St. Jude and the Tell-Tale Heart


 







  Literature is full of hearts, both real and metaphorical: Heart of Darkness,
Bury My Heart at Wounded Knee, Hearts in Atlantis. But my favorite has always
been Edgar Allan Poe's story, "The Tell-Tale Heart." In Poe's taut story, a
murderer is haunted, and finally forced to confess, by the sound of his
victim's heartbeat persisting long after the fatal act. And I think of that story
almost every day, when my own heart startles me with its tick-tick-ticking.

  Several years ago, my cardiologists at George Washington University found
that my mitral valve, transplanted from the heart of a large pig, was
calcifyinggrowing stiffand no longer working as it should. I felt fatigue,
shortness of breath, and frightening irregular heart rhythms. The specialists
then worried me further by recommending another open-heart surgery, to
implant a device called the St. Jude Mechanical Valve. I had heard of the St.
Jude valve, but never thought it was for me. After all, St. Jude is the patron of
impossible causes, right? I couldn't be that sick!

  But it turns out that St. Jude is the name of the company that makes the
valve; it's not named to be the valve of last resort. Still, it seemed an
unnecessarily cruel twist for an already-weakened heart patient: "Yours is a
tough case. We'll have to bring in St. Jude."

  The phrase "hopeless cause" nagged at me for weeks. And even now,
friends who customarily turn to the intercession of saints look at me with
concern when I mention my St. Jude heart valve.

  My doctors did prepare me for the surgery's most notable aftereffect: Unlike
the mitral valve I was born with and the porcine valve I carried for 9 years,
the St. Jude valve, made of lightweight metals and plastic, is noisy. They said
the valve would last the rest of my life, and I'd get used to the noise.

  The valve ticks and clicks like a cheap watch. But the thing is not cheap; it
cost thousands to make and install. The surgeon's skill is priceless. You'd
think the implanted valve, a showpiece of biomedical engineering, would
sound more resonant and ponderously drumlike, more deep and important
than the Timex counter at Kmart.

  I hear the valve mostly in the morning, after I shuffle from bed to bath. In
the predawn quiet, with no distractions, and before taking the heart
medicine that controls rhythm, I marvel at the noise: It's a troupe of tiny
flamenco dancers under my nightgown! And it sounds like the beginners'
classflailing away on their tinny castanets in a dysrhythmic frenzy, trying
to find a consistent pace.

  At night, the noisy valve can keep me awake. Sometimes it’s just too loud;
other nights it keeps reminding me of its presence and lifesaving work, and I
can't help wondering: What if I stop hearing it? It's been totally, noisily
reliable for years, but what if it goes quiet?

  During the workday, my noisy valve is less intrusive. Or maybe I'm just too
busy to notice. But sometimes a muffled ticking breaks through the clicks of
my computer keyboard. And automatically I look down at my left wrist. After
all this time, and knowing full well what that clicking noise is, I still
foolishly bring my arm up in front of my face and ask, "What is wrong with
this watch?"

  Then I remember St. Jude and Edgar Allan Poe and the sound he said was
"like a clock wrapped in cotton." And I recognize the noise is not the ticking
of my watch but the beating of my own tell-tale heart.
  

Copyright © 2005, Barbara Shine; published Washingtonian magazine, March 2006