Oxford professor and cardiologist Robin Choudhury told David Hennessy about his book, The Beating Heart.
This month is Irish Heart Month.
In his recent book The Beating Heart: The Art and Science of Our Most Vital Organ University of Oxford professor and cardiologist Robin Choudhury explores the heart and what it means.
BBC Radio London presenter Asad Ahmad calls the book “Fascinating” while Brunelleschi’s Dome author Ross King says, “A remarkable exploration of how the human heart has been studied and portrayed across a wide range of cultures and disciplines.”
Professor Choudhury says, “Over the years, I have come to realise that I am far from alone in my sense of the pre-eminence of the heart. It is a notion that has persisted for millennia. The Beating Heart is a cultural detective trail to try to understand how and why we have come to see the heart as we do. It is a story of the heart, and in some sense a cultural history told through depiction of the heart.
“The story uncovers beautiful heart images that illuminate the age-old dance between art, religion, philosophy and ‘scientific’ thinking. Across time, we meet saints, artists, lovers, scholars and eventually scientists who unwittingly influence each other, in approaching and building an understanding of the beating heart.”
He was also involved in a project which used MRI to test Leonardo da Vinci’s theories on the flow of blood through the aortic valve and his work has been published in The Spectator and more than 200 academic papers.
In The Beating Heart Cardiologist Professor Robin Choudhury explains how human perception of the heart and scientific understanding have developed over 2,500 years of history.
Choudhury says no other human organ has been so richly depicted over the years and across cultures.
He looks at the relationship between the depiction of the heart in different eras and cultures and the prevailing religious and philosophical discourse.
And he considers how scientific understanding of the heart has evolved from the observations of Aristotle to the detailed anatomical examination of the Renaissance and the full 20th-century understanding of the heart’s processes.
Choudhury is professor of cardiovascular medicine at the University of Oxford and runs a laboratory working on molecular and cellular mechanisms of heart injury and repair.
He is co-editor of the Handbook of Cardiology Emergencies and contributor to the Oxford Textbook of Medicine.
Robin spoke to The Irish World about the book.
It has obviously been your area of interest and work but what inspired you to write this book?
“People would say to me, ‘Why have you become a cardiologist?’
“And I had this long standing conviction that the heart was the most important part.
“That probably started when I was 14 learning about it in biology at school but I had never really stopped to think about why I have this conviction.
“I had always had an interest in visual arts all my adult life.
“Years later my colleague in Oxford, Elena Lombardi, who’s the professor of medieval Italian, gave me a book called The Medieval Heart and that had a whole revelation of how people in the Western tradition had been seeing the heart, depicting it both in a sacred and secular context for hundreds of years.
“And that fascinated me.
“On the back of that we put on a symposium at the Ashmolean Museum, that was about ten years ago and I didn’t stop reading and thinking about it since so that’s how it came to pass.”
No one has ever looked at the heart as it is examined in his book taking into account different philosophies, religions, science..
“I think that’s right.
“I don’t think anyone’s taken a step back.
“If we look across time and we look across different cultures from India and Upanishad, the Ramayana, all the way to the Egyptian Book of the Dead, to the Bible, and then you fast forward to street art across the world in the 21st Century, we see not only how we depict the heart in very consistent ways but try to unpick what is it that fascinates us about this organ that isn’t the same about the brain or the eye or the kidney or the pancreas?
“There’s something really special about the heart and that’s what the book’s trying to hunt down.”
Were there surprises for you along the journey of writing it?
“Yeah, loads.
“I had no idea that Aristotle, Thomas Aquinas, Rene Descartes and Pascal had all been preoccupied with the heart, why it beats and what it meant to life.
“They all interpreted it through the lens of their age by which I mean, if you’re a philosopher, you see it as a philosophical thing.
“If you’re Aquinas you’re living in the age of astronomy and planets, you see it in relation to planets.
“If you’re William Harvey in 17th century England, you see it as a mechanised thing, as a pump, so it tracks through a broader cultural development so the way we see our heart reflects what’s going on in the cultural background.
“I really tried to bring that through in a way that didn’t look back and say how clever we are because now we really understand it but really tried to tie in what was happening at each stage of the human story to how we saw the heart.
“It was key and really tied in closely at every stage.”
Leonardo da Vinci was really ahead of his time in terms of understanding it, wasn’t he?
“Yeah, unbelievable.
“Leonardo da Vinci was studying the heart but he was studying the heart on his own because he was doing this private research and keeping a record in his enormous, copious notebooks but he never published them so all the work that Leonardo did, that we’re familiar with now, was invisible to the world until the 18th century.
“Mainstream medical research developed independently of Leonardo in the way that it understood things about 100 years later so Leonardo was a real virtuoso and the really cool thing that he did was to try to dismantle the inherited wisdom from the classical doctors and tried to look at it, in the spirit of the Renaissance, for the first time and try and understand.
“He broke the ancient thinking but he bridged into this new world of discovery, of individual exploration, of originality of thought which, of course, really fit with the many ideas that were active in the Renaissance.
“What he did with the heart, really challenging the old and innovating and discovering in a new way that was based on observation, not merely on learned material really captured the spirit of the Renaissance.”
Were any cultures or time periods particularly illuminating for you as you looked back?
“That’s a great question.
“Actually the Renaissance and Leonardo.
“And then I really enjoyed learning about the early anatomists in Padua in Italy.
“And then William Harvey came back to England from Padua and then he was studying the circulation of the blood and I make the case that’s the single most important discovery in the whole of biomedicine because everything- medicine, surgery, therapeutics- all just depend on understanding about the circulation of the blood.
“And then there’s a really exciting time in Oxford after Harvey goes there, there are a number of investigators including, believe it or not, Sir Christopher Wren, who is a young research assistant in Oxford working with a man called Thomas Willis.
“And Christopher Wren draws some of the early anatomical images that come out in the early textbooks.
“The way I’ve told the story, I’ve tried to include some beautiful nuggets about Christopher Wren and redesigning the City of London after the great fire, all of which was born out from this study of the circulation of the blood.
“I tried to give lots and lots of nuggets of, ‘He didn’t? Really? You’re kidding me? that happened?’- all the way through the book.
“Christopher Wren, and Leonardo for that matter, are really good examples of how that works.”
Hasn’t it been said that semen possibly comes from the heart?
“In not just one tradition in multiple traditions, it was believed that semen was made in the heart.
“You have to understand the idea.
“Aristotle wrote it down, ‘What is life? Where does life come from?’
“So he opens a chick egg and he finds a beating heart and he knows from other animals that when you’re alive, your heart beats and it’s this moving thing and it moves on its own and he attaches a lot of life, life meaning, seasons, source of ideas, all to the heart so then it’s pretty natural step- If you’re going to propagate life, where does the life come from? It’s going to come from the heart, isn’t it?
“So both in ancient Indian traditions, semen is made in the heart and in the book, there’s a great image early in Leonardo Da Vinci’s drawings when he’s still drawing what he’s reading rather than what he sees.
“He does some complex plumbing where he connects the male genitalia to a pipe that comes from the brain and another one from the heart and another one from the testicles so there’s a lot of fuzzy thinking going on until Leonardo unpicks it all.
“The end of the penultimate chapter in the book is describing how in the early 1960s when he was still a young man in his 20s and a graduate student Dennis Noble unpicked how the heart beats for itself and he did that through a combination of experimentation and computation.
“Even once we understood how the heart beats and we have now for 70 years we still in literature, in metaphor, the way that we represent the heart and if you doubt me look at street art all around the world, look at Banksy and how he uses the heart, we still have all of the emotional attachments that we’ve always had about the heart and what’s striking is that the way the heart’s used in street art echoes the way that it’s been used for centuries.
“I don’t think that’s because street artists are learning how to use the heart.
“I think it’s something that comes from within and there are various ways in which they articulate ways that we’ve thought about the heart consistently across cultures and across time.”
Has it always been associated with love or did that start somewhere?
“Yeah, it’s widespread.
“In Indian religious text the god Hanuman bares his heart and inside is Rama and Sita, the hero and heroine of the story and they’re occupying his heart as an indication of their love and devotion to him.
“That’s a sort of sacred love.
“There are lots of examples in Catholicism, of nuns exchanging and receiving Christ into their hearts as an act of devotion.
“The other thing that’s interesting is how anatomical hearts, which come from the medical tradition, were transposed into sacred art.
“You can think of images of the Sacred Heart in Catholic traditions and they don’t show little pretty motif love heart.
“They show these very anatomical hearts, pierced hearts, bleeding hearts, sometimes with the arteries on the surface and their anatomical images.
“And in the book, I tell the story of how that image of the heart moved from anatomy into the Christian world.”
Heart rates go up watching penalty shoot- outs or other tense sporting events..
“Absolutely and you’ve put your finger on it really. That’s why we care about the heart because in a sense, there’s this organ that lives inside of us and it’s obviously a part of us but in some sense, it’s apart from us because it responds and it tells us how we feel and when we’re scared or excited or anxious.
“It’s our heart beating, beating more rapidly and more forcefully, not controlled consciously by us but in response, seemingly, to what’s going on.
“And we have this sort of relationship with our heart and that’s the case that I make in the book of why it’s the beating heart rather than the kidney or the brain or anything else that has this enduring fascination for us.”
And if someone has no passion for something they say, ‘My heart isn’t in it’..
“Completely, and we talk about obviously ‘heartfelt’ and ‘heartbroken’.
“I love that phrase you’ve picked up, ‘My heart isn’t in it’.”
And people have literally died of broken hearts too, suffered some tragedy and actually never recovered…
“Yes and I write about that.
“We think that is the relationship between the so called symptomatic nervous system so the fight or flight part of the nervous system overloads the heart and it can, effectively, stop working.
“That’s now described as a particular type of problem, Takotsubo cardiomyopathy, and we recognise that in a clinical setting.”
What can we do to keep our hearts healthy?
“Well, if you’re an adult you don’t smoke and treat where necessary, your blood pressure, cholesterol and blood sugar or diabetes risk.
“Get good sleep. Take exercise. Don’t get overweight, that’s a good start.
“If we all did that, that would have a big impact on heart disease.”
How have you enjoyed reactions to the book?
“It’s been great fun.
“I’ve had some opportunities to speak with patients and hear their own take on this.
“I’ve started to understand a bit better why my patients are so concerned about the heart.
“They have so much emotional attachments to their heart, in a way- again- that they don’t for other organs.
“I gave a talk on a woman who received a heart transplant and we were able to hear from her what it’s like to live in the context of all these feelings and all of this psychological overlay what it’s like to feel that you live with someone else’s heart and how that affects your outlook.
“So It’s been a really interesting new avenue to explore.”
Could you easily return to the subject for another book?
“Quite.
“I mean more will continue to be uncovered but my sense is that we will still use the heart in our language.
“It’s so fundamental to the things, the way that we experience life, that I don’t think it becomes dismantled simply by understanding things better from a scientific point of view.
“We like to think we’re working on the cutting edge of science and we’re trying to regenerate hearts and we’re looking at the immunology of hearts, all those things in my laboratory on the science side but none of that undermines and nor do I seek to have it undermine all of this other wonderful romance of the heart.
“It’s a very deeply human experience.
“The thing that really excited me about it was the idea that it’s a story.
“It really is.
“I approach this from a position of curiosity and asked the question, ‘So who else feels this way about the heart?’
“And once I started to dig, there’s this really clear cultural history that gets told through understanding of and depiction of the heart.
“It’s full of beautiful images.
“I sometimes strap line it ‘Botticelli to Banksy’ but there are many, many more than that.
“People have taken a lot of trouble to depict the heart over the years.
“You could barely name a modern artist who hasn’t depicted the heart in one form or another.”
The Beating Heart: The Art and Science of Our Most Vital Organ by Robin Choudhury is published by Head of Zeus, £35. It is available at bloomsbury.com.
