Anatomies: A Cultural History of the Human Body (17 page)

Functional MRI is also being applied for less lofty purposes. Brain scans of people on slimming regimes made as they choose whether to eat healthy or junk food, for example, appear to highlight areas of the brain involved in self-control. Product manufacturers and advertising agencies are naturally very interested in this activity of the brain – and in being able to circumvent it. Now that MRI has proven itself as a diagnostic technique and the cost of the equipment is falling, businesses are starting to think about what it could offer them. Gemma Calvert is a former academic psychologist and now managing director of Neurosense, a company that uses brain imaging to probe the mysterious recesses of the consumer’s mind. ‘There is a perception out there that this was developed as a medical technology, and now you’re using it for commercial purposes, and what are you playing at?’ Gemma admits. But major corporations clearly have no such qualms. Neurosense used brain imaging on behalf of a British breakfast programme on commercial television, producing the self-serving result that viewers paid more attention to, and were better able to recall, advertisements screened in the morning.

‘You shouldn’t be sceptical that this technology allows us to see how the brain performs a certain task,’ Gemma chides me. ‘The tricky bit comes when you start asking more social questions. Will you ever really be able to use these technologies to read what I’m thinking? I for one would like to see that.’ The prospect remains theoretical for now, though, requiring scanners with much greater resolution than those available today that could capture the firing of individual neurons in the brain. This might indicate what someone is thinking in response to a certain stimulus. ‘But that still doesn’t get at the sense of experience. The sense-of-being-alive thing is a biggie.’

In San Diego, meanwhile, a company called No Lie MRI shows one direction where this technology is headed. It hopes to use fMRI to enable its clients to assess job applicants and insurance claimants. Because the imaging technique monitors the central nervous system directly, rather than the autonomic nervous system that controls body functions, No Lie MRI claims it is able to bypass American legal restrictions that apply to companies’ use of polygraph lie detectors. Its plan is to set up Orwellian-sounding VeraCentres where subjects will be interviewed while being scanned by an MRI machine. The company is presently lobbying so that fMRI ‘evidence’ will be admissible in American courts. Even neutral organizations such as the British Psychological Society concede that it is probably only a matter of time until brain scans are admitted in court, even though, as with DNA evidence, the aura of science that surrounds them can mean that jurors give them a credence that they do not always merit.

In its zeal to catch fibbers, No Lie MRI may be missing the big picture. To a neuroscientist, and increasingly to all of us, we are our brains. The day may not be far off when a man can walk into court and accuse his own brain of the crime, and the evidence will support his claim. Or, to put it another way, any defendant in future may be able to plead a sophisticated modern equivalent of the insanity plea. The question then is whether it makes any sense to punish the person – or their brain.

The Heart

The heart is a hollow muscular organ of a conical form, placed between the lungs, and enclosed in the cavity of the pericardium.

The heart is pyramidal, or rather turbinated, and somewhat answering to the proportion of a pine kernel.

The heart of creatures is the foundation of life, the Prince of all, the Sun of their microcosm, on which all vegetation does depend, from whence all vigour and strength does flow.

The heart, like a chasuble.

The heart, like a fleshy whoopie cushion.

The heart is deceitful above all things, and desperately wicked.

The heart has its reasons of which reason knows nothing.

The heart is a hungry and restless thing; it will have something to feed upon. If it enjoys nothing from God, it will hunt for something among the creatures, and there it often loses itself as well as its end.

The heart is forever inexperienced.

The heart is a lonely hunter.

The heart, then, is many things to many people, as these varied descriptions attest. The first three descriptions here are by anatomists at different periods, taken respectively from Gray’s
Anatomy
, Helkiah Crooke’s
Microcosmographia
and William Harvey’s
De Motu Cordis
. The next, ‘The heart, like a chasuble’, is from
Pantagruel
by François Rabelais, who was an anatomist as well as a monk, a lawyer and a writer. On one occasion, in Lyons in 1538, a corpse spoke to Rabelais, at least as told in a contemporary poem by Etienne Dolet. The corpse clearly felt he had got his own back on the judges who had only sought to increase his punishment by sentencing him to death with dissection when he learned he was to be dissected by the great Rabelais: ‘Now Fortune you may rage indeed: all blessings I enjoy.’ The next, possibly more informative, simile comes from Louisa Young’s
The Book of the Heart
. The remaining statements are drawn from the Old Testament Book of Jeremiah, the seventeenth-century French philosopher Blaise Pascal and his contemporary the English clergyman John Flavel, and the American writers Henry David Thoreau and Carson McCullers.

The idea that the heart represents in some important way our very core goes back to Aristotle and beyond. According to Young, Egyptian and Greek stories of more than 3,000 years ago reveal that the heart was already regarded as the seat of ‘identity, life, fertility, loyalty and love’. Whether this was physiologically true was to remain unknown for many centuries. But the fact that it was absolutely the case in a symbolic sense was underwritten for some 1,300 years when Galen in the second century
CE
placed the liver, heart and brain in charge of the tripartite body (abdomen, thorax and head), the heart inevitably central of the three.

Unlike all the other internal organs, the heart is clearly discernible as a site of activity: it beats, and beats at a rate that changes in response to the world around it, faster in the presence of a lover, or of danger, slower in sleep and at the approach of death. Classical physicians saw the heart as the source of the body’s heat and as connected with the blood, but it is astonishing that its true function as a pump sending the blood round the body was not understood for so long. Leonardo da Vinci came tantalizingly close to the truth when he observed, as Galen had not, that the heart has four chambers, is highly muscular, and is the source of all blood vessels. Had he only noticed that some of these vessels carry blood out from the heart and others return it, he surely would have drawn the obvious conclusion, and sealed his reputation as rather more than an amateur in the field of anatomy.

When I hold a heart in my hand, it is immediately obvious that it must once have done something. Compared with the lungs or brain, liver or kidneys, which have an inscrutable uniform texture, this organ has a convoluted architecture. I pull aside the thin folds of fat that wrap it like tissue paper round a piece of china. It has a muscular base with its various chambers (two atria and two ventricles) above. Empty of blood, it is noticeably bottom-heavy. Blood vessels trace wormlike paths across its external surface. This particular heart has been cut away across the aorta, revealing it as a huge tunnel about two centimetres in diameter. I read that the heart pumps 10,000 pints of blood in a day, and that it can squirt blood six feet into the air through this tube. How, in the past, could people imagine that the body simply manufactured blood at the colossal rate that this gaping conduit surely demands? The major vein of the body, the vena cava, is almost as big where it enters the heart. Four other large blood vessels, the pulmonary veins and arteries that transport blood to and from the lungs where it is oxygenated, are about a centimetre across. The whole design reminds me of a diagram of an underground train station. I imagine it will be a puzzle to place the heart back in the prosected body from which I have lifted it so that the severed tubes meet up, but in fact it slips easily back into the hollow left for it by the lungs, finding its correct orientation as it falls into place, like an animal settling in its nest.

In places, I can see wavy flaps of flesh. These are the valves that regulate the blood flow. They create the characteristic double beat of the heart, which is typically spelled out as ‘lub-dub’ or ‘lub-dup’. If you speak these two syllables aloud your tongue will mimic the action of the two sets of valves that regulate the flow of blood. Part of the reason why William Harvey was able to discover the circulation of the blood where Galen and Leonardo had failed may be owing to advances in hydraulic engineering made in the early seventeenth century, including, oddly enough, Pascal’s invention of the hydraulic press. Perhaps these water-pumping contraptions enabled Harvey to see the heart afresh. In any case, Harvey elucidated the mechanism of the heart and blood flow with exemplary scientific clarity, although he remained baffled as to what all the activity was for. This would have to await the discovery of oxygen and the role of red blood cells more than a century later. Sadly, once his book was published, things went less well for Harvey. His friend and biographer John Aubrey wrote that he ‘fell mightily in his Practize, and that ’twas beleeved by the vulgar that he was crack-brained; and all the Physitians were against his Opinion, and envyed him; many wrote against him’.

Harvey’s breakthrough did no harm to the conventional reading of the heart as the centre of things, though. Though in fact slightly off-centre (to the left) within the body, the heart represents a sensible centricity, a midpoint between the head and the sex, the fulcrum of reason and lust. Its newly understood role in pumping blood round the entire body simply strengthened its metaphoric importance, as Harvey himself was not slow to realize when he wrote his gushing dedication to Charles I. The heart was now appreciated as a regulator of the body, and became therefore more powerful than ever as a symbol of moral self-regulation. We speak from the heart when we mean what we say. We keep secrets in our heart. Even though we know the brain is the centre of perception and cognition, the heart is still where we wish to
feel
things. In the West, the heart has for long been the organ most closely associated with the emotions, though in the East it has often had more to do with the intellect and intuition. Once, Western beliefs called on the heart to perform these duties, too. ‘For as he thinketh in his heart, so is he,’ warns Proverbs 23:7. The prayer known as the Sarum Primer after the 1514 book in which it is found runs:

God be in my head,

And in my understanding;

God be in my eyes

And in my looking;

God be in my mouth.

And in my speaking;

God be in my heart

And in my thinking;

God be at my end

And at my departing.

At this date, the heart is identified with thinking, while the head, or brain, is concerned with understanding. Ironically, Harvey’s discovery a little over 100 years later that the heart was a pump – a central pump, regally important in the body, but just a pump for all that – was one of the first breakthroughs to begin to persuade people that the brain was in fact more important, marking what the cultural historian Fay Bound Alberti calls the ‘scientific transition from a cardio-centric to a cranio-centric body’.

In 1997, a Canadian cardiologist, Andrew Armour, published a paper making the revolutionary claim that the heart actually has a ‘little brain’ of its own. Neuronal circuits observed on the heart may be capable of ‘local information processing’, Armour suggested. The heart is here reframed as analogous not to a pump or any mechanical contrivance, but more fashionably to a computer system: the brain is our mainframe while the heart and perhaps other organs too are served by local processors. Dismissed in some quarters as pseudoscience, Armour’s findings were seized upon by churches and theosophists as providing scientific evidence for the biblical thinking heart.

One way or another, the heart retains its place in our hearts, as it were. Metaphors to do with the heart seem very real. To die of a broken heart is surely one of the most awful ways to die, never mind that this squashy, elastic organ cannot break in a physical sense. It can weaken, become atrophied and diseased, but it is never the brittle object implied by the cliché of a heart with a lightning bolt cracking it in two. The emblematic status of the heart is assisted by its compactness and portability. Especially in the case of saints and martyrs, the heart was often buried separately from the rest of the body. This practice stemmed in part from necessity – guts and eviscerated organs were buried first in order to lessen the stink of a rotting corpse in church. But it was also symbolic. The heart, as Young tells us, can also be ‘pickled, sent, given, kept, eaten, or worn round the neck’. A heart could even be repatriated from foreign wars when plague laws prevented the return of the body.

Given its symbolic importance, it is perhaps surprising that we are happy to remain largely ignorant about the real appearance of the heart. The beating, visceral thing itself plays so invisible a part in our lives that we do not even know its shape. This is true of the human heart and animal heart alike, for the latter has been marginalized in the kitchen, not central at all, but classed with offal. At the same time, the heart has become ever more standardized as a symbol. Drawings of the seventeenth century show the heart shaded as a three-dimensional object, not always delineated with anatomical accuracy perhaps, but nonetheless at least displaying some of the irregular morphology of the real organ. But during the eighteenth and nineteenth centuries, on playing cards, in woodcuts and embroidery, and finally on commercial Valentine cards, the heart became far more familiar as a flattened and symmetric figure.

How did the heart arrive at this stylized, and most unrealistic, two-dimensional device – a red, twin-lobed, inverted triangle? Theories are many and ancient. In Egyptian hieroglyphics, a vase stood for the heart. Is our heart icon the outline of a vase? The curlicued design of a lyre offers a Greek explanation. Or it may simply be a development from that inverted triangle used to represent the female sex, a symbolism celebrated by the fashion designer Mary Quant, who got her husband to clip her pubic hair in this shape. In fact, the design we interpret today as a symbol of the heart had its beginnings as the depiction of an ivy leaf or a bunch of grapes. The symbol on the suit of cards that we call ‘hearts’ was originally such a leaf.

Hearts in medieval art and literature were often described as pear- or peach-shaped. Giotto’s fresco of Charity in the Scrovegni Chapel in Padua has her offering a teardrop-shaped heart from a bowl of fruit. But at some point the flattened ivy leaf motif seems to have taken over as the preferred shape for the human heart. The first heart with a cleft may be that depicted in Francesco da Barberino’s book of emblems,
I Documenti d’Amore
, dating from around 1310, while the first stylized heart in an illustrated anatomy dates from 1345. In churches, worship devoted to the Sacred Heart of Jesus gradually supplanted the Franciscan devotion of the five wounds of Christ. Later, the Sacred Heart alone became the symbol of the Roman Catholic backlash against Protestantism. This lurid symbol was not without its problems, however. At the end of the nineteenth century, for example, Catholic missionaries in Rwanda found themselves accused by their would-be converts of cannibalism because of the graphic nature of their crusading logo.

The simplified heart shape was cut into furniture by the Amish and the carpenters of the English Arts and Crafts movement. Today, it features in the branding of many products, promising, confusingly, either that they are good for you or that they are naughty-but-nice. There is even a key option for a heart symbol on my Apple computer, which has served me no purpose until now:
.