Posted by: M. J. Arcangelini | November 2, 2013

A selection of poems written out of the experience of having triple bypass surgery (CABG) on November 2, 2012

These poems, inspired by my open-heart surgery on November 2, 2012, tell a story. They were written between then and October 29, 2017. Most of them are ways of remembering and many of them are attempts to wrestle with the conflicting emotions and confusion that came out of the surgery experience and how I’ve dealt with the aftermath. I did not know I had heart disease when this started and it all happened so fast that I barely had time to register it before it was over. This is what has come out of it so far.
– M. J. Arcangelini (updated w/revisions & additions 10/29/2017)

“It was an illusion that we were ever alive.” – Wallace Stevens

“I survived myself; my death and burial were locked up in my chest. I looked round me tranquilly and contentedly, like a quiet ghost with a clean conscience…” – Herman Melville, Moby-Dick

NOTES:

CABG = Coronary Artery Bypass Graft, the specific open heart surgery I had, a triple to be exact.

Revenant = A person who returns from the dead; a reanimated corpse; a ghost, a zombie

Wraith = 1. A ghost. 2. An apparition of a person supposed to appear just before that person’s death. 3. An insubstantial copy of something: shadow.

The film referred to in “Under” is “Bullhead” (2011), wtr/dir. Michael R. Roskam

CTU = Coronary Telemetry Unit, the way station between ICU and release.

DSCN2446

CABG PRELUDE

the poet’s heart is overactive,
the doctor tells him –
inappropriate beats thumping away,
multi-sourced without discernible rhythm,
without navigable purpose –

what are you thinking about?
the doctor asks
nothing, says the poet
nothing special –
yet the poet’s heart is overactive –

the poet thinks:
there should be no surprise in this,
isn’t that my job?
open eyes, open ears, open nostrils,
overactive heart –

yes, no surprise –
it all fits

 

EXPIRATION DATE

he was snaking that thing,
that camera, the laserlight,
through my body and there,
just before the tubes empty
into the atrium, on the video
monitor I had been watching
before unconsciousness over
took me, he spotted it,
my expiration date –
there in the place too narrow
for a stent to wedge,
my expiration date –
spread across three arteries,
repeated, a motif, a design, a sign,
my expiration date –

When the cardiologist said
he was checking me into the
hospital right then, when I
had only come there for a test
he was telling me he had
seen my expiration date and
he was about to throw me
in the freezer to see how
much longer I could last –

 

THE SURGEON

The surgeon enters my hospital room
walks over to my bed, smiles,
offers an ethereal handshake,
a wisp of church frankincense
in this cathedral of medicine.
He sits down and starts the
questions: “Where were you born?”
“Is that a large town?”
He takes me chronologically
through my life, until we are
back to this hospital room.

He doesn’t inquire into my diet
nor castigate me for lack of exercise.
He doesn’t tell me what he’s going
to do when he operates on me.
He doesn’t ask me if I want surgery.

My first thought is that he is
crazy and I became frightened
that this is my surgeon,
that he is going to open me up
and mess around with my insides.

Then, like a locked door
Suddenly falling open,
I see that he has humanized me.
He has found what he needs to know
so I won’t just be the next
slab of meat on the table.
I will be a person to him, with a history,
and he will operate on that person
not just on the body beneath his scalpel.

I know now that he is the one
I want operating on me –
terror temporarily recedes
beneath his kind, confident voice.

 

REVENANT

was i plucked from the edge of a cliff
i didn’t know i as on? sleepwalking
under all those sweet drugs? saved from
a danger i didn’t know i was in?

did i die when they sliced open my chest,
sawed through my sternum
to open the rib cage like
a spring-loaded bear trap,
then collapsed my lungs and
rolled them up out of the way?
when they stopped
my heart to rebuild a part
– was that a kind of death?

was I then resurrected?
and what am I now?
how can life go on the way it was before,
knowing what I know about what was done,
knowing how I have temporarily cheated
death with the help of the surgeon –
how the surgeon has cheated death on
my behalf – is this something between the
two of them? some competition, some deal –
does the surgeon too play chess with death?
but this Seventh Seal was only half broken –

everything now relates to the surgery
there is nothing which does not appear
to have emerged from the surgery
as though there was nothing before
the surgery and everything has been
created anew out of its violence
the rest of my life emerging from my
chest like a baby emerging from the womb,
dripping, bloody and squalling
there is no part of my life which is not
touched by the surgery
there is not a thought, an action, intent
which does not seem to arise somehow
from the surgery –

was I dead before the surgery
or am I dead now? what am I now?
have i been to the land of the dead
and come back or did they keep me
tethered to life with their machines,
and
what is there to bring back from that?

a revenant, shadow of myself,
walking dazed and angry
without understanding why

MY FATHER’S SURGERY

34 years too late for him
I had the surgery that could
have saved my father’s life

my mother, 2000 miles across
the country, awaiting word
from the surgeon
on the fate of her firstborn
must have wondered

so many miles
so many years
too many questions

 

THE ICY YOU

Crawling into consciousness
In the Intensive Care Unit –
A day and a half missing –
Nauseous, “happy bucket” ready
To catch the verging vomit,
Which never emerged.

Friends visit in the afternoon,
Uncertain apparitions and that
Day and a half lost.
Memories of it buried deep
In the bone and sinew.
The body remembering
What consciousness cannot recall.
The drugs, sweet companions.
“You were quite a handful
In the recovery room,”
The night nurse confides,
“Pulling out your endotracheal tube.”
Bruises and scratches on both wrists.

All those wires and cables.
Mechanical hums, beeps, and tweets.
Massaging booties all night emitting
Alternating soothing hydraulic chords.

The temperature intrudes. The room,
Kept cold to inhibit bacterial growth,
Makes me think of it as the “icy you.”
Nurses bearing heated blankets
Like sweet warm embraces.
In lucid moments I pretend
There is a window open
And the cool comes, refreshing and
Fragrant, from somewhere outside.
But this space is as windowless
And self-contained as a womb.

The drugs. The dreams. The nightmares.

 

WRAITH

They tell me I fought in the recovery room,
violent they say, striking out at anyone
who dared to come near.
Yanking out tubes and wires which had been
skillfully placed to keep me alive until finally
they got me strapped down to a gurney
and pumped full of drugs
for sedation, for control,
for their own relief
as much as my own,
maybe more –

Might I then have met my wraith?
Hovering above my carved and bloody body,
gripping me in its bony grasp and
thrashing me around in hopes of
birthing itself, my own ghost, into this life –

I awoke the next afternoon, nauseous and
baffled, swimming up out of the drugs
as though through a heavy oxygen-infused oil –
I remembered nothing of the rearranging
of my parts, of my reluctance to return,
but my body remembered –
those occasional ornaments of medicine,
bruises and scratches, adorned both wrists.

And the tubes and wires all carefully replaced,
emerging like stray porcupine quills
sharp, awkward, but useful –
each held in place with sutures –
the long incisions, I would later learn,
glued together like a broken tea cup –

Fearful at having betrayed my body,
angry at my body’s betrayal of me,
as though we could somehow be
separated –
I drew my wraith back in with a deep
and difficult inhale, deep enough to
please the respiratory therapist,
deep enough to hide, to bury within
my flesh again the clawed and fanged
beast struggling to escape.

 

DOWN THE HALL

Down the hall a man
cries out in pain
“oh please!
oh please!
oh please!
help me!”
in my head his cries merge
with an old Beatles tune,
the bouncy pop song urgency
so in-congruent with his plea

“10 out of 10” he cries
describing his pain level
I think of my pain,
of how easy it has become
to say 3 out of 10
instead of 6 out of 10
because the drugs fill the gap
and I fear that I will lose
control of my pain
as this man down the hall
has done

A doctor arrives
to tend to the man –
he and I in here
at the same time
me just waiting
to go home
and he just
waiting
to die.

HOSPITAL TURTLE

Like a turtle I exist in a
virtual shell of tubes and wires
all movement hobbled
to the maneuvering of
these scientific accoutrements
attached like medical leeches
draining serosanguinous fluids
out of my chest cavity
and gathering them in
a bag at my side where
they can be measured
periodically to determine
when I can finally go home –

ROOM 304

rumor is that there are machine guns
mounted on the insides of the elevator shafts

and special sensors to detect the presence
of drafty hospital gowns in forbidden halls

keep a man in hospital long enough
and they’ll find a way to kill him

HOSPITAL TIME

I – ICU
time is distorted in the ICU, fluid in spite of
the calendar in every room telling me what
day it is one day at a time, in spite of the
clocks on the walls, which only seem to be
there to remind me at what absurd hour i
have been awakened to have my vitals taken,
along with small vials of blood – the lights
are dutifully adjusted on schedule to reflect
the agree-upon reality outside the unit and
activity slows down during those hours when
people whose lives are not teetering in quite
the same way try, to various degrees of success,
to sleep, but with no windows onto that world
these divisions of the day could as well be
random – here flow constant IV pain medications,
and sleep can come at any time of the day or
night, consciousness fades in and out, fluctuating
in degree – it does not discriminate, and the regular
patterns of checking blood pressure, heart rate/pulse,
oxygen saturation, respiratory rate, temperature
punctuate the twenty-four pre-arranged day,
dividing it up like the slashes on the side of a
measuring cup, more reliable than any clock –

II – CTU
they call it a schedule and maybe
outside the squishy, drug drenched
haze in which I spent those first days
post-surgery there was something
which might reasonably be called
a “schedule” but it was difficult to
discern lying in that bed, hour after
hour, fading in and out of consciousness,
the powerful drugs given direct access
through the IV to my blood,
to my brain,
to my
self –
distorting the world outside in unpredictable ways –

perhaps there was something one could
call a schedule, but it was alien to me

I was as likely to awaken at 2:30 AM
with no inclination to return to sleep as
I was to drift off into unconsciousness at
2:30 PM, without much in the way of warning

III – HOME
i wake just before 2 AM and work on this poem
still operating on hospital time though two weeks
out of the ICU cocoon – outside the window is
the deep darkness of a cloud covered night,
rain dripping and the wind blowing each drop
there is no reason for me to pay attention
to the time, but I do, the same way the hospital
had clocks on every wall even though it meant
nothing – like putting a railing on a particularly
steep mountain trail even though they know
the winter rains will wash it away every year –

 

UNDER

in the movie I’m watching, the handcuffed
steroid case in the elevator with three or four
cops proceeds to swiftly and surely demolish
them before one finally shoots him and even then
he appears to survive them long enough to feel
victory arisen from pure and undiluted rage –

I glance at the shadows on the insides of my wrists
where the scratches and bruises are fading away
and try to imagine myself doing what has been described –
they say I came into the recovery room hysterical,
violent, trying to pull tubes and wires out of myself
and to harm anyone who tried to stop me – I don’t
know how many of them it took to subdue me, the
nurse didn’t say for sure, three or four – they tied me
to the bed and injected more and more drugs until I
finally became docile and fell fully into the abyss of
unconsciousness, unawareness, loss of self –

from underneath that state I have no memory
just an odd mourning for something lost that
i’m probably better off without – loss and a
sense that the memories remain inside hidden
somewhere to later become accessible as dreams
and nightmares, the mysterious raw materials of
poetry or perhaps to merely linger just under
the surface and color everything i say and do
without attribution –

to have the drugs release all constraints on actions
and leave me free, as free as that guy in the elevator
in the movie, to do what feels right at that moment –
to live and act without restraint if only
for the briefest time before i die and then to
live just long enough to savor how that feels.

ENDLESS ROAD

What was once ignorance’s illusory bliss
has given way, through the surgeon’s
knife and needle, to a series of certainties
no longer avoidable – the knowledge and
understanding i thought i had before, now
revealed as the shallow deceptions necessary
to sustain the mundane activities on which
i’ve wasted my life for too long –
i want
adventure again –
i want endless roads and
seemingly unreachable peaks
at the end
of steep winding wilderness trails,
i want the feeling of moving toward the unknown
and beyond –
i want to feel alive and free and, yes, young –
to live out of my backpack again,
travel on my thumb,
sleep where ever i find myself –
never sure what the next day may bring –

but now there is health insurance to consider,
the next surgery,
the constant medications,
the groaning joints and gaseous gut
and this house full of shit i can’t cut loose –
there is the reality of 60 years of living,
some of them as hard as i could make them,
and whether life is sweeter now than it was
before is too difficult a question to answer –

the unknown has occupied the mundane
and things can never be the same –

(a tanka & haiku upon returning home from hospital)

five-twenty AM –
this profound silence tells me
i am home again –
no click, no whir, no alarm
disturbs the morning stillness

looking out at the
morning as day awakens –
these familiar trees

FRIENDS COME

Visits in hospital and phone calls.
They fetch my mail, notify others,
Listen to my drugged confusion.
Hang out, uncertain what to do.

Once released to home I am still
Banned from driving for 30 days,
The friends schlep me here and there,
That red, heart-shaped pillow
Clutched fearfully to my chest.
To the market, the drugstore,
To Thanksgiving dinner
In a fancy restaurant.
They bring meals. Do my laundry.
Lift the heavy stuff.
Mediate with visiting nurses.
Sit with me and watch movies.
Listen to more confused babble,
The absurd questions
The experience has spawned.
Respect solitude when
Everyday life is too much and
Profound issues must be
Wrestled with alone.

Through it all the friends come,
Until they don’t.

LATE AFTERNOON PHYSICAL THERAPY

Old men crowd the tiny locker room,
jostling for space, loose skin hangs in
wrinkles and folds. I retreat to the
only bathroom in the place to
change into my gym clothes.
I place discs on my torso which are wired
to a telemetry unit strapped to my waist,
one on each collarbone, on the right side
one just above the breastbone and on the
left side one at the bottom of the rib cage,
which I’m pleased to know I can still find
beneath the broad band of fat.

They call it a brisk walk on the treadmill,
by definition a walk to nowhere,
or somewhere unseeable, felt only.
My mirror image stares back at me, reflected
off the thick pane of glass separating
me from the steep-angled, ivied slope beyond –
the lines in my round face appear worried,
anxious, what is all this sweat getting me?
Are these old men carefully placed
all around to try and make me feel young?
It doesn’t help – I’m beginning to feel that I
belong here so I fight each machine in turn,
satisfied with nothing less than
exceeding the recommended limits,
trying to push the levels a little bit
further each time I mount one,
to prove that I am not just another
old man, used up and worthless,
that there is still life left in me
worth working toward.

OLD NEWS

the house is quiet again,
the phone hardly ever rings
I have become old news
everyone has seen the evidence
everyone has done their bit
everyone has grown tired of hearing:
yes, I feel better than yesterday
and i’ve grown tired of saying it

it’s all old news now, me and
the rain falling lazy outside
no more the violent storms of
the last few days, or not yet,
tonight another storm will come,
or maybe it won’t – old news –

and the violence of the surgery is
old news, even to me who dwells
on it in the silent mornings, the quiet
afternoons, the sleepless nights –
rolling the details round and around
in my head like marbles in a bone box,
imagining what it might have felt like,
wondering if those memories will
ever rise back to conscious awareness,
emerging out of the dirt of obscurity
like the shards of glass that turn up in
the yard, squeezed by time out of the
hard earth to slice an unwary bare foot-

SCARS

every morning in the mirror
that brick-red slash down
the middle of my chest and
the smaller, orbiting asterisks –

i’m told that in time this
welt will become a white
ghost of itself drawn
beneath the sparse hair –
memories fading with it,
bragging rights reserved,
while i try to preserve the
feelings, replace the fading
images with words, creating
an external memory to replace
what gets lost in the healing –

to not forget anything –

and in time, perhaps, a lover at my side
to kiss these long scars making
them easier to bear, validating and
healing them in ways that do not
get logged onto a clipboard, do not
emerge from a prescription pad –

11.20.2012.2.revB&W

A MAP OF THE SCARS

as the numbness slowly fades it leaves these
odd pains within the left side of my chest,
muscle adhesions tightening and letting loose,
evidence of scars beneath the surface to match
these visible reminders scattered across my torso,
reaching down my right leg to below the knee –

connect the scars, like dots, to see what they
hide, what image will emerge, what man has
been reborn from the surgeon’s scalpel
sutures and glue, veins re-used for arteries –

connect the dots to uncover
mortality
disguised as a rebuilt engine
good for at least another 20 years –
the good doctor said that
and i believe him
i suppose

a new constellation of skin instead of sky
a personal zodiac of obscure meaning
open to multiple interpretations –
mortality is part of the surgeon’s mercy
the guarantee inscribed in the flesh
20 more years, 20 more years

20 more years.
 
 

I AM JOE’S HEART

You think that’s easy? Being a poet’s heart?
Then you try it – let’s set aside genetics,
we’ll presume he had no control over that and
won’t hold it against him
but all that bleeding heart, flowery poet bullshit,
running around like he thinks he’s the only one
who can truly feel things –
I’m the one who pays for that,
why do you think they call it “bleeding heart”?

Now let’s consider hamburgers and bacon,
and cheese, let’s not forget cheese, he seldom has –
and do you think those extra pounds he’s put on are
a piece of cake?
Don’t get me started on cake –

And the way he goes for weeks or months
without anything that could be stretched to be considered exercise,
and then suddenly expects me to spend three hours
hiking up some mountain.
Okay, so maybe it wasn’t a mountain, it was a damned steep hill
I still can’t figure out why he bothers spending
all that money every month on a gym membership.
He hardly ever goes, there’s always some excuse.

But really, he never thinks about me –

And all that unrequited love,
years of it, decades of it,
you think that’s easy for a heart to deal with?
How many times do you think one heart
can be broken before it just gives up?
Well, I could almost tell you exactly how many times –
because I finally had it – enough, I said,
I’m throwing in the towel – I quit.
My decision had been made
and I was not about to turn back.
I was all set to be done with this
and then, before I could take action,
he went to that god damned cardiologist.
I wasn’t even giving him any trouble yet,
I hadn’t even begun to show him what
I’m capable of when I get mad enough.
And yet there he was getting an EKG
and a chemical stress test.

I’d thought I was done with all this
that I would finally get some rest,
the eternal kind.
But noooooo,
I wasn’t about to get what I wanted.
Like always this was all about Joe
and before I knew it the surgeon
had sawed through Joe’s sternum,
rolled his lungs up out of the way
and was staring at me,
lying there naked
under those ridiculous lights
with people in masks and latex gloves
standing all around, watching –

And then they stopped me.

That had never happened before and while
it was certainly what I’d been contemplating
I didn’t like the fact that it had suddenly
been taken out of my control –

By the time they woke Joe up it was all over –
I had been re plumbed
against my will –
I could feel blood rushing back through
my chambers,
moving like it hadn’t in decades,
I almost felt young again –
I guess I’m not going anywhere now,
not for a while anyway –
Joe is getting a second chance.

But I’ll tell you this much,
the son-of-a-bitch doesn’t deserve me –
and he doesn’t deserve another chance –
look at him, has he lost any weight?
He’s already pigging out on pizza
The next thing you know he’ll be
falling in love again,

and we’ll see where that leads.

DOWN THE LINE

the old fart
with the rebuilt heart
thinks he’s smart
sneaking potato chips, pizza,
fried chicken, and bacon –
but he’s only cheating himself,
whittling days off his life
with each bite he takes
his waist gets thicker,
the stick gets thinner,
more fragile,
it will snap
one day
and everyone
will finally see
how smart
he really was –

HEART ATTACK OVER MY SHOULDER

The dull ache just under my left shoulder blade
That doesn’t seem to want to go away –

The pain in the left elbow which echoes
Up and down my arm – only arthritis?

Those onion rings, that hamburger –
Does olive oil really make a difference?

The shortness of breath, is it only anxiety?
My father’s dead body lying on the kitchen floor –

My beating heart in the night taunts like a
Tell-tale countdown when it should comfort –

The scar stretching down the middle of my chest
Itches as though waiting to be re-opened –

Stalking me from a distance or
Leaning tight over my shoulder,

The heart attack whispers into my ear:
“Now? Shall we dance now?”

MORNING ABLUTIONS

I turn in the wings
on the bathroom mirror,
step up to the sink
and multiply myself
by three
to prove to myself
I am still here

three vertical scars
on three chests
echo back at me,
mortality carved
into my skin –
the always reminder
of an encounter with
death interrupted
by the surgeon’s knife
but waiting patiently
for the right moment
to return.

BACK TO THE GYM

Backsliding down the greasy road
Of gastronomic indulgence,
I allowed my tastebuds and
Anxieties to expand my waistline,
Leading to indolence and atrophy.
As though denying those
Eleven days in the hospital,
Those months of recovery,
The lifesaving medical miracle
Performed upon my person
By a surgeon who, like a blind
Date, had never met me before.

Now I’m back at the gym,
Got my weights workout set up,
Cruising through cardio,
Sticking to the doctor’s diet,
Shedding fat like beads of sweat –
Scared, I suppose, heard too many
Stories of second CABGs, strokes,
The implantation of stents,
Post-surgical heart attacks.
So here I am, five years post-op
Still alive, still wondering why.
Trying to see how long I can stretch it,
How long I can make this life last.

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Responses

  1. I your usual marvelous way, you have captured what has to be said and given it to us. These are so good. Glad you are ok.

    • thank you Martina for your kind and always supportive words – and i must apologize because i still haven’t gotten that Amazon review of “Learning By Rote” finished & posted yet – one day it’ll get there –

  2. To step out of long friendship and into commentary: some of this is stunningly good and timeless. I wonder how it could be run thru cords of copper tubing and emerge tighter and almost 200 proof, or pure morphine, or the blinding light of the living God, and us who see and hear able to only say stupid things in response out of habit of words? Some of this approaches the place Lewis speaks of, that where God is, past, present and future all are simultaneous. Stepping back into friendship: I’m so glad you’re still here and grateful for your friendship.

    • AMEN to that!

    • and right you are Danny, a number of these pieces are much too wordy – they do indeed need to be trimmed down or as you aptly put it, distilled to their essence, miles of coils of copper tubing – that’s part of what I meant when I introduced them as drafts and so am grateful for the feedback – I think that overall my legal writing for the last 25 years has been a good influence on my creative writing, causing me to be more aware and focused on clarity – unfortunately, and as you surely know, legal writing sometimes seems to value verbosity over precision, and there is an odd kind of poetry in that sort of legal writing – but i think poetry really should be about precision and some of these poems seem to be more about verbosity, they flirt dangerously close to prose – there’s an idea in there but i can’t seem to pin it down precisely – someone told me that anything, any feeling, can best be expressed as haiku, and i certainly write enough of those (most of them not worth reading) but i can’t agree that haiku is the ultimate form for everything – some poems need more space, more words and sometimes i have to give up and switch to prose – I too am grateful for our long friendship (43 years? 45?) and for the honesty and love you bring to it – (BTW couldn’t find that Wall Street Journal article online – it probably wants me to pay money and you know me, I would never do anything to support the Wall Street Journal – maybe you can cut-and-paste it and put it in an e-mail to me)

  3. Immediately after reading your poems, read “Queasy Rider” in the Saturday Wall Street Journal. There’s usually a hiking or road trip story every Saturday. This one reminded me of our journeys together although the facts are very different. Maybe you can see it somewhere.

  4. Frankenstein, Baby, Frankenstein! How did he feel after his jolt of life revival? None of us are who we started as, in the flesh. Shedding cells and days, hopefully, regrowing in valid ways. Not who we were, but ever who we have always been. That’s the dichotomy of our anatomy. I’m very glad you made it through all that, my friend.

  5. Storm fronts along the cardiac range–
    where the primordial, the premortal & immortal collide–
    One can see those storm fronts
    moving through all that stirred up earth– and there you are,
    alive, uprooted, shocked, synapses firing…
    scar chested, taking transcription, an emotional survey of the land
    and the sky
    before the winter rains return to wash it all away–

    thanks Joe– whatta ride through your vision–
    Ben

  6. A Poem For Joe;

    Like the butterfly, I find
    I can no longer stay behind
    Self made walls of protection
    I struggle to be free
    Breaking the bonds of what was me
    To soar in a new dimension ………………..


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