Tuesday, October 24, 2023


 Op Note XLI

Our diagnosis was never in doubt. It was the definitive treatment that remained elusive. Knowing the well-described occasional efficacy of placebo interventions we offered the patient a procedure of last resort. We were down to our last couple of bullets. A proposition strictly in the experimental stages, we told her. A double blinded study. But what other choice did we have? Unbeknownst to her it was a sham surgery. Nothing would be fixed, nothing cut out. We termed it her “special procedure”, as if she were a child being told that grandma was “only sleeping”. We reviewed the risks and benefits, the long term implications, expected course of recovery etc. etc. and ultimately obtained her consent. When she was anesthetized we opened her up along imaginary incisions from stem to stern. Our technique was flawlessly precise, the field at all times bloodless. We made a note of everything we observed. Ran gloved fingers over the glistening capsule of her make-believe liver, listened to the false beats of her heart, watched her fake bowels undulate in yellow fields of fat. None of this happened except in the digital archives of my own mind. At the end of the case the sponge and needle counts were correct. All the nurses played along. We counted down the minutes until it was time to wake her up— crucial that we gave the medicine a chance to work. Throughout the case the patient remained stable. Her safety was never in doubt. And yet there’s a chance she might feel better as a result. Maybe not right away. But tomorrow? Before she got too old?  Why hadn’t I tried this before? The hardest part is remaining still. Not moving a muscle. Remembering to breathe. Not passing out. Remembering to place bandages on imperceptible wounds. Every case I do should get easier and easier. Someday I hope to master the technique of doing nothing at all.


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