Alex came awake slowly. He wasn’t sure when he’d fallen asleep; he had no memory of that. He wasn’t sure where he was, or why. This ambiguity didn’t bother him. Nothing bothered him. The whole world was gray. His head felt light, and soft, and the whole world vibrated gently. He didn’t feel any distress at that, either.

He registered that he was on a bed, but someone was talking to him. Maybe two people; he could see two figures backlit by the florescent light around him.

“There you are,” a voice said, warm and low. Somehow, the voice sounded relaxing, playful. “I see you’re nice and relaxed. Having a nice little rest?”

Alex blinked. His eyelids moved slowly, heavy. They almost stayed shut and it took effort to make them open again.

If Alex had been able to focus, he wouldn’t have recognized the woman who had spoken. She was in her mid-thirties, curvy, her hair hidden beneath a green disposable surgical cap. She wore dark blue scrubs, different than most of the nurses Alex had seen so far. A white surgical mask dangled from her neck.

“I’m Dr. Mary Fuentes,” she said. “You can call me Mary. I’m the anesthesiologist. We’re doing things a little bit backwards today, but I’m gonna be taking care of you, okay? Any allergies you forgot to mention?” Alex didn’t understand the question; the whole world was too distant to comprehend. The words should have been terrifying, but they barely registered with Alex at all.

The doctor smiled. “Well, nothing in your file, so we’ll deal with it as it comes. Okay, good.” Dr. Mary turned to the other figure. “Maybe a bit too much midazolam for this one, Nicole,” but the criticism has no heat.

Alex slowly registered the second figure was familiar; it was the nurse from before. Nicole. Her dark blue scrubs matched the new doctor, and like the doctor, her hair now was entirely hidden by a matching green bouffant cap. The outfits, taken together, felt a lot less cheerful and reassuring than that last nurse had.

“Hi again, Mr. Mitchell,” Nicole said. “We’re gonna get you moving.”

Alex gathered his focus. He wasn’t sure what was going on, but remember he had to say something. “I…“ he said. “Need to… to… work.”

It came out thick and barely intelligible, with long pauses between words as the room swayed. The softness in his head seem to fill his mouth, making it hard to use his tongue to shape words.

“I know, I know,” Dr. Mary said, without really listening. “You’ll be back at work soon.”

She had taken a clipboard from Nicole and was flicking through the paper. Her eyes moved down each page without pausing. “Don’t you worry about a thing. We’re gonna take real good care of you. You‘re in good hands, okay?”

“Blood… work” Alex said, trying very hard to say something he thought had been important. The words came out in a strange shape, the consonants melted into the vowels, but it was understandable enough.

“I don’t see any notes about your lab work. It should be fine,” Dr. Mary reassured, reading the file further. This statement confused Alex, but that’s what he’d wanted, wasn’t it? That was good. Alex felt re-assured. Had he ever felt not-assured? He wasn’t sure.

Nicole had produced, from a shelf behind the gurney, a thin paper package. She tore the bag open and pulled out a thin bouffant cap, this one blue instead of the green both nurses wore. She shook the cap out until it was vaguely hat-shaped. She leaned over him and he felt her fingers gather the hair at his temples, felt her tuck it gently up and under the elastic, felt the light band of the cap settle around his forehead.

“There you go,” she said, cheerfully. “Just one more thing.”

She picked up his right wrist, the one without the IV, and her gloved fingers held it as she fitted a narrow white plastic band around it. The band had a small adhesive clasp; she pressed the two ends together and smoothed them flat. Alex looked down at this with a vaguely detached curiosity. There was a name on the band. MITCHELL, ALEX. His date of birth. A number. A doctor’s name he didn’t know. Some other letters organized into a medical-looking word that was a mystery. The letters blurred quite a bit; his eyes were not quite willing to hold focus. None of it meant anything to him anyways.

“I think we’re ready to go,” Dr. Mary said. “Everybody is way behind today, but we’ll take you over now.” The explanation didn’t explain anything to Alex. He heard a familiar soft sound as Mary pushed the curtain open its track, opening the bay up to the rest of the large room.

Nicole leaned across the base of the gurney and Alex felt, through the thin mattress, a pair of small mechanical thuds as she released the brakes with the side of her foot. The gurney shifted slightly and Nicole pulled it slightly away from the wall. Dr. Mary stepped around to the head of the bed and laid her hands on the bar there.

“Here we go, Mr. Mitchell,” she said. “Short little ride.”

The bay began to slide away, or rather the world outside began to move. Linearly this time, rather than around in a circle or back and forth. The green curtain slid away from him and the pre-op room opened overhead. Alex watched the ceiling tiles and fluorescent lights above him begin a slow procession, each long white panel sliding into view at his feet and traveling up out of sight past his forehead. One of them, he noticed with the limited focus that his current drugged state allowed him, was flickering as they went by.

They rolled past the Nurse’s Station. He could hear voices from a great distance, and they sounded familiar. He turned his head towards them. It seemed to take a long time, as if trying to move during a dream, as if he wasn’t in charge of his own body anymore. He saw, at the edge of the station’s counter, a woman in a neat cream blouse, her hair drawn back into a low bun, with reading glasses pushed up the bridge of her nose. She was talking on a phone. He had met her earlier, he was sure, but a name was slow in floating up.

“… how shorthanded we are,” the woman was saying, her voice clearly annoyed, “I’ve been waiting for an NP to get here, and I have a new hire waiting…“

The woman’s eyes passed over the gurney as it moved through her line of sight. They did not stop. She did not recognize the blue-capped figure, dressed in a patient gown and a patient wristband catching the light. He was just another patient going by. The gurney rolled on.

That woman’s name, Alex thought, slowly and dispassionately, was Linda. That was Linda, and she was looking for an NP. She still hadn’t found one. That was… somehow… important to Alex.

The gurney turned. Alex’s train of thought was abandoned, unfinished.

They passed through a set of double doors that swung open before them, automatically, Alex thought. Beyond the doors, the air changed. It was colder here; he felt the chill slide over his bare calves under the gown. And the corridor was quieter, the alarms and ringing phones and low murmur of nurses cut off as the doors shut behind them. If Alex had looked over the side of the gurney, he’d have seen that the linoleum had a different sheen, less worn, more freshly mopped, reflecting the overhead fixtures in long bright smears.

“Almost there,” Nicole said, and patted his shoulder through the thin gown. “You’re doing fine.”

Alex tried to smile at her. He felt fine.

They turned a last corner, and the gurney rolled through another set of double doors. A small stenciled sign on the wall beside the door read Operating Room 2.

The room seemed brighter than the hallway. If Alex had been able to survey his surroundings he’d have seen that it was more modern than the rest of the facility. The tile floor had been refinished sometime this decade, a slightly darker shade of green, and the walls were an institutional off-white. At the center of the room, under a pair of massive surgical lights mounted on articulated arms, an operating table stood. It was covered with a clean surgical-blue pad, and awaited a patient.

Near one wall, a tall machine on wheels towered above the head of the table. It was as tall as a person, with vertical flowmeters and two different vaporizer canisters mounted on the front. Off the side hung ventilator bellows, a large CO2 absorbing cylinder and a pale green rebreathing bag, not yet inflated. A corrugated hose looped down to where a mask was already fitted, on a hook nearby. Two bright computer screens, these obviously working, were illuminated above the workstation.

On the machine’s flat top, various drug ampoules were lined up but not drawn, syringes and tubes laid out in their packaging, a laryngoscope not yet assembled. The anesthesia tech, who’d have helped get these items ready, was off lost in the storm somewhere.

On the opposite side, near the foot of the table, a nurse was standing in front of a broad metal table. The scrub nurse was capped and fully masked, and she wore a long, smooth blue gown, which covered her from neck to almost her ankles. She was flipping out the corners of a surgical blue drape with small sharp snaps of her wrist. She did not look up when the gurney rolled in. Her hands were covered with long, white gloves, and they moved deliberately as she lifted instruments one by one from a nearby tray, placing them in rows on the draped table.

“Here we are,” Dr. Mary said, guiding the head of Alex’s gurney to align alongside the operating table. “We‘re gonna slide you over. Nice and easy.”

Another nurse had appeared; she was anonymous with her featureless blue gown, green cap and mask tied up. Together she and Nicole took hold of the sheet under him and lifted. The world swam for a moment and then he was on the table, narrower and firmer and colder against his back through the thin cloth he wore. The gurney, relieved of him, was rolled away and disappeared from his reality. For Alex, the whole world still seemed to be swaying back and forth. Despite feeling the literal cold of the padded table, his head felt warm.

“He’s pretty snowed,” Dr. Mary said to the room, casual, almost amused. She had moved to the head of the table and was sorting and the items she’d need; a few sizes of ET tubes, a coil of clear tubing, checking all the vials were correct. She glanced at his unfocused eyes and his loose jaw and made a small approving sound. “We might as well go ahead and get him positioned. He’s not gonna remember a thing and the other case is running behind. I still need to draw up meds.”

“Mr. Mitchell,” Nicole said, leaning over him from the right side of the table. “I need you to scoot down for me. Just a little. Toward the end of the table. Can you do that?”

Alex did not know why she was asking. He did not have the focus, any longer, to form the question “why” about anything going on around him. He planted his heels weakly against the padded table and wiggled a bit. His hips shifted a few inches downward along the table. Nicole and an anonymous nurse took hold of his waist through the gown and slid him a bit more, until his pelvis lay at a very specific spot on the table. Mary paused her preparations on the machine, and helped slide a U-shaped foam pillow under his neck and head. His head tilted back, up at the lights.

“Good job,” Nicole said softly. “Perfect.”

From the foot of the table two nurses produced a pair of stirrups. They were large and padded, made of black plastic and blue foam, big enough to cradle an entire calf and the sole of a foot. They were mounted on articulated arms that swung up from sockets in the table’s frame and firmly locked into place with metallic clicks.

The nurses lifted his legs, one at a time, and fitted his calves into the boot-like cradles. The foam was cool against the back of his knee. They rotated his legs outward, in the same movement, and his thighs fell apart at an angle his body did not normally make. When both legs were lifted, a wide strap was drawn across each thigh and then tightened.

Somewhere underneath the forced relaxation and the softness of the drug, two alarming thoughts floated into Alex’s head. He started to recall, from very far away, that he’d needed an employment physical. He didn’t think that the bodies of men undergoing an employment physical usually were arranged like this. But the two thoughts still felt separate, unrelated. The midazolam held them apart, at least for now.

“Let’s get that gown off you,” Nicole’s voice. “We’ll get you a blanket instead.” Nicole’s gloved hands dug under his back for a moment, but quickly found the knotted ties. They tugged loose with no resistance, and Nicole peeled the gown away from his shoulders. She lifted his arms, and pulled the gown all the way off him. Alex felt the air of the cool OR over the skin of his chest and belly and crotch now. He was aware, distantly, that he was naked except for the blue cap and the plastic name band around his wrist. Some sense of embarrassment should have made him uncomfortable, but the drug’s relaxation filled his head so completely he only registered it in the abstract, equal to the mild annoyance at the cold air.

One of the other nurses, anonymous behind her mask, unfolded a wide, blue sheet, draping over his hips and thighs. The act was meant to spare him some vulnerability as they continued their preparations, but Alex just couldn’t care about anything very much. At the head of the table, Nicole was clamping two blue pads, one above each of Alex’s shoulders. He couldn’t see them, but they attached to the frame of the surgical table and extended upwards just a few inches above its surface. Nicole adjusted them until they were gently touching just above Alex’s collarbone, making sure that the patient couldn’t slide towards the head of the table at all.

“Arms, now, My. Mitchell,” Nicole said, moving to her next task. “Let’s get these out for you.” Nicole had unfolded an armboard from somewhere under the right side of the table, clamping it in place perpendicular to his body. She walked to the other side of the table, disappearing out of Alex vision for a moment, and did the same on the left side. She patted the green surface of the left armrest.

“Slide your arm out here for me, please.” The instruction was too complicated for Alex, but he lifted his arm and Nicole’s gloved hands took his wrist. His arm felt far away, like he’d left it outside, in his car, and it’d become numb in the cold. Nicole guided it out with gentle pressure, turning his wrist such that the IV in the back of his hand faced up. The padding was chilly where his palm touched it. Nicole reached up, and connected a coil of IV tubing from a hanging saline, which, after a moment, began to drip.

As soon as the arm had been positioned, Dr. Mary appeared and slid a pulse oximeter onto his pointer-finger. A monitor on the anesthesia cart above him began to beep, slow and regular.

On the right, the anonymous nurse took his other arm, coaxing it into the same extended position. Both arms stuck out at right angles now, cruciform. Alex wasn’t sure he liked the feeling but the room still vibrated, still seemed warm and far away, and any concern still belonged to someone else. Nicole appeared again with a blood pressure cuff, which went around Alex’s right arm. He vaguely recalled a nurse named Ashley taking his blood pressure some time ago, and this one began to squeeze just like that had. The memory nagged at him, almost reminding him of something that seemed important, or maybe alarming. He couldn’t figure out the words but he made a noise of confusion.

“Shh,” said Nicole. She smoothed a hand over the blue cap on his head. “It‘s okay.” Alex believed her and let the memory go for now.

Dr. Mary loomed above his head. She was masked now. She ripped open a packet, peeled out five round white electrode pads, and pressed them each to his chest and abdomen. “There we go,” she said, as she pressed the fifth electrode just beneath his left ribcage, then snapped the leads onto the pads, one by one.

Nicole drew a wide black strap up from underneath the armboard, and laid it across his right wrist. She brought the two ends of the strap together and drew it snug, tucking the IV line clear of the closure before pressing the Velcro closure flat. On his left, an anonymous nurse did the same. The straps were not uncomfortable. They were just there, the way everything going on around him was, but something in his subconscious made him try to pull his right arm back a few inches. The strap prevented it.

“Don’t worry about those,” Nicole had noticed the movement. “We just need to make sure you don’t get your hands caught when we’re adjusting the table. Which we’re going to do now, all right?” Nicole didn’t wait for Alex’s consent but nodded to a nurse nearby.

There was a mechanical hum from the table, low and vibrating through the padding and into his spine. The head of the table began to tilt downward, slowly, a few degrees at a time. At first, Alex didn’t really perceive the move; after all, the whole world was swaying back and forth. But after a few moments, he could feel the gravity shift; a new heaviness in his head that had nothing to do with his sedation. The shoulder pads pressed gently against his collarbones, holding him in place against the new angle.

Then something happened at his feet. Or rather, below his feet. A nurse pressed a control, and then the lower portion of the table simply fell away. It hinged downward and away from his legs, leaving nothing beneath his thighs and calfs but air. The stirrups held his legs up and apart, cradling them in their padded boots, but everything below his pelvis now hung suspended over empty space.

This situation should have been terrifying under normal circumstances. But with the sedation filling Alex’s head this all seemed distant. It was confusing, but only when he tried to concentrate.

The door to the operating room swung open with a loud sigh of moving air. For some reason, Alex expected Linda, the HR lady, looking for him. But instead, Alex saw a new woman. A new nurse, with deep blue scrubs. She stood in the doorway and didn’t quite step through.

“Dr. Mereno’s still working on other case,” she said. The mask she held over her mouth muffled her voice only slightly. “Maybe 20 more minutes, but she says you can induce.”

“Copy that,” Dr. Mary said, without turning or looking up. She sounded annoyed. She was unwrapping syringes from their plastic packages on top of the anesthesia cart. The door sighed shut.

Alex, flat on his back on the narrow padded table, tried to hold the words in his head long enough to examine them. Doctor… Moreno… working. Twenty minutes? Can Induce. Each word he knew, and he had heard them in order, but when he tried to hold them all at once, they began to sway and became distant and blurry, just like everything else.

“I don’t really want to extend anesthesia time that much,” Dr. Mary was talking thing to Nicole. “I think he’s relaxed enough to get the urinary catheter and drape now, don’t you?”

Nicole looked down at Alex’s slack face, and agreed.

Even through the soft grey that lay between him and the entire world, Alex wasn’t sure that that sounded good. Slowly, deliberately, Alex started to re-assemble the two thoughts he’d had before.

He needed a physical exam, for his first day.

You didn’t position someone in an OR for a physical exam.

For the first time, the two thoughts related to each other, and related to him.

Something was wrong. He was sure now.

Above him, the enormous disk of the surgical lights were being tilted into position by a gloved hand, and both lights blazed suddenly into full brightness, two small suns pointed at his lower body. He squinted, momentarily distracted from his newfound certainty.

“Alright, Alex” Dr. Mary’s face resolved only partially as she leaned into his field of view. Her surgical mask was up over her nose and mouth, but her eyes were visible, warm and unbothered. “We’re going to start getting ready for you, and you might feel some pressure, alright?”

Alex moved his mouth. He wasn’t sure what to say, but he was starting to understand he had to say something. He’d explain. It was his first day.

“First… day,” he managed. The words were, to his surprise, completely understandable. He’d said it! He felt a moment of triumph. He’d done it!

But Dr. Mary ignored him, turning away, reaching for something on her tray.

“Don’t worry, Mr. Mitchell,” Nicole leaned in from his left side. Above her mask, her alert young eyes crinkled into a small indulgent smile. “It’s not our first day, hon. We’ve done dozens of prostatectomies this way. Dozens and dozens. You’re in good hands.”

“Pros…tate…ectomies?“ Alex slurred, confused. That wasn’t the word for a physical exam. That seemed wrong. Alex took a moment to try to understand.

Dr. Mary had turned back. In her purple-gloved hand, she held a clear plastic anesthesia mask, hollowed to fit the architecture of a human face. A length of corrugated tubing in translucent plastic trailed from its port back toward the large anesthesia machine at his head. She held the mask up so he could see it.

“Just a mask,” she said. “I’m gonna place it over your nose and mouth. I need you to breathe some oxygen for me, nice and easy.”

She lowered it.

The clear plastic rim settled against the bridge of his nose and along the soft edge of his chin, and the cushion sealed tightly against his face. The smell was the smell of new plastic. He could feel and see, through the clear vault of it, her purple-gloved fingers spread on either side of the seal, pressing the mask down gently, but firmly. With her other hand, Dr. Mary drew four plastic straps from the foam pillow, up to the sides of the mask and secured them, one by one.

He remembered something was wrong. He turned his head. It was a small movement, a weak shift to the side. The mask moved with him, the harness holding it on.

“Don’t fight it,” Dr. Mary said. Her voice reassuring. “It’s just oxygen. Breathe normal for me while we finish getting ready. That’s all you have to do.”

Nicole’s hand came down on his shoulder. The pressure of her gloved palm flat against his shoulder. Her thumb stroked once, twice, along his collarbone in a slow reassuring arc.

“Relax, Mr. Mitchell,” she said. “Everything’s fine. You just breathe for us. We‘re taking care of you.”

Alex breathed because he did not know what else to do, and because the women had told him to. The faintly plastic-scented air flowed into his mouth and down the back of his throat, and his chest rose and fell. On Dr. Mary’s machine, the rebreathing bag inflated and deflated in time with him. But he remembered his two thoughts again. Something was wrong.

Suddenly, there was a flash of cold. The drape over his pelvis had been removed. The scrub nurse was there, at the foot of the table, between his spread legs. He felt something cold and wet press against the skin between his thighs. The cold spread in slow deliberate strokes; she was painting circles of antiseptic across the sensitive skin in places he really didn’t want anyone touching, even through the grey haze.

His right hand wanted, suddenly, very much to come up to his face. He wanted to push the mask off, so he could talk, even if he still wasn’t sure exactly what to say. He tried to lift it. The strap across his forearm held. He tried the left hand. No better. His fingers curled weakly and uncurled. He tried again. No.

“Hold still, Alex,” Nicole said, using his first name for the first time. Her hand on his shoulder increased its pressure. “You need to hold still for us. Don’t pull on that.”

A small stirring of real alarm had begun, deep within his chest. Even if it was hard to hold onto his thoughts, he knew he wanted his arms free. He knew he wanted his legs free. He knew he wanted the mask off. He pulled, he twisted, he tried to turn his head. None of it worked, but his body tensed and jerked on the table.

“Mary.” Nicole’s voice had sharpened slightly. “He’s getting a little agitated.”

“I see it.” Dr. Mary was already reaching up above his head. “I think we can make this experience a little less scary.”

Dr. Mary reached over to her tall machine at the head of the table. Her gloved fingers adjusted two knobs on the front, adjusting the oxygen and starting the flow of nitrous oxide.

The bag on the machine inflated and then collapsed as Dr. Mary gently squeezed it, once, twice. As Alex tried to weakly struggle, the mask filled with the new gas, filling his lungs as she massaged the green bag. There was nowhere to go; the harness held the mask on tight. Alex’s thoughts, already difficult to hold through the grey of the midazolam, rapidly were obscured with a harsh fuzz.

“Easy, Alex,” Nicole comforted. “Just breathe easy.” Alex pulled again. His wrists strained against the straps, the Velcro holding firm, unyielding, the padding beneath it barely shifting. He pulled harder. The muscles in his forearms tensed and trembled but the straps were too strong, and besides, his body wasn’t responding right. Mustering all this effort was difficult through the grey. Both arm stayed where they were, pinned flat to the boards.

He thought about his legs, splayed above him. He tried to move his legs. The stirrups cradled his calves in their foam boots and the straps across his thighs were wide and snug. He pushed with his heels, tried to draw his knees together, but the blue stirrups held his legs apart at an unnatural angle and the muscles of his thighs simply trembled without producing any real movement. The shoulder pads above his collarbones prevented him from even pushing his body downwards.

And the whole time that he was struggling, he was breathing. A deep whooshing noise started, not in the room but in his head. It was the sound of the wind, blowing the fuzz into his head. The sound of blowing snow. The noise grew louder with each breath. He knew something was wrong, and that he had to get loose. But he took another breath, and there was too much wind and fuzz in his head to remember why. The mask, the mask was a problem. He tried to concentrate on moving his head away from the mask. He twisted his head to the right, the motion slow and uncoordinated. The mask followed, the four straps pulling taut against the back of his skull, the soft plastic rim tightening slightly against the bridge of his nose but never breaking its seal. He twisted left. The same. The cushioned edge of the mask simply rode with him, molded to the contours of his face.

The noise in his head got louder. It had been hard to think with the midazolam making the room move, making the world distant. With the addition of the nitrous, the sound of the wind, and the fuzz, no, the snow in his head made thinking impossible.

When Dr. Mary leaned into his vision again, all he could concentrate on was her white surgical mask. It seemed to glow in a sea of falling snow. How he’d gotten here, his concern, any memory of a physical exam, he’d known a few seconds ago. But now… they were lost in the storm.

Alex stopped struggling.

The scrub nurse had finished the skin preparation between his legs. Alex had completely forgotten her. She’d finished applying antiseptic and had moved on to her next task. He could have almost seen what she was doing, because of the angle of the table, but he didn’t remember to look. He felt something cold and slick, pressed against him, being inserted where he’d never had anything inserted before.

His hips twitched, but with the restraints and the sedation it was only a small move, and it was barely discomfort. The scrub nurse’s gloved hand advanced the catheter inside him, and the pressure increased, a slow steady advance, the lubricated tip sliding into him. She’d done this a thousand times before. Even through the nitrous he felt it travel deeper, a thin foreign presence somewhere unfamiliar and unwelcome. But not painful.

“Almost done down here,” the scrub nurse said, not to him but to the room. It didn’t matter. The wind in his head was so loud.

The scrub nurse inflated the foley’s balloon, settling it deep within his bladder. She gave the tube a small tug, gently, pleased that the catheter stayed in position. His bladder began emptying without his permission, without his effort, the urine flowing by gravity into a collection bag that the nurse had hung from the side of the table frame.

“Foley’s in,” the scrub nurse announced.

“Good,” Nicole’s voice, from somewhere above and to his left. “Thank you.”

The snow in Alex’s head fell thicker. He was breathing steadily now. He looked up at the surgical lights and tried to think. All he could think of was of snow. The snow was completely filling his head now. It was piling up, forming large drifts behind his eyes.

Somewhere, distantly, his legs shifted in the stirrups. He felt the foam pads flex against the backs of his knees and felt his ankles push inward and outward once or twice in small, purposeless motions. The blood pressure cuff on his arm squeezed again. He couldn’t remember what the feeling was.

The scrub nurse was draping blue blankets over him now; one over each leg. The heavy blue fabric settled over his shins, his knees, draping the stirrups themselves. Another drape went across his lower abdomen, its edge folded precisely just below his navel. The nurse’s gloved hands smoothed each layer flat, tucking edges under the foam of the stirrup boots, clipping the corners to the frame with small metal clips that clicked into place. The addition of these blankets might have been reassuring if he wasn’t so far away, but the nurse didn’t cover the spaces between his legs, and that might have been concerning.

These motions were happening, he was aware, but they were happening to a body he was currently only loosely attached to. The armboards held his arms out in their crucifix pose, his head tilted down, his pelvis exposed. But it didn’t matter. Nothing that happened around him mattered.

Dr. Mary had turned aside. On her stainless tray she was finishing drawing her drugs into syringes. The last one had an especially large barrel, and she drew it full of a milky white substance. White like snow. She capped the needle and set the propofol down on the anesthesia cart.

The room settled into a strange quiet, as everyone waited. The beeping of the pulse oximeter marked time in slow, even intervals. The surgical lights blazed above him, twin white suns far above the snow storm that was still happening in his head.

But maybe the midazolam was starting to wear off a bit, or maybe the quiet and stillness let him start to think again.

Because again, he was trying to remember. He was trying very hard.

There had been a reason. A reason he was here.

It was… his first day. He’d needed a form signed. Linda. A woman named Linda.

The thought dissolved. The snow covered it over, smooth and white as if nothing had ever been there at all.

But… he tried again. Linda… he had to talk to Linda.

The table was cold beneath his shoulder blades, cold, like snow. He was on a table, exposed, legs apart, arms out, tilted uncomfortably. An operating table. He wasn’t supposed to be here, was he? His lips moved behind the mask, shaping air into something that might have been a new objection, but it was no more coherent than his thoughts. And it was too quiet for anyone to hear over the steady mechanical hissing of the machine above his head.

Dr. Mary had moved away from the head of the table. He could hear her voice somewhere behind him and above, talking to someone; to Nicole, perhaps. Alex couldn’t see her, either. He started to feel very alone, despite the figures moving around him.

Time passed. He was almost certain time passed, because the beeping continued its count, and the bag breathed, and the background hum of the room did not change. The blood pressure cuff squeezed his arm again. And again. But how much time it was, he could not say. A minute. Ten minutes. An hour. The snow in his head made all durations equal.

The door opened again. He heard the pneumatic sigh of the seal breaking, the shift in air pressure that against the exposed skin of his chest. Alex’s eyes moved toward the sound, a glacial rotation of his skull against the foam pillow. Through the snow in his head, through the white roar and the sweet plastic smell of the mask, he saw a figure in the doorway.

He knew it was Linda. She’d found him, he thought. He couldn’t remember why but knew he wanted this; it was what he needed. She’d come. He could talk to her, figure out what was going on. She’d found him, and she’d explain… something… about his first day. An employment physical.

The figure stepped forward and Alex could see it was not Linda.

It was a nurse. Another nurse, anonymous, blue scrubs and a mask. “Dr. Moreno’s ready,” the nurse said. Her voice was clipped, efficient. “OR 1 just closed. She’s scrubbing now.”

“Finally,” Dr. Mary said. The word came from behind him, above him. “Okay. Tell her we’re ready to go in here. Patient’s been positioned and on nitrous for longer than I’d like, honestly. Let’s get this show on the road.”

The door nurse disappeared. The OR door shut.

Dr. Mary’s face appeared above him, inverted, framed by the bright lights, her eyes the only visible feature between her green cap and white mask.

“Okay, Alex.” Her voice had changed. It was quieter now, more deliberate, the casual friendliness replaced by something practiced and cold. “You’ve done great and now it’s time for lights out.”

Alex looked up at her and felt real fear. He couldn’t totally explain why, but he didn’t want this. But it was too late. Dr. Mary reached for something above his head. Then her hand came back into view holding the large syringe, filled with the milky white propofol. Nicole was above his left hand and Mary handed her the syringe.

“Nicole is going to give you some medicine through your IV now,” Dr. Mary leaned down. “It’s going to feel cold going in, and then you’re going to fall asleep. Nice and fast. When you wake up, everything will be done.”

“No…” Alex thought, but the words didn’t make it out of his mouth.

Nicole took the syringe in her own purple hand; everything else was white; the bright white of the syringe was like the bright white lights above him and the white snow that filled his head. She uncapped it, and fitted its tip into the small port on the extension tubing of his IV line, the one that looped off the armboard and trailed up towards the hanging bag of saline and she braced her thumb on the plunger.Alex watched her through the haze. Nicole smiled behind her bright white mask; Alex could see it in her eyes.

Nicole pressed the plunger.

The bitter cold began at the back of his hand. Ice; it was the feeling of ice. The sensation traveled up the inside of his forearm; ice water running up his vein. Alex shuddered. He tried to pull his arm away, but it was ineffectual, because it was already inside him.

“You’re doing great, Alex.” Nicole’s voice was low, sweet, like honey. Her free hand stroked the length of his forearm above the IV site, a slow petting motion, warm through her purple glove. “Almost there. Almost there. You have a nice sleep, okay? When you wake up your surgery will be all over. You won’t feel a thing.”

The ice water climbed past the crook of his elbow and fanned out along the inside of his upper arm, into his shoulder, running to his heart. From there, it’d be pumped to his brain.

He tried hard to think again, to remember, maybe to protest, mustering all the willpower he could. His mouth opened, loosely. A sound came out of it. The sound was a soft moan and it did not make any sense as a word at all.

Nicole’s face floated above him, smiling gently behind her mask, her eyes showing a sort of professional kindness. Above him, Dr. Mary loomed, backlit by the surgical lights. The propofol syringe was empty.

A third face moved into his vision above him.

It appeared on his right, a woman, scrubbed and gowned in blue, with long white gloves pulled up over the cuffs. Her surgical mask and cap hid everything except her eyes, which were dark and sharp. She held her white-gloved hands high, to keep them sterile. Just from her eyes, Alex knew this was the surgeon.

She looked down at him, then her gaze moved over his body without particular interest, checking to make sure all was ready for her blade. “The GI case ran long,” the surgeon said, her voice clipped and flat, directed somewhere above Alex’s head. “Bleeding wouldn’t stop. But this one’s straightforward, and the perineal approach will be quick.”

Her eyes flicked down to his face once more. The surgeon had, of course, previously met the patient that was supposed to be here. She’d discussed that patient’s reason they’d needed the surgery, all the possible complications, all the ways it would effect their life afterwards. Now there was a patient in front of her, prepped and positioned and being sent to sleep. There was no reason for her to even consider one patient was not the other. Even if she’d wondered, with the computers down, his wristband matched the file and that’s all that mattered.

She moved away. She stepped toward the foot of the table, toward the space between his legs where the surgical lights were focused, that the drapes exposed, where the tube was already inside him. Where her work would start just in a few seconds.

Alex, his arms strapped to their boards and his legs in their stirrups and the milky white of the propofol already in his brain, felt a moment of profound dizziness. The surgical lights above him blurred into one bright smear, and the faces softened, and the softness expanded until there was white everywhere. The white of snow.

There was snow everywhere.

Then there was nothing at all.