In Sao Lourenco da Mata, in northeastern Brazil, you can get a cat neutered for about $4 US. In Phoenix, the same neutering will run you $50. Adjusted for currency and local markets, American vets would only be able to charge about $17 for the procedure if they forewent the presentation, and operated with Brazilian transparency.

I’ve had many pets neutered in my lifetime, and had always envisioned a typical OR scene: a veteran surgeon, surrounded by able underlings accustomed to the rigors of surgery; a young but eager resident whose sole responsibility was to monitor the patient’s vital signs, which were reported in real time by a whole wall of expensive equipment that beeped intermittently; a tray full of surgical tools; an antiseptic bed on wheels. The animal patient of my imagination was anesthetized in triage, where a mask was placed over his whiskered face to help him relax as the IV was inserted in his furry arm.

Then he was wheeled in the back, where the real magic happened. American vets have you drop your pet off at a specific time on a specific day, and request that they not eat anything for twelve hours before the operation. They take the animal behind closed doors, where we imagine all the really high-tech stuff is kept, and we assume his situation is being taken very seriously until we pick him up six hours later. When we do, he’s doing fine. He walks a bit stiffly and gives you resentful looks for a few days, and then he’s back to normal, minus making overtures to your leg while you read. We imagine we have the best vet in the world. A good vet will have the receptionist do a follow-up call the next morning, and she’ll make recommendation about dosages and keeping the animal’s bed on the floor where he can get into it.

In Northeastern Brazil, there is no such pomp.

Cueca (koo-WEH-kah) came to us as a kitten. He was cowering in the weeds in front of our house, and we took him in. He became a charming cat – the kind who interacted with people, and when the time came to make him a homebody, we asked the pet food vendor where to procure the required operation.

The vendor owned a shop beside the river, on our side of the bridge. It was of the same vein as our better fireworks stands – cinder block construction, steel rolling doors and a tile countertop. The customers stood on the sidewalk to place their order. It had electricity to power a light and a radio, but no running water. The vendor’s teenage son ran the shop when he was out, and we had been buying Cueca’s food there for a few months. We told him we needed to neuter our cat, and he said that it was wise, that it would make him stick around the house. His son said “alas, he’ll never know what’s good in life.” When asked where we could go for such an operation, he said he could do it right there – just bring the cat by anytime.

It took some consideration to entrust this slipshod outfit with extricating my cat’s reproductive system, but as I thought back to the knee replacements I’d seen on TV as a youth, I came around. After all, at the core, they’re just sawing and hammering. The following Monday, we carried Cueca down to the vet in the booth by the bridge, and asked whether we could watch. “Well, yeah, I’ll need you to hold him still,” he answered.

The vet spread some newspaper on the tile counter top, set out a scalpel, some rags and a mustard bottle that appeared to have some molasses residue on the spout. Then he got a couple of syringes and held the cat by the scruff of the neck. He gave Cueca a general anesthetic between the shoulders, amid some protest, then massaged his back until he loosened up. His front legs got soft first, and he slumped down to a flaccid, feline athletic stance. He opened his mouth wide, gyrated his head for a few seconds, and a mass of half-digested cat food paste leaped from his throat to the newspaper like a banana-sized Chinese dragon. He groaned. His back legs gave out and he flopped on the counter.

With the general anesthetic in command, the vet lifted the floppy and oblivious Cueca by the tail and inserted a numbing shot in each doomed testicle. With the confidence of a veteran surgeon, he sawed an incision in each side of the satchel and squeezed out the offending organs like gigantic blackheads. A quick snip of the vas deferens and he was tossing the extractions onto the sidewalk. “A dog will eat those”, he stated, matter-of-factly. With that, he took the mustard bottle and injected a surplus of the dark, molasses-like substance into the genital voids. He grabbed an empty cardboard box and plopped down the remains of the once-proud Cueca. Then he wadded up the newspaper that had guaranteed a sterile operating environment for our pet, took our money with a congenial grin and said he’d see us later.

Now, you would suppose that American vets tell you to come back six hours later because it’s that long of a procedure. But the real reason is that most of us would be appalled to see a cat’s slow recovery from a general anesthetic. Brazilians have no such scruples. For the first two hours, he stays as floppy as a sack of bread dough, though his eyes remain open. It’s times like these that you most wish that your pets could talk, so you could ask them whether they remember all the absurd outfits you dressed them in while they were under. Once you’ve taken a satisfying amount of pictures, gone to lunch and come back, his eyes begin blinking with more and more regularity. Then, as you would expect, his tail starts to twitch, and you perceive through this that the cat is displeased. As the hours pass, he gains more and more cognitive and physical control, and by mid-afternoon is waddling stiffly around the house with a scowl on his face, just as though he’d been neutered in the high-tech American operating room of one’s imagination. Within four days, he’s back to lurking behind furniture and attacking your bare feet as you pass, with no apparent recollection of what you did to him.

In fact, the aftermath of the Brazilian roadside operation was so uncannily like that of the expensive American pet hospital operation, that I immediately began to question whether the Arizona vets that I’d previously entrusted with my animals weren’t doing exactly the same procedure! Since the incident, I’ve paid closer attention to operations on TV, and have spotted a very similar routine: slice, tug, snip, sterilize. Take away the shiny tables, the outfits and the beeping machines and a triple-bypass looks just like a Brazilian cat castration. I’ve kept a sharp eye out at pet clinics since arriving back in the US, and have yet to see the shiny tables, outfits and beeping machines, which has led to the obvious conclusion that American neuterings look just like Brazilian neuterings, but behind closed doors.

The difference is that American pet owners will pay a premium to think that their pets are being treated with the same care and attention as their aging parents, and American vets have learned not to dispel this illusion. “On the day of operation, make sure Rigley eats nothing for at least twelve hours before arriving. If he shows any sign of trepidation before arriving at the pet hospital, don’t be concerned, it’s quite normal. If, however, [insert very unlikely symptom, like his pupils getting really, really small] please notify us immediately. I’ll be prescribing 500 mg of [insert fancy name for pet aspirin] after the procedure. He should take it every four hours, wrapped – are you writing this down? – in a slice of American cheese. Make sure she doesn’t miss this, or she’ll experience some pretty adverse effects [like discomfort].” These savvy, American vets aren’t being disingenuous in the least. They aren’t misleading you into thinking that they’re adding some value that they aren’t. They’re simply demonstrating that they are every bit as concerned about your pet’s operation as you are.

Just like we at Melaroo have a better way of saying “dude, your website sucks – we can fix it for you,” American vets have a better way of saying “basically, I’m gonna knock him out and cut off his balls. Ten minutes, tops.”

It’s all about the presentation.