gas-writer - Tumblr blog

gas-writer · 14 days ago

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Working After Hours...

I don't use Tumblr that much, and already posted this new story over on DeviantArt. But if you haven't already read it over there, maybe you'll like it here: A happier, more positive, and longer anesthesia story! Let's see if tumblr will do 9000 words in a single post...

I power down the last computer at the registration desk. The screen clicks off.

Friday nights at Riverside Surgical Center always end like this. Just me, alone in the building; wandering the halls, making sure everything is powered off, closed and packed up for the weekend. It's my favorite part of being the sole IT support specialist here. When everyone else rushes out, I get these perfect moments alone. With the equipment.

The hum of the building's air handling system becomes noticeable as I cross the deserted, silent lobby. My footsteps click against the polished vinyl flooring. I walk to the entrance, diligently checking that the automatic door is locked closed. It is. I’ll lock it again when I leave, but tonight I don’t want any unexpected visitors.

I turn and begin my rounds through the facility. The surgical center’s manager thinks I'm dedicated. In reality, I'm obsessed.

Medical technology has been my special interest since I was a teenager. While other kids collected posters of rock bands, I hoarded medical supply catalogs. By eighteen, I could name every component of an anesthesia machine and knew the admin passwords to a handful of patient monitors. The job here at Riverside isn't high-paying, but it gives me access to a playground of sophisticated equipment that nobody outside the medical profession would get to touch.

The pre-operative area is my first stop. Six curtained bays line the wall, each containing a stretcher with accompanying vital signs monitor. I walk slowly, making sure each monitor (a Phillips model I know well) is powered down. When in use, their screens show blood pressure, SPo2 and pulse rates. They’re seldom used with ECG leads in pre-op. I notice things like that. I’ve always been into the small details.

Regardless, they’re all dark now. The monitoring system's central station sits at the nurse's desk. They’ve already turned it off.

I walk into one of the bays, and push an IV pole out of my way. Mounted on the pole is an infusion pump, its digital display dark. I check the bay's cabinets, making sure the stock of IV catheters, saline flushes, and adhesive dressings are orderly. I don’t really have to do this; it’s a med tech’s job, but… I want to.

As I check the next one, I pocket a couple of alcohol prep pads. Then a few pairs of purple nitrile gloves from the wall dispenser. Nothing that would be missed. I've been collecting “supplies” for months this way. I tell myself I’m building my own personal medical kit for home, but I know I just like having this stuff.

The staff lounge is next. There’s not really anything in here that I need to power off; we’d all be in trouble if I shut the refrigerator down. Nothing seems out of place here. It was one of the nurse’s birthdays today, and there are cake crumbs on the table. I skipped the party, but I helpfully wipe them up. There’s a box of masks by the door, though, and I take one, adding it to my scrub pockets. My heart rate increases slightly at the thought of what I'm planning later, but for now, I just turn out the breakroom’s lights.

Moving on with my patrol, I enter the post-anesthesia room; the PACU. This is more or less a mirror of pre-op, but with closer monitoring. The ECG traces on the monitors get used here. Eight recovery bays face a central nurse's station where the staff can observe all of the waking patients at once. Like pre-op, I verify each is powered down, and catch one that the nurses missed.

I pass through the automatic double doors that separate the PACU from the main corridor. My pulse quickens as I approach my actual destination tonight: the surgical suites. Riverside has three operating rooms; more than average for the facility’s relatively small throughput. Each is specialized for different types of procedures.

OR 1 is the largest, equipped for general surgery. Its boom-mounted equipment arms hang suspended from the ceiling in standby mode. The room lights are off, and the surgical lights on articulating arms are stowed neatly against the ceiling. I stare through the door for a moment, then move on.

I walk to OR 2, which is set up primarily for orthopedic procedures. The C-arm x-ray unit is parked in the corner, draped with a protective cover. Riverside sees a lot of broken arms, ACLs that need repair, and the like, but I’ve never been that interested in medical carpentry. Everything looks alright here, so I move on again.

Finally, I reach OR 3. It’s the smallest of the three rooms, sometimes used for endoscopies, but also for gynecological and urological procedures. This one has always held a special fascination for me, for reasons I leave unexamined for now. The operating table here is equipped with integrated leg stirrups, really more like giant yellow boots, that can be positioned at various angles. The table itself is computerized with both foot pedals and a remote. It can be easily moved to nearly any position, which is why I’ve chosen it for tonight.

I hesitate at the doorway, my heart pounding. The room, like the others, is dark and still. My hand finds the light switch, and I flip it. The room lights and overhead surgical lights come on at once, uncomfortably bright. I let my eyes adjust for a moment, then I step inside and let the door swing shut behind me.

This is my plan. This is the reason I’m so helpful on Friday nights.

I move purposefully. The anesthesia workstations here are slightly older than I might find in an academic center, and frankly, that’s what I want. It still has physical knobs that I could twist, instead of a touchscreen. I approach it; running my fingers along its smooth surface. I think, just for a second, how embarrassed I’d be if someone saw me basically petting the machine. But I’m alone. That’s the point.

On the far side of the operating room is an entire wall of supplies. Opening a cabinet, I locate the components I need. A disposable breathing circuit, nicely packaged with a filter and a gas sampling line. A pair of rebreathing bags, and an adult-sized anesthesia mask. In another cabinet, I find a four-point head harness, designed to keep the mask securely in place during procedures. I lay these items out methodically on the anesthesia machine's work surface.

Next, from a different cabinet I retrieve a pulse oximeter sensor, and a blood pressure cuff. I return to the anesthesia workstation, and connect both to their respective ports on the machine. Even if I didn’t know where they went, the plugs are colored and fit only in the right place. It just takes a few seconds, despite my slightly trembling hands. I think about getting ECG pads; the machine is already setup for 5-lead, but I decide it’ll be too awkward to manage the wires.

I connect the breathing circuit to the outlet and inlets on the anesthesia machine, carefully attaching the corrugated tubing and the rebreathing bag. The mask will go at the end of the circuit, but for now, I just slightly inflate the plastic seal around the mask’s rim with a syringe, then I lay it down on top of the machine

I press the power button on the anesthesia machine, listening to the startup sequence of beeps and watching as the ventilator performs its self-test. When it’s done, I perform a machine check, following the same protocol the anesthesiologists use each morning. I verify that oxygen flows properly from the wall outlet through the machine's pipelines. The backup oxygen cylinder shows pressure on its gauge. The nitrous tank is open and full. I check the carbon dioxide absorbent canister; it's fresh, the granules still white instead of the purple that would indicate it’s all used up. This is good, because I’m not actually sure which cabinet would hold a replacement, and I don’t want to search.

It takes a few minutes, but the checks complete cleanly. The rebreathing bag inflates and deflates properly and everything holds pressure. I slip the mask onto the business-end of the anesthesia circuit, pressing it in place firmly.

This machine, I note, has two vaporizers on it, purple and yellow, iso and sevo. I don’t plan to use these, but I see that the liquid level indicator on the sevoflurane shows about a quarter full. I’m intrigued but volatiles are far too dangerous to mess around with.

With the electronic foot pedals, I adjust the operating table to its lowest height setting and position it at a slight incline, so I can sit comfortably on it. The table’s dual armboards easily fold down, out of the way completely. I’m relieved to see the stirrups are likewise folded down; I'll have no need for those tonight. When I’m done, the operating table resembles a very expensive, very black chaise lounge.

I wheel the anesthesia machine closer to the operating table, careful not to pull the gas supply hoses too far. With some effort, and a couple more change to the operating table’s pitch, I position it where I can just about reach the machine’s controls, while seated on the table.

I shimmy to the center of my operating-table-made-chair. I smooth out the sleeve of my left arm and wrap the blood pressure cuff around my own bicep. It’s awkward. I struggle with the Velcro, trying to get the cuff closed in the right place on my arm, and to tighten it appropriately. After a few attempts, though, I get it close enough. The pulse oximeter clip goes easily onto my right index finger, and rhythmic beeping starts to track my heartbeat. I reach to the anesthesia machine, and using my middle finger to put the button, start the cuff. Within seconds, the monitor displays my vital signs: heart rate 92, blood pressure 138/84, oxygen saturation 99%. My elevated heart rate and blood pressure doesn't surprise me. I've been fantasizing about this whole thing for months.

I reach out to the machine’s controls and set the oxygen flow rate to 6 liters per minute. The flow meter's ball rises in its chamber, indicating the gas is flowing as expected. The room fills with a quiet hiss.

I pick up the mask, and I feel a momentary hesitation. What I'm about to do crosses a line, from a special interest to something more dangerous and much more against the rules. But the temptation is too strong to resist. I've come this far, after all.

I bring the mask to my face, feeling the soft plastic seal against my skin. It's cool at first, but quickly warms against my face. I take a deep breath, smelling the significant plastic scent of the new breathing circuit and mask. The oxygen fills my lungs.

I pickup the black head harness, and, with a little more awkwardness, I secure the mask to my face, tightening the straps until it stays sealed tightly even when I’m not holding it.

My breathing sounds loud inside the mask. For a few moments, I watch the rebreathing bag inflate and deflate rhythmically with each breath I take. I watch my oxygen saturation maintain at 99% on the monitor. Everything is working perfectly. It’s time to take the next step.

I reach for oxygen flow knob again. This time, it twist down… and twist the nitrous oxide tap open. I know how the flowmeters work, and set the balls to a roughly 33% nitrous oxide flow. I take a deep, deliberate breath through the mask, and the effects begin almost immediately. A pleasant warmth spreads through my limbs. I hold the breath for a second, then deliberately take another very big breath. My fingertips tingle with a curious numbness. By the third breath, a buzzing sensation starts at the base of my skull, radiating upwards into my head. I’m surprised, and more than a little bit pleased, at how fast I’m feeling the nitrous. I've read about this feeling countless times in medical literature and online, but experiencing it firsthand is amazing; both the physical sensation and the forbidden nature of what I'm doing. I want more. I turn the oxygen down slightly again, and the nitrous up.

I lean back onto the operating table, letting my arms fall to my sides, and take in more of the gas as I relax.

The room maintains its sharp edges and clinical brightness, but my perception of it begins to shift. The surgical lights above me seem more intense, their glow extending just a bit beyond their actual boundaries. The rhythmic sound of the gas flowing through the circuit becomes hypnotic. My breathing is less intentional now, but even so, I’m still breathing slowly and deeply. The rebreathing bag inflates and deflates and I enjoy watching it for a couple of minutes. Inhale, exhale. Inflating, deflating.

I check the monitors with slightly unfocused eyes. My heart rate has decreased to 84 beats per minute; it’s still elevated from my normal resting rate but lower than before. My oxygen saturation remains good. The blood pressure reading cycles automatically every five minutes. The cuff tightens around my arm before letting go with a soft hiss: 125/76. The beep of my heartbeat has slowed.

I laugh, muffled by the mask. I watch the rebreathing bag some more.

The blood pressure cuff cycles again; time is stretching, I’ve floated here five minutes already, and dissociated without realizing it. There’s a clock on the OR wall, and I watch it for a minute. It moves simultaneously slowly and fast. I smile. I’m happy, and… I want more.

I decide to increase the concentration. My movements are deliberate, almost ceremonial, as I pull myself upright, then reach out to adjust the flowmeters. I’m already around 50%, and I want a bit more. I twist the nitrous upwards, nearly as high as it’ll go. I can tell the difference almost immediately.

The buzzing in my head intensifies, becoming a gentle vibration that extends through my entire body. The boundaries between myself and the room begin to blur. The operating table beneath me seems to become softer, much softer, as if I might sink through it if I relaxed completely. I don't, though; I still have the presence of mind to lower myself back onto the table gently, instead of falling off.

I let myself drift again. I think about the nurses and surgeons who work in this room, wielding their instruments, controlling life and consciousness with practiced hands. Now I'm doing the same, in a way. This thought seems somehow hilarious and profound. I don’t start laughing but I’m pretty close. Before I know it, the blood pressure cuff is cycling again.

I raise my hands in front of my face, fascinated by how distant and blurry they seem. I wiggle my fingers, watching the movement with detached curiosity. There's a delay between my intention and the action, as if I'm connected to a video game on a bad internet connection. I slide my palm along the cool surface of the operating table, the sensation of touch seems simultaneously intensified and muted.

A new thought surfaces through the haze of nitrous oxide: what would sevoflurane feel like? I know that nitrous, at normal pressure, can’t actually knock anyone out. But sevo, at even at moderate concentrations, induces unconsciousness within minutes. I don’t want that. Even while intoxicated, I clearly understand the consequences of gassing myself to far. But my understanding of MAC is that at lower concentrations, like, say, 1% or 2%, people my age will generally remain awake. At least for a little while.

I could try it. Just a little.

I know it’s dangerous, but the idea is irresistible.

I sit up again, and reach for the anesthesia machine, my movements a lot less coordinated now, through the nitrous fog. First, I turn down the nitrous oxide flow to zero, allowing pure oxygen to clear my system for a moment. I take several deep breaths, feeling some of the fuzziness recede. My thoughts sharpen enough for me to recognize the recklessness of what I'm about to do, but not enough to stop me.

I turn the yellow vaporizer dial just a bit, turning it to 1%, then to 2%. Enough to taste it, to feel its initial effects for real. I’m not feeling tentative now, like I was with the nitrous, even though I know I’ll need to quickly turn it off. I breath all the way out, and the sevo begins to flow.

The first breath is still mostly oxygen, and I let myself settle back onto the table. When I take the second breath, though, a distinctly sweet smell fills the mask. It smells chemical, like a harsh cleanser, but… not unpleasant. I don’t feel anything. I take another careful breath, then another. Only then, does the effect hit me.

A heavy warmth spreads through my body, like someone’s thrown a weighted blanket over me. Another breath, and I start to feel distinctly tired. The nitrous made me feel fuzzy primarily, this is making me feel drowsy.

I try to breath normally, and the edges of my vision begin to blur, the periphery darkening slightly. It’s as if a camera’s vignette effect has been applied to my eyesight. The beeping heartbeat sound in the room seems to recede, becoming muffled and distant. It’s much more intense than the nitrous, and much more intense than I expected. I understand, in a moment, how stupid I’ve been. I need to turn the gas back off.

I sit up, trying to reach the machine, and it feels like I’m moving through syrup. My intention to move my hand doesn’t match my muscles exactly; the same effect as the Nitrous but more severe. The machine seems farther away than it was a moment ago. I reach for the vaporizer dial, and my own hand seems disconnected, as if it’s not mine.

Before I can reach the dial, another hand appears in my peripheral vision. A hand that is, for sure, not mine.

I try to turn my head, movements sluggish, brain struggling to process this unexpected development. A figure in blue appears, standing beside me, and grabs my wrist, pulling it back from the vaporizer.

"What have we here?" a female voice says. "Someone's been playing with toys they shouldn't touch." The words have a British accent, and seem to echo strangely in my ears.

I start to speak, but the mask is still harnessed to my face. I try to reach up to remove it, but the woman grabs my other wrist, too.

In the harsh surgical lighting, I see it’s a woman in blue scrubs, a surgical cap covering reddish hair, bright eyes above a white surgical mask. It's a nurse, but in my disoriented state, I can't immediately identify which one. Panic cuts through the chemical haze. I wasn't supposed to be discovered. No one should be here. The staff all left. I made sure of it.

I’m not sure what to do. I try to stand, to pull away, but my reactions are dulled by the anesthetics already in my system. The sevoflurane continues to flow; I still haven't turned it off, and each rapid, frightened breath draws more of the agent into my bloodstream.

"Turn it off," I manage to say, my voice muffled by the mask. "Let go of me!"

"I don't think so," the nurse replies. I feel myself being pushed backwards, down onto the diagonal operating table. "You've set everything up so nicely. It would be a shame to stop now."

I'm larger than her, stronger under normal circumstances, but the sevoflurane has substantially undermined my coordination. She pushes me down easily. But I’m not done yet; I turn sharply, trying to break her grip, and succeed in pulling one arm free. I reach for the mask, intending to tear it away, but she’s fast, or I’m slow. She blocks my hand, catching my wrist again.

"Oh no, you don't," she says, her voice hard. "Keep that mask on."

Fear spikes through me. Each breath is drawing more sevo into my system. I thrash, but the head harness keeps the mask firmly in place despite my movements, and the continuing supply of anesthetic makes my fight increasingly clumsy.

The nurse adjusts her grip, pinning one of my arms under her body, while reaching for something on the anesthesia machine I’ve placed so conveniently close by. To my horror, I see her turn the sevoflurane vaporizer not down, but up. I can’t see where she’s set it, but I know anywhere above 3% will rapidly render me unconscious.

"No!" I shout this time, the word completely intelligible even through the mask. I buck upward, pressing my legs against the table, trying to get up. For a moment, I think I might break free. The pulse oximeter rips free from my finger, setting off a high-pitched alarm from the monitor.

I’m able to slide my right arm free of the tangle of limbs, and I grasp at the mask, fingers scrabbling at the head harness, but they just… won’t… get it… My fingers don’t work right.

The nurse recovers quickly, catching my free wrist a third time, and forcing it down. She swings one leg over me, straddling my chest and fully jumping on the table. Before I know it, she’s on top of me. She’s using her weight to pin me down. Her face is close to mine now. It’s aggressively intimate, her blue eyes intense above her mask.

"Don't struggle, love" she says, her voice simultaneously soothing and menacing. "You'll only make it worse for yourself."

With her full weight on top of me, my movements grow increasingly fruitless. Even if she wasn’t on top of me, the feeling of heaviness, the feeling that started after my first few breaths, is much stronger now. Each time I try to push her off, the physical exertion forces me to breathe harder, deeper, pulling more sevoflurane into my system. I realize that the more I fight, the faster the anesthetic is taking hold.

My vision begins to waver, the straight lines of the room twisting and bending. The nurse's face above me seems to split and rejoin, her mask and eyes turning blurry and confusing. I blink rapidly, trying to clear my head, but my eyelids are harder and harder to open each time I do. It doesn’t help at all.

"You're quite strong," she comments, sounding slightly out of breath, but in control. "But the sevo is stronger, love. Always wins in the end."

My strength is failing rapidly now. My arms feel impossibly heavy, as if I’ve been tied down with giant elastic bands. I still struggle, but my movements are feeble, uncoordinated. I’m losing.

The room begins to spin in slow, nauseating circles. The lights overhead multiply, separating into a rainbow of colors. My hearing seems more affected now too: the nurse's voice echoes strangely, as if coming from multiple directions at once. The alarm from the disconnected sensor sounds distant, as if I’m underwater.

I'm aware of my breathing becoming slower, deeper.

"That's right," the nurse says, her voice drifting to me through layers of distortion. "Stop fighting now. You're doing so well."

I watch the nurse as she climbs off of me, but somehow, her weight seems to stay. She maintains her grip on my wrists for another few seconds, but my arms have gone limp. She releases them cautiously, maybe prepared to restrain me again if I’m faking it, but I am very much not faking it.

I can barely lift them now. My eyelids feel impossibly heavy. I force them open only with tremendous effort, trying to focus on her face, but my vision is degraded, or my brain won’t control my eyes. I can’t tell which. I try to think of something to say, but I can’t.

"Good," she says, her tone shifting to something almost… sexual. "You're submitting beautifully now."

I hear the sound of electric motors as she repositions the table, I feel myself tipping backwards. She’s straightening my legs, raising the table, returning it to a flat configuration. She gently places my arms at my sides. I want to resist but can only manage the weakest of movements.

The nurse moves to the anesthesia machine, adjusting something I can't quite see. The sevoflurane concentration, I realize distantly. She's increasing it again. The time I breath, the gas rushes in forcefully, making me breath fully and deeply. She’s squeezing the rebreathing bag.

"Just close your eyes and drift off now," she orders, her voice seeming to come from very far away. "It’s dreamland for you."

My eyelids flutter. No amount of effort can keep them open. I realize with a distant sort of horror that I'm about to lose consciousness. I make one final, feeble attempt to sit up, to roll off the table, but my muscles refuse to cooperate.

A strange feeling of peace begins to replace my fear. The inevitability of going under becomes almost comforting. I can no longer remember why I was fighting so hard against this feeling. I’m so incredibly tired and I just want to sleep. With each breath into the mask, it gets stronger.

"Perfect," she murmurs, watching as my resistance fades completely. "That's exactly right. Let it happen." I hear her, but I don’t understand.

I can’t see the nurses’s face anymore, as spinning blackness rushes in from the edges of my vision. Yet somehow, I know she's smiling as she watches me fall down to oblivion. The world clicks off.

I drift up through darkness. Consciousness returns in fragments as my brain boots up.

First comes the sensation of touch: cool air on bare skin, pressure around my wrists, on my back, on my thighs and ankles. A moment later, my sense of position; proprioception. I’m on my back, my arms splayed outwards, my legs in a strange position.

I try to rub my eyes, but the pressure on my wrists keeps them from moving.

It takes several seconds, maybe a whole minute, to process what just those two senses are reporting, what all that means. I'm lying on my back, restrained somehow.

Next, I hear a steady beeping. It’s increasing in speed as I wake up. No memories yet, but the sound seems familiar.

My eyes are closed. Only with some effort am I able to force them open. As soon as I do, I blink against harsh, circular lights overhead. Surgical lights. The operating room comes into fuzzy focus, and with it, my fragmented memories.

I'm completely naked, immobilized, and splayed open on the operating table. I remember being caught, overpowered.

My mouth feels incredibly dry. I try to swallow but barely produce enough saliva. My whole body feels sore, like I’ve just run a marathon or fought a wrestling match, which, in a way I did.

I try to move my arms again, turning to look at my wrists restrained to the table’s perpendicular armboards. I’ve seen Velcro positioning straps used here before, the kind intended for patients at risk of pulling out IVs or simply moving too much while anesthetized for surgery. The restraints here are not those, but padded leather cuffs that more resemble something from a 1950s insane asylum. I don’t know where they came from, but I’m not sliding out of them any time soon.

I lift my head slightly, fighting against residual dizziness, and look down the length of my body. As I feared, I’m completely naked; my clothes and underwear both gone. ECG electrodes have been placed on my naked chest. That’s not good.

Much worse, my legs are elevated and separated, positioned in the yellow leg-lifting stirrups that hold my feet and ankles. I'm in the lithotomy position; as if someone’s positioned me for a gynecology, urological, or rectal procedure. I try to pull my feet down, but unsurprisingly, the yellow boots and straps are tight and strong enough that it’s useless. A strangled noise escapes my throat as I realize how completely vulnerable I am. My heart beats faster and I hear the heartbeat monitor on the anesthesia machine match it. I try to stay calm and finish examining my situation. I’m not going to find a way out by panicking.

I don’t see any people around, thankfully. But it’s obvious the room has been transformed since I lost consciousness. The anesthesia machine has been pushed back to its usual position above my head. I can stretch to see it; its displays glowing with data, my heart rate, blood pressure, oxygen saturation, and now ECG and respiratory traces.

My eyes dart around the room, taking in details that send fresh waves of adrenaline through my system. Surgical instruments have been arranged on a Mayo stand beside the table; gleaming metal specula, retractors, forceps, and scissors. An electrocautery unit sits ready, its grounding pad visible but not yet attached to my body. A black endoscope is coiled on a blue-draped table nearby that I’m sure wasn’t there before. Everything is positioned as I’ve seen it used during the work week, all as if in preparation for an actual procedure. Or more than one procedure.

I remember the clock on the OR wall. It reads 6:17 PM. I try to remember when I started my self-administered anesthesia experiment; the surgical center closed at 4, so it couldn’t have been long after 5:00. More than an hour has passed that I can't account for. An hour during which someone, the nurse who caught me, has prepared this nightmarish scenario.

The door to the operating room swings open, and she enters, as if summoned by my thoughts. Now that I can think clearly, I know who this is. It's Nurse Evelyn, the British transplant who joined the surgical center staff six months ago. I suddenly recall it was her birthday cake crumbs I cleaned up an hour or so ago.

She’s fully attired for the OR now, a disposable yellow isolation gown tied over her scrubs, her hair tucked completely under a bouffant cap. No hint visible of her red locks anymore. Her hands are white latex.

Her bright blue eyes above her mask crinkle at the corners, suggesting the smile I can't see.

"Ah, you're awake," she says, her accent pronounced as she approaches the table. "Welcome back to the land of the living. How are we feeling, then?"

"What the hell is this?" I croak, my voice hoarse. "Let me go right now!"

Nurse Evelyn tilts her head, studying me with amusement. "That's not a very diplomatic way to address the person who caught you abusing clinic equipment, is it? You're in quite a sticky wicket. Imagine what administration would think if they knew you were playing doctor after hours."

She moves to the anesthesia machine, checking the displays as if we’re in a normal, professional situation. "Your vitals are stable. No worse for wear, I think. How’s the nausea?" I have no nausea, thankfully, but I don’t answer.

"Why am I restrained? Why am I…" I can't even say it, the vulnerability of my naked, exposed position.

Nurse Evelyn laughs, the sound light and warm despite the circumstances. "Why are you strapped down and undressed? Self-preservation, love. Couldn't have you waking up and bolting before we had our little chat."

"As for the stirrups, well, I needed to conduct a thorough examination while you were under. Very thorough. I had to make sure you were healthy enough for what I have planned, you understand."

Heat floods my face as the implication sinks in. I think she’s joking, but I have no way to really know. "You had no right…"

"Rights?" she interrupts, stepping closer to the table. "Let's discuss rights, shall we? Did you have the right to use the anesthesia machine on a lark? To use controlled substances for your personal entertainment?" She leans over me, her eyes intense above her mask. "No, you didn't. But I understand why you did it. We're not so different, you and I."

"What do you mean?" I ask, trying to keep my voice steady despite my racing heart. The beep of the heart monitor betrays me.

"I saw how you set everything up. The care you took with the preperation. The way you monitored yourself." She runs a gloved finger along my forearm, a strangely gentle and intimate gesture. "I think you’ve been planning this a long time. And I also think you weren't just curious about the physical sensation. You wanted to experience the vulnerability, the surrender of control. The submission."

Her assessment hits uncomfortably close to the truth. I don’t know what to say to her. She’s not exactly right, but it’s frighteningly close. There’s for sure some connection between the equipment I’m especially interested in and intense power dynamics; anesthesia has, along with it, the requirement to complete surrender to another's care. I, of course, don’t voice this, but my silence speaks volumes.

"While you seem to enjoy being the patient," she continues, "I prefer the other role. The one who decides what needs to happen. When consciousness begins and ends. The one who holds complete power over another human being." Her eyes glitter. "Quite the perfect match, wouldn't you say?"

"You're crazy," I whisper, though I think I don’t really mean it. I think she can tell that I actually do understand. I feel something inside me; not just fear, but a flicker of dark excitement I don't want to acknowledge.

"Crazy? No. Unconventional, perhaps." Evelyn moves to the foot of the table, between my spread legs, and I feel a fresh wave of vulnerability. "Here's what's going to happen. It's Friday night. No one's due back until Monday morning. You and I are going to this entire weekend exploring our mutual interests. I’ll send you under in various ways; different medicines, different combinations. I was an anesthesia nurse in England, you know. I'll take care of you quite professionally, of course."

"You can't just keep me here," I protest, though my voice lacks conviction. "People will look for me."

She raises an eyebrow. "Will they? The solitary IT worker who avoids social interaction and lives alone? Will anyone call on you?” I don’t answer, and again my silence speaks. “No. You're not due anywhere until Monday morning. Same as me."

I struggle against the restraints, panic rising again. "This is kidnapping!" I protest. It’s not halfhearted; I’m genuinely scared, even if that’s not the only emotion anymore.

"It’s hardly kidnapping," she counters smoothly. "You mostly did this to yourself. I just… helped you a bit.”

What you should realize now, love,” she continues. “Is that I could easily report what I caught you doing. That's career-ending at minimum, maybe even criminal charges." She leans over me, staring into my eyes. "Or, we could have a mutually beneficial weekend. You get to explore your fascination with anesthesia in ways you never could alone. I get to practice my skills and indulge my own… interests."

Her gloved hand rests on my thigh, the touch clearly intended to be suggestive, intimate. "Do we understand each other?"

I stare up at the surgical lights, my thoughts racing. The situation is surreal, terrifying, and yet… I can't deny the dark thread of excitement growing under my fear. Part of me has always wondered what it would be like to fully surrender to anesthesia in the hands of someone who knows what they're doing. To let go completely.

Something in her tone, in the absurd situation itself, makes a hysterical laugh bubble up from my chest. "This is insane."

"Perhaps," she agrees, "but I think it's exactly what you wanted. Just not how you expected to get it."

"What exactly are you planning to do to me?" I ask, my voice steadier now.

"I’m going to put you to sleep again," Evelyn tells me. "I’ll try different induction techniques. A sevo mask induction, as you've already experienced. We’ll try the isoflurane, too, I think. A standard propofol induction. Certainly ketamine in some combination. Perhaps etomidate, if I decide you’ll risk the side effects" Her voice takes on a dreamy quality. "I’m told each one feels different going under."

I swallow. “You can’t just anesthetize me over and over,” I object, but I don’t think I’m convincing.

She doesn’t seem convinced. “It’s definitely not recommended. But neither is the scheme I caught you playing out, is it? There are some risks, but you’ve already been taking some of those, haven’t you? I’m sure you’ll be able to handle it.”

I swallow hard, looking down at my spread legs. "And the position I'm in now? The surgical tools?"

"I think it's better if I don't explain everything I have planned," she says, voice dropping to a near whisper. "Fear of the unknown heightens the experience, doesn't it? You’re vulnerable. Exposed. At my mercy." Her eyes crinkle as the heartbeat tone speeds up. "All I’m going tell you is that you won’t feel a thing."

Nurse Evelyn leans closer. "If you cooperate, though, this could be quite pleasant for you too. Some patients report euphoria, lovely dreams. You may even find the experience… arousing." Her tone drops on the last word, sending an involuntary shiver through me.

I close my eyes, weighing my options. While she’s implied I have a choice, I suspect there really is none. She has me literally and figuratively tied down. Fighting seems pointless; she controls the drugs, the restraints, everything. But I’m not ready to trust her, even with the desire she’s ignited below my fear.

“Please, just let me go,” I protest again. But I’m not sure if I really mean it.

"I don't think you mean that, love" Evelyn reads my thoughts, her voice dropping to a husky whisper. She moves to stand beside me, her white gloved fingertip tracing a line from my collarbone down my naked chest, all the way to my waist. "I think you're just scared to admit it."

The latex of her glove feels cool against my skin. I shiver again, and my breath catches involuntarily. Evelyn leans in close. I can feel her warm breath through the mask she’s wearing. She whispers in my ear.

"You enjoyed it, didn't you? When I caught you… when I held you down… when I made you breathe in the gas until you couldn't fight anymore."

My pulse quickens, betraying me on the monitor with an accelerating beep. My memories replay as she describes them; her weight on my chest, my useless struggle, the sweet smelling gas filling my lungs against my will. I realize, to my horror, that I’m getting noticeably aroused thinking about it.

"I saw your eyes before they closed," she continues, voice silky and intimate. "That moment when fear gave way to something else. When you realized you couldn't stop it happening. You want that feeling again, don’t you?" I don’t answer. My mind races. I can’t help but feel she’s right. But I think about all the surgical tools laid out. And I don’t trust that I have a real choice here.

"You're going to put me under again no matter what I say, aren't you?" I finally ask.

"Clever," she says approvingly. "You'll be spending quite a bit of time off with the fairies this weekend. But how pleasant that time is, and how pleasant the time in between is, depends entirely on your attitude."

She moves to the head of the table, starting up the fresh gas flows. "Shall we begin? Don’t answer. You’re right, you don’t have much of a choice. A little nitrous again to start, I think."

Despite everything, I feel my resistance beginning to crumble. The fear remains, but alongside it grows a perverse curiosity. What would it be like to experience all those different anesthetics, administered by someone who knows exactly what they're doing? I think I’m going to find out.

She lowers the mask towards my face, holding my chin only lightly with her gloved hand. I move my head to the side, trying to avoid the mask. It's a futile gesture, but some part of my brain, maybe the majority, still rejects the idea of submitting so. The mask follows my movement, and her grip on my chin tightens.

"Let’s have no foolishness," Evelyn scolds, her tone sharpening.

She presses the mask firmly against my face, creating a tight seal. "Deep breaths now. Be sensible."

Against my better judgment, I feel myself relaxing slightly. The fact that it’s all being decided for me is strangely reassuring, even as the situation remains profoundly frightening. I do as instructed, and begin to breath, deeply.

She turns the nitrous oxide flowmeter, and I hear the gas begin to hiss through the circuit. "Just breathe normally. Fifty percent to start, I think. You'll feel it soon enough."

I inhale obediently. I can’t really smell it, but within moments, the familiar warm tingling begins in my extremities, slowly spreading inward. The steady beeping from the pulse monitor starts to slow.

"There you go," Nurse Evelyn says, her tone suddenly soothing instead of sharp. "Just like that. Nice deep breaths."

The nitrous works quickly, creating the same vibrating sensation I experienced earlier. The fear fades, replaced by a slight detachment that makes my situation seem less threatening, more surreal. The restraints around my wrists and ankles no longer feel quite as imprisoning. I forget about my nakedness after a few more breaths. My head starts to feel fuzzy, as if cotton is being stuffed into my brain.

"Good?" she asks, watching my face closely. I nod, unable to deny the pleasant sensations washing through me. I try to organize my thoughts. The gas already makes it difficult to think critically, but the fear and desire still war within me. Evelyn watches me with those intense blue eyes, monitoring my response to the nitrous oxide. She seems to know exactly what she's doing with the anesthesia equipment. Professional. Controlled.

Can I trust her? She's holding me captive, but there's something oddly reassuring about her dominance. She’s confident, and she clearly knows what she's doing. But she's also clearly unhinged, willing to cross professional and ethical boundaries without hesitation.

Just like I am.

I really did want this, in some way.

"Alright," I say finally, my voice muffled by the mask. "I'll cooperate."

Her eyes light up with genuine pleasure. "Brilliant! I knew you'd come around. We're going to have such fun together. I think we have a bit more to do tonight, but it’ll be over before you know it.”

I wonder exactly what she means, and exactly what she’s planning for me, but I don’t have time to ask.

"Now we'll add the sevoflurane. One percent to start." She adjusts the vaporizer dial. "This will be just like before, only now I’m in control the whole time."

The distinctive odor of sevoflurane mingles with the nitrous oxide. My eyelids grow heavy again, the room's edges softening. Nurse Evelyn secures the mask with the harness, which I hadn’t realized was already behind my head.

“Now, love, with both sevo and nitrous, you’ll go off quickly,” she explains. I know there’s a phenomenon where having both nitrous and a volatile on at once increases the effects, but I can’t remember if 1% is already enough to anesthetize me.

I’m starting to feel more drowsy. Like before, the nitrous made me detached, but the sevo is making me want to sleep. I force my eyes wide open, trying to stay awake as long as I can.

“Up to three percent,” Evelyn’s voice seems distant and echos in my ears. I know that’s enough to put me out. The visual hallucinations begin immediately. The vignette effect from before returns, my vision narrowing. The lights begin to wash out, strange colors begin to fade in. When Evelyn leans over me, her white mask seems to glow. The yellow color from her isolation gown seems to stretch out around the room.

"Time for dreamland again. Why don’t you count backward from one hundred?" she instructs, increasing the sevoflurane concentration. I can’t see how far, but the smell increases significantly.

"One hundred… ninety nine…ninety eight…" My voice sounds distant to my own ears, the words slurring together. I look up at her and her face seems to distort. The room begins to spin. The yellow of her gown changes into a confusing medical rainbow, yellow, blue, white, green, along with nameless colors that don’t exist in normal reality.

Nurse Evelyn's gloved hand rests gently on my forehead, a gesture that might be comforting under different circumstances. "You’re doing brilliantly. Keep going."

I’m supposed to be counting.

"Ninety seven… ninety six… ninety five…" The numbers come with increasing difficulty. I already can’t remember what number I was on. Have I made a mistake? My tongue feeling thick and uncooperative in my mouth. The ceiling above me seems to spin faster, expanding and contracting with my breathing.

"Nine…" I manage, though I can’t hear myself. I'm no longer sure if I'm speaking aloud or just thinking the numbers. What was I counting?

"Almost there," she encourages, her British accent barely penetrating my mental haze. "Just slip off again."

The room begins to spin faster, Nurse Evelyn's face above me, already blurred and stretched, begins multiplying and rejoining like a kaleidoscope image. I try to raise my hands, to pull the mask off. One last moment of confusion. Of course, the restraints don’t let me move at all. I’ve been helpless this whole time.

"Perfect," she murmurs down at me. My eyes close of their own accord. My body relaxes. The spinning, the drowsiness, the sense of weight over my body is all too much to fight.

Consciousness fades even faster now. Darkness takes me again. My brain turns off.

My head throbs. I realize I’m awake. I don’t remember going to sleep. I try to open my eyes, but my eyelids feel impossibly heavy. It occurs to me that maybe they've been taped shut, but I don’t know why that thought comes to me. A mechanical beeping lines up with the throbbing in my head. Rhythmic. Familiar. A patient monitor? I shift and it feels like I’m in a bed. Somehow, I think I'm in a hospital bed. My mouth feels like it's stuffed with cotton, my tongue thick and clumsy. I try to swallow, but produce barely enough saliva and my throat is sore. The details of how I got here elude me, for the time being.

It takes a minute, but I finally manage to force my eyes open, only to immediately squint; above me are harsh, fluorescent lights. White, institutional ceiling tiles come into focus. They also seem familiar.

With effort, I raise my right hand to rub my eyes, and feel a tug. Looking up, I see an IV catheter secured to the back of my hand with section of transparent tape. A line of clear IV tubing snakes up to a half-empty bag of fluid hanging from an IV pole nearby. The movement causes my hospital gown to shift against my skin, and I discover I’m wearing a hospital gown.

I’m disoriented but my memories begin to fall into order. I remember my plan for the night. Going to the operating room. I remember my interrupted experiment. Evelyn catching me. Her weight on my chest as she held me down, forcing me to breathe in the anesthetics. I think of the restraints. I remember her making me go under a second time. I think I remember something else, something after that, but it’s too blurry to piece together. In any case, I remember enough.

I bolt upright, but like opening my eyes, I instantly regret it. The sudden movement makes the room spin and my headache momentarily gets worse. I grab at the IV site, about to simply pull it out, when a voice stops me.

"Are you sure you want to do that?"

I hadn’t noticed until now, but Nurse Evelyn is quietly standing at the foot of my bed, arms crossed. Her mask is gone and her red hair is down now, freed from the surgical cap, falling in waves around her shoulders. She's changed into fresh scrubs, feminine, pink, instead of the light blue from before.

Her blue eyes evaluate me.

"How are you feeling?" she asks, her British accent pronounced in the quiet room. She steps closer, and taps a few buttons on the patient monitor, silencing the rhythmic beeping. She turns, and reaches for my wrist to take my pulse manually. I don’t think to pull away, my brain is still booting up. Her fingers are cool against my skin, and strangely intimate.

"Headache," I manage to croak. "Tired. Thirsty." My voice sounds like a dry croak; my throat is rough. "What time is it?"

"Just before 9," she answers, releasing my wrist. "Post-anesthetic headache is not unusual. The volatile agents can do that, even sevoflurane. It'll pass."

I look around, taking in my surroundings more fully now. I am in a hospital bed, or more accurately, I'm in the Post Anesthesia Care Unit. Eight recovery bays, mine right next to the doors. The other beds are still empty, their monitors dark, including the one I’d turned off when I’d checked it just a few hours ago.

I glance down at my body, suddenly aware of how little I know about what happened while I was unconscious. Quite a lot of my body is vaguely sore, maybe from exertion, but maybe from something Evelyn did after I was anesthetized. I try to recall what time Evelyn told me, a what the time on the OR clock had been, and I think it’s been more than an hour. That’s time to do quite a few things. My throat hurts, so I’ve probably been intubated. The memories are missing, but I know, deep down, she’s done something.

I pull at the thin hospital gown, searching for any signs of surgical intervention.

"What did you do to me while I was out?" I ask, my voice carrying an edge of fear as I examine my lower body, looking for incisions, stitches, anything out of place. "Did you… operate on me?"

Evelyn watches my frantic self-examination with amusement in her eyes. She tilts her head slightly, a small smile playing at the corner of her lips. She lets me search for a minute; I can tell she’s enjoying it.

"You won’t find anything amiss this time, love. Nothing that left a mark or that’d put you out, really." She steps closer, her voice dropping to a whisper. "I suppose I did start the world’s most painless IV. But I might do more next time. Wouldn't that be interesting?"

I try to not to react to how close she is, or her comment. I think I shiver slightly. Maybe in fear, but maybe very much not. I look into her eyes, and for moment, there’s only the sound of the patient monitor taking my blood pressure again.

"I'm not restrained," I observe, quietly. After being tied down in the OR, the freedom feels strange, almost suspicious.

Evelyn smiles widely now; since she’s not wearing a mask anymore, the expression is fully visible. "Do you need to be? You're hardly in any condition to cause trouble. Besides, you agreed to cooperate, remember?"

I nod slowly, though I’m still somewhat conflicted. Did I agree? I recall the moment of surrender, the choice made. It was surely made under duress, but was also driven by something deeper, my special interest, and the connection to Evelyn that I’m not quite ready to admit.

"There's water if you need it," she says, gesturing to a plastic cup with a bendy straw on the bedside table, stepping back. "But nothing to eat, and nothing to drink after midnight. You're scheduled to go back to the OR first thing in the morning."

My stomach tightens at her words. "Back to the OR? For what?"

"For whatever I decide," she replies simply. "We have a full weekend ahead of us, remember? Different induction techniques to try. And once you’re asleep, whatever I want." Her tone is light, conversational, as if discussing plans for a casual outing rather than forced unconsciousness and potentially surgery.

I swing my legs over the side of the bed, the movement causing the IV tubing to pull slightly. The floor feels cold beneath my bare feet. This is my chance. I could rip out the IV. I could leave now. Evelyn is alone, I'm not restrained, and despite my headache and lingering soreness, I’m confident I could overpower her now that she’s not holding an anesthesia mask. Or I could just run. I could run out the door. I could tell someone what she’s done. Or I could try to keep it all a secret.

But I hesitate. I don’t do any of that. Not yet.

Evelyn watches me, head tilted slightly, a knowing expression on her face. She's not moving to stop me. She's not threatening me. She's simply waiting, as if she already knows what I'll decide.

"Get some natural rest," she says finally, turning toward the door. "Tomorrow will be a long day."

And just like that, she walks away, her footsteps fading as she crosses the PACU. At the doorway, she pauses to turn out the main lights, leaving only the dim glow of the single patient monitor and the emergency exit signs. Then she's gone, the door clicking shut behind her.

I sit there on the edge of the bed. She left me alone. Unrestrained. With a clear path to escape. I think through it all again. I could pull out the IV, find my clothes, and be gone before she returns. I could report her, or I could simply say nothing. She’s surely cleaned up all the evidence already. I could just leave.

Instead, I find myself thinking about what she said earlier in the OR. About how we’re similar. My fascination with experiencing anesthesia, her desire to administer it. Two pieces of a disturbing puzzle that somehow fit together perfectly.

I groan. My body is sore, and my head pounds. I'm exhausted from fighting and from the drugs still circulating in my system. My thoughts aren't entirely clear. At least, that's what I tell myself as I swing my legs back onto the bed and lie down again.

I'm just too tired to make any decisions tonight. I'll think more clearly in the morning. Then I'll decide then what to do. In the morning.

I roll onto my side, adjusting the thin PACU pillow under my head. Despite everything, despite the danger and the fear and whatever else I’m feeling from my complex new connection, I feel myself drifting back toward sleep. And somewhere beneath the exhaustion and confusion, a small part of me knows that by putting the choice off, I’m making the choice.

I wonder what tomorrow will bring.

I close my eyes and shut down again, back to dreamland.

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