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The fundamental problem, the silvery idea glides through the surgeon's mind as he pops his neck, is that the anesthetized guy lying on the operating table over there, his head twenty degrees lower than his feet to help gravity coax the contents of his abdomen out of his pelvis, this man whose real life takes place somewhere else, whose face the surgeon can't see from his seat at the console nine feet away, this thirty-four-year-old whose face the surgeon can remember only indistinctly, although he is fairly sure it involves a patchy stubble-scruff beard, this overweight filmmaker the surgeon is entering as the silvery idea glides through him--the fundamental problem is he was born inside this body instead of another.
Settling into the ergonomic chair, willing himself into focus, the surgeon leans his forehead against the pad inside the console where everything becomes three-dimensional high-definition real-time image of the right robotic arm he controls tipped with a traction device like a pair of miniature plyers, the left with electrocautery scissors.
He inhales. Holds. Exhales. Last night he slept like a power failure. These days nothing can wake him once he's under. Sometimes it astonishes him how his resilience has already initiated a slow depreciation. Not a lot, no, but he can already feel how it isn't what it was, say, three years ago, four. He barely stepped into his fifties before he wasn't there anymore the way he'd once been.
Now he is this almost imperceptible unraveling, an evaporation when no one is looking, a corporeal enactment of how anything moving forward into the future contains a growing element of chaos.
He inhales, holds, exhales, announces into the quarter-sized mics built into the console on either side of his mouth that he's ready to go and with that commences snipping and burning his path through a cosmos of pale yellow-orange fat, the console's force feedback allowing his fingers to sense the tissue tension as he advances.
It has been almost a week since he's flown through a person like this.
He loves the feeling so hard.
It reminds him what awake every so often can come to mean--all this I'm-here-and-nowhere-else-ness, the cool air in the OR abundant with Betadine, the whisper of anesthetics like the scent of a black magic marker.
Somehow the surgeon is both aware and not aware how many systems of mechanical and electrical components, how many AI network calculations per millisecond, how many people in baby blue scrubs and caps and masks are functioning around him to make these next few hours happen. The anesthesiologist. The surgical RN. Two physicians assistants. The resident. Two men. Four women. Connecticut. West Village. Brooklyn, South Bronx, Northern Jersey somewhere, Northern Jersey somewhere else.
Six of them, a squad, a crew, a gang, everything collapsed into this cluttered beeping OR cut off from the rest of the planet--so much so the place even has its own power supply in case something misfires in the one on the other side of those swinging doors over there.
Six of them together and six of them apart, alone, each swimming through his or her own thoughts, habitual tasks, anticipations, focal points, risk assessments, the da Vinci Surgical System hovering like some giant white spider over the patient in stirrups who looks less like a stirruped patient than a heap of sterile blue surgical sheets thrown across a couple pillows on the operating table, nothing apart from a pregnant hot-pink belly inflated with carbon dioxide protruding, more like a hot-pink BOSU ball than some part of human anatomy, isolated and estranged, the da Vinci's carbon-fiber arms wrapped in thermoplastic tilting and adjusting with whirrings and clicks amid all the other noises, burrowing toward its target.
Someone says: You hear about the couple in Florida who sold hundreds of people tickets to heaven? On the street. $99.99 each. They convinced the potential buyers the tickets were made from solid gold and reserved a spot in paradise. Present them at the pearly gates and you're in. This is what my weekend felt like.
Inside the console the surgeon thinks: I wonder what I'll have for lunch today. The pizza station. The portobella mushroom panini. The bacon cheeseburger.
With a side of what.
Garden salad. Fries. No. Garden salad.
With that, he feels himself sinking into the currents of the procedure, how they carry him farther into this body on his screen, this body across the room and right in front of him, his name is what, this patient's, his face looks like what, distractions thinning around him, thinks: Look at this. Look at us. Look at all this living going on.
Announces into his mics: Sound system, please.
Thinks: I am an emergency in process.
Thinks: Everyone is. If not now, then later.
Thinks: --
The squat chunky physicians assistant steps over to the iPad dedicated to the speakers, asks: What's it gonna be this morning, folks?
The surgical nurse: Ramones. "I Wanna Be Sedated."
Rote chuckles.
The PA who buzzcuts her gray hair, whose profile always brings to mind for the surgeon a plucked parrot: Sinatra. "I've Got You Under My Skin."
The anesthesiologist: Cutting Crew. "I Just Died in Your Arms."
Jesus, says the surgical nurse.
Sorry. How about Queen--"Another One Bites the Dust"?
Goldberg Variations, the surgeon says into his mics.
There will be no new thoughts on a day like this. On a day like this, it will be the old thoughts in predictable patterns. Adrenalineless practice in motion, muscle memory like Bach's opening aria, the French ornamentation, the careful musical reflection over thirty-two bars in G major.
These meticulously willed violences.
His name, the surgeon's name, is Donald. His name is Don. His name is Donny. His name is Dr. Monetti. A horseshoe band of what's left of his own graying hair wraps around his head, eyes magnified behind generic rectangular silver-rimmed glasses.
An understated voice, narrow shoulders, nimble.
He has performed three, on occasion four, robot-assisted radical prostatectomies every week, minus vacations in Hawaii, Aspen, Avignon, Nice, Lake Como, Hallstatt, and Lapland to see the northern lights on Christmas, minus holidays at home in Greenwich, all with his wife and two daughters, for the last nineteen years. Call that, conservatively, 2800 and change.
The first thirty, fifty, you learn your way around this new dimension of belief. The next two thousand, you refine your proficiency, each a minor experiment in possibility, and then here you are one May morning, a sunny chill as he walked into the hospital, absorbed by the movements your hands are making, just that, just what's immediately in front of you, like driving 120 miles an hour on a race course, like landing a military jet on an aircraft carrier at night in a storm, by the awe that opens and opens.
Look at this. Look at me. Look at us.
Time outside time funneled to an arrangement of details and stages, first this and then that, the tissue planes giving way in predictable shifts. You won't even begin to sense the fatigue until you flump down into your chair in the lobby cafeteria for lunch. Out of nowhere it will feel like you just stayed up two days and two nights, brain slurry, body a pickup truck stuck in mud.
A bacon cheeseburger with a side of what. Garden salad. Fries. No. Garden salad. Small. Balsamic vinaigrette on the side.
A triple-shot latte.
Catching the first acrid-sweet whiff of burning flesh, pale yellow-orange fat giving way to pink-red muscle, robotic arms worming forward, it occurs to him: A body is the only answer to any question you could ever want to ask.
Except when it isn't.
A similar thought glided through Louis XIV's mind three hundred and fifty years earlier when the Tooth Puller called to Versailles found himself having a particularly difficult time extracting the rotten molar from the Sun King's upper jaw.
The monarch remembered he had lingered on the verge of death like this once before, nine years old, not so much from the smallpox fever, headache, backache, fatigue, and blisters overrunning his body, as from the excessive bloodletting his stable of physicians administered which he could feel elbowing him toward that three-day coma he fell into.
We know this because the monarch's health was monitored closely by those doctors, who meticulously recorded his earthly state each day in a special journal, where it was noted, among other details, that Louis XIV was bright, articulate, sociable, athletic, a fine dancer, relished sweets, and contracted gonorrhea by the time he was sixteen.
That didn't prevent him from keeping at it with diverse mistresses, several years later prompting one husband whose wife was having an affair with the Sun King to visit a brothel with the sole objective of gifting the sovereign with a dose of syphilis, too.
A victim of Crohn's disease, the man who redrew the maps and power relations of Europe and North America in the Treaty of Utrecht received guests while perched on the royal commode, punctuating his encounters with sundry acoustics, some nearly symphonic in scope and sonority, associated with his rococo defecation.
Those in attendance were told in advance to behave as if nothing were out of the ordinary.
A junior court noble, whose name has sadly been forgotten by history, stood nearby, ready to execute his single role in life: wipe Louis XIV's ass when his majesty intermittently raised one of his pale flabby cheeks by reaching under with a double-folded pad of moist lace.
This was a task it would never have occurred to the man who believed himself France's source of light directly bestowed by God to perform upon himself.
The Sun King suffered from gout, typhus, and diabetes.
He was bald by the time he was twenty.
Hence the craze for wigs at court.
Because of his addiction to sweets, coupled with a lack interest regarding dental hygiene, Louis XIV possessed almost none of his own teeth by the time he was forty.
His breath, the daily journal chronicled, smelled like a mouthful of dogshit.
Thus the Tooth Puller early one May morning as a sunny chill draped the ornate gardens and park surrounded by a twenty-five-mile-long, ten-foot-high wall punctuated by twenty-four gateways.
The most experienced if humorless barber in France bore down on the rotten tooth in question.
The king (held in place against his straight-backed chair by two of the Tooth Puller's assistants) groaned, thinking to himself: The cursed human body never ceases its goddamn chattering, does it?
Then came the terrible crunch.
A lightning bolt slammed him.
Louis XIV supposed his brain had just been submerged in a vat of boiling oil.
His eyes rolled back in his head.
He swooned.
The Tooth Puller proudly held aloft his prize for all to see.
Much to everyone's surprise, in his pliers gleamed, not simply the bloody brown tooth that had been giving his majesty trouble, but also a fairly large chunk of his majesty's upper jaw.
Within days the abscess seeded in the surrounding bone flourished.
The man who through his patronage fostered a golden age of French Baroque literature, music, and architecture while persecuting Protestants to the point most were forced to flee the country, spending lavishly on himself and his wars, and ruling with absolute control was certain for the second time in his life he was on the verge of death.
His stable of physicians went to work.
One stood behind him and braced the sovereign's head between the physician's muscular hands; a second forced the sovereign's forehead against the high back of his chair; a third jammed down his lower jaw; a fourth tugged his lips out of the way; and a fifth, using another set of pliers, broke open the sovereign's upper jaw farther to allow the built-up pus to drain, then signaled yet a sixth to quickly bring forth from the next room the red-hot branding iron that had been heating in a fireplace there before Louis XIV could fully take in the arriving information.
That physician guided said branding iron into the king's wide-open mouth in order to sear the cavity the pliers had created and, by accident, a section of Louis XIV's tongue.
Louis XIV swooned again.
Still, remarkably, over the following months he recovered relatively well, aside from the hole in his palate connecting his oral and nasal cavities.
From that day forth, whenever the monarch attempted ingesting them, soup, wine, gravy, and/or water poured from his nose.
Now and then a tiny nugget of meat or potato.
The gurgling, snorting, and spatter-sneezing produced while he ate turned the stomachs of his dinner guests and could be heard, the daily journal observed, all the way out in the corridor.
Despite such shocks to his body, Louis XIV lived another thirty-six years, succumbing at Versailles only four days shy of his seventy-seventh birthday, an extraordinary feat for anyone living through the second half of the seventeenth century and launch of the eighteenth, given the life expectancy in France then was thirty.
The daily journal attributed the Sun King's longevity to the very best medical care available.
In fact, his majesty would outlive all his legitimate sons and grandsons.
Upon his death, in accordance with the French custom established in the thirteenth century, Louis XIV's body was divided into three: his bowels were placed in one reliquary, his embalmed heart in another, and the rest of his remains in a double coffin of lead and oak.
During the Revolution three-quarters of a century later, the royal tombs and reliquaries were desecrated and destroyed.
His heart was stolen by an architect named Louis François Petit-Radel and ended up in the hands of a minor landscape painter, Alexandre Pau de Saint-Martin, who ground it into powder and soaked it in alcohol and herbs to yield a rich burnt-umber bituminous pigment known as Mummy Brown, a color popular among painters from the eighteenth through the nineteenth centurie--including such Pre-Raphaelites as John Everett Millais and Dante Gabriel Rossetti--at which point fresh supplies of mummies and mummified body parts began to dwindle.
Nonetheless, suppliers would continue to offer Mummy Brown to artists until the middle of the twentieth century.
The murky caramel shades in Saint-Martin's tedious painting of a port city in Normandy, Vue de Caen, kept in the basement of the Pontoise museum due to its singular mediocrity, are the Sun King's heart turned pigment.
But Alexandre Pau de Saint-Martin didn't grind up the whole of his find.
Rather, he held back a chunk no larger than a walnut as a souvenir, returning it to the state in 1814 after the first restoration of the monarchy following the abdication of Napolean.
At least that is one story.
There is another, however.
In this one, that chunk fell into hands of one William Harcourt, founder of the British Association for the Advancement of Science, who in 1848 passed it among his guests over port at a dinner party he hosted.
When it reached William Buckland, the esteemed if eccentric theologian, geologist, paleontologist, and Dean of Westminster, he held it toward the light to examine it as if examining an exceptional fossil and proclaimed: I have eaten many strange things, but I have never eaten the heart of a king.
With that, he nibbled off a piece and savored.