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The Heart of the Matter
James P. Hall

From “Fast Times at Ridgemont High,” you recall of course Jeff Spicoli’s reaction to one of Mr. Vargas’s laboratory lessons on the human body—memory fails me as to what system Mr. Vargas was showcasing on the day in question—but Jeff’s loud response was “Gnarly!”

Spicoli’s classmates displayed similar reactions, many recoiling in disgust, turning away and putting their hands to their mouths.

What lessons like Mr. Vargas’s bring to light may be our general ignorance of what our innards are like. Perhaps the problem is our skin. If it were translucent we could see into ourselves readily, and over time not respond with “Gnarly!” at what we see inside ourselves. Because we can’t see in there, at least two things happen: first, we naively assume that everything is ticking along the way we’d like it to, and second, we don’t take the time to learn how we can keep everything ticking along the way we’d like it to.

When our vehicles accumulate 100,000 miles, we consider that quite a milestone. When we search for vehicles online, we may filter our search to rule out any vehicle with more than 100,000 miles. The assumption is that having traveled that far, the vehicle may have limited life left in it. Of course we add the caveat that if a 100,000-mile vehicle has had good care, it may well travel another 100,000 miles with few problems.

Our hearts beat 100,000 times per day, 36,500,000 times per year.

Let’s just say that again.

Our hearts beat 100,000 times per day, 36,500,000 times per year.

Now when our cars give out, a variety of things can be done (most of the time), to make them roadworthy again. Even the word “totaled” doesn’t really mean that a car cannot be made roadworthy again, just that it would be proportionately more expensive to accomplish this than it would be to replace the damaged vehicle.

It’s sort of that way when our hearts give out. Some of the time. Midway through my brother Bob’s 48th year, he went out to play golf one day, returned home late morning, collapsed on the living room floor and died of a massive heart attack.

But sometimes the results are not so final or dramatic. We can discover signs that all is not right in there with our hearts, and take them into the shop for repairs—so to speak. Again, if we could just see in there, this would be so much simpler.

But failing that, we rely on tests and resulting diagnoses to make ourselves aware that all may not be well in there. Sometimes we can actually feel that all may not be well, and often after much reluctance and denial, take ourselves to the doctor to find out for sure.

That’s what happened to me. I thought that I was just getting old. I got out of shape. I got tired very easily, but I assumed that—of course, it was just age. But I finally realized I shouldn’t be aging as quickly as I apparently was! Our property slopes pretty severely from the back of our house down to some woods. Doing yard work, coming back toward the house from the lower part of the property, I had to sit down for a moment to catch my breath. Then I had to sit down more than once to catch my breath. Then I had to lie down.

I went through a typical battery of tests to discover what the problem(s) could be, and we discovered that there was a fairly severe blockage in my left anterior descending coronary artery. I learned that this artery is critically important; should it become totally blocked, the prognosis is not good. As in, prepare the tag for Jim’s big toe.

So twenty-two months ago I had heart surgery. It was accomplished with the aid of a robot. Rather than cracking my chest open and moiling around in my chest cavity, my surgeon—at least for a goodly part of the process—sat at a console and operated controls which manipulated instruments capable of very precise movements.

He performed what’s called Coronary Artery Bypass Grafting (CABG) surgery. This consists of first finding a suitable artery in my chest cavity that could be used to bypass the blocked part of the coronary artery. Today—as in my case—this is often the left thoracic (mammary) artery. The surgeon dislodged and severed a chunk of this artery, and grafted it onto the coronary artery. One end of the mammary artery section was attached to the coronary artery below the blocked part, and other to the coronary artery above the blockage. The surgery was supposed to last three hours, and it lasted six.

For that time, my heart and lungs were stopped. I was connected to a machine that supplied my body with oxygenated blood. Not really a comfortable thought, but of course I was sedated and completely unaware that this was happening. Sometimes robotic surgery can be accomplished “off-pump,” in surgeon-speak, but I was definitely “on-pump.”

When my beloved wife Marsha and I first spoke to the surgeon about the procedure, we were comforted by his saying that this was considerably “less invasive” than the afore-mentioned chest cracking. A small incision between the ribs, the robot “hands” go in, perform their magic, the little incision gets sewn up, and the next morning, back on the handball court.

Of course that’s not what he said, but that’s pretty much what I concluded.

I had planned to have the surgery over my college courses’ spring break (I teach writing at a community college) and perhaps miss one additional week following the break.

That didn’t happen. I was pretty much flat on my back for three weeks, except the medical people don’t let you lie flat on your back. I was up and walking not long after the surgery. Well, “walking” is something of a misnomer. It was more like “shambling,” or perhaps “creeping.” I had the surgery on a Friday morning and was released the following Monday morning.

I’m convinced that the CABG method is indeed much less invasive than the traditional approach. But, gentle reader, it is not your standard walk in the park. Your innards are seriously manhandled (robot-handled) over a period of several hours (even though you’re “on-pump”), and I learned that you just don’t come back from that very quickly. My recovery was delayed through, of all things, “night terrors” or severe panic attacks that I experienced in the first week or so following my surgery.

Simple things were extremely difficult, like the aforementioned shambling/creeping. Poor Marsha had to bully me into walking the pitifully short distances I was able to walk in the first days of my recovery. One of the worst things was showering. I would get so cold. I had to take elaborate precautions to make the shower experience as brief as possible. I’d stockpile clothes and towels in the bathroom, and shiver myself into them after the shower.
But you will be pleased to hear that all turned out well. I feel unbelievably healthy these days, ancient though I may be. Yesterday I went to our local high school’s track, in still-frigid temperatures, and walked and ran four miles in one hour. Not speedy, to be sure, but a wondrous change from the shambling and creeping. This last Fall I completed a massive landscape project at the front of our house that consisted of much shoveling and lifting, many trips with a wheelbarrow to the bottom of the property and back. No stopping; certainly no sitting or lying down.
Our hearts beat 100,000 times per day, 36,500,000 times per year.

Our hearts are our power plants. If we were cars, our hearts would be the engines. As you know, internal combustion engines require air and fuel to operate effectively. They need the proper mixture of air and fuel. The guy at the oil change place is always bringing us the gnarly (sorry) air filter, usually at arm’s length, afraid to get the filthy thing next to his body—and he tells us, “You need to change this out.” And, since we believe everything he tells us, we do. Much like a coronary artery, if a fuel line becomes blocked, the engine stops.

The air filter doesn’t actually supply air; it cleans the air your engine needs to work properly. The engine, in effect, needs to breathe. So do you. When surgeons talk about “re-vasculating” parts of our damaged hearts and other organs, they’re talking about clearing the channels (arteries) that bring re-oxygenated blood to all systems of the body. Anything that affects the supply of oxygen to the body is critical to health. Should we talk at length about heart health, I would talk to you about smoking. Stop it. It killed my brother (he was a 2-3 pack a day person for more than thirty years), and it will kill you.

The more weight our cars have to carry, the more strain we put on their engines. We also put more strain on their suspensions, literally on what we could call their structural integrity. What that means is that God designed us to carry an optimum amount of weight on our respective frames, and if we exceed that amount by a significant degree, our entire human system is stressed—from our hearts and lungs to our muscular/skeletal systems. To our joints; perhaps to those knee joints especially.

Will you please remember this? Will you please become as diligent about taking care of your heart and your body as you are about taking care of your car?

You want to get as much mileage as you can out of your car. The same holds true of your heart and body. This is not complicated; it’s the same thing your health teacher told you in the seventh grade. Maybe you can still find that textbook: eat heart-healthy food; stay away from fast food; get to the doctor regularly; exercise; lose weight.

Most of us go through many cars in the course of our lifetimes. Some of us may be lucky enough to get another heart should we need one, but this is a long shot. A much better option is to take care of the ones we have.

I only had the one brother. We were only 23 months apart in age. I miss him a lot.

3 Responses to The Heart of the Matter

  • I recently attempted to run like I had been in the summer. A harrowing reality. I have not been actively health conscious in a bit. I needed this read. Thanks for the insightful reminder!

  • Brother Jim,
    Quite an interesting comparison. I always tried physically to be like “somebody” never thinking I could just as easily be like “some thing” (a car). Great analogy. I really can relate to the seventh grade health lesson as I used to teach exactly that! But one little footnote; although everything you have written is true .In my current profession I have found that sometimes genetics overrides some who do and eat all the right things and are OH SO FIT! Keep up the good work. SKM

  • Jim this is an excellent post. Our bodies are amazing but they rely on us to take care of them. The realities of what is going inside us coupled with your personal story made for a powerful read. I appreciate this detailed and inspirational post. Well told. I am happy to hear that you are feeling good and have regained your health! Cheers to your amazing healthy heart and good wishes for sustained health and optimal functioning!

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