Med Diary

There is a voice that doesn’t use words. Listen!

Lub-dub, Lub-dub …the music of heart …

Most of the time you don’t hear it, but if your heartbeat were to suddenly stop, you’d stop too. You live from one beat to the next. In between, death resides. If after one heartbeat there isn’t another, the clock of life stands still. It might happen while we’re sleeping – or shopping. None of us knows the hour of our death.

As a cardiologist ,your heartbeat is my profession. Sixty to eighty times per minute, this sound creates life. Most hearts beat calmly and strongly, some in a constant rush. Even if the heart stumbles occasionally, it always tries to go on. I have seen many hearts labouring with their last ounce of strength. The heart knows no weekend, no holiday. If you live 75 years , it will have beaten about three billion times on your birthday . It started its work eight months before your birth, twenty-two days after procreation. The heart is the first organ to develop, long before the brain and the first breath. The heart, simply put, is a pump that circulates blood , an astonishing workhorse. It is the only organ that can move itself with the capacity to empty a swimming pool in a week. Nothing works without the heart.

Many cultures have revered it as the emotional seat of the soul. It is a symbol of romance, sadness, sincerity, fear and even courage. The heart is extensively described in multiple Qur’anic verses and prophetic traditions as both an organ of psyche, intelligence and emotion, as well as an important organ that can be harmed by several factors. The prophet Muhammad, Peace Be Upon Him (PBUH), stated: “Beware! There is a piece of flesh in the body if it remains healthy the whole body becomes healthy, and if it is diseased, the whole body becomes diseased. Beware, it is the heart”. It throbs through the years and decades, unnoticed – until something ceases to function. Or until a high-tech scan, by accident, discovers a defect that has not yet been felt .

Then The Heart Cries in Silence…,

My Pain Kills You Inside !

Afflictions of the heart are always dramatic. A pain in the chest is completely different from a pain in the hip. We perceive everything to do with the heart as an attack on our lives, on our inviolability. Even if later it turns out not to be life-threatening, an aching heart is a cause for concern and often triggers a fear of dying. A headache can also be a harbinger of danger; it can eventually lead to death by stroke or brain haemorrhage. Yet a severe headache worries us less than a light pressure in the chest. Deep inside, human beings sense that the heart is the source of all life.

As an organ, the heart has been investigated down to its smallest parts. We seem to know everything about it – and yet we know nothing. But in the age of heart transplants , the magic of the heart seems to have vanished – as if it could not withstand our mechanised world.

Your negative emotions break me !!

Ask my neurologist friend , he will say that the heart is not the source of our emotions. As cardiology fellow ,I have been trained to think of heart as a machine that we can manipulate with the tools of modern medicine but ,as practising cardiologist, I have come to understand that those manipulations must be accompanied by greater attention to the emotional life as connection between the heart and the emotions is an intimate one.

Emotions can overwhelm our brains and our bodies. True love rushes. As does anguish. They travel our emotional highway between our hearts and our minds in a beat, the connection undeniable but difficult to measure.During emotional distress, the nerves that control the heartbeat can set off a maladaptive “fight or flight” response that causes blood vessels to constrict, the heart to gallop and blood pressure to rise, resulting in injury to the heart and damage to the body.

Broken Heart Syndrome (we call it takotsubo cardiomyopathy) is a more sudden version of this , a maladaptive flight and fight response ,when you're under severe emotional distress; for example, hearing about the death of a relative, spouse or romantic breakup . The coronary arteries may go into spasm. There may be decreased blood supply to the heart. The heart might not contract the way it is supposed to.Stress hormones, particularly norepinephrine, may flood the circulation. This predisposes the heart to rhythmic disturbances, which can end up being fatal.

I broke because I couldn't see her weeping ,

Tears trickling down her cheeks

Can one see one's beloved losing blood ,

For tears are nothing but drops of blood having lost colour !!!

Thou shouldst eat to live, not live to eat !

The so called modernisation has made us victims of our own success. We have gotten so good at processing foods that we are getting more calories than we burn in a day. Rough breads have given way to Twinkies, apples to apple juice.

It’s this shift to processed foods, taking place all over the world, that’s contributing to a rising epidemic of obesity and related diseases. If most of the world ate more local fruits and vegetables, a little meat, fish, and some whole grains (as in the highly touted Mediterranean diet), and exercised an hour a day, that would be good news for our health—and for the planet.

Alas !! We have become slaves to “hedonic hunger” rather than "homeostatic" eating.

Ibn Sina (Avicenna ), the founder of medicine, suggested that eating habits have a health effect. While the habit was to eat twice a day full meals, he recommended to eat little by little and only small amounts.

Erzurumi Ibrahim Hakkı,(eighteenth century) ,Turkish and Islamic thinker, has examined six titles in his “Marifet,” “little food, little sleep, little talk.” He said that there are three things that cause problems in our life: too much food, too much sleep, and too much talking.

You can provide the health of your body by eating less, and you can provide the health of your soul by sleeping less. To stay a little hungry helps us to sleep less .

“Eat and drink, but do not be excessive. Indeed, He does not like those who commit excess.”(AlQuran )

I need Love and laughter !!

Love is a universal, connective force. Some say it is very old and everlasting, the origin, the beginning of the beginning. Since time immemorial, people have entered into romantic relationships. We understand that reproduction is the true reason for the evolution of love. During our legitimate romantic interactions (touches and hugs of beloved ones ) ,we discharge a very special essence of the heart, the love hormone (moral molecule ) oxytocin. It is one of the oldest substances of life that we know of today; it was active on Earth over 600 million years ago. In human studies, intranasal oxytocin has been shown to improve parasympathetic tone during a mental stress test and offers relief in chronic pain; the latter has intriguing implications on heart and vessels (cardiovascular system) , because chronic pain is associated with increased risk of death from heart disease and stroke happiness. Our bodies are affected by all our positive emotions .Laughter as therapy positively influences not only psychological aspects, such as stress, anxiety, depression, but also physiological and psychosocial aspects, including immune system, pain threshold, and stress reaction .

And Heart cries, “Your laughter and love makes me soothe with your endorphins and Oxytocin , I wish you make your lifetime experiences as positive and hilarious as possible. You can’t cure the world of sorrows but you can choose to live in joy.”

When you feel a peaceful joy,

that’s when you are near the truth.

Meditation : “You were born with wings, why prefer to crawl through life.”(Rumi)

Healthy heart is by no means the Swiss clock it was long thought to be; the interval between the beats is normally chaotic by a fraction of seconds and is a healthy sign (medically we measure it by Heart rate variability) .Thanks to healthy Brain -Heart interaction (Autonomic nervous system).

Modern life involves a daily bustle of noise, distraction, and information overload. Our senses are constantly stimulated from every direction to the point that a simple moment of quiet stillness seems impossible for some of us. This continuous agitation hinders us from getting the most out of each moment, subtracting from the quality of our prayers and our ability to remember the Creator .

We all know that we need more presence in prayer, more control over our wandering minds and desires. But what exactly can we do to achieve this? How can we become more mindful in all aspects of our lives, spiritual and temporal? That is where the practice of exercising mindfulness comes … muraqaba in Islamic tradition , Yoga and Tai Chi in other traditions .

The available Scientific evidence now shows that meditation—quieting the mind and being focused on one activity—reduces stress and anxiety, which in turn can lead to a lower risk of heart disease by stimulating the healthy (parasympathetic) limb of the brain -heart interaction system (autonomic nervous system ).

Let me conclude with following verses by Rumi :

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they are a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still, treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice.

Meet them at the door laughing and invite them in.

Be grateful for whatever comes.

because each has been sent

as a guide from beyond.

Dr Showkat Hussain Shah is Consultant Cardiologist at GMC Anantnag

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author. The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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