Irving, who hovered about her like a handmaiden.
Esther's face was cleaned in the nasal region with green soap, iodine and alcohol. The hair inside her nostrils was clipped and the vestibules cleaned gently with antiseptics. She was then given Nembutal.
It was expected this would calm her down, but barbituric acid derivatives affect individuals differently. Perhaps her initial sexual arousal contributed; but by the time Esther was taken to the operating room she was near delirium. 'Should have used Hyoscin,' Trench said. 'It gives them amnesia, man.'
'Quiet, schlep,' said the doctor, scrubbing. Irving set about arranging his armamentarium, while Trench strapped Esther to the operating table. Esther's eyes were wild; she sobbed quietly, obviously beginning to get second thoughts. 'Too late now,' Trench consoled her, grinning. 'Lay quiet, hey.'
All three wore surgical masks. The eyes looked suddenly malevolent to Esther. She tossed her head. 'Trench, hold her head,' came Schoenmaker's muffled voice, 'and Irving can be the anaesthetist. You need practice, babe. Go get the Novocain bottle.'
Sterile towels were placed under Esther's head and a drop of castor oil in each eye. Her face was again swabbed, this time with Metaphen and alcohol. Gauze packing was then jammed far up her nostrils to keep antiseptics and blood from flowing down her pharynx and throat.
Irving returned with the Novocain, a syringe, and a needle. First she put the anaesthetic into the tip of Esther's nose. one injection on each side. Next she made a number of injections radially around each nostril, to deaden the wings, or alae, her thumb going down on the plunger each time as the needle withdrew. 'Switch to the big one,' Schoenmaker said quietly. Irving fished a two-inch needle out of the autoclave. This time the needle was pushed, just under the skin, all the way up each side of the nose, from the nostril to where the nose joined forehead.
No one had told Esther that anything about the operation would hurt. But these injections hurt: nothing before in her experience had ever hurt quite so much. All she had free to move for the pain were her hips. Trench held her head and leered appreciatively as she squirmed, constrained, on the table.
Inside the nose again with another burden of anaesthetic, Irving's hypodermic was inserted between the upper and lower cartilage and pushed all the way up to the glabella - the bump between the eyebrows.
A series of internal injections to the septum - the wall of bone and cartilage which separates the two halves of the nose - and anaesthesia was complete. The sexual metaphor in all this wasn't lost on Trench, who kept chanting, 'Stick it in . . . pull it out . . . stick it in . . ooh that was good . . . pull it out . . ' and tittering softly above Esther's eyes. Irving would sigh each time, exasperated. 'That boy,' you expected her to say.
After a while Schoenmaker started pinching and twisting Esther's nose. 'How does it feel? Hurt?' A whispered no: Schoenmaker twisted harder: 'Hurt?' No. 'Okay. Cover her eyes.'
'Maybe she wants to look,' Trench said.
'You want to look, Esther? See what we're going to do you?'
'I don't know.' Her voice was weak, teetering between here and hysteria.
'Watch, then,' said Schoenmaker. 'Get an education. First we'll cut out the hump. Let's see a scalpel.'
It was a routine operation; Schoenmaker worked quickly, neither he nor his nurse wasting any motion. Caressing sponge-strokes made it nearly bloodless. Occasionally a trickle would elude him and get halfway to the towels before he caught it.
Schoenmaker first made two incisions, one on either side through the internal lining of the nose, near the septum at the lower border of the side cartilage. He then pushed a pair of long-handled, curved and pointed scissors through the nostril, up past the cartilage to the nasal bone. The scissors had been designed to cut both on opening and closing. Quickly, like a barber finishing up a high-tipping head, he separated the bone from the membrane and skin over it. 'Undermining, we call this,' he explained. He repeated the scissors work through the other nostril. 'You see you have two nasal bones, they're separated by your septum. At the bottom they're each attached to a piece of lateral cartilage. I'm undermining you all the way from this attachment where the nasal bones join the forehead.'
Irving passed him a chisel-like instrument. 'MacKenty's elevator, this is.' With the elevator he probed around, completing the undermining.
'Now,' gently, like a lover, 'I'm going to saw off your hump.' Esther watched his eyes as best she could, looking for something human there. Never had she felt so helpless. Later she would say, 'It was almost a mystic experience. What religion is it - one of the Eastern ones - where the highest condition we can attain is that of an object - a rock? It was like that; I felt myself drifting down, this delicious loss of Estherhood, becoming more and more a blob, with no worries. traumas, nothing: only Being . . .'
The mask with the clay nose lay on a small table nearby. Referring to it with quick side-glances, Schoenmaker inserted the saw blade through one of the incisions he'd made, and pushed it up to the bony part. Then lined it up with the line of the new nose-roof and carefully began to saw through the nasal bone on that side. 'Bone saws easily,' he remarked to Esther. 'We're all really quite frail.' The blade reached soft septum; Schoenmaker withdrew the blade. 'Now comes the tricky part. I got to saw off the other side exactly the same. Otherwise your nose will be lopsided.' He inserted the saw in the same way on the other side, studied the mask for what seemed to Esther a quarter of an hour; made several minute adjustments. Then finally sawed off the bone there in a straight line.
'Your hump is now two loose pieces of bone, attached only to the septum. We have to cut that through, flush with the other two cuts.' This he did with an angle-bladed pull-knife, cutting down swiftly, completing the phase with some graceful sponge-flourishing.
'And now the hump floats inside the nose.' He pulled back one nostril with a retractor, inserted a pair of forceps and fished around for the hump. 'Take that back,' he smiled. 'It doesn't want to come just yet.' With scissors he snipped the hump loose from the lateral cartilage which had been holding it; then, with the bone- forceps, removed a dark-colored lump of gristle, which he waved triumphantly before Esther. 'Twenty-two years of social unhappiness, nicht wahr? End of act one. We'll put it in formaldehyde, you can keep it for a souvenir if you wish.' As he talked he smoothed the edges of the cuts with a small rasp file.
So much for the hump. But where the hump had been was now a flat area. The bridge of the nose had been too wide to begin with, and now had to be narrowed.
Again he undermined the nasal bones, this time around to where they met the cheekbones, and beyond. As he removed the scissors he inserted a right-angled saw in its place. 'Your nasal bones are anchored firmly, you see; at
