“We said we’d see it through, Donna. The ultimatum was she has one more month to move out. It’s only a few more days. Allow her that time, wait it out, and then we’ll get on with our lives.”
“I can’t do it another day, Edward.”
He wasn’t going to budge. He wasn’t going to answer his phone and argue about it, and a few more days weren’t going to kill anyone.
As he got out of the car in the parking lot of his practice, there was yet another call. He ignored it. By now Donna was worked up about him not answering his phone, about not being able to get off her chest whatever had prompted her and Penelope to quarrel. He used to intervene but over the past few months their behavior had become increasingly difficult for him to navigate, and he was tired of walking around on eggshells in his own home and had a hard time shaking it all off and didn’t they know the pressure he was under? They’d understand if any of them had any responsibility, held the lives of others in their hands like he did.
Once in the office, he checked labs and X-rays and prepared for the first operation of the day. A straightforward lipo followed by a mastopexy.
Every surgeon he knew performed rituals, every single one, and he was no different. He had always found the following to be true above all else: there was tremendous solace in rituals, in symbolic behaviors. The entire preparatory activity calmed his mind in ways nothing else could. It created control and reduced uncertainty.
Time to scrub in. A glance at the clock above the sink and he began timing. Tick tick tick. Leave nothing to chance.
He focused on the antimicrobial cleanser turning from yellow into white suds as he scoured his left hand with a brush. Scrubbing each finger and in between, the back and front of the hand for exactly three minutes, he moved on to the forearm, consistently keeping the hand higher than the arm at all times. Time check. He repeated the process on the other hand and arm, envisioned cuts and proportions, sutures and muscle fiber, existing scar tissue, and then he imagined the perfect end result.
Tick tick tick.
The operating suite phone rang. He looked up in surprise. It was unusual for a call to be put through once they had all gathered and were prepping for a procedure. Some last-minute funky lab result? Once a patient’s husband had a heart attack in the lobby, such things happen.
A nurse answered on the third ring. “Dr. Pryor, it’s your wife. It’s urgent.”
The nurse was unrecognizable behind her mask and splash guard—Connie maybe, or Debra, he couldn’t tell—all he saw were raised eyebrows. The nurse glanced back and forth between him and his hands as she held out the phone.
“Put it close to my ear,” Edward said and proceeded to scrub the left arm to three inches above the elbow for exactly one minute. An emergency. He couldn’t deviate from the inescapable ritual, he had to adhere to his self-imposed constraints.
Tick tick tick.
“Donna. What’s going on?” he asked, keeping his ear a safe distance from the phone to avoid contamination. She was breathless. He only comprehended every third word. Here. Penelope. Come home. Need. How glad he was he hadn’t told the nurse to put the phone on speaker. “Focus,” he said. “I don’t understand what you’re saying.”
Hands in the air he stood, the nurse moving the phone in closer as she shifted from one leg to the other. He jerked backward. If the phone touched his mask, he would have to change his gown, would have to repeat the entire procedure. He rinsed his hands and arms with one single movement from fingertips to elbow by passing them through the water.
He had lost his momentum. He was supposed to be draped in a yellow paper gown in the operating suite, yet there he stood, hands above elbows, not understanding Donna’s words. He glanced through the door into the operating suite where a nurse stood with a sterile towel in her outstretched hands, waiting to dry him off. A third nurse stood holding his gown and sterile gloves.
“Start from the beginning. I don’t understand what’s going on.” He listened intently, even closed his eyes attempting to better concentrate on Donna’s breathy words. “What happened? Repeat that?” The nurse holding the phone looked past him as if to give him a semblance of privacy, while the others were clustered in a far corner.
Much was made later of this phone call. Each nurse had a different recollection of his reaction. One said he seemed impatient, another said he was business as usual. One said he balled his hands into a fist. In reality he said—and these were his words verbatim—“I’m scrubbed in. I’ll call you back,” and all the while he attempted to maintain a sense of order. There were no balled fists, and it wasn’t business as usual either, but there were no harsh words, no gasping, no argument. Nothing of that sort.
What he did do was tell the nurse to hang up the phone. Standing off to the side, waiting for the anesthesiologist to give him the nod to begin the procedure, he attempted to focus on the patient in front of him, her areas of perceived plumpness; the body lined and dotted by permanent marker in front of him like a rudimentary map. The man in him saw the body on the table as perfect, the plastic surgeon recognized areas for improvement.
He couldn’t get Donna’s voice out of his head, winded words escaping her mouth, come home, come home, come home, the slurring of her words as if she couldn’t be bothered to enunciate each syllable. He felt his breathing become rapid and shallow and a primal urge to flee the OR came over him and there was a momentary silence in the room but for the beeping of the machines behind the patient when he thought he might lose control. He would remember this day with absolute clarity later: this epiphany, this moment of knowing something horrible was going to happen.
How many times had he returned home from work and watched Donna set the table, impeccably dressed and poised and put together? They would have dinner and not until they went to bed would she tell him of something Penelope had done and he wanted to scream how did you just get through this dinner without telling me? How did you just sit there and eat and make small talk when your daughter has become unhinged again? How did she get through all this unscathed, at least seemingly so? And now this, a breathless stuttering phone call, her incoherent carrying on.
Behind the blue drapes the anesthesiologist leaned to the left and glanced at him. The nurses became aware of his hesitation though he didn’t know what they were thinking of this entire affair. He cleared his mind, willed himself to concentrate on the task at hand. After all, attention to detail was second nature to him, just like compartmentalizing had become a strength of his, cultivated by all these years as a surgeon.
“Let’s do this,” he said and nodded at everyone in the room.
He worked quickly and with focus. He injected diluted local anesthesia to reduce bleeding and swelling. Once the tissue was swollen and firm and the epinephrine took care of possible bleeding, he made a series of tiny incisions around the navel and one on each side of the patient’s flanks. He inserted a thin hollow tube through the cuts and loosened the excess fat with a controlled back-and-forth stabbing motion. He reached farther and farther to the outskirts of the markings on the body in front of him while holding the tip of the tube down with his flattened hand so as not to puncture the skin. In a radiating pattern he pushed the cannula into layers of fat, creating tunnels, sucking liquid until the tube refused to give up any more blubbery secretion. The contents of the plastic containers, which were marked with lines and numbers, settled as the fat floated to the surface.