A Home Within the Chest

A 63 year old male presents to a rural Honduran clinic with symptomatic end-stage aortic stenosis. If he is a candidate, a valve replacement may be the only thing to save his life. We wish & want this for him, but in truth know little of his life. I have thought much about him since I returned home & below imagine the world in which he may live.

Mechanical thunder rumbles up the hillside.

Trucks carry foreign doctors to our village.

Dust billows & lifts upwards, mingling with dirt & pollen

I upturn in tending to my crops.

An ache has grown within my gums,

a seed dropped by birds in a field it shouldn’t be.

It must be a bad tooth. I hear the foreign doctors

can wrest it like a weed from my mouth.

So I begin the journey towards our clinic-church,

pace myself to avoid exertion, but grow quickly air-starved,

So I must stop to rediscover the wind within my lungs.

This is time- Crops, birds, farmers, & foreign doctors all age-

& this has been my year of aging.

Air washes in & out my chest like well-worn burlap

leaking grain- so it goes with old things like me.

The foreign doctors beg to differ.

I try to show the rotten tooth, but they point at my heaving chest,

skin sagging from thinning bones,

& wonder at ways to turn back time. With a stethoscope

they listen to the drum of my heart,

then listen again,

bright eyes narrowed in concentration (the dust of age

has not yet dulled their glimmer). They speak in hushed tones,

nodding, considering, & finally tell me that my heart

is a home. It has four rooms. Blood moves in-turn

through these rooms & the doorways of my heart,

until it exits to spread like water

across the fields & hills of my body.

But my home has grown old.

Rust has come to the hinges

& blood struggles to open its doorways.

It can barely tend the gardens just outside.

What I need, they tell me, is a new doorway.

Fresh hinges no longer stiffened by age.

They call this an aortic valve & without it,

fear the land of my body may fall into its final rest.

The new doorway will take this year’s harvest

& many more to buy. They ask if I have family.

“A son,” I tell them, but wonder if he should pay

when his house holds a wife & daughter,

with homes inside their chests filled

with vibrant blood, newly oiled hinges,

& dreams of a world where their daughter doesn’t work

our family fields, but cultivates the furrows of her mind.

The foreign doctors may know much of medicine,

but understand little of farming, the churn of seasons,

& the dreams which whisper

through the rooms of my granddaughter’s heart.

Ethan Sellers, PGY-III

KP Napa-Solano Family & Community Medicine