[Verse 1] Smoke curls up from a cigarette ember, Whiskey breath that the tonsils remember, Squamous cells keep copying wrong, copying wrong, That's the old duet of tobacco and gin singing along. But here's a younger face in the waiting room, No pack-a-day, no decades of barroom, HPV sixteen hiding in the tonsil crease, Test for p-sixteen — this one fights easier, bends to peace. [Chorus] One to six, the levels stack up like a staircase, Submental, jugular chain, the shoulder's own space, Radical takes the muscle, the vein, and the nerve too, Modified spares your shrug, selective picks a node or two, Squamous writes the chapter, but HPV flips the page, Head and neck's a territory — the surgeon reads the stage. [Verse 2] Level one sits under the chin, below the jaw's own ridge, Two, three, four ride the jugular vein like a long low bridge, Five's the back triangle, six camps in the middle, low and tight, Six little countries on one map, each with a border to fight. Radical dissection clears the shoulder's muscle and the vein, Modified leaves the spinal nerve so the arm can lift again, Selective is a scalpel's whisper, precise and small, Chasing only the nodes the tumor's drainage would call. [Chorus] One to six, the levels stack up like a staircase, Submental, jugular chain, the shoulder's own space, Radical takes the muscle, the vein, and the nerve too, Modified spares your shrug, selective picks a node or two, Squamous writes the chapter, but HPV flips the page, Head and neck's a territory — the surgeon reads the stage. [Verse 3] Here's the sneaky part that catches surgeons off their guard, The whole mucosal lining's bruised, battle-scarred, One tumor cut out clean? Don't pack away the scope, Second primaries wait along that smoldering rope, Field cancerization — every cell's been soaked in smoke, Years of toxin bathing tissue till the whole terrain's half broke, So we scan the esophagus, the trachea, the lip, Damage doesn't stay put — it spreads like oil from a ship. [Bridge] Nineteen ninety-one, the VA trial made its claim, Chemo paired with radiation could spare the voice from flame, Larynx preservation — let the vocal cords stay whole, Swallow, speak, and hum again, keep the engine's soul. When the tumor's lifted and the tissue's torn away, Surgeons borrow muscle, skin, to build a new relay, Flap reconstruction hands the throat a second start, Stitching speech and swallow back — it's plumbing, but it's art. [Chorus] One to six, the levels stack up like a staircase, Submental, jugular chain, the shoulder's own space, Radical takes the muscle, the vein, and the nerve too, Modified spares your shrug, selective picks a node or two, Squamous writes the chapter, but HPV flips the page, Head and neck's a territory — the surgeon reads the stage. [Outro] Six levels, one field, a voice box worth the fight, Know the nodes, know the virus, get the biology right.
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