bundle in my hands.
‘In 15 minutes …’ I stammered. ‘I’ll need to put a fresh pot on.’
The first mistake of my medical career: incorrectly filling the coffee machine, transforming it into a coffee-spouting gargoyle. Disastrous! It was the only coffee machine on the entire ward.
Well, that’s a great start, I thought. What can I say to the people in the staff room to turn this situation around?
‘Well, you’ll just have to take your breaks without a cup of coffee,’ I piped up, smiling hopefully at the assembled company. ‘It could be worse, and it’s healthier for you, too.’ After all, this was a hospital. They should agree with my reasoning.
So, what did I learn on my first day? The simplest way to turn even the friendliest of hospital departments into a baying mob is to deprive them of their coffee fix. And acting like a pompous know-it-all compounded my mistake. No wonder, then, that I instantly rose from the position of intern to that of Public Enemy No. 1. To make amends, I baked them a marble cake.
The fact that I never actually had a serious mishap with a patient during my work experience was mainly down to the gradual, well-prepared way I was introduced to the jobs I was allowed to take on. As it turned out, I was not expected right away to treat gaping wounds, stem blood-spurting arteries, or deal with any other serious medical emergencies. Before I was allowed to join in with any such activities, I had to complete a very intensive program of learning and, most importantly, watching.
Shadowing the senior consultant on his rounds, learning bandaging techniques, practising the taking of blood pressure and pulse rates on the staff, entering data into the computer, and assisting in the treatment of minor to moderate wounds — this was my day-to-day experience as an intern. Additionally, the senior consultant would give me a short lesson at the end of each day, when he would explain in some detail the patient care and treatment strategies during the shift. He had a talent for explaining even the most complicated things in such a way that I could understand them, even without a medical degree.
Soon, I was learning to sew wounds. Well, okay, I started on bananas. But, importantly, I learned that wounds are not always necessarily bloody. And perhaps most importantly of all, I came to understand the close connection between sensitive patient care and effective medical treatment. The senior consultant had the ability to recognise when patients were unhappy and to bring a smile back to their faces. He mentored me, far beyond the realm of medical issues.
With great patience, he explained the structure of the human body, from the skin down to the internal organs. And that’s when I once again encountered my great (medical) love: the heart. Full of awe, I listened to him explain the muscles of the heart and its four-chambered structure. I heard tales of his time on call as an emergency doctor, of heart attacks, and of how to treat diseases of the heart. And the more I learned, the more my admiration grew for this fist-sized bundle of energy nestling in our chest. From that point on, I knew there could be no other — the heart had stolen my heart.
This book will take you on a journey to the heart. I begin by looking at the development and growth of the heart, and find out what that has to do with the theatre, loops, and bunny ears. I will also show you that our vascular system behaves like a network of highways — sharing all their features, from damaged roads to traffic congestion. You will see the sophisticated design of our heart, and how the processes of our atria and ventricles can run out of control. You will also learn what happens to our ticker when we smoke like a chimney, pay regular visits to McDonald’s, and enjoy more than the occasional drop of the hard stuff. And I explain why emergency medicine has nothing to do with the esoteric arts but it’s still necessary to be able to read coffee grounds.
Moving on, I will describe what diseases weaken our heart and pass on a few tips about healthy eating for the heart. I will then investigate whether the Easter Bunny would have a healthier heart if it were a vegan, why medieval physicians liked to quaff their patients’ urine, and why Bucks Fizz isn’t the only deadly quartet.
Next, we’ll go on holiday together, but it will be a white-knuckle ride. The scene of the crime: the ventricles of the heart — since, as I will reveal, many a young holidaymaker’s heart is less rested after their holiday than before. I’ll clarify what exactly determines a healthy heart rhythm, what factors can influence it, and what we can do when that rhythm goes wrong. And I will take a look at the most drastic measure to get a heart beating again: resuscitation.
That’s only required when one’s heart stops beating — and to make sure this doesn’t happen to you, I will prescribe a little something to prevent it: sex, which strengthens and supports the body and its defensive army, the immune system. I will zoom in on the tiny little warriors that make up our defence forces, and explain why Churchill’s recipe for a long life (‘No sports!’) might not be the best advice. In passing, I will take you on a tour through our blood and its components, and have a look at blood pressure.
Finally, I will show that even our state of mind and butterflies in the stomach can influence our heart. Is it possible to die of a broken heart? Whether it is or not, we should never underestimate the powers of self-healing. But modern medicine also has quite an inventory of tools to help repair a damaged heart, from replacing worn parts to installing a completely new engine.
These are the stations on our journey to the heart — each more fascinating than the last. And now it’s time for that journey to begin!
The Loop in the Heart
How our heart develops, how it is structured, and how its transport routes work
The Longest Theatre Play in the World
Ba-boom, ba-boom, ba-boom, ba-boom, ba-boom. The sound of a beating heart, powerfully performing its life-preserving service day after day. It beats without a break, no matter whether we’re asleep or awake. It’s already beating on the first day of our lives and continues until we draw our last breath. But what happens to our faithful ticker in the time in between, that is, during our lifetime? The answer is actually not very complicated.
I’m a passionate theatre-goer, and it occurs to me that the experience of a heart over its average 80-year existence is like a classical drama with five acts. The first act is the introduction. From the beginning of the second act, the action begins to rise. It reaches its climax in the middle of the drama, in act three. From that point on, all begins to go tragically downhill. After the fourth act, when everything moves from bad to worse, the fifth act ends with the inevitable tragedy, the curtain comes down, and the play is over.
But enough of this talk: the scene is now set for a real drama of the heart.
Act One: the unborn heart
In the theatre, plays usually begin by presenting the characters in the first act. So, allow me to introduce you. Very soon after an egg cell is fertilised, which is the point that marks the start of the rather complicated process of embryo development, the foundations are laid for the construction of a functioning heart. A rather unprepossessing collection of cells assembles, called the cardiogenic plate.* It forms two strands, which then develop into tubes.
At the same time, the pericardium, or heart sac, forms, and the heart continues its development inside this. The pericardium will later continue to envelop the adult heart. Inside the pericardium, the two parallel tubes now merge to create a larger one, called the tubular heart. It begins to move and eventually to curve in shape. Although it bears
