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a pretty good idea of what I'll find.'
    'They get all sorts of adhesions and fistulas, don't they?' she asked.
    'Yes,' he said. Loops of the inflamed bowel of a patient with Crohn's disease often adhered to each other, and sometimes fistulas, or small channels, opened up between the loops. Clay could visualize it readily, having seen it many times. 'All those loops can form a solid mass...a real mess. The temporary ileostomy will rest the bowel.'
    'I don't envy him,' she said feelingly.
    Rhona May poked her head round the prep room door. 'Time to get scrubbed, Sophie,' she said.
    'I'll give you a few extra minutes to prepare, Ms Dunhill,' he offered to her retreating back as she silently left the room. 'Good morning, Rhona,' he added cheerfully. 'How are you today?'
    'Morning, Dr Sotheby. I'm just fine,' the nurse greeted him warmly.
    'I've promised Sophie not to be too much of a tiger,' he told Rhona. Gratified by the nurse's startled expression, he walked into the operating room, then out to the corridor where his patient, a young man of twenty-eight, lay on a stretcher waiting to be wheeled into room four. Alex White MD, who was another of the anaesthetists, was with him.
    'Morning, Clay,' Dr White said quietly when Clay came to stand beside him as he was putting a second intravenous line into their patient. 'How goes it?'
    'Pretty good,' he said, and found that he meant it. Monday mornings were not always good, particularly after a weekend on call. Chronic fatigue was par for the course. Right now he felt rather buoyant.
    'Good morning, Mike,' he greeted his patient, whose illness he had chronicled for months before finally deciding on surgery. Inflammatory bowel disease, of which there were two types—ulcerative colitis and Crohn's disease—weren't easy to diagnose initially, he reflected, as the early symptoms could be somewhat vague, similar to a number of other diseases and infections.
    Chronic fatigue, some weight loss and abdominal pain had brought Mike Dolby to his general practitioner. That doctor had made the referral to University Hospital, specifically to him. Already Clay was thinking ahead to the details of what he would have to do, what he would most likely find when he had Mike Dolby's abdominal cavity opened. They had already done various procedures in order to make the diagnosis. The pathologist had made the final diagnosis from biopsies of the gut.
    'Morning, Dr Sotheby,' Mike Dolby said. 'I feel at a disadvantage like this, flat on my back.' He tried to joke to hide his apprehension. He looked pale and ill, a slight young man who looked younger than his twenty-eight years. The disease had played havoc with his life.
    Clay placed a hand on his patient's shoulder. 'I'm pretty sure that this will be a routine procedure,' he said, repeating what he had said before. They had already gone over, several times, all the ramifications of the operation, as well as the implications for the future. In particular he had explained that a ileostomy would almost certainly be a temporary measure. 'Just keep in mind that you're going to feel much better in every way when this is over.'
    Mike nodded, trying to relax. Clay had ordered a pre-op sedative for him, in consultation with Alex White, which had already been given. That, no doubt, was taking the edge off his understandable anxiety.
    'I'll leave you in the capable hands of Dr White,' he said with a smile, 'then I'll see you inside the room in a few minutes.'
    When he went to the scrub sinks, Sophie was still there, soaping her hands and arms. With her face mask and plastic goggles on, he couldn't see the expression on her face as she swiftly noted his entry and then turned away again. There was something about her body language, her physical stance, that made him certain she was less than pleased at having to scrub for his first case.
    'I'll give you five minutes' head start, Ms Dunhill,' he said, as he casually tied on a face mask and put on his plastic goggles.