Heart talk
Heart talk
Posted 11:29pm (Mla time) Feb 10, 2005
By Michael Tan
Inquirer News Service
Editor's Note: Published on page A15 of the February 11, 2005 issue of the Philippine Daily Inquirer
IT'S February, the month of hearts, but I'm writing this column thinking about how each year, over the Christmas holidays, I have friends who succumb to cardiovascular diseases. This last holiday season I lost a friend, aged 52. The holidays of 2002 were particularly difficult: I had a close friend, only 48 at that time, who had a massive heart attack as well as one acquaintance who had a stroke. Both survived, but still another friend lost her husband to a stroke.
I've observed that the responses to these events have taken on qualities of religious moralism, with so much blaming and guilt feelings. The temptation to do that is especially strong in our culture, with our religious beliefs built heavily around notions of sin and punishment.
Over Christmas holiday feasts, the conversations inevitably drift toward naming the latest victims of heart disease. People around the table respond, "Yes, I heard," while staring down with guilt at a plateful of “lechon” [roasted pig]. In hospital corridors, relatives and friends shake their heads after visiting the victim, whispering about how so-and-so was such a heavy smoker, or lacked exercise.
The patient, too, goes through long and hard soul-searching, wondering what he or she did wrong. The mea culpas -- I have sinned, I have sinned -- are followed by a vow to be born again into a life without cigarettes and fatty foods, and more exercise but no sex, please.
Zealotry
No doubt, lifestyle changes are necessary both to prevent heart disease as well as to help survivors to recover. But I would warn, too, against the zealotry that emerges on the part of patients or caregivers, especially when they resort to fear tactics and victim-blaming.
We think that heart diseases strike because someone did something "wrong" but there are people, too, who lead perfectly healthy lifestyles but still get strokes or heart attacks. I have a very close relative who has had three transient ischemic attacks (sometimes known as "mini-strokes") within a few months, even if she rarely ate meat, walked at least a kilometer a day and never smoked in her life. It turned out she had a family history of strokes, and did tend to be a worrier. "Genes and nerves," her cardiologist told me.
But can you blame people for worrying too much? The colleague who had a Christmas heart attack had been suffering tremendous stress for several months because of workplace intrigues. People say he should learn to be more detached, but I wonder, given the viciousness of the intrigues, how anyone could just take things in stride.
I have to emphasize again that I believe in healthy lifestyles, but helping people to attain these lifestyles will require more than an appeal to guilt feelings. In the case of my relative who had the transient strokes, I started out with the very positive aspects of her lifestyle, pointing out that her long walks and fairly meatless diet probably helped her to avoid more severe attacks.
Taking good old aspirin was going to be important to help reduce her risks for more serious strokes, but we then tackled her being a worrier and we both acknowledged it wasn't going to be easy to just stop worrying. At the same time, there was much we could tap from her existing lifestyle. Her long walks were usually for going to Mass, but I pointed out that she could take walks for a timeout, in times of stress.
Heartless
I've noticed too how New Age therapies are coming into the picture: going vegetarian, doing yoga and meditation. Again, all that is fine with me, but I also worry at times about how these practices lose their original context of social compassion, and instead become very individualistic quests for health.
If I can take that observation a step further, I keep hearing stories about people who are vegetarian and who meditate and do yoga and tai chi and all that, and yet can be outrageously callous to people around them. In one office, people used to complain about one of their staff who would take over one of the rooms for her meditation and never mind people needing to use the room for their rest. If people dared, politely, to knock, she would snap, "Can't you see I'm meditating?" I'm sure she had a healthy heart, even if at the cost of breaking other people's hearts.
It's interesting, too, how some medical studies are disputing earlier research about Type A and Type B personalities. Originally, they thought that it was Type A people -- the assertive, aggressive workaholic types -- who were more prone to heart disease than the more laid-back Type B personalities. Now there are other studies suggesting Type A personalities may have fewer health problems because they express their frustrations, their anger, when they feel it. It's the humble and the meek, suffering in silence, that might end up with a heart attack.
To summarize, I often suspect that the most evil people in the world probably are at very low risk for heart disease because they know no guilt, know no remorse. Put another way, the issue of healthy hearts has no relevance for the heartless.
Elephants
All this talk about "learning to relax" and "avoiding stress" actually becomes absurd right after a heart attack or stroke, events which are themselves sources of tremendous stress. The friend who had a heart attack told me how, as he was wheeled into the emergency room, he felt like an elephant was sitting on his chest. After the doctors injected him with a drug for the heart attack, it was almost as if the elephant got up and off his chest.
But even as this was happening, he overheard the doctors warning his elder brother that if the heart drug failed, they'd have to resort to other measures, and that the cost could run to about half a million.
"Oh, Mike," my friend told me, "I could feel the elephant storming back in and jumping back on my chest." I can imagine he gets that feeling again, even if only of baby elephants, whenever he has to buy the many medicines prescribed to him.
One last anecdote here: I had to take over part of my friend's teaching load and administrative responsibilities, which has led people to warn me, "Hey, you might be the next one to get a heart attack. Relax naman." Easier said than done. The fact is that I would be more stressed out if I just shrugged my shoulders and avoided taking on the responsibilities.
Life's that way. If we are to be vegetarian, it shouldn't be just because of our hearts but because we respect life and want to avoid causing pain and suffering. If we take time off to relax and meditate, it should be to reflect on how we might become kinder, more helpful to people around us. For survivors of heart attacks and strokes, the attitude should be, "I survived. No sense regretting. Life must go on and I will live, more fully, for my friends and my family."
Take heart and live again, with a vengeance.
Posted 11:29pm (Mla time) Feb 10, 2005
By Michael Tan
Inquirer News Service
Editor's Note: Published on page A15 of the February 11, 2005 issue of the Philippine Daily Inquirer
IT'S February, the month of hearts, but I'm writing this column thinking about how each year, over the Christmas holidays, I have friends who succumb to cardiovascular diseases. This last holiday season I lost a friend, aged 52. The holidays of 2002 were particularly difficult: I had a close friend, only 48 at that time, who had a massive heart attack as well as one acquaintance who had a stroke. Both survived, but still another friend lost her husband to a stroke.
I've observed that the responses to these events have taken on qualities of religious moralism, with so much blaming and guilt feelings. The temptation to do that is especially strong in our culture, with our religious beliefs built heavily around notions of sin and punishment.
Over Christmas holiday feasts, the conversations inevitably drift toward naming the latest victims of heart disease. People around the table respond, "Yes, I heard," while staring down with guilt at a plateful of “lechon” [roasted pig]. In hospital corridors, relatives and friends shake their heads after visiting the victim, whispering about how so-and-so was such a heavy smoker, or lacked exercise.
The patient, too, goes through long and hard soul-searching, wondering what he or she did wrong. The mea culpas -- I have sinned, I have sinned -- are followed by a vow to be born again into a life without cigarettes and fatty foods, and more exercise but no sex, please.
Zealotry
No doubt, lifestyle changes are necessary both to prevent heart disease as well as to help survivors to recover. But I would warn, too, against the zealotry that emerges on the part of patients or caregivers, especially when they resort to fear tactics and victim-blaming.
We think that heart diseases strike because someone did something "wrong" but there are people, too, who lead perfectly healthy lifestyles but still get strokes or heart attacks. I have a very close relative who has had three transient ischemic attacks (sometimes known as "mini-strokes") within a few months, even if she rarely ate meat, walked at least a kilometer a day and never smoked in her life. It turned out she had a family history of strokes, and did tend to be a worrier. "Genes and nerves," her cardiologist told me.
But can you blame people for worrying too much? The colleague who had a Christmas heart attack had been suffering tremendous stress for several months because of workplace intrigues. People say he should learn to be more detached, but I wonder, given the viciousness of the intrigues, how anyone could just take things in stride.
I have to emphasize again that I believe in healthy lifestyles, but helping people to attain these lifestyles will require more than an appeal to guilt feelings. In the case of my relative who had the transient strokes, I started out with the very positive aspects of her lifestyle, pointing out that her long walks and fairly meatless diet probably helped her to avoid more severe attacks.
Taking good old aspirin was going to be important to help reduce her risks for more serious strokes, but we then tackled her being a worrier and we both acknowledged it wasn't going to be easy to just stop worrying. At the same time, there was much we could tap from her existing lifestyle. Her long walks were usually for going to Mass, but I pointed out that she could take walks for a timeout, in times of stress.
Heartless
I've noticed too how New Age therapies are coming into the picture: going vegetarian, doing yoga and meditation. Again, all that is fine with me, but I also worry at times about how these practices lose their original context of social compassion, and instead become very individualistic quests for health.
If I can take that observation a step further, I keep hearing stories about people who are vegetarian and who meditate and do yoga and tai chi and all that, and yet can be outrageously callous to people around them. In one office, people used to complain about one of their staff who would take over one of the rooms for her meditation and never mind people needing to use the room for their rest. If people dared, politely, to knock, she would snap, "Can't you see I'm meditating?" I'm sure she had a healthy heart, even if at the cost of breaking other people's hearts.
It's interesting, too, how some medical studies are disputing earlier research about Type A and Type B personalities. Originally, they thought that it was Type A people -- the assertive, aggressive workaholic types -- who were more prone to heart disease than the more laid-back Type B personalities. Now there are other studies suggesting Type A personalities may have fewer health problems because they express their frustrations, their anger, when they feel it. It's the humble and the meek, suffering in silence, that might end up with a heart attack.
To summarize, I often suspect that the most evil people in the world probably are at very low risk for heart disease because they know no guilt, know no remorse. Put another way, the issue of healthy hearts has no relevance for the heartless.
Elephants
All this talk about "learning to relax" and "avoiding stress" actually becomes absurd right after a heart attack or stroke, events which are themselves sources of tremendous stress. The friend who had a heart attack told me how, as he was wheeled into the emergency room, he felt like an elephant was sitting on his chest. After the doctors injected him with a drug for the heart attack, it was almost as if the elephant got up and off his chest.
But even as this was happening, he overheard the doctors warning his elder brother that if the heart drug failed, they'd have to resort to other measures, and that the cost could run to about half a million.
"Oh, Mike," my friend told me, "I could feel the elephant storming back in and jumping back on my chest." I can imagine he gets that feeling again, even if only of baby elephants, whenever he has to buy the many medicines prescribed to him.
One last anecdote here: I had to take over part of my friend's teaching load and administrative responsibilities, which has led people to warn me, "Hey, you might be the next one to get a heart attack. Relax naman." Easier said than done. The fact is that I would be more stressed out if I just shrugged my shoulders and avoided taking on the responsibilities.
Life's that way. If we are to be vegetarian, it shouldn't be just because of our hearts but because we respect life and want to avoid causing pain and suffering. If we take time off to relax and meditate, it should be to reflect on how we might become kinder, more helpful to people around us. For survivors of heart attacks and strokes, the attitude should be, "I survived. No sense regretting. Life must go on and I will live, more fully, for my friends and my family."
Take heart and live again, with a vengeance.
posted by Dante at 12:00 AM
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