My heart beats…

The stunned look on Science’s face said it all.  There were tears of pride, awe, surprise and gratitude.  His children had just found a way to replace the human heart!  After decades of trying to help man heal his heart, finally they had found a way not just to repair the existing one but to completely replace it with a new mechanical one!  This was so close to the feeling of overcoming death that Science was bewitched by his own powers.

God gently tapped Science’s shoulder

God:  Feeling all powerful eh?

Science:  (With tears) No Father!  Feeling humble!  The human heart is a miracle and several decades of trying to replicate it had all been in vain, until very recently. 

God:  What made it so challenging to spend so many decades on a simple heart?

Science: Every time my children tried to imitate the lub dub of the heart, they found no machine could actually work continuously for more than 5 weeks.  Yet the actual heart beats on an average 35 million beats a year!

God:  And it will continue to beat for as long as the human is alive…

Science: That is the miracle Lord!  The heart beat – the spurts of pumping deoxygenated blood from the body to the lungs to be infused with oxygen, the lub; and then drawing the good blood back into the second chamber and pumping it back to the body – the dub; was so difficult to copy.  How to make a pump that works in spurts?  One of the first machines man created to assist the heart was the Jarvik-7.

God:  Hmmm…  Your experiments are very interesting and I would love to hear more.  But I have a question before you proceed.  Did that replacement heart actually work efficiently for that first patient without any maintenance?

Science:  That is the irony Father!  The Jarvik-7 was so cumbersome that the man managed to survive 120 days on it but there wasn’t much else he could actually do. The very process of wiring and keeping his blood flowing through the mechanical heart deprived him of the ability to do anything else. 

God:  Every human being knows that all man-made machines need maintenance.  They take enormous measures to service and keep their toys well running.  Pity, they don’t even consider a few moments to invest on what I have gifted them – the human body.

Science remained silent. The father’s words were so true.  Man spends inordinately long time and resources to maintain all the machines he has invented.  Annual maintenance contracts were considered deferred payments.  They were recognised by businessmen as protecting the future.  And yet no practical methods are largely practiced to ensure optimum functioning of the human organs!

God:  Please continue… Have your children found an alternate to the ‘beating’ heart?

Science:  Yes Father!  We were unable to make a machine that could imitate the lub dub flow of blood in spurts of the human heart.  So in an inspired moment they decided to see if a continuos flow pump can be used.  After all pumps are what man has used for several centuries!  So they have designed a ‘Continuous flow’ blood pump.  The stunning part is that now man can live without a heartbeat!

God:  So how does this actually work?

Science:  The 10,000 rpm no-pulse artificial heart does not resemble the organic heart Father. It is made of two grey metal cylinders — turbines, each the size and shape of a saltshaker—connected to each other by white tubing.  Attached to each is a white cone made of a spongy rubberised cloth. 

God:  Why two turbines?

Science:  Initially, it was not designed to replace the heart.  It had only one turbine and it was invented to assist the heart.

God:  Assist the heart in what way?

Science:  In the 1980s when it was first invented, the machine was actually a Left ventricle assist device LVAD, to help the heart push blood throughout the body.  The right ventricle that pushes blood to the lungs for re-oxygenation was left to the original heart.  This machine however wore out very quickly and needed too much maintenance.

God:  So how did they arrive on this model of a continuous flow?

Science:  Richard Wampler a surgeon and engineer watched Egyptian villagers use an Archimedes’ screw to pump water from a well.

God:  Hmmm… The third century B.C. invention that lifts liquid using a simple auger in a pipe as it turns…

Science:  Wampler patented a device to move blood through the body without a pulse using an Archimedes screw.  Bud Frazier, a renowned heart surgeon had by then realised that pumping blood in spurts was the actual issue to find a substitute for the heart.  Both of them began work together and a NASA engineer Davis Saucier helped design an archimedes screw and motor small enough to fit a person’s chest. The Heart Mate II – an archimedes model continuous flow blood pump was launched in 1998.  It was meant only to be a Left Ventricle Assist Device (LVAD) and not a replacement heart.  Nearly 11,000 people across the globe have benefitted by this device.

God:  That must have looked like a big blessing for people with a heart condition! But did the continuous flow not cause any other unforeseen effects?

Science:  We were worried about its impact on the Lymphatic system.  As you are aware, unlike blood, the ducts that move lymph through the body have no motor of their own. They surround arteries and get their motion from the pulse of the blood.

God:  Hmmm…  That could be a cause for concern without a pulse.

Science:  But thankfully, so far we haven’t found any evidence that continuous flow creates problems with the lymph. The LVAD has proved to be a blessing. It reverses heart failure!  Until the past few years, damage to the heart was thought to be permanent. But it seems that by relieving the strain, an LVAD helps some hearts damaged by heart attacks, repair the wall tissues and grow healthy again. Often the LVAD can be removed at a later date.

God:  You do realise that the ‘growing healthy’ part is intrinsic to the heart and not instigated by the machine, right? So how did an assist device replace the original heart?

Science:  On one occasion when a patient had been planted an LVAD support for his left ventricular action, his heart slowly retired and stopped beating.  The machine automatically took charge, doing all the work: not just helping the left ventricle push oxygenated blood to the body, but pushing the blood hard enough to flow through the body, then back through the useless heart to the lungs, through the useless heart again, and into the pump to complete the loop and begin the process all over again.  So Dr.Bud Frazier and Dr.Billy Cohn, another expert at the Texas Heart institute, are now trying to introduce two turbines – one to do the job of the left ventricle and the other to do the job of the right.

God:  So how does this LVAD machine run?  Doesn’t it also need maintenance?

Science:  It runs on a battery the size of a video cassette which can be worn on the patient’s shoulder.  It most certainly needs to be looked after!

God:  (Almost in a whisper) Wonder what will happen if the battery comes loose…

Science:  It did Father!  One of the patients’ who were connected with a continuous flow artificial heart was explaining to her cousin how it works. The cousin disconnected the battery by mistake.  Even as the patient screamed ‘you cannot do that’ she passed out.  On such occasions the device rings an alarm and the cousin thankfully connected it immediately. 

God:  That must have really spooked her! 

Science:  The impression was almost like rising back from the dead.  Reminded me of the Tin man in the Wizard of Oz crying to get a real heart. Only here it is reversed – the human getting a ‘tin’ heart for support! 

There was a poignant pause. Science now had to ask what had been occupying his mind all along.

Science:  So Lord, what really is death now?  If the human heart can be replaced,  man can live without a heartbeat, does he now need to redefine death as that which causes his brain to stop functioning?  The cessation of cellular growth… What is it?

God:  Why are trying to re-define death my child?  You should be trying to re-define life!

Science remained silent.  What did he really know about life?  It was true that in the process of defying death, or at the very least delaying death, his children had come with so many different mechanisms to keep the sick alive.  But in what way has man really worked to enhance living life?

God:  My dear, in this huge universe, life as you know it appears only on planet earth. Do you ever wonder why?

Science:  (With a self conscious grin) Actually all the time Father!

God:  (With a smile) Good! Because, what you see around and perceive as life ‘only on planet earth’ is actually life ‘limited to what you perceive’.  To you life seems to be defined as ‘not yet dead’.  So you go about trying to delay the inevitable.  Every endeavour has become working towards avoiding disease, studying the causes of death, protecting your life interests in monetary ways.  But my dear, life is all about enhancing the sense of being alive!  Every atom in this Universe is alive and in tune with my cosmic dance!  Time you stopped worrying about clinging on to your perception of avoiding the inevitable ‘death’ and begin instead to perceive the potential of life.  By the very process of living you avoid death.  Indeed, my heartbeat is diverted to you in little pulses.

Written by Gita Krishna Raj  |  Published in infinithoughts in September 2012

When Science met God… |  Segment Four: The dance of a trillion cells

Chapter Seven: My Heart beats…

Browse through these...

For my sake…
The conclave had just begun.  There was an air of restless tension in all the members.  Those in charge of the meeting were trying hard to maintain control and order. ...
It’s all about ME
Life is such a paradox. On the one hand being selfless, being in service to others, is considered the greatest virtue. And yet, with the world being such a subjective...
Reversing Age
“I feel like I am falling apart” whispered the woman. She was hardly 45. But somewhere along the way of making a living she had forgotten to actually live. A...