Heart Strings (2/8)

Hilma af Klint, The Dove, No. 13, 1915

As a challenge to myself, I’d like to post a piece of writing from every semester of medical school. With that being said and it only being quite a few months late…here is something that I wrote one night while in our second semester. 

Studying the heart while feeling like yours is betraying every ounce of logic and reason is a special kind of cruelty few will have the privilege (or is it a punishment?) to experience. I can learn how the stroke volume changes when a disease prolapses a valve but no matter how hard I try I can’t understand why my heart is blindlessly and haphazardly led by illogical desire. 

Maybe someone will chime in now and say “That’s what makes us human! Our heart defies all logic and isn’t it beautiful!”. I’m sure one day in the future I will arrive at that bittersweet conclusion but at the moment I’m stuck learning the mechanics of what I feel is ruining my life. 

The heart is strong and resilient, it survives shock and myocardial infarctions and misconducted electrical currents, but it’s also a fool. Maybe the biggest one. It’s a beautiful, dynamic, life-creating engine that would probably lead us straight into the abyss if our brain wasn’t keeping it in check. Which is ironic because I think my mind is losing itself doing this job of keeping my heart in line and on a leash, but I haven’t gotten to the neuro part of medical school yet, so the fine details of this psychosis won’t be revealed to me until later this year. How exciting, to lie in wait of combing through the wreckage, am I right? It feels like standing in front of an oncoming train unable to leave because you’re just too darn curious of a cat to not know how it ends, how it truly and intricately unravels, and how you can post-mortem that ending for days, weeks, maybe even (unfortunately) months. 

The heart is a foolish optimist. It is the organ with quite possibly the rosiest of rose colored glasses from the day we are born. It mocks the brain for the way it ruminates on thoughts endlessly and scoffs at the gut for its so called “instinct”. There are no songs called “My Gut Will Go On” or “Total Eclipse of the Brain”. It gets all the glory - precisely because of this perpetual sense of newness that it approaches life with. It is a child that never grows up — it glosses over the past, forgives people, tries again — no matter how many times it has been shown how dangerous or fruitless that choice is.

I’ve seen large hearts, small hearts, sliced opened hearts, hearts with a leg vein, hearts with metal coils coming out of it, but I’ve never seen one unscathed. I’ve seen hearts looking very healthy, sure, but beyond that pristine appearance is someone’s life, something that is never gentle. They can have the most beautiful looking trabeculae carnea but I know their cordae tendinae must’ve been put through the ringer at some point or another. That something must’ve happened that made them clutch their chest and curse that beating object.

In the anatomy lab there would be 10 hearts just sitting there, cold and wet, side by side, on a metal table for us to pick up and examine. It’s true that you become immune to the absurdity of the anatomy lab with the cadavers and dissections as time goes on, but all I could think about when I saw those hearts was the lives that each one had lived. 

What had hurt their heart the most? What had made it skip a beat with joy? What had it carried their donor through?

Despite learning about heart failure no less than 600 times this semester, I don’t actually think I’m any closer to understanding the deeper mysteries that the heart carries. I think the answers I am looking for lie outside the anatomy lab – in literature, life, and in making mistakes.