Morbidity and Mortality: A Surgeon Under Exam
Pauline W. Chen
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If you poke a hole from the belly into the diaphragm and with your fingers clear away the cobweb-like tissues that separate the heart from the spine, there will be just enough space back there to fit your entire arm. And if you put a small incision along the base of the neck, as you do when you remove an esophagus, you might even see, if your forearm is long enough, the tips of your fingers poking out while your elbow remains enveloped by the soft, rubbery stomach and a flap of liver.
It’s tempting to leave your arm in that warm, reassuring space. On the back of the forearm, you can feel the hardness of the vertebral bones, at the tips of the fingers the coolness of open air, and at the elbow, the slithering contractions of the small bowel. But what you will marvel at most, and why you may keep your arm there for just a few seconds longer than you probably should, is the sensation you notice against the patch of skin on the underside of your wrist, that most tender area where mothers gauge the temperature of milk for their babies.
Against that small swath of skin and squirming of its own accord, you will feel the strong, twisting contractions of the heart. And it will remind you as you look down at the open belly and warm skin and bloodstained instruments on the table that the person whose body embraces you is very much alive.
