Obligatory Consent

He is young, so very young
vibrant with life and
brimming with the kind of
confidence that sailed him through
medical school and his high-flown
ambition to achieve the status and 
respect that emanates from the
elderly whom time and wear have
brought to his ministration as a
cutting-edge heart surgeon for
whom arterial resection and
heart-valve replacement has
become routine. His quavering
patient, on the other hand is
wan and resigned, dreading
open-heart surgery while yet
acknowledging multiple test results
whose high-tech insight that skilled
medical technicians parse and
interpret with unquestioned accuracy.
Pre-surgery the surgeon patiently
scrolls step-by-step through the
clockwork mechanics of fuel,
pump and the metronomic regularity
required to ensure the human brain
and body function optimally. And
how, when the delicate process
is impaired, expert intervention is
required to elongate life expectancy.
And where the patient's signature is
to be appended on the consent form.