Between Discordant Eras

Stephen L. Talbott

During the 1880s the young Norwegian poet, Knut Hamsun -- who would several decades later receive the Nobel prize for literature -- put in time as a transient laborer on the American prairie. In Vagabond, his brief memoir of the period, Hamsun related the story of an accident that befell a small boy named Edwin. While handling some lumber, "Farmer Rodgers" -- Edwin's grandfather -- lost control of a plank, which struck the boy just above the eye. Edwin fell down "and lay there as if dead."

Hamsun, out on the prairie plowing, was urgently summoned. He quickly loosed the mules from the plow and ran to the homestead.

When I came to the farm, both grandparents were in full despair, and there was no end of their wailing. Mrs. Rodgers rolled the child on the floor this way and that, but could not bring him back to life. An ancient memory from youth came to my aid, and suddenly I had no doubt what was to be done. "Take his jacket off," I said. I had put my razor on my bed under the pillow, and now I quickly retrieved it. When I returned, I ripped off Edwin's shirtsleeve and began to cut into a vein of his arm.

The woman gave a shriek and threw herself upon me like one possessed; Alice [the boy's aunt], too, could not be stopped, and said I wanted to kill the child. I shoved her aside with my foot. "It is a matter of life or death; I want to save the child." The old Rodgers recollected himself at these strong words and helped to hold the arm. He only asked, "Can it be good to open the vein?"

When I cut a little deeper, blood came, at first only as a tiny leakage, and then in a fine line. I opened the shirt and listened to Edwin's breast. The heart was silent. Then I seized him by the legs and whirled him, head downward, this way and that. The blood now came in a stream. Then I laid the child down again and listened -- the heart beat very softly. That was the most wonderful operation I could have wished for. We all stood there and regarded the child. The small finger on his one hand moved a little. "He just moved his finger," said Mr. Rodgers, half choking for joy. "He moved his finger," the old grandmother said too, and she went sobbing out of the room. Soon the child opened a pair of confused eyes and closed them again. "He opened his eyes!" said Mr. Rodgers. "He's alive."

Despite serious injury, Edwin survived.

It is a curious story. Where you and I might have shouted, "Pound on his chest!" Hamsun, driven by an ancient memory, bled the boy and whirled him around. He sought first, it appears, to get the blood moving in the hope that this would bring the forgetful heart back into dutiful motion.

But with a poet's restraint and delicacy, Hamsun refuses to speak directly of his inspiration. Having received his memory with faith, and having staked a young boy's life upon the memory's truth, he was content to leave the episode behind a translucent veil.

The reader today may be justified in the perplexed feeling that, whatever the truth of the matter, it is now out of reach.

Hearts Not Revived

Two and a half centuries earlier we find another gesture of restraint and reticence toward the beating heart.

In 1628 William Harvey inaugurated the modern science of medicine by publishing his impressive treatise, An Anatomical Disquisition on the Motion of the Heart and Blood in Animals. In this work he traced the blood's heart-impelled circulation. While he could not yet know of the capillaries, he nevertheless demonstrated through painstaking experiment and lucid argument that the same blood traveling out from the heart eventually finds its way back along a closed set of pathways. Among his many achievements, he was the first to recognize that the blood does not flow both ways through its vessels.

The engine of this movement, Harvey wrote, was the heart, "a piece of machinery in which, though one wheel gives motion to another, yet all the wheels seem to move simultaneously." Previously the heart had been charged with heating the blood, transforming its substances, helping to refresh the vital spirits -- but not driving the blood throughout the body. With Harvey's revolutionary publication, the study of the heart as a pump was launched, leading finally to the miracle of open-heart surgery assisted by sleek pumping devices that exceed, along certain dimensions of mechanical perfection, anything Harvey could have imagined.

But I spoke of reticence. Harvey had already broached his new understanding of the mechanically pulsating heart twelve years earlier in a lecture. Yet throughout the intervening period he avoided publishing his views to the world at large. Puzzled by this, Robert Romanyshyn tries to imagine the extended interlude:

In these twelve years he will converse with the king [to whom his book would later be dedicated] and become his friend, and he will walk the evening streets of London between his patients' houses and his home, knowing what he has seen and marshalling more evidence on behalf of his daring vision. But in this same period of time he will not raise his voice above a cautious whisper to proclaim his views. Only a select circle of colleagues will hear of his discovery. For twelve years he will remain tentative and perhaps even diffident in the elaboration of his conviction. (1)

Eventually Harvey's colleagues prevailed upon him to publish what he knew.

At a time when politicking for Nobel Prizes achieves distasteful proportions, we may have a hard time undertstanding this hesitation in a working scientist who had successfully heaved aside some fifteen hundred years of learned inquiry going back to Galen and Aristotle. Nor can we know the causes of his hesitation with any certainty.

But we can at least surmise. The linguistic historian, Owen Barfield, points out that Harvey, sufficiently rooted in the past to assume the existence of vital spirits, consciously based his discovery of the blood's circulation upon two Aristotelian and medieval doctrines: the intimate, interpenetrating relation of the human microcosm to the celestial macrocosm (with the heart ruling the microcosm rather as the sun rules the macrocosm); and, secondly, the perfection of circular movement.

So the discovery of the circling of the blood, while pointing to the future, also bore testimony to the past. This, of course, is the way with every discovery. Harvey, like all men to one degree or another, lived between two eras. We can assess no human work except as a work of transition.

But we must also attend to the other, practical side of his undertakings. Harvey dissected animals -- all sorts of animals: dogs, cats, pigs, serpents, frogs, fish, crabs. And human cadavers. Looking for the secret of the living heart, he was driven by a seemingly inescapable logic toward the dead, dismantled heart. He was discouraged by the dizzying unclarity of the heart's motion during the uncertain interval between incision and death -- a motion "which in many animals is accomplished in the twinkling of an eye, coming and going like a flash of lightning." He confessed that "I was almost tempted to think, with Fracastorius, that the motion of the heart was only to be comprehended by God."

But he persevered, "having frequent recourse to vivisections," and paying particular attention to those moments "when the heart begins to flag, to move more slowly, and, as it were, to die." It was only through these repeated attempts to catch the fleeting secret at the moment of its passing -- situating himself between life and death -- that he finally grasped the essential principles of the circulating machine.

Harvey lived in the passage from one era to another, and the very heart of that transition, displayed in all its earthy, putrefying gore on the tables of his study, was found in the passage from life to death. Living between two eras, might not Harvey have sensed the world-shattering significance of both his methods and his discoveries? And, in this, wasn't there cause for reticence?

When Did the Heart Begin to Beat?

Where William Harvey, glimpsing the age to come, sought the throbbing secret of the living heart by stilling and dissecting it, Knut Hamsun, reminded of an ancient memory, strove to bring a paralyzed heart back into life-sustaining motion. Harvey's vision focused incisively upon the heart organ itself, as the central motor of the body. Hamsun's ministrations addressed the heart indirectly, via the blood in the farthest extremity. Harvey discerned a pumping machine, the efficient kickstarting of which would eventually be performed in the most direct manner possible, by compressing the chest or administering a violent shock. Hamsun brought the entire body -- and the heart with it -- into something like the flowing, rhythmical motion of the heavens.

Both men may have shown a certain reticence at the threshold of mystery, but if they did so, it appears they were straining in opposite directions -- Harvey toward the clear, bright, objective light of the laboratory, and Hamsun toward...well, who can say exactly, for if there is a light of the past -- if there was reason in the ancient doctrines of vital spirits and mixed blood and the transformation of substance -- it is not a reason we can easily appreciate today.

And there, apparently, the tale ends. We are left with a provocative juxtaposition, a properly muted hint of mystery, and a poetic gloss that one occasionally hopes may substitute for profundity -- just the formula that many popular books on science employ as diverting interludes before they get back to the clear-headed, hard-nosed business at hand. We must, after all, be honest: the juxtaposition was hardly an equal one. Harvey fathered medical science; Hamsun was a poet, and even if he really had a clear idea about what he was doing with the stricken boy, he didn't let on. What is to be gotten from such a lopsided comparison?

So let us by all means stick with William Harvey. But if we are to understand his achievement, we must first look across the threshold that he looked across -- except in our case the only way to look across it is in the opposite direction and from very far away. Harvey's boldness is our conventional wisdom. That is the difficulty. Hamsun's memory -- of unknown provenance and content -- may be impotent to point the way, but we must find some means to gaze back into the world from which Harvey emerged, bringing it alive. Otherwise, we can only applaud Harvey for saying the obvious -- hardly a matter of historic note.

One way to become aware of the ground covered in a historic step forward is to look back and see, if we can, how the step appeared to those who refused it.

Harvey drew the attention of his readers to the heart's beating. "With each motion of the heart, when there is a delivery of a quantity of blood, a pulse can be heard within the chest." The Dutch historical psychologist, J. H. van den Berg, drawing on a history of the sounding heart (2) as well as his own extensive researches, tells us that "Harvey's view met with no approval. No one in the field of medicine from the time of Hippocrates to William Harvey ever heard the heart beat, and no colleague of Harvey showed any inclination to follow him in this unexpected and strange point." Van den Berg goes on to cite a pamphlet against Harvey by Emilio Parisano, a physician and anatomist in Venice, published in 1635:

Nobody in Venice ever heard the heart beat, and nobody will be able to know what Harvey means until the time comes when he is inclined, which nobody expects, to lend us his ears. (3)

The French historian, E. Guyenot, noting this objection, declared that evidently "human stupidity knows no bounds." (4) Nearly everyone today would agree. But such dismissal is always dangerous; it easily conceals a refusal to stare into the strangeness lying across a historical threshold. Such, in fact, is the case here, for "there can be no doubt that not one physician before Harvey mentioned the sound of the heartbeat." Van den Berg is dead serious. No physician before Harvey mentioned the heart's beating. And yet, the heart's audible sound is discussed freely by various authors of religious and artistic literature. How, van den Berg asks, can this puzzle be understood?

The answer is that nobody before Harvey saw the heart as a pump, with the consequence that nobody, particularly no physician, was able to hear the heart beat as a pump. But this is exactly what William Harvey did. He saw and he heard the heart as a pump. The religious and artistic writers discussed the heart in a different, non-medical context...and that context allowed them to hear the heart: to hear the whispering, wailing, loving, longing tale of that center of the human body. (5)

Perhaps, inclined to accuse van den Berg of playing word games, you are adamant: "Regardless of whether physicians had previously thought of the heartbeat as the sound of a pump, what they heard was nevertheless a pumping sound." But that is to miss the point. Parisano could have no hope of winning his debate on the strength of a transparent word game. He did not say, absurdly, "No one ever thought to liken the heart's sound to a mechanical beating before, so the heart doesn't make a beating sound." Rather, he said, "the heart obviously does not beat; it does not in fact make any sound that could be likened to a mechanical beat" -- and he spoke in the manner of those who have incontrovertible fact on their side.

So here, precisely at the threshold, we are met with a nearly incomprehensible datum: a physician and anatomist, doubtless eager to find the most effective means to discredit Harvey before the general public and the medical profession, appeals confidently to an empirical fact, available to everyone, that refutes Harvey's claims.

Perhaps, at least, we can now understand Harvey's delayed publication a little better. Every genuine revolution in understanding is at first foolish and obscure -- precisely because it is a revolution in understanding, and therefore is not readily accessible to previous modes of thought and experience.

Putting it a little differently: what we are capable of perceiving is determined by what we are capable of conceiving, and the great discoverer -- by thinking ahead of his contemporaries -- perceives what remains inaccessible to them.

But surely Parisano heard something, for he possessed ears. Why does his hearing escape our ears? Are we as benighted as Parisano was when it comes to rising above the provincialism of our own age? He could not hear the heart's beating amid all its other voices; we, on our part, can hear nothing but the beating. Our backward gaze is as uncomprehending as Parisano's forward gaze -- this despite the fact that we might expect our own past to be more reliably accessible to us than the future was to him.

So perhaps we should admit: No, we can't understand Harvey's achievement, since his achievement consisted in overcoming the force of contemporary objection, and that objection seems laughably empty to us.

What Is Scientific Truth?

Harvey's public lecture of 1616 occurred only seven years after Galileo first turned his newly constructed telescope upon the heavens, where he observed the moon's pockmarked surface, the phases of Venus, the moons of Jupiter, and the sun's darkened blemishes. As Romanyshyn notes, these observations would contribute heavily to the immediate, psychological reality of the still much-disputed Copernican heliocentric outlook.

This ferment and discovery, repeated in so many fields of inquiry, was characteristic of the scientific revolution -- which is the broadest name for the threshold we have been considering. Of the central element in the revolution, Barfield writes:

The popular view is, that Copernicus "discovered" that the earth moves round the sun. Actually the hypothesis that the earth revolves round the sun is at least as old as the third century B.C., when it was advanced by Aristarchus of Samos, and he was neither the only, nor probably the first astronomer to think of it. Copernicus himself knew this. Secondly it is generally believed that the Church tried to keep the discovery dark. Actually Copernicus did not himself want to publish his De Revolutionibus Orbium, and was only eventually prevailed on to do so by the importunity of two eminent Churchmen.

Barfield explains further that the decisive turning point in the history of astronomy occurred, not because of the unoriginal Copernican hypothesis, nor because many people came to accept the hypothesis as a reasonable one, but rather because investigators like Kepler and Galileo "began to affirm that the heliocentric hypothesis not only saved the appearances, but was physically true." In other words, "it was not simply a new theory of the nature of the celestial movements that was feared, but a new theory of the nature of theory; namely, that, if a hypothesis saves all the appearances, it is identical with truth."

Deriving geometrical hypotheses that "saved the appearances" of the celestial motions was a respectable pursuit of long standing -- the Ptolemaic system itself was taught in the same way, not as the underlying truth of the matter. "It worked," as we might say today with full scientific respectability. The Church was quite willing to accord similar status to the Copernican hypothesis -- and even to say, "it works better."

All this is hard for us to stomach.

When the ordinary man hears that the Church told Galileo that he might teach Copernicanism as a hypothesis which saved all the celestial phenomena satisfactorily, but "not as being the truth," he laughs. (6)

But laughter, like Guyenot's charge of stupidity, is risky. What are we missing?

Interestingly, contemporary physics presents us with troubling questions about the status of our own hypothetical models. The orthodox view today -- despite our inability to live up to it -- is precisely that the models must not be mistaken for reality. Our light behaves as if it were a wave and as if it were a particle, but it is neither -- certainly not in any literal, picturable sense. This has been a painful pill for us to swallow -- and it is not clear that we have yet succeeded in the swallowing. Apparently the movement in the opposite direction -- to accept a mechanical, explanatory model as equivalent to reality -- was just as painful for Galileo's opponents.

Our own science, then, is strongly encouraging us to look back across the threshold of the scientific revolution for possible relief of our perplexities. Did those who resisted the arguments of Galileo -- and those who stumbled at the extraordinary idea that the heart is really a machine -- instinctively sense the difficulties that have come to haunt the most advanced researchers today?

The Human Machine

Years before Galileo, as Barfield reminds us, the Arabs, following the Ptolemaic hypothesis, had constructed mechanical models of the solar system for purposes of calculation. The modern understanding of the world was born "when men began to take the models, whether geometrical or mechanical, literally....It was soon to be stamped indelibly on men's imaginations by the circumstance of their being ever more and more surrounded by actual artificial machinery on earth."

William Harvey stood in the midst of this transition. It was in 1633, seven years after the publication of The Motion of the Heart, that Galileo kneeled in Rome to recant his Copernican views. We can begin to suspect, then, that Harvey's achievement, too, may have had less to do with the demonstration of new facts -- although it certainly had to do with that -- than it did with an assertion about what sort of fact could throw a penetrating and true light upon the human being. And his contention was that mechanical facts could do so.

So far as we know, Harvey was the first person to conceive the heart in such a fashion. Apparently, one simply could not imagine a mechanical heart during earlier centuries. In our time, by contrast, it is nearly impossible to find a discussion of the heart, whether popular or scientific, that does not mention "the body's marvelous pump." Yet even now it is nearly impossible for us to sustain the mechanical habit of thought when we face our own bodies. The heart's "skipped beat" presents itself to immediate experience more as a tiny seizure of unease than as an equipment glitch. And nothing rouses in us a more primal fear than a sudden bout of arrhythmia or tachycardia (wildly accelerated heart).

Following his own, late-night resort to an emergency cardiologist, the poet Charles Siebert noted the consensus among physicians that "the best way to cure this fear for one's heart is to instruct patients to look at the heart mechanically, technically -- to, in a sense, dehumanize it. If the heart's a pump, there is nothing to worry about. We make those. They're simple, long-lasting, and easily repaired -- even replaced, at least in part -- when broken."

Siebert was moved by his own crisis to investigate the badly failed experimental implants of the plastic and titanium Jarvik-7 heart back in the 1980s. Quite apart from the systematic breakdown of other organs following the implants ("it's as though the organs asked for more from the heart than an efficient, robotic output, asked for some subtlety and variety of pulse, a virtuosity the Jarvik-7 was simply not capable of"), Siebert asked himself about the peculiar psychological symptoms of these patients:

How it actually felt to be alive with a monorhythmic piece of plastic clicking where once the mime -- if not the author -- of our emotions dwelled is a secret the recipients have taken with them. But I've always wondered if this depression, this loss of aspects of their personalities, had anything to do with a proportionate loss of aspect in their new heart's response to the varying emotional stimuli around them. Could [Barney] Clark's or [William] Schroeder's depression have stemmed not only from physical suffering but also from the severance of that natural conversation between the heart and the brain -- a disparity they recognized, say, between the way their natural hearts may have once reacted when they saw their wives walk into a room and the way their new ones couldn't in that same instance? (7)

So, again, we observe a poet seeking the living heart. But now, thanks to the attempted reengineering of Harvey's "piece of machinery," the search is more urgent and the motive more impelling than ever before, even if the goal remains discouragingly obscure. Can we discover a unity between the heart of the poet and the heart of science, or must we forever accept a heart broken between two incommensurable worlds?

It is not only the poet who sends us upon our search. Today we are urged from many sides to rise above mechanism by making our thinking holistic, organic, or even spiritual. Yet, for all the value in some of these efforts, one wonders whether the trillion-dollar juggernaut of institutional science has been deflected more than a degree or two by the new movements -- many of which, it must be admitted, sorely lack the rigor, efficacy, and objectivity of genuine science.

If there is one place above all others where we might demand a clear demonstration of explanatory power by the alternative approaches, it is in our understanding of the human heart. But this power must be real and down to earth; it must, as Hamsun told the frantic grandmother, be a matter of life and death.

The Movement of the Blood

I sat in the small lecture hall with my eyes closed, trying to fulfill the speaker's charge. "Visualize the human circulatory system in its fullest reality," he had instructed us. Those several years ago I did not even remember the nature of the major divisions of the heart, let alone the primary pathways leading to and from it. But I knew enough to summon a vague, anatomy-book image of the central heart, with red arteries emerging and branching out to all parts of the body, and blue veins returning to the heart. I also knew that capillary networks joined the arteries and veins. That was about as far as I got with my imagining; I didn't even have the presence of mind to start the heart beating.

My view of the circulatory system, it turned out, was not atypical, at least not so far as the members of this particular audience were concerned. The lecturer, Philip Incao, seemed unsurprised. We had, he pointed out, visualized the relevant structures and mechanisms quite well. But how much of the truth of the circulatory system is discernible from these static entities? He answered by offering us another sort of picture. (8)

The human organism, Incao told us, begins life as streaming protoplasm. In the young embryo, blood cells form and move first; then some of those cells lengthen and shape themselves into vessels; and finally, from a swollen portion of blood vessel, the heart is formed. Structures take shape only as as a kind of condensation or filling in of the forms first established by streaming movement (rather, I thought, as if the energies of an invisible dance, over time, were to precipitate the perfect material dancer for that dance -- a dancer who was the very embodiment of the dance). He cited the German poet, Novalis, to the effect that the human body is a formed stream.

The body solidifies and hardens with time -- until rigidification finally produces death. But so long as it lives, movement and fluidity remain primary. Incao asked us to imagine the circulatory system from a red blood cell's viewpoint. It is a life of ceaseless, bustling movement. Surging into the aorta from the heart, the cell jostles together with uncounted billions of its neighbors, traveling with surprising speed through wide, dark tunnels whose walls suddenly expand and then contract again every second or so. The cell itself vibrates, expanding and contracting two hundred times per minute.

Progressively -- never allowed to stop and rest -- our red blood cell finds its way into narrower and narrower tunnels, until finally it is constrained by a channel that might be narrower than its own body. Thanks to its donut shape and its inherent powers of mobility, it squeezes and elongates itself to conform to this capillary vessel, pressing on through. The fluid in which it swims is meanwhile passing with remarkable freedom through the walls of the vessel into the surrounding tissues, each cell of which consequently floats nearly weightless in a nutritive sea. At the same time, other fluids pour into the vessel from the outside, accompanying the red blood cell along its way.

Then the channels begin to widen again. Life might seem easier, and yet the cell is growing blue from tiredness. It also has to travel steeply uphill, but somehow it never stops moving. And just when it appears it can go no further, it finds itself in a huge room with doors at the far side. The doors suddenly slam shut, and a moment of rest seems to have arrived at last. But almost immediately the doors open again and something like a great wind, a tremendous tornado, sweeps the cell and its neighbors through the open door and down into the next room, where they are hurled against the round sides of the room. Sliding around these sides, they are then swirled in a great vortex toward the lungs where our adventuresome cell finally "gets some fresh air" and feels full of life again.

Periphery and Center

Till now, Incao -- who is an M.D. and general practitioner -- had followed conventional scientific understandings, even if his point was that our imaginations, ever willing to rest in death-like immobility upon structures and mechanisms, usually belie those understandings.

But then his argument turned downright medieval. "We shouldn't ask why the blood moves," he said. The question betrays a false picture, a picture of death, not life. The blood moves because it is inherently alive, and it is the property of all life to move. Blood that needs a heart to pump it is dead blood." He then offered us a series of statements, almost in verse form:

** Spirit precedes matter.

** Life precedes death.

** The whole precedes the part.

** Movement precedes stillness.

And if we really believe this, he said -- if we are capable of seeing it -- then we will realize that

** The heart is not a pump; rather the blood moves the heart!

Incao no longer seemed to inhabit the world of modern science. What was one to make of it? The fullest clue he offered to his overall line of thought was contained in repeated references to "peripheral forces." The blood's primary movement, he declared, arises from the periphery rather than the center. But what this periphery amounted to was hard to grasp. He spoke of "the whole cosmos streaming into us and converging upon our heart, from which it is reflected out again as spiritual light." He pictured how the springtime sun, embracing the redwood tree, raises the sap to a height of two hundred feet -- without any benefit of a pump. He quoted Harvey, who likened the blood circulation to the cycling of water in nature:

For the moist earth warmed by the sun develops vapors, the rising vapors again densify to rain and fall downward again, moistening the earth. Here we have the circulation of the sun.

Applying the analogy in a way that Harvey did not, he noted that "in the vast network of capillaries in our bodies, the surface area of the blood is so enormous that it is able to achieve a near weightless state, like mist or fog in the air."

Not waiting for me or anyone else in the audience to brand his thought "medieval," Incao took the label upon himself by adverting to the hoary notion of levity. Referring to the rising and falling of the blood with heat and cold, anger and shame, he related heavy-heartedness to a genuine heaviness of the blood, and light-heartedness to a lightness of the blood. Lightness, he went on, is not merely the absence of gravity; it is an aspect of life. The sap rises in the spring just as the young animal or human being rises up on its legs, opposing gravity and achieving lightness and freedom of movement. But this rising is always accompanied by a falling: the plants fall back to earth in the autumn, we ourselves lie down to sleep at night after rising in the morning, our bodies eventually descend to a stooped and shrunken posture, and we lose the lightness in our steps as we get old and approach death.

So, in the rising and falling of the blood the human being in ancient times felt himself to be participating in the great rhythm of all nature -- part of a great cosmic dance between sun and earth. Heaviness was of the earth, and lightness as well as light and life itself, was of the sun....All life does indeed come from the sun, through the dance of the sun's light and lightness with the heaviness of the earth. The Latin word for gravity also means pregnancy. In the womb new life approaches the heaviness of earth. But in order for life to develop, earth's gravity must be offset somewhat by the sun's lightness, by buoyancy, and that's why all animal and human life develops in the fluid-filled womb or the fluid-filled egg.

And what is true of the embryo remains true for the fluid-immersed cells of the body. At the level of the cell, where an almost inconceivably extensive network of capillaries determines the nature of the circulation, the law of the sun, of levity, prevails. Motion arises here as it does in the sap of the redwood, and the movement from thousands of miles of capillaries converges from all sides upon the heart, through the veins, bringing the heart into movement. This primary sun-movement of the blood provokes an answering beat of the heart, which transiently accelerates the blood in its course.

But this acceleration soon plays itself out in the tissues. And if it weren't for the activity of the life field of the sun sphere in our body in the periphery, the blood would pool in the tissues and not be able to overcome gravity and return to the heart.

Shifting the Light

One thing seemed certain: this physician was trying to gaze back across the threshold that Harvey had crossed. But could his strange, archaic-sounding thoughts survive translation into the language of science? How could one go about attempting such a translation? More broadly, is it the unorthodox researcher's main task to hit upon some startling discovery that vindicates his misunderstood views, or rather to help his listeners look upon the existing facts with new eyes?

The historian Herbert Butterfield expressed little doubt about the answer to this last question. Change, he says, was brought about during the scientific revolution "not by new observations or additional evidence in the first instance, but by transpositions that were taking place inside the minds of the scientists themselves." The challenge lay in "the art of handling the same bundle of data as before, but placing them in a new system of relations with one another."

The supreme paradox of the scientific revolution is the fact that things which we find it easy to instill into boys at school...things which would strike us as the ordinary natural way of looking at the universe...defeated the greatest intellects for centuries, defeated Leonardo da Vinci and at the marginal point even Galileo, when their minds were wrestling...with these very problems. Even the greatest geniuses who broke through the ancient views in some special field of study -- Gilbert, Bacon and Harvey, for example -- would remain stranded in a species of medievalism when they went outside that chosen field. It required their combined efforts to clear up certain simple things which we should now regard as obvious to any unprejudiced mind, and even easy for a child. (9)

Butterfield notes the dangers in his own field: the student of history, confronted with a huge mass of data, has a kind of magnet in his mind that, unless he is careful, perceives just those elements that fill out the picture he has already formed. Similarly in the sciences: during the centuries immediately preceding Harvey, "though dissection was being practiced to an increasing degree it produced little result -- men only observed the things which the ancient writer Galen had taught them to look for."

Much of the dissection at the dawn of the age of science was for demonstration before a class, not for experiment and discovery. Its whole purpose was to make visible what Galen had seen:

These poor creatures knew that Galen was a much greater artist in the work of dissection than they would ever be, and they took no end of pride in themselves if the result came out as Galen said it ought to do -- a matter not at all easy, especially as Galen used apes, for example, instead of human bodies when he conducted his dissections.

Many a modern student in the dissecting laboratory will recognize the truth of these words! It's a difficult dilemma to escape, since the student who would learn quickly must show a certain deference toward authority. On the other hand, the effort to see things in a shifted light, to look for a different sort of possibility in the appearances lying before one's eyes, is a task to which the greenest student (an apt metaphor in the dissecting laboratory!) might usefully contribute -- in fact, might especially contribute, due to his very inexperience -- if only he has previously learned how.

Such thoughts encouraged me to ignore, at least as a worthwhile, temporary exercise, any hunger for immediate, factual proof that Philip Incao was right or wrong in his problematic lecture. Instead, I turned toward the existing literature with a humbler goal in mind: to loosen as best I could those interpretive prejudgments that would blind me to all but the truths surveyed by my own, post-Galenic authorities.

"The heart is not a pump; rather the blood moves the heart!" This seemed to be the rallying cry. It was just bald enough to pique my interest -- and to bring me quickly to some curious facts of the literature:

An experiment on toads

The immature, beating heart of the larval orange-speckled toad can be surgically excised, turned 180 degrees around, and reinserted between its artery and vein, yet the direction of blood flow, instead of reversing, remains the same. So at this early stage, before the structures are fully and rigidly developed, the flow shows itself to be primary, determining the heartbeat rather than being determined by it.

The beating heart requires flow

According to one of the classic principles of heart function, known as Starling's Principle, the heart's arterial output is directly modified by (among other factors) the pressure of venous inflow. To this degree, then, the heart is governed by the flow coming to it.

Moreover, without any flow at all, the heart fibrillates -- that is, beats chaotically and ineffectually. In order to function normally, the heart must have fluid moved through it. Researchers have made a human heart beat again as late as twenty hours after death by supplying an inflow of blood. (During the interim the heart tissues must be perfused with blood so that they do not die.) Rabbit hearts can similarly resume beating several days after death.

Arteries are not passive

As shown by embryonic development, the heart is a strengthened and elaborated blood vessel. Not surprisingly, then, the blood vessels, which possess their own layer of smooth muscle, share in the rhythmical function of the heart. The pulse felt in the arteries has been found to be an active and resonant one, not simply the passive effect of a pressure pulse issuing from the heart.

Circulation without Heart Movement

In experiments with dogs, the animals were asphyxiated. A half hour after the hearts stopped -- when the oxygen content of the arterial blood had fallen to that of the venous blood -- artificial respiration was begun. Within ten minutes the oxygen content of the arterial blood rose to normal levels, indicating a persistent, if slowed, blood circulation in the absence of a beating heart.

Questions

We are justified, it seems in stepping back and trying to piece together a fuller, more organic context for the beating heart.

When imported into the life sciences, mechanical notions -- whether of a pump or any other device -- tempt us to discard part of what we know about the living organism. We naturally desire to achieve the same clear chains of cause and effect that seem so serviceable when applied to automobiles and washing machines. But we can achieve that one-dimensional clarity only by sacrificing the rich interplay through which the whole organism lives in every part and every part serves the whole. After all, when the wheel learns to fiddle with the carburetor's adjustment, things begin to get complicated -- perhaps, in the living organism, even complicated enough to make addressing the recalcitrant heart through an incision in the arm a reasonable gesture.

There are no isolated systems in a living organism. Every aspect of its being is somehow intertwined with every other aspect. Finding an appropriate and disciplined language for this organic relatedness is the challenge confronting any holistic science. Unfortunately, most alternatives to mechanistic explanation today present us with a choice between obscurantism on the one hand, and what turns out to be a mere elaboration of mechanism (as in feedback mechanisms and computational mechanisms) on the other hand. This is hardly surprising, given our centuries-long training in quantitative and mechanistic styles of thought.

Where Harvey lived between two eras and passed from one to the other by watching the heart as it died, we, the children of the scientific era, have buried the threshold he crossed deep within ourselves. It lives on now only as dimly reflected in the unequal contest between poetic and scientific truth, between metaphor and fact, between the vagaries of qualitative experience and the certainties of reliable, quantitative data. Harvey killed off his living specimens to gain a knowledge of the heart's mechanism; we compulsively vivisect, so to speak, our own living hearts in favor of inert, mechanical ones.

I was reminded of this when my wife, Phyllis, told me about her opportunity to observe a caesarian birth while in nursing school. After the delivery, the surgeon pointed to one of the mother's exposed abdominal organs and asked the students, "What is this?" Without thinking, Phyllis immediately responded, "the womb." It was the wrong answer. Visibly irritated, the surgeon corrected her with caustic emphasis: "The proper term is `uterus'."

It was as if this physician, charged with attending at the threshold of a fellow human being's emergence into the light of this world, could not tolerate any but the most detached terminology for the miracle he assisted. Did he feel, somewhere inside, that his entire training depended for its validity upon his ability to put a deadening distance between himself and the life that might otherwise break in upon him? One suspects that an obstetrician who will not hear of the womb can, in a very real sense, deliver only stillborn children.

But we are all the offspring of our age, and in one way or another we employ the same disinfectant when crossing a certain internal threshold. All of us have experienced, for example, the aching constriction of heart following a personal loss. But the aching heart, as also the light and heavy heart, the courageous heart, the wise heart, and the loving heart -- these, if we even notice their murmurings, become mere background noise the moment we present ourselves to the cardiologist for an examination. We can scarcely imagine that the ignored voices might be relevant to the jagged spikes of the electrocardiogram. The threshold that Harvey crossed lives on as a split within each of us -- except that the one side of the threshold has faded into little more than an "ancient memory" for which we can no longer find meaning or justification.

The split is even visible within science itself. As Barfield observed several decades ago, "in Medicine, the whole of the surgical branch has reached a point little short of perfection; but when it is a question of treating malignant growths and, in general, diseases of the living organism, where are we?" (10)

The fact is that disease of the heart is more rampant in our technically enlightened society than ever before in history. We thought that we knew enough to create and implant artificial hearts; the reality is that we haven't even had the wisdom to prevent our natural hearts from deteriorating at epidemic rates.

Are our modern hearts able to bear any longer the burden of being treated like mechanisms? The question is a valid one if the contemporary urge toward holism is at all justified -- if the health of the human organism depends upon our healing the split between consciousness and matter, between our innermost experience and the data of science, between the "whispering, wailing, loving, longing tale" at the heart of our being and the machine that Harvey first heard beating.

Every orthodoxy, every received wisdom, has its one-sidedness and limitations, which must be transcended in due time lest decay set in. A science whose fundamental character was determined at birth by the fact that machines were then gaining prominence is, after all, likely to be an imbalanced science, and the imbalances are likely to become ever more acute as the science matures. How better to seek the terms of a renewed wisdom than by listening afresh to the throbbing Balance and Center of the human being?

Notes

1. Robert D. Romanyshyn, Psychological Life: From Science to Metaphor, p. 74

2. G. Joseph, Geschichte der Physiologie der Herztoene vor und nach Laennec bis 1852, in Janus, 1931. Quoted in J. H. van den Berg, Het Menselijk Lichaam, 1962.
3. Emilio Parisano, Recentiorum disceptationes de motu cordis, sanguinis et chyli (Leiden, 1647), p. 107. Quoted in J. H. van den Berg, Het Menselijk Lichaam, 1962.
4. E. Guyenot, Les sciences de la vie aux XVIIe et XVIIIe siecles, Paris, 1941, p. 173 (L'evolution de l'humanite, no. 68). Quoted in J. H. van den Berg, Het Menselijk Lichaam, 1962.
5. J. H. van den Berg, Foreword to Psychological Life: From Science to Metaphor, by Robert D. Romanyshyn (Austin, University of Texas Press, 1982), pp. xi, xii.
6. Owen Barfield, Saving the Appearances: A Study in Idolatry (New York: Harcourt Brace Jovanovich, 1965), pp. 49-51. See also Pierre Duhem, To Save the Phenomena: An Essay on the Idea of Physical Theory from Plato to Galileo (Chicago: University of Chicago Press, 1969), chapter 7.
7. Charles Siebert, "The Rehumanization of the Heart," Harpers, February, 1980, pp. 53-60.
8. What follows is a summary drawn from portions of three or four lectures delivered by Incao between 1989 and 1995.
9. Herbert Butterfield, The Origins of Modern Science (New York: Free Press, 1957), pp. 13-14.
10. Owen Barfield, "Thinking and Thought," reprinted in Romanticism Comes of Age.

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Steve Talbott :: Between Discordant Eras