Reptiles and Angels

I

ROLLING along in my hospital wheelchair, I passed through a narrow door and came to a stop in a whitened concrete vault. As this was, no doubt, the place (for it was plain that we could go no farther), I gathered my blanket about me and composed my mind to meet the further eventuality. I was now to be connected up, by both wrists and my left ankle, to an electric plug in the wall.

On a shelf or table at my right was a coil of electric wire, rather stifflooking and black. On three ends of it were electrodes, these being zinc plates shaped like a shoehorn, and so curved that they would fit snugly, like wristlets and anklet, to the three parts of my body. Aside from this wire and its terminals, there was no indication of machinery in the place.

But while there was no machinery here, there was, down in the basement, where it could rest on solid earth and be free from all vibration, a machine about ten feet in length. Of its several parts, the dominating feature is a large electro-magnet. This magnet, which is circular in form, so that its poles face each other and approach closely, is as big round as a stovepipe and about two feet across. With its large iron core and interminable wrappings of fine wire it is a most able-bodied magnet. It is with this that the electric plug in the wall makes connection.

Anyone seeing the wire to which I was to be fastened, and noting the careful arrangements for getting good contact, would naturally conclude that I was about to have a charge of electricity passed through my body. But this would be a mistaken conclusion. There was no source of electricity in that apparatus. The source was in me. The electric energy created by my heart, incidental to the muscular contractions of each separate beat, would go down through the plug in the wall, course through the fine wrappings of wire and give the big magnet its power. Thus my heart would operate the machine.

The result would be a record of how the muscles of my heart were acting. Each beat could be analyzed by means of the photographic representation which the electro-cardiograph inscribes on a roll of paper. This long message, when decoded, might offer me encouragement, within certain limitations. Or it might be news that I should not be very glad to hear.

Not much power is needed to work the essential parts of the electrocardiograph — only enough to carry the news and make it manifest. The reader will therefore get a truer conception of it if he regards this black wire not as a power line, but as a telegraph wire. It was news we were after — important information; and to this end we were arranging for a cablegram from my heart.

A fitting end for the average man to come to! Considering how remote from his mind is any knowledge of his own inner mechanism, and how careless he is of its upkeep, it is quite appropriate that he should have to get in touch with his heart after the manner of a message from afar.

To get appreciable power out of the electricity of a single heart, and to measure each slight fluctuation of the current, requires some very delicate mechanism. This the electro-cardiograph has. It contains a thread, a filament, so fine that when the front of the machine is off, one dares not speak in the room for fear of breaking it. It is really a thread of stone. When quartz is melted with the blow-pipe, filaments form and float away invisibly on the air. They are imperceptible to the eye except under the most favorable circumstances. A piece of black satin, suspended nearby, serves to catch some of the filaments and make them visible. With much patience and many mishaps, a thread of suitable length is finally captured and strung on a glass bow, its ends being caught and fastened in drops of gum. And now, after it has been lightly silver-plated, it is ready to be put in its appointed place, which is in the magnetic field between the poles of the big magnet. The amount of current passing through the magnet is indicated by the extent to which this filament is deflected. And a record of the behavior of this filament, which is obtained by means of a microscope, a projecting lens and a roll of photographic paper, serves to define the waves of energy that pass over the heart, making a weakness visible.

The filament between the poles is delicately’ stretched, and it must be brought accurately to a certain tension. This is determined by electrical test. In order to regulate the tension, a micrometer screw of great diameter and extreme fineness is provided. The electro-cardiograph is a very sensitive instrument — musical instrument one might almost call it in view of this little Æolian harpstring which the very spirit of life is able to pluck and play.

II

My case was diagnosed rather suddenly — unexpectedly — all the symptoms falling together at once under the head of The Stokes-Adams syndrome.’

I was fully expecting to get into my car and drive the thirty-six miles which would take me home; and then the consulting physicians, who had withdrawn to consider my case, came back with this puzzling phrase on their lips: ‘The Stokes-Adams syndrome!’ They put my car in one garage and me in another — which is to say, a big, new hospital. Such are the mutations of a minute!

The trouble with my heart, as I soon discovered when I brought it to be repaired, was that the timer was out of order. Between the upper chambers, or auricles, and the lower chambers, or ventricles, is a muscle or tissue called the Bundle of His. This is the timer or coördinating device. Its function is to carry the muscular impulse, or wave of energy, over and across from auricle to ventricle, thus causing it to beat. If this device becomes impaired, the ventricle lacks muscular force, and when it does gather enough energy to beat, it beats out of time, one part not having due regard for what another part is doing. The result is a lack of compression, a loss of power; and this loss of power accounted for my tendency to faint, my pulse being forty and my blood-pressure ninety.

Five days I lay in state, as it were, on a high hospital bed. Serving creatures, mute ministering angels, came in and did things to me and passed out again.

No one ever takes the trouble to introduce a trained nurse. At least they do not do so when you are being attended by the general staff of the hospital. You are supposed to know her when you see her; and so you do, no matter how often she may change her outer form and demeanor—her eyes, hair, and complexion — in the course of a night and a day.

There must have been a dozen of them, — eight whom I distinctly remember,— all making entrances and exits according to some system of particular hours and special duties. On the first morning my temperature was taken and so many things were done that I began to suspect that they were letting the neophytes practise on me. I found however that certain things come under the head of ‘routine.’ These things they do to all; and further attentions follow the doctor’s orders.

As they said little or nothing, so did I. If a beautiful stranger came in and suggested that I sit up or turn over, I did so, knowing that she would rub my back with alcohol. Without saying anything at all, she could change all the bed clothes, taking the sheet from under me and putting another in its place. In these things they have a particular white magic.

Hospital beds are now made very high, so that the nurse can manipulate you readily, as on a table or workbench. When your narrow bed is made, and you have been tucked in just so, with the white covering stretched taut upon you so that your big toes make two peaks like tent-poles, it is all very invalidlike and sculpturesque and formal. You lie as on your monument, a perfect effigy of yourself, all motion stopped and inhibited. Any suggestion of activity upon your part—of getting up and doing things — is promptly put down by the nurse. If you start to argue she falls back on the formula:

‘The doctor says — That settles it. She has quoted authority. But sometimes I have suspected that the doctor was herself.

Finally, after five days of this sort of life, a different nurse, one whom I had never seen before, appeared at my left hand. She had a wheel-chair with her, and as she rolled it up beside me she said cheerfully, ‘Well, shall we take a little ride?’

It is my opinion that they make the proposition in just that way in all the hospitals in the United States. The phrase has been universally adopted; it has become standard, having proved to be the one best way. Along with the remark, which comes at the end of the ride, — ‘Now we are going to take a little nap,’— it may be classed as technique. She says it wonderfully well.

As for my nurse, she came in and did her part so perfectly, with such entire naturalness, that she quite misled me. I had been hearing of certain big sun parlors where convalescents are taken to bask in unison, and cripples sit and wait for their limbs to mend; and I had conceived a desire to look in upon them before I left the place. As I had been told that I might be sent home on the fifth day, I was now in a mood of leavetaking. Consequently, when the nurse came in and made such a cheerful proposal,—just as if I were going to be her guest and make a grand tour of the place, — I accepted gladly. But, as I felt quite able to get up and walk, I told her that, if she would only wait till I put on my clothes, I would accompany her personally, and not in a wheel-chair.

This reply, evidently unexpected, put her clean out of her part. She was at a loss for a way to carry on. She fell back resolutely upon the lines as she knew them and repeated, now less naturally, ‘ I think we had better — take — a — little — ride.’

’Oh!’ I remarked. ‘Yes, I guess we will take a little ride.’ So saying, I rolled out in my pajamas and took my place in the chair. And I became as a little child again as she wheeled me through corridors, and into an elevator, and then on by several turns till I found myself delivered into the keeping of the aforementioned white-walled vault, or little windowless chamber or cell.

This place, as I could see when I noted certain lockers and shelves, was used for storing the surgical supplies of a large hospital; but as it had no opening except the one door at my back, it struck me as a crypt or dungeon. And when my eyes rested on the zinc shackles prepared for me, and I fell to considering those extensions of iron bolts that were soldered to them, I began to think of Poe’s story of ‘The Pit and the Pendulum,’ and all the things that happened therein.

The nurse, having pushed me in here, deserted me — let go of the handle, walked away, and disappeared! She who had approached me with such fair words, and held forth such a cheerful prospect of our journeying together — where was she? Gone! She had delivered me here and was done. In this solitary situation I began to feel apprehensive and distrustful.

This mood was quite put to rout when a new nurse came to me — this one to be writ down and remembered as the little Swiss maid. I needed someone in whom I could place my trust, someone to talk to and believe in; and now that the other nurse had proved unfeeling and fickle, I pinned my faith to her. She was a dainty being in black — a most maidenly form. I suppose it was because she was dressed in black that my eye caught each curve of her, a striking silhouette against the white wall. She was a fine feminine mechanism, like a Swiss watch; and she had big, brown, truth-telling eyes as open and clear as the crystal on the same. She was very reassuring; and as I needed reassurance, I made the most of her.

As I was now her invalid, she took hold of me with the frank freedom of a sister and set to work to bind me hand and foot. She wetted my wrists and left ankle and rubbed and rubbed till she had worked the wetness in. Then she wrung woolen cloths out of warm salt water and bound them on. Over the wet wool she fitted the zinc electrodes; and over these again she wrapped more of the damp warm cloths and firmly tied them.

The iron bolts, soldered to the zinc plates, protruded from these cloths and extended out beyond my fingers. On the ends of these tentacles were the binding posts; and to these the ends of the wires were screwed. And now I might prepare myself, she said, to sit perfectly still. I must not work my foot up and down (as I was then doing) and I must not lean forward to look at things. I must lean back, passively, and let my heart beat.

But no, not yet. She had been called away. Coming back, she sat down on the floor, examined the end of the wire, and inserted it in the binding post again. There was something here which she would have to pay close attention to while the test was going on. To have her thus bound to her post, virtually chained to my ankle, was a great relief to me. I knew that she could not desert me in the time that was to come. So now all was in readiness — she would sit still and let the machinery run.

I could now feel it pumping away — running regularly.

Ill

The human heart is a duplex forcepump, each half being independent of the other in the sense that there is no opening between the pumps to right and left. One side pumps the used blood through the lungs; the other side takes it from the lungs and forces it through the body in general.

Each side has an upper part, or auricle, which is a receiving chamber for the blood, and a lower part, or ventricle, which is the pump proper. These parts work alternately and connect with each other by means of a valve. The auricle collects a charge of blood from the veins which supply it, and then, at the proper moment, contracts and delivers it through the valve to the ventricle. And the ventricle, which has been expanding to receive it, now contracts and sends it through the circulatory system. It is evident that the two parts, upper and lower, need to keep time.

The heart starts to beat with an impulse which begins at the base of a vein that forms the inlet; and this impulse passes down over the heart in a wave of muscular contraction. The effect is, first, to contract the two auricles. The Bundle of His, situated between the auricles and ventricles, passes the impulse over to the lower chambers. Thus the ventricle closes its valve and starts to contract just as the auricle has emptied itself. And while it is contracting, the auricle expands and gathers a new charge of blood. The Bundle of His coördinates the machinery, so that the four chambers of the heart, and their various valves for intake and outlet, work to some effect.

If infection reaches the heart, forming scar tissue; and if this scar tissue happens to be on the Bundle of His, there is confusion. It is called ‘heart block.’

The block, or obstruction to the wave of energy, may be partial or complete. The ventricles may beat but once while the auricles beat, or try to beat, twice or even three times. Or the heart may seem to be quite normal, so far as the ordinary examination would reveal; but it will have spells when it becomes so baffled and confused that it is on the point of giving up.

The electro-cardiograph, being operated by the electricity from such a heart, responds to all the fluctuations in the wave of energy. The fine filament is deflected according to the force that comes over the wire; and these deflections, being recorded photographically, are an index to the true state of affairs.

Such, in short, was the nature of the machinery that was now operating. The button had been pressed, and my heart was steadily working.

IV

Einally, after a long spell, — it may have been ten minutes and it may have been twenty, — my little Swiss maid rose in answer to some signal and hurried away.

When she came back, she told me that the record would have to be made over. There was something wrong about this one. The superintending surgeon was not at all satisfied that he was getting a true record of my heart. The machine had probably been disturbed and the adjustment put out. However we would now try to get a true record. So saying, she again sat down at my feet and turned her gaze downward as she placed her thumb against one of the connections at my ankle. Again I was not to move. So I lay back in my chair and let my heart beat.

I have always felt a little pride in my ability to comprehend mechanical principles. I am good at locating subtle ailments, — even in a machine that is new to me, — and making the repair.

I now saw what had been ailing the electro-cardiograph, and I did it by the following chain of reasoning.

The electricity that was operating that machine was simply the electricity from my body as a whole, and not any selected electricity that came from my heart. Indeed, unless it were possible to put binding posts on a man’s heart, and then isolate that organ from the rest of his body, it would be impossible to draw electricity from the heart exclusively. The electrical connections were made to my arms and one leg; and this would result in drawing off any electricity in my body that might arise from muscular activity. That the electricity used to operate the electro-cardiograph was heart electricity was due to the fact that my heart was the only part of me that was engaged in muscular contraction. This was a safe conclusion in view of the nurse’s objections when she saw my foot moving nervously up and down.

These facts, in connection with certain others now occurring to me, led to a startling conclusion. When I was first brought to earth with fainting spells, I diagnosed my own case (quite wrongly) as tobacco heart. I had too long been a smoker; and now that I saw the results, I broke off at once. And as an alternative to the habit, I began chewing gum.

It was this gum-chewing of mine that had baffled the electro-cardiograph and given it such surprising symptoms. When I was wheeled into that vault to undergo a new and nameless ordeal, I naturally had a reserve of gum stowed away in my cheek ‘as an ape doth nuts.’ And when, after the uncanny preparations, I leaned back to hold my nerves in leash during a long and trying silence, I started promptly to chew gum. I was now releasing muscular electricity by both heart and jaw, a beat and a bite, a bite and a beat —.or beats and bites together; and the results were going over the wire. The machine was putting the doings down as the true record of a single heart, whereas no two hearts could have equaled it. I dare say that, as compared with the energy my heart was producing, the record of my maxillary muscles, as they came down at regular and frequent intervals, was hardly a secondary dynamic force. But, as the combined and unrelated efforts were fused into one electric current and translated on paper as coming from one source, the record was one of neither jaw nor heart — neither fish, flesh, nor good red herring. It was a thing to puzzle any expert.

When this little matter, and its scientific bearing, occurred to me, just as I was composing my nerves to sit for a second test, it took me somewhat aback. I could see just what that record looked like. It was no wonder that the superintending surgeon refused to believe it human.

As for what the man of science said when he learned the cause behind that set of phenomena, I must report that he did not say anything, the reason being that I did not tell him. I was on the ground floor at the time, and he was down in the basement. And besides, I was speechless. Later on I decided to remain speechless.

When I had been taken back to my room and tucked into bed, he came up to see me. I found that his visit was a social one, purely a personal call. He was in a conversational mood, and, as I soon began to see, really apologetic. Because of the strange aberration of his machine, I had been kept down in that vault an extremely long time. He wished me to understand that something unusual had happened — some careless push or jar had put it out of adjustment.

There are not a great many of these machines — only three in the state. And I could see that he, as the expert in charge of one of them, was quite embarrassed by its wild behavior.

By this time I was no longer chewing gum. At the head of my bed was a little stand with a drawer in it. The gum, deposited in a tin box and stowed away in this drawer, was now out of sight. And so I listened and said nothing.

V

On the fifth day of my lying in state, the junior surgeon came to make another physical examination. This was to be a clean-up of all the minor details, a final work of elimination.

When he had gone through the usual auscultations, chest-rappings and thumpings, and depressed my tongue with a wooden spatula, and tested my reflex centres with a little triangular hammer, and tucked his fingers up under my short ribs to find how my liver might be, he turned his attention to my eyes.

This interested me at once. It reminded me of something I wanted to know.

At the inner corner of each eye, next to my nose, there seems to be a growth over the eyeball in the form of a film or skin — a thick yellowish film which gathers in wrinkles when the eyeball is moved and becomes increasingly evident. When I look straight forward, the wrinkles pass out and the loose skin is not so plain.

For several years I have felt that this thing would bear watching. Other people’s eyes, as I observed, did not have it; and I suspected that it might be a growth of sinister portent. The surgeon got through with his examination without saying anything about it; and then, in the nick of time, I thought of it. I told him to look closely and he would see it gather as I turned my eye.

‘Oh, that,’he said, without giving it so much as a glance, ‘that is a prenatal remnant.’

And then he went on to explain. Certain of the lower orders of animals, as reptiles and birds, have an extra eyelid in the form of a semitransparent film or sheath. It is called the ‘nictitating membrane.’ It is situated at the inner angle of the eye, the same as mine is, from which position it can be drawn up by certain muscles to cover the whole eyeball.

The human being, in its early prenatal stages, goes through a progressive development, a series of resemblances — worm, reptile, fish, and quadruped — which is a condensed history of the process by which the human race was evolved. At a certain stage there is a film over the eye. This gradually clears away until, at the time of birth, it has totally disappeared.

‘In your case,’ he said, ‘it never quite disappeared. It is a prenatal remnant.’

‘A reptilian remnant!’ I commented. ‘Or might I claim a kinship with the lordly eagle?’

‘It is the reptiles that have that sort of a rudimentary film,’ he explained. ‘With the exception of the crocodile, it is not nictitating; it is merely a rudiment in the corner of the eye. Birds have the complete membrane. Through it the eagle can gaze upon the sun.’

‘Possibly,’ I reflected, ‘if I have a streak of reptile in me it will prove advantageous in my present condition.’

‘Yes, that is a good view to take.’ he agreed. ‘A reptilian relationship would not be a bad thing for a man whose heart is out of order. The heart of the lower orders is especially retentive of life.’

With such light comment — due to my inward uplift upon finding that my dyes were in good condition — we brought the subject to an end.

On the afternoon of the same day, my own physician, Dr. G—, came in to make a call. And now that diagnosis had progressed to the point of certainty, I brought him around to the point of ‘laying the cards on the table.’

My physician is an able optimist. He has such a ready command, not simply of language but of science, that in an argument about your condition he can think instantly of an interesting fact which will checkmate your gloomy and pessimistic position. They say he plays Mah -Jongg well, but I would say that, in his own profession, he plays hearts better.

‘You say,’ I insisted, ‘that I have organic heart disease — not functional. That is what people die of. So I may expect at any time to give one gasp, and that will be the end.'

‘The heart,’ he replied, ‘does not live by means of the blood which goes through it in pumping. Like any other organ, it has a circulation of its own. If it were the circulation of the heart itself that was obstructed, that would be a different matter. Your heart loses the impulse to beat, that is certain; and you might think it was going to stop suddenly. But the heart has an inherent impulse to beat, quite apart from any impulse communicated to it. The heart of one of the lower animals, a reptile for instance, when placed in a normal salt solution, will go on beating for quite a while. The human heart has the same instinct in its very tissue. Its inherent rate of beating is about thirty to the minute; but it will not continue its independent beating so long as that of a reptile because it uses up its sugar sooner. Your heart, while it has its communicated impulse partially blocked, still has a normal rate of forty to fifty.’

‘I see the idea,’ I said. ‘The circulation in my heart is not obstructed; all the passages are open. As long as it beats at all, my heart will partake of what circulation there is; and as long as it partakes of that circulation, it will remain alive and keep on beating.

I can see from that that I am going to live forever.’

‘Not so bad as that,’ he answered.

‘ But the heart is a wonderful organ, and it has great power of self-repair. For that reason, if a patient will be careful and do just as he is told, it is a most satisfactory organ to work with.’

As I have said, my physician is a talented optimist. When I have been over the ground with him, I am convinced that my heart is bound to keep on going. I am reminded of the man whose liver was in such good condition that after he had passed away they had to take it out of him and beat it to death with clubs.

At the same time, I am glad that he brought out those facts about reptiles and their hearts. Added to my prenatal remnant, they reinforce my position greatly. When worst comes to worst, I have something to fall back on.

It was a few days after this that my country doctor — he who sent me to his confrères in the city — came in to resume relations with me. By this time I had grown very mechanicalminded, greatly interested in the heart as a pumping device, regardless of whom it belonged to. And considering how much the average man understands about an automobile, I began to marvel that he should be so blissfully ignorant of a piece of machinery which, if it were not for his shirt bosom and a few other integuments, would be right under his eyes.

Regarding it as a great invention, I ventured the opinion to my country doctor that it might have been built somewhat differently. It need not have been constructed according to the present design.

He quite agreed with my views, radical as they were. ‘Yes,’ he said, ‘there are a number of differently designed hearts in nature, all of them very good. The frog has but one ventricle and two auricles. In fact, the human heart itself is different at different stages of development. Among the more primitive forms of life, the heart is but a tube, with valves at each end. In the human being it is first of this variety — a mere tube. Later it has what is, practically, a single auricle. But before birth the auricles become separate chambers.’

‘Rather reptilian!’ I exclaimed.

‘Yes, it is, somewhat.’

‘I am pleased to hear it,’ I said. ‘Glad of it, in spite of Mr. Bryan’s views to the contrary. A man with heart disease ought to take some comfort in harking back to his remote ancestors.’

‘It would not be a bad point of view,’ he admitted. ‘Anyway, it is a good deal better than worrying about your condition.’

From where I am now lying in bed, along with a supply of paper and a pencil, there are no books of a modern scientific nature to be had. There is quite a display of fiction, essays, and the drama, but nothing dealing with the human heart. A good encyclopædia might yield up considerable information, but I am held back by the doctor’s opinion that I had better not make an exhaustive study of my inner machinery.

On a certain lower shelf, however, is the World Almanac for 1923, ‘a book of facts.’ This afternoon I made a trip as far as the bookcase and brought the ‘ World ‘ to bed with me.

I find here, on page 357, that of all the causes of death in the United States, ‘organic heart disease’ stands at the top of the list. We hear much of cancer, but that is only fifth. Tuberculosis is much in the public mind, but that is not even second. For 124,143 who died of organic heart disease in 1920, there were but 72,931 who died of cancer and all tumors, and 88,195 who died of tuberculosis.

As I am now writing for the largest audience in the United States, namely those who expect to die, and for that decided plurality who will finally take an interest in the heart, I am sorry that I have no books out of which I might get reliable and helpful information. I shall have to content myself with this screed as it is — inconsequential and frivolous as it may appear.

I found, after two weeks of lying in bed, that my object in taking no exercise was to give nature time to provide me with a ‘compensated heart.’ It must automatically strengthen itself in certain regards, to compensate for the breakdown in others. Thus I am lying low and putting great reliance on the reptilian retentiveness of life. I never felt, anyway, that I was exactly cut out to be an angel.