Explicit recall under general anesthesia is a major concern among members of the public and has even been featured on the popular Oprah Winfrey Show. Several patients presenting for surgery at Barnes Jewish Hospital have questioned whether the anesthesia provider would be using a BIS monitor to "prevent awareness". Excluding the cost of the BIS monitor itself, the cost to use BIS is $17.50 for the disposable strip. If this monitor was to be used for every anesthetic administered at Barnes Jewish Hospital, this might translate to an annual cost of about $500,000. Explicit recall, especially when patients have been aware and unable to move, is a serious complication that frequently precipitates posttraumatic stress disorder. If indeed the BIS monitor does decrease the incidence of explicit recall, this could translate into a cost effective and more importantly clinically imperative intervention. Currently BIS monitors, or similar alternatives, are not used routinely to monitor depth of general anesthesia at Barnes Jewish Hospital.