The heart gives us true sustenance to our lives, not only physically, by keeping our vital organs and tissues alive, but also psychologically, as a symbol of love, faith, hope, and courage. In short, it the core of what makes us human- it stands for our emotions and our passions. What happens when the heart that we are born with is suddenly replaced by a man-made machine? Do we lose a bit of our humanity because our heart is not our own?
To start, let's turn to an old friend of ours who knows quite a bit about heart transplants- the tin man from the Wizard of Oz, who embarked on the journey of a lifetime in search of a real heart. In a sense, he exemplifies our own search for humanity in an ever increasingly mechanical world. He is not aware that he has already become a sort of machine, being made of solid tin and metal joints. Yet though this material is stronger and more resistant than human flesh, it is also colder and more impersonal, since it is a result of mass production. Thus the tin man wants to deny his mechanistic nature and seek something that will make him feel more human. Though his metal body allows him to perform the basic physical functions of a human, he still feels a sort of emptiness psychologically.
When a man's an empty kettle,
He should be on his mettle.
And yet I'm torn apart.
Just because I'm presumin'
That I could be kind-a human,
If I only had a heart.
How is it that the heart seems to embody this concept of humanity, and at the same time we have no qualms about replacing it with machined parts that are distributed by a commercial company? Have we progressed in technology to the point where we can manufacture the soul of a person, the essence and humanity of a being?
We have arbitrarily delineated the difference between what is human and what is machine, what is feeling, and what is fact. The tin man's personal dilemma ultimately arises from his dissatisfaction with himself- he doesn't consider himself human until he finds a heart. What is ironic, though, is that the heart he ultimately finds is not a human heart, but an artificial one- it is, in fact, a watch shaped like a heart. None of the characters in Oz find this to be bizarre, and in fact they are mesmerized by it as they listen to the mechanical ticking.
Just as the tin man is convinced that this mechanical heart will allow him to be human, so are we convinced that our artificial hearts will grant us a degree of humanity, through the extension of our lives. Here we have a strong correlation between a physical object and an important abstract concept- humanity.
What does it mean, then, to be human?
I'd be tender -- I'd be gentle
And awful sentimental
Regarding Love and Art
I'd be friends with sparrows
And the boy who shoots the arrows
If I only had a heart.
Our interpretation of humanity is often one intertwined with emotion. While machines simply "do", humans feel- for each other, for beauty, for life. Central to this theme of emotion and humanity is, of course, the heart. Does it not make sense, then, that the tin man finds himself incapable of feeling emotion without a heart?
This is literally the work that our heart does for us- it empowers us with a sense of humanity. Because of its central role in our physical sustenance, it has also come to play an integral role in our perceptions of ourselves as human. Without the heart, we would experience a death of not only our physical being, but our psychological being as well. The heart is especially unique because it fuses these physical and psychological interpretations and makes them indistinguishable.
I hear a beat....how sweet!
Just to register emotion
Jealousy -- Devotion --
And really feel the part,
I could stay young and chipper,
And I'd lock it with a zipper,
If I only had a heart...!
Another interesting concept that comes up in this course of exploration is the pursuit of immortality. What would be better than replacing a tired, frail heart with a new, vibrant mechanical one that has been tested in laboratories and developed by geniuses? Out with the old, in with the new! Not only do the new devices perform the same function as the old ones, but they do it better, and they allow you to be young again- if you have a new heart, you must have a new soul and a new passion for life.
Though this type of optimism has never appealed to me, it seems to make itself into nearly every aspect of medicine. In one sense it is a reflection of the "grass is greener on the other side" saying- we always want something better, some flashier. Current technologies have extremely short shelf lives these days, and marketing techniques play on these desires to sell everything from the hottest new iPods to the new wonder drug of the day. Though few people today may want to trade in their own heart for the Jarvik-7, the general public holds a great deal of faith in the progress of human knowledge and human developed technologies.
In another sense, this type of restlessness may also be a manifestation the most basic human instinct of all: survival. What is a more powerful motivation than the thought of imminent death? The "big picture" in nearly every medical and scientific grant proposal is exactly that- my research can save lives. Whether the target population has diabetes, high cholesterol, Alzheimer's, the story is the same- we want to preserve human life. As heart disease is one of the leading causes of death in the US, what is a jazzier field to go into than the construction of indestructible, immortal hearts?
Your heart's not working properly? No problem- we'll replace it, and you'll live. It's sounds beautiful, almost too good to be true... because it is. In reality, the patients that receive total heart transplants are those with literally no other hope. There are strict guidelines that dictate the qualifications necessary for this type of patient- for example, being in a terminal state of heart disease and being ineligible for a live donor transplantation.
Thus if life before the implant was difficult, it will only get worse if we're trying to cheat death. Patients who received the Jarvik-7 gave themselves a hospital bed for the rest of their lives, tethered to a three hundred pound console. Drugs were pumped into the body in attempts to quiet the protesting immune system, but it would occasionally prevail, in the form of nosebleeds, seizures, and ultimately death. In short, "nothing better exemplifies medicine's relentless efforts to avert death and restore some measure of health to gravely ill patients than the attempts that have been made to replace failing human hearts with man-made substitutes" (Fox 100).
So what have we learned from this exploration? We have established that the symbolism associated with the heart is a result of a tight convergence of its physical role in our bodies and its psychological role in our minds. We might say, then, that the heart is “the locus of the inner self, the home of the soul and the seat of the metions, the center of knowledgeable wisdom and understanding, the source and repository of love, desire, and courage- a cosmic space where the body, mind, and spirit coexist and penetrate each other" (Fox 161). With such a complex, sacred meaning tied to the heart, how is it that we are able to manufacture replacements that do not disturb these delicate balances?
The development and implantation of the artificial heart is perhaps a result of our desire for ultimate control. After all, "what greater act of domination could we as humans devise, than to substitute a machine for the most conspicuous agent of life, the heart? (Fox 162). For centuries we officially defined death according to the activity of the heart- when it’s beating, you’re alive… when it’s not, you’re dead.
By creating an artificial heart, we are, in a sense, creating life. We now have a limited degree of control over a force that has come to fascinate and terrify us for our entire human existence- death. This is why the decline in the quality of life post-transplantation has come to be accepted by the general public. Whether this is moral, is beside the point, as is the ultimate fate of our continued struggle to defy death.
References
Fox, RC. Spare Parts: Organ Replacement in American Society. New York: Oxford, 1992.
Ten Things 2006: Projects >
Tammy Wang: A New Heart to Heart >
Hearts: Let's Begin!
