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The paradoxical heart

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Over the past couple of Sundays I have attended a first aid training course. Great trainer – we had lots of laughs along the way. But it was time well spent.

Not only was I able to earn professional development points, but it was a great refresher for things like CPR (resuscitation) that I first learned a long time ago as a medical student and put to good use as a junior doctor. Happily I have not had any occasion to use it for many years now.

In all that time there has been a slight variation in protocol – the number of breaths to compressions is slightly different, hands are held with fingers intertwined not just on top of each other. But other than that CPR hasn’t changed and my muscle memory kicked in and I could do it just fine. I was the frantic junior doctor once again.

I was reminded of the time I resuscitated one of my patients back in the days when I was an intern in Concord Hospital. I remember so clearly the nurses telling me Mrs D was looking strangely blue. She was strangely blue indeed. My training kicked in instantly. I called an arrest and in the intervening few minutes before the designated arrest team arrived with the defibrillator I kept her alive, but managed to crack all her ribs in the process.

Later her surgeon came to thank me for saving her life. This was a huge moment. It was extraordinarily rare for a surgeon to thank an intern. But when Mrs D had recovered and was leaving hospital it was the nurses who got the chocolates. I don’t think she was very happy about the broken ribs.

Interesting flashback. But as we reviewed how the heart works, it struck me just what an interesting and paradoxical organ it is. We depend completely on it for our survival. Yet in the very process of giving life to us it takes first for itself. The heart in its way is supremely selfish.

With each pump of the heart, as it pushes oxygen rich blood around the body, the heart takes from the rest of the body and channels off blood into the coronary arteries to feed itself.

And it’s a good thing too. If the coronary arteries can’t give enough blood to the heart, the muscle dies. That’s essentially what a heart attack is. In a heart attack, one or more of the coronary arteries become blocked and not enough blood gets to the heart and the heart muscle begins to die.

So in taking from the rest of the body, the heart is actually giving to rest of the body. It’s not selfish at all. For without the life and health of the heart, we can’t have any life at all.

So it struck me that we need to be the heart in our own lives, just like the heart in our body. Whether we are parents, carers, partners, whatever role we play in the world we need to emulate the selfishness of the heart.

It can be easy to neglect ourselves in the process of giving to others. It can seem selfish to give to ourselves first. But like the heart, giving to ourselves first is not selfish, but necessary. Giving to ourselves first (in the right amount of course) enhances our ability to give to others. We can do and give much more if we are nurtured and healthy ourselves than if we are burnt out and exhausted.

So think about the paradox of the heart taking so it can give. How can you build that into your life? Think what small things you can do to look after yourself so you can keep on giving.

It might be getting extra sleep, eating better, exercising, meeting a friend for a coffee.

Whatever it is, do it…and do it with joy. And then you’ll be like your own heart, paradoxically supporting yourself and supporting those around you too.

 

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3 Comments

  1. Rob Burnside

    A great post, Dr. J. I couldn’t read it without thinking of another Dr.J, the late Jose Manrique a fine cardiologist and teacher who introduced my paramedic class to rhythm interpretation.
    Like you, he made a character out of the heart itself (I believe you writers call it “personification”) and entertained us while he educated. As a result, this fairly complex subject was much easier to grasp, and actually fun. I’ll never forget his lilting pronunciation of terms like “paroxismal atrial tachycardia with block.” And I can still tell you exactly what it is today–thirty-five years later. Your personification of the heart–and the lessons it holds for us– is equally memorable. Now, if I can just get another thirty-five years….

    • Thank you Rob. What a lovely comment. Great teaching moments are certainly memorable aren’t they.

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