He spoke to Ana in a way that no other doctor had. The medical terms washed over her, but his casual manner, his easy slouch, his youth and confidence made up for what she didn't understand, and she liked that he asked what she thought.
It helped, too, that she noticed a change. Once the swelling from the first surgery had subsided, she could see that her forehead was less creased, her brow less sunken. She could see her left eye, and her cheek followed more closely the outline of her jaw.
Two months later, when an invitation arrived for "Midspring Night's Dream," a benefit for Batra and Hall's nonprofit, she knew she wanted to attend.
Of course she was nervous. During the surgery, some of her hair had been shaved off, and she wasn't certain how she'd style it. But she wanted to go out, and Fran offered to drive.
The benefit was held at the Marriott Del Mar in San Diego. The surgeons' clients, wearing formal low-cut dresses with ample décolletage, crowded the small room. Glittery jewelry, perfect eyebrow lines, tinted hair and highlighted cheeks accentuated the doctors' work, and as the women sipped champagne, chatted and made bids on Botox treatments and skin care products, beauty and fragility never seemed more inseparable.
Ana stepped into the room, wearing a brown pin-stripe skirt with a spaghetti-strap shell. Her hair was tied back, her toenails painted black. She looked stunning, and when Batra spoke later that evening, she did not mind being singled out.
The summer heat came early that year, and Ana tried to put aside thoughts of the second surgery. The prospect of returning to the hospital always made her worry. At night, just before falling asleep, she would startle herself awake with the memory of needles and IV lines.
She tried to distract herself. She got a new dog, a Chihuahua she named Charlie. Her application for Social Security disability benefits was approved, giving her a monthly income. She bought a new cellphone. She and her mother got tattoos. Hers was a scorpion, her astrological sign, inked just below her neck. Margarita's was the letter A on her right shoulder, with a teardrop falling beneath it.
Batra wanted the next procedure to take place by midsummer, but it wasn't until September 2006 that Ana was wheeled back into the Scripps operating room.
The plan was to remove at least 12 teeth that were abscessed or impacted because of the tumors and were a risk for infection. They also wanted to reshape Ana's nose.
The first cuts were the easiest but, as always, out of the corner of his eye, Batra caught sight of Pi's tiger restlessly casting about.
Andrew Chang, the oral surgeon on the team, was optimistic. The bone was strong, good for implants at some later date. He worked quickly and efficiently.
When he was done, Batra and Halls got started, occasionally interrupting chitchat about patients and the latest surgical gadgets to talk through the next step. Everything was a reflex, a seemingly thoughtless association between brain and hand that directed their rearrangement of Ana's face.
Then Batra hit a large sinus of blood vessels by the left eye. The tiger lifted its head and moved toward him.
"Give me another suction tip. The suction tip is blocked."
There was never any way of knowing how thoroughly the blood vessels had infiltrated the tumors, and there was no way of knowing how the body would react to this bleeding.
Batra put his finger and some gauze on the vessels to try to slow the flow, shaking his head with sudden frustration. Forceps slid onto the floor. The boat was starting to rock, but Ana's vitals remained strong. He kept the pressure on the bleeder, and soon the cat lay down.
Batra made another incision from her left nostril to the bridge of the nose. Deep beneath the skin, he and Halls identified the pyriform aperture, the bone beneath the nose where they would establish an anchor to help create the groove between cheek and nose.