Each month, Esquire commissions an unsparing inspection of Will Self ’s body. This month: the heart
This month, the award-winning writer’s anatomical survey is an affair of the heart
my brother was in hospital last week for something called catheter ablation. He was under a general anesthetic for 10 hours, during which catheter-borne electrical gizmos were stuffed up the arteries leading from his groin to his heart. When they got there, the gizmos began zapping (or “ablating” as it’s known technically) the cells in his heart that have run amok, and are causing it to beat irregularly. My brother has been suffering from chronic cardiac arrhythmia for a number of years, and it’s a testimony to just how stoical he is that he takes this “procedure” (as it’s predictably euphemised) in his stride. I very much doubt I’d be as sanguine: indeed, the thought of anything at all going wrong with my ticker fills me with what one of my sons once described — aged four — as “the death feeling”.
Ach! Kids! Don’t they say the funniest things, especially before they’re old enough to feel Death’s bony digits poking between their own ribs. This being noted, for men of my age, class and nationality, the headline news on the heart — and all matters cardiac — has been consistently good for the majority of my life. True, during my childhood, to call a middle-aged male myocardial infarction a “heart attack” was something of a misnomer; a cardiac cliché would’ve been closer to the truth. What with their diet entirely comprising unsaturated fats, and their Mad Men-esque intake of booze and fags, for men of my father’s generation, the daily commute to their desk jobs was a veritable sniper’s alley. I remember seeing them most mornings, lying spasming on the pavement as I passed them on my way to school, tightly-rolled umbrella and copy of The Times cast to one side, their leather shoes kicking feebly at the privet hedges’ understorey.
OK, I’m exaggerating — possibly for comic effect; but not much — the number of deaths from heart attacks really was staggering in those days, as they manifested around the world in a great Mexican wave of up-flung arms and downturned faces. First, rates picked up along the Pacific seaboards of Australia and America. Next, they rose across the rest of the continental USA, before, in the late Sixties, leaping the pond to plague Britain and western Europe. Indeed, “plague” may’ve been no metaphor: I remember chatting to James Le Fanu, the contrarian medic and writer on matters unhealthy at some cheesy, winey do — it must’ve been around the time heart attack rates began declining in the UK and increasing in eastern Europe. Vigorously munching on a root vegetable crisp dipped in something polyunsaturated, Le Fanu had fulminated: “All this stuff about fat and heart disease, it’s a typical case of statistical correlation, but no proof of causation. Whereas, if you examine the actual epidemiological data — the way the disease has spread geographically — there’s a strong case for some sort of virus being implicated.”
An intriguing idea — it’d be almost like finding out cream-stuffed cannoli were good for unblocking your own little tubes — but I’ve heard no more about it. There certainly aren’t signs up in my local chemist, inviting the over-fifties to stop by and get inoculated against heart attacks. What there have undoubtedly been is plenty more transplants, bypasses, ablations and other sorts of procedure that remind one — rhythmically, insistently — that the heart is the most mechanical-seeming of the major organs: a two-stroke engine of a body part, putt-putting away at 60–100bpm, and thereby powering the entire odd-wobbly bubble of each individual human existence.
Dr Christiaan Barnard’s performance of the world’s first human heart transplant, in South Africa, in 1967, was a landmark Frankensteinian event in my childhood: “Ippa dippa-dation, my op-er-ation!” we chanted in the playground, but it wasn’t our operation… yet. It was Louis Washkansky’s, who survived for 18 long days after having his chest hacked open, his stopped clock removed, and another one, meticulously wound-up, inserted.
My own Uncle Bob underwent major heart surgery around the same time; unsurprisingly, since he was indeed the creative director of a large Madison Avenue advertising agency. I remember him sending us a sort of schematic diagram, which showed how he’d been opened up then zippered back together again. It was a key moment for me: the point at which that childhood sense of undifferentiated “body stuff’ gives way to something more complex — and more terrifying. I’d like to think of my brother’s “procedure” as just another form of what a mechanic friend of mine calls “cold engineering” — basically, either bashing at the thing with a hammer, or, if it’s fitted with a microprocessor, turning it off and on again — but I fear it’s altogether more tricky.
Look, I realise you might’ve expected me to discuss affairs of the heart under this very general heading. After all, for most people any talk of the organ calls our attention to its status as the world’s most vital metonym, but I’m afraid I’m not feeling it today. I mean to say, there comes a time in every man’s (and woman’s) life, when he realises that the pictograph on the Valentine’s card isn’t a realistic depiction. I’d wager that’s when our disillusionment really sets in, a factor not of actual romantic disappointment, but anatomical inaccuracy.
“The heart is a lonely hunter,” is a ringing phrase and it made an excellent title for a steamy Southern novel, but I wonder how helpful such metaphors really are? I mean, you’ve only to transpose them to some other, less glamorous organ, for them to seem bizarre, if not disgusting. The lung is a lonely hunter? The gall bladder as well? I think not. No: the heart is a pump that drives the blood around the body, and its systole and diastole are the strophe and antistrophe chorusing in our tender ears: You. Are. Alive. You. Are. Alive… For now, at any rate.
The heart is the most mechanical-seeming of the major organs: a two-stroke engine of a body part, putt-putting away at 60–100bpm, powering the entire odd-wobbly bubble of
each individual human existence