A lot of people make a big deal about open-heart surgery, especially those undergoing it, but in fact it’s quite easy to do, the Czar figures. Think about it. The heart’s always in the same place, it makes itself pretty easy to find, and everybody’s heart is pretty much like any other. How hard is this? Our own Dr. J. performs a bunch of these every day, and he doesn’t seem particularly put out by it.

Let’s take an example. Say you know somebody who’s got a bad ticker, maybe because their heart is three sizes too small, or they’re super-old, or maybe they just hang out with ‘Puter and the Czar and can’t keep up with the alcohol and hot wings. Probably, at this point, you’re thinking “heart transplant,” and without even bother to research this for a second, the Czar say’s you’re right. Let’s do a transplant.

First thing, you need a patient to operate on, because they’re no point doing open-heart surgery unless you have one of these. So go get one. We’ll wait.

Got one? Great. You know, the Czar probably should have said you should make sure he’s got a bad heart, but frankly (for purposes of instruction) this doesn’t really matter.

Second thing: you need a donor. Doing a transplant with only one person is a waste of time, as well. You could do it, one imagines, by taking it out and just putting it back, but… no, wait! That’s an excellent idea! Instead of a messy heart transplant, and you going to have to thump some second doofus in the back of the head only to find out his heart is even worse than the first guy’s, the Czar has just figured out how to do a heart transplant with one person. Read on. This is even easier than you think. Probably, even easier than the Czar thinks.

Okay, so your patient needs to be sedated. You could try the expensively traditional route, with anesthetics, but that stuff is hard to get. Plus, the Czar thinks you need to know how to use them, as too much or not enough is going to cause trouble. Therefore, stick to the less-expensive, less-complicated methods: tequila works well, or you could just swing an elbow into the side of the guy’s head, about an inch or so above his ear. If you’re on the smaller side, like Mrs. GorT, you might want to swing a couple of times to make sure he’s out and not faking. Frankly, we’re not sure why you’d want to fake being unconscious during open-heart surgery, but people are sure funny, you know?

Now, let’s say you got that down and your patient is out cold. Get a decently sharp knife and open up that chest. Move any ribs that are in the way. Ribs, by the way, are easy to find: they’re the ones going left-to-right. If you see them stacked up, top to bottom, that’s the spine and the Czar is very sorry, but you’ve open him up on the wrong side. Flip him over.

All right. By this point, you’ve got his chest open and there should be a lot of blood. This can make the heart hard to find, even if you knew where it was to begin with (hint: it’s in the center of the chest). Fortunately, the heart makes its location known by pulsing (what doctors call “beating”), often quite dramatically. You need to find it quick, because it won’t be beating long. Because of the blood, you might have trouble seeing it, so just reach into that pool of blood and feel around. It’ll be obvious once you do, so don’t make a big deal about this.

Remove all the connections to heart with your knife. Be advised, there are quite a few. Maybe only two, but some of these could be nerves and stuff so try to pay attention to what you’re cutting. When that’s over and done with, you simply lift the heart up and out of the pool of blood. Be ready, because there may be even more blood coming out of it. Pretty much that’s all the heart does, is dump blood on everything. Science does not know why.

Once the heart is up and out of the chest cavity (does that sound technical, or what?), wring it out. Try to get all the blood out. There may be some buttery stuff inside. If there is, you definitely want that out, so get out as much of that heart butter as you can. Also, you definitely don’t want to eat that. It may look like ear wax, but it’s really quite nasty stuff that was almost certainly responsible for his heart being bad.

If you don’t find much butter, well, he probably wasn’t that sick, so that’s on you. Either way, don’t fret too much because it’s probably good to just clean it out anyway. Maybe a couple times a year.

When the heart has been cleaned, you may notice it’s stopped beating. That’s not reason for worry, because remember you just unplugged it a couple of steps above. Put the heart back into the chest, as best as you can remember it looking, and reattach all those connections. Remember to get this right: there are definitely inputs and outputs, and maybe some nerves. You want this to be as close as possible to they way it was, because pretty much all those connections do important things.

Almost certainly, you should see the heart begin beating on its own again, due to the big nerve being connected. This is truly a miracle of nature. But you’re not done, yet! Because, as it stands, you have a patient with a huge hole in his chest. You’ll want to do something about that if you expect him to get up again and start walking around.

Fortunately, this is pretty straightforward. Put back and ribs you took out (they’re all pretty much the same, so don’t spend a lot of time monkeying with this), and pull the edges of the big cut you made together. Doctors will spend a lot of time and money with stitches, but they’re all on the take to begin with. Time is of the essence here, so just a couple of really wide strips of masking tape or, if you have it handy, duct tape. Just tape the wound closed until the bleeding has mostly stopped. In a few days, or maybe a week at most, that wound should heal up and the guy can just peel the tape off himself. It’s probably better if he does it, himself, especially if his chest is really hairy.

Not surprisingly, that’s all there is to it! You’re now a qualified and experienced cardiovascular surgeon, which is pretty sweet. The Czar may have left a step out (pretty sure we got it all, though), so Dr. J. can easily fill in any details or minutiae in a subsequent post. If you don’t see a subsequent post, well, that’s because we got it pretty much right the first time. And that’s awesome.

The Czar of Muscovy

Божію Поспѣшествующею Милостію Мы, Дима Грозный Императоръ и Самодержецъ Всероссiйскiй, цѣсарь Московскiй. The Czar was born in the steppes of Russia in 1267, and was cheated out of total control of all Russia upon the death of Boris Mikhailovich, who replaced Alexander Yaroslav Nevsky in 1263. However, in 1283, our Czar was passed over due to a clerical error and the rule of all Russia went to his second cousin Daniil (Даниил Александрович), whom Czar still resents. As a half-hearted apology, the Czar was awarded control over Muscovy, inconveniently located 5,000 miles away just outside Chicago. He now spends his time seething about this and writing about other stuff that bothers him.