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Heartless

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In early December, 1982, humanity passed a threshold hitherto the purview of God. At University Hospital in Salt Lake City, Utah, Dr. Robert Jarvik gave a man a heart. And not just any heart. This was a heart of Jarvik’s own creation. Fifteen years in development, the Jarvik-7 artificial heart – and all its previous incarnations – had passed through developers’ hands thousand of times before being dropped into the yawning chest cavity of 61-year-old Seattle dentist, Barney Clark. You would think that the recipient would have been grateful. Clark’s own heart was so busted that he would lose consciousness just walking from his bed to the ensuite bathroom. Yet of all the words to describe Clark’s feelings over the next 112 days, grateful certainly wouldn’t make the list.

According to the record, Clark on several occasions begged the medical staff to just let him die. A series of post-operative infections had left him weakened and in severe distress. And the large, noisy compressor running non-stop next to his head hardly improved matters. Perhaps that’s why, as February’s final frosts yielded to the first green buds of 1983, everyone involved in Clark’s case agreed that he had suffered enough – even for a dentist. Turning off that damned compressor undeniably bought the good doctor the best sleep he’d had in years.

“The problem was the pulse. All we had to do was get rid of the pulse,” pioneer surgeon and inventor Dr. Billy Cohen explained to Popular Science magazine in February of this year. According to Cohen and his Texas Medical Center colleague, Dr. Bud Frazier, the major problem with all artificial hearts since the Jarvik-7 has been the attempt to recreate the human heartbeat. In the mind of mainstream medicine, that crazy lump-de-dump rhythm that separates all fauna from flora must surely serve a purpose. Perhaps it was some role in the health of blood vessels keeping arterial walls clean. Or maybe it’s those steady contractions that give our organs their longevity. What no one was willing to try was dancing through life without a beat. No one, that is, until a 36-year-old mother of two named Rahel Reger.

In 2009, Reger went into the hospital for what her doctor described as a routine heart surgery – if splitting your sternum open with a car jack can ever be called routine. Reger had lived with a heart murmur since childhood, and her specialist now believed that the timing was right for a valve replacement that would solve her condition permanently. “I was planning on being home 12 days later, at the latest,” said Reger. But after the operation, it was quickly apparent that something had gone wrong. Her heart wouldn’t start again, no matter how heroic the efforts. For Reger, whose two- and five-year-olds were waiting for her at home, that telltale flat line and droning alarm on the heart monitor should have signaled the end of the waltz. Instead, what it signaled was the beginning of a brand new career – as a test pilot for an improbable piece of plumbing called the “Heartmate.”

Heartmate is Cohen and Frazier’s contribution to the legacy of the Jarvik-7. But rather than trying to match the matchless human heart stride for stride, the two Texas doctors set their focus on what could be done. The human heart, besides alerting male libidos to the proximity of bikini-clad bottoms, does two jobs essential to life. While moving blood from the oxygen-rich cells of our lungs to oxygen hungry cells in our organs, it also maintains our blood pressure – so that we don’t end up looking like on of those folks from a “got milk?” commercial. And it performs both these tasks an average of 60 times per minute, day and night, for the entire lifespan of its host. How to accomplish that trick artificially has been one of medicine’s most elusive targets since Dr. Denton Cooley first attempted it in 1967. But Cohen, who as a kid was one of those take-everything-apart-and-see-if-you-can-put-it-back-together – only better – types, was sure he knew the answer. A pump. Not a lump-de-dump pump. Just a plain old pump, of the sort that has been moving liquid on this planet for hundreds of years. The question sitting on the end of everyone’s nose though, was whether it would work. If a gizmo pumps blood in a forest of veins but no stethoscope can hear it, does it make a sound?

72 days after entering the hospital for a repair to her existing heartbeat, Rahel Reger went home without one. Yet when writer Dan Baun arrived at her door for the Popular Science interview two years later, he mistook the vigorous, pink-cheeked woman who answered the door for a health care worker. Reger’s firm handshake and strong voice announced a woman not just alive, but overflowing with it. Undoubtedly, that’s a feature of Cohen and Frazier’s battery-operated plumbing that her family appreciates most. Especially her kids.

For more than two decades now, Canadians have struggled deeply within themselves over their own medical mystery: How to best tackle the hundred-headed hydra they call crime. And every time the hot button names “Olson,” “Bernardo,” or “Pickton” enter the conversation, that battle only gets harder. Even when the problem isn’t as wet and sticky as serial killers, there are still stubborn questions. Is the solution to “treat” criminal offenders with specialized programs designed to rehabilitate their thinking, or to mistreat them with punitive retribution? Both sides of the battle have their champions, their statistic, their moral justifications. Both have their rhetoric, their propaganda and their hidden agendas. But as Canada prepares to mark 175 years of dungeon research with the closure of its very first penitentiary, this seems like a good times for its citizens to pause and review their own belief on the topic. Can criminal thinking ever truly be rehabilitated? Or will building dozens of new double-bunked crime schools and filling them to the seams finally give Canadians the peaceful sleep that no statistics can? Then again, maybe those who live in the world’s most celebrated democracy have it right. In America, popular consensus is that the best way to respond to criminal conduct is with a .357 slug. It’s even enshrined in their constitution – arguably the most venerated legal document in history. Are they right? If so then shouldn’t we all learn from that and stop wasting resources on the highly taxing experiment called incarceration?

There is of course, a third option – one where both the con-huggers and con-killers would be wrong. It’s an option that takes everything we think we know about justice… and throws it out the window. The option where everyone gets what they need, instead of chasing their tails around a never-ending list of wants. But how we get from here to there will hardly be a path of simple choices. If Dr. Jarvik hadn’t unplugged Barney Clark in March of 1983, would the Reger children ever have played tag with Mom again in 2009? From my perch, the answer is as obvious as a heartbeat. But then, I’m no cardiologist. I’m still trying to get a seat in locksmith school.

2 comments

  1. ElizabethNo Gravatar

    Love your writing. Love your perspective. Love your insight. Thank you!

    1. I.M. GreNada

      Love your “thank you’s.”

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