“Yeah, fascinating,” she said, but her heart wasn’t in the sarcasm, and once the speed slowed to normal, she leaned closer to the screen, drawn into the drama as the woman’s trachea and esophagus were pulled to the side and the front of her spine was exposed to view. The surgery was accompanied by a sound track—country music, turned up loud—with an occasional indecipherable murmur of human voices underneath the drawling, twanging music.
With a series of tools—forceps, scissors, scalpel, forceps again—the surgeon attacked the disk, yanking and snipping and gouging out the crumbling cartilage that separated the third cervical vertebra from the fourth. The surgeon’s gloves and the surgical drapes were soon spattered with blood and tissue. “Wow, I hadn’t fully appreciated how much an orthopedic surgeon has in common with a butcher,” Miranda remarked, adding, “Not much elbow room there in the neck.”
“Not much,” I agreed. “Back when I was teaching anatomy, the surgery residents used to put pieces of tissue down in the bottom of Styrofoam coffee cups. They’d practice cutting and suturing without touching the sides of the cup.”
She paused the video. “Like that doctor game for kids? Operation? The one where it buzzes if the tweezers touch the board while you’re lifting out the funny bone or the brain or whatever?”
“Like that. The name of the patient was something-Sam, I think. Yosemite Sam? No, that was a cartoon character. Cavity Sam, maybe. Kathleen and I gave Jeff that game one year for Christmas.”
“Did he like it?”
“Not so much. I thought it was fun, but Jeff was disappointed. What he really wanted was a BB gun.”
Miranda snorted. “He wanted a BB gun, and he got Operation? Poor Jeff—he’ll probably need therapy the rest of his life to get over the pain.”
“We didn’t want him to shoot his eye out, you know? But I felt so bad when I saw how sad he looked that Christmas morning that I got him a BB gun two months later, for his birthday.”
“Did he shoot his eye out?”
“He never did. Not yet anyhow. I do seem to remember replacing a window or two, though.” I laughed.
“Oh, and the neighbor’s cat stopped coming over and eating our cat’s food. Which wasn’t such a bad thing.”
“Just think of all the money you could’ve saved on cat food if you’d gotten him the BB gun two months sooner,” she said. “You ready to watch surgery again?” Without waiting for an answer, she hit “play,”
and the bloody fingers and tools resumed their assault on the spinal disk. The scraps of cartilage grew smaller and smaller; then, after a pause, I heard a high-pitched whine, like a dentist’s drill. Gripping a small grinder, not unlike the Dremel tool I’d bought at Home Depot, the surgeon angled the tool into the opening in the patient’s neck. “Yikes,” said Miranda. “This is when you really don’t want your spine surgeon to have the shakes. One twitch and you’re a quad.”
He laid aside the grinder and then, with a pair of forceps, held a small, white peg—a short, squat bone graft, roughly twice the diameter of a pencil eraser—in the neck, measuring it against the gap between the two vertebrae whose surfaces he’d just smoothed. The back of the surgeon’s head leaned into the frame, bending down for a closer look, and then he withdrew the forceps and reamed out the gap between the vertebrae a bit more. After another inspection he reinserted the peg into the opening in the neck, wedged it between the vertebrae, and then tapped it deeper into the intervertebral gap, using a small hammer and punch, creating a snug fit: a fit whose snugness I’d noticed when I removed the section of spine from the neck of the corpse. Finally he took a silvery metal bracket and screwed it to the bones. The procedure he’d just performed was an anterior decompression and fusion; the “fusion” part would be completed by the patient herself—or would have been, if she hadn’t died—as new bone grew from her vertebrae to surround and incorporate the grafted piece.
On the monitor the surgeon removed the retractors and clamps from Lowe’s neck; once released, the skin contracted and the gaping incision half closed itself. With a curved needle and stiff black thread, the surgeon took fifteen neat stitches in the neck: the fifteen stitches that had so readily parted, only hours before, under the blade of the scalpel in my hand.
A different, smaller pair of hands entered the video frame. With brisk efficiency they scrubbed the dried blood off the patient’s neck, then swabbed on iodine and applied a gauze dressing. The surgeon’s hand reappeared; it waved to the camera, then gave a cheery thumbs-up.
Clarissa’s surgery was finished.
Her swift death spiral was starting, and no inventor’s high-tech video system could rewind that.
CHAPTER 18