Julio was a nervous boy, and his anesthesia started at 11:43.

Dr. M, the anesthesiologist I was shadowing, explained that this was not Julio’s first time in the hospital. Far from it. He had been through a lot—unexplained seizures, a brain tumor diagnosis, excisional surgery, and chemo. In comparison, his visit today was minor: a restaging MRI. But Dr. M said Julio had been nervous the last time and would probably be today. He needed to be perfectly still for imaging, so he needed general anesthesia.

We walked into his room at 11:00. Sitting on the bed—no, crouching—was Spiderman. He looked up as we entered and flicked some imaginary webs at us. Dr. M’s hands flailed in an exaggerated backstroke motion. With her hands up, she reintroduced herself and asked if she could approach the tiny superhero. He looked at the other person in the room, his sister Marietta, and nodded.

Dr. M explained the anesthesia procedure to Julio and Marietta. Julio’s hands and feet never stopped moving and his eyes were constantly flicking around the room as if memorizing every detail. I went up to him and waved. He waved back and the first thing he said was, “I’m not nervous!” My mask hid my smile, and I gave him a high-five. He said it again, so forcefully I could hear the exclamation marks, as if saying it with enough force would make it true. Then he asked if I wanted to arm-wrestle.

While I arm-wrestled with Spiderman… with Julio, I heard Dr. M ask Marietta about how Julio had been doing. “He misses Mom, but otherwise he’s been a trooper. He’s been watching a lot of basketball lately.” I was later told that their grandparents had recently gotten custody because living at home was no longer safe.

After their sidebar, Dr. M and Marietta turned back toward us just in time to see me lose my seventh match in a row. Dr. M knelt so she was eye-level with Julio and asked if she could see his special mask.

He carefully unwrapped his blanket and pulled out a lovingly decorated anesthesia mask, cradling it like a baby rabbit he was afraid would hop away. I saw Marietta nod toward Dr. M and Julio extended the mask forward. The whole outside was decorated with stickers. It made me feel old, not recognizing the latest Disney characters. A disquieting feeling, for sure. Marietta piped up and said, “And he got to choose the flavor, too. Bubblegum.”

Dr. M nodded and said, “Good choice!” Just before leaving, she asked Julio to pull his hospital mask down so she could check inside his mouth. He yanked it off and beamed at us, aiming his mouth at each of us deliberately in turn to make sure we saw the gaps of a few newly missing teeth. His smile widened a bit more with each of our claps and cheers.

With Marietta in tow, we entered the operating room and finalized preparations. Dr. M handed me some sheets of paper and told me to crumple them up into balls while she added the bubblegum flavor to Julio’s anesthesia mask. She asked Julio to hold the mask himself for a minute and breathe, without any gas, to get used to the feeling and smell. Marietta squeezed his hand.

When we were ready to begin the induction, I handed the paper balls back to Dr. M. She gave them to Julio and had him shoot free throws into a trash bin. We all cheered every time he scored. I had not noticed, but the gas was on. He made one last shot with his eyes half-closed— another score—and Dr. M cradled his head, lowering him gently down to rest. Marietta squeezed his hand one more time, kissed his forehead, then headed to the waiting room. The MRI proceeded without any incident.

Since that day, I’ve thought a lot about Julio’s visit—the elegance of it. The appointment had been seamless. Despite being warned that Julio was nervous, I had watched his fear evaporate and be replaced by excitement. Dr. M had reinforced his confidence and courage by playing along with his Spiderman outfit. She had thoroughly involved Marietta, someone he trusted completely. She gave him autonomy in the process with his mask decorating and anesthetic gas flavoring. She validated and encouraged his emotions, especially when they were positive, like with his lost teeth. She had shown personalized care and comfort, having his last pre-anesthesia memories be about “basketball” and holding his sister’s hand. When I contemplated all of the steps she had taken, it was nothing short of pure artistry. From the very start of his 11:00 appointment—from the moment we entered the room—she had been easing his pain and anxiety.

Julio had been a nervous boy, and his anesthesia start time was documented as 11:43. But in my head, I have it down as 11:00.

Author’s note: Names and identifying details have been changed to protect patient privacy. Dialogue has been reconstructed to the best of my memory.