The late Alden Nowlan was a cancer survivor who wrote a significant body of work devoted to his illness and treatment. “In The Operating Room” is such a poem. It begins strongly, starting off with a man's voice. The opening song is appropriate to the occasion, for the autobiographical “I” of this poem is about to be shunted off by the ritualistic acts of the anesthetist (positioning the patient on the OR table, starting intravenous medication, etc.) into the nether-realm of the general anesthetic. These first few lines are packed further with meaning: “Michael, Row the Boat Ashore” is an old slave song that used to be sung by American blacks rowing their masters' goods across Virginia's rivers. The song form—a hymn—is apropos to the poet's funereal circumstance of general anesthesia, a state one remove from death. The occasion of the song is also apt in that the anesthetist will be ferrying the poet from the waking world into unconsciousness.

Nowlan then infuses the poem with the precise physical detail of the anesthetist's arms, which are covered in “red, curly hair/ like little coppery ferns.” Nowlan's attention is devoted to the hairs on the anesthetist's arms, and on first reading this may seem absurd. After all, the poet is about to be put to sleep and have surgery performed upon his body; aren't there more important things to think about? Nowlan's answer is no, that this detail is somehow important. He then proceeds to make the case, writing that he desires to touch the arm (touch being a basic act of comfort) because “it may be the last living thing” he will ever see; furthermore, the arm is vibrantly alive, not just “white and hairless.” Nowlan is therefore using the arm to subtly introduce mortality into the poem, and he makes clear his preference: he chooses to grasp life.

The poem then changes tack. Nowlan disarmingly deflects seriousness away, focusing on how embarrassed he might feel should he survive. How human to worry about embarrassment even as one is about to undergo life-threatening surgery. On this note the poet refocuses his attention on the anesthetist's singing, song being itself a life-affirming act, but this time invoking “muddy and cold” waters—undoubtedly a metaphor for death.

The poem has a bravura ending: its syllabic quickness reflects the rapid onset of loss of consciousness from drugs; “everything/ is dark/ and nothing/ matters.” This is a discomfiting sensation as related by the poet, a violent acceleration. Most importantly, the idea that “nothing matters” is repudiated by the lines that immediately follow this faux nihilism; Nowlan instead aligns himself on the side of life, for he wishes to touch the hair that he now thinks of as “little jets/ of fire.” There is no longer any doubt that the hairs on the anesthetist's arm are important. That his arms are strapped down also seems to matter in a more mysterious way; is Nowlan upset that he has been stripped of freedom? Is this another metaphor for the powerlessness of affliction? The image itself is a powerful evocation of powerlessness. Or is it? I believe the poem's real power lies in its antithetical representation of helplessness and quiet hope.