Page 82 of Silent Night

your skin slowly becomes more elastic, enabling us to put a silicone implant in several months later.”

She had a sharp intake of breath.

“We’ll add a nipple later, much later. Then you’re done.”

Deb set her chin. She cleared her throat. “How do you add a nipple, exactly?”

“A graft. And we dye the skin to be the exact same color as the other side.”

“A graft? From where?”

“Your upper thigh. We find that works well. On the inside. It’ll bug you for awhile. People do complain about discomfort. But we like that area the best.”

“But,” she blushed. “Is there hair? Does it grow on the nipple?” Her face was hot.

He continued looking at his clipboard. “Sometimes. Then you deal with that.”

He cleared his throat. “OK. Our other options are to suction belly fat out of your stomach and put that into your breast. So then you get a tummy tuck in the process.” He put his large hands on her abdomen and felt it, massaging. “Sadly, you don’t have enough for that technique. I wouldn’t worry about it. That process is very long, lots of appointments and painful.” He sat back and looked at her in the eyes. “The last procedure involves using skin from the shoulder area and building a breast, but I see a nasty scar there. What’s that from?”

She felt dizzy. She wanted to sit down, tired of standing here almost naked, so exposed and scrutinized like a bug under glass. She felt like an old car up on a lift. Rusty, deteriorated. And this nice mechanic/ doctor was here to put her all back together. She was a virtual Humpty Dumpty. Her eyes wanted to fill. She did not let them.

(Page submitted by the author, MH Gerber; ebook available here)

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My Review

A friend of mine just died of cancer, so perhaps I'm overly susceptible to the material. Nonetheless, I found this page thoroughly compelling. The author has captured an intense and personal moment, crisply spelling out for us both the clinical details and the protagonist's reactions to them. It would be very easy (and for most writers would be very tempting) to fill up a page like this with the inner workings of the character's mind (or heart, or soul, whichever you prefer). Instead, MH Gerber chooses to tell us what the patient is feeling by way of her physical responses, eschewing any description of thoughts or emotions until the last paragraph of the page. And even there, the character's emotions unfold through artful metaphor, not heavy-handed emphasis words about grief or mortification.

With a deftly placed intake of breath, a flushed face, and a couple of quick mannerisms, we've been shown rather than told what it feels like to be this person in this situation.

Just as skillful is the dialogue: simple, believable, flowing very naturally. The only hiccup on the whole page for me was the doctor's line, "We find that works well. On the inside." He seems to have meant to say that the tissue comes from the inside of the thigh, rather than that the graft works well on the inside. But even the momentary confusion that I experienced, while reading those seemingly transposed sentences, added to the overall effect, in that it was disorienting to me, and difficult to process, and those feelings were exactly the ones being felt by the character. It's completely believable that the doctor would invert those two sentences, and while they might be clearer to the reader if reversed, I think there's a real value in choosing to leave them as they are.

An excellent page, and one that tempts me to step outside of my typical genres to see if the rest of the book is as moving and rich.