congestive heart failure

[seemslikeadream]

The great Dick Cheney empathy test

By Mark Morford, SF Gate Columnist
Friday, July 16, 2010


Mark Wilson / Getty Images
The Great Dick Cheney Empathy Test (GDCET) is not for the faint of spirit. It requires tremendous fortitude, a deeply benevolent worldview, much unchecked screaming, and copious amounts of whisky. Also, reading. Do you have what it takes?

Former Vice President Dick Cheney disclosed Wednesday that he has undergone surgery to install a small pump to help his heart work, as the 69-year-old enters a new phase of what he called "increasing congestive heart failure." -- Associated Press

Here's how it works. You read the story above. You note how Dick Cheney, former vice president, Bush babydaddy, sneermaster supreme, befouler of nations, lover of war, hater of, well, almost everything else -- has undergone yet another major heart operation, this time to place a little valve-assisting pump (called an LVAD) in his withered and long dysfunctional ticker.
You then read how Dick is recuperating in intensive care following said installation -- which, by the way, is usually only a stopgap measure, just a delay tactic until the device in question gives out and the patient requires a full heart transplant. Is Dick a candidate for that? Doubtful. Also, they say LVADs are usually reserved for patients with end-stage heart disease, a last resort, the final straw. It is, they say, only a matter of time.

So it begins.

The first knee-jerk response to the Great Dick Cheney Empathy Test (GDCET) is, of course, the easiest, and the most obvious, the most available to your giddy puppydog consciousness, and my guess is it shot through you like a fast and wonderful lightning bolt of OH MY SWEET JESUS YES the instant you read the story above.

That response was, shall we say, not very subtle. It was, I'm guessing, a not-so-secret howl to the universe that the sooner Dick exits this earthly plane, the healthier, lighter and happier we will all be, planetwide. Dark shadows will lift, flowers will bloom more brightly, 10 million female uteri can finally unclench, and so on.

But then, perhaps you sigh, ponder, probe a bit more deeply. Is that how you really wish to be? What of those noble traits we all strive for: compassion, benevolence, forgiveness, a wan but merciful smile in the face of thine enemy's condemnatory sneer? Is wishing a scaldingly painful death on one of the worst and most shameful characters in American history really the right way to treat your fellow man? Any fellow man? Of course not. Well, maybe. No, no, definitely not.

After all, if you wish such a thing, what does that say? About you? About us? About this paragraph? Would we not all be wallowing on the same filthy level? Is it not similar to the death penalty argument so beloved by liberals, that no matter how vile the criminal, to wish death upon any human makes us just as base and ugly as those we deem to be evil? This is no way for an enlightened consciousness to evolve.

I know what you're thinking. And yes, passing the GDCET would require all your courage, all your gumption, willpower, whisky and every ounce of benevolent energy you can muster. You would have to invoke all your Jesus-flecked Buddha nature to turn the other cheek, love thy enemies, forgive the sinners -- basically dredge up every maxim, axiom, aphorism, proverb and Hallmark card you can think of, toss them into a karmic blender and shoot them straight into your wary soul like a desperate and godly emetic.

It ain't easy. You must first resist the very reasonable, insistent screaming of your calmly vengeful side, the one that would be very pleased indeed if Dick suffered a million scalding rashes and burned in hell with Jerry Falwell, Saddam and Strom Thurmond for all eternity. That would be wrong. Stop thinking that.

Perhaps a reversal is in order. Perhaps it's better to wish someone like Dick a longer life, so that he may bear witness to the well-deserved implosion of all his nefarious plans, his cronyist empire. The man is, by most accounts, responsible for countless thousands of innocent deaths, the acerbic tainting of our national identity, a flagrant mutilation of everything we once held dear. You sort of want the guy to feel it. Repeatedly.

Are you a seriously impassioned ultraliberal with a thing for vengeful whimsy? You might even take this notion a step further and hold out a flicker of hope that Dick will live long enough to one day be put on trial for his war crimes, hung in a public square, slowly eaten by swarms of feral pigeons. Or crows. Pugs. Whatever.

This is, of course, a total fantasy, akin to imagining Rush Limbaugh getting busted for snorting meth from a gay teenage hooker's thighs just after fellating Mel Gibson in Newt Gingrich's fetish dungeon. Doesn't matter. As long as Dick is alive, it's a fantasy that keeps many a liberal heart aflutter.

Maybe you sense there is no rush. Maybe you know there's need to wish Dick an immediate demise, given how everyone knows that before long he'll be taking the Great Escalator down to the basement. Surely a great reckoning is coming. In the grand arc of spacetime, what's a few more years?

Besides, will it not be lovely for Dick to witness Obama sail into his second term, replace a third of the Supreme Court with people who actually have souls, and overturn/reverse nearly every law, stance and spiteful stratagem with which Dick ever fouled the earth? You bet it will.

Or perhaps, finally, you can appreciate the value of a living Dick. Every culture needs its demons, yes? The villain is just as important as the hero. Dick has been, and continues to be, an ideal foil, the complete monster, the perfect perversion of humanity by which we can all measure subsequent people and deeds. You may look upon any modern atrocity, any upstart political ogre, any personal abuse and say, well, at least it's not Dick Cheney. That's something.

So, how did you do? Did you pass the GDCET? Fail instantly, way back up top, when you read the headline to this column? Not quite sure?

You might be like me. See, I try to wish no violence or death, illness or pain on my fellow man. I do not always succeed, but still I strive, every single day, with every breath, even if I can't always forgive or be as uniformly compassionate as I'd like, then at least to proffer kindness, to see the larger picture and above all, to refuse to let the poison enter my heart.

However, I'm quite sure I would not be the slightest bit displeased to learn that the laws of brutal karmic repayment have come into full, painstaking, searing effect on our boy Dick. No, I wouldn't mind that in the least. After all, it's the empathetic thing to do

[jingofever]

By the way, I hear he's "undecided" on a heart transplant. You know, as I understand it, some patients who receive vital organs from others sometimes begin to show some of the donor traits in the weeks and months following transplantation. Wouldn't it be interesting if Dick Cheney receives the heart of a really, really good person — and then began to feel real horror over his own errant life?

Peter Houghton, the longest surviving person who had a heart pump (he's dead now), complained (or maybe just noted) that he lacked emotions after the surgery.

Peter Houghton is grateful for his artificial heart. After all, it has saved his life.

He's just a little wistful about emotions.

He wishes he could feel them like he used to.

Houghton is the first permanent lifetime recipient of a Jarvik 2000 left ventricular assist device. Seven years ago, it took over for the heart he was born with. Since then, it has unquestionably improved his physical well-being. He has walked long distances, traveled internationally and kept a daunting work schedule.

At the same time, he reports, he's become more "coldhearted" -- "less sympathetic in some ways." He just doesn't feel like he can connect with those close to him. He wishes he could bond with his twin grandsons, for example. "They're 8, and I don't want to be bothered to have a reasonable relationship with them and I don't know why," he says.

He can only feel enough to regret that he doesn't feel enough.

The new heart was a marvel. Soon Houghton was not only back on his feet, he was traveling the world, giving speeches, writing books, becoming chairman of the Artificial Heart Fund and engaging in a 91-mile charity walk. This all caused those who enthusiastically embrace bionic enhancement to hail Houghton -- part man, part machine -- as the model cyborg.

There were just these few nagging problems in the recesses of his soul.

"My emotions have changed. Somehow I can't help that," he says.

"Being a Jungian psychologist, I would describe myself as less intuitive. More of a thinking, more rational, less intuitive person. Less sure if I can do things by inspiration."

No one really knows why Houghton has this trouble -- whether it is the machinery, or the drugs, or depression, or advancing age, or the lingering effects of major surgery, or a lack of hormones secreted by the heart, or even that for hundreds of thousands of years, human brains have been optimized by having their oxygen delivered in pulse-driven spurts, not constant pressure.

Given his training, however, Houghton naturally reaches for psychological explanations. "The procedure lands you in a position that no one has ever pioneered -- what it does to a person as a person. You're an invented person trying to cope with it, trying to deal with the emotional context of it."

He says he can see that those close to him "can do without you. So you protect yourself against that knowledge. You're not very central to their lives any more. This means you're much more cautious about how you use your emotions. You try not to invoke them. You become coldhearted. The thought doesn't agree with me, the fact that it happens. But I don't know what to do about it."

His grandsons "are gorgeous little boys, but when you come down to it, they're not going to remember you very much. So automatically you sort of think, there isn't anything I can do about this. Not going to get too hurt about it. You give them hugs and the usual things. You just don't feel -- they're not part of my life, you know what I mean?"

Five years after the operation he went through a period of clinical depression. "Several times I thought, better off if I wasn't here. Let everyone get on with their lives. I felt I'd like to put an end to it. But choosing the methods puts me off. Feel cowardly about killing yourself."

He saw a psychiatrist about his suicidal thoughts. "He wasn't too worried," Houghton says. "It's a perfectly rational response to a difficult set of circumstances. Wasn't surprised by it. Advised me to try and think about what I was doing. He didn't try to put me off. He challenged me -- 'Are you sure you mean it?' I did mean it, but not sufficient to overcome my fear of the actual process."

He was prescribed antidepressants for 18 months, and was weaned off them six months ago.

Depression is apparently not the norm:

People who have had VADs implanted have had lower rates of depression than those people suffering from cardiac disease that have not undergone implantation surgery.

I wonder if his lack of emotions has anything to do with how much emotions are felt physically through the beating of our hearts. If your beat is replaced with a whirring maybe you disrupt a feedback cycle and your mind isn't used to not feeling anything. Later in the three year old article it goes into the supposed change in Cheney that his old colleagues noticed and wonders if his heart problems had anything to do with it. Anyway, this Houghton fellow started referring to himself as a cyborg, kind of like adopting the donor traits of a machine I guess.

[Iamwhomiam]

Hmm... Seems there is a heartbeat for those implanted with the Jarvic 2000:

"Unlike the natural heart, the Jarvik 2000 pump does not "beat." Instead, it uses a spinning rotor to propel blood from the left ventricle into the aorta. But the natural heart continues to contract and relax, and the volume of blood moved by the spinning rotor rhythmically increases and decreases in synchrony with those contractions.

Jarvik 2000 patients do, therefore, retain a pulse. The Jarvik 2000 magnifies the blood output of the heart, effectively producing a pulsatile blood flow in concert with it. The device truly assists the patient's own heart without hindering it. With both the biological heart and the mechanical pump moving blood into the aorta, the congestion of fluids brought on by heart failure can quickly subside."

http://www.jarvikheart.com/basic.asp?id=21

[slomo]

Dick Cheney was merely a channel. A horse to be ridden by the darknesses who will no doubt find other eager and willing vessels.

[Simulist]

Dick Cheney was merely a channel. A horse to be ridden by the darknesses who will no doubt find other eager and willing vessels.

That's so chilling — and so true — that it literally sent shivers up my spine.

[slomo]

Peter Houghton, the longest surviving person who had a heart pump (he's dead now), complained (or maybe just noted) that he lacked emotions after the surgery.

For a year I dated a guy with a pacemaker (installed at a relatively young age for that sort of thing). He had been a highly placed executive but was recently retired, at a young age due presumably to his acquired wealth. There was something oddly cold and mechanical about him. He was unquestionably the most intelligent person I have ever dated for any length of time (in a calculating, conventional kind of way, though my ex-partner before him, whom I had recently broken with after a very long and difficult period, had been scary smart in social matters; in any case I was relieved to be dating somebody who was able to hold an intellectual conversation about cerebral things). I came to feel that there was something missing with him. Interestingly, over Thanksgiving my mother had dinner with him and then with my ex (who loved my mother and insisted upon seeing her even though he and I had been apart for almost a year) - and even knowing all the bad things that had occurred between my ex and myself, and admitting that the new boyfriend was exceedingly charming, her final assessment was in favor of the ex at the expense of the new guy. The final proof of his emotional stuntedness was a small thoughtless thing he did over Christmas, but it confirmed without a doubt his emotional cluelessness. After that I cut off all communication with him.

The thing is, there is much about his past that would suggest that he was like that before the pacemaker. Does machine create heartlessness, or does heartlessness merely attract machine?

Once, many years before him, and before even my ex-partner, I had a vivid dream that I had gone to business school. (At that time, I was kicking myself for being in a science doctoral program and consigning myself to a life of poverty relative to what I could have done with an MBA, although I was vaguely aware of the moral dimension to the decisions I had made.) In the dream, all of the courses, the entire curriculum, were conducted upside-down, so that we all had to walk on the ceiling going to and from classes, sitting upside-down listening to lectures, etc. In the dream I felt blood rushing to my head, and wondered whether this would eventually damage my heart. I awoke breathless with my heart pounding.

[elfismiles]