Wednesday, October 29, 2008

Bionic heart will soon start throbbing

The old-fashioned American gesture of holding a hat over one's heart is hilarious, like the opening of some kind of Stetson song-and-dance routine in a musical comedy.

To my mind, it's ridiculous. It doesn't correspond to any reality, not even symbolically. On the other hand, I can imagine a society in which a male, swearing an oath of allegiance in the name of his biological forefathers and offspring, would be expected to place his hat over his genitals. But the ideal symbolic place for a hat, in such a ritual, would be up above his brain, in its normal position, sitting on top of his skull. As far as solemn oaths are concerned, that's where all the action takes place, rather than in your gut or your genitals or even your heart. Many common folk still seem to respect the medieval belief that the heart is the origin of human sentiments, whereas the brain is merely a cold calculating organ. But it's time to abandon antiquated symbolism such as hats held over hearts, which is just as silly as astrology, superstition and religious ritual. I'm not suggesting that laws should be passed to prohibit such behavior. I'm merely saying that antiquated antics of this kind should be interpreted by intelligent observers as external signs of relative stupidity, like fumbling with rosary beads, or making a sign of the cross on your breast.

The heart is in fact a rather simple pumping gadget, of a vastly lower order than the brain. These days, in a surgical environment, the usual work of the heart can be taken over by a machine that looks like this:

Needless to say, neurosurgeons have no equivalent machine to replace the patient's brain during an operation. On the other hand, the problem with a typical heart-lung machine is that a patient can't expect to move along the hospital corridors with the apparatus trailing along behind him. Before leaving the operating theater, a patient has to get back to using his own patched-up heart, or maybe a donor's revived organ. Obviously, what we need is an artificial heart that a patient can "wear" in his chest in much the same way that you might walk around carrying a portable computer in a bag thrown over your shoulder.

The design, production and installation of such an artificial heart has been the constant challenge of the 75-year-old French cardiologist Alain Carpentier, who founded a company with the aim of developing such a prosthesis. [Click the photo to see the Wiki article about this celebrated international medical figure.]

Today, Carpentier's invention has reached the stage of an operational prototype that has been tested successfully in animals:

Often, we hear people say despondently that, if only their leaders were to invest as much money in medical research as they invest in aeronautics, space and defense, then citizens would lead far better lives. Well, Alain Carpentier's artificial heart is based, to a large extent, upon fallout from the domains I've just mentioned. Fifteen years ago, the professor struck up a partnership with Jean-Luc Lagardère, chairman (now deceased) of a vast industrial group that had evolved from the renowned French high-tech corporation named Matra, which manufactured a wide range of electronic products that included missiles and minicomputers. Professor Carpentier is a distinguished medical researcher, who was awarded the Albert Lasker prize in 2007 for his research on heart valves, which resulted in products made out of chemically-treated pig tissues.

When the latest white-skinned model of the artificial heart is placed upside-down on a table, so that its tubes are hidden, it looks a little like a freshly-prepared chicken ready to be roasted. Some chicken!

Clinical testing of the device on human patients will start in 2011, and it should normally be ready for real transplants by 2013.

If we telescope together the last three-quarters of a century in such a way that the US president behind Hiroshima and Nagasaki were able to become a patient of Professor Carpentier, we create the setting for a fascinating philosophical question. Let's suppose that Harry Truman were to be fitted with an artificial heart. Would it still be appropriate for him to place his Stetson over the electronic device whenever he listened solemnly to the Star-Spangled Banner?

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