BOUND TO PLEASE / Cardiologist prescribes emotional healing for your heart

The Yomiuri Shimbun

Tom Baker / Japan News Staff WriterHeart: A History

By Sandeep Jauhar

Farrar, Straus and Giroux, 269pp

You are at risk of heart disease. So is everyone else. Heart attacks are “the most common cause of death throughout the world,” according to New York cardiologist Sandeep Jauhar.

Fortunately, there have been revolutionary improvements in heart medicine over the past century, as Jauhar describes in his book “Heart: A History.” He also sheds light on the emotional factors that can literally cause hearts to break.

You already know that being a smoker or a couch potato is bad for your heart, but Jauhar writes that stressful jobs and unhappy marriages also contribute to heart ailments. He cites a study that found that “psychosocial factors, including depression and stress, were as strong risk factors for heart attacks as high blood pressure and nearly as important as diabetes.”

An ailment called takotsubo cardiomyopathy, for example, is a temporary but dangerous heart deformity seen in the aftermath of traumatic experiences. (Its name comes from the idea that the heart, swollen at its bottom, resembles a Japanese takotsubo octopus trap.)

“Heart” is divided into three sections, treating the title organ as “Metaphor,” “Machine” and “Mystery.” The middle section is the longest and most exciting, as it describes doctors and engineers figuring out how to fix the machine. It sometimes gets technical, but Jauhar writes in a clear and anecdote-rich way that is almost always easy to understand. (I do confess to being confused by a couple of pages on “spiral waves.”)

Hearts beat. But for surgeons to operate on one, they need it to lie still. The heart-lung machine, invented by surgeon John Gibbon in the 1950s, takes blood out of a patient’s body, oxygenates it, and then pumps it back in, thereby allowing doctors to stop the heart without killing the patient.

Gibbon tested early versions of his device on stray cats that he and his wife “plucked with tuna fish bait and a gunnysack from the streets of Boston.”

If that sounds distressing, consider the human lives saved. Thanks to Gibbon’s invention, “The mortality for cardiac surgery dropped from 50 percent in 1955, to 20 percent in 1956, to 10 percent in 1957.”

Another major breakthrough was the invention of the implantable pacemaker by engineer Wilson Greatbach. An early version “was sealed with electrical tape, so body fluids caused it to malfunction after a few hours. ‘The warm moist environment of the human body proved a far more hostile environment than outer space or the bottom of the sea,’ Greatbach wrote.” As part of his efforts to overcome this challenge, “Greatbach invented the first long-lasting lithium battery.”

In another case of an invention having beneficial side effects, the developers of the electric defibrillator stumbled upon the basic concept for CPR when they noticed that simply pressing defibrillator paddles into position on a patient’s chest — in this case a laboratory dog — was enough to cause a slight rise in blood pressure.

Today, many heart patients go about their lives with implantable defibrillators roughly the size of a credit card inside them.

Amazing as that is, Jauhar thinks heart disease treatments may be near the limits of their potential for improvement. The focus now, he says, should be on prevention.

So, eat well, exercise, don’t smoke, and be kind to the people around you. It’ll do your heart good — and theirs, too.

—Tom Baker

Japan News Staff Writer

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