By the time he completed the left side of the abdomen, tension began to grow in the back of his neck like a tumor spreading at warp speed. It wasn’t until the nurse was about to fit the compression garment, as he inspected the exposed chest of the patient, in that moment of mental easing that his mind produced images of his daughter: Penelope breastfeeding. Her first steps, first day in school. By then Penelope was elusive to him, no longer the small child holding on to his hand. He had maintained an image of her as being perpetually four years old with wispy hair blowing in the wind, cheeks flushed and hands sticky after a day at the beach, never as a grown woman. Did he want her to remain forever dependent on him or was it a wish on his part to return to happier times?
Etched into his brain stem was Penelope’s perfect face with long lashes around green eyes the color of seaweed. So poised and graceful even at that age. She knows things about this world other children don’t, he thought. How composed she was. Donna had called her Pea back then, and told him proudly how unruffled she was, how Pea couldn’t be thrown off by anything. She’s so brave, Donna said. She never so much as grimaced when she got her shots.
Donna’s pride was one thing, but Edward was taken aback by Pea; was it normal for a child her age to ask to use the restroom when children her age still had accidents or wore training pants at the very least? Pea sought out adults rather than children, who didn’t seem to be worth the bother. She was intellectually ahead, breezed through elementary school, picked up on reading and writing as if it was the most natural thing but Edward had always thought Penelope’s maturity uncanny for a child, saw how she observed other children as if taking clues from them, watched and studied their mannerisms and sometimes she did something completely out of character because she’d seen another child do it. And with every incident he became more alarmed, and it dawned on him that he wasn’t witnessing just his daughter’s copying others but also feeling bewildered about how to be in this world.
Sooner than most children knew how to use their clumsy little hands, Penny insisted on using a fork, wouldn’t eat unless they handed it to her. Maybe they shouldn’t have allowed her such a thing—was that why she stabbed a child at a birthday party? Out of the blue, Donna told him, Penelope had raised a plastic fork and slammed the tines into a child’s forearm.
How absurd it all sounded, melodramatic and removed from reality, and Edward caught himself ranting on in his mind like Donna had done earlier. Donna had just exclaimed to him the other day that she was no longer able to drive because of all the stress with Penelope and he didn’t know what that was all about and suggested she get her eyes checked, to which she responded, bless your heart, but it has nothing to do with my eyes.
His stomach locked up tight.
“Dr. Pryor.”
The voice of the OR nurse pierced through his thoughts, as if she had been attempting to gain his attention for a while. “The patient is ready for the next procedure. Everything okay?”
He wasn’t okay. He was worried and the truth was, he had been for a while. Donna was acting peculiar and she couldn’t be trusted. And Penelope. Her state of mind. He hadn’t had a conversation that made sense with her in a week or two. Good at picking up on changes in her mood and variations in her verbal patterns, he had years of experience spotting something off.
“Scalpel,” he said and reached for the shiny metal object but stopped just short of allowing it to make contact with his hand. There was a slight tremor in his left pinky finger. He wasn’t concerned—his father and grandfather both had the same tremor, it was a nonspecific tremble, nothing to worry about—but he had observed it lately while tying sutures, had cut himself shaving even. All this stress with Penelope and Donna didn’t help.
Suddenly the marked body in front of him seemed like an abomination. This was a forty-year-old woman who looked like she was supposed to look; slight drooping of her breasts, a minimal amount of excess skin around the navel from three pregnancies, nothing he considered imperfect. But he would cut open her skin and stanch the bleeding, he’d tug and slice her breasts, had already ruthlessly stabbed her hips with a tube sucking out fat. It was a disgrace really, to spend his talent and his time with these surgeries when he could do so much good in the world. He would talk to the office manager as soon as he finished for today, would tell her to keep a week or so free so he could do some work abroad, like reconstructive surgeries, cleft palates, facial abnormalities, benign tumors disfiguring otherwise healthy bodies. Plastic surgeons had their root in postwar reconstructions of faces blown apart by grenades, skin grafts of mutilated bodies, the surgeon a tool of more than healing physical wounds, but restoring patients to their former selves. Not middle-aged men and women wanting to compete with a younger generation. He couldn’t help but draw parallels to his very own life.
There he was again, ranting. Focus, he told himself. The woman’s upper chest was sufficiently full, no implants needed. Raise the nipple, reduce the size of the areola, and remove excess skin. He knew every move, every single cut he had to make, could do so blindly guided by muscle memory alone, had done thousands of these lifts. Yet the tremor wouldn’t stop.
“Dr. Pryor.” The voice of the OR nurse ripped him from his hypervigilant state. “The patient is ready. Are you okay?”
“Scalpel,” he said, and this time he grabbed the shiny metal object the nurse extended to him.
In the background were the soothing rhythmic sounds of the heart monitor and the gentle lifting of the oxygen sleeve. He poked the breast with the tip of his finger. The tissue was spongy, bounced back. He touched the body with the tip of the scalpel, increased the pressure, and watched the blood appear. The nurse wiped the scarlet line with gauze.
That tremor, he felt it more than he saw it, and hoped the nurse wouldn’t pick up on it. He shifted in place, willed his mind to engage. A perfect circle around the areola. The second cut: vertically down to the breast crease. He knew every slice and tuck in his sleep, could reshape the tissue to improve contour and firmness in the dark, remove excess skin to compensate for a loss of elasticity with one eye closed. The third cut: horizontally down to the breast crease. He repositioned the nipple and areola to a natural and youthful height.
He stepped around the table and began work on the right breast. When the incisions were concealed and the sutures layered deep within the tissue and in the natural breast contours, he stepped back and motioned the nurses to prop up the bed, allow gravity to take over. The symmetry was perfect, the patient was going to be very happy.
He reached behind his back and pulled the strings, loosening the coat. He tucked the gloves within the fabric and tossed the bundle into the bin.
What the next step with Penelope was he wasn’t sure. He’d been kidding himself. Penelope would never make it on her own. But what did his involvement look like? He couldn’t lock her up, put her away in a box underneath the ground to keep her safe. Donna had used those words and he was taken aback by them then. He imagined a box in the ground, just how had her mind gone that far? Donna had her faults but she was a good mother, and for her to use those words frightened him.