First, study lungs. See lungs in trees, bronchial the limbs, packed cells cycling carbon dioxide. Recall the lesson of two students standing shoulder to shoulder, shuffling in tandem to demonstrate the lining of the lung
clung to the wall of the chest cavity.

Second, attend medical school in the cold Erie wind. Live on ramen noodles and nothing. Sleep on nothing. Break the hearts of kind men, who might have been good for you, because they were doing nothing
but getting in the way.

Third, have your face fitted for a respirator mask at your first paid job in a hospital. Laugh as the Employee Health nurse tells you to laugh, tells you to smile, tells you to talk, while you wear a mask with an umbilical cord, the man checking the percentage of air that leaks into your mouth while you tell a joke.

Fourth, develop an addiction for the adrenaline of chest compressions. Feel the high of sticking a wide needle into a man’s spongy lung to reinflate while he lies in a dirty hospital bed.

Fifth, become a respected attending in Intensive Care. Bark orders at residents. Rest easy in your big house, with your loans almost paid off, but one night, wrestle with a dread in the base of your sternum when the world turns for the worse.

Sixth, come into work to find a woman with gray, tattered hair dying on the floor because she has no bed. Because the hospital beds are piled high with coughing and fevers. Black tags stack up in the ED.

Seventh, put your respirator mask in a sandwich bag that you packed with Goldfish crackers for your kids, and carry that bag in your lab coat, so the respirator mask can be reused while you talk to patients and nurses. Remember how the Titanic ran out of lifeboats?

Eighth, plead with the mayor to send you more masks.

Ninth, reassemble Y-tubing on a ventilator to breathe for two patients instead of one, done in sheep but not in humans, until today. Double the tidal volume. Picture iron lungs. Picture rust. Let your imagination paint alveoli that look like bursting grapes in your dreams. Wake up in the middle of the night to another alarm. Plead with the bureaucrats to send you more ventilators.

Medical students in Venezuela inflate bags with their hands to keep patients alive during power outages. Do that. Feel your hand cramp after two minutes.

Tenth, observe the military come into your hospital and move patients to hotels. Watch people die in greater numbers than you imagined you ever would.

Eleventh, be in a high enough position of power that a nurse looks at you and asks you to decide which human to intubate

because you can only pick one:

this dying man, or that dying man

because you ran out of ventilators

and you only have a moment

to make a decision that will ripple across the globe like wake on water.

As you decide which human

to put on your last ventilator,

remember there was a boat named Entropy

the day you became Persephone.

poetry-magazineHow to decide which human gets your last ventilator

How to decide which human gets your last ventilator