Anatomy Theatre
………………..And She had a Heart! – E. Simonet
………………………………………..oil on canvas 1890 *
Simonet asked to observe my autopsy. I refused.
I know he painted her. Perhaps
more than just her face.
Internally, there’s a different intimacy.
Dark nipples suggest what I now fear to find.
No bruising on her neck or arms.
…………………………Down her back
livid stains show how she lay after death.
I am anxious to explore her heart.
It repeats its cadence in my ears.
I trace a line from throat to diaphragm,
………divide breast bone, splay ribs,
………………………….reflect pleura and retract lungs.
Their sponginess is lost in a congestion of blood.
I dissect veins and arteries to free the heart
from its attachments.
……….I lift it from the cavity.
A draught from the high window shivers gaslight
onto silver pericardium. Its fibres are impenetrable
to all but the sharpest blade.
I hold a troubling heaviness in my hand, recall murmurings
from my stethoscope in her shadowed room.
…………The weight tells of a fault I failed to hear.
I suspend the scale on a hook
………….and place the heart in the bowl below.
The needle swings and loses equilibrium.
.
*
https://commons.wikimedia.org/wiki/File:Enrique_Simonet_-_La_autopsia_-_1890.jpg
3rd place, Ledbury Poetry Competition 2019
https://www.poetry-festival.co.uk/ledbury-poetry-competition/
.
When the heart fails
fluid fills the interstitial spaces of newborn lungs.
Perihilar shadows appear on the X-ray.
Serous liquid leaks into air sacs.
They whisper together, our sponginess is lost
in a congestion of blood.
From the first breath, we want to cry
‘It’s not our fault’ but lack vocabulary
and the vocal cords are immobilised
by a tube reaching into the chest.
Their susurration is audible in crepitations.
The clue lies in careful auscultation.
Artificial ventilation cannot remove carbon dioxide
or improve oxygenation.
………………..In the kidneys, renal arteries do not provide
…………….….adequate forward flow.
………………..Venous stasis dilates capillaries
………………..inside each glomerular cup.
………………..The drip of urine drops to a trickle.
………………..A million nephrons falter,
………………..we cannot form our liquid words
………………..to pretend we’re working well.
………………..We neither absorb sodium nor excrete
………………..potassium, creatinine or water.
………………..Hyperkalaemia tickles the heart
………………..into extra-systoles.
………………..It tells us we’re not pulling our weight.
………………..We shrug metaphorical shoulders
………………..and try to hold the acid-base steady.
………………..Consultants shake their heads together,
………………..increase the infusion rate of epinephrine.
In the liver, hepatocytes necrose.
The intern reports hepatomegaly
from portal vein obstruction.
Marked elevation in the serum levels
of bilirubin, alkaline phosphatase
and the transaminases
are no surprise to anyone.
Coagulopathy complicates the picture
and fibrinogen is administered
in aliquots of ten millilitres.
Remaining liver cells advise,
someone should make a decision soon.
We understand open heart surgery
is under consideration.
………………The cor culprit slows
……………….to an erratic lub-dub, stops.
……………….It starts again in a lower gear
……………….but without momentum.
……………….In far off fetal times my myocytes contracted
……………….to grow liver, kidneys, lungs
……………….but I disordered myself early on
……………….when I failed to produce a left atrium
……………….or ventricle so I’m only half hearted.
……………….I’d just like to say,
……………….it’s up to the surgeon now.
.
Denise Bundred was a consultant paediatric cardiologist in Liverpool and has an MA in Creative Writing. She is a Fellow of the Royal College of Physicians and won the Hippocrates Prize in Poetry and Medicine in 2016, coming second in 2019. She came third in the Ledbury Poetry Festival Poetry Competition in 2019. Her poems have appeared in a number of anthologies and she has poems in Envoi, Under the Radar and Magma. Her debut pamphlet, Litany of a Cardiologist, will be published by Against the Grain Press in 2020.
Abegail Morley 