Short Story: Carotid Surgery



There’s a good reason women make the best surgeons, she thought. Quick, deft hands, single-pointed concentration, focus. She thought of the women jet engine mechanics she had met in the Air Force. Not that she had been in the Air Force; but in the course of her duties she had met them.

Now, however, she was intent on the task at hand. Drat this light, she thought. She really needed a more direct light source, but one has to work with what one has at hand.

Slowly, painstakingly, she drew the outlines with a surgical marker: carotid triangle; carotid vein; carotid artery. This, the artery, was what she wanted.

She steadied the syringe she had readied with an oh-so-fine needle: 27 gauge. 2% lidocaine with epinephrine. Enough analgesia for comfort, and enough epi to ensure a relatively bloodless field. She couldn’t help chuckling: bloodless indeed.

Squinting in the insufficient light, she injected the layers: first the skin, then the loose fascia of the neck. Lastly, the layer surrounding the vessels of the neck, careful to avoid direct injection into the wall of the vessel, which might cause a spasm.

Now it was time to cut. She picked up the number 11 scalpel and steadied her hand. Carefully, carefully opening the delicate skin of the neck, noting with satisfaction that the epinephrine had done its job. There was no need for the tiny hemostats she had ready, in case of superficial bleeders. The next layer, the loose fascia, pulsated bluish, overlying the great vessels of the neck. These she would blunt dissect with the larger curved hemostats, just teasing away the delicate layers of gauzy tissue to expose the artery. She injected a bit more of the anesthetic, just to be sure. No need to cause discomfort, which might result in involuntary movement.

At last the artery was exposed. She marveled at its pulsations, at the tiny arteries that nourished the big one, and the miniscule veins that issued from it, carrying its waste into the larger system of veins, to be cleansed by the liver and kidneys downstream.

Holding her breath, she slid the first hemostat jaws open, under the artery. Clamp. The vessel, trapped in the jaws of the clamp, stopped pulsing abruptly. There was no going back now. Now the second hemostat, exactly one and a half centimeters below the first: clamp. She raised the surgical scissors, poised for the definitive cut between the clamps.

Tilting her head to see better in the mirror, she cursed the dim light in that bathroom again. And then, the definitive cut! She removed the two clamps and was instantly drenched in red liquid.

A scream of agony splits the night as she sits bolt upright in the bed, heart pounding, drenched in sweat, clutching the sodden bedclothes as she struggles, locked in the arms of the Angel of Death like biblical Jacob.

Frantically clutching her throat, she rushes to the bathroom, the very same bathroom, and strains toward the mirror in the same dim light.

Nothing. Her throat, graceful and bluish white as ever, shone back at her from the reflection.

Sucking in a deep gulp of air, letting it out in a sigh that brought the dog running, she splashed water on her face and neck, toweling off the sweat.

“It’s OK, buddy,” she whispered to her whining canine companion, “just another nightmare.” The dog smiled anxiously, wagged his tail tentatively, and licked her calf. She reached down and patted his faithful head.

“Good thing I have you,” she murmured. Stripping off her sweat-soaked nightgown, she rinsed off in the shower before throwing on a fresh one. She sank into the recliner with a book: sleep would not visit her again, tonight.

2012 Laura P. Schulman, all rights reserved. Reproduction in any form prohibited without express written permission from the author.

Leave a comment


  1. I have no words but “thank you”.

  2. Wow. Vivid and frightening. This is a very powerful piece of writing. I do hope that you are okay, Laura.

    • Yeah, vivid and frightening is right! I wrote this ten, twelve years ago during a terrible period in my life when all I could think about was suicide. I obsessed on dreaming up new and different ways of killing myself. I was hospitalized a couple of times. My therapist finally realized that I actually wasn’t going to do it, so she simply had me check into a nice hotel when I got out on a virtual cliff. She reasoned that it was much cheaper and infinitely more pleasant than the hospital, and I could just as well wait for the new drugs to kick in there, while being protected from the aggravating circumstances at home. My service dog came too, of course. That at least got me out of bed three or four times a day, to see to his needs. rTMS changed all that. I’m still not terrifically functional, but at least I rarely if ever think about suicide, and then only theoretically.

      I hope the literary mag I recently submitted this piece to also thinks it’s good literature–wish me luck!


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