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Humanities

Arrhythmia

Eve Joseph
CMAJ June 15, 2010 182 (9) 944; DOI: https://doi.org/10.1503/cmaj.100653
Eve Joseph
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I hear, as if from a great distance, the sound of a clock on my bedside table. It is beating sixty ticks a minute and my heart is keeping perfect rhythm. I feel, briefly, the deep even pulse of my blood for the first time in a month.

Who knows why the heart misfires, skips a beat and then can’t find its way back. Like the skipping game we played as girls:High, low, jolly, slow, salt, sugar, mustard, pepper! Miss a beat and you were out.

In one day the blood travels 12 000 miles: the distance from New York to Nagano, the number of miles a gray whale travels each summer on its way to feast on ghost shrimp and herring eggs. On clear nights we see the satellites orbit the heavens 12 000 miles above the surface of the earth.

In the early 1600s, William Harvey wrote: “The blood is moved perfected, made vegetable, and is defended from corruption.” In bed I feel the uncorrupted, vegetable flow of it through my entire body.

When I was a child I cupped an injured bird in my hands. Its one good wing beat frantically against my palms. One month ago I woke to my heart fluttering in my chest cavity. One good wing beating. Sparrows often flew into our windows. In our house we put injured birds in cardboard boxes with holes punched in the lids. My friend put the ones she retrieved in paper bags where 50 per cent of them recovered. I buried most of mine in the backyard; she watched some of hers fly out of brown bags. The cardiologist tells me there is a 50–50 chance my heart will return to atrial fibrillation once I stop taking flecainide and diltiazem.

Da Vinci believed the heart was of such density that fire could scarcely destroy it.

Like the earth’s hum we hear the heart only when we stop and listen. In a recent echocardiogram I heard the wet thwump of it; on the screen bursts of red and green static pulsed with every contraction. To my eyes the heart looked like a weather map with one hell of a big storm on the radar.

Figure1
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Image courtesy of ©2010 Jupiterimages Corp.

Lately, I’ve become aware of its erratic knocking. A bit like having a drunk at the wheel.

Who knows why the heart misfires? The cardiologist says it has to do with age. The mystic believes the heart wants to leave, wants to hear its voice reverberate through the valley. For once, it wants to beat as the one heart of the world, to light whole cities with its circuitry, to swagger through the mountains with the ancestor of thunder and his attendants of rain.

The human embryonic heart starts beating approximately three weeks after conception; we are older than our hearts by 21 days. In the end however, they often outlive us, firing on for seconds, sometimes minutes, after our last breath.

So many last beats. The man who sat up all night waiting for death to approach. The woman who cried for the heads to be chopped off all the flowers in case the smell of earth, rain, jasmine held her back; in case the morning light, afternoon sun, the neighbour’s dog barking at nothing called to her as she was leaving. The ones who died alone. The ones I have forgotten.

One of the ways to return the heart to regular rhythm is to shock it with defibrillator paddles; another is to slow it down with drugs. Like rebooting a computer. The first time I was given adenosine, my heart went from 180 beats a minute to 20; the second time it stopped for four seconds. One minute the engines were full throttle, the next I was in a glider; conscious, coasting in a silent body.

Not long ago, a dry exhalation ripped through the sky. In bed I felt my heart circle and drag between strikes, composing in a rhythm all its own, trading the metronome for the musical phrase.

In the storm’s violet light, it wants to follow that wild music.

Footnotes

  • Previously published at www.cmaj.ca

    Eve Joseph’s first book of poetry, The Startled Heart (Oolichan Press, 2004), was nominated for the Dorothy Livesay Book Prize; her second book, The Secret Signature of Things, was published in 2010.

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Canadian Medical Association Journal: 182 (9)
CMAJ
Vol. 182, Issue 9
15 Jun 2010
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Arrhythmia
Eve Joseph
CMAJ Jun 2010, 182 (9) 944; DOI: 10.1503/cmaj.100653

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CMAJ Jun 2010, 182 (9) 944; DOI: 10.1503/cmaj.100653
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