I walked into the room and was reflexively handed the patient’s chart by one of my nurses. Out of comfortable habit, I flipped it open and quickly scanned the first two pages. The words and numbers on the page were not news to me. That same, so comfortable smile slid onto my face, that business veneer I plastered on to help ease my patient’s nerves. It was all a routine, a series of actions which helped me get into the part, play the role of the caring and sympathetic doctor no matter what happened to be swimming in the murky rivers of my mind a few moments before.

“Good morning Victoria, how are you feeling this morning?” I said warmly, the words so practiced I found myself falling into them even at inappropriate times, like in the grocery store checkout line. As I look up past the edge of the folder my eyes slide over the woman before me.

Nerves hid, not too convincingly, behind a smile. Pale skin and a general beauty that would probably be lost to age but for now, in the prime of life, she was a striking figure especially with those flowing locks of simmering flame which had not been diminished by the unfortunate circumstances of her current living conditions. I take in her form quickly, wrapped in a thin pale blue hospital gown, but my eyes are drawn down to her leg, to her toes and there they catch as an unexpected spot of color holds my attention. A bright mint green painted across her delicate toenails. A shade of color that was suspiciously close to the color I used to see in operating theaters about 10 years ago. Normally such things would not give me pause, certainly would not cause me to stumble in my well rehearsed train of thought and action but this one did. Such an odd little thing, that color spread across 10 toes, it was so small, subtle in a certain sense, but it stood out to me like a neon sign. I didn’t know what to make of it.

I caught myself, I am sure the pause was probably nearly imperceptible to Victoria or any of my nurses but it felt like an age to me. Victoria had responded. I had missed it entirely. Something normal I assumed based on the fact none of my nurses gave any hints in their body language of something unusual. So I slid back into the familiar rhythm, trusting any oddity I might display would be quickly overlooked or forgotten. “Good and do you have any questions about the surgery today?” She shook her head briefly and I would have sworn there was a slight smile on the corner of her lips but it was gone in an instant and I had the sneaking sensation that my lack of sleep last night might be playing tricks on me. I then notice the pile of clothing on the chair in along the fall wall, neatly folded and on top of it sat a pair of dark black stiletto heels. It was so very hard no to stare but it would be wise not to jump to any conclusions, no matter how much a part of me wished they might be true.

“Excellent, well as discussed it's all very straight forward, everything should take a few hours at most. Don’t worry you're in excellent hands. Dr. Armstrong, your anesthesiologist, will be in shortly to start the medication and answer any questions you have about being put under.” Victoria nodes towards me.

“Thank you Doctor, thank you so much for giving me this opportunity, for helping my husband and I out like this.” I smile another reflex to make sure my face doesn’t express anything that would be unprofessional.

“Truly it is no problem. I’ll see you in the OR.” I say as I turn and slide the chart back into the holder on the door on my way out. I walk down the hall towards the operating suites. I adjusted my glasses, my mind walking several paths but all of them led back to that little spot of mint green on my patient’s toes.

The mystery captivated me all through my preparation and it still had a latch on my mind when I walked into the operating room. The air was brisk and heavy with the caustic odor of antiseptics. The sight of the lights looming down over the table in the middle or the room, bathing its occupant in bright clear light brought a peace to my mind. Everything was once again right, where it should be, instrument trays arranged where my staff knew I liked them. Monitors already on and little colored lines flicking across screens like boats being rowed across Perimeter Lake by the University. Nurse Stevenson helped me into the surgical gown and then into a pair of sterile gloves. She shared a warm knowing look with me and I returned it. Her brown eyes glinted and I winked at her.

As I walked up towards the side of the table I took in my patient. A long flowing curve of pale flesh against the dark blue drapes, her hair now pulled back into a thin bouffant cap which though blue itself made her hair seem auburn rather than its bright red from some thirty minutes before. The gown still clung to the upper half of her torso, draping gentle curves through her lower half was bare, her legs up into holders secured and spread. A dark blue curtain had been put up right above her breasts which would make it impossible for her to see what was being done to her now. One of my attendants was in the process of finishing placing a catheter. The tray of shaving equipment was being rolled away and replaced with another tray sporting a large Collins speculum, several sets of forceps, a syringe, and a small basin.

But then, my eye was caught once more on that little bit of green paint upon her toes which wiggled ever so slightly in the air. Suddenly my mind began to spin and that those 10 little facts had a hold of my mind once more. This time I know I paused for a moment longer than before. Ideas collided into each other in my mind and they brought me to a halt. I shook it off, looking past the carnage of my sanity and relied on well worn routines to keep myself moving in the right direction. I moved up past the drape. Victoria’s head turned slightly and watched me approach. She blinked her eyes, her pupils struggling to focus. I smiled behind my mask.

“Doctor Ward?” her words came out ever so slightly wispy. I nodded. “Yes, I’m right here as I said I would be. I promise I will take care of you.”

A warm, innocent smile spread across her face and she nodded slowly. “Gooooood,” she intoned. I look over at Dr. Armstrong and nod. He moves to pick up the dark black mask and his fingers twist a few vales.

“Now Victoria you need to go to sleep for me so I can begin my work. Just take some nice deep breaths for me,” I say as Dr. Armstrong lowers the mask over her nose and mouth.

Our eyes lock for a brief moment, as the mask discends. I see something shoot across her eyes, across her lips, a rush of excitement, a thrill, a slight flush and the edges of her lips quirk into a faint smile. Then the mask is in place and I am left wondering if they any of it was ever actually there. My heart starts to pound.

I watch her take a deep breath, Dr. Armstrong’s gloved hands rock her chin up slightly. “Just relax Victoria and start counting backwards from 100 for me.” She takes another deep breath and then her muffled, slightly unsteady voice starts, “One hundred..ninety-nine…. Ninety…eight…..ninety…….seven…….” Her eyelids start to flutter matching the flutter in my own chest. I watch her chest rise and fall deeply, and I remind myself to do the same. I move down the table slightly and pull the gown from her, revealing the rest of her torso. I watch her breast shudder and she takes another deep breath. I exhale. My mind is racing now. My eyes trail down her curves down to her feet, to her toes which are curled up tight and then it happens, that wonderful moment of peace descends. The tension begins to drain from her body and I watch as her toes slowly unclench. I walk down and gently draw my gloved hand over her left foot, drawing my thumb down her big toe and across the painted nail. I pause again, the chaos in my mind finally unraveling and starting to make a bit of sense.

I run my hand down her leg as I take up my seat upon the stool at the end of the table as my attendants begin placing the drapes over her torso and legs. I drew my hand down her vulva, stained an almost garish orange in comparison to her delicate freckled skin, and I spread her lips with fingers, noticing a bit of fluid at the base of those tender pink folds. I smile broadly as my assistant hands me the collin’s speculum. Oh I am sure now. I am sure I saw all of it and she meant for me to see it. I’m also very sure about what I am going to do next.