Leo Gordon
Los Angeles, California, United States

As Dr. Sylvia Samsa, Chief of Surgery at the Metropolitan Medical Center, awoke one morning from uneasy dreams, she found herself transformed in her bed into a piece of synthetic mesh.

Dr. Sylvia Samsa, Chief of Surgery at the famed Metropolitan Medical Center, awoke last Tuesday morning, lying flat in her bed.

She was unable to move.

This was a serious and unanticipated problem for Dr. Samsa, as she had a full day of surgery scheduled and was anxious to get to the hospital.

As she tried to clear her thoughts through the haze of sleep, she looked up. Instead of seeing her overhead bedroom light, she saw an operating room light.

Her right hand was immobilized. She tried to figure out why she could not move her entire right arm or shoulder. She examined her right hand and found that it was attached to what looked like a ligament.

Unable to reach her glasses, she had enough visual clarity to realize that her right hand was fixed to a ridge-like structure that had a striking resemblance to the inguinal ligament—an anatomic landmark with which she was intimately familiar as a tenured professor of herniology.

She then tried to move her left arm. But similar to the right arm, it was frozen in place.

She examined the structure to which her left arm was fixed. It resembled another anatomic structure with which she was quite familiar—the rectus abdominis muscle—an entity which for many years was the basis of intense grilling of residents as to its Latin meaning.

The inability to move both arms frightened Dr. Samsa. She then thought it would be best to swing her legs over to the side of what she thought was her bed.

She could not.

She was frozen in her position.

“I must be dreaming,” she thought. “This is a true surgical nightmare! I am trapped in the middle of Hesselbach’s Triangle!”

Struggling to free herself, she tried to move her left leg. It was stuck to a knobby, bony prominence.

“Sweet justice!” she thought. “I have asked residents for years how many tubercles are in the human body!”

With her left leg cemented to the pubic tubercle, she could not move.

Her brilliant surgical mind then reasoned that she had been trapped in a dream-like state by some unknown force.

But why? She had never offended any aspect of Franz Kaspar Hesselbach.

“Why would the ghost of Professor Hesselbach do this to me?” she thought.

Was this some sort of cosmic payback for Sid Mermelman’s ischemic orchitis or Andrea Flieber’s honeymoon recurrence?

It must be a dream. This cannot be happening!

An uneasy feeling came over her—a feeling that allowed imaginary objects to pass through her, a porous feeling like the screen on her backdoor.

“My God,” she thought, “I am strung across Hesselbach’s triangle—immobile, looking at my operative team!”

It was becoming clear to Dr. Sylvia Samsa that, by some inexplicable force, she had been transformed into a piece of synthetic mesh.

She stared for a moment at the operative light.

She could hear the mumblings of the operative team.

Dr. Hamilton, her associate, was speaking.

But wait, Hamilton had the case following hers. How could that be?

“It’s not like Dr. S. to be late. Where is she? Does anybody know?

Dr. Samsa tried to yell, but the interstices—the screen-like lattice work of the mesh in which she was trapped—prevented her from moving her jaw.

So she just listened.

They were asking questions: “Is the mesh in good position?”

Sylvia tried to shout, “Yes, I’m in good position, but I need to be freed.”

A second question followed: “Have you constricted the internal ring too firmly and occluded the spermatic vessels?”

She tried to scream, “I feel the spermatic vessels pulsating!”

The final question was—and this question frightened Professor Samsa the most—”Do we need to irrigate the field?”

“Irrigate the field? I am going to drown!”

Another voice said, “We always irrigate to make sure there’s no debris on the field.”

Sylvia tried to scream.

“Stop! You’re going to drown me!” No one could hear her as she was submerged in a sea of saline.

Her last words were, “I’m drowning!”

Gasping, she now considered the unthinkable.

She would be buried in this groin and no one would ever know she was missing.

She heard in the background, “Close the fascia over the mesh.”

The operating room light receded further and further into the distance.

The last words Professor Sylvia Samsa heard were: “Approximate the subcutaneous tissue and close the skin with a running subcuticular suture.”

In her dream-like state, Sylvia Samsa was trapped in a saline grave suspended over Hesselbach’s triangle.

A resident asked, “I wonder where Dr. Samsa is this morning? She missed her first case. Everyone is looking for her.”

The Chief of the Medical Staff was notified. The police were called. Her remaining family was contacted. Her apartment was searched.

Posters were distributed: “Have you seen this woman?”

The media was alerted.

Several weeks passed.

No one could find the Chief of Surgery.

Life continued at the Metropolitan Medical Center. Enthusiastic residents graduated. Careers began. Older surgeons retired. But the collegiality and camaraderie among the staff always seemed to lack a certain something after Dr. Samsa’s disappearance.

Five years later, at the annual Department of Surgery picnic at the lake, one of the first-year residents asked:

“Did anyone ever figure out what happened to that surgeon who disappeared?

Erica, a long-time circulating nurse at Metropolitan, responded:

“Dr. Samsa. She used to be Chief of Surgery. Really ran the place well. Big news nationally when she disappeared. All kinds of theories and rumors. Now no one remembers her.”

Somewhere in the ether—the other-worldly, alternate surgical universe—is a segment of synthetic mesh enlivened by the career and good intentions of Dr. Sylvia Samsa.

A hospital myth arose around the corridor cabinet housing the synthetic mesh. Many believed that the cabinet was haunted.

And every July when the new residents arrived at the Metropolitan Medical Center, they were told that one could occasionally hear a muffled, distant sob every time that cabinet was opened and a piece of synthetic mesh was requested by a surgeon.