my favorite

It's my favorite organ. I know that sounds silly.
Or weird.
But it is true. I love my heart.

This isn't some shallow decision, to love my heart above the rest.
I know more about each organ than most people.

I know about my brain. About the beta-amyloid and neurofibrillary tangles that may already be accumulating, even if I won't know it for a few more decades.
And the circle of Willis. And the courses of the cranial nerves. Even how to test them.

I know about my lungs. The little nodule that scares the doctors every time they get an x-ray. Sitting there, looking suspicious, but unchanged all these years later. And about pleural transudates and exudates. And neuroendocrine tumors. And my theoretical marfanoid predisposition to apical pneumothoraces.

I know about the gastrointestinal tract. From the complex neurological mechanisms that make swallowing possible (truly a miracle in my book), to the terminal ileum and its lymphoid follicles. Even the colon. And the fact that Westerners seem to get colonic diverticuli in the descending colon, while Asian's often get them on the ascending side.

I know about the kidneys. Both of them. Their blood supply. The glomerular basement membrane, podocyte foot processes, electrostatic charges - all these crazy things that really mean that my kidneys filter my blood hundreds and hundreds of times per day and only allow the loss of a select filtrate balance of chemicals and fluids. And I know about those sly adrenals perched atop each renal miracle.

And the endocrine system. It's complicated. I'll tell you that. But I can map and explain the hypothalamus, the pituitary, the thyroid, the adrenals, the gonads, the pancreas, and so much more. How they flip the switch to the on position. How they flip it back off. Even what happens when they get outta wack.

The reproductive system. I know about that, too. Follicles and fallopian tubes, vas deferens and seminal vesicles. And when the two systems work together, I know about the embryology - that crazy biological origami, folding and turning the cells as they differentiate and form a human. And the missteps along the way the lead to a cleft pallate, or spina bifida.

I can tell you about the skin. Oh, it does so much more than you think. I simply can't even begin to explain it here.

Or the nervous system. Nodes of ranvier, supratentorial lesions, venous sinus abnormalities, and the electrical system that makes everything else work together. Can you believe those nerves can actually tell the difference between hot, cold, pressure, vibration, and pain? God is a Master Electrician, among other masteries.

But the heart. It is truly my favorite. No other system can do its job without the heart. No other system works in quite the tireless, faithful way the heart does. Dutifully. Quietly. So central and important that death is designated by its state. If it is pumping, you are not dead. Not completely anyway.

It has an electrical system built-in, keeping it beating. If one shorts out, another takes over. If that one goes, another backup is already ready. And so-on, down the line, striving to stay alive even under the worst circumstances.

When I sit quietly, I can feel each heart beat. Every one. I can tell you my rate just by paying attention.

Laying in bed at night, I can feel each part of the process: the slamming closed of the mitral and tricuspid valves, the shifting of the heart as it squeezes the blood to the organs, the quick and solid closure of the aortic and pulmonic valves - sometimes together, sometimes slightly split. It just depends on where you are in your respiratory cycle, you know.

Unlike my other organs, that silently do their work, my heart quietly but firmly reminds me that it is there. This isn't true of many people. Maybe not even of most people. But it is of me.

My heart is why I love. That wild and beautiful girl of my dreams, by my side in bed every night. Those three little weeds and their bursting laughter, creativity, and passion for smiling.

My heart is why I run. Oh I love to run. Getting into my own head. Dumping out the waste and frustration and confusion. Running to exaustion. 4 miles or 41, my heart simply meets the demand.

When the endocarditis hit, I could hardly believe it. Had my heart betrayed me? Or had I betrayed it, allowing those gram positive cocci to find a home? But it was treatable. Truly recoverable. I thank the heavens for ultrasound technology. That tiny aucustic camera, snaked down my throat, gave a perfect view. Intact. Undamaged. Still ticking. Fully recovered after a month of antibiotics.

Then this week. New pains. New sounds. A fluttering rub I'd never felt before. Of all the injuries or illnesses, nothing consumes my mind with worry and frustration and even anger like my heart. The thought that it could be malfunctioning. Or damaged. Or sick.

The thought that it might be the rate limiting factor in this life-long chemistry experiment.
The thought that it might cut short my time to love.
The thought that it, the greatest supporter of my running, might force retirement.

Those hours in the ER were frustrating. I had already spent a sleepless night taking care of a children's hospital full of sick and dying children. Now I sat waiting. A private ER room. Those magic words got me in fast. "Chest pain." "Cardiac history."

I know how to play the game. Not that it matters. It was all true.

Blood tests. No enzyme elevations.
EKG. Normal sinus bradycardia. No ST elevations. No prolongations.
Cardiac monitoring. Alarming simply because I'm healthy.
Another echocardiogram.
A useless 500mL bag of 0.9% saline open wide. It only made me need to pee.

10 hours of waiting.

Drowsy
eyes closing
cardiac alarm sounding
waking me back up

You see, when most adult's hearts go below 60 beats per minute, there is a good chance there is a problem.

Sitting and conversing, mine hovers at 50. Sometimes 44.

And then I get drowsy.
I start to fall asleep.
And that dutiful heart, made efficient by countless miles pounding the pavement, it gets to relax a little, too.
44 beats per minutes
42
40
38
even down to 36.

Beautiful. Emotionally magical. That is my heart! So strong. So powerful. So efficient. Only needing 38 beats per minute. One every couple of seconds. Having trained and improved itself under my constant demands. Having created its own efficiency.

It has mastered itself.
Oh if only I could do the same.

The echo result was fine. But not perfect. Few people have a perfect echo.
But mine?
How could it not be perfect?

In reality, I'm just getting to know it better. Getting to know things that surely have been there all along. And coming to grips with the reality of life. Things get old. Things get rusty. Things wear out.

In the mean time, I have a life to live.

And I love it. I love life. And I love my heart.

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