23 April 2015 "The Body's Powerhouse"

The human heart is the body’s strongest organ. Typically the size of a fist, it pumps blood in and out of every organ system, beating and continuing circulation for the entirety of a person’s life. It’s beautiful, really. That an entire body can be dependent on one rhythmic motion, much like the beach depends on the rhythmic waves of its ocean. In the world of medicine today, one can survive without parts of the brain, with no pancreas, with part of a regenerating liver, even without all bones or skin, but a person cannot ever survive without a functioning heart.

            As the center of blood circulation in the body, the heart regularly pushes oxygenated blood out to the body’s organs and takes in deoxygenated blood to be re-oxygenated. It does this from the aorta while simultaneously taking in circulated blood through the superior (blood from head, arms, and upper body) and inferior (blood from the lower body) vena cava.

If these arteries at any point become so blocked that blood can no longer pass through them, the heart will no longer be able to receive oxygen and parts of it, if blood flow is not quickly restored, will begin to die. The heart is vulnerable in this way. Without a connection to the rest of its body, the heart, like the living organ it is, cannot survive. Of course, when the heart dies, the rest of the body has no chance. But without feeling its body, without a connection, the heart cannot live either.

When questioned about the heart, most people will describe the empty shape we are taught to draw in pre-school. They will picture it as red or pink, and most likely will mention Valentine’s Day. It’s simple: when we think of the heart we don’t consider it as an organ, we remember it as a symbol. We connect it with the color red, but not with blood. The heart represents love between people, but not the love between an organ and the body it sustains. It’s unfair, really, because the heart works tirelessly. It spends every second of its life beating constantly and singlehandedly maintaining a life, and yet for some reason we don’t naturally connect it with power or with incredible work ethic.

One irony of recognition of organ importance in the body is that many people believe instead of the heart it is the brain that marks the core of a person. The truth is that the brain has almost no part in maintaining life, at least not in the way the heart does. But perhaps since memory and perception and understanding are more or less contained in this fragile area, it is somewhat fair to say that the brain is an important piece of what makes a person who they are. The brain, after all, tells the body what to do and who to be. However, the overarching fact remains that the brain is one of the most fragile organs of the entire body. It takes a short four minutes without oxygen for the brain to suffer permanent damage. Mere seconds longer and a person will likely lose function of the brain entirely. The most important thing to remember is this: take away the heart, and the brain is asphyxiated. And yet, for a time, take away the brain and the heart will beat uninterrupted.

            When a person’s brain dies, the heart diligently keeps every other organ alive. But it cannot do this forever. The heart must have a purpose, a reason to keep beating. If the life it sustains feels disconnected, such as a life with no function other than organ survival, the heart will tire itself out, eventually giving up entirely. When the brain is no longer there to tell the other organs what to do, the body will begin to naturally shut itself down. The heart can live forever, but only in a forever alongside its living, breathing, thinking body. This is the reason heart transplant surgeries are so universally successful: when the heart is given new purpose it is invigorated. It beats with overwhelming motivation.

Cardiothoracic surgeons are born with heart disease. Figuratively, of course: it is with the chest that their passion for surgery is consumed. The responsibilities of a cardiothoracic surgeon lie in the heart and lungs: the very core of a body’s survival system. Working together, the heart and lungs pump oxygen to and through each other. The lungs cannot survive without blood from the heart, and the heart cannot survive without the oxygen provided by the lungs. This is why CPR is the most commonly taught rescue method to professionals and laypeople alike. It is why most public facilities require the presence of an AED machine somewhere on the premises. It is why a person complaining of chest pain always becomes top priority in an emergency room. If you want to save a person’s life, you must save the heart first.

             Car accidents are one of the most common causes of brain death. It’s a surgeon’s dream and nightmare at the same time when a patient is reported as brain dead; a life is gone, but from the tragedy comes the opportunity for a miracle: transplant surgery. During a transplant, an organ is given another chance at life. Taken from its old body and put in a new one, the organ not only gets to live, it gets to save a life. Failure of an organ is tragic, but its significance pales in comparison to the magic of organ replacement surgery.

Heart transplants are one of the most common surgeries performed by cardiothoracic surgeons. Typically done for patients with end-stage heart failure, the procedure involves the removal of a diseased heart and the replacement of it with a donated, healthy heart. The procedure is approached as a last-resort: only if a patient absolutely cannot survive with his own heart any longer is he able to receive a heart transplant.

            The transplant is officially complete when the donor heart starts beating. In tune with the rhythm of its new body, the heart takes on its new purpose and begins pumping blood regularly—as if it never stopped. Forgetting all of its body before, the heart is consumed with its new task, falling in love with its new connections. When a heart transplant is successful, a patient wakes up feeling invigorated. Someone who may have been chained to a hospital bed for years of waiting for a donor can often walk out of the hospital in as little as one week after a heart transplant surgery.   

            But sometimes the body and heart do not accept each other. It’s a tragedy known in transplant surgeries of all organs—it is the killer without a cause. An organ can be perfect in every way on paper, but when put in its new body, it simply will not survive. The connection is not formed, and if it remains that way, the heart will wither and die, taking its new body with it.  

            It is a tragedy like no other when a transplanted heart refuses to start beating. Surgeons do all that they can to coax, encourage, and inspire it, but sometimes the heart simply refuses. An organ must be discarded forever, and only because it refused to live and beat again.

             

"About Heart Attacks." About Heart Attacks. N.p., n.d. Web. 01 Mar. 2015.

Lewis, Tanya. "Human Heart: Anatomy, Function & Facts." LiveScience. TechMedia

Network, 07 Jan. 2015. Web. 23 Feb. 2015.