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By Cynthia Ybarra

I remember him and when I close my eyes, I can see myself, standing in his room, looking down at him. This is by design; you can’t help but look down. The environment is created this way; unless you raise the height of the bed to a dangerous level or steal a moment to sit at the bedside to engage with your patient, person to person, human to human, you will always look down on them.

I see myself stopping and looking. No, stopping and seeing, trying hard to see him as more than the click, click of the ventilator, the sound of air being forced in and drawn out, creating a rhythm of its own. The alarms trying to tell me what I already know. I see him. Alive. I see life in his eyes, Carlton, can you see me? 

What are we but synapses zipping and zinging across one neuron to the other, stimulating and blocking our most human responses through chemical release? A junction, a diffusion of human emotion, neurotransmission targeting classes of cells that make movement, thought, sensation, and emotion possible. We are the sum of our parts, gray and white matter. Is this what we call free will?

“How is room 36”, they ask? Rumpled, and sometimes, dirty white coats, serious faces, tired and dragging. Sometimes annoyed at having been called in the middle of the night for something for which they would not dare wake the attending physician. Some, only first year residents, trying to figure out this medical maze, this virtual rubric’s cube, where outcomes are not in simply solving the puzzle, but doing it well. The very essence of life depends on it. “Carlton? you mean Carlton? He isn’t a room number”. 

Can you tell me what mystery lies behind the rhythmic lub-dub, chordae tendinea opening and closing delicate chambers of flesh? these heart strings, not easily broken, thread bands of fibrous tissue, make it possible to open and close valves, move blood through these corporeal angles, in the blink of an eye. This mechanical process keeps him alive, tick, tick, tick, as we all move toward the inevitable. 

He resists when we turn and reposition him, his hand clutches mine when I have time to step outside of the chaos, taking a moment to turn off and become human once again. I take his hands in mine, lean over and whisper reassuringly in his ear. “Carlton, you can go, it’s ok, everything will be ok, you can go now, ok?”  It is only the whirrs and clicks of the machine that answer. His eyes follow me as I collect supplies, change his bed, bathe him, give him daily feedings and crushed medication. He is here. 

Is there magic in the machinations of the heart? The myocardium has three layers and only exists in one place within the human body. It is not only mechanical intervention, but electrical activity that keeps the heart beating. Like all big cities in the world, the heart has an electrical grid, a generating station. The ventricles can squeeze and twist in several different directions at one time, ensuring the maximum amount of blood circulates to feed the heart and other vital organs. Contract, relax, contract, relax.

We forget to think about what lies behind the tubes and wires, the anatomy and physiology. We forget the person in our care is more than a number, he has a name. We forget that there is somebody who loved the landscape of his chest, the shape of his lips, his thighs, now a medical work site. To what end?

We forget he had a voice that could once rise above the noise of these machines, hiss, whirr, hiss. Beeping so often that we have created dances to match the melody coming from the ventilators. Room 36 has a name. 

Author Bio: Cynthia Ybarra served five years in the US Army until she was discharged under “Don’t Ask, Don’t Tell” for coming out to her command. She writes, mostly, creative non-fiction, although she dabbles in many forms of writing. She has been involved with Warrior Writers since returning to Nebraska from California in 2015 and appreciates the opportunity to write with other brothers and sisters who wore the uniform. 

Image description: A woman with short grey hair and black tshirt is smiling. Photo courtesy of Cynthia Ybarra.

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