My hand trembles and my glasses mist over as I hold the blade over my wife's pale body. I stop to wipe the lenses, then pick up the knife again.
"Just do it!" I say out loud to myself. There is no-one else to hear me. Sandy is out cold; well, not cold exactly. It has to happen now.
She herself has drawn a line across the smooth skin below her ribcage with a felt-tip pen to be sure there's no mistake. It's just a matter of overcoming my - what? Fear? Revulsion?
"Stop thinking about it, and just do it."
Although perhaps not a manly admission, I do accept that Sandy wears the trousers in this marriage when it comes to making important decisions; well, making almost all decisions, come to think of it. Anyway, we get on well, and spend a lot of time together. We have no children, preferring to focus our energies on our careers and on each other. I am more passive than she, and although I get called "dull" and "boring" at times, we've been together for a good many years and Sandy shows no signs of wanting to change that; I certainly wouldn't be without her. We're a pretty happy couple, I'd say.
Sandy had been unwell for some weeks, and three months ago she went to her GP, and a month after that, to see a specialist. It turned out she had a dodgy gall-bladder which needed to be removed rather urgently. She came home, gave me the news and then announced that there was
"No way" that she was going to hospital; I knew why. Her father died in a medical negligence situation at the local infirmary only two years ago.
"Okay Sandy. Of course you're worried, but what's the alternative? You've got to have the wretched thing removed, or it could kill you. Your symptoms are already pretty unpleasant, aren't they?"
"Well, you could do it. You were in the St John's Ambulance."
"What! St John Ambulance? Darling, sitting in a stuffy tent all day at the Agricultural Show hoping someone is going to twist their ankle, and having the know-how to make an arm-sling out of two hankies; these things not training enough to undertake abdominal surgery, you understand?"
But my heart and brain were already racing, because I could sense in the matter-of-fact tone of her voice that Sandy had already thought all this out, and was in deadly earnest. I also knew that when Sandy has decided on something it is not easy to change her mind. But to get me, a Local Authority IT Manager, to undertake amateur surgery? Surely not.
The element that made this extraordinary notion more than just a fanciful stupidity was that Sandy was a vet. She had her practice-surgery in the annexe to our house. She routinely cut open bodies, large and small, poked about inside, did some corporeal plumbing and joinery and stitched them up again no problem. She also had all the requisite gear; not just the green gown and hat, but also scalpels, anaesthetics, needles, lights, operating table, "machines-that-go-ping", and a husband. Not yet a willing one, but one that was basically obedient, I suppose.
Sandy just sat and waited. Said nothing.
"Christ, Sandy! You're serious, aren't you? Anything could happen. I could easily kill you!"
"Yes, well you would certainly have the opportunity. However, when I consider how I cook, clean, and clear up around you, I consider your motivation for keeping me alive is probably a hundred times greater than that of some anonymous saw-bones down at St Lukes who doesn't know me and my gall-bladder from a Chinese take-away." Sandy is not fond of Chinese food.
So you see, that's how the idea was mooted a couple of months ago. A lot has happened since. All my most reasonable and persuasive arguments were offered and brushed aside, and soon I was being shown "the ropes" in her surgery after office hours. Then there's been eight weeks of research in medical books, on the internet, and on videos. We've had discussions and arguments. For Sandy: eight weeks of training me to be a proper surgeon and a reliable anaesthetist; for me: learning how to make a creature unconscious for a period of time without killing it, and finding out what I am likely to encounter as I cut my way into a mammal from outer skin, through fat and muscle, working my way towards my goal, the gall-bladder; then the removal, the repair and returning the creature to consciousness.
In the first weeks we gradually worked our way through a considerable number of previously "put-down" dogs and cats.
"But Sandy, these unfortunates are dead; when it comes to cutting into
you won't there be a lot of blood?" I asked in my now-habitual panic.
"Ah, yes. That will be a bit of a problem. I usually have Viv to cope with that. You'll just have to find a way to keep the bleeding to a minimum, I guess."
"What! Well, can't Viv help me ?"
"Oh, don't be daft, Keith." Sandy smiled at me tolerantly. "Viv is my vetinary nurse. It wouldn't be ethical to involve her, now would it?"
"But, what about me? Aren't there some ethics that deal with husbands cutting up their wives?"
"Don't be such a wimp, Keith. I'm showing you what to do, aren't I? You've only got to follow instructions. It's not rocket science."
"But, but . . ."
And I turned back to look into the innards of a large, very dead Labrador bitch, as I tried to imagine it to be the interior of my own dear, but infuriating wife.
"Now find the gall-bladder. No, Silly. It's going to be bigger than that. Yes, that's better, though it'll be a different colour in me, because I will still be alive, I hope."
"Oh for goodness sake, Sandy!"
"Sorry. I shouldn't have said that. You know, Keith," and now she looked at me with such genuine warmth, "I am really grateful that you're doing this for me, darling. . . . Whoa! Stop there! Don't, whatever you do, use
a clamp on that artery. That would be very serious. But don't worry, Darling. You'll get the hang of it all soon, I'm sure."
I learnt how to scrub-up, disinfect, incise, monitor, suture, swab, bandage, and clean-up – all the practical stuff, and also how to recognize the organs, the different tissue types and the array of pipes that contribute so much to the survival of us hairy animals. "At least," I comforted myself, "I'm only having to do one particular operation, and not having to consider the remaining 99.9% of the workings of the human body."
I read books. I watched videos. I studied diagrams. I asked questions again and again.
"Sandy, suppose I see your blood-pressure falling below. . . what? When should I start to worry?"
Sandy remained surprisingly - or was it stubbornly? - optimistic and light-hearted. "I can't see why there would be any problem with my blood-pressure. Never has been in the past. Look, if the worst comes to the worst just stitch me back up, bring me round, and then we can discuss whatever it is that's got you panicking." - as if it were the simplest thing in the world. Madness. The rhetorical question whirling about in my head: "What am I doing? What the hell am I doing?"
However, as the weeks pass, I began to believe that Sandy's crazy proposition was a feasible one. In fact, whilst not actually wanting to do it, I could recognize that a part of me was keen to find out if it was possible. But I did have to keep reminding myself that this was not like a computer problem. There is no possibility of "Saving a Back-up" of Sandy in case things don't work out well. No. This operation would be for real.
One evening, after removing the gall bladder from a dead poodle, I heard myself in my imagination saying to my friend at the Golf Club, "Hi Toby. Fine, thanks. As a matter of fact, I removed my wife's gall-bladder at the weekend. Tricky operation, but it all went rather well, I think. She should be up and about in a couple of days." No, perhaps not. Probably best not to mention it to anyone.
At other times I lay awake at night, sweating with fear, and imagining all the awful possibilities, and saying to myself, "Tomorrow I will definitely refuse to go any further with this." But then, somehow not getting round to actually saying "No".
Tuesday 5th December, the day fixed for the operation was fast approaching. By now the contrast between husband and wife was very marked. Sandy: calm, amenable, and steady. Keith: all the opposites and a lot more. Sandy had managed to save-up various old and ill furry pets that had been recently brought in to the clinic to be put-down, so that I could practice my surgical skills on living creatures every evening between 8 and 10pm and, though I say it myself, I had become pretty slick at homing in on the gall-bladder of anything from a rat to a St Bernard, and deftly removing said organ. By now I believe that I had operated on more animals, dead and alive than any other IT Manager on Earth. However, it is true that the stitches (or "sutures" as I know smugly called them) with which I concluded the operation on the St Bernard made even Sandy look anxious.
"Not too late to change your mind, you know, my dear." I quipped manically as we stared, appalled at the ragged scar. "Perhaps blanket stitch would look better?"
Sandy not amused. "For God's sake, Keith, just do it better on Tuesday."
There was just one more rehearsal to perform before Tuesday. We needed to prove that I could put Sandy to sleep and then return her to consciousness. I had achieved this feat several times with large dogs, before the poor things were put-to-sleep in a more permanent manner. Things had gone well with the dogs, and I was feeling pretty confident, but, well, it's bound to feel a bit different when it's your wife lying there on the table. We planned that I would undertake this anaesthetic practice on the last Thursday before the operation, but nerves got the better of me, and I just couldn't face it.
"No, I'm sorry Sandy, this is madness. I just can't go through with it. Be reasonable, woman, and put yourself in my shoes. Look, there are good reasons why we humans have developed hospitals and surgeons and nurses and everything, in fact there are lots of really excellent reasons."
My whole body was shaking as I spoke.
"Okay, Keith. Let's leave it till tomorrow," Sandy responded, cool as anything. I gave her a big hug, and kissed her. I never expected her to let me off the hook just like that. I had only really heard the "Let's leave it" and failed to register "till tomorrow". But it was enough. When tomorrow arrived I was calm, and I was ready, and later that day, when she opened her eyes after fifteen minutes of planned and monitored unconsciousness Sandy gave me such a beautiful smile. "Keith," she said, "I am so proud of you."
Time doesn't mess about, does it? Monday evening arrived as predicted by everything from the Radio Times to the setting of the sun. Sandy had grilled a Sea Bass for me, a favourite of mine, although, of course she wouldn't be eating before the op. tomorrow. I really tried to enjoy the wretched fish but I was too worried, and felt mildly sick throughout my solo meal. Conversation about tomorrow's activities had been put off-limits, but neither of us could resist the temptation to double-check arrangements with each other.
"Oh, sorry Keith, but I did give you the blood-pressure chart, didn't I?"
"You mean the one that's a nice calm blue in the middle, and a scary red at top and bottom? Yes, its Blu-tacked just under the monitor, but you did say I wouldn't be needing it, didn't you?"
"Yes. That's right. It's only, just in case . . ."
I was moving about a lot. Restless.
"Keith. Come here and sit next to me, please love"
So I did, and it seemed to help. I even managed a couple of hours sleep that night.
So Tuesday comes around. A dull fog clings to the house, emphasising our isolation. Veterinary Nurse Vivien has been given the week off. As far as the rest of the world is concerned Sandy and I are away for a tour of Scotland. My mother-in-law lives locally, but we waved her off on a two-week package-holiday to the Mediterranean last Wednesday. The outside doors to the house and the surgery are all locked, and the blinds are down. We stand together in the surgery. The various stainless-steel machines are all functioning, with dials and screens illuminated. The surgical instruments lie in a neat row.
Sandy and I pause, and look at each other. I cannot remember a more significant moment in our relationship. I am struck by the immense trust she is putting in me and my newly acquired skills, and my eyes fill with tears. It is a relief, in a way, to see that Sandy is similarly moved.
"Crikey!" I say, inanely. We hug, and kiss.
She smiles reassuringly as she checks the preparations. I busy myself too, looking at some dials. We comment unnecessarily about this and that in an unsuccessful attempt to ease the tension that threatens to paralyse me.
Oh God, we're ready.
"Just pop up on the table then, my dear, and I'll soon pop out that nasty old gall-bladder, and you can pop back to bed and have a lovely rest for the afternoon." I manage in my comic doctor routine.
"Thank you, Doctor" she sweetly responds as she mounts the table, "That would be simply super. I do find this surgery business gets right under one's skin, don't you?" Sandy isn't normally one to make jokes. She must have been saving that one up for this moment.
The routine that follows, that which puts her into unconsciousness, we undertake in mutual silence. We are together in this. Her skill in training me, my ability to fulfil this unthinkable task, her future and mine are all inextricably pressed together in this next hour of our lives. Both of our futures are in my hands as never before.
For all surgeons the time must come to perform their first solo operation, and, no doubt, they have to cope with some of the anxiety I am feeling. They have to just get on with it, and so do I.
"So," I mutter stupidly into my medical-mask, "Here we jolly well go!", as I cut into my wife.
After so much pet-surgery the scale of everything seems overwhelming; too big, too much blood escaping all over the place. I feel panic rising. I force myself to remember how many feline and canine gall-bladders I have recently removed, and gradually I settle down. The suction and swabbing are proving adequate and I'm not drowning in Sandy's blood. I have a job to do, and the activity and the concentration help to calm me.
"You're doing OK, Keith. You're making steady progress, and the patient remains in a comfortable condition." It helps to hear such bland reassurances, and fortunately I am able to ignore the fact that it is me, surely the maddest person in the city, that is providing them.
Then the sheer stupidity - the gross illegality - of what I'm doing hits me, and my mind veers off. I'm in court. The prosecuting barrister is saying with a professionally sceptical sneer, "I see! So, your wife asked you to remove her gall-bladder, and you agreed. Now Mr Thompson, would you kindly explain to the court what your medical qualifications are?" And awful images of Sandy lying dead.
No! I must just keep my mind on the moment; on the task, on the gaping wound.
I find that, despite all the qualms, I am actually well prepared and trained. The scale is different, but the similarities between the inside of a Labrador bitch and that of a woman are much greater than the differences; also, it's really nice not to have so many dog-hairs around! The layout is, yes, very similar, and now, amongst the complex of shiny internal organs I can see, yes, and touch, the glistening and unwanted organ and its pipe-work, and even I can recognize that there is something amiss with this one. Yes, here is the offending, swollen and misshapen gall-bladder that must be excised and removed. By me. Right now.
It is at this very moment, with the scalpel poised to cut through the Ductus Cysticus , that I hear, above the sound of the various monitors and pumps, a familiar sound. A sound which I have heard with pleasure on many occasions, but a sound which, when heard at this particular moment, creates such a flood of dread, panic and confusion that mind and body lock into a rigid blankness for several seconds.
"Coo-ee, Darling!" The call-sign of Sandra's mother, Gwyneth. The only other person in the world with a key to the building, but . . ??
As usual, Gwyneth starts the conversation before actually getting into the room.
"I've come back early, my dear. I didn't really like Tunisia. The food! Eugh! I just couldn't put up with it another day. I hope you don't mind. Where are you, Sweetheart? Ah! You're in the surgery; I can see the light." Her sharp steps approaching.
Now don't get me wrong, Gwyneth is an open-minded woman in many ways; but this . . . . this really is going to take some explaining. . . .
©SteveSmith May 2014