Don't Go Breaking My Heart

Ben Bryner -- Around Valentine's day you see pink heart shapes everywhere, symbolizing love and all kinds of warm feelings. But of course, the heart is actually entirely unsentimental -- beating constantly and relentlessly, billions of times over a lifetime. It's the hardest-working part of the body -- the James Brown of organs. The shadowy, impossible mysteries of the brain, the alien squirming of the gut, the intricacies of the eyes -- these are all fascinating, but the brute force and dedication of the heart make it quite impressive. It's hard not to be struck by the heart when you see it up close. I remember being particularly impressed during a dissection of a pig's heart in a high school biology class. Dissecting the heart was one of the most rewarding parts of our gross anatomy class in the first year of med school.

But (again like James Brown) seeing it perform live was a whole different experience. Last year I watched a CABG (coronary artery bypass graft, or "cabbage"). The whole procedure was very interesting, but the most amazing part of the whole spectacle was at the beginning, right after the surgeon opened the chest. He sliced through the sternum and parted the bony halves, revealing the heart pumping away with incredible force. I hadn't expected to see it contracting so violently; it looked like a wet towel being wrung out over and over, but without any hands doing the wringing. I'm sure a sternotomy is something you get used to seeing if you're in that line of work, but to a newbie it was pretty impressive. It was hard to believe my own heart was working that hard under my layers of gown, scrubs, skin, and bone. I resolved to treat my own heart better from that day forward.

That said, I'm not planning on going into cardiology or cardiac surgery. There's a difference between finding an organ system academically interesting and actually wanting to work on that system for the rest of your life. The nervous system is endlessly interesting, and before medical school I thought I might end up in one of the specialties that deal with it. But when I got actual exposure to those fields in the third year, they just didn't feel like the right place for me, despite the fact that I worked with some great people on those services. (Since I can't do everything, I feel fortunate to have found something I am really interested in, as well as to have found lots of fields that I'm not interested in going into.) Of course, you certainly need to know a lot about cardiac pathology and treatments to be a good doctor in any specialty. But I'm happy being impressed with the heart from afar, not from inside the cath lab or the cardiology clinic. Also, the idea of treating my own heart better hasn't really panned out. I ate way too many heavily-frosted sugar cookies this week, all of them shaped like little hearts.