[by Adair V]
Seminar Title: “Works of Heart: Literature and Medical Humanities”
Guide: Lois Leveen
The Wet Engine by Brian Doyle
The Heart by Maylis de Kerangal
The idea of “heart” permeates our lives, so ubiquitous we’re hardly aware of it, kind of like our own heartbeats. It’s at the center of how we feel, how we sense and experience the world, what it means to love, to have courage, to grieve and to experience spontaneous joy. It’s said we are each blessed with only so many possible heartbeats. Like any other machine, the heart can wear out.
One way to get to the heart of any matter is to approach it from all directions. Lois Leveen is one of DELVE’s most experienced guides. She is a novelist and an expert in medical humanities, a field that focuses on how content and approaches from the humanities can shape our understanding of wellness, illness, health care, and the end of life. She’s selected an eclectic range for Works of Heart, including a novel, short stories, personal essays, a selection of poetry, news items, short videos, art websites, and more. In all, there’s a tension between heart as a metaphor for our humanity and heart as the anatomical organ that throbs within each of us.
In the19th century short stories by Edgar Allen Poe (“The Tell-Tale Heart”) and Kate Chopin (“The Story of an Hour”), the physical heart underscores the way we’re accustomed to view it as a metaphor for psychological states. For Poe, the beating heart pounds in the mind of the narrator, in a heightened awareness of a crime just committed, which is then projected onto the police who arrive by chance. Chopin’s story chronicles the emotions of a young wife on being told of the death of her husband. In this case, the woman’s family and friends make assumptions about her feelings, misinterpreting her reactions according to the conventions of the day. The collapse of her “heart” is similarly misinterpreted. These two stories served as our introduction to Works of Heart.
The selection of contemporary poetry we read is less about the psychological and emotional dimensions of heartbreak and more about literal heart ailments. The emphasis is on the physical — autopsy, transplants, blood types, heart attacks, murmurs, the pump that keeps us going. In “Heartsounds”, the poet Glenn Colquhoun slices through the divide. Each section in this poem uses language and rhythm to reflect different heart conditions. For example, The heart batshereyelids at a boydemonstrates sinus arrhythmia. The heart/ bangs/ like a door/ in the wind at/ the/ back of/ the housemimics atrial fibrillation. And The heart makes the whine of a kettle that has begun to boil./ Somewhere else tea is getting coldimitates the sound of a-systole.
In the novel The Heart, Maylis de Kerangal underscores what it means to be alive and what it means to be dead:
…[it] was like a cluster bomb exploding in slow motion: the moment of death is no longer to be considered as the moment the heart stops, but as the moment when cerebral function ceases.
This shift in how the medical world — and ultimately how we — have come to determine the moment of death heralded the era of transplants. This is de Kerangal’s focus: she dissects every moment of a heart transplant, from the tragedy that precipitates it, the stunned grief of the patient’s family and the awkwardness of friends, to the skill, competitiveness, ambition, and humanity of the medical team that huddles together to bring about a miracle.
Each of us carries the potential to save the lives of others. Considering this, questions about ethics abound: What obligation do we have to designate in advance our wishes should we ever be in an accident that makes donating organs a possibility? In lieu of such a designation, what responsibility should family members have to decide? What about privacy issues? Should the one who receives an organ be in contact with the donor’s family? How best should a doctor approach difficult conversations about life and death? What are the impacts? What about the economics of medical advances? Public figures like Bill Clinton and Barbara Walters have benefitted by heart procedures and spoken about their experiences publicly, extolling the need for regular examinations to save lives. This begs the question: what about those who can’t afford the exams or the procedures?
Carrying around the heart of another is a might responsibility. Those who receive transplants are left wondering, Where do I begin and the donor end? How do I honor the fact that in order for me to live, someone else had to die? Given this second chance, how do I live a better life? One recent initiative reunited transplant recipients with their former diseased organs. In 2014, William Roberts, the chief cardiac pathologist at the Baylor Heart and Vascular Center began the Heart-to-Heart program, initially for the purposes of education. However, patients were overwhelmed — both by the loss they felt and by a renewed sense of blessing.
Personal stories reveal much about how central the heart is to how we carry on. The selection of readings depict a range of experiences. Debbie Reynolds died one day after the death of her daughter Carrie Fisher, and our collective imagination assumes it was because of a broken heart. In a New York Times article from 2010, Katy Butler considers how saving her father’s life by installing a pacemaker ended up destroying her mother’s. The pacemaker was designed to keep her father alive long after the rest of his body — and mind — deteriorated. Her mother went from a vibrant middle-aged woman to the weary caregiver of a beloved husband who was no longer there, the victim of stroke and dementia with a ticker scheduled to last many more years. Adina Talve-Goodman considers her transplant in the personal essay “I Must Have Been That Man” in which she acknowledges a keen sense of blending self with other.
I’ve only touched on a few of the many narratives we read. The multi-dimensional approach, reading a variety of perspectives across genres, served the topic well. And, guided by the lively and knowledgeable Lois Leveen, each week brought spirited discussions full of insight, care and humor — participants as full of heart as the texts we considered.