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Gauloises cigarettes, rank and stinking in the confined room. David's
eyes felt raw and gravelly for he slept little during the night, and the
smoke irritated them. He kept looking at his watch, and imagining what
was happening to Debra during these last minutes, the undignified
purging and cleansing of her body, the robin& and the needles of
sedation and antisepsis.
The slow drag of minutes ended at last when the screen began to glow and
hum, the image shimmered and strobed then settled down into a high view
of the theatre. The set was in colour, and the green theatre gowns of
the figures moving around the operating-table blended with the subdued
theatre green walls. Height had foreshortened the robed members of the
operating team and the muttered and disjointed conversation between the
surgeon and his anaesthetist was picked up by the microphones.
Are we ready there yet, Mike? David felt the sick sensation in the pit
of his stomach, and he wished he had eaten breakfast. It might have
filled the hollow place below his ribs.
Right, the surgeon's voice sharpened as he turned towards the
microphone. Are we on telly? l Yes, doctor, the theatre sister
answered him, and there was a note of resignation in the surgeon's
voice, as he spoke for his unseen audience.
Very well, then. The patient is a twenty-six-year-old female. The
symptoms are total loss of sight in both eyes, and the cause is
suspected damage or constriction of the optic nerve in or near the optic
chiasma. This is a surgical investigation of the site. The surgeon is
Dr. William Cooper, assisted by Dr. Reuben Friedman. As he spoke, the
camera moved in on the table and with a start of surprise David realized
that he had been looking at Debra without knowing it. Her face and the
lower part of her head were obscurred by the sterile drapes that covered
all but the shaven round ball of her skull. It was inhuman-looking,
egglike, painted with Savlon antiseptic that glistened in the bright,
overhead lights.
Scalpel please, sister. David leaned forward tensely in his seat, and
his hands tightened on the armrests, so the knuckles turned white, as
Cooper made the first incision drawing the blade across the smooth skin.
The flesh opened and immediately the tiny blood vessels began to dribble
and spurt. Hands moved in the screen of the television, clad in rubber
so that they were yellow and impersonal, but quick and sure.
An oval flap of skin and flesh was dissected free and was drawn back,
exposing the gleaming bone beneath, and again David's flesh crawled as
though with living things, as the surgeon took up a drill that resembled
exactly a carpenter's brace and bit. His voice continued its impersonal
commentary, as he began to drill through the skull, cranking away at the
handle as the gleaming steel bit swiftly through the bone. He pierced
the skull with four round drill holes, each set at the corners of a
square. Peri-osteal elevator, please, sister. Again David's stomach
clenched as the surgeon slid the gleaming steel introducer into one of
the drill holes and manoeuvred it gently until its tip reappeared
through the next hole in line. Using the introducer, a length of sharp
steel wire saw was threaded through the two holes and lay along the
inside of the skull. Cooper sawed this back and forth and it cut
cleanly through the bone. Four times he repeated the procedure, cutting
out the sides of the square, and when he at last lifted out the detached
piece of bone he had opened a trapdoor into Debra's skull.
As he worked David's gorge had risen until it pressed in his throat, and
he had felt the cold glistening sheen of nauseous sweat across his
forehead, but now as the camera's eye peered through the opening he felt
his wonder surmount his horror, for he could see the pale amorphous mass
of matter, enclosed in its tough covering membrane of the dura mater
that was Debra's brain.
Deftly Cooper incised a flap in the dura.
We have exposed now the frontal lobe, and it will be necessary to
displace this to explore the base of the skull. Working swiftly, but
with obvious care and skill, Cooper used a stainless steel retractor,
shaped like a shoe horn, to slide under the mass of brain and to lift it
aside. Debra's brain, staring at it, David seemed to be looking into
the core of her being, it was vulnerable and exposed, everything that
made her what she was. What part of that soft pale mass contained her
writer's genius, he wondered, from which of its many soft folds and
coils sprang the fruitful fountain of her imagination, where was her
love for him buried, what soft and secret place triggered her laughter
and where was the vale of her tears? Its fathomless mystery held him
intent as he watched the retractor probe deeper and deeper through the
opening, and slowly the camera moved in to peer into the gaping depths
of Debra's skull.
Cooper opened the far end of the dura mater and commented on his
progress.
We have here the anterior ridge of the sphenoid sinus, note this as our
point of access to the chiasma David was aware of the changed tone of
the surgeon's voice, the charging of tension as the disembodied hands
moved slowly and expertly towards their goal.
Now this is interesting, can we see this on the screen, please? Yes!
There is very clearly a bone deformation here, The voice was pleased,
and the two students beside David exclaimed and leaned closer. David
could see soft wet tissue and hard bright surfaces deep in the bottom of
the wound, and the necks of steel instruments crowding into it, like
metallic bees into the stamen of a pink and yellow bloom. Cooper
scratched through to the metal of the grenade fragment.
Now here we have the foreign body, can we have a look at those X-ray
plates again, sister The image cut quickly to the X-ray sca
again the students exclaimed. The girl puffed busily on her stinking
Gauloise.
Thank you.
The image cut back to the operating field, and now David saw the dark
speck of the grenade fragment lodged in the white bone.
We will go for this, I think. Do you agree, Dr. Friedman? 'Yes, I
think you should take it.
Delicately the long slender steel insects worried the dark fragment, and
at last with a grunt of satisfaction it came free of its niche, and
Cooper drew it out carefully.
David heard the metallic ping as it was dropped into a waiting dish.
Good! Good! Cooper gave himself a little encouragement as he plugged
the hole left by the fragment with beeswax to prevent haemorrhage. Now
we will trace out the optic nerves.
They were two white worms, David saw them clearly, converging on their
separate trails to meet and blend at the opening of the bony canal into
which they disappeared.
We have got extraneous bone-growth here, clearly associated with the
foreign body we have just removed.
It seems to have blocked off the canal and to have squeezed or severed
the nerve. Suggestions, Dr. Friedman? I think we should excise that
growth and try and ascertain just what damage we have to the nerve in
that area. Good. Yes, I agree. Sister, I will use a fine bonenibbler
to get in there.
The swift selection and handling of the bright steel instruments again,
and then Cooper was working on the white bone growth which grew in the
shape of coral from a tropical sea. He nibbled at it with the keen