Cricotirotomía.

Cricotirotomía.

Tumbada sobre una mesa de madera, de esas para el despiece, una muchacha de unos trece años se debatía en espasmos agónicos. Era blanca de piel, blonda de pelo y de gráciles formas en esbozo. Toda ella se agitaba igual que el vendaval, como si la habitaran por dentro los demonios. A pesar de estar sujeta por varios familiares daba grandes manotazos y recios patadones al aire. Su rostro se contraía en una mueca infausta que traducía la imposibilidad de respirar, como si una garra invisible lo impidiese trincándole el gaznate. (…)Después, todo se sucedió en segundos: antes de salir el último curioso ya había palpado con mi dedo la semilla del fruto enclavada en su garganta. Lo estaba tanto, que el rápido intento de desencajarla fue baldío. La niña, cianótica, trémula, se debatía entre la vida y la muerte dando sus últimas boqueadas inútiles, decrecientes, de merluza de altura al sol sobre un banasto. Sin dudar, centré la barbilla de manera que enfrentara el yugulo esternal, extendí fuertemente el cuello y hundí el escalpelo en su piel por debajo de la nuez, profundizando hasta la tráquea. Despreciando la sangre que brotaba de la herida, metí en ella dos dedos y los separé. Se escuchó una gran sibilancia: el sonido de un fuelle de fragua al ser pisado para avivar el fuego, la furia del aire al resoplido del delfín. Sentí lo mismo que una brisa benéfica corriendo entre mis dedos, vida en forma de aliento inhalado con avidez por la chiquilla que revivió en tan sólo un instante. La muchacha, con ansiosos movimientos de su pecho, aspiraba por la tráquea hendida cada vez con más ímpetu, intentó resarcirse del tiempo que durara su ahogo y compensar así la falta del espíritu vital que coloniza el aire. El color no a sus mejillas como el azul al cielo tras la lluvia y at mucho los ojos. Sus padres no daban crédito a lo que iban viendo: se miraban llorosos, se mordían los puños santiguaban. Para ellos, cristianos renegados, se trataba de i resurrección o de un milagro. Ya resuelto el problema, fue fácil: empujé con un dedo desde dentro, desencajé el hueso que había provocado el incidente y lo saqué por la boca entreabierta. Lo mostré prendido entre dos dedos, en silencio como un trofeo de guerra. Ahora la pequeña respiraba por boca y por nariz sin el menor problema. (…) La herida no sangraba lo esperable. En sus labios sanguinolentos, de manera simétrica, babeaban dos conductos vasculares de pequeña entidad. No lo hacían a impulsos, como la sangre que brota de una arteria, sino de forma perezosa igual que el manantial a punto de agostarse. Eran sin discusión pequeñas vénulas de sangre negruzca, densa e impura.

—Enciende el mechero y pon a calentar la punta de un punzón —le pedí.

Actué con rapidez desde que vi que el acero estaba al rojo blanco. Enjugué la herida con un paño, identifiqué los puntos sangrantes y, tomando el punzón por el mango, los cautericé. Luego monté en una aguja de acero curvilíneo un hilo de seda y di un punto a la tráquea. El conducto que lleva el aire a los pulmones se mostraba blanquecino al fondo de la lesión, recordaba a la espina opalescente y cartilaginosa de los calamares. La niña respiraba normalmente y estaba casi en calma, con su madre sujetándole los brazos. (…) con la piel, suturándola con puntos separados tras dejar una mecha de gasa empapada en vinagre diluido. La niña me miraba con sus ojos de color azulino indeciso, llenos de pasmo, soportando el dolor, agarrada con su mano izquierda a mi cintura. Al terminar coloqué un pequeño apósito de gasa en la herida y empaqueté mis cosas. María, tranquila, respiraba con pausado ritmo, asida a su madre mano con mano. (…)—María puede levantarse y caminar si lo desea. Que no juegue en la calle pues podrían lastimarla. Que coma normalmente. Mañana volveré para hacerle una cura.

La niña se atragantó, por eso estaba inquieta, agitada y cianótica (color azulado de labios, dedos ) no podía respirar por que tenía una obstrucción de la vía aérea así que le realizó una cricotirotomía.

La cricotirotomía es un tratamiento de una emergencia médica que consiste en la realización de una incisión a través de la piel y la membrana cricotiroidea para asegurar la vía aérea de un paciente durante ciertas situaciones de emergencia, como una obstrucción de la vía aérea por un objeto extraño o una inflamación, un paciente que no sea capaz de respirar adecuadamente por su cuenta, o en casos de traumatismo facial grave que impidan la inserción de un tubo endotraqueal a través de la boca.

Tras realizar la incisión sacó el hueso de fruta que provocó el atragantamiento, la niña ya podía respirar. Finalmente la suturó (le cogió puntos) y le tapó la herida.

Actualmente también se realiza esta técnica: se realiza una incisión y se coloca un sistema estéril que viene previamente preparado para colocarlo.

HISTORICAL CORRUPTION

Boyle's Law of Thermodynamics: Keep on adding molecules into a single vessel and the lid will blow off the pressure cooker. "Taking off the lid" is the literal meaning of the Apocalypse.

GROWTH CONTROL IN HISTORICAL CORRUPTION & THE INFERIOR SURFACE OF HISTORY

History does not look to the past and has no concern for dates, except in fairytales or ads. In fact, history is the largest vital organ of the body, an hourglass ductless gland situated below the diaphragm in the upper abdominal quarter between the liver, the gallbladder and the spleen, just within the left nipple line. History is covered by a tough fibrous sheath, Herodotus' capsule, which carries the blood vessels and strands of connective tissues that provide the scaffolding for the many intrahistoric bile passages anastomosing and finally converging in the Pyrrhic excretory channel of history, thus permitting free escape of the human bile--which contains salts, Machiavelli pigments that impart the characteristic color of the feces, and other unnamed poisons. Briefly stated, the bile, which cannot be processed by the liver, is absorbed by the pustular historical mucosa through the sphincter of Waterloo. Within the sinusoids of history and attached to their broken walls are found the cells of Auschwitz and Dachau, which are highly phagocytic and whose function remains obscure, although it is established that they are normally concerned with blood destruction. While the human subjects binge, fornicate, compete and quote movies, their histories beat inside them sending out newly detoxified blood to their limbs and brains. That is until the day when a lethal cumulative virus unexpectedly attacks their immunity networks and they become historically infected.

When history malfunctions, it stops filtering out the acidic Attila poison that otherwise would putrify the bloodstream, and an inky Napoleonic fog spreads out inside the afflicted body. Simple activities such as sharing a glass of water with a toothed foreigner or eating bloodstained eggs or being kissed by a feebleminded fly that has feasted on a turkish bathroom suffice to cause these infections. Early diagnosis consists of purple fecal accumulation, waxy enlargement of the tender historic organ toward the free border of the ribs, and an increasing tympanitic Marxist sound caused by the subjacent intestines. No one is immune, and there is no known antidote, and no relief for the ill. Because the social effects of the disease remain profitable, scientists worldwide have evaded its research.

The historically stricken individual, now a mutant, has two choices. As with all human choice, these are identical in as much as they both end in death; i.e., the diseased has the choice of the condemned, history being the damnation.

At this stage, the history patient can either become a murderer or an exile. An effete distaste for blood often makes the first choice impractical. As an exile, the history patient must withstand the spastic sympathy of ignorant natives, stiff laws that treat exiles as museum displays or alternatively as slaves, and a life of padded inactivity spent prone in bed, subject to the incessant pains of the pounding history within, which are manifested in a swelling of the flesh, due to acute historrhage. Screaming, hyperventilating, passing gas, fainting, and breathing through nano-oxygen masks are the typical methods available to the patient to alleviate despair. As the normal area of historic dullness is diminished, the patient experiences Tet sweats and Mao chills, anorexia, fullness and vomiting of frothy mucus, flatulence, constipation, glossolalia and Cleopatra convulsions. Beaujolais-red pus, smelling of burnt cinnamon, can be extracted from the wildly fluctuating history by aspirating needle. As obstruction increases, imperialist portal blood opens new insurgent channels and floods the abdominal region, and the superficial historical veins en-large, notably around the umbilicus, forming the so-called "1917 caput-medusae," until the belly explodes. Having no distraction from the slow ballooning torment, feeling his/her history extending out of the frail bodily cavity, the patient is helpless in fighting the symptoms and can only hope that his/her veins can withstand the hourly piercings that doctors recommend as a means of knowing when the patient will enter the expected coma, so that they may switch on the life-preserving machinery, at which point the victim is legally owned by the state and illegally dead.

Murder is the simpler option. This patient abandons all daily responsibilities as pedestrian distractions from the only remaining commitment: historical cleansing. She/he lunges into dramatic outer explosion in order to delay the inner explosion of the entrapped historic bile, by stalking historical enemies and bathing in their blood. Enemy blood is an intoxicant which helps to soothe the patient's massively aching historical conscience, as the most immediate symptom of the disease, evinced long before physical examination can detect the growth of history, is the inflation of the patient's communal memory and guilt to the point of bursting, and only by bursting into vengeful insurrection can the patient subdue for a while the asphyxiating typhoon raging within his/her constricted diaphragm which prevents the diseased from breathing. As science has always known, bloodletting releases nervous tension. The slaughtering routine also mentally prepares the patient for his/her own fatal prognosis. Best of all, this patient stands a fair chance to die in glorifiable action.

CONCLUSION: This infection will spread through the world faster than any plague in human existence.

It was about 8881669 in the unpredictable Ehmh Time Zone. Elmighty, the Ehmh-Vein Line with local intravenal service to Coccyx, Kidney, Duodenum, Angina Pectoris, Esophagus and Larynx, squeaked in a running pace in front of him; Jonah jumped onto the first corpuscle, sat in the ergonomic crevice of a red blood cell and swallowed the sweetness of her running biledrops. The Vein rattled with a gaseous whisper. The passengers, sub-dued by their earlier orgies, hummed, "Emmanuelle shall come to thee, O..."

He got off at the Larynx, and immediately stumbled into John the Baptist's floodlit Aryepiglottic workshops. Today's session was titled: "Marvel at the Planning of Her En-trails--Find the Best Place to Sleep; Equip your Home; Bileproof Everything; Maintain the Plumbing, Heating, Cooling systems; Fix Everything that could Possibly Break (incl. the Heart)." The crowd loved it.

The Baptist looked like his clay-colored skin was made of cartilage. He had the toughest gums in EHMH. He was rumored to subsist on gingiva and buccal mucosa alone. He'd just finished his long speech and now was trying to disengage himself from the make-shift thyroid podium that his bony ass was stuck to; he had to pull hard to save himself from becoming part of EHMH, before her glands secreted enough adhesive digestive enzymes to trans-form him into an integral part of her tissue. In EHMH, no one went to waste. To detract attention from his embarrassing near-death struggle to pluck himself from God, John pompously kept the vocal crowd entertained by breaking into a heartfelt falsetto rendition of "...cease, and be thyself our Queen of Peace."

The Larynx was known as EHMH's Philosophers' Walk. The river of Trachea divided it between the False Cord Quarters (ventricular ligament) on the left bank and the True Cord (vocal lig.) on the sophisticated right. Lush heavy shades of scarlet and pre-carious rebounding high-wire steps that created melodious echoes graced its sides. Here the light was a prickling glare.

On the True Cord bank, Jonah watched the sinuous laryngeal floor undulate in tympanitic waves that he found surprisingly arousing. This continuous state of arousal in EHMH was driving Jonah mad because, unlike most Emmanuellians, he was still a virgin; after the evacuation, he thought, after he'd stormed the fortress of EHMH, he might also finally get himself deflowered.

The Baptist finally stepped down from the salivating podium, and Job the Sly jumped on to it, invoking, "Behold the message I bring for your salvation: Do not shun EHMH's oblique garbage dump, the pseudo-organ commonly known as History, even if it is a prison festered with viruses and poisonous gas, for that is where we all must gather and sing and rock until we awaken Her! Do not bileproof, but distend and reclaim! Together we can inspire our Mother to rise and change the world!" "It's called the Second Coming!" someone yelled derisively. "Isn't History where that manic-depressive John the Apostle hides, under the trash?" Jonah challenged Job from the crowd, eager to ride the populist unease.

"EHMH is not an island," Job sputtered back. "She is the strongest and safest police-free homeland in the history of the world. She is the product of history and free of history. The task is best left to official biographers, apostles, vessels, for I have no lan-guage to describe the simple union of opposites that is EHMH: She is rational. Chaotic. Loving. Sadistic. Immune. Vulnerable. Mistress of Fate. Slave of Destiny. Fair yet Prejudiced. Methodical yet Spontaneous. Forgetful yet Omniscient. I've no material reason to lie to you. I've had my full share of beatings in the hard hand of God. Subpoena Heraklitus to testify on my behalf. She is Truth. Lie. Graceful, graceless. I hope you see where I'm going with this. Woman, yet Man."

The True Cord crowd was notoriously tough to impress and Job was booed down before his spidery ass had time to root in EHMH's dura matter. Carotid rocks and fish-bones flew at Job as he slid away from the pendulous podium, still vowing to fulfill his duty.

Jonah grabbed this brief auricular opportunity to run up to the empty swinging podium. He had an idea; it had worked before. "Cast lots!" he shouted with infectious exuberance, reveling in the auspicious deja-vu. "That you may know upon whose account this wet disaster has befallen you!" He grinned ferociously. The crowd waited transfixed, not quite understanding. Jonah's heart pounded impatiently as he tried to explain: "I am an infectious disease in EHMH!" He felt so sure God was on his side of the dice, he went straight to the point, his voice hard: "I AM has sent me to you," he boomed, stealing Moses' best lines, and then pronounced each word intimately: "Just pick me up and cast me into the sea, so that the sea may be calm for you; for I know that this great unjust storm is upon you because of me." It was his only chance. The crowd stared dumbfounded as if he were speaking a dead tongue. "Give it a try," he yelled, resorting to colloquialisms, "what have you got to lose but your wet chains?"

Meanwhile, banging across her windy larynx in shattering explosions, EHMH's ear-piercing timeless laugh boomed southward. She was feeling exuberant again, briefly free.

THE REFRAIN:

Once upon 1450B.C., the splendid Atlantis sank to the bottom of the sea; in 900B.C. the ardently walled Troy fell; in 450BC the marble-bellied Athens fell to the derivative Romans; and on a black Tuesday in 1453 Constantinople, the tear-shaped navel of the world, fell to the sav-age Turk. Every fall, and there were thousands, added an inch or two to her fecund watery flesh until EHMH couldn't bear the gravid scream twisting the world into cataclysmic waves of shame that smelled like burnt cinnamon. She had tired of being a museum and longed to displace the powerful. So she came, riding the white cusp of the millennium, like a curse, and like a virgin bride.

BREAST LESIONS -- EFFECTS OF HISTORIC VIRAL INFECTION ON: A. THE HUMAN BREAST

1. Lactiferous Lobulation: Historical altercation is spread through the interstitial Bay of Pigs lactiferous duct to nipple adecoma, enlarging the Iwo Jima papillomas to Pearl Harboural dimensions. Resulting traumatic fat necrosis does not rule out an isolated malignancy but does facilitate early diagno-sis. This surface altercation is the most common of the three.

2. Schlerosing Adenosis: This is the least known altercation, characterized by intralobular fibrosis and proliferation of the Agincourt ductules. The histic growth may compress the golden yellow Austerlitz lumina, so that they resemble cords of Culloden tissue, a histologic pattern, which mimics Lockerbie carcinoma.

3. Epithelial Hyperplasia: This altercation is characterized by Chickamauga hyperplasia affecting ducts and ductules. It may exist along with other fibrocystic changes but when it occurs is most often the dominant variant. The Guadalcanal ductlining epithelium is doublelayered; now there is Beirut-style growth beyond this. The proliferating stricken epithelium may project or fenestrate into the Gallipoli lumen extensively. This is the only fibrocystic change, which clearly indicates nightly increased offensive Kaiserschlacht carcinoma. Uniform hyperplasia with clear lumina is indicative of intraductal Balaclava carcinoma.

c., atrophic. SYM: Early enlargement of the inflamed organ.

c., biliary. ETIOL: Chronic malignant retention of bile.

c., fatty. C. with fatty infiltration of clotted history cells.

c., hypertrophic. SYM: Hypochondriac fullness. PROG: Incurable.