[Verse 1] Scalpel skating pericardial edge, near the branch PA's thin shelf, phrenic nerve rides lateral, easy to nick by yourself. Stretch it, cauterize it, bruise it blue and through, one dome goes slack, hemidiaphragm paresis — weakness creeping where the breath was due. Infant on the ventilator, can't wean, can't climb, diaphragm floats useless, wasting precious time. Plication is the answer — tuck the floppy sheet, stitch the slack dome flat so the lung gets room to beat. [Verse 2] Follow the vagus, left side, down past the aortic bend, looping the ligamentum arteriosum, that's the recurrent trend. Near the left PA it travels thin as fishing line, tug it in dissection, voice box pays the fine. Hoarse rasp, a crow's whisper, stridor on inspire, silent aspiration — milk slips past, lands where it shouldn't transpire. Scope the cords before extubating, know before you cut, protect the hidden loop or the voice stays shut. [Chorus] Nerves, brain, lymph and kidneys — the wreckage hiding in the chest, phrenic drops the diaphragm, laryngeal nerve fails the test, bubble or clot finds the brain through a hole that shouldn't be there, chyle weeps milky sorrow, kidneys stumble gasping for air. Five roads where the surgery bites — phrenic, laryngeal, cerebral, chyle, renal, learn the map before you cut, make the knowledge eternal. [Verse 3] Beating heart, right side open, the PFO's a secret door, air sneaks through like a stowaway, particulate on tour. Cross the shunt, hit the carotid, infarct blooms dark and slow, low flow on the bypass pump starves the cortex of its glow. De-air the field like scripture, bleed every needle hole, watch the pupils, watch the wake-up, minutes cost the whole. [Verse 4] Thoracic duct's a lacteal river, milky white and shy, running near the left subclavian, easy to pass by. Nick it in dissection, or raise the venous pressure wild, pleural space floods triglyceride, breathless little child. Medium-chain fats skip the broken duct's complaint, octreotide throttles the flow, drainage clears the paint. Weeks of patience, tube and diet, let the vessel knit, milk stops running when the pressure and the tear both quit. [Verse 5] Pump runs inflammation like a squall through every vein, low output starves the nephrons, kidneys feel the strain. Aminoglycosides, NSAIDs, contrast dye — a toxic choir, hemolysis frees loose heme, tubules start to smolder, inch by inch, dire. Creatinine creeps upward, urine slows to a trickle, tiny kidneys, narrow margins, fluid math gets fickle. Peritoneal dialysis — a catheter in the belly's dome, gentle slow exchange until the kidneys find their home. [Bridge] Five systems, one scalpel, every millimeter matters, nerve beside the vessel, lymph beside the ladder, brain downstream of bubbles, kidney downstream of the pump, check your map, check your doses, before you make the jump.
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