Now, anaesthesia is a symphony. Demmet had given the patient, a healthy, forty-five-year-old male, an initial injection of sodium pentothol, which put him quickly to sleep. The opening note.

Then oxygen through the anaesthesia machine to assure good breathing. Intravenously, the succinyl-choline, which relaxed the body muscles and made way for the endotracheal intubation, affording Dr. Demmet greater control over the patient's breathing. Then, through the anaesthesia machine, nitrous oxide, a further nerve depressant. And finally halothane. Very carefully with the halothane, for this was the basic anaesthetic of the operation.

It was also what was going to kill the patient.

Intravenously, Dr. Demmet administered a small amount of curare to relax the stomach muscles, making the appendectomy that much easier for the surgeon to perform. The electrodes of the electrocardiograph were attached to both arms and a leg. There was a constant intravenous flow of 5 percent dextrose. Dr. Demmet felt for the pulse, checked the blood pressure, listened to the heartbeat through a stethoscope, which was not of course as accurate as the electrocardiogram but still a good backup check. Then he proceeded to kill the patient.

He also did something that never appears in television dramas or great romances about hospitals but that is not at all uncommon in real operating rooms. He passed gas. Sitting on high stools for several hours, under great tension and with great need for concentration, anaesthesiologists help make operating rooms smell more like lavatories than like Marcus Welby's office. This is reality. No one ever comments, because everyone is too busy to notice.

Dr. Demmet increased the level of halothane. He did not do it with a jolt. Everything was precise. He watched the screen. Normal sinus rhythm. He increased the halothane. The ectopic response came with a flutter.