Tuesday, November 23, 2010

Fate, Costochondritis, and the Desire to Write Honestly

This is going to be a blog of all over the place while in the same place, a seemingly disparate group of threads that end up swirling together in a random mix. It is today and yesterday and and a few days before that. And all of those moments combined with the beginning, which was a handful of days that happened last year.

Yesterday was spent in the sensation of drowning--me, the editor hard at work on multiple projects--flailing in repeated waves of chest tightness and bound up in the feeling of someone stepping on my ribs, all the while moving through the day trying to focus, act as if nothing was wrong and reminding myself to remember that I was alright, that it was nothing more than costochondritis ("an inflammation of a rib or the cartilage connecting a rib") and working despite and around the fact that for at least 90 percent of the time I was thinking about my heart (the situation that led to the costochondritis was inevitably unearthed by it) and falling lost in the feeling of suffocation as I resited the urge to panic.

I am writing about this because when I started this blog, I promised myself I would be honest, that I would use it as a place to openly talk about the phenomenology of my experience, and that I would say whatever I was compelled to about the experience of almost dying. Not because I think I am so important that the world needs to listen to ME, but because I was so lonely and afraid as I lay in my hospital bed in the cardiac ward after surgery. I still remember thinking a lot about how I was just one sad and scared body in one room in a hallway of seemingly endless rooms with a lot of other undoubtedly sad and scared bodies. I remember thinking that at some point, when I was OK again, that I wanted to put those feelings, that empathy, to use. (Referring to myself and the others in the ward as "bodies" is apropos, because the days after surgery, like yesterday, were defined by moments of drowning, of feeling lost in my own flesh.) I decided to write whatever came to mind because I think someone out there who has hung out in cardioworld too may find something of value here. And I also write because I think honesty is imperative in relation to the near-death experience. It is easy to move to the "let's just think happy thoughts" place, but that isn't real. And catastrophe is a part of this strange thing called living and there is not reason to write as if it isn't.

And now, back to yesterday:

Later, in the middle of the night last night, when the sudden thunder woke me up, I realized that the not-able-to-breathe day had been caused by the coming storm. The shifts in the barometric pressure and the fluctuating temperature had triggered an intense flare up of my now ever present, sometimes sleeping, but too often raging costochondritis friend who has burrowed in and set up shop around my ribs. This is one of the things that can happen after a sternectomy. It is part of the new me who still catches me off guard.

Oh, costochondritis, you fancily named, five-syllabled reminder. Thank you for inhabiting my body and giving me the opportunity to think about my almost-death as I tried instead to edit well ...

Of course, that ode is tongue and cheek as I would much rather have never encountered this new inhabitant at all. Just as I would have preferred to never run into those ripping arteries that have led me to this. To this blog. To this moment. To this night when I feel better and the stifled breathing is for a moment just a memory I choose to write about.

This weekend I encountered the unexpected vehement frustration of someone who could not believe it when I said I would take my heart attacks and surgery back. In her mind where I am now is a result of fate and something that happened to show me my purpose in life. By saying I would take it back, I suppose in her mind I was somehow scoffing at this opportunity and denying the gravity of the situation and the gift it has provided.

According to this view, I am alive because of fate. I had my heart attacks because of fate. I had a bypass all because of fate. The universe somehow got itself together to mix things up in such a way that in July of 2009 I received this fabulous event that would reveal (in part) to me my purpose. So I suppose I could have sat at home and not had surgery if it were my fate to survive anyway? Forget the scientists and the doctors, nevermind the ER staff and the nurses, skip past the anesthesiologist and the perfusionist: let's be sure to not thank them!

Yesterday, for whatever reason, conditions converged in such a way that my flare up of costochondritis was the worst it has been since I first had symptoms of it earlier this year. Usually it's achy and I feel like my breath is a little shallow. Yesterday, however,  the tight, throbbing sensation in my rib cage made me feel like I did just a few months after surgery when I was still healing. Not only was it intrusive physically, but mentally as well. The pain was a reminder, carrying me right back to those days when I was still wondering if I would live.

So ... would I take my heart disaster back?

Well, what do you think? And my life, by the way, I wanted to say the other night (and actually did say to some extent) was just fine before it happened. I actually had plans and felt like I had purpose. I lived my days encountering those others and those moments that continually give life meaning and point you in the next direction. I don't know if I would have said I knew what my Purpose was with a capital P, but I don't believe there IS any such thing as a ONE grand Reason for a person's life anyway, at least not in the sense that it is written in a book by another's hand and at a distance. Instead I continue to dwell in the world of the moment to moment, day by day, one encounter then another. Because isn't there sufficient meaning and purpose there, without taking it to the next level and insisting on having my life inscribed as part of some Grand Narrative?

So no, my heart attack and surgery are not things that I will ever call good. I will never be thankful for them. I would rather they hadn't happened. They were random events that happened to me. Just like random events that happen to biological bodies all the time. No stars converged to send me a message. No fingers reached from the universe to say hey, let's give these coronary arteries a little tug. It just happened. And here I am. Thinking about my life in ways that I hadn't thought about it before from a perspective I didn't expect. But it isn't "better" or "desired" but just something that is.

And of course, it hasn't killed me, and in some ways I may have even become stronger because of all of it, but it could also be true that I have gotten through the situation by relying on strength and the love of others that I already had. "What doesn't kill you makes you stronger" isn't so cut and dry. We live and we are wounded. We live and encounter setbacks, disasters, losses, and all kinds of chaos. What doesn't kill us may not always make us stronger. Sometimes events that happen simply change us, scar us, build up our immune systems a bit, and leave us changed and permanently altered as we look around us and gather our new selves up again, while possibly always on some level missing the ones we were before.

One night, as I lie there in the hospital last summer, a code red alert sounded. I listened as nurses and doctors ran down the hall. Someone was dying. I was alive. If my "fate" was to live because I had a purpose, does that mean the dying one didn't have a purpose or get the same chance to find out what her or his purpose was, after surviving such a horrible thing? To answer yes, would mean I find myself just a bit more special, would mean I deny the random, and would mean I deny that I simply got lucky.

So, fate?


And the ache of costochondritis days making me stronger?

Not really. It's more a matter of getting used to it, taking more ibuprofen, and simply finding ways to deal, but I certainly wouldn't mind if it decided to go away.

Saturday, November 20, 2010

The Importance of Flow for the Health of Women's Hearts

Research presented earlier this week at the American Heart Association's 2010 Scientific Sessions indicated that women who report having high job strain have a 40 percent increased risk of heart disease (This includes heart attacks, arterial blockages, and the need for procedures to open blocked arteries.), compared to those with low job strain. On initially reading the headlines, part of me thought, well, of course, this is a no brainer, isn't it? After all, that thing called "work" is where we spend at least 40 hours of every week. So a stressful job is naturally going to take its toll on the heart. What really grabbed my attention though, in addition to the HIGH percentage of those with increased risk of heart disease, is the way job strain was defined:

"Job strain, a form of psychological stress, is defined as having a demanding job, but little to no decision-making authority or opportunities to use one’s creative or individual skills."

The italics are mine, and the italicized text is worth repeating. Little to no decision-making authority or opportunities to use one's creative or individual skills.

So it's not having a job that is demanding, but it's alienation from oneself and ones job that puts the strain on the heart. Reading this, I started thinking of so many different things--about women, being a woman, seeing smart women around me who aren't valued for what they have to offer, and even the ways women often don't value themselves and perhaps even settle into situations and jobs that really don't do it for them without recognizing that settling is what they're doing. Just the day before, in a conversation with a friend (yes, a woman), our discussion turned to the way one can sometimes find oneself inhabiting the space of comfortably numb (some Pink Floyd settling) compared with the psychological concept of "flow" as defined by psychologist Mihaly Csikszentmihalyi.

Flow, a positive psychology concept, is basically a mental state of being in which a person in an activity is fully immersed in a feeling of complete, energized focus, full involvement, and success in the process of the activity. Importantly, flow is a delicate balance, an in-between space where the challenge is neither too much or too little. Too much challenge can disrupt flow (when one is involved in an activity that is completely overwhelming, such as being tasked with writing an article about the evolution of bird wings without a background in ornithology). Similarly, a lack of challenge also makes achieving this state of flow unlikely (say being tasked with proofreading articles about the evolution of bird wings when one has written five books on ornithology). In both instances, getting lost in the moment, becoming one with the activity, falling into it to the point that the boundary between you and the task begins to collapse, isn't likely. Not that being challenged too much or too little are bad things in and of themselves, but when these non-flow states are the norm and not the exception, it's another story altogether.

This idea isn't new to me, generally. I can think of times in my life when spending most of my days unchallenged began to spill over and leak into all other areas of my life, but the idea that this could be bad for my heart, adds another dimension to the topic.

Getting back to the conversation with my friend and my thoughts about smart women in unchallenging, not-nearly-enough jobs, with all economic considerations aside (yes, these days, it's simply good to have a job and a regular paycheck), I worry about that invisible line that one crosses when not-enough is pushed aside and replaced by that sense of numbness, of being comfortably numb, of no longer even knowing what one wants. It is the spillover effect of not having flow. Say I am bored, but comfortable for 40 hours of week; the job is familiar, I know what to do, everything about the work environment is "safe," if I stay in this situation long enough do I eventually risk losing a sense of who I am? Even in my off hours? I think of times in my life when I am challenged and invigorated and my days are filled with hour after hour of "the flow zone" and what I notice is that my life itself becomes more expansive, more energized, more alive. In every way. I work hard, but I am not drained. I work hard, but I am motivated. To do more, to reach more, to open more, to keep going. It is the opposite of dwindling. If I haven't quite made my point, think of those long weekends or even weeks where you decide not to do too much except watch a marathon of some fabulous TV series. You spend three or four days watching three seasons worth of Dexter, for instance. Hell, it's a good time. You really do enjoy it, but how do you feel at the end of it? Bleary, a bit sluggish, perhaps even brain dead? Compare with a day spent with friends in good conversation. The words bounce and gleam and sentences burst to overflowing. The world shimmers in that way it does when you see parts of it in a new light. You eventually part ways with your friends only because you have too--because the bar or coffee shop is closing or you realize day has turned into night, but you go home and you still have more to say. You fall asleep still thinking of the conversation. You wake the next morning and you are compelled to write about it, even.  A follow up email, a blog, a journal entry ...

That's the difference between non-flow and flow.

So flow is good for a woman's heart. I think about the women I know. The women I have known who sell themselves short. Ultimately, it could be bad for their heart, especially if they accept job conditions that aren't enough.

One of the unexpected directions the reported outcomes of this heart study led me is back to my early graduate school self. There I was, in my second year of my PhD program. One day I asked a friend if I took up too much space in our seminar. Not physically, but I was worried about being a giant class conversation hog. Did I talk so much that others didn't get the chance to speak? Was I rude? Did I blurt out my ideas and run roughshod over others? No, my friend said. In fact, he pointed out to me that I was quite the opposite, that every time I had something to say, I would apologize before saying it.

Imagine. I was worried about taking up too much space when in reality I was in the habit of dismissing my ideas before uttering them. "This is probably a dumb idea, but ..." You know the game.

This was an eye-opener. At first I didn't believe him. So I started listening to myself. And sure enough, there I was; apologizing for my ideas. Then I started listening to all the other students. What I noticed was that almost without fail the other women in the room were doing the same thing. SMART, INSIGHTFUL women, all working on their PhDs in philosophy were apologizing for their thoughts. The men in the room weren't apologizing at all.

I eventually cured myself of this self-deprecating behavior by allowing myself to say "This is a dumb idea, but ..." but ONLY in my head. So this habit started making itself noticeable to me. Every time I caught myself about to say it, I would say it silently, then share my thought. This had the two-fold effect of making me see how often I was demeaning myself and the effect of making me speak out more confidently (no one could see what was going on inside). Eventually, I realized that I wasn't saying anything dumb at all and that my ideas were just as important and valid and even as interesting as my cohorts'. But I never stopped noticing other women caught in this cycle of self-flagellation.

I thought of this when I read about this 40 percent increase in heart disease risk caused by job strain, because I worry that women may sell themselves short, saying yes to staying in jobs that don't allow them to flourish.

Again, I am not for a minute trying to dismiss the nuts and bolts of having a job or the difficulty of finding new jobs, if the one you are in isn't enough for you. What I am trying to get at is the importance of not losing sight of yourself, of remembering who you are and everything you have to offer, and strategizing to find ways of offering it, if indeed you are in a job situation that is sucking you dry because you aren't given the space to grow. How to get enough water for your roots is the question.

Because, it turns out that water for your roots is good for your heart. Imagine your heart in flow. Burgeoning, blossoming, reaching out, unfolding, giving to the world. To yourself. To you, the insightful woman you are, to others.  If you can't find it in your 40-hour-a-week life, but you have to stay in that job for now, then look for that flow elsewhere. Start today. Without hesitation. Feed your heart in your non-work hours and watch as you fall into the abundance of flow. Once again, it's a mind body thing. The corporeal/non-corporeal loop, one becoming the other, yet another time again.

Saturday, November 6, 2010

Some Random Thoughts about Bodies and Words

Trying to get myself out into the "philosophical world" again, I have been formulating ideas for conference paper proposals (on the subjects of embodiment, illness, writing ...) over the past couple of weeks. Putting the heart into language is difficult, even if, ironically, the call to put my heart into language has been incessant for me since the weeks soon after my surgery. Or maybe it's not that it is difficult, exactly, but when I really start to ask the question: How DO I write about this? immediately revealed is that strange slippery space where language and body meet.

Depending on what your definition of language is, words may simply, transparently, point to the object being written; words may actually shape the written object; or words may both shape the object written and be shaped by the object written, and thereby disrupt the subject-object dichotomy altogether. As far as what I think language is and does, I fall into the third camp: Words shape flesh as they write flesh and are at the same time shaped by that very flesh. Our language is an echo of our socially located biological from.

If I unravel this thought and follow it all the way to where it leads, for me, this means my way of writing about my heart attacks and heart surgery, will be shaped by the events themselves. "But, of course," you might say, "this isn't any real epiphany." Yes, of course. But, what I mean here is more than a superficial sense of having a new topic to write about, but that there is an actual way of writing that will be an outcome of what happened. A language that feels like the pulse of the events themselves. This is where the difficulty comes in: as soon as I start to think about it, I wonder what such a language will look like. And again I think about that slippery space between language and the body. Because, even given everything I have just written, there is always for me that sense that a bit of what I am trying to write slips past the words I write. Is the reverse true, I wonder: when writing about my heart, do the words I write also slip past my heart just a bit to evoke something beyond it, even at the same time it doesn't completely capture the heart?

These are some of the random thoughts I am playing around with this early Saturday afternoon. I have more questions than I do answers, but I am a lover of "the question" so that is ok with me, and I think its more honest anyway. I admit I am uncomfortable with anyone who approaches me (and yes, this has happened) to tell me with certainty that they know what my heart attack and survival "means." As if there is meaning to be found in any intrinsic sense in the events themselves. Really, what happened is just something that happened to me as a biological being. And I am with Christopher Hitchens: instead of asking "Why me?" it's more like "Why NOT me?" Bad things happen all the time; it's easy (and seductive) to think you won't be included in that. But not honest. This doesn't mean I haven't "Made Meaning" of the events or learned a lot about myself in the process, but simply that the heart attacks themselves had no Meaning with a capital m. I like it better this way: as it give me more room to negotiate this "after."

I just went off on a tangent that I didn't expect. This is one of the things I love about writing. Just start: pen to page or fingers to keyboard and if you let the words takeover you will just end up .... where? You don't know; and that's the gorgeousness of it!

As far as what I have come up with for those conference paper proposals, I had the thought this week (and included it in a proposal)  that, for me, writing about the experience of almost dying is a meditation that begins on the surface of my flesh. One place it begins is on the six-inch scar that runs between my breasts that is at once an end and a beginning, a line of demarcation designating a before and after. I start with the scar because it is the jarring echo of unscarred flesh; to notice it means I remember a time when it wasn't there. This meditation also begins on the surface of my heart, which, as I have written about in a previous blog, I have seen resting bare, vulnerable, and exposed to the world in a photograph my surgeon took during my operation. The picture of my heart is a memory though (as all photographs are). It is a heart that is no longer, a moment before any slice has been made. But it is also a memory that doesn't feel like mine; in the picture, my heart is a stranger to me, not least because my surrounding body is invisible. The bare, silent heart, the beating of which has been temporarily stopped, is anonymous, disembodied, stripped of gender, skin color, and identity. And yet, this organ without a body is the one that must live for me to be.

Writing about my heart—as a woman, a philosopher, a painter—is something I have been compelled to do. Obviously, it's been another way to process what happened to me. Psychoanalytically I could say that I have been conducting my own little fort-da. Gathering my heart and shaping it again, gathering another time and reshaping it again. I suppose I have been fort-da dancing since I first woke up unable to walk but a few steps across the hospital room. Painting, naturally, has been another way of processing, often (through the weeks of the Watersketch Prospectus) providing a window that reveals a glimpse of what I am feeling that words alone don't.

When last summer happened, I had the experience of being betrayed—by my body, my heart—I found myself caught in an ambiguous, yet all-too-familiar dichotomy (and a very Cartesian one to boot): on the one hand, I felt myself to be drowning in the pain of “mere” and overwhelming, crumpling-into-itself flesh, while on the other, I felt myself to be profoundly disconnected from that very flesh. My damaged heart called to me as a stranger, and I wanted to turn away. Turning from the stranger was impossible, however, because it was a voice that was my own. In the haze of an unexpected after, my stranger demanded gestures—in words and paint—that listened to it and took it seriously, even if I wanted to look the other way.

I consider the line of my scar and the image of my heart as surfaces that unfold to become metaphors of the Möbius strip as offered by Elizabeth Grosz (who borrows the metaphor from Jacques Lacan.) Expressions of my stranger—in words and paint—become gestural loops, continuous motions informed by damaged/healing flesh that reach out into the world to return back to my body to reach out to the world again. My near death experience and my newly strange/estranged heart prompted me and continue to prompt me to revisit Hélène Cixous' call for women to write their bodies. Wounded, my body demanded a tactile language, and in those first months after surgery it became apparent to me once again that expressive articulations always begin in the flesh. My scar and the image of my heart had simply thrown into high relief the often terrifying strangeness of the biological interior that already was.

And just as my scar intrudes on my skin to remind me of the teeming heart-world beneath, I consider my 'scar of intrusion' as a metaphor for the place where biology and language meet, one oozing out onto the other, continually feeding the fleshly loop of embodied language.
All of this takes me back to the question: what does a this language I am after "sound" and "read" like? To throw another kink in the mix, is it a language of only words, or do I need a language that includes words and image in conversation with each other: not set up so one eludcidates the other, but to continually feed a continuous dance of evocation?

Sunday, October 10, 2010

Seeing my heart. Holding it in my hand.

A few days after surgery last year, when my surgeon stopped by my hospital room in the morning on his rounds, I had the privilege of seeing an image of my own heart. It was the first time I was coherent enough to hold a conversation with him since coming out of surgery, and as we talked about the procedure, I asked him if there was any video of it (not by nature a squeamish person, if there was a video, I desperately wanted to see it). "No," he said, "no video, but I did take some pictures." He then promptly pulled his iphone out of his pocket and showed me the image of a heart--quiet, still, its being open to the world.

There I was, looking at MY own heart--though, naturally, I didn't recognize myself at all. The picture is cropped in tight. You see the heart, part of the metal frame holding my chest open, the pink mesh net in which my heart was cradled as it was lifted out of my body and then placed back in my chest once the cavity was filled with ice. The heart I see is no longer beating. And when you look closely, you can see the two candelas piercing my heart that were used to direct blood from my body to the heart-lung machine and back. A few days after surgery, still confused about what had even happened, there I was, following the line of my surgeon's finger as he pointed out the damaged parts of my now-fixed heart. I asked him if he would email the image to me, and he agreed, though why I should want it, he said, he wasn't quite sure.

I couldn't say exactly, but, on the other hand, how could I NOT want this new picture of me? Or this picture of the new me?

As morbid as it may seem, I now have a picture of my heart taped  to one of the walls of my studio. I have studied it, painted in response to it, written about it, and studied it some more. I have come to know it as my own, and yet, if I saw it in a room full of others, I would never recognize it as mine: there is nothing about my bare heart that screams "Lori Anne."

I have thought a lot about what it means--this seeing into the (my) body like that, what it means to have gotten a glimpse of myself--exposed, vulnerable, stripped open to the world in moments I will never recall since I was already knocked out. Forever vanished from that scene. It is a view of the abject, in a way, isn't it? (this thought came to mind today and I am still trying it out, so if you have any response or thoughts about this, please don't hesitate to share. I want to write about all of this, NEED to write about it, I've realized. This blog is a great way for me to commit, to throw nascent ideas out into the virtual world, and see what sticks. Or what I come back to later on.) 

French philosopher Julia Kristeva has this to say about the abject in her book Powers of Horror:

"A wound with blood and pus, or the sickly, acrid smell of sweat, of decay, does not signify death. In the presence of signified death—a flat encephalograph, for instance—I would understand, react, or accept. No, as in true theater, without makeup or masks, refuse and corpses show me what I permanently thrust aside in order to live. These body fluids, this defilement, this shit are what life withstands, hardly and with difficulty, on the part of death. There, I am at the border of my condition as a living being."

Experiencing the abject, the reaction to ones own materiality, is a confrontation. I confront my death, I encounter it. I am not simply shown evidence of it, but experience right up in my face the dying that is my own.

I am wondering this afternoon, if seeing my own heart--a connotation of death in this instance--since this type of seeing only happens when something is gravely wrong, could be likened to seeing the corpse of another, which pulls you back into the experience of death. We live our lives fleeing from this. Fleeing so we can live, for how could we live if we constantly mired ourselves in our own decay?

And yet, seeing my own heart has also reminded me of my connectedness to other beings, has reminded me of my own creatureliness in a way that is not abhorrent to me. The other night, I watched a documentary about evolution and crocodiles. Crocodiles have amazing hearts equipped with valves capable of redirecting the flow of blood to those parts of the body needing it the most depending on what the crocodile is doing. When a crocodile stays under water, for example, the heart redirects the flow of blood so more blood cycles to the crocodile's brain. I confess: as I watched the documentary and saw the crocodilian autopsy that afforded me a glimpse of the heart of another, I did think about my own and saw myself reflected (connected) there.

The abject or an opening? Or, more likely, quite a bit of both?

Although, how precisely does an image function? Here, questions about the nature of photography and image come to mind. What is a photograph? To what extent does it enable the viewer to experience the original depicted scene? What does it mean to have in one's possession a photograph of one's own heart? For seeing a photograph of my own heart, regardless of how long I stare and how much I imagine myself back into the scene, is much different than opening my eyes on the operating table and looking into the mirror that happens to be mounted on the ceiling and seeing myself cut open with my heart bare. Certainly THAT experience would be one of abjection, but I wonder if the photograph is closer to the encephalograph mentioned by Kristeva--a sign that offers distance and rational understanding?

The abject or an opening or the momentarily abject as eventual opening?

I am trying to understand without short-circuiting either possibility.

Just some thoughts and questions more than a year later as I continue holding my heart in my hand and putting it up to the light, turning it this way and that ...

Monday, October 4, 2010

Friday, October 1, 2010

Knitted Heart by Artist Ben Cuevas

Thanks to my friend, Micaela, for sharing this link with me. Ben Cuevas's work is interesting--not just his knitted heart, but his overall explorations of embodiment and medicine, of which this knitted heart is just a part. Follow the link and look around!



Sunday, September 26, 2010

Going Red and Taking Care of Your Heart

It's been some time since I have updated the blog, but much has been going on--especially in areas related to the heart. Mine and the hearts of 14 other incredible women, who I am lucky enough to now call friends. And sisters of the heart.

Who are we--this group of 15 women who will now, I know without a doubt, be friends for life? We are the 2010-2011 national spokeswomen for the Go Red for Women movement, a grassroots movement launched by the American Heart Association in 2004 to get the word out to women about heart disease. Heart disease is the number one killer of women, though so many women aren't aware of this at all. We tend to worry about things like breast cancer, without giving a second thought to that 11 oz. powerhouse that keeps us going every day. The workhorse of the body doesn't always get the attention it needs. And here's the rub: give the heart attention and you'll find that is exactly what it needs. According to the AHA, though heart disease is the number one killer of women, 80 percent of it is preventable. So women taking care of their hearts is precisely the thing to do.

It might sound daunting, but it isn't. For inspiration and tips go to http://www.goredforwomen.org/. And if you would like to meet us (the fabulous 15 who demand nothing less than heart healthy habits), go to http://www.goredforwomen.org/meetrealwomen/2010/.

Last week we were announced in the NASDAQ building in NYC. And in the midst of the lights and never ending glitz that is Times Square, I paused for a moment and thought of our hearts. Beating their songs in our chests, keeping us afloat, as we mingled: biology dressed up in heels and red dresses filled to the brim with the stories we have decided we and our bodies (and our hearts) need to share.

Thursday, August 12, 2010

Tactile Meditations on the Interiority of the Heart

Eleven ounces, approximately the size of one's fist, the heart belongs to the world beneath the skin. The invisible territory, the absence, the hidden interior that is the scaffold allowing us to be.  We see ourselves, each other, from the outside. Eyes, hands, lips, hair. We speak, come together, and part ways only  to speak, come together, and part ways once again, our exteriority taking precedence, our outsides dwelling together, touching in a space between us that is only possible because of the interior, even if we don't notice it (for why would we?) as we move through our days.

Elizabeth Grosz likens our corporeality to a mobius strip. If we stop to trace our bodies we discover we are interior to exterior to interior to exterior. One continuous infinite loop. For where is that boundary, the delineation between inside and out? My heart beats beneath my rib cage; it is hidden. And yet I feel my pulse on the outside when I press my fingers to my wrist.

The interior. If we forget it or don't acknowledge it often, for it certainly deserves our continual respect and recognition, perhaps it is  because seeing most often means something has gone wrong. A fall breaks a bone and the bone rips through the skin. A knife slips, a finger is cut, blood flows, a tendon is glimpsed. Seeing the inside or representing the internal, whether it be organs, muscle, bone, blood, may be considered morbid, grotesque. Respectable representations are repetitions of our exteriors. But our skins are what they are precisely because of the insides. The interior shapes us, makes us tall, stout, broad shouldered, slim. Our skins service our interiors, keep them packaged up, neat, safe. Is it too much to think of the exterior (if only in a moment of poetic reverie) as a continuous embrace that cares for that wonderful flowing world made of intricate pathways and inlets, that place where wild highways of capillaries, arteries, and veins twist and swing about, where in the depths of the interior neurons and electric life continually move, in that hidden world where aveoli trees open to receive the exterior even as we sleep?

The exterior becomes interior becomes exterior once again. Represent the inside or the outside, but remember they are a continual dance. And notice when the interior is approached with the intensity of an artist enthralled, the interior--even the torn open corpse--rumbles in gorgeous muscularity and form. Artists who have done this, who have succeeded in ripping open, divulging, without landing in the merely or reductively grotesque are Hyman Bloom, Chaim Soutine, and the younger, still alive Jenny Saville. There are others, of course, and their representations are worth more than a quick glimpse, for in such hands paint reveals what Adorno refers to as the "shudder" in reference to Soutine. The shudder, the tremor, that is an energetic interior bursting forth in richness. The rich complexity that we human animals along with other inhabitants are.

And now, in this moment, when I think of the human heart, of my own, of that surprisingly small muscle upon which I rely, I stop in the history of it--not merely the 39 years of its individual life, but of the hearts of other animals and ken that led to this four-chambered one of now. And going further, I remember the stars. I envision eleven ounces of stardust. I think of the stardusted interior that feeds the  ones I see as I move through my days, their skins not merely skins, but infinitely rich coverings that envelope the seemingly hidden shudders within.

Saturday, August 7, 2010

Four Miles In and One Year Later

Four miles and several hours into the Smokies, at the end of an often steep, exhausting hike we sit at the foot of a waterfall with all the others who, like us, made it this far, kept going despite--and probably in spite of--the heat, the humidity, the unexpected incline, the precarious twists and turns, and the sheer calf-burning labor of stepping over and around the hard, shiny tree roots twisting themselves jagged and claw-like along the path. I once again silently give thanks to the smiling strangers we passed along the way--those on their way down saying it's worth it, keep going, you're almost there, just a little bit longer. My muscles ache, my clothes are soaked with sweat, but I made it. I am here. I lie back on the sun-heated stones and see the trees--their furry pine green and olive bodies arched over and pushed up against the bowl that is the sky.

Yes, I am here.

A year ago at this same time I couldn't yet make it up a flight of stairs. My days were marked by painkillers, naps, fear, nightmares, worry, hyper-vigilance, shock, and the stunned faces of friends coming to visit me for the first time after my heart and its unanticipated detour took us all by surprise.

A year ago, I would have been hard pressed to believe I would once again hike up mountains, that I would go off in the woods and off the grid where my cell phone was nothing more than a useless gadget and doctors were out of reach. But here I am. And I am exactly where I want to be. And though my body is a mystery and though I cannot see the inner workings of my heart or monitor it in the way I can look at the details of my face in the mirror every morning, it is resilient. As I close my eyes and breathe, I am reminded of this again, just as I was reminded that first day I walked into cardiac rehab and stepped on the treadmill and didn't collapse, but met my body at a new intersection and realized it was possible for me to rely on her again. And as I breathe I see myself, my body, in the world--the raw, material flesh of it that is in and of and also itself the world.

"Visible and mobile, my body is a thing among things; it is caught in the fabric of the world, and its cohesion is that of a thing. But because it moves itself and sees, it holds things in a circle around itself. Things are an annex or prolongation of itself; they are incrusted into its flesh, they are part of its full definition; the world is made of the same stuff as the body." *

Visible, I am seen: a body among other mammals seeing, being, feeling, as we rest together at the top of a mountain taking in our rewards. Visible, but paradoxically always invisible to myself too (my insides, my heart, my lungs, the intricate world beneath the skin) I move through and with this invisibility, becoming a circle with myself and the things and others I experience around me--the trees pushing back against the sky, John next to me on rocks, the cadence of the waterfall's notes, a lone cloud drifting past a single, bare-armed tree. And I take these things in, hold them tight, allow them to become part of me in this moment a year later. And, of course, part of me again as I write of that day when back home and on the grid I remember the steps and bodies that brought me to now.

"There is a human body when, between the seeing and the seen, between touching and the touched, between one eye and the other, between hand and hand, a blending of some sort takes place ..." *

Yes, there is a human body when:

(Quotations from Maurice Merleau-Ponty's The Primacy of Perception)

Monday, August 2, 2010

Study explores PTSD among women heart attack survivors

Women heart attack survivors may be as psychologically traumatized as victims of violence
health By Heart Sisters , on 25 July 2010, 08:22
Canadian study describes surviving a heart attack "as if you're in a bank during a holdup." Many heart attack survivors experience frequent nightmares, flashbacks, and a constant reliving of the fear, helplessness and horror of having a heart attack. Continue reading »

Thursday, July 22, 2010

Awesome Artrial Images

Some fabulous heart and anatomical pictures to scroll through here, courtesy of the Utah Medical library.

Tuesday, July 20, 2010

Atrial News Roundup:

Heart surgery patient and his surgeon complete a triathlon:

Heart transplant recipient climbs mountains, though weather gets in the way this time:

The same heart transplant recipient and the heart-centered non-profit she founded: http://movinghearts.org/index.php

A new heart pump prolongs the lives of heart failure patients (Apparently former Vice President Dick Cheney no longer has a pulse):

The rare occasion when pizza delivery is good for your heart:

Currently, damaged heart tissue cannot be repaired, but GGF2, which is one of a family of proteins knowns as neuregulins, may change that. Acordia Therapeutics and Vanderbilt University Heart and Vascular Institute received NIH grant to study GGF2. The award was announced today. This could eventually be great news for heart patients--heart attack survivors, for instance, sometimes have trouble down the road as damaged heart muscle becomes stiff and unyielding and is unable to contract. Depending on the amount of heart that is damaged, this could eventually lead to heart failure. So the research could prevent problems and could eventually mean excellent news for those already suffering from heart failure as well.

More medicare patients are using their cardiomyopathy meds!


Sunday, July 18, 2010

Sylvia Plath on a Sunday

Excitable tulips and a heart blooming salty red: Sylvia Plath, whose atrial articulation occurs in the last stanza. Enjoy ...

"Tulips" by Sylvia Plath

The tulips are too excitable, it is winter here.
Look how white everything is, how quiet, how snowed-in
I am learning peacefulness, lying by myself quietly
As the light lies on these white walls, this bed, these hands.
I am nobody; I have nothing to do with explosions.
I have given my name and my day-clothes up to the nurses
And my history to the anaesthetist and my body to surgeons.

They have propped my head between the pillow and the sheet-cuff
Like an eye between two white lids that will not shut.
Stupid pupil, it has to take everything in.
The nurses pass and pass, they are no trouble,
They pass the way gulls pass inland in their white caps,
Doing things with their hands, one just the same as another,
So it is impossible to tell how many there are.

My body is a pebble to them, they tend it as water
Tends to the pebbles it must run over, smoothing them gently.
They bring me numbness in their bright needles, they bring me sleep.
Now I have lost myself I am sick of baggage ----
My patent leather overnight case like a black pillbox,
My husband and child smiling out of the family photo;
Their smiles catch onto my skin, little smiling hooks.

I have let things slip, a thirty-year-old cargo boat
Stubbornly hanging on to my name and address.
They have swabbed me clear of my loving associations.
Scared and bare on the green plastic-pillowed trolley
I watched my teaset, my bureaus of linen, my books
Sink out of sight, and the water went over my head.
I am a nun now, I have never been so pure.

I didn't want any flowers, I only wanted
To lie with my hands turned up and be utterly empty.
How free it is, you have no idea how free ----
The peacefulness is so big it dazes you,
And it asks nothing, a name tag, a few trinkets.
It is what the dead close on, finally; I imagine them
Shutting their mouths on it, like a Communion tablet.

The tulips are too red in the first place, they hurt me.
Even through the gift paper I could hear them breathe
Lightly, through their white swaddlings, like an awful baby.
Their redness talks to my wound, it corresponds.
They are subtle: they seem to float, though they weigh me down,
Upsetting me with their sudden tongues and their colour,
A dozen red lead sinkers round my neck.

Nobody watched me before, now I am watched.
The tulips turn to me, and the window behind me
Where once a day the light slowly widens and slowly thins,
And I see myself, flat, ridiculous, a cut-paper shadow
Between the eye of the sun and the eyes of the tulips,
And I hve no face, I have wanted to efface myself.
The vivid tulips eat my oxygen.

Before they came the air was calm enough,
Coming and going, breath by breath, without any fuss.
Then the tulips filled it up like a loud noise.
Now the air snags and eddies round them the way a river
Snags and eddies round a sunken rust-red engine.
They concentrate my attention, that was happy
Playing and resting without committing itself.

The walls, also, seem to be warming themselves.
The tulips should be behind bars like dangerous animals;
They are opening like the mouth of some great African cat,
And I am aware of my heart: it opens and closes
Its bowl of red blooms out of sheer love of me.
The water I taste is warm and salt, like the sea,
And comes from a country far away as health.

Saturday, July 17, 2010

Writing the Stranger that is My Heart

Writing the trauma, the wound, that is my heart is to wander in a text of irreconcilable meaning. Of course, I am already inside this text and more precisely then, though there isn’t anything precise about this act, writing becomes an attempt to evoke this irreconcilability, to make some sense, however tenuous, of myself here and now as the woman who almost died, but didn’t. The one who was stunned by her body expressing itself in a way she couldn’t have anticipated. And the one who stitches together the before and after of a strange, estranging, unexpected event.

In this text, this after I inhabit, is the wounded one, but the unwounded one as well. I look in the mirror, notice my scar, and remember my scar again. I lift my arm, feel a twinge along my sternum, and remember I have changed. Remembering means I had forgotten, if only for a moment, and means I lived my body once again as it was before.

But what was this before? This is a question I continue to ask as I think back to last summer. I write of my damaged heart and the heart becomes symbol; I write of my heart and realize I write of something else. Substitute the words “my death” for “my heart” and immediately thrown into relief is the fact of my dying that always was. Even before my cardiac event. My heart, pushed up close and center in this life after surgery, is in many ways simply a reminder and nothing new. I am flesh, cells, organic body. I am born. I will die. As I survive, I move closer to the very one I escaped. The escape is temporary. And who knows how long it will last? This time it was severing arteries that took me to the edge, but, of course, it could have been something else: a car wreck, a fall, a terrible flu, a random, violent act. And who knows what it will be? The details of its delivery is unpredictable, but we all know death will come. It may be my heart one day. Or it could be that my heart will from here on out never skip a beat.

Jean Luc-Nancy, whose dying heart was replaced with a dead person’s heart in 1990 asks:

"What does “survival” mean? Isn’t life always an escape from death? And this escape from death—which at the same time doesn’t cease moving toward death, of course—what is it if not life itself—that is, not the grand movement of all the living of the world, ... but rather the quite small, the slight, singular movement of a “some one” that accidently slips its “own” life to the heart of and to the edge of this great living thing?"

Into the heart of and to the edge. The man with the transplanted heart uses heart as a metaphor for center, and it’s the perfect metaphor to use. Accidently alive, because having a life is much more unlikely than likely (according to biologist Richard Dawkins, the number of people who could have been alive but never will be “far outnumber the sand grains of Arabia.”), we humans, our animal selves, slip for a moment beneath the skin of this greater motion, sharing briefly in a pulse larger—collectively—than our own. Human, aware of this finitude, and cognitively evolved to understand these skins as little more than temporary encounters, we are born into this precarious and rare condition of survival. Accidentally we drift each and every day. The precariousness of embodiment becomes our raft, though when the waters are smooth, we often don’t notice it there at all.

Illness, wounds, near-death events return our gaze to the raft that carries us through. We notice its inability, its short comings, and the degree to which we cling to fantasies of its stability.

I too cling.

I return home afraid. I want my old body back. I grapple for a body I can rely on. On the one hand, nothing is new: philosophically speaking, I am mortal, I don’t have control over my body, and I will die, but on the other hand, everything is new: the searing acknowledgement right up in my face that I am mortal, I don’t have control over my body, and I will die. A moment of aporia. Irreconcilable contradiction. Fear. There is a sense of acceptance: I survived: time to gather and move on. But also acceptance: yes, this happened, I survived, but what exactly did just happen and what is coming next?

I seek reassurance in the objective numbers, patterns, and results displayed on my blood pressure machine, the electrocardiograph at cardiac rehab with the view it offers of the steady up and down script of my heart, and the outcome of blood tests assuring me there was no underlying illness that caused my heart to rebel. I realize I have more time.

How much?

Who knows?

Will I be alive this time next year?

Who can say?

I understand this, but want a guarantee. There is none. There never was. It’s the aftershock of wanting that’s the difference.

Writing the wound, the trauma, the mystery that is my heart, I wander in text of hazy understanding.

I write my heart, but my heart slips past. I study the photographs of my heart, but I study a heart that is no longer. I see my heart, but I could be looking at the heart of anyone. If I saw it in a roomful of others, I certainly wouldn’ know it as my own. I am healthy again, but my scar reminds me I am not the same. I write of my heart, but I write of something beyond it. There is something. There is nothing. It is. It is no longer. There are many words. There are none. When asked about the experience, I often don’t know what to say. Not knowing what to say means there are so many places I could begin.

Because what is there, really, to say or write about my heart that will come close to the matter? At best (but perhaps this is enough?), I evoke a weakened heart (for the moment a symbol of mortality instead of love) that we read in a specific instant only to find that instant gone.

But here I will stop for a moment. In an attempt to describe it simply, straightforwardly, as the events of biological body stripped of its poetics:

A year ago, at the age of thirty-eight, with no risk factors for heart disease, no family history of such, and in what I would have said was in a state of excellent health, an artery on the surface of my heart began to rip. It tore backwards, from the bottom of my heart up, until it reached the artery that linked to it, and that one began to rip as well. Blood began to collect and clot between the inner lining and the outer wall, which increased the length of the tear and eventually caused a near obstruction of the artery. I suffered one heart attack, then another. The first I’ve identified in hindsight (symptoms that night ultimately led me to think it was probably the flu), the second led me to the ER (that time, four days later, I knew it most certainly wasn’t the flu).

I was admitted to the hospital and told I needed an emergency bypass.

Anesthetized before I had the chance to really consider what all this meant, my skin and muscle were cauterized open, my sternum sawed in two and pried apart, my heart stopped, my body cooled, and I was repaired as blood, with the use of a heart-lung machine and the trained eyes of a perfusionist, was directed to circulate around my heart, carried deoxygenated and blue out of my right ventricle and into the machine where it was oxygenated then sent back red to my aorta to make its rounds through the rest of my body.

Bypass complete, my heart was restarted, my body disconnected from the heart-lung machine, my sternum sealed tight with titanium mesh, my skin sewn shut, and five days later I was released from the hospital—sent home to heal, to live, to put distance between the event and my new life.

Biologically speaking, that is what happened.

Of her own experience with illness, philosopher Havi Carel writes:

"It is only when something goes wrong with the body that we begin to notice it. Our attention is drawn to the malfunctioning body part and suddenly it becomes the focus of our attention, rather than the invisible background of our activities. The harmony between the biological and the lived body is disrupted and the difference between the two becomes noticeable."

When something is wrong the biological body is an interruption, a stumbling block. Its sheer inability and refusal is glaring, for instance, when two days after surgery I can barely walk the few steps necessary to get from the hospital bed to the bathroom. I think I should be able to walk across the room with the same speed as before my surgery, but my biological body tells me otherwise. Instead of unfolding and being part of a mutual conversation in which the biological and the lived body bleed together and coexist, the biology of me is an obstacle over which I trip.

A different sort of description then of some of the events that happened:

I wake after surgery to my family, my lover, and my best friend telling me in their different ways that I will be alright, to my fear and shock as I begin through a drug-induced haze to remember what happened and the fact that I am lying in a bed in the cardiac intensive care unit at one of the city’s prestigious heart hospitals. I am feeling my body and its unexpected turn. The interior of me has risen to the surface. I don’t yet know the details of what happened: how many arteries were tearing and in which directions or why. I only know that I am alive and very much afraid.

I wake after surgery to the stranger that is my heart, for it has become a stranger to me. And in the same way a stranger in my house would command all of my attention, my heart too insists that I see it above and beyond everything else. This will continue for many months. Sometimes my heart is the focus of an entire day. Sometimes its presence is central in sporadic moments: it beats fast suddenly and all my attention is on the well-being of my heart—is it ok? am I? Does this event have any significance beyond this moment?

An abstract notion (a vague organ beating out the rhythm of my pulse) has begun to form itself into a concrete presence (fist-sized muscle, chambers, torn arteries, bypass), and yet, when I write this, I realize that any idea of concreteness, if by that I mean clarity of definition or transparency of understanding (of my heart, of my experience), should be qualified, because what I refer to as the interior is shrouded in strangeness, a mystery that demands I continue filling in the pieces even as there are too many blanks to fill. Yes, I feel and see my heart, but it is a heart I didn’t know. And ironically, the more I see, the more opaque to myself I become.

For it is true: In more than one way, I have seen my own heart. (During the procedure, my surgeon took pictures). My eyes have touched its image and its image has touched me in return, has moved me, and yes, has changed me, for who, after all, ever expects to see her own heart—a visceral view of her mortality, in the flesh, exposed to the world, lying vulnerable in her own cut-open chest, especially out of the blue?

(quoted passages are from Jean-Luc Nancy's The Intruder, Richard Dawkins's Unweaving the Rainbow, and Havi Carel's Illness.)