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with the proper dose, according to Carl’s weight.
    She found Carl Vandermeer in one of the pre-op bays of theCSPC. She couldn’t help but notice that he was a handsome man with dark, thick hair and startlingly wide-open blue eyes. Except for his apparent anxiety, he was the picture of health. The thought went through her mind that working with him was going to be a pleasure.
    “Good morning, Mr. Vandermeer,” Sandra said. “I’m Dr. Wykoff, I will be your anesthesiologist.”
    “I want to be asleep!” Carl stated with as much authority as he could muster under the circumstances. “I went over this with Dr. Weaver, and he promised me that I would be asleep. I don’t want an epidural.”
    “No problem,” Sandra said. “We’re all prepared. I understand you are a little anxious.”
    Carl gave a short, mirthless laugh. “I think that is an understatement.”
    “We can help you, but it does require me to give you an injection. I know you don’t like needles, but are you okay with getting one? It will help, I guarantee.”
    “To be truthful, I’m not excited about it. Where will you give it?”
    “Your arm will be fine.”
    Steeling himself, Carl dutifully exposed his left arm and looked away to avoid seeing the syringe. After a quick swipe with an antiseptic wipe, Sandra gave the injection.
    Carl turned back. “That was easy. Are you finished already?”
    “All done! Now I want to go over with you the material the admitting nurse recorded.”
    Rapidly Sandra asked the same questions about Carl not having had anything to eat since midnight, about allergies, about drug intolerance, about medical problems, about previous anesthesia, about removable dentures, on and on. By the time Sandra got to the end, Carl’s attitude had completely changed, thanks to the midazolam. Not only was he no longer anxious, he was now finding the whole situation entertaining.
    At that point, Sandra started her IV. Carl couldn’t have cared less and watched her preparations with a sense of detachment. It helped that she was extremely confident and competent with the procedure. She always made a point to start her own so she could trust it. She used an indwelling catheter rather than a simple IV. Carl never stopped talking through the process, particularly about his girlfriend, Lynn Peirce, who he said was a fourth-year medical student and the best-looking woman in her class. Sandra diplomatically let the issue drop.
    A few minutes later Dr. Gordon Weaver appeared to have a few words with Carl, including which knee they were going to work on. He checked that the X that the admitting nurse had made with the permanent marker was on the proper thigh.
    “You people are really hung up on which knee,” Carl joked.
    “You better believe it, my friend,” Dr. Weaver said.
    With Sandra guiding in the front and Dr. Weaver pushing from the back, they wheeled Carl down and into OR 12, stopping alongside the operating table directly under the operating room light. Somewhere en route Carl had drifted off into light sleep in midsentence, again reminding Sandra why she was so fond of the midazolam. Only much later would Sandra question the dose she had given in the process of reviewing everything she had done. Sandra, Dr. Weaver, and Claire Beauregard moved Carl over onto the operating table with practiced efficiency.
    When Dr. Weaver went out to scrub, Sandra pulled the anesthesia machine close to Carl’s head. This was the part of the case that she liked the best. She was center stage and about to prove once again the validity of the science of pharmacology. Anesthesia was a specialty marked by extreme attention to detail; periods of intensive activity, like what she was now beginning; and then long segments of relative boredom, which required dedicated effort to stay focused. Whenever she thought about it, the analogy of being a pilotcame to mind. At the moment she was about to take off. After that had been accomplished she would be in the