The art and science of the heart

I recorded an interview for Radio 4 this week for their upcoming programme on the Art of Living, which looks at the work of artist Sofie Layton and bioengineer Giovanni Biglino at Great Ormond Street Hospital. Sofie and Giovanni worked with patients on visual images and stories about the heart, as an object of science and a metaphor for emotions. As an interdisciplinary art project, The Heart of the Matter is an important intervention into the different ways we look at, and think about the heart as both a pump and something so much more.

In Matters of the Heart: History, Medicine, Emotion published by Oxford University Press in 2010, I explored the reasons why we focus so much on the heart in popular culture - why the heart stands for authenticity, truth, meaning and emotion (especially love) - when it is widely regarded as a pump. The answer lies in the 2,000 years of medical history, when the heart was not only the warming centre of the body under humoral medicine, but also held a significant role in mediating the demands of the soul that worked in and through the physical body.

For the Ancient Greeks, as well as for the Ancient Egyptians and Mesopotamians, a Cardiocentric or heart-centred model of the body predominated. The heart swelled to attract all that was good and contracted to repel all that was evil; an early attempt to account for the sheer physicality of emotions as lived experiences. Not until the 19th century, when the brain was erected as the organ of the self par excellence, did the heart begin to diminish as an explanation of feeling and emotion, though the metaphors have continued, as I discussed in an interview in The Atlantic.

The rise of Cardiology, the parallel rise of Psychiatry and Psychology - as I explored in This Mortal Coil: The Human Body in History and Culture - these were the processes by which the heart’s scientific status was limited to a passive rather than an active organ. The heart responded to the brain’s desires, but it did not have a life-force of its own; it as motivated by reflex rather than the soul.

The origin of these changes can be traced back to the seventeenth century, and the popularisation of the circulation of the blood by the physician William Harvey. I say popularisation because, contrary to popular wisdom, it was an Arab physician, Ibn Al Nafis, who discovered pulmonary circulation in the thirteenth century. This historical oversight reinforces the great man of Western medicine model at the same time as it diminishes the significant impact of Islamic medicine and culture on the West for thousands of years. Yet it took the Renaissance and the flowing of visual arts and books on human anatomy, most notably by the Flemish anatomist Andreas Vesalius, for the idea of circulation to take off in the West.

One could argue that it was not until artists made visible new ways of thinking about and imagining the physical body that physicians were able to see and create alternative narratives of the body and the heart. This is a reminder that science does not simply reflect the body “as it is” but partakes of the wider cultural context in which it takes place. Science works in conjunction with popular narratives and beliefs - such as the well-entrenched idea of the heart as the centre of emotion, feeling and the self - even as it rebuts them. I spoke to one eminent heart surgeon who was unable to contribute to a discussion about the metaphorical heart for a simple reason: it would be impossible to remove the heart from a human chest if it was the site of the self, or love, or emotions. And yet medical students often report anxieties about dissecting the heart - just as they do the brain. Both are weighty organs, after all.

Art and science are always linked, which is what this exhibition makes clear. Part of the reason is the shared languages, metaphors and visual images that provide hooks for our understanding; that help to make the interior visible, and coherent. Hearts are objects of the self and emotions as well as pumps. And after all, though we schematise hearts as pumps versus hearts as metaphorical symbols, physicians are aware of the two-way process between the hearts and the emotions. We do not have to go as far as cellular memory theorists, and the belief that the heart has more neurons than the brain (and is therefore capable of physical memory) to understand the significant ways the heart impacts on feeling. The brain-heart connection is a deep, enduring part of the chemistry of the human body.

That connection is also based in language and metaphor. Hearts were furnaces, now they are pumps. But they are also receptacles of feeling and compassion, and linked to our fears and anxieties around transplantation, and where the limits of the human might be. In other cultures, too, besides the West, hearts matter. The heart (or Anahata) is the fourth Chakra of the body in Hindu, Yogic, Shakta and Buddhist Tantric traditions. The heart Chakra is associated with balance and calmness, as well as truth. In Chinese medicine the heart is a yin organ, that governs joy among other emotions. As in the West, ‘heart’ means more than a mere organ.

Talking about the meanings of the heart is important. It reminds us not only that the body carries symbolism and meaning that is more than the sum of its parts, but also that the stories we tell are also carried along with us. As patients, parents, lovers and friends, as much as artists, philosophers, medics and scientists, we are all curators of an ongoing discussion of what the heart means in the 21st century.