Isaiah studied his reflection in the mirror. This was the last time he’d see himself in this familiar and wrong way. His single fundamental flaw was about to be corrected. In mere hours he would no longer be a woman trapped inside a man’s body.

He didn’t despise his male physique. He accepted that he was attractive. In medical school he’d experimented enough to learn both men and women appreciated a healthy athletic form. This reconstruction concerned more than his physical appearance, although having his outward looks reflects his inward reality would be such a gift. This final step in his metamorphosis ended one life and began another.

At last he’d take control of his future with this life-altering surgical procedure. Today represented the end and the inception, the connecting of his spiritual entity with the sacred hoop of physical existence. His escape from the sweltering stink of Miami for the wet heat of Bangkok seemed a symbolic rebirth. The sex-change operation was the final stage in his transformation. Soon he would emerge from anesthesia-induced dreams, like a lunar moth bursting free of the cast-off chrysalis, reborn into a new life. A new identity. A new world.

The culmination of his journey lay just ahead. The conclusion of a lifetime spent out-of-sync with every person of his acquaintance, living as a partial human being rather than a whole. The oxygen mask slipped over the lower half of his face and he sighed a shiver of pleasurable anticipation. The physician smiled down at him, the laugh lines around her dark eyes crinkled into a fine roadmap, and at that moment he thought her more beautiful than any other woman.

 “This is the last stage of our journey, Isaiah.” She said.

Her gloved hand smoothed across his jawline as his eyes became heavy. The simple movement offered a comfort he gratefully accepted. His eyelids dropped. His hearing muffled. His last thought before the darkness claimed him was that when he wakened, he would at last be Alicia.

                                                *                       *                       *

Dr. Kanokwan eyed the monitors. She watched the steady pulse and the EKG graph blip in regular arcs. The sacrifices her parents endured to send her halfway around the world to medical school in the United States had resulted in a financial windfall after her return to Thailand. Strict laws and intensive public scrutiny made procedures like this one impossible in America. Fortunately, she and Isaiah had kept in touch over the years.

She’d made certain to do so.

Part of her regular practice was communicating with former classmates and colleagues. Everyone came to explore Bangkok sooner or later. She maintained the guest cottage in constant preparation and over the last decade had entertained a steady stream of visitors. Isaiah’s arrival one week before was no longer the most recent. Already Jillian was settling in to the accommodations, having fled New York, leaving behind a soured marriage. She’d come seeking breast implants and a sampling of the sexual adventurers on Nattapong Street. She’d only experience one of those goals.

Dr. Kanokwan slanted dark eyes at the anesthesiologist.

“His numbers are good.” The man said.

She leaned down next to the patient’s ear and squeezed his shoulder. “Goodbye, Isaiah.” She whispered the words, kissed his temple, and smiled a tiny smile. Her educational experiences had paid unexpected dividends yet again.

She turned away and walked toward the exit, pausing at the door to speak over her shoulder, her tone clipped and clinical. “Harvest his organs and prep the room for the next one.” She pulled off the nitrile gloves with a snap and dropped them in the trash receptacle. “These rich Americans make our work easy.”

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