Things like users' showdead value, as well as whether the user is deaded, can drastically change the output of each page. Eg, comments by a deaded user won't show as dead to that user, but they will for everyone else...
sub vcl_hash { set req.hash += req.http.cookie; }
What this means is that the cache is per-logged-in-user and pretty much personalized. The server's going to need a lot more RAM than usual. You can set a low TTL on the cache entries so they're flushed and not kept in memory indefinitely. But the performance boost is great.
This is not recommended as an always-on measure. We wrote an entry about accomplishing something similar w/ python&varnish. Here it is if you're interesting in reading about it: http://blog.unixy.net/2010/11/3-state-throttle-web-server/
Regards