Preterm Neonate C/F Pulmonary Stenosis
I examined a baby today, it didn’t cry
chest tubes drained yellow pleural fluid
saliva frothed from a feeding tube
and SATs dropped each time I touched
its blue belly, pulmonary pressures
made massive its muscular right ventricle
I couldn’t wait to leave, eat bagels
endlessly refresh a glazed-over feed
whipped cream cheese catching wheat’s
toasted trabeculations, brown and crisp
a praiseful ceremony to behold, the baby
survived the morning, which is everything
I know of its history, but by noon
I was long into the hard exam
of an elderly man’s strange, bright heart
fused stiff by inflamed granulomas
an echolucent infiltration that reminded me
how smashed beer bottles glittered
in Riverside streetlights the night after
my father asked if I was a tough guy
Organ Donor
Hippocrates claimed the liver’s
spongy filter formed
from congealed clots
that pooled where systemic veins
return spent blood to the heart.
I press my chest against
her ice-pack cooled flank
and heave her
from lateral decubitus to supine.
Slowly, dusk draws the shades.
What do I know of this person
outside the pencil-drawn, circular faces
on a visitor’s lunch menu,
one with hoop earrings,
another with a single strand of hair
that rises springlike from their head?
Ay chiquitín, I think but do not say—
the language and tone feel
of another world.
I view her living heart
through subcostal liver parenchyma.
“Parenchyma”
from Greek via Latin means
from the outside, poured in.
Is to be human to be a human
poured into a body?
Lights are off, summer’s dark felt
fills window-spaces, tree-spaces.
I can’t see the nurse’s station
but her voice is deep and rich.
“History of alcoholism.”
Silence, and then key-taps.
“Maybe that’s why she fell.”
To Hippocrates the liver
was the source of pleasure,
the stomach emotion and love.
Thus the expression “trust your gut.”
Ezekiel: to seek an omen,
shake the arrows,
consult the idols,
and examine the liver.
How fast the liver regenerates—
the Greeks knew.
Their science gave us
Prometheus’s eagle-pecked flank
blessed with immortality.
What do I know of this person
outside dirty, white sneakers
some hand tucked under the gurney,
or that she checked a box
so her body will save
six lives?
Is the human in the body or the action
of pouring it?
What mercies fill me?
What scars form my circumference?
I watch blood flow from
hepatic veins to vena cava
to the heart’s ellipsoid atrium,
a hemodynamic waveform
that rises and falls on my screen,
and rises and falls,
until it becomes
a rhythm
I anticipate even after it is gone.
STAT Cyanotic Neonate
I just finished assessing an Alfieri stitch repair
of a once-flail valve when I began to watch
the baby’s study. Sarah was upstairs
scanning a newborn with pulmonary atresia.
I turned on the screen and there it was
in short axis, an underdeveloped semi-lunar valve
grown over with trabeculated muscular tissue.
One by one her images loaded; wide open
intracardiac fenestrations kept the baby alive,
a pathology in any other circumstance, but now
the thread that pulled the baby through laborious life.
The tricuspid regurgitant jet was 6 meters per second—
a rush of wild blue gushing backward through the valve.
Can I define this velocity in terms of astonishment?
The world is vast and mysterious, each moment
flooded with truths I never guessed existed.
My phone buzzed with friends who asked why
I wasn’t yet at the restaurant. And where was I?
Blood aliased blue and red toward heart and lungs
through the aberrant duct the body made life of
as the baby writhed against its urgent diagnosis.
I had to see this story to the end.
***
Author photograph courtesy of Paul Hlava Ceballos
