Preface: Next week I am due to have sestoplasty surgery for the third time in 30 years. The last time I considered it was in 2001. That’s when I wrote this (fictional) story. This morning I found it in my archives and cleaned it up a bit to share here.  



“Well Jim, it looks like you’re going to need surgery.”

It wasn’t what I wanted to hear. I leaned back.

“Not what you wanted to hear, huh?” The doctor asked, rhetorically.

I shook my head and smiled, “What makes you think you can do it Doc? I mean, this will be the third such surgery – and the other guys tried too.”

“The other guys were butchers.”

“Excuse me?” I asked.

“No – excuse me,” he paused, “it’s not ethical to talk that way about medical colleagues.”

“Well,” I added, “my first surgery was on a Navy base.”

The doctor looked up from his paperwork, “Like I said, butchers.”

I laughed. “Seriously Doc, what has changed since the last time I had this done? Do you have better technology or what?”


“Does that mean the procedure is bloodless and painless? Do I still have to go under?”

“No, no, and yes. It still hurts, and you will lose blood, but where once you had to stay awake during the procedure, now we use sedation. You won’t feel a thing – until afterward, of course.”

I dreaded the thought of anesthesia. “Did I mention that we just bought a house?”

“Did you? Congratulations! You really are making Charlotte home aren’t you?”

“So it appears. Oh, and we’re also having a baby.”

The doctor slapped his knee, “I’ll be damned! Kudos my boy – Kudos!”

“Yeah, kudos. Now how do you explain to your pregnant wife, who’s already stressing, that surgery has just been thrown into the ring?”

“You can handle it. Hell, with the year you’ve had, you guys can easily handle a little sestoplasty. We’re not removing a kidney, here.”

He was probably right. But I was still apprehensive. We’d moved to the area on New Years Day, eight months earlier. But it wasn’t just any New Years Day, it was the Millennial New Years Day. Two thousand. The big one. I kept telling Anna how this move was going to change things for us. Three years earlier we’d moved from New York City to Miami. For me, that was going home.  Only, I disregarded the parable that you can’t go home again. From the day we stepped foot in Florida, it was one struggle after another. Nothing was easy. And in three years there, we nearly lost ourselves. Going broke in the process. But then came an opportunity in Charlotte and we took it. The fact that we were moving on New Years Day was pure coincidence. Though not insignificant.

The moment we arrived in Charlotte, the needle started moving in the right direction. The money was good. We met some good people. Then, the day after we stumbled upon a house we knew we had to buy, we learned that Anna was pregnant.  Twelve months earlier it was a guess as to whether we’d have money to pay the rent at the end of the month, much less have a down payment for a mortgage. And forget about a baby.  Yes, things had indeed changed for us here. We were on a roll.

Then this.

“I suppose you’re right doc. It’s just that I don’t want anything to go wrong that’s all.”

“What could possibly go wrong?” He leaned in and looked at me over the rim of his glasses, “Look Jim, it’s an hour-long surgery. Things have changed since the last time you had it done.  In a month you’ll be breathing like never before. Besides, I’m doing it.”

He said this last part like he was a sestoplasty rock star. But the truth was – I hardly knew him. This was only my third visit to his office, and although the guy had a tremendous bedside manner and a wall full of certificates, in the operating room he could be Mickey Mouse for all I knew.

“Do you have a list of references I could contact?”

He leaned back, “Whoa, where did that come from?”

“I’m sorry, it’s nothing personal Doc, but this is my third go round with this surgery. I’m sure you understand.”

He slid a chart from the countertop and started writing on it. Then he handed me a prescription slip, “Here, this is the number of a woman named Dawn. I operated on her this morning. She’s a real sweet lady. Give her a couple days to catch her breath but then feel free to give her a call and ask her how she feels.”

“That’s pretty cocky don’t you think Doc? You don’t even know if she’ll take well to the whole ordeal.”

“Yes I do.”

It was unsettling to see a surgeon puff out his chest.

He put a hand on my knee, “Look Jim, everything will be fine. You have nothing to fear.” He swung around on his stool. “Betsy? Betsy could you come in here, dear?”

A moment later a nurse appeared in the doorway, “Yes Dr. Hoover?”

“Betsy, how’s your nose? Your breathing I mean? Have you not noticed vast improvement since before your surgery?”

“Of course, Dr. Hoover. The difference is like night and day.”

He swung back around to me, “See there?” And then back around again, “And was it painful at all, Betsy? Did you experience any nasty side effects?”

“Oh no.  None whatsoever, Dr. Hoover.” She smiled.

“Thanks Betsy, that will be all.”

“Thank you,” she said, and left.

He swung back around with his arms open, “See there? Living proof that you have nothing to worry about.”

I sighed. “Let me discuss things with my wife and I’ll get back to you.”

“Sure thing Jim.” He started writing on his clipboard again, then ripped off another prescription slip and shoved it in my hand, “Here, get this filled. A week before the operation take one per day until we see you again.”

“What is it?”

“Something to help you relax. You seem a bit tense.”

I left his office knowing I’d probably have the surgery. Then on the drive home it occurred to me that he never qualified himself as Betsy’s surgeon.



“It wasn’t him.”

“But you don’t know that for sure,” Anna said from across the dinner table.

“I’m pretty sure it wasn’t.”

“So call tomorrow and find out.”

“I will.” I took a bite and looked up. “By the way, how’s the baby doing today?”

“She’s doing great.”

“So it’s a she today is it?

“Yes. But check back tomorrow. You never know.” Anna laid her fork on her plate, “Let’s get back to your nose for a moment. I think you should have the surgery.”

“That’s easy for you to say – it’s not your nose.”

“Yes it is. I have to sleep next to you for the rest of my life. And honey, that isn’t such a great thing sometimes – let me tell you. You need the surgery Jim. You know you do. We have insurance. And if you wait, well, the baby will be here and then…”

I stood up with my plate and walked into the kitchen.

She continued, “I’m not saying that it’s a little thing, honey, it’s not. It’s a very serious surgery. But I think you’re tough enough to do it. And I’m certain that this time it will work!”

“Don’t patronize me.” I mumbled from the sink.

“I’m not patronizing you.” She got up and joined me, “Look at you – you’re a healthy man. You can do it. I just don’t know what the problem is?”

“You’ve never been under.”  I said.

She didn’t say anything.

“It’s no fun Anna,” I said turning to her, “It’s as though you’re dead.”

“That’s silly. You’re not dead. You’re just asleep that’s all.”

“And the awful pain afterward from having your nose cut upon. I remember the first time I was in the hospital for a whole week. It hurt Anna!”

There was a long pause between us before she spoke again, “You’ve got to do it Jim. Think about it from an opportunistic point of view. A year ago we couldn’t have done this. This is just another example of how good things are going for us here. We endured the bad side of life in Florida. Think of this as just another reward from the good side.”

“Like the baby?”


“Like the house?”

She nodded, “And like our jobs, and our friends, and everything else that has changed for us.” She put down a dishtowel and hugged me. I could feel her pouch press against my abdomen. “You’ve got nothing to be afraid of honey. I’ll be with you every moment.”

“Not when I’m under you won’t.”

“I’ll see to it.”

I smiled. “But what if it’s not supposed to be fixed Anna?”

“Don’t be silly. Of course it is. You can’t go around your whole life with a clogged nose.”

“Why not? I mean, who am I to say that God screwed up?”

She sighed. “Just get it done Jim.” Then she reached down and ran her hand across her belly, “And the sooner – the better.”



The morning of the surgery I threw up.

“What are you doing?” Anna asked.

“Getting some water.”

“You can’t do that. You’re not supposed to have anything on your stomach.”

“It’s just water Anna.”

“That doesn’t matter. There are reasons they tell you not to eat or drink anything.”

I stopped drinking and on the way to the hospital we had to pull to the side of the road for me to throw up again. “I guess we don’t have to worry about anything on my stomach now.”

Anna stayed with me during the whole pre-op procedure. When the nurse tied the rubber rope around my arm and began tapping my forearm for a vein, I shot a terrified look across the room at my wife – but she was too busy grimacing to notice.

I looked down just in time to see the needle pierce my skin and slide into my vein. I clenched my teeth and eyes and let out a little grunt as the needle found its place a few inches under the flesh. The nurse released the rubber rope, “You can unclench your fist now Mr. Augustine.”

I did.

When she finished dressing the area, the nurse handed me a blue pill and small paper cup filled with water.

“What’s this?”


I looked at her with high brows, “Excuse me? What exactly do you mean by that? What exactly is this pill lady?”

Anna, sensing my frustration, walked over and laid a hand on my shoulder, “Nurse,” she glanced at embroidery on the nurse’s breast, “Jones, my husband is just a little worried about this procedure, that’s all. And the doctor specifically told him not to eat or drink anything 12 hours prior to surgery.”

While Anna said this, Nurse Jones continued to work diligently, gathering her vein-piercing utensils and placing them on the metal tray she’d wheeled in a few moments earlier. Then she said, “It’s for his nerves. It will help the anesthesia take effect quicker. It’s called Primasil.” She then looked at me directly, “You just go ahead and take that Primasil Mr. Augustine, and enjoy that drink of water.” She tapped my shoulder, forced a smile and left the room.

“Bitch.” I said as the door closed.

Anna’s silence meant she agreed with me.

“Well, I’m just not going to take it.”

“Don’t be silly, just take it. She would never have given it to you if it were at all dangerous. She seems to be good at her job – she’s just very serious that’s all.”

I took the pill, and by the time Dr. Hoover came in for the pre-surgery pep talk, I was feeling rather queer.

“Good morning Jim. How are you feeling? Ah, Mrs. Augustine I presume?”

“It’s Anna. Nice to meet you, doctor.”

“The pleasure is indeed mine.” They shook hands, “I understand you’re expecting?” He then looked down at her stomach, “How far along are you?”

“Almost five months,” she said running her hand across her lower abdomen, pulling the fabric of her dress taut.

The doctor reached out to touch Anna’s pouch.

“Don’t let him near the baby, honey – his specialty is much higher up on the body.” They laughed.

Dr. Hoover joked for a bit, then turned serious, “Don’t worry Jim. Like I said in my office, there’s nothing to fear. Before you know it, you’ll be back at home in bed.”

An orderly appeared. “OK then, it looks to be game time.” The doctor said standing. “Anna, you can either wait just outside of the operating room, or in the lobby. Either way, I’ll see you in about ninety minutes.”

As Dr. Hoover turned to talk with the orderly, Anna squeezed my hand and smiled, “There’s nothing to worry about honey. By this time next week, you’ll be breathing like normal.” Then she kissed me.

As I was wheeled out of the room I looked back at Anna and thought I saw a tear.

Under the bright lights of the operating room, a nurse held my arm in an act of reassurance, then explained to me how the surgery would be performed. All around me were the sounds of shuffling sneakers and people preparing for the operation. My mouth was dry.

“There’s the man of the hour,” Dr. Hoover appeared above me wearing a surgical mask. “Ready, pal?”

“Yes.” I said lying.

“Great. Remember, there’s nothing to fear. We’re in complete control in here.” He looked across the room, “Janet, let’s get Mr. Augustine started on the sedative. Mr. Jackson?”

“Yeah Doc?” Came a voice from behind me.

“What’s on tap for today’s proceeding?

“I was thinking the Grateful Dead.”

“Perfect,” Dr. Hoover replied.

Dr. Hoover disappeared and a young nurse replaced him in my line of sight. She twisted a dial on the tube that ran out of my arm and up to a drip line, “Mr. Augustine, I want you to start counting backward from one hundred. Can you do that for me?”

My heart was racing. “Sure.”

“Are you a little nervous Mr. Augustine?” She asked stroking my forearm. “Did you take the Primasil?”

I nodded.

“That’s good. You get extra points for that, you know.” She laughed a little. “Now if you’ll start counting.”

I swallowed. “One hundred. Ninety-nine. Ninety-eight. Ninety-seven. Ninety-six…” then as I felt myself growing tired, I heard the beginning lyrics of Sugar Magnolia, “Ninety-five. Ninety-four. Ninety-three. Two.”

Then everything went black.



Wakened by thunder, I sat upright in bed – wet with sweat. A flash of lightning and then more thunder. Anna lay next to me sleeping while outside the rain chaotically slapped against the window. I attempted to get out of bed when a dizzying head rush reminded me of the surgery. Raising a hand to my face I felt the splints that lined my nostrils – sticking out of each just a bit.

I made my way into the bathroom, turned on the light and couldn’t believe what I saw. Large, purple half-circles held up both eyes and my nose looked completely disfigured. Something had gone terribly wrong – of this I was certain. Then it occurred to me that I had no recollection of leaving the hospital.

“Honey?” Anna appeared in the doorway.

“Jesus! You scared the hell out of me!” I said as clearly as I could

“How are you feeling?”

“Look at me!”

She placed a hand on my cheek and joined me at the mirror. “What? So it’s a little bruised, it will go away. How do you feel?”

“Like a train wreck. How would you think I’d feel looking like this?”

“Why don’t you come back to bed? You’ve had a very stressful day. Things will be better in the morning.”

“What time is it?”

She looked into the bedroom, “Two-thirty.”

“When did we get home?”

“Around three this afternoon.”

“Really? Was I conscious?”

She laughed a little, “Of course you were. Don’t you remember?”


“Well, everyone in the hospital will. You made quite a stink as we left. I’m pretty sure they were going to call the orderlies had I not gotten you out of there when I did.”  She laughed again, “You really don’t remember?”

“No. I mean, yes – I don’t remember.”

“Come back to bed and I’ll fill you in on all the gory details in the morning.” She smiled, grabbed my hand and flicked off the light, “C’mon. Let’s get some rest, handsome.”

I released her hand, “Don’t patronize me Anna.”

She got under the covers, “Well, I’m not going to feel sorry for you. I’m tired and need some sleep. The baby is restless tonight.”

I stood in the doorway for a moment and watched as another flash of lightning lit up the yard. “I think I’m going to stay up for a bit.”

“And feel sorry for yourself?”

“Fuck you.”

“You wish. Goodnight, grumpy.

I walked down the hall to my office using the wall to keep balance. I reached my desk and flicked on the light just as the power went off. Rain raged against the window and the limbs of trees scratched and pawed the roof. I grabbed a cigarette and walked out onto the front porch as far as the rain would allow.

It appeared that the power was out everywhere. I lit the cigarette, took a long drag, and watched the wind whip leaves along the street in front of our house. More lightning, followed immediately by thunder. Somewhere in the distance, I heard a siren and I thought about how I made it home from the hospital without remembering anything. Then I thought about how grateful I was for the whole thing to be over. Maybe everything was going to work out, after all. I took another long drag and in the orange glow I saw in my periphery the silhouette of a man standing flush against the wall behind me. I froze. But he knew I saw him. He fired a shot into my back.

As I lay on my porch, the man stepped over me and into my house. I tried grabbing his foot, but was too weak to stop him.

“Jim? What was that noise? It sounded close. Honey?” Anna called from inside the house.

I watched as the intruder turned down the hallway toward Anna’s voice. A moment later, two shots were fired. Lightning flashed. And everything went black.


“Jim? Jim honey, can you hear me?”

“I think he’s coming to.”


I opened my eyes to see shadows of people outlined by a bright light.

“He’s back.”

I heard Anna crying. “Oh my God. Oh my God.”

When I was able to focus, the first image I recognized was the smiling face of Dr. Hoover, “You put quite a scare into us, big guy. We thought you’d decided to stay on the other side. The good news is, the surgery was a success.”

Anna laid her head on my chest and held me tight. We went home an hour later.


Jim Mitchem, 2001

Welcome To Charlotte
What I Want

Jim Mitchem

Writer. Father to daughters. Husband. Ad man. Raised by wolves. @jmitchem on twitter. First novel, Minor King, out now.