I always loved science, specifically anatomy and physiology. I really loved when we got to dissect pigs and frogs in high school. As a psych major, we weren't required to take any advanced A&P courses in college, but we did get to do neuroscience. I loved it. During 'family dinners' my junior year of college, I would tell my housemates all about the brain, specific neurotransmitters, why people can't quit smoking, why smell is so strongly associated with memory, why we get drunk and then subsequent hangovers... I thought I was going to study the brain as a career. As it happened, I got the opportunity to work in a few very applied settings, and realized that I really love the application of science to solve practical problems.
However, if someone had told me that I would get to watch surgery as part of my professional life, I would've laughed. I feel like the luckiest person in the world when I get to go into the operating room. I am always amazed at what happens in there. Before we moved to Scotland, I used to get to go down to the cardiac surgery operating rooms whenever I wanted to and watch the surgeries (I wasn't just going down to watch, it's not a sporting event, I actually did some studies and all that). The awe never has worn off for me.
When I first started spending lots of time in the OR, my job was to help think of ways to improve teamwork and patient safety in the cardiac surgery division. However, that's pretty difficult when you know absolutely NOTHING about the task that the team is trying to accomplish. So for a few weeks, I just went down to the OR and watched. I remember the first surgery I was in, the surgeon introduced me to the team, and the circulating nurse asked if I was squeemish. I told her I didn't know, becuase I'd never seen anything like this before. She said 'if you start to feel woozy, just try to fall backward' (ie: not onto the sterile table). Helpful tip.
As the surgery started the circulator came over to me and said 'You can go stand up at the head of the table if you want'. So I went around where the anaesthetist stands, and asked if I could look over. Side note: in some surgical disciplines, they hang a sterile sheet between the patient's head, where the anesthetist works, and the surgical field. The sterile sheet is a bit like a huge flexible post-it, with adhesive on one side that sticks to the patient, and then gets pulled up and clipped to IV poles on the anaesthetic side. This way the anaesthetist can monitor the patient's head and all their equipment without worrying that it'll get blood on it from the surgery. Surgeons and anaesthetists call this the 'blood-brain barrier' (brain joke!). Anyway, so I went around and stood on a stool and looked over the sheet. The surgical assistant was watching me (probably for signs of faintness, and to make sure I didn't touch anything sterile), and when I caught his eye and almost laughed out loud. I couldn't believe what I was seeing. It was a heart! A real heart! It was beating, moving, keeping the patient alive, even though their chest was cracked open. It looked like a science project. As a novice, I almost forgot that there was a person, a living breathing thinking feeling person, attached to the open chest that I saw.
The heart is awesome (not in the 'duuuude! awesome!!' way, but in the formal definition of the word). It's not like a balloon that fills and then empties. Rather it's a muscle that twists on itself to push the blood through. It's such a complex thing. If you make a fist with your hand, and then squeeze it, pinky first, then ring finger, middle finger, index finger, and hold it, then release, that's a beat. It is a muscle. You can strengthen and train it like you can any other muscle, and it atrophies or stops working properly if you don't care for it. On the outside, it looks very smooth, usually pink, but it depends on the age of the patient and the progression of the disease. The inside is very complicated, lots of small compartments and intricate muscles and valves that open and close to allow blood and nutrients in and to push waste out. When one of these valves or chambers is broken, it means that bad things are coming in when they shouldn't, and good things aren't coming in when they should.
In order to do heart surgery, the team must stop the heart from beating (in most cases, sometimes they do beating heart surgeries) which they do by re-routing the blood into a machine that oxygenates it and sends it to the brain and body, and that takes the waste out when the blood comes back the other way. There are about a million very complex steps to this process, which I know very little about, despite some very patient and intelligent people explaining it to me over and over. This is called cardiopulmonary bypass. The point is, they have to stop your heart in order to fix it. They have to do a manual reset.
Throughout history, emotions have been associated with the heart, although most scientists will say that they exist because of interactions in the brain. I've said time and time again 'I know it in my heart' or 'my heart is telling me...', 'my heart goes out to you', 'my heart will go on' (just kidding) etc. Even in the bible there's reference to God hardening pharoh's heart. Aristotle (I think it was Aristotle) rejected the brain, seeing it a superfluous to the heart, which he thought was the seat of emotion and reason. Historically, the Egyptians thought that the heart was the center of emotion because the pulse would change with great emotion, and would create visible differences in the psyche.
There is some research that says that the heart has an effect on emotion because it effects blood flow to the brain and oxygenation, which makes sense. Negative emotions, stress, frustration, anxiety, can lead to heart diesease. It's also been shown that the heart has a very strong electromagnetic force, because of all the electrical activity that's going on in there. I suppose this is why sometimes I can swear that I've felt my heart hurt or swell or twinge when something really good or really bad is happening.
Its really interesting to consider that there's such a connection between the physiological and the psychological. I've heard that a lot of heart surgery patients feel like their heart is giving up on them when they are faced with heart or valve disease. Like their heart rejected their body. Maybe all it needed was a manual reset? I don't know. There's a small but forceful push in medicine to start to investigate more holistic treatments for patients- ie: treat the patient not the disease. Using things like yoga, psychological therapy, homeopathy, etc. as a compliment to surgical intervention to fix a leaky mitral valve.
In my work, I don't interact much with patients, rather with their care-givers, hoping to improve the system in which the care-givers work, thus improving outcomes for patients. But this is a really interesting, and entirely different perspective that I've only recently begun to think about. Obviously, it's something I need to think about more.