Soon enough, the even more dramatic heart transplants made bypasses seem routine. And as the success rate of bypasses surpassed 95 percent, they grew into the most common major operation in the United States -- 309,000 patients received bypasses in 1993.

The Yeltsin bypass got us thinking: Exactly how is this operation performed? We decided the only way to find out was to have a bypass -- just kidding. Seriously, we decided to watch one, from beginning to end, so we prevailed on Robert Love, a thoracic surgeon at University of Wisconsin Hospital and Clinics, to allow a pen-and-pencil scribe into the operating room.

He agreed, and here's what we saw:

© University of Wisconsin-Madison Medical School, Edward Joseph, photographer.

7:00 a.m. The patient -- we'll call him Mr. Smith -- is rolled into the operating theater, groggy but awake, and a crew of nurses and doctors go to work. In scenes entirely reminiscent of ER, they shave Smith's chest and insert an intravenous line in his arm. 7:30 Mr. Smith is urged to breathe deeply as the anesthesiologist places a mask over his face. He promptly drops off to a peaceful sleep, aided by an intravenous cocktail of drugs mixed specifically for him.

He gets narcotics for the pain, isoflurane for the "sleep," an amnesia drug so he won't remember the ordeal his body is about to endure, and a muscle relaxer to keep him still.

8:00 a.m. The anesthesiologist, from a position near Smith's head, inserts a catheter (defined) into the right jugular vein and threads it through the heart's right atrium, right ventricle and out into the pulmonary artery. The catheter will read the output pressure from the heart's right side, which is devoted to pumping blood to the lungs (that's where the blood gives up its carbon dioxide and picks up fresh oxygen). The catheter also has holes allowing the doctors to place medicines directly into the heart.

It's the anesthesiologist's job to keep the patient unaware of what's going on -- and alive. It's a classic "hours-of-boredom-punctuated-by-moments-of-sheer-terror" job. But even sitting still, waiting for something to happen, the anesthesiologist, like the rest of the team, oozes purpose and competence.

8:16 Another milestone: the first cut. With a single stroke of the scalpel, the surgery resident cuts the flesh from the top of the collarbone to below the breastbone.

To lighten things up, the anesthesiologist asks the resident and board-certified surgical fellow who is taking a specialty in cardiothoracic (heart and thorax) surgery, whether they want more light. "Do you like to be alone in the dark?" he asks, as if a 5-foot diameter operating light were not blazing within inches of their heads. "We're sharing this moment of tranquillity," the resident responds dryly, without missing a beat.

Things won't be tranquil much longer.

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