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Heather Lanier | Longreads | January 10, 2023 | 24 minutes (6,652 words)
Left Atrium
Blood enters the left atrium, a thin-walled upper room in the house of the heart, through the pulmonary veins, and you enter the Heart Wing through a southern-facing door engraved with a health insurance logo. You step into a tall, red-ceilinged room with crown molding where giant blood molecules float across beige walls and children dart hummingbird-like between stations. Blood enters the left atrium rich in oxygen because it just came from the lungs, and you — if you’re me — enter the museum’s Heart Wing well-fueled because you’ve just dined on a packed lunch in a courtyard outside.
A spiral of life-sized plastic hearts rotates at the center of one station. The hearts are in ascending order, from smallest to largest. The heart at the bottom is the width of an M&M. It’s the heart of a woodpecker. Someone could pop it in their mouth and use it for a tooth implant. Your own heart — or one roughly the size of people like you — is midway up the spiral, just beneath “ostrich” and above “large dog.”
Near the spiral, an unassuming gray rubber bulb is at waist level. Shaped like a joystick, it invites you to take hold and squeeze. Above the rubber bulb, a fake heart sits in a Plexiglass box. Can you keep up with your heart? a screen beneath the fake heart asks. Can your hand mimic the heart’s pace for even a minute? Seventy-four squeezes of the bulb?
One, two, three … With each beat, the heart in the Plexiglass box glows pink at its base, illuminating raised coronary veins. The screen keeps tab: How well is your hand mimicking the cardiac rhythm? At 12, you’re a beat behind. At 37, you’re two beats off, and your forearm kind of aches. At 47, the bulb is so squeezed of air that it won’t re-inflate, but you get the point: Your heart is the muscle that never stops. It beats 100,000 times a day, says the display. While you fret about your bank account, your forehead wrinkles, or that person who hasn’t replied to your email, the heart — your heart — just keeps on keeping on in a way no other muscle could.
And this is what, if you are me, you might learn early on and can’t quite shake in the Heart Wing of Philadelphia’s Franklin Institute: The heart is an overworked organ. It’s the muscle that never unionized. You are in a daunting codependent relationship with an organ that, if it were a person, should file a lawsuit against you, should summon the ACLU. The heart needs a vacation, a chaise lounge by the sea, and a mai tai with an umbrella.
Nobody should be drinking mai tais though, at least not according to the section of the Heart Wing that I’ll call The Corner of Guilt and Doom. At its center, a clear column pushes plastic discs through water. They’re meant to be platelets but they resemble cinnamon red-hots or valentine candies, swirling up and down several feet in the clear cylinder. Their cheeriness is misleading. Beneath them, at eye level, a pair of stony-gray wings stands to the left of a photo of similar wings, leathery pink. Except they’re not wings. Plastinated human lungs, reads the sign. Quit smoking, reads a larger one. Preemptive strike, I think, knowing the median target age of the museum visitor is 10.
Another station invites you to toss bean bags onto a scale. Are You at Risk for a Heart Attack? Do you drink alcohol? Have high cholesterol? A family history of heart disease? Yes? Then toss red bean bags onto the side of the scale marked “high-risk.” Watch the bean bags pile up like pillows at a dolls’ slumber party. (Here’s something the museum omits from its advertising: Glean your chances for the nation’s top cause of expiry!) Do you exercise? Maintain a low-to-average weight? Have no family history of heart disease? Toss green bean bags onto the low-risk side of the scale. Imagine, as I do, a Barbie doll lying upon them, her plastic life never sending her into cardiac arrest.
I’ve recently entered the age where I get screened for colon cancer. I’ve recently received a call from my doctor that my cholesterol is alarmingly high and I should go on medication, despite running and eating whole grains and having whatever body-size markers the medical industry deems “low-risk.” It’s the oldest story in the book: I’m mortal, and somehow surprised by it. Inching further into my 40s, the collagen-full curve of my chin has been replaced by what some might, accurately, call “jowls.” A cartoonish number 11 sits between my eyes in Zoom meetings whether I’m troubled by the budgetary changes or not.
While you fret about your bank account, your forehead wrinkles, or that person who hasn’t replied to your email, the heart — your heart — just keeps on keeping on in a way no other muscle could.
A few weeks ago, the heart of a friend stopped inexplicably in his sleep and didn’t restart. He was 42. A year younger than me.
In his essay, “Joyas Voladaros,” the late Brian Doyle tells us that each species gets roughly the same number of heartbeats in its lifetime. Both the hummingbird and the giant tortoise have an equal number of ticks. And tocks. Doyle says that number is about two billion. The heart-as-clock is a cliché the Heart Wing does not entertain.
My heart has beaten approximately one billion, 500 hundred million times in its lifetime, which happens to also be my lifetime. It beat 150 more times while I calculated that fact. Your heart has either beaten more or less than mine, depending on your age. If your heart has beaten less than mine, you are statistically less likely to meditate on the finitude of your heartbeats.
I can’t help myself: I throw the bean bags. I watch the little pillows pile onto both sides of the metal scale. Like nearly every human who plays the game, I have risk. The scale cannot reassure me that I will not die tomorrow. The surest way to live with zero risk is to not be alive. But then we couldn’t stand in a crowded room of ornate crown molding and toss bean bags foretelling our chances of death.
Left Ventricle
Blood is continuously moving through arteries and veins and capillaries that measure 60,000 miles long. Where do you mark the start of a daily circuitous trip that stretches the length of the globe twice over? Blood might symbolize life, but it’s not like life: It doesn’t have a clear entry point the way my kale salad entered my body hours ago in the courtyard, or the way the baby version of you entered this world slippery and wailing, at the start of your story.
But if you begin the life cycle of blood in the left atrium, the next room it visits is the thicker-walled, larger room below it, the left ventricle. It’s the most powerful room in the heart. And if you start the Heart Wing in the room that contains the heart-in-a-Plexiglass-box, the next room you flow into displays the museum’s most iconic feature: a walk-through replica of the human heart.
Two stories tall, 100 times the width of my heart and yours, the giant heart looks alien. It consumes half the room. Its bulbous red self is gripped claw-like by raised blue veins and red arteries. A red aorta emerges from its top. A blue vena cava hugs its right side like the trunk of a ghastly Seussian-blue tree. These vessels ascending from and extending into different parts of the Heart Wing suggest that the entire museum is somehow subsumed by the circulatory system of a giant. The museum says this heart befits someone 220 feet tall.
You can enter the giant heart. You can let proportion shrink you to the size of a blood molecule and traverse the four chambers, through tricuspid, pulmonary, mitral, and aortic valves. That is, you can do so if you aren’t in a wheelchair or don’t need handrails to manage steep steps. And you might do so if you aren’t yet menopausal like one of my museum guests and aren’t sent into raging hot flashes — because the giant heart is warm as blood and stuffy as a concert port-a-potty. Bipedal and of (albeit waning) reproductive years, I round the back of the 28-foot-wide organ, walk along a muddy-pink wall that’s lumpy and gently marbleized and meant, I’m assuming, to evoke the unsettling aliveness of human flesh. I duck beneath a big blue artery. The drumming gets louder.
I have not yet said this: The entire Heart Wing throbs with a nonstop lub-dub, lub-dub. Deep as a bass drum, pulsing about once per second, it’s the constant auditory reminder that the organ in your chest can’t stop, can’t stop, can’t stop. This means that, if you’re like me, the zone under your ribs — just slightly left of your sternum — starts to ache.
Brian Doyle titled a book about the heart The Wet Engine, but this giant non-ADA-compliant heart is dry, made of fiberglass and paint. When you step into it, you meet the glowing blue cave of the right atrium. You climb a few steps, then descend a few more into the right ventricle, where the wall’s white ridges evoke a whale’s palate. A kid shouts, Ew, gross, and you ascend uneven red steps. You arrive at a coverless bridge that serves as a brief reprieve from the cardiac claustrophobia, then reenter the heart through beigey-pink hallways, crawling with fake capillaries and fluffy white bronchi. You’re in the lungs, a sign says, and the lub-dub is louder. When you head into the left atrium, you might glisten with sweat. A sign says you’re fully oxygenated. You descend red steps into the left ventricle, head out the heart through another narrow stairway labeled aorta, and pour out of a flesh-painted wall and back onto the museum’s bluish carpet, your own heart now quickened.
“I remember rushing into it as a kid and then getting a queasy feeling … and bolting to the exit,” wrote journalist Greg Robb on Twitter, when the Philadelphia Inquirer asked for memories of the iconic giant heart. “Couldn’t wait to do it again and again,” he added. This afternoon, kids run into the vena cava entrance, pop out the flesh-walled exit, then round the bulbous veiny beast to enter it again, like the giant heart is a playground slide and they want another turn. They’re giddy and panting. They have all the time in the world and none of the patience for it. I ran around the same giant heart 30-some years ago. Studies prove it: The older you get, the faster the days and weeks seem to pass. Or, as another person responded about the heart, but could have easily written about time: “The older I got, the more it got tighter.” Because the stairways are narrow and the clearances are sometimes under five feet, the giant heart seems designed for children — people with zero face wrinkles and very few reminders that we’re not immortal. That we’re not permanent fixtures on this planet. That we have endpoints.
Two stories tall, 100 times the width of my heart and yours, the giant heart looks alien. It consumes half the room. Its bulbous red self is gripped claw-like by raised blue veins and red arteries.
The giant heart was never meant to be permanent. Originally constructed in 1953 of paper maché, chicken wire, and lumber, it was the brainchild of Dr. Mildred Pfeiffer, a physician who traveled Pennsylvania, lecturing on cardiovascular health. Popularity kept the heart alive, as have reconstructions and upgrades — “surgeries,” the museum calls them. The version I walked through had a distinct but unplaceable smell, built up from years of heat and sweat and the occasional puking kid. This heart does not smell. Its most recent upgrade involved a paint job and a brand-new beat.
The old pulse — the one I heard, the one that sent journalist Greg Robb bolting in panic — was synthetic. Now, the lub-dub is drawn from a database of real human hearts. Now, a bunch of heartbeats have been recorded and mish-mashed to stay alive long past their owners.
My friend whose heart stopped was a spiritual seeker and adventurer. He had what some would call a big heart, although not made of fiberglass, and probably not any bigger than yours or mine. His face held a bright-eyed wonder usually reserved for toddlers. His eyes lit in awe at the stick figures my children drew or the dandelions they plucked. He was mostly my husband’s friend, which is how he became my friend, too. They had been Trappist monks at the same monastery, at different times. They’d experienced the same tender wisdom, gentle correction, and odiferous flatulence from elder brothers in long robes who prayed the Psalms six times a day.
Each time he stayed with us, it felt like we were hosting a beloved brother who we rarely saw but wished lived closer. At night, he sat on our living room rug cross-legged, telling us stories of miracles he traveled to see: a monk who could walk through walls, another who could hide a candle behind his back and reveal the flame by turning his skin and organs transparent. He traveled widely, our friend, our citizen of the world, to places like Mexico and Ireland, and Bhutan. He interviewed Christian teachers and Buddhist masters with a tape recorder, searching for — for what? For the truth of things? For God? For who or what we really are? I can’t say for sure. If we, as he believed, can pass through walls, can render our skin and bones invisible — maybe we are more than flesh. Maybe we are citizens of a world even bigger than this one.
When he left, I said, “Come back anytime” and meant it, snapping a photo of him with my children. In the picture, he’s kneeling at their level on the grass, smiling the unassuming, simple, luminescent smile of a man who is alive, truly alive, and therefore looks like he’ll be alive forever.
Aorta
Blood exits the left ventricle through the aorta, and the only way to exit the giant heart is to climb up the staircase labeled aorta, hang a left, and walk down the steps into the museum again.
Just across from the giant heart is another reminder that, no matter how much you think you’re immortal, your body will meet its last moment. Heavy black rectangular slides sit inside a case taller than my body — and possibly yours. Grab a silver handle and you can yank a slide out of the case. I do. It shows the outline of a human body. The ovals and globules and blobs of someone’s innards float like islands inside a yellowy human-shaped ocean. The blobs are labeled: Brain, deltoid, lung. A plaque on the case explains what you’re looking at: razor-thin slices of a man who was frozen solid after he died. He donated his body to science. There are four more slides. I can’t draw them farther than a few inches before wanting to push them back with a thud.
Because he was so young, and his death so unexpected, an autopsy was performed on my friend’s body. Only his close friends and family know the answers, and if I knew them, I wouldn’t share them here. Some things should stay inside the body of a family.
Slicing apart dead bodies was forbidden in many cultures, like Ancient Rome and Medieval India. The body was seen as too sacred, and necessary to preserve for the afterlife. But in 16th-century Hispaniola, when conjoined twins Joana and Melchiora Ballestero died, the Catholic Church ordered an autopsy. Did they have one soul or two? When two hearts were found, the girls were declared to have two separate souls. The soul, it was believed, resided in the heart.
Only his close friends and family know the answers, and if I knew them, I wouldn’t share them here. Some things should stay inside the body of a family.
Here’s a miracle my friend would have liked: When 90-year-old Tibetan Chokpa Tenzin still felt warm several hours after her heart had stopped, her family postponed the funeral arrangements. Several days later, Chokpa’s skin was still supple. “She was no longer breathing,” wrote one journalist, “but she looked calm, her skin remained warm, as if she was in a deep, eternal sleep.” She stayed this way for seven days.
And when the Dalai Lama’s tutor Geshe Lhundub Sopa died, Tricycle Magazine described him as “lean[ing] upright against a wall, his odorless body perfectly poised, his skin fresh as baked bread. He looked like he was meditating.” His heart had stopped three days before. He too remained this way for seven days.
According to Tibetans, these people had entered a rare post-death state called thukdam, when the body is clinically dead but the person doesn’t decompose for days, sometimes weeks. Tibetans say it’s because the person’s consciousness is engaged in a deep form of meditation called “clear light” meditation. When Tibetan monk Geshe Jampa Gyatso was in thukdam, a physicist measured his blood-oxygen level at 86, even though his heart hadn’t beaten in 10 days.
Decades after Saint John Vianney of France died, he was exhumed and found to have a fully intact heart. Called the “incorrupt heart,” it now travels the world in a reliquary. The reliquary looks like a miniature castle, with glass walls, gold spires, and a gold-shingled roof. The heart sits on a red velvet cushion. It resembles a brown fossil or a stone valentine. Visitors say they can spot a bit of pink in its center.
If the Heart Wing displayed Vianney’s heart, it would be the opposite of the heart-in-a-Plexiglass-box. Where one ticks away your seconds, reminding you of the countdown in your chest, the other stoically suggests that it never quite died — not the way things normally do.
At secular-humanist funerals, people say the dead live on through our memories, which suggests that people really die not when their hearts stop beating but when ours do. This means that we don’t die until the people who remember us do. It’s meant to be comforting, but I find it a sad replacement for miracles or magic or actual immortality.
Septum
Between the left and right chambers of the heart is a muscular wall called the septum, and between the two major rooms of the Heart Wing are two giant severed arteries. If you’re a kid, you can crawl through them, as mine does. If you’re an adult, you’ll probably stand and watch, analyzing the layers of flesh in the arterial walls. Thanks to a layer of yellow clumps, one artery is significantly narrower than the other, crowding the kids with simulated fat until they can’t make it through. This artery probably warrants its owner to go on medication. There’s a hole at the top of both arteries, and if you’re a kid, you can poke your head out and wave to people, like your parents. You can wave to the people who gave you life, the people whose hearts — if you’re lucky — will stop beating before yours. Riley, look at Daddy, says a man to a toddler in the artery. She won’t quite put her face in the frame. Riley, stand up, look at Daddy. Smile, Riley. I snap a photo of my smiling daughter, her face framed by the fatty artery’s opening.
There’s a hole in my heart / That can only be filled by you. Those are the lyrics of a song I blasted when I was a ‘90s teen. Hole hearted, the large-mouthed, long-haired frontrunner sang over and over. This song is now played on oldies stations. The phrase, hole in my heart, suggests an emotional absence, a longing. A gaping need that begs to be filled.
Maybe that’s why it’s so dramatic to say my daughter once had a hole in her heart. This is what a cardiologist told me when she was a few months old. This hole was in her septum, the wall that separates the left chambers from the right ones. Because the oxygenated blood traveling from the lungs pours into the left chambers, and the deoxygenated blood flows into the right chambers, a hole in the septum means the two kinds of blood could get mixed — which is trouble. A hole in the heart speaks to the potentially unmet physical need for oxygen. “Look for blue lips,” a nurse told us on the phone.
Her lips did not, thankfully, ever go blue. The hole in her heart eventually closed on its own. Called an atrial septal defect, it’s the most common cardiac anomaly. But doctors don’t say anomaly. They say defect, which always conjures in my mind a factory line — hearts spaced evenly apart on a conveyor belt, traveling toward inspection. Some are deemed defective. Some don’t fit industry standards. They get sent back, called out of order, subtracted from the bottom line.
Because of my daughter’s heart condition, I spent a fair amount of time in the heart wings of children’s hospitals. They sometimes resemble art museums, with kid-created drawings of hearts, large heart sculptures, and even a lava-lamp-like installation with valentine-hearts floating inside. A painting in one exam room featured multicolored hearts in the sky, each with a set of wings. Hearts soaring to heaven. Hearts eternal.
I’ve reasoned that all this art is because the heart is a high-profile organ. It elicits an emotional response. Tiny hearts inside tiny children who need big surgeries — this makes us bite our lips and donate.
But once when I arrived at the room to consult with the cardiologist about my daughter’s abnormal echocardiogram, he said this: The heart is just a pump. We like to sentimentalize it. But really, it’s nothing more than a pump. I nodded with my infant in my lap, which meant I held not just my love but my love’s heart and the hole that heart contained.
I was being told: There is nothing magical about the heart. There is nothing mystical or meaningful. The heart is a machine in the factory of the body. The heart pumps, you live, it stops, you die, the end.
When my father died, I felt like I had a hole in my heart. Rather, I felt like the place where my heart was had become a hole. My chest ached. I thought it was a metaphorical ache. I called it the grief hole and imagined a cosmological black hole under my sternum, a thing made of nothing yet drawing absolutely everything into it. A gravity of grief.
Cardiologists now recognize a condition called takotsubo cardiomyopathy, or “broken heart syndrome.” After a big breakup or the death of a loved one, the heart weakens for an acute time. “The grieving heart,” says cardiologist Dr. Sandeep Jauhar, “appears stunned and frequently balloons into the distinctive shape of the takotsubo, a Japanese pot with a wide base and a narrow neck.” Patients with hearts in the shape of this pot are at greater risk of a heart attack.
Two days after a teacher was killed in the Uvalde school shooting, her husband died of a heart attack.
The heart is just a pump. We like to sentimentalize it. But really, it’s nothing more than a pump. I nodded with my infant in my lap, which meant I held not just my love but my love’s heart and the hole that heart contained.
Although I’ve known plenty of people who’ve died, I’ve never experienced “the grief hole” other than 20 years ago, when my father died. I did not, for instance, experience it when my friend died.
But sometimes I think maybe I’ve just gotten used to living with something akin to it, because when I hear the highest note in Barber’s “Adagio for Strings,” or when I remember I’ll someday pick up my child and put her down and never pick her up again — either because she’s too heavy or I’m not here or (unthinkably) she’s not here — the place I can most accurately call “my heart” throbs unmistakably, and it feels like it’s reaching back to a moment when I lay in a cot beside my father’s deathbed and reached my arm across the space between our mattresses so I could slip my hand inside his still-alive hand.
Before a man received the first heart transplant, his wife reportedly asked the doctor if he would still love her.
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Jauhar calls for a change in how medicine treats heart disease. He wants us to consider not just exercise and low-fat diets but love. He cites a study where two sets of rabbits are both fed high-cholesterol diets. Rabbits in one set are petted and held, talked to, and played with, while the other rabbits are left alone. The loved rabbits have 60% less aortic disease than the left-alone rabbits, even with similar blood pressure and cholesterol. “The heart may not originate our feelings,” Jauhar said, “but it is highly responsive to them. A record of our emotional lives is written on our hearts.”
Get yourselves a new heart and a new spirit, God tells the people of Israel.
Right Atrium
There are only two rooms in the Heart Wing, but four in the actual heart. Blood enters the right atrium oxygen-depleted, and I stroll back through the Heart Wing’s two rooms fatigued.
Heart valves are meant to be like one-way swinging doors — their closing is what makes the lub and dub. Tiny threads tether the flaps of the valves to the heart wall. If blood flows backward through the heart, the valves aren’t doing their job. You don’t want blood flowing in reverse. That’s called regurgitation.
Still, I keep reversing course in the Heart Wing, revisiting spots I’ve already seen. I pass the heart-in-a-Plexiglass-box. I pass the spiral of animal hearts. I pass a wall of plastic tubing meant to show me how hard my heart must work to pump the blood down my legs and up again. I look for beauty here, for the sense that I’m not doomed at any moment should a fist of muscle decide to stop. I look for an understanding that the heart is more than a belabored mechanism, that my body is more than a machine — one I need to try to keep alive forever, but never will.
The museum is not coy about the fact that it views the body as a machine. The original heart exhibit from 1954 was called “The Engine of Life.” Today, the museum has an article on its website called “How Your Body is Like a Factory.” In a car factory, the article says, “One team might make steering wheels. Another team might make seats…. They all share a common goal: to make cars. Your body operates in much the same way … [with] the common goal of keeping you alive.”
By equating staying alive with making cars, the museum echoes the priorities of late-stage capitalism. If you’re not making gadgets or deals or website content, who are you? Like a grinding factory of the Industrial Revolution, your worth is measured by your production — your bolted widgets or sent emails or new clients — which someone can then commoditize.
In the years we didn’t know were his last, our friend took small troupes of spiritual seekers to Bhutan and met with Tibetan Buddhist monks there. Bhutan measures its progress, not by emphasizing its GDP, or Gross Domestic Product, but by measuring its GNH: Gross National Happiness. In other words, Bhutan has attempted to rearrange the measurement of a nation around the well-being of its citizens rather than their economic output. If you’re a resident, the Gross National Happiness Commission surveys you every five years, asking things like, How many hours do you sleep? How many hours do you work? How often do you quarrel with your family? Do you trust your neighbors? And because Bhutan is a Buddhist nation, it asks, How often do you meditate? How often do you pray?
The survey takes several hours to complete. Participants receive a day’s wages. Their output for the day is a record of their well-being.
That the Heart Wing stresses me out is probably not good for my happiness index. But it’s also not good for my heart. “Fear … can cause profound cardiac injury,” says Jauhar. “Emotional stress … is often a matter of life and death.”
I look for an understanding that the heart is more than a belabored mechanism, that my body is more than a machine — one I need to try to keep alive forever, but never will.
In the days after our friend’s death, I overheard my husband talking to different people on the phone. He repeated certain phrases. Forty-two. Died in his sleep. Funeral in a week. I know, man. I know. Light laughter. Heavy sigh. The conversations almost always drifted to this: He had a condition. A rare respiratory ailment that conventional western medicine couldn’t explain.
This is what we do. We piece together the story of a death — and a life — the way we piece together a jigsaw puzzle. One picture that doesn’t make sense: dying at 42 in your sleep. Because a human heart has over two billion beats. And he didn’t get almost half of his. So the phrase, he had a condition, gets repeated into a receiver and changes the direction of the conversation, from shocked to somewhat pacified. As though any of our hearts couldn’t stop at any moment. As though all the beats are owed to us, not bestowed upon us, not graciously and mysteriously and troublingly given.
How can we all be machines, when the deaths of machines would never crush you the way the person you love most in this world will crush you when they leave it? Your heart might even balloon from the loss. Your heart might even stop.
Right Ventricle
It might not be until after you leave the Heart Wing, after you leave Philly entirely, once you’re settling into your home and yanking pots from cabinets for dinner, that you hash out to your beloved exactly why the museum made you feel drained. This is the person whose death — if it occurs before yours — would make your heart balloon into the shape of a Japanese pot. And that’s when your beloved could, as mine did, say to you: “Did you know the heart might not be a pump? Did you know they have no idea how blood actually moves through the body?”
And your eyebrows, as mine did, might lift past the ceiling and your chin might, as mine did, fall through the floor, and you’ll tell your beloved: “No way.” You might even shake your head. The heart is a pump. You’ve been told as much for eternity, or since third grade. Then you might, if you’re me, spiral like a tower of spinning plastic hearts into research, where you learn that the heart-as-pump is not actually a fact. It’s a theory.
What’s the history of the heart-as-pump theory? When did we turn the circulatory system into a machine? Many credit 17th-century physician William Harvey, who discovered that blood moves in a circuit, from the heart and back to it. But Harvey never believed the heart’s mechanical function was the primary source of blood’s movement. He believed in a divine vital heat called calor innatus. This idea came from Aristotle, who said our vital heat is connected to something called pneuma, “the primal stuff of heavenly bodies.” Pneuma is an ancient Greek word for breath, but also for soul or spirit.
In the fable that is the first book of Genesis, Adam comes to life when his Creator breathes into him.
“I found the task so truly arduous,” wrote Harvey of his attempt to map circulation, “that I was almost tempted to think … that the motion of the heart was only to be comprehended by God.”
The pump, gotta check the pump. My father-in-law repeats these words every summer when he aspires to a crystalline swimming pool. When I research how a pool pump works, in order to understand how people think the heart works, I land on a pool supply website. The first sentence reads: “The pump is essentially the heart of the swimming pool’s circulation system.” To try to understand the way an actual machine works, I’m pointed back to the body.
Vascular anesthesiologist and professor Dr. Branko Furst cites a number of instances in which the heart, when intervened with during surgery, doesn’t behave at all like we’d expect if it were a pump. He and others also point out the heart’s relatively small size compared to the task for which it’s being credited. Less than a pound in weight, the heart must, over the course of an average 75-year life span, push 400 million liters of very sticky fluid that is made of molecules sometimes larger than the vessels through which the heart supposedly “pumps.”
Admit it: You’ve made a fist and held it to your chest, just slightly to the left. You’ve marveled, maybe, as I have, at the size of the thing keeping you alive.
Furst says that as the field of cardiology advances, “the number of discrepancies between the observed phenomena and the constraints imposed by the existent circulation model is likely to increase.” In other words, as we intervene with circulation for treatment purposes, the heart will continue to behave in ways that make no sense if we think of it as a pump.
Years ago, I sat in a large meditation hall and listened to a teacher say over and over, “The heart is the organ of spiritual perception.” For the first two days of the five-day retreat, I thought she meant metaphorically. But after listening to her for a few days, I realized she meant literally. The heart is the organ of spiritual perception, she said, like the eyes are the instruments of sight, and the ears are the instruments of hearing. She was an Episcopal priest and meditation teacher, as well as a friend of our friend who died. The heart, she was saying, contains its own intelligence.
In an experiment, participants were hooked up to a number of brain, skin, and heart monitors and shown 45 images on a screen. Two-thirds of the images were emotionally neutral: a tree, a cup. A third of the images were emotionally charged: a bloody corpse, a snake ready to strike. The images were shown at random — the participant had no way of predicting what kind of image would appear next. But approximately four-and-a-half seconds before an emotionally charged image appeared, the participants showed signs that their bodies somehow knew. Their reactions were physiologically detectable not in their brains, but in their hearts.
Admit it: You’ve made a fist and held it to your chest, just slightly to the left. You’ve marveled, maybe, as I have, at the size of the thing keeping you alive.
If, as Furst believes, the heart is not primarily responsible for the movement of the blood, then what is? He proposes that the heart interrupts the blood already in motion and that the blood possesses its own kinetic energy — a theory that harkens back to Harvey and Aristotle. In other words, maybe it’s not the heart that moves the blood. Maybe it’s the blood that moves the heart.
Maybe the heart, weighing less than a pound, is not an overworked organ meeting an unthinkable quota of labor. Maybe it simply supports something already in motion. Maybe we’re not walking around with doomed-to-stop clocks in our chests. Maybe we’ve just erroneously applied our Industrial Revolution work ethic to the organ that gives us our beat. Maybe we’re walking around with a miraculous, mysterious life force autonomously moving through us.
What makes your heart beat? asks a text box from the editor-in-chief of Pumps Magazine, a periodical put out by a technology company that makes pumps and motors. I expect a scientific answer involving electrical pulses and closing valves. But employees reply in their own text boxes: Old Hindi songs. Reaching high goals. Wild white horses. Travel. Pistachio ice cream.
Sometimes I’m comforted when we don’t fully understand things, when mysteries remain unsolved, and explanations are beyond our minds’ capacity to grasp them. Maybe that’s because when the mind releases a hard question — like why I’ll one day set my daughter down and never pick her up again, like why a 42-year-old friend died in his sleep — it drops that question down, finding answers in a place deeper than our minds, where a steady pulse still beats.
The heart, said the meditation teacher, is capable of living in spontaneous connection with something called the divine heart. And this intelligence of the divine heart, she said, is what lives beyond our death. “You begin to discover,” she said on day three of the retreat, “that the heart knows no death, and nothing is ever lost that has been held in love, if you know how to find it.”
I think of the grown children of Chokpa Tenzin, placing a hand on their dead mother’s chest on a Wednesday, and still feeling heat on Thursday, Friday, Saturday. Thukdam, translated literally, means the mind in a deep meditative state. To date, no discernible brainwave activity has been detected from a person in thukdam. Mind in this case can’t mean the organ located inside the skull. It must point to a consciousness that exists somewhere else in our bodies.
For a body in thukdam, the skin above the heart is what stays warmest.
Pericardium
The pericardium is the sac in which the heart sits. It’s a fibrous membrane around the outside of the heart, providing protection. Without it, the heart could over-expand. The pericardium is the heart’s edge, its limit, its reminder to not go beyond its size.
The risk, of course, with an essay about the heart, is that it could go on forever. Expand to include every scientific fact, every mythic association.
I haven’t, for instance, said that the heart of a blue whale weighs 1,000 pounds and beats just a few times per minute.
I haven’t said that in 1673, a French nun reported that Jesus appeared to her with his heart on fire, visible outside of his chest. The sister said he spoke these words: My Sacred Heart is so intense in its love for humanity, and for you in particular, that not being able to contain within it the flames of its ardent charity, they must be transmitted through all means. Jesus’s heart, in other words, couldn’t be contained by his pericardium.
Maybe we think of ourselves as machines because it’s been so long since we’ve seen miracles. Or maybe it’s hard to believe in miracles because we’ve thought so long of ourselves as machines. I want another night with my friend, telling stories of monks walking through walls and turning their intestines translucent.
Here’s something that borders on miraculous but that scientists in California confirm: The heart emits a magnetic field expanding outward in all directions and returning to the chest in a donut shape. One hundred times greater than the magnetic field emitted by the brain, it changes depending on our emotions. Anger, for instance, produces a markedly different magnetic field than appreciation. The field itself can be measured three feet from the body. Some believe the distance of three feet indicates, not the limits of the heart’s emissions, but the limits of the technology used to measure it. In other words, some suspect the heart might emit a magnetic field that extends much farther — possibly, however faintly, for infinity.
Here’s what I’d like to see in the Heart Wing. Here’s what — as the editors of Pumps Magazine say — would make my heart beat:
A heart-shaped bag of fluid you can touch, heated to the precise temperature of Chokpa Tenzin’s chest a week after she stopped breathing.
The cells of Saint John Vianney’s “incorrupt” heart under a microscope. A graph revealing its chemical composition.
The heartbeat of the man who received the first heart transplant. His wife’s heartbeat when, after the operation, they reunited. A slideshow revealing all the things he enjoyed in the 112 more days that he lived.
A visual representation of my friend’s heart’s magnetic field, arcing like a donut around his body.
And a platform that, when you stand on it, displays your own heart’s magnetic field. It would display whether you’re feeling anger or gratitude, grief or joy. Your heart’s magnetic field would project on the wall beside my friend’s, radiating three feet to touch his, radiating five feet past museum visitors, radiating twenty feet through the giant heart — radiating maybe even infinitely.
Heather Lanier is an assistant professor of creative writing at Rowan University. Her memoir, Raising a Rare Girl, was a New York Times Book Review Editor’s Choice. Her poetry collection, Psalms of Unknowing, is forthcoming from Monkfish Publishing next year. You can find her on Instagram at @heatherklanier or at her newsletter, The Slow Take.
Editor: Carolyn Wells
Fact-checker: Julie Schwietert Collazo
Copy-editor: Krista Stevens
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