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:

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.)