kept in a unit without windows, and the other in a similar unit with translucent but not transparent windows.Survivors from the windowless unit had a less accurate memory of the length of their sfay, and were less well orientated in time during their stay. The incidence of hallucinations and delusions was more than twice as high in the windowless unit.The phenomenon of depersonalisation in the face o j life-threatening danger is described and discussed.

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During a single 5-day working week, all adult National Health patients undergoing general anaesthesia for routine surgery a t a District General Hospital were interviewed on the day following the anaesthetic, and taken through a questionnaire designed to examine their impressions of the anaesthetic and the anaesthetist. MethodsThe survey was conducted without prior notice, and as confidentially as possible, so that the anaesthetists' method of working would not be affected by the knowledge that the survey was in progress.The specialties involved were general, thoracic, ear, nose and throat, dental, orthopaedic and gynaecological surgery. Patients under other specialties are operated on at a separate branch of the hospital and were not included in the survey. The questionnaireThe questionnaire was designed to elicit the following information:1. Whether an anaesthetist had visited the patient pre-operatively, or postoperatively; and, if so, what he did at that visit and what effect the visit had on the patient.2. The patient's estimation of the status of the anaes thet is t.3. Whether the patient had had a previous anaesthetic, and, if so, what effect that experience had had on his attitude to this anaesthetic.4. The patient's main fears about the anaesthetic. 5. The patient's first and last memory before and after the anaesthetic, and his general impression of the conduct of the anaesthetic. 6. Any complaints about, or following, the anaesthetic. ResultsThirty-five patients were discharged before the questionnaire could be completed. Thirty-three patients were excluded because they were too ill, were unwilling to participate, or were mentally confused. Five were found to be too illiterate to cooperate.This left 102 patients, but for the sake of simplicity, the first 100 replies only were included. All the anaesthetics were administered by specialist medical anaesthetists or by medical anaesthetists in training.Sixty-four of the 100 anaesthetics were given by consultants, fifteen were by Senior House Officers, fifteen were by clinical assistants and six by medical assistants.Pre-operatiire assessment. All the patients were assessed and investigated by the medical staff of the admitting surgical unit and sixty-five of them were seen by an anaesthetist pre-operatively. In twentythree cases, the visit consisted simply of an interview. Forty-two patients had their chest examined at this visit, twenty-eight had their mouth examined, and seventeen had their blood-pressure taken.Of the sixty-five who were seen by an anaesthetist, forty-one said that the visit reassured them and made them feel less apprehensive. Twenty-four said the visit made no difference. No-one felt worse following the visit: but those who had been physically examined expressed no greater feelings of reassurance than those who had simply been interviewed.Pustoperatiue oisit. Only three patients said that the anaesthetist had visited them on the ward after the operation but this series excluded patients having very major procedures which necessitated s...

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