Open heart surgery: it’s not for the faint of heart.
The Heart Of The Matter
“Suffering is part of our training program for becoming wise.”
Ram Dass
Can you love too much?
Ouch.
Inevitably, when you love deeply, you will no doubt experience grief. It’s bound to happen. We often get the first taste when a beloved pet goes “over the rainbow” and if we’re lucky, we have loving parents who help us cope with that. I did have loving parents, but they weren’t that great at dealing with death or loss.
My first one was Poika, a black and white kitty who came to live with us when I was about four. (So named because poika means “boy” in Swedish, and our Australian shepherd was named Flicka, for girl. This was my Swedish dad’s idea.) Poika was my constant pal, always there when I got home from school, snuggling up next to me in bed every night. He was the first pet who taught me that love requires commitment and responsibility, and patience. There would be many more animal companions during my life, all of whom would teach me more and more, although I confess I didn’t learn the lessons very well for a long time. Now, in the last third of my game, patience, responsibility and commitment have become conscious elements in how I live my life; I’ve learned a lot from my animals, including how to let go, and grieve.
I have a visceral memory of the shock of grief.
Poika had gotten sick, and my mother took him to the vet. I think I was there when we dropped him off; I must have been about nine or ten. I kept asking when he was coming home, and my mother kept saying “maybe tomorrow.”
Finally one afternoon she said “Let’s go for a drive! I have a surprise for you.” I jumped in the car, not sure what the surprise could be, and as we turned a corner, I realized we were headed in the direction of the vet’s. “Oh mummy, we’re going to get Poika!” I was so elated.
Of course that wasn’t the case, Poika was no more, but I didn’t know that.
My mother must have been stabbed in the heart, as she hadn’t considered the fact that I knew the route to the vet. She had planned on taking me out to the country to see a litter of kittens at a barn, but couldn’t bring herself to tell me that Poika wasn’t ever coming back.
I remember the shock when I realized the truth, that feeling of deep anguish, the physical wrench in my stomach, the wail that came out of my mouth. Hitting the seat, pounding it with my little fists, the flood of tears. My mother trying to comfort me as she drove, saying “Oh honey, I’m sorry, I didn’t know how to tell you. Let’s go find a new kitty!”
Of course I was not ready for a new kitty, and over the next few weeks my young heart and mind processed this truth: that love = loss, eventually.
There were many other pets, dogs and cats, Guinea pigs, hamsters and parakeets, and I loved them all. The loss of them always hurt, but somehow my parents always sort of covered up the dying thing; we never actually “experienced” their deaths. We didn’t talk about it, there wasn’t any ceremony involved, no burials out in the back yard. When people died, there was a similar approach- the sorrow was real, but after the memorial service, while there was always a celebratory reception, there was no real burial, no interment of the ashes, no discussion about the death. Denial was my family’s way of dealing with loss. Perhaps if my parents had had less fear about discussing the reality of death, our family would have had a healthier relationship with grief. Perhaps if I had had graves to visit, I would have understood it better.
Losing a loved one, pet or person, to death is the penultimate loss, but grief and grieving come in varying shades and intensities. The loss of a marriage, a home, a deep love relationship — these losses also constitute serious reasons to grieve, and the grief is just as real, if perhaps not as enduring. The stages of grief have been studied and catalogued over recent decades, with the groundbreaking work of Elizabeth Kubler-Ross lighting the way. The essential stages are denial, anger, bargaining, depression, acceptance — there is now much research and help available to navigate the pain of loss, whereas in my parents’ generation, they seemed to avoid the subject altogether.
If love begets loss, which begets pain and sorrow, then how do we get beyond that?
Maybe by loving more, letting go of the memory of the pain, and choosing to allow love to take center stage, while knowing that there will, at some point, be pain as a result. Courage. Acceptance. Trust.
Where does trust come into the mix? I’m still trying to figure that out. I realize that I have a tough time trusting. Somewhere I read that trust is “a considered letting go.” That implies that in order to trust, you must consciously let go of whatever the fear is that is keeping you from trusting. Fear of pain, loss, abandonment, death. Fear of failure, fear of success. Fear of never being loved. Fear of being loved, and left. Fear of being betrayed, being hurt.
I loved my husband wholly, completely, for twenty five years. (Is love blind? Sometimes.) I trusted him, as well, as my partner, lover and friend. When that trust was betrayed, when a light finally illuminated what was actually the truth, my relationship with trust became so altered, so skewed, twisted, fractured and damaged that I’ve had a hell of a time accessing trust, in relationship, ever since. It’s taken me a long time to realize this. Therapy helped, some, but I think I’ve come to understand it on my own, really.
And then there was my own betrayal, my deep plunge into the depths of love with a dear friend. A married friend. And the subsequent loss of that love left its own deep wounds.
The heart is such an extraordinary organ. There are organs we can do without, or manage to live with just a part of, like a kidney, a pancreas, a liver, a spleen, a thyroid, a bladder, a colon, even a stomach. It’s possible to survive without a vital organ, though not fun. However, clearly the heart is the star of the organ show, the one at center stage, always and forever. It is the only organ that can move itself. You can’t live without a heart. You can’t feel without one, either, or love without one. It’s been said that the heart is the seat of the soul. A physical thing, yes, but also a metaphysical one.
In Dr. Sandeep Jauhar’s Heart: a History [Farrar, Straus and Giroux, 2018] he talks about the heart as metaphor, as machine, and as mystery. As a practicing cardiologist and director of the Heart Failure Program at Long Island Jewish Medical Center, as well as a contributing opinion writer for the New York Times, Dr. Jauhar has done extensive research and delved into (literally) the fascinating physicality and complex biological elements of the heart. In this book, his third, he also goes deeply into the historical, religious, emotional and mythical aspects of the heart. Dr. Jauhar says: “Even if the heart is not the seat of the emotions, it is highly responsive to them… a record of our emotional life is written on our hearts. Fear and grief, for example, can cause profound myocardial injury. The nerves that control unconscious processes, such as the heartbeat, can sense distress and trigger.. a response that signals blood vessels to constrict, the heart to gallop, the blood pressure to rise, resulting in damage.” [p. 23, Jauhar.]
Think of the phrases, starting with “broken heart”: hard-hearted, soft-hearted, pouring out one’s heart, an aching heart, a black heart, heartfelt, one’s “heart-throb”, to take heart, to be open-hearted, to speak from the heart, a change of heart, when your heart goes out to someone. In your heart of hearts. Wearing your heart on your sleeve. The heart of the matter.
What is the heart of the matter? To get to the heart of the matter, whatever it might be — takes bravery, strength and courage.
There’s an illness whereby one can literally die of a broken heart. It’s called broken heart syndrome, or Takotsubo cardiomyopathy, and it is caused by a reaction the heart has to a surge of stress hormones caused by an emotionally stressful event. Deep emotional pain can precipitate broken heart syndrome. Sorrow. Sadness. Loss. Over time, Takotsubo cardiomyopathy causes the heart to stop operating normally, possibly resulting in heart failure.
I had put a barrier around my heart to protect it. It became calloused, hardened, the way callouses form on fingertips from practicing guitar. The metal strings dig into the ends of your fingers, and eventually those fingertips become as hard as little pebbles, until the strings no longer have any effect on them. Unbeknownst to me, that was happening to a part of my heart, specifically the aortic valve, which controls the flow of blood into the aorta from the left ventricle as it beats. My aortic valve was slowly becoming calcified, hardened, stiffened.
It’s as if my heart had become wounded, and was building a shell around that valve, like a pearl forming around a grain of sand in an oyster. It was a self-defense maneuver.
Perhaps my heart was trying to protect itself, after the trauma it experienced. Whether my own personal trauma and emotional pain had initiated this disease or not, it happened.
I was in great shape, for a single sixty-six year-old gal, doing lots of cardio, Pilates, swimming and biking; eating healthy, taking my vitamins, not drinking (too much.) I’d been having what I called little heart-aches, from time to time, usually at night. They didn’t concern me, but after a frightening spell of vertigo, and having lots of tests, an echocardiogram showed the problem. I was diagnosed with aortic stenosis, and an aortic aneurism, and told I needed open heart surgery, the sooner the better.
After nearly fifteen years of protecting and wrapping up a wounded heart, that heart demanded repair. It needed to be opened. Literally.
While aortic valve replacement and aortic aneurism repair are now fairly common surgeries, nevertheless it’s a huge thing having your breastbone sawed in half and your heart connected to a heart-lung machine to keep you alive while the surgeon stops your heart to do the repairs. Not to mention all the tubes going into and coming out of your body at various spots (and the months of recovery.) After being prepped for surgery, I looked up at the nurse as she was wheeling me down the hall and said “This is a pretty big deal.” She looked down and said “Well hon, it’s a big deal for you, but we do it all the time.” I recall feeling a little scared, but calm. Then the I.V. anesthesia kicked in and I was down for the count.
That was over two years ago, and my heart seems to be working pretty well. I’m trying to teach it to trust more, to be bigger, and more embracing. I’m working on accessing joy, bliss and gratitude. Undoubtedly there will be more pain, sorrow and grief, as well.
This last third of my journey is about getting to the heart of the matter, which, in the long run, is love.
My task is to be open to it. It would be nice to have a companion on the journey, I admit. In the meantime, I’m doing a pretty good job of learning to love myself, and working on the wisdom thing, too.
