Concepciôn helped Alex to lie on the jointed leather table. She touched her foot to a floor pedal. A worm gear whined beneath the floor. The table bent at Alex's hips and rose beneath his back, to a sharp angle. Alex coughed twice.

Dr. Mirabi drew on a pair of translucent gloves, deftly unwrapped one of his canvas-bound machines, and busied himself at the switches. He opened a cabinet, retrieved a pair of matched, bright yellow aerosol tanks, and inserted both tanks into sockets at the top of the machine. He attached clear plastic tubing to the taps on the tanks and opened both the taps, with brief pneumatic hisses. The machine hummed and sizzled a bit and gave off a hot waft of electrical resistance.

"We will set the liquid to blood heat," Dr. Mirabi explained. "That way there is no thermal shock to the tuberdes. Also heat will dissolve the chronic mucus more effectively. Efficiently? Is it 'efficiently' or 'effectively'?"

"They're synonyms," Alex said. "Do you think I might throw up? These are my favorite pajamas."

Concepción stripped the pajamas off, then wrapped him briskly in a paper medical gown. She strapped him against the table with a pair of fabric belts. Dr. Mirabi approached him with the soft plastic nozzle of the insert, smeared with a pink paste. "Open widely, don't taste the anesthetic," he warned. Alex nevertheless got a generous smear of the paste against the root of his tongue, which immediately went as numb as a severed beef tongue on a butcher's block.

The nozzle slid its way down a narrow road of pain along his throat. Alex felt the fleshy valve within his chest leap and flap as the tube touched and penetrated. Then the numbness struck, and a great core of meat behind his heart simply lost sensation, went into nothingness, like a core mechanically punched from an apple.

His eyes filled with tears. He heard, more than saw, Dr. Mirabi touching taps. Then the heat came.