The surgeons won't operate on you you have a "hostile abdomen," their note says, not suitable for "exploration" and upon reading this, I picture them dressed in khaki, holding torches as they descend a staircase into the cavern of your belly. Their torchlight illuminates the surrounding landscape: a thicket of scar tissue, a squirming heap of bowel, and far in the distance, the purple mountain of your liver. One surgeon takes a machete to the scar tissue, cutting forcefully through each diagonal, fibrous attachment as if it were a vine in a jungle, inching toward My stomach hurts, you say. I sit on the edge of your bed and examine your belly, and when you wince, it occurs to me that there is something very innocent, almost childlike, about abdominal pain. Chest pain seems a problem for the aged: the term conjures images of pipes clogged with grime, of white-haired people collapsing without warning in their driveways, but abdominal pain  it feels more grounded, more central, more primitive. Next, I am a small girl crouched in the bathroom, alternately vomiting into the toilet and resting my forehead on my mother's thigh; I feel the fabric of her housedress against my cheek, her cool hands smoothing back my hair. She leaves a metal mixing bowl next to my bed (just in case), along with a glass of ice chips, and whenever I reach for the glass, it clangs against the bowl, making a sound like a bell; for years thereafter, the sound of metal cookware clanging against itself would remind me of being sick to my stomach. I'm sorry we can't operate, I say to you, and you shrug your shoulders. You contracted HIV in the 1980s and watched most of your friends die of that virus; you're grateful to have lived this long. Your husband knocks on the door. He is holding a bag with blue cellophane sticking out the top: today is your birthday. He says, I came to bring you home

This post was written by Emily Silverman, MD. It was published in the fall 2016 issue of The Examined Life Journal at the University of Iowa Carver College of Medicine.