The American and his girlfriend are in the midst of a disagreement about.... ?

The subject of the disagreement is hidden until the man says, "It's really an awfully simple operation, Jig.... It's not really an operation at all." When Jig fails to respond, the man tries several more times to tell her that the "operation" is all "perfectly natural." His description of the operation implies that Jig is pregnant and he is trying to talk her into having an abortion.