"Do you want to see your tendons?"
Dr. Asif Ilyas, a hand and wrist surgeon, was about to close his patient's wound. But first he offered her the opportunity to behold the source of her radiating pain: a band of tendons that looked like pale pink ribbon candy. With a slender surgical instrument, he pushed outward to demonstrate their newly liberated flexibility.
"That's pretty neat," the patient, Esther Voynow, managed to gasp.
The operation Dr. Ilyas performed, called a De Quervain's release, is usually done with the patient under anesthesia. But Ms. Voynow, her medical inquisitiveness piqued and her distaste for anesthesia pronounced, had chosen to remain awake throughout, her forearm rendered numb with only an injection of a local anesthetic.