For the Week of February 12, 2018: Matters of the Heart

…Do you note that the world has changed since you began

Your tatoo beneath my chest bone?  I would guess that, if

you do, you don’t care.

“Life is pretty simple,” you say, “and besides, I have my

work to do.”

(“To My Heart As I Go Along,” by Kenneth Koch, Poetry Magazine, 2000)

Wednesday is Valentine’s Day, and the retail world has reminded us of the date for weeks.  As a child, it was the anticipation of choosing a packet of 36 valentines to be addressed to my classmates and placed in the decorated cardboard box at the back of my classroom.  There was chocolate, of course, and those little decorated sugar candy hearts with messages stamped on them and, thanks to our mothers, a party with red and pink cupcakes.  We didn’t understand much beyond those exchanged valentines then, nor did we know much about anatomy and physiology when it came to our hearts.  The history of the symbolic significance of the heart was completely lost on us.  We didn’t know then that the heart, in religious texts, is a metaphor or attributed with the spiritual or divine, or that early philosophers and scientists believed the heart to be the seat of thought, reason or emotion.  Despite today’s scientific and medical knowledge, the heart continues to symbolize what we humans feel.

Take a look at, the website for the Academy of American Poets, enter “heart” in the advanced search, and you’ll get 734+ poems about the heart, whether filled with the joy of love or ache from love lost.  If you Google “heartache,” you’ll find a reference to the top 100 heartache songs,   like “Unbreak my Heart,” “How do You Mend a Broken Heart”, “Heartbreak Hotel”, “Total Eclipse of the Heart”, or “Don’t Go Breaking My Heart,” all confirming the heart is where we feel not only love, but our pain, whether  love gone awry or sorrow for others in our lives.  In fact, the definition for “heartache” is “anguish of mind,” or “sorrow.”

It turns out that a broken heart is more than imagined and more than emotion.  In a June 5, 2010 post on his former blog, All Heart Matters, journalist and heart patient, James Borton, cited a number of research articles on “Broken Heart Syndrome,” a left ventricular dysfunction brought on by acute emotional or physical stress.  “Hearts actually can break,” he wrote, quoting an article in a recent edition of The Wall Street Journal, suggesting there is some emotional connection to our hearts.

Our hearts can break; they also ache.  As she thought about the death of a friend, the constant onslaught of bad news in the world, and challenges being faced by others in her life:  cancer, a brain tumor,  life and health challenges, former Kansas poet laureate, Caryn Mirriam Goldberg wrote,  “When I still myself and just feel what there is to feel, my heart hurts…” (Blog post, February 9, 2011).  One of Caryn’s poems came to mind, written after breast cancer and a double mastectomy, begins with the words:

I am still a woman

even if my heart hurts–

my whole chest aches with emptiness…

(“Reading the Body,” in Reading the Body, Mammoth Publications)

The heart–it knows love, and it knows heartache and so much more.  Our hearts.  The amazing organ pumping life-giving blood throughout our bodies.  I’ve certainly suffered from periods heartache and loss as many of you have, but I hadn’t thought about my physical heart much until a December afternoon in 2008, when I collapsed while walking my dog and ended up in the emergency room a short time later, dazed and confused.  It turned out I was experiencing a very different spin on “heartache.”  A day or two later, my family doctor appeared at my bedside.  “We think you’ve had a heart attack,” she said.  WHAT?  How could that be? I asked.  I’d just had an annual physical two weeks earlier.  She shook her head; she had no answers for me, saying “we don’t really know; it could be any number of things…”  My doctor held my hand as I wept, and told me nothing had been confirmed; a cardiologist was reviewing the battery of tests I’d had when I arrived and would shortly confirm or deny the diagnosis.  Two days later, I had officially become  a heart failure patient, with left ventricular dysfunction and atrial arrhythmia, and I had an ICD (implanted cardiac device) implanted, leaving a rounded lump on the left side of my chest, a constant reminder of how suddenly my life changed.

“It’s always something… “I wanted a perfect ending. Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next.

(It’s Always Something, by Gilda Radner, 1989)

After the shock and heightened fears of mortality settled down, I continued to read and research, looking for answers.  It wasn’t until five years later, when I stumbled on a 2013 study in the New England Journal of Medicine that found exposure of the heart to radiation during radiation therapy could increase the risk of heart disease among breast cancer patients later in life, particularly in women who were irradiated for cancer of the left breast.  I’d been treated aggressively for DCIS (ductal carcinoma in situ) in my left breast in 2000, and seven weeks of daily radiation therapy was a significant part of the prescribed treatment.  Eighteen years later, DCIS is treated somewhat differently; radiation doses have also been reduced and become more precise. Yet I wondered if the radiation I’d received was a possible explanation for why I now suffered from heart failure.

Ironically, it was only late in December 2017 that my new cardiologist raised and discussed the likely probability with me.  Her candor and knowledge of the research was gratifying; I felt as if I was getting some confirmation of all I had come to suspect.  Then, several weeks later, on February 1st, NBC evening news reported that the American Heart Association had just issued a warning about potential harmful effects of certain breast cancer treatments–including radiation.

“Any patient who is going to undergo breast cancer treatment…should be aware of the potential effects of the treatments on their heart,” Dr. Laxmi Mehta stated, director of the Women’s Cardiovascular Health Program at Ohio State University.  “This should not deter or scare patients from …treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

...allow them to make informed decisions with their doctor...” And there you have it, the importance of asking questions about treatment.   I wish I’d known and asked more questions eighteen years ago, but I didn’t.  The word “cancer” had paralyzed me–I operated in a fog for weeks after the diagnosis and numbly accepted the treatment regimen as “normal.”  Now I live with heart failure, and I am very aware that more older women die of heart disease than of breast cancer.  Thankfully, medicine and treatments continue to advance for both cancer and for heart disease treatments.  And for the continuing research, development, and new treatment available to any of us, whether cancer, heart disease, or other life-threatening illnesses, I am forever grateful.

Gratitude is, as it turns out, what Valentine’s Day has come to symbolize for me–not just for my loved ones and dear friends, but for all those healthcare professionals who have made a difference in my life–the gifted neurosurgeon who saved my life as a teenager, caring family physicians who showed compassion and concern in times of illness or crisis, my cardiologist, who literally breathes life into the examination room when she enters and discusses my condition in clear, direct terms.  Medicine is science, yes, but there’s art in the way in which it’s administered by those men and women who become our physicians and surgeons.

And Wednesday is Valentine’s Day, but I’m well beyond scribbling out “To Jane, From Sharon” on the paper envelopes into which those little dime store valentines were stuffed.  The excitement of exchanging valentines as we did as children disappeared a long time ago, but Valentine’s Day is an opportunity to celebrate with my husband the years of marriage, family and companionship over a dinner out.  We’ll toast together the ever-present matters of our hearts–gratitude for the romance, family, friendship, and life we have.   Happy Valentine’s Day!.

Carefully placed upon the future

it tips from the breeze and skims away,

frail thing of words, this valentine,

so far to sail.  And if you find it

caught in the reeds, its message blurred,

the thought that you are holding it

a moment is enough for me.

(“This Paper Boat,” by Ted Kooser, in Valentines, 2008)

Writing Suggestions:

Expressions of sentiment, captured in small verses or lace-trimmed cards, in letters or postcards, are a way to say “I appreciate you” or “I’m thinking of you,” or “I love you.”  1.  Write a valentine.  In a world full of suffering, war and economic downturns, taking the time to express your sentiments for family, friends, or others whose presence in your life you appreciate is a great gift.  In fact, you can do it anytime.  You don’t have to wait for February 14th!  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.

  • Write a valentine.  In a world full of suffering, war and economic downturns, taking the time to express your sentiments for family, friends, or others whose presence in your life you appreciate is a great gift.  In fact, you can do it anytime.  You don’t have to wait for February 14th!  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.
  • Perhaps there’s a poem, song or ode to your heart or some other body part you’d like to write. Why not try, whether serious or humorous, to send a valentine to some part of your body that does all the physical work of keeping you going?
  • “I carry your heart/ I carry it in my heart,” e.e. cummings wrote in his famous love poem. What do you carry in your heart?

About Sharon A. Bray, EdD

Best known for her innovative work with cancer patients and survivors, Sharon is a writer, educator and author of two books on the benefits of expressive writing during cancer as well as personal essays, a children's book, magazine articles and the occasional poetry. She designed and initiated expressive writing programs at several major cancer centers, including Breast Cancer Connections, Stanford Cancer Center, Scripps Green Cancer Center and Moores UCSD Cancer Center. She continues to lead expressive writing groups for men and women living in the San Diego area and teach creative writing workshops and classes privately for UCLA extension Writers' Program. She previously taught professional development courses in therapeutic writing at Santa Clara University and the Pacific School of Religion, was a faculty member of the CURE Magazine Forums and at the Omega Institute in 2014. Sharon earned her doctorate from the University of Toronto and studied creative and transformative writing at Humber School for Writers, University of Washington, and Goddard College.
This entry was posted in expressive writing, writing from cancer and serious illness, writing from life, writing to heal. Bookmark the permalink.

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