Surgery as Performance Art: A Restoration Comedy

I’m in a surgical center in Scottsdale, Arizona, being treated as if I were an esteemed guest at a Marriot. Better. A series of very nice people are being serially very nice to me, asking me questions, checking-in with how I feel, giving appropriate boosts: “Well, you’re clearly in very good shape,” welcome words when one is lying in a hospital bed wearing a hideous smock and a bloody bandage.

Though each interlocutor asks variations on the same questions, I take no offense, since these questions are intercut with those compliments. I am being fussed over, professionally. Each stage on this comfortable cross features a person of higher status, from receptionist to intake (“patient advocate”), to dresser, to prep nurse, to legal lady (they really want to make sure you have signed, not necessarily read, everything about their responsibility and your responsibility and your insurance company’s responsibility), to anesthesiology nurse to anesthesiologist to finally, finally, the doctor himself, whom I had met the previous week. Otherwise, I would never know from his appearance. The entire medical staff is uniformed in blue scrubs, status not delineated. As with any uniform, there are surely clues, I just don’t know them yet, and won’t have time to learn. Very soon I shall be unconscious, or more properly, in a “fugue state”: responsive and awake but not really present and not remembering anything. Yes, it’s that drug, the one sexual predators favor. I know this from a prior operation; it’s not information the nice people are likely to want to “share” or “reach out” to me with right now.

I know what’s going on here. I’m schooled in communication; I’m a performer, and know my experience in this medical theater is carefully calculated. I’m not special but these nice peoples’ specialty is to make me feel so, which they do well. My attention is being pulled away from my body and its failings so that I may focus on process, interaction, and these people, whose focus is on me. Listening and showing empathy while moving things along is a skill, and these nice people are skilled. I am very fortunate; my operation is relatively minor and not life threatening. This relative privilege allows me to focus on the finishing touches, the surface and the flow. Unlike an aesthetic event, this experience is constructed so that I will either not remember, or remember only the ease, the attention; the intake/outtake and not the “ouch.” The plot, the instigating event, will remain camouflaged.

Falling into my fugue state, I drift back to a bewildering yet bewitching performance experienced in early 2010, Tino Sehgal’s This Progress at the Guggenheim Museum in New York. I begin ascending the ziggurat, and a pre-adolescent child engages me in conversation. He is paying intense attention to me, asking me questions for several minutes as we walk, and then seamlessly I am passed to another interested person, of slightly elevated status, expressed through age. There are more pass-offs, always just as I am feeling most involved with my current companion, for whom the feeling appears  to be mutual. As we rise up the ramp, we are ramping up the duration of the relationships. The more I am engaged in this system, the more I believe in it. I am invested, enmeshed.  I am a person of interest. I forget that I came here for an aesthetic experience. I am simply here, now.

I knew how much I paid to get into the Guggenheim, and that the experience was going to be art, though one of the many mysteries of Sehgal’s work is that there is almost no prior information available to participants or the media. But the museum is recognizable as a place of culture, though this particular artist denuded the winding walls of all official “art” (barring, of course, the architecture). Sehgal’s works are known for their “inanimate materiality”  (or so says the Guggenheim). They can be bought and sold but you cannot really put your finger on them or point and say “Look!” They are experiences. Only that.

In the Surgery Center, I know I’m in a hospital, no matter how euphemized. I am here to be operated upon, my body invaded, costs calculated, problems encountered and corrected. I also know I am going to be knocked out; the experience of not experiencing. Therein the wonder of modern medicine (in most cases): soothe them on the intake, drug ‘em up, get them out, and send the bill elsewhere. The real performance is hidden behind the ubiquitous hospital curtains where the trained performers enact something intimate upon the naïve spectator/patient. We may contaminate each other in the waiting room and various holding areas, but once the real show starts, the curtains close.

While ascending the ramp at the Guggenheim, I could hear snatches of other conversations between the visitors and the interpreters (the term for Sehgal’s performers). Curious about my own place in this performance, I wanted to hear how others were reacting. Likewise at the Surgery Center. The patient in the bed across the aisle is very chatty. What I determine to be a masculine voice is talking about breasts, I’m not sure whose. Another voice, feminine, comments, “Well, my girlfriend was 38DD and I was like, ok, that’s enough!”  Is this a planned augmentation or reduction? Or does the voice belong to a transperson in for some transformative work? I’m intrigued. The curtain is pulled away, revealing the presumptively masculine speaker as a middle-aged woman with bad teeth. Ah, perhaps reconstruction after breast cancer? Is that her daughter? There is no cast list. Construct your own scenario. The curtained-off fellow to my right is discoursing on sports or some other reliably masculine (and mundane) subject. I hear much joshing and joking as a rather large man with a silly moustache enters. I saw him earlier at my other neighbor’s bed. Is he the Surgery Center Clown? How do I avoid his visitation? Is their conversation related to my forthcoming experience?

Perhaps this is the time to mention that I am here for plastic surgery. Reconstructive plastic surgery. For a skin cancer wound near my eye. I’m feeling noble since my procedure is not to make me more beautiful, desirable, or youthful but simply to restore me. Why I see this as noble is buried deep in my psyche. Skin deep. I want to be the well-made play; beginning with calm, then complications rising to a (manageable but dramatic) climax, ultimately receding to a well-ordered world once again. And I want to behave appropriately. Performance art is for elsewhere.

Earlier that day, I had deposited my computer with the IT crew at my university. Their assignment? To “re-image” my desktop, wiping my hard drive and disappearing bug-plagued phantoms lying dormant (and not so dormant) after twelve years on this particular operating system. Today, all shall be made anew, both virtually and bodily. This is easier with a hard drive; a face is far too close to the bone, the brain, the blood. And an operating system, while it may feel hardwired into our own neural pathways, remains a machine separate from our bodies. One re-imaging comes with my job, the other, though provided as a “benefit” (the American monetization of health) will require some financial contribution from me. All those forms I filled when admitted to the Surgery Center will see to that.

In most theaters you pay as you enter, but in our medical version, the actual accounting comes later. This final act arrives electronically: $14,083.70. The actual bill from the medical center “for information purposes only” elucidates further: $9,015 of the charge is for “ambulatory surgical care” (all those nice people and pleasant rooms and rolling about on beds) with $2, 487.70 for “recovery room.” Having been unconscious during what I am sure was a very nice recovery, I cannot evaluate whether the décor and decorum justify such charges. I ask a relative in nonprofit hospital administration, and he acknowledges that such facilities generally receive about 10% of that initial charge. My insurance, for example, obligates that I pay a mere $50, while they pay the remaining “negotiated” amount.  Once again, the Marriot metaphor: there’s the trunk rate, the group rate, the business rate, and then there’s Priceline.

Yet our expectations rise as the price for an experience ascends. If I were responsible for the entire bill for my “reconstruction,” would I have demanded something a bit more aesthetically improving? Had the Guggenheim charged me $75, would I have been more poised to critique? Would I insist on a quantifiable experience, a story certifiably “memorable?” Had I spoken, while conscious, only to the support staff at the surgery center, with no appearance by the doctor, would I have felt cheated? If all the interpreters in the Guggenheim performance were children, would I have been charmed but dismissive?

Sehgal’s performance ended, formally, at the top of the ramp. Abandoned for the final time, I was left to muse on what had occurred. That last encounter — what exactly were we talking about? I was conscious and participating, but what did I say? What was the question? Was there a question? Fugue state. I chose to linger, gazing down the ramp on  others in various stages of their own ascent, observing the backstairs activity and the discreet dispatching of interpreters, finding myself now engaged in the process of the performance behind the curtain.

Medical centers, like the one in which I received such nice treatment, are so nice because they are seldom the staging areas for major experiences, the trauma/drama of heart attacks, strokes, knife wounds, and other life-threatening events. Those are for hospitals and their emergency rooms. My medical center memory will be of a few hours of immersive dinner theater; relaxed, reassuring, restorative.

But in both museum and surgery center, attention was paid. Longing for exchange, a social interaction not digitized or remote, we interact with someone with whom we can share something, an event putting us center-stage. The bill taken care of offstage, we twitch the curtain surrounding our bed or cast our eyes back down the ramp to make sure not to miss what we ultimately won’t remember.