Thomas McGuane - The Bushwacked Piano

“On the table.”

Payne obeyed. He could see the doctor was not in the mood for chatter. Neither, for that matter, was he. Endless nightmares of the possible violations of his body had left him rather testy.

“How do you mean, doctor?”

“I mean on the table. Right now. Crossways.”

The nurse came in and the doctor looked up. Payne sat across the examining table.

“Where are we with this guy?” the doctor asked. The nurse looked at her board.

“He had the pentobarbital sodium at six this morning. Then the atropine and morphine an hour ago. I—”

“How do you feel?” the doctor asked Payne.

“Okay.”

“Relaxed and ready for the operation?”

“Vaguely.” Proctor looked him over, thought: tough guy with the lightest possible glazing of civilization: two years at the outside in some land-grant diploma mill. “I forget,” the doctor went on to his nurse, “are these external?”

“A little of both.”

“Ah, so. And thrombosed were they not?”

“I should say.”

A wispy man, the dread anesthesiologist, came in wheeling a sort of portable autoclave with his ghastly instruments inside. Through the drugs he had been given that morning, Payne could feel some slow dread arise. As for Proctor, this skillful little creep — Reeves by name — with his hair parted low over his left ear and carefully deployed over his bald head, was an object of interest and admiration. He watched him lay out the materials with some delight and waited for the little man’s eagerness to crest at the last possible moment before saying, “Thank you, Reeves. I think I’d rather.” Reeves darkened and left the room. “Hunch your shoulders, Mister—”

“Payne. Like that?”

“Farther. There you go.”

After his little moment with Reeves, Proctor had second thoughts. He knew the sacral block shouldn’t be taken casually; and he didn’t do them often enough to be really in practice. But what the hell. This guy was preoperatively well prepared; he’d just wind it up.

“Nurse, what kind of lumbar puncture needle did Reeves bring us?”

“A number twenty-two, doctor.”

Proctor chuckled. That Reeves was a real mannerist. A little skinny needle like that; but maybe that’s how they were doing it now. Used to be you had a needle like a rifle barrel and you’d get cerebrospinal fluid running down the clown’s back. It made for a fast job but memorable headaches for the patient afterwards.

Proctor went at it. He pressed the needle into the fourth lumbar interspace well into the subarachnoid region and withdrew two cc’s of spinal fluid which he mixed with a hundred mg’s of novocaine crystals in a hyperbaric solution which he reinjected confident he had Payne’s ass dead to the world for four good hours.

Just for precaution — it was really Reeves’s precaution — he gave Payne fifty mg’s of ephedrine sulfate in the arm. “Keep this man sitting up straight,” Proctor said and went outside to the drinking fountain and popped another goof-ball, this one covered with lint from his pocket. He peered sadly into the middle distance and thought: I was the darling of the fleet .

Payne was wheeled by, on his way to the operating room. He began to review his life. Very little of it would come. He could go back — lying there numbed, the victim of purloined spinal fluid — about two weeks with any solidity; then, flashes. As: boarding school, Saturday morning, in a spectral study hall for unsatisfactory students; Payne and three other dunces watched over like meat by the master on duty, in pure Spring light, in silence. At one window of the hall, striped boy athletes rock noiselessly past for batting practice; a machine pitched hardballs out of a galvanized hopper and the base paths were still muddy. Payne shielding his eyes in apparent concentration, occasionally dozes, occasionally slips a magazine out from under the U. S. History text: Guns And Ammo . In his mind, he cradles a Finnish Sako rifle, sits on a ridge in the Canadian Rockies that glitters with mica and waits two hundred years for a Big Horn Ram. Something moves a few yards up the draw: The master on duty has spotted Guns And Ammo . Payne’s heart whirls in his chest and loses traction.

“Miss?” Payne asks.

“Sir?”

“I feel like a dead Egyptian. You and Proctor are fixing to pull my brain out of my nose.”

“No, sir!”

“I feel that life has handed me one in the snot locker. You see I’m the last buffalo. And I’m dying of a sucking chest wound. Isn’t there something you could do in a case like mine? Some final ecstasy you could whip up?”

“Nothing that comes to mind, sir.”

“Miss, if my beak falls open and cries are heard during Doctor Proctor’s knifework, will that be it, as far as you’re concerned? I mean, will you sign off on yours truly? As another has?”

“Possibly a leetle.”

“In other circumstances I would be a simple hero to you. But maybe your life already is not unencumbered. Is there a certain someone?”

Proctor strode in. “Let’s do it.” Payne intoned a helpless sphincteric dirge. He was in terror. This room was filled with strange and frightful machinery which would have been the envy of any number of pirates whose names are household words.

“Will there be pain?” Payne inquired.

“I don’t know what you mean.”

“Surely the word rings one little bell in your medical carillon tower.” Payne regretted his words instantly. He did not want to antagonize Proctor.

“It appears,” said the doctor to the nurse, “that the medication has taken our friend by storm.”

Proctor looked down from his end of the operating table. He had Payne on his back, in the lithotomy position; not the one Proctor was most comfortable with; but the only one a serious proctologist would consider with spinal anesthesia via the hyperbaric solutions that Reeves found so irresistible. Reeves! What a bleary little cornball.

From this perspective, Proctor saw with a tiny almost atavistic horror the ring of thrombosed hemorrhoids. And it was now a question of demonstrating the internal complications so that they could be excised without any further fiddling around.

Proctor thought helplessly of how he could have been a big, clean career aviator instead of staring up some wise guy’s dirt chute.

He inserted his index finger well into Payne’s rectum withdrawing and reinserting several times without, in his opinion, sufficiently extruding the internal hemorrhoids. In a moment of impatience and almost pique, he stuffed Payne’s rectum with wads of dry gauze which he hauled out slowly dragging the hemorrhoids with them. Now he had a perfectly beastly little mess to clean up. The entire anal verge was clustered with indisputably pathological extrusions. Proctor sighed languorously.

With a certain annoyance, he dilated Payne’s sphincter to an anal aperture of two centimeters and then, making more work space for himself, rather zealously went for, and got, three centimeters without tearing even a teensy bit of sphincteric muscle. He swiftly clipped four forceps into position to keep the site exposed. A smile broke out on his face as he remembered his Asian days.

All of the sound and movements around Payne were informed with the most sinister lack of ordinary reality. Implements passed his vision which were not unlike those with which we eat; yet, somehow, something was wrong with them. They had crooked handles or the ones you thought were spoons had trap doors or when they touched each other they rang with an unearthly clarity. And surrounding the hard if intolerable precision of all this weaponry were various loose bags, drooping neoprene tubes, cups of deep blubbery gels, fleecy, inorganic sponges in space-age colors, and the masked, make-up lacking face of the nurse, her hair yanked back in utilitarian severity.