"Good morning, Mr. Smith," he said, an ominous tone in his voice. "Let's get started." With a sharp nod of his head, the doctor indicated that he was about to start. Across the room, a nurse flipped off the overhead lights. The glow from the television screen filled the room, and two spotlights illuminated the surgical field and the instrument tray. The not-so-relaxing sound of adult contemporary music was an eerie background to the sounds of the machinery in the room.
"The fifteen and the point one-twos," the doctor said sharply, holding out his hands. The nurse hurried to place the instruments, careful to keep the points facing her, rather than the doctor, terrified of incurring his wrath. Looking through his scope, the doctor placed the forceps against Mr. Smith's eye, then slid the fifteen blade into the tissue at the greyish line that separated the white of his eye from the clear front portion. A small amount of liquid oozed from the fresh wound, though there was a complete lack of blood. The doctor handed back the instruments and waited for the next piece. Again, the nurse hurried, placing a syringe filled with a viscous material into his hand. With a deft movement, the doctor depressed the stopper, and a thin snake of the material began to fill the front portion of Mr. Smith's eye. In only moments, the natural fluid of his eye had been forced out and replaced with this thick substance.
"The diamond blade," the doctor demanded, sounding impatient. He deftly opened the sharp instrument, momentarily admiring how the light glinted off of the perfectly shaped blade. Holding the eye carefully, he smoothly made the second, larger incision. Withdrawing the blade, he looked at it again, almost disappointed that he would have to put it away. Slowly, at least relative to his other movements, he handed the blade back to the nurse and accepted the next instrument, a sort of pick. He made a small nick in the membrane in Mr. Smith's eye, then carefully peeled a hole in it with a pair of forceps. Taking a syring filled with saline, he injected the fluid behind the hole he had just created. Behind his mask, the doctor grinned as he watched the zonules breaking as the saline swirled around, making little eddies in Mr. Smith's eye. This was his favourite part. He prodded inside the eye until the newly-freed lens began to twist gently.
"Phaco," he said, his voice getting softer. The nurse handed over the heavy, silver-toned instrument, carefully arranging the cords so they would not interfere with the doctor's reach. With a slight pressure on the footswitch, the phaco leapt to life in the doctor's hand, humming as he began to remove tissue from within the eye. The humming changed in pitch as he worked, making its own little tune, contrasting with the music that played over the speakers. The doctor preferred the hum of the phaco, though he would never admit that to anyone else. All too soon, it was over, and he had to hand it back to the nurse. She replaced it with a smaller instrument, and he removed the last of the offending tissue from within the eye.
"Lens," the doctor said, feeling more cheerful than he had when he started. "Lens!" he repeated, looking up from his scope to glare at the nurse. Above her mask, her eyes looked terrified as she fumbled with the injector mechanism. "I don't have all day. Lens."
The nurse managed to finish loading the injector and handed it over, nearly in tears. The doctor glared at her once more, his good mood vanishing as quickly as it had started to appear. Almost roughly, he inserted the tip of the injector into the patient's eye. Twisting the end of the injector, he watched as the yellow plastic piece entered Mr. Smith's eye. Handing the injector back to the nurse, the doctor was pleased to note that she had the Sensky in his hand immediately. Carefully, the doctor manipulated the two haptics, the little curved pieces that came off of the middle circle of plastic, manouevering them into place.
It took only a few moments longer to remove the remaining viscous substance from the eye and replace it with saline, then inject another medication to constrict the eye. As the doctor checked his incisions one last time, the nurse across the room turned the lights back on and the nurse beside him began to clean her instruments.
"That's it, Mr. Smith," the doctor said, pulling the sticky drape from the patient's face with little regard for the pieces of eyebrow that now found a home on the drape rather than on Mr. Smith's face. "We'll see you tomorrow." He rose from his stool and tore off his surgical gown and gloves, shoving them into the trash as the two nurses turned their attentions to the patient.
"That's it?" Mr. Smith asked. "He's not going to do anything else?"
"That's it," one of the nurses replied, looking at her coworker with a meaningful glance. "We'll take care of the rest of it."