poem

Tension Pneumothorax

Last thing to do before leaving.
You don’t have time for his shit.

A pile of undictated notes,
An appendix waiting at the hospital ten miles away.

You remember striking the jugular flush
On the first stick with a harpoon needle,
A nice blush of fine Merlot in the hub.
Then: guidewire, dilator, catheter sliding into place.
Stitch it to the skin, order the x-ray.

Half an hour later she’s crashing.
Code blue over the PA.
Is that my lady?
She’s intubated, hypotensive,
Absent breath sounds.
You push through the crowd
And ram an angiocath between her ribs
To release a whoosh of air.

Every time you breathe everything gets worse.
You’re injured inside,
A tiny rent in a one cell membrane,
A small gash to the sense of self
Even though you’ve done everything right.
You can’t just walk it off;

Carrying on is an ancient art.
Someone will need a line next week.
Someone will need you, once again,
While you silently fill up
With an unrelenting pressure,
An unobservable, escalating strain
That quickly crushes your heart.

12/1/20