CVA

Cerebrovascular accident:
brain bleed in the gears
of our human machinery.
We detect the obvious signs
and symptoms of injury
with the acronym BEFAST:
Balance, Eyes, Face, Arms,
Speech, Time. Asymmetrical
hemiplegia, say “squeeze.”
Only one side works, the other
paralyzed or markedly weak.
Word salad, alphabet soup,
blurred vision, slurred speech.
Ataxia, like trying to say “chisel”
in a single syllable . . . impossible.
We obtain a blood sugar, an ECG,
blood pressure (too high), start an IV
in a proximal vein for potential
stat CT contrast dye. We hope
the scanned head results are decent,
like a slow oil leak, partial occlusion,
or TIA, where the stroke abates
and the patient returns to normal,
full mobility. Hemorrhaging
is the worst thing, but like fractures
or heart attacks, some human vehicles
recover with their own determination
and mechanized modern medicine,
that coils the maybe no longer shiny
but strong, stubborn, and stalwart
reverberating human beast.

Make the Call

Does he have a POLST form?
You know, end of life requests?
Did he want lifesaving measures performed?
CPR, intubation, cardiotonic meds?
Are you power of attorney? DNR?
We have to make a decision quickly.
The man is in bed, peacefully spent.

Not breathing. Cyanotic. It’s morning.
Last seen last night, feeling unwell.
Recently diagnosed with cancer.
Ninety years old, stroke paralyzed
on his left side. Been wishing to die.
I read the wear on the family’s faces.
The daughter, now more a nurse aide
who has taken care of him for years.
Tender grief pervades the stale room:
piled old bedding, commode half full.
TV dinner and apple sauce congeal.
They just don’t know. He has no pulse.

Asystole. Probably passed in his sleep.
We are supposed to initiate CPR fast.
But in this rapid-fire scene, I can see
the family wants me to make the call.
Reaching over, I turn the heart monitor off.

I’m sorry for your loss…

Long Hauler

There’s a catch in my throat.
+++++++Fuzzier than trite tickle.
+++++++++I can’t breathe all the way through.
+++++++++++Stuck like a food bolus.
+++++++++++Right below my larynx.
+++++++++Where a thoracostomy would go.
+++++++Slit hollowed skin—ram tube in.
Intake fresh gulps of oxygen.
COVID left a tiny, love-bite scar.
+++++++My lung has a Harry Potter mark.
+++++++++Lightning jagged as my hack.
+++++++++++Cumulonimbus rumble.
+++++++++++Staccato, unproductive dryness.
+++++++++Short gasps out my nose.
+++++++Timorous timbre lacking magic.
Pretty minimal for a malady (I think).
I cough. I cough.
+++++++Stridorously wheeze.
+++++++++Attune with my new, ever-present friend.
+++++++++++The other person inside me.

Joe Amaral’s first poetry collection The Street Medic won the 2018 Palooka Press Chapbook Contest. His writing has appeared in 3Elements Review, Anti-Heroin Chic, Catchwater Magazine, Last Leaves Magazine, Rise Up Review, River Heron Review, The Night Heron Barks and University Professors Press. Joe works 48-hour shifts as a paramedic on the California central coast. You can find him on Instagram @joeticmedic.