Jugular venous pressure is estimated by positioning

A patient’s head at a 45-degree angle.

When the veins in the neck

Are swollen as high as the angle of the jaw,

Blood pressure rises.

 

Austin slaps against the veins in his neck.

Thick, spongy, they’re swollen

Almost as high as the angle of his jaw.

He swallows saliva and air.

 

How our final sip of atmosphere tastes so sweet.

 

January 10th, 1996, 

1:16 a.m.

An NYPD dispatcher receives notice

Of gunshots fired in the greater Manhattan area.

 

Austin blasts a single lead bullet

Through his jugular vein;

A fatal incision leaving 658 served patients and

A waiting room full of regret on the passenger’s seat.

 

His fate was not decided upon a misdiagnosis,

But that the cancer that inhabited his conscience

Had gone undetected for so long.

We’re so far from knowing what

Our loved ones are thinking until

Their minds are splattered on the pavement.

 

December 24th, 2011:

I’m staring at Austin’s obituary in

The last living room that I would ever see him.

Cara, his fifteen-year-old daughter,

Had invited me to family occasions before,

But on this Christmas Eve,

 

Where the only angels shining more brightly

Than the one atop the tree were

The ones that pierced the gaps in

Cara’s teeth,

The melody of “Joy to the World” is drowned out by

What she whispers into my ear:

 

“Some days, I wonder if I should follow in father’s footsteps.”

 

Cara never wanted to be a doctor.

She hated blood as strongly as she hated memories.

There is no medical school

That teaches students how to save their own lives.

 

I wish that I could unwrap

Her father’s leftover sterile syringes,

Draw 20 milliliters of hope from

Every drip drop of ambition that I have left,

Tilt her head to a 45-degree angle,

Inject it directly into her jugular vein,

And rely on the venous pressure to beat out

The carbon copy apologizes that

Diluted her conscience with every

“I’m sorry, he was a good man.”

 

January 10th, 2012:

Seventeen days after Christmas Eve;

My cell phone is systolic alarm clock

Sending service signals down my spine.

 

12:46 a.m., 12:48 a.m., 12:53 a.m.

Each minute bears an angel who couldn’t convert

Cara’s telephone calls to brainwaves.

This receiver is a concrete shield shattered

Into broken syllables and voice mailbox messages.

 

I sprinted through Manhattan back alleys,

Down three blocks covered in mid-winter mist

To Cara’s porch, shimmied the doorknob,

Felt that it was locked and kicked down the door.

 

Cara is lying patiently, peacefully,

Atop the living room couch.

Her hand is clenching the Ambien bottle that

The doctors had suggested for her bouts with restlessness.

 

None of those doctors were her father.

Austin’s obituary and an empty jug of Absinthe

Decorate the nightstand.

 

Silence is an inaudible frequency

Echoed when the sound of desperation is too loud.

 

January 10th, 2012

Cara Johnson is pronounced dead

At 4:27 a.m.

The doctor’s wished that

There was something that they could do.

 

I told them that she had an appointment

With an astounding doctor in Heaven;

An appointment made far too soon.