I stared blankly at the website’s flashing cursor. Maggie was 103 years old when she died. She had no medical problems. One winter, she started staying in bed more, then died six weeks later. Completing her death certificate felt impossible. The Department of Health and Human Services (DHHS) disallows entering “old age” or “cardiac arrest” as legitimate causes of death, yet those were the only two of which I was certain. She just folded up her tent, punched out, or her giddy up got up and left without her. I didn’t think DHHS would find that funny. So, the cursor flashed in the “Cause of Death” field, unperturbed.
No matter what diseases or conditions a person lives with or, in this case, without, everyone has the same cause of death: cardiac arrest. It’s the easiest statistic ever. It happens at the end of life 100% of the time, without exception. While not useful for population disease statistics, it’s an observation ripe with meaning.
Circulating blood carries life-giving oxygen and nutrients to all body cells and carries away toxins for disposal. When the heart stops, so does all that. In today’s way of thinking, the heart stops for one of three reasons:
#1: Its electrical system malfunctions so it can’t pump blood;
#2: It is too weak or stressed and won’t pump blood; or
#3: Disruption in its own blood supply leads to starvation and death of clusters of cardiac cells, which leaves the heart prone to #1 and #2.
By today’s thinking, the heart stops when a condition of its environment wears it down or breaks it. This quietly leads to the expectation that the heart would otherwise pump forever if properly maintained. That is machine mentality, though experience tells us that it is ridiculous. While few would accept that one heart could beat forever, many accept that risk factors are the conditions that cause diseases that go on to cause death. You can’t have one without the other. Both ideas stem from the same machine mentality: one that describes the machine under perfect conditions, and one that describes the conditions that wear it down.
In effect, today’s recognized “causes of death” describe how we die, but don’t answer why. Why we die, cardiac arrest, is not a cause of death. The paradigm traps us in an endless cycle of answering how questions with the hope they will miraculously answer why. Let’s rethink the why here.
Cardiac cells form a complex, adapting, communicating, and therefore intelligent society of Little Beings. If my 103-year-old patient had a lifetime average heart rate of 60 beats per minute, then her society of billions of cardiac cells beat together over 3 billion times. Not only is that unfathomable in comparison to human societies, but why after 3 billion iterations, did that society agree to quit?
Can you imagine performing the same task every second for 100 years, crammed in the dark with the same neighbors? Given that heart cells live as long as you do and aren’t thought of as “shift workers,” then the only time they rest is during the brief pauses between beats. If true, then cardiac arrest would understandably be the result of strikes and worker burnout. It’s easier to think of them as automatons.
The point is that just because a person observes and experiences the pumping action of a heart doesn’t mean cardiac cells experience the same. What they do for us isn’t why they do what they do. Whatever benefit their actions and interactions create for them, modern ideas about economics don’t adequately capture it. Whether talking about individuals or societies, human experience does not translate to cellular experience. It is not a useful analogy though unfortunately it underpins modern beliefs about the body.
I suspect that the secret to understanding why the heart stops is buried in what we call ageing. Ageing is a poorly understood phenomenon no matter what anyone is selling. Some people age faster or slower than their number of trips around the sun would indicate. Gluing the concepts of “year” and “age” together doesn’t change that a year measures an object’s duration of existence in earth’s terms, but ageing is something else. If people that share a planet don’t age at the same rate, then why would anything else? Perhaps organs that share a person or cells that share an organ don’t age at the same rate. Rapidly ageing kidneys or livers may contribute to conditions that eventually stop the heart, but that is not confirmation of modern beliefs about how conditions work.
I want to know what happened to Miss Maggie. What was her secret? I may have entered “heart disease” on her death certificate as an offering to the paradigm, but frankly, it was as inaccurate as it was meaningless. Categorizing events so they fit into population statistics will never get us where we want to go with understanding life and disease. This is where understanding stops, but this line of inquiry invites so much more.
In conclusion, today’s approach to disease reminds me of a segment in the poem How Did You Die by the 19th century Canadian poet Edmund Vance Cooke.
Death comes with a crawl, or comes with a pounce,
And whether he’s slow or spry,
It isn’t the fact that you’re dead that counts,
But only how did you die?
Want to read more on the heart topic? Go to Meet the Conductor in the first edition of Permutations HERE