V.

It was a routine operation; Schoenmaker worked quickly, neither he nor his nurse wasting any motion. Caressing sponge-strokes made it nearly bloodless. Occasionally a trickle would elude him and get halfway to the towels before he caught it.

Schoenmaker first made two incisions, one on either side through the internal lining of the nose, near the septum at the lower border of the side cartilage. He then pushed a pair of long-handled, curved and pointed scissors through the nostril, up past the cartilage to the nasal bone. The scissors had been designed to cut both on opening and closing. Quickly, like a barber finishing up a high-tipping head, he separated the bone from the membrane and skin over it. "Undermining, we call this," he explained. He repeated the scissors work through the other nostril. "You see you have two nasal bones, they're separated by your septum. At the bottom they're each attached to a piece of lateral cartilage. I'm undermining you all the way from this attachment where the nasal bones join the forehead."

Irving passed him a chisel-like instrument. "MacKenty's elevator, this is." With the elevator he probed around, completing the undermining.

"Now," gently, like a lover, "I'm going to saw off your hump." Esther watched his eyes as best she could, looking for something human there. Never had she felt so helpless. Later she would say, "It was almost a mystic experience. What religion is it - one of the Eastern ones - where the highest condition we can attain is that of an object - a rock? It was like that; I felt myself drifting down, this delicious loss of Estherhood, becoming more and more a blob, with no worries. traumas, nothing: only Being . . ."

The mask with the clay nose lay on a small table nearby. Referring to it with quick side-glances, Schoenmaker inserted the saw blade through one of the incisions he'd made, and pushed it up to the bony part. Then lined it up with the line of the new nose-roof and carefully began to saw through the nasal bone on that side. "Bone saws easily," he remarked to Esther. "We're all really quite frail." The blade reached soft septum; Schoenmaker withdrew the blade. "Now comes the tricky part. I got to saw off the other side exactly the same. Otherwise your nose will be lopsided." He inserted the saw in the same way on the other side, studied the mask for what seemed to Esther a quarter of an hour; made several minute adjustments. Then finally sawed off the bone there in a straight line.

"Your hump is now two loose pieces of bone, attached only to the septum. We have to cut that through, flush with the other two cuts." This he did with an angle-bladed pull-knife, cutting down swiftly, completing the phase with some graceful sponge-flourishing.

"And now the hump floats inside the nose." He pulled back one nostril with a retractor, inserted a pair of forceps and fished around for the hump. "Take that back," he smiled. "It doesn't want to come just yet." With scissors he snipped the hump loose from the lateral cartilage which had been holding it; then, with the bone-forceps, removed a dark-colored lump of gristle, which he waved triumphantly before Esther. "Twenty-two years of social unhappiness, nicht wahr? End of act one. We'll put it in formaldehyde, you can keep it for a souvenir if you wish." As he talked he smoothed the edges of the cuts with a small rasp file.

So much for the hump. But where the hump had been was now a flat area. The bridge of the nose had been too wide to begin with, and now had to be narrowed.

Again he undermined the nasal bones, this time around to where they met the cheekbones, and beyond. As he removed the scissors he inserted a right-angled saw in its place. "Your nasal bones are anchored firmly, you see; at the side to the cheekbone, at the top to the forehead. We must fracture them, so we can move your nose around. Just like that lump of clay."

He sawed through the nasal bones on each side, separating them from the cheekbones. He then took a chisel and inserted it through one nostril, pushing it as high as he could, until it touched bone.

"Let me know if you feel anything." He gave the chisel a few light taps with a mallet; stopped, puzzled, and then began to hammer harder. "It's a rough mother," he said, dropping his jocular tone. Tap, tap, tap. "Come on, you bastard." The chisel point edged its way, millimeter by millimeter, between Esther's eyebrows. "Scheisse!" With a loud snap, her nose was broken free of the forehead. By pushing in from either side with his thumbs, Schoenmaker completed the fracture.

"See? It's all wobbly now. That's act two. Now ve shorten das septum, ja."

With a scalpel he made an incision around the septum, between it and its two adjoining lateral cartilages. He then cut down around the front of the septum to the "spine," located just inside the nostrils at the back.