By DR. VICTOR S. SIERPINA
“The heart has its reasons which Reason knows not.” — Blaise Pascal
Mankind seems to enjoy metaphors of the human body, often based on our current state of technology. For example, 100 or so years ago, the brain was compared to a telephone switchboard with wires connecting the various parts. Now, it is more like a cluster of digital arrays in a computer. The bones are likened to our architecture. Not a bad analogy since they hold us up. The heart has an enduring metaphor as a pump, which endlessly circulates blood to and from the body, cleaning it through the lungs. It reminds of the city waterworks in some ways.
The heart also could be likened to the internal combustion engine complete with compression cylinders — the ventricles, valves — between its chambers, intake carburetors—the atria, and of course the spark plug or ignition system. The latter are composed of the various electrical generating and conducting structures of the heart that create energy flow through wire-like bundles to activate the powerful heart muscles. One of my patients referred to his two cardiologists as “the plumber” and “sparky” because one took care of his arteries and the other the electrical rhythm problems.
Cardiac technology is indeed impressive with “the plumbers” able to open clogged drains of coronary arteries with little roto-rooter like springs and stent coils to keep the vessels open. The “sparky” electricians can practically re-wire the house by knocking out bad wires with radio waves, implanting a pacemaker, and even a defibrillator in case of a short circuit. We now have heart transplants, a truly astonishing technology.
Here is a true story, though, about how the heart is more than a machine. A young man lost his life and was the organ donor to a heart transplant recipient. The recipient and his family were understandably grateful and sought out the donor’s family to thank them for this ultimate gift of life. As they talked, the conversation turned to the recipient’s health. His parents had noticed changes in him after surgery. Some of these worried them. Since getting his new heart, he had developed a new craving for fried chicken and beer, not necessarily an optimal diet for prolonged heart health. The parents of the donor looked at each other in shock. It turned out that their son was killed in a motorcycle accident while driving home after picking up his favorite evening meal: fried chicken with a six-pack of cold beer.
Strange things happen in medicine, but this was a most remarkable one. It seems that the heart is more than a pump. It also can hold our desires, our hopes and dreams, our goals and meaning, our love and maybe even our food and drink preferences.
Perhaps this helps account for the fact that only an estimated one in seven people with heart disease follow the advice of their doctors to modify their lifestyles through regular physical activity, dietary changes, weight loss or stopping smoking. They want their heart’s desire even when it might be killing them. After all, if it breaks, hopefully they can just take it to the shop.
Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.