It's a little before noon right now. My surgery is not scheduled to begin until 3-freaking-15. I have never had planned surgery that commenced after about 9:00 in the morning. I have not had anything to eat since about 8:30 last night (banana cream pie at Ron's choir's annual post-holiday dinner). I have had only clear liquids, and not even that since 10:00. (Coffee with half-and-half is not a clear liquid.) My knee hurts a lot. I am not having a good time.

I've had a lot of surgery in my life, and with each new episode I have to make the list. I'm running out of room on the standard form. I often forget about the tonsillectomy in 1954. For nearly thirty years after that I didn't enter a hospital except to visit people. Then in 1982 I had a laminectomy (L4-L5) to remove the herniated lumbar disc injured sixteen years before in a bounce down some steps. In 1983 I had another spinal procedure (at L5-S1) to "debride some scar tissue." In 1985 there was the emergency cesarean when labor "failed to progress," in 1988 a partial thryroidectomy to remove a growth that had developed post-partum (not uncommon) but would not go away, and in 1995 the "reduction with internal fixation" of the fractured right fibula.

I commonly do very well in surgery. I hardly regarded the cesarean as surgery, although it's essentially abdominal surgery, among the most difficult to recover from. But the reason for it and the outcome (for me) was so joyful and by then I was so tired of being pregnant that I had neither the time nor the inclination to pay attention to essentially minor aches and pains. In fact, except for the thyroid thing (which was asymptomatic), the condition causing the surgery was so painful that any new feeling was a welcome change.

And that is what will happen today. This knee is so horribly painful (she whined) that the soreness caused by time on a surgical table and stitches that need to heal will seem like a headache compared to what I am feeling now.

We are in the age of managed care, slice and sew and send 'em home "quicker and sicker." With the laminectomy I was in the hospital for almost two weeks (you don't mess around when there's a chance of a bone infection, at least you didn't then), and if at all possible they didn't do the surgery after Wednesday because they didn't want your critical days to fall on a weekend (nursing staff fewer in number and often less experienced). Today's surgery is just as complicated (possibly moreso), but I'm entering the facility at 1:45, will be prepped at 2:30, operated on at 3:15 (I hope), shuttled to recovery at 4:15, and sent home by 6:00.

And that won't be too bad. I have a lot of support at home (my sister referred to Ron last night as my "saintly" husband), and I'd prefer to be among my own things without the hustle and bustle (and piped in music) of a busy hospital floor. (Hospitals are no place to go for a rest, especially if you're an introverted writer.)

It's the anesthetic, its application and recovery therefrom, that I am most not looking forward to. The older I get the harder it is for me to throw off the lingering effects of a general anesthetic. (I tried to negotiate a local for the ankle reduction. "For bone work? My dear, you do not want to listen to it!") A general is easier to maintain constant, especially when the surgeon is unsure of just what he will find and how long it will take to repair. (A friend had hernia surgery under a local and was quite alarmed when he heard the surgeon say "Uh-oh." "What! What!" "Oh, this is just a little different from what I expected." It turned out to be a whole lot different, taking two hours longer than had been planned.) I think the "pre-op tranquilizers" do me more harm than good, and I'll take one today only if they open my mouth and force it on me.

I hate coming back from anesthetic. It's like pulling myself from a deep dark hole, I can't breathe, I can't move, I can't speak. With the ankle reduction, I awoke knowing where I was and that I had been under a long time because it was dark out the window. At the foot of the bed was the most beautiful young woman I had ever seen. She had blonde hair that cascaded down over her shoulders. She was wearing a soft fuzzy white sweater and a gold cross on a delicate chain. She was writing something on a clipboard. "Hello, Mrs. DeAngelis," she said, "and welcome." I swear I could see the wings.

The hours after anesthetic I am restless. My concentration is off, and I know that life is happening but I can't keep track of it. I suppose I could regard it as a new beginning, a wiping clean of the slate and a brand new start, but I just did that on the Feast of Stephen.

It's 12:45 now. I have to set the VCR timer for tonight's episode of ER. It's a new one, and I want it on tape just in case I'm able to watch it but have no recollection of it.

See you on the other side.