Short Story · Surgical Symphony

By Juan Pablo Morini

Translated by Victoria Pehl Smith, Ph.D.

It’s seven forty-nine in the morning when I cross the threshold of the operating room. A prostate procedure is scheduled for eight that I’ll then add to my long list of urological interventions. I stretch my arms forward and the surgical nurse dresses me in a new layer of sterile clothing. The patient is already asleep and covered with green sheets except for the area in which I am going to work. I finish putting on the gloves. I test the sound on the heart monitor. The anesthetist informs me that I can begin. I look at the assistants, two surgery residents; the second, in addition to assisting me, should be reciting aloud the surgical technique as we proceed. I require this of the new surgeons as part of their training. There’s no music. Beethoven’s Fifth Symphony has the appropriate tempos. I signal the anesthetist who knows the routine. Three short notes resound in the room.

I extend my hand out and the surgical nurse hands me the scalpel. “Incise the mid-line of the skin, from the umbilicus to five centimeters above the pubis,” says the second assistant. Strings and clarinets in the background. With the fourth note, something more prolonged, I open the skin, the subcutaneous tissue and muscle of the patient, in one swift cut. No one speaks, the sonata continues vigorously. Red spots appear on the recently opened yellow tissue, one for each capillary. I take the cauterizer and with its point coagulate the vessels. The smoke rises, the smell of barbecued steak reaches the face of the novice and causes him to tear up. The melody acquires a slower and heavier tempo. I blot the incision with gauze. It appears to be pearly white tissue. “What’s this?” I ask as I point with the pick-ups. “The line where the abdominal aponeurosis joins,” one of the assistants answers. I am pleased and smile under my surgical mask. I extend my hand to the surgical nurse. She hands me the scalpel again. I open the tissue, the bladder emerges like a released balloon. Again I hear the four notes, somewhat slower. “Opening the bladder and suctioning urine,” I hear the assistant say. The violins emit a soft melody while I proceed and leave that hollow organ open. In the posterior area one can see two small orifices. They release the urine that comes from the kidneys. All the walls of the bladder flow together in the shape of a funnel towards a duct below the pubis. The urethra, and at its end, the prostate. The moment arrived: I submerge my hand in the incision. It disappears in the patient’s body. I lean forward to be able to get my index finger to the bottom. The cellos and violins get louder and mark the moment to ask the assistants what I am doing. They look at each other. One has a sweaty forehead. “If you don’t know, you’ll never operate,” I tell them. I blindly insert my finger into the urethra, and scratch the tissue with the edge of my fingernail until I find the plane of separation. Just a few movements: like pealing a mandarin orange, a professor had once told me. The prostate comes loose. Beautiful. I close my eyes. Horns in E flat to finish up the manoeuver.

I twist my hand inside the body. I pull it out, dripping with a mixture of urine and blood. I open my fist and show the entire, freed gland. “Place the retractors.” I hand the organ over to the surgical nurse. The assistants separate the edges of the incision and we see the bladder again. “That empty space that’s at the bottom of the bladder is the prostatic capsule and what you see at the end, the tube, is the penile urethra. We’re going to suture them together.” The operating room lights do not illuminate the space well, they are poorly aimed. I ask a nurse to reposition them. The music repeats the three short notes and the longer fourth one in distinct variations. The nurse moves the lights and they fall on the bladder. I hold my breath. I don’t know what it is. I think about some loose piece on the lights. It had never happened before. The ball inside the bladder is moving now, it stretches. They are hairy legs mixed with some blood clots. “A spider,” one of the new assistants says. Impossible, I think. No one moves. The creature is large and there is a sphere attached to the back part of its body. The spider has remained quiet. One of the assistants wants to grab it with her hand. “No!—I yell, before she manages to touch it—we have to take it out whole.” Cellos and woodwinds coming in late. The surgery is contaminated, it’s necessary to give the patient more antibiotics. The spider raises two front legs and threatens us. A stream of urine comes out of one of the bladder’s orifices and rinses part of its coat. The nurse comes up behind me, takes out a cell phone and tries to take a picture. I forbid it. The strings and clarinets come in again. “Turn off the music,” I order. I stretch my hand toward the surgical nurse and she passes me the long pick-ups. The assistants further separate the edges of the incision so I can see better. I proceed with the pick-ups until I touch one of the creature’s legs. It pulls back swiftly and hides inside the funnel. It can’t be seen. I look up and everyone in the OR is looking at me.

I search my memory for some academic reference that might help me solve the problem. There is none. The nurse comments on the possibility that the spider had been hiding behind the lights. The anesthetist tells me to hurry up. I feel my irritated eyes. I try to concentrate, but the only thing that appears in my mind is the name Luis Buñuel. My right hand trembles. The assistant notices. He nudges me and takes my place. I am separated from the operating table. I hear the assistant order that the patient be catheterized. “Inject saline solution into the catheter,” he says with certainty. The liquid flows swiftly from the urethra to the bladder, and rinses the spider out. The other assistant throws gauze on top of the creature, wraps it up and extracts it from the patient’s body. Afterwards, he rinses the entire surgical field with an antiseptic solution. When he finishes, he looks at me and assumes his previous position, leaving my space empty. “Shall we close, doctor?” he asks me. I cannot return. I ask that they do it. I go over to the gauze and see the whole spider, already dead. The operation is over. We leave the OR.

I see the surgical nurse laughing with the assistants. Their eyes sparkle with joy. Assholes, I think, they already have a joke to mock me with until they, too, fuck up. I keep walking and go into the locker room. I pass by the anesthetist who pats me on the shoulder. “Did you see that Turca won the year-end trip—he tells me—from surgical nurse to VIP, what do you know!” He goes off laughing. I remain alone. My street clothes are hanging in my locker.