Surgeons working in an operating room.
[ This image is in the public domain. ]

when the doctors opened his chest
exposing the heart, a family legacy,
and his body lay on the operating table
they discovered the patient’s heart
had created a natural bypass—

over quiet years in the dark
air of movie theaters,
in nighttime car rides
and moments in bed
a fleet of vessels
had assembled
to do the work the heart
was not able to do

from the stresses of management,
a high cholesterol diet and lack
of physical activity, how this heart
suffered but found a way through
to create its own safe passage

midway through the surgery
the cardiac specialist discussed
his progress with the family
their chairs in a semi-circle
around his scrubbed form
perched on the edge of his chair
he described the work so far:

the doctors added on to
the heart’s own natural fix by
repurposing a vein from the left
leg; its health and thickness
meant it would survive the regular,
enormous pressure within the chest

later, after the midway,
what they found next
made them all gasp:
four small children in his gut
near the aorta as it entered
the abdomen, likely causing some pain
and trouble breathing, a boy
rested on a kidney as he might a pillow,
three girls dozed quietly
near the spleen.

the team fell silent
as they observed the scene—
exchanged glances,
raised eyebrow indicators over their
surgical masks. an intern flipped
off the OR intercom radio station

they leaned in close to listen
but heard nothing except
the vacuum hum of the heart lung machine
as it breathed for the patient
his chest rose and fell
and the cradled children
slumbered on in their small ways

there was no physical trauma
caused by the children so with a nod
to the nurse and resident and
a typical wordless tilt of his head
the lead surgeon indicated they should
clean up and close up. as they slid
the retractors back, they paused

and the team slowly, slowly,
with great skill and grace, closed
the man’s body around the family.