Matters of the Heart

From Aristotle's misguided meanderings to modern open heart surgery.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Neil deGrasse Tyson?

  Welcome to StarTalk. Your place in the universe where science and pop culture collide. StarTalk begins right now. Welcome back to StarTalk Radio. I'm Neil deGrasse Tyson. I'm an astrophysicist and director of New York City's Hayden Planetarium. In this special edition of StarTalk, in celebration of Valentine's Day, we're calling it Matters of the Heart. And I have with me, in the studio, a cardiac surgeon, Dr. Darrell Hoffman.

• 0:34Speaker 01

  Thank you.

• 0:35Neil deGrasse Tyson?

  How many of these you do a year?

• 0:36Speaker 01

  Couple of hundred.

• 0:37Neil deGrasse Tyson?

  Yeah, so is someone not getting operated on because you're here in the studio with me now?

• 0:42Speaker 01

  No, no, I have a great crowd of colleagues who are taking care of things this weekend.

• 0:45Neil deGrasse Tyson?

  Oh, that's good. Don't worry me about that. I know you have an accent. Where do you hail from?

• 0:50Speaker 01

  South Africa originally, via Scotland, and then the Bronx.

• 0:53Neil deGrasse Tyson?

  The Bronx?

• 0:54Speaker 01

  The Bronx.

• 0:55Neil deGrasse Tyson?

  Bronx in the house. You know I'm from the Bronx.

• 0:57Speaker 01

  I do.

• 0:58Neil deGrasse Tyson?

  Yeah. So you from the enclave where ex-Patriot South Africans landed in the Bronx?

• 1:03Speaker 01

  That's the one, right around Einstein on Morris Park Avenue.

• 1:06Neil deGrasse Tyson?

  So there is such a place, apparently. So we want to talk about the heart not only as this perceived organ of emotion, but also as a functioning part of the human body. You know, it goes way back. You know, we might have, some people might remember, either from their history class or from their philosophy class, that Aristotle, I don't know if he started it, but he certainly was influential about all that he said as the heart being the seat of intelligence and of emotion and of sensation. And clearly, I mean, it's all wrong. Aristotle was wrong on a lot of stuff, especially when it came to physics and astronomy, but apparently he's also wrong there, right?

• 1:44Speaker 01

  Well, yes, it wasn't only Aristotle. Unfortunately, Galen described two circulations, and they were sort of in parallel, they didn't mix. And the idea was that the heart was the seat of emotions and that the brain actually provided cooling for the heart. A really extraordinary notion, but it was believed by the church and until the Middle Ages, that was an inarguable fact.

• 2:09Neil deGrasse Tyson?

  So what made it an arguable fact? That two smart guys, like Aristotle and Galen, said it, or that it somehow resonated with church dogma?

• 2:18Speaker 01

  I don't think it resonated with Dogma, it just was accepted and human experimentation was obviously not an option and despite animals being widely available, dissection just wasn't properly practiced and-

• 2:30Neil deGrasse Tyson?

  Well, plus, why would anyone believe that other animals had anything to do with humans, right?

• 2:33Speaker 01

  That's an excellent point.

• 2:35Neil deGrasse Tyson?

  Yeah, I mean, especially mammals, as close as they are to us, they're just some other creature on the earth and can't have anything possibly to do with us. Even though they had two eyes, a nose, a mouth, a head, shoulders, arms, elbows, legs, hips, toes-

• 2:46Speaker 01

  I guess there weren't too many great apes around there either, so were the animals they had were all four-legged and they bore no resemblance to mankind.

• 2:54Neil deGrasse Tyson?

  So the great apes being our closest genetic relative, the chimp among them at the top of that list?

• 2:58Speaker 01

  Absolutely.

• 2:59Neil deGrasse Tyson?

  And they're all in Africa, not in the, in wherever Galen and Aristotle practiced, right?

• 3:03Speaker 01

  Yeah, not in the Mediterranean basin, I don't believe.

• 3:05Neil deGrasse Tyson?

  Yeah, that'd be a different situation if apes were running around town. They would, I wonder what they would have said about that. You know, we have our, intermittently, we have our sort of comedic contributor, Brian Mallor, he's actually the Science Comedian, he tweets under the Science Comedian. And he, every now and then, we ask him to reflect on the subject of our show. And this time, he actually, he's, he's funny as always, but he gets a little sensitive because in fact, he has firsthand experience with the heart. Let's find out what he has to say.

• 3:38Speaker 02

  Although I love my girlfriend, when I think of the heart, I don't think of love and romance. I don't say I love you with all my heart because I know it's all in my head. The brain is the seat of consciousness. But that's not to play it down. The brain is the most advanced piece of biological technology ever dreamt up by natural selection. It's the most important organ, well, according to itself. Full of mystery and possibility, the brain may be the final frontier. But where would we be without the heart? The body's rhythm section, the pump that powers the circulatory system. It sends food, oxygen, and chemical messages to every part of the body. Then it picks up the waste and carries it away, comes back around again.

• 4:22Speaker 02

  With proper maintenance, you might get seven, eight, maybe nine or 10 decades out of it. But, there's no guarantee. When I think of the heart, I think of my father. My senior year in college, he had his first heart attack. That's not a phrase you ever want in your vocabulary. My first heart attack. I got to know St. Luke's Hospital in Houston much better than I care to. It famously has a McDonald's on the lobby level, as if to guarantee a flow of new patients. Now, I'm as old as my dad was when he had his first heart attack. And what's brewing inside me? I don't know. Now, he was overweight, a heavy smoker, and a workaholic. And frankly, I'm none of those things.

• 5:06Speaker 02

  But how much is genetic and how much environmental? He had a second heart attack 10 years later. Then he received an implantable defibrillator, essentially making him a cyborg. You know the defibrillator? It's those paddles, they yell clear, and then they shock you back to life? Well, this is a smaller version that goes inside you. It's a little computer pack, ironically about the size of a pack of cigarettes. And it's attached to your heart, or his heart. If it detects arrhythmia and abnormal heartbeat, it sends a little jolt of Frankensteinian electricity to the rescue. For a couple of years, my dad was on the heart transplant waiting list, slowly moving his way up to the top. The hospital gave him a pager.

• 5:49Speaker 02

  If it went off, it meant my parents had to get to the hospital immediately so he could have his heart removed and replaced with another. Because the new heart, his new heart, would only be viable for a few hours. And several times the pager went off, my parents called in only to discover it was a false alarm. How's that for someone who already has a heart condition? In the end, they got the genuine call. My dad lived the last five and a half years of his life with somebody else's heart beating inside him. And we were grateful for that extra time. So I guess my Valentine's Day message is, for you and your loved ones, take care of your heart and all your organs.

• 6:33Speaker 02

  Your body is a machine that needs proper maintenance. Treat it right, and be an organ donor. For StarTalk Radio, I'm Brian Mallow.

• 6:45Neil deGrasse Tyson?

  That was Brian Mallow.

• 6:47Speaker 01

  I meant everything that he said. It was really great stuff. Heart transplantation works. There aren't enough organs out there. Electrical technology, mechanical pumps, these are all great things. We've made huge steps forward, but we still need organs for transplantation. And everybody should be aware of organ donation and sign their organ donor card.

• 7:06Neil deGrasse Tyson?

  Sign their organ donor card. So if there aren't enough organs to donate, does that mean we should repeal the helmet laws for motorcycles?

• 7:13Speaker 01

  Some people have argued that. It didn't seem entirely moral to do that. But in the United States, every year, there are 2,400 heart transplants done. Many more people than that die on the transplant waiting list awaiting an organ.

• 7:27Neil deGrasse Tyson?

  And 40,000 people die on the highways of all ages.

• 7:31Speaker 01

  Absolutely. So it's easy to do. The back of your driver's license in New York State, just get it and sign it. Let your family be aware of it. And if something awful happens, you can save one, and in frequent cases, many other lives by donating your organs.

• 7:45Neil deGrasse Tyson?

  And it's probably not only in New York where that signature enables it on the back of your driver's license. So check in case you've never looked. Often you have the occasion to look at the back of your driver's license. So Dr. Daryl Hoffman, cardiac surgeon, while we were listening to Brian Mallow's sensitive yet comedic take on open heart surgery and transplants, you whispered to me that you just installed a defibrillator in your mother-in-law.

• 8:09Speaker 01

  Yeah, and I like my mother-in-law.

• 8:11Neil deGrasse Tyson?

  We have to establish that fact first before we continue the story.

• 8:15Speaker 01

  Full disclosure, I put it in. I put my father-in-law's pacemaker in as well.

• 8:19Neil deGrasse Tyson?

  They let you do this? I thought you're not allowed to operate on family.

• 8:22Speaker 01

  Well, you're not supposed to operate on blood relatives. And if it was a more complicated operation, I wouldn't have done it because I would have been concerned. But under the circumstances, I was comfortable doing those things.

• 8:31Neil deGrasse Tyson?

  So your mother-in-law. So this puts you in good forever, I guess.

• 8:36Speaker 01

  I'm hoping.

• 8:38Neil deGrasse Tyson?

  That might be what it takes because the rest of us are still struggling on this one.

• 8:42Speaker 01

  It's it's it's great technology. It's like buying an insurance policy. It watches your heart. And if you have an arrhythmia that is life threatening, instead of them coming as they do on television with the paddles and whacking them on your chest and yelling clear and giving you a massive electrical shock outside the body. This gives a small shock inside the heart.

• 9:00Neil deGrasse Tyson?

  But that makes such good TV to do that.

• 9:02Speaker 01

  Oh, I know.

• 9:03Neil deGrasse Tyson?

  If we just say, oh, we have a little thing inside you that did it. There's no scene to film. I'm just saying.

• 9:09Speaker 01

  You're right, but it's sad that television and popular media have been able to distribute these messages and yet haven't gotten home the idea that there's more that people can do about prevention and that patients should come forward and donors should come forward.

• 9:25Neil deGrasse Tyson?

  Well, let's look at some of the statistics. Before 1900, very few people died of heart disease. Now, it could be because they died of other things.

• 9:31Speaker 01

  Absolutely. People died of infectious disease in that era. The average life expectancy was around 30 or 35.

• 9:37Neil deGrasse Tyson?

  Well, wait, not in the 19, but I'm saying before 1900. So the 1800s, it wasn't 35. That was, we're talking cavemen 35.

• 9:43Speaker 01

  Well, if you, no, if you average, absolutely not. If you average it out, you'll find out that.

• 9:47Neil deGrasse Tyson?

  You have to average in all the infant mortality, I guess. Okay, fine. But those who survived infantdom surely died of other things. But back then, no one, hardly anyone was leading a sedentary lives that we do today. Back, they didn't have elevators, they didn't have escalators. You know, they would clean their rugs by hand, by beating. I mean, look at all the chores.

• 10:09Speaker 01

  Yeah, they walked miles to school in the snow. Absolutely.

• 10:12Neil deGrasse Tyson?

  Uphill both ways, you know. Nowadays, it's downhill both ways. So, so, so do you, do you lament that modern culture does not have built into it ways to keep our heart healthy?

• 10:24Speaker 01

  Well, it, what you're saying is very important and it starts at an early age. I, I've read studies which were done during the Vietnam era where young men who died in the conflict had autopsies and they were already showing signs of atherosclerotic heart disease in the aorta.

• 10:41Neil deGrasse Tyson?

  Which means?

• 10:42Speaker 01

  20 years old. That's the precursor of the disease that goes on to block your coronary artery.

• 10:46Neil deGrasse Tyson?

  Now, how does that happen by the time you're 20? Were they eating too much ice cream? Because ice cream had to be invented. What a great invention that was. And what an efficient way to get saturated fats into your bloodstream.

• 10:57Speaker 01

  Well, we don't, we don't understand enough about this. We know some of the risk factors and the most important ones are genetic and you can't pick your parents. So, once you're stuck with those.

• 11:07Neil deGrasse Tyson?

  Maybe the day will come where we can.

• 11:09Speaker 01

  Well, that, that probably is here now with genetic engineering. But on the other hand, there are things that we know that you can modify. Cigarette smoking, diabetes, diet, exercise, stress. These are all things that are high blood pressure are significant contributors. And can and should be modified by people and their doctors.

• 11:29Neil deGrasse Tyson?

  So I heard that stress, like abrupt stress to your, to your psychological state, not just physical stress, but psychological state can actually have an adverse effect on the stability of your heart. Possibly leading to a heart attack, which means you can die of a broken heart.

• 11:46Speaker 01

  You can die of a broken heart. That's absolutely true. It's been documented. It's extraordinarily rare and we don't understand the mechanism.

• 11:52Neil deGrasse Tyson?

  So it doesn't happen nearly as often as the, the retell, retold stories of love in fiction would have as.

• 11:58Speaker 01

  No, absolutely not. The common or garden reasons why people die from heart disease are really preventable. Some of them, of course, are inherited abnormalities. The heart is a very complicated pump. And in development, there are a number of stages at which things can go wrong. Holes can develop in the heart, valves can be.

• 12:15Neil deGrasse Tyson?

  I always hear about there's a hole in the heart. What, what's, what's that about?

• 12:18Speaker 01

  Well, in, in a complicated situation in the uterus, the fetus has to have blood circulating and the blood can't go to the lungs particularly. Because the, there's no air going in and out of the lungs. So that blood has to find a way to be shunted from the right side of the heart to the left side. Normally, the right side would pump blood to the lungs. It would come back to the heart and then the left would go to the rest of the body.

• 12:44Neil deGrasse Tyson?

  I see. So in the fetus, you're not breathing because you're just sitting there in this, in this fluid. And so other things have to work out. And if it doesn't, it fails.

• 12:52Speaker 01

  So there's.

• 12:53Neil deGrasse Tyson?

  It fails in utero.

• 12:54Speaker 01

  Right. So there's a shunt of blood from the right to the left side. And after birth, that shunt should close. It sometimes does not, and that creates an atrial septal defect.

• 13:02Neil deGrasse Tyson?

  Very bad birth defect.

• 13:05Speaker 01

  Very bad, but entirely manageable by a simple operation and now even manageable by catheter-based techniques.

• 13:11Neil deGrasse Tyson?

  When we come back, I want to bring on to StarTalk Radio, somebody who just had open heart surgery. And I'll talk to him to find out what that was like on StarTalk Radio.

• 13:51Neil deGrasse Tyson?

  I'm Neil deGrasse Tyson, your host. Welcome back. Today's subject is matters of the heart in celebration of Valentine's Day. We're going to talk about the heart, not only as an organ of emotion, but as an organ that keeps you alive, as a pump, and some milestones in cardiology. Most of what we know and understand about the heart has only happened in the last couple hundred years. Given that the heart's been around for several hundred thousand, at least the heart in a human being, it's kind of embarrassingly late in our understanding of how things go on. 1628, William Harvey, an English physician, first describes blood circulation. 1706, Raymond de Vucins, a French anatomy professor, did I pronounce that right? Vucins.

• 14:34Neil deGrasse Tyson?

  French anatomy professor, first describes the structure of the heart's chambers and vessels. That's an important advance, right there. 1733, Stephen Hales, an English clergyman and scientist, first measures blood pressure. That's good, because you need, in fact, the physics of the phenomenon before you can even say that it's going on inside your body. The concept of pressure itself was new at the time. 1816, Rene Le Neck, a French physician, invents the stethoscope. Where would we be without the stethoscope? It's the doctor's necklace. That's how they prove to you they're a doctor, as they walk around the halls of the hospital. Where would they be without that? 1903, the year the Wright Brothers first took flight with heavier-than-air

• 15:18Neil deGrasse Tyson?

  William Eintoven, a Dutch physiologist, develops the electrocardiograph. Electricity was relatively new in the early 1900s. And the good medical doctors figure out how to use that to understand what's going on in the human body. 1912, James Herrick, American physician, describes heart disease resulting from hardering, hardering, hardening of the arteries. That's an important result right there. And that's not even 100 years old. 1938, Robert Gross, an American surgeon, performs the first heart surgery. I'd hate to have been that first patient. In fact, what you never learn about are all the patients where heart surgery was attempted, and they just never survived.

• 16:01Neil deGrasse Tyson?

  They don't show up in the encyclopedia. Only the ones who survived. That was 1938. 1951, Charles Huffnagle, an American surgeon, develops a plastic valve to repair an aortic valve. Plastic was coming online as a new material. And so, good thing to know that medical doctors are exploiting the technologies of material science to find out how their craft can be improved. 1952, John Lewis, an American surgeon, performs the first open-heart surgery. Crack the chest, get in there, and see what's going on. 1953, John Gribbin, an American surgeon, uses a mechanical heart and a blood purifier. 1961, J.R.

• 16:42Neil deGrasse Tyson?

  Jude, an American cardiologist, leads a team performing the first external cardiac massage to restart a heart. These are all milestones. We have on our show Dr. Daryl Hoffman. He is a cardiologist, a heart surgeon. We'll get back to him in a moment, but I first want to introduce a friend who, was it only two weeks ago, was under the scalpel, having his chest cracked open as they did new plumbing on his heart. Let me introduce to StarTalk listeners 58-year-old Glenn Wood. Glenn, welcome to StarTalk.

• 17:18Speaker 03

  Thank you for having me on.

• 17:19Neil deGrasse Tyson?

  And you are alive?

• 17:20Speaker 03

  I am, ridiculously so.

• 17:22Neil deGrasse Tyson?

  What day was your surgery?

• 17:23Speaker 03

  It was actually three Fridays ago, so it's three weeks and two days.

• 17:28Neil deGrasse Tyson?

  And you're walking around and kicking, you're not?

• 17:30Speaker 03

  I'm doing marathons.

• 17:32Neil deGrasse Tyson?

  And you're in the zipper club. How big is your scar? Let me show it to me now. I'll describe it to everyone on StarTalk. No, don't show me a photo. Show me. Pull up your shirt there. Here it comes. It's past his belly button now. Up. There it goes. It's about 10 inches long and it's clean right down the center. Good job.

• 17:51Speaker 03

  I'm very pleased with it, I have to say.

• 17:52Neil deGrasse Tyson?

  What so, what kind of smoking and drinking were you doing that they had to perform this operation on you?

• 17:57Speaker 03

  Well, funnily enough, uh, my hedonistic lifestyle up to now has not had anything to do with, um, what they had to do to my heart.

• 18:04Neil deGrasse Tyson?

  So you just got the bad genetic lot in life?

• 18:05Speaker 03

  I got the, the duff heart in the first place. Uh, the aortic valve, uh, was a bicuspid instead of being a tricuspid and...

• 18:14Neil deGrasse Tyson?

  So you're a genetic anomaly, but you've known this your whole life then?

• 18:16Speaker 03

  Since I was two, apparently, yeah.

• 18:18Neil deGrasse Tyson?

  So why choose now to do it and not when you were younger?

• 18:20Speaker 03

  Uh, cause my heart was about to expire.

• 18:22Neil deGrasse Tyson?

  Oh, so as long as-

• 18:23Speaker 03

  It was getting very bored with, uh, with the excess work.

• 18:27Neil deGrasse Tyson?

  So as long as you're alive and kicking and not dying, there's no reason to actually put your life at further risk by doing the operation?

• 18:33Speaker 03

  Well, it got to the stage where, um, the risk of the surgery, uh, was less than the risk of not doing it.

• 18:41Neil deGrasse Tyson?

  I see. So that's a, that's sensibly conceived that way?

• 18:44Speaker 03

  Yes.

• 18:45Neil deGrasse Tyson?

  So I'm told, so what, they repaired the valve? They repaired it or they swap it out with new parts like?

• 18:49Speaker 03

  I, I now possess, uh, uh, part of Ermentrude. Uh, I have a cow valve going on inside.

• 18:54Neil deGrasse Tyson?

  You have part cow? You're a part cow?

• 18:56Speaker 03

  I am part cow and grass is looking extremely tasty.

• 18:58Neil deGrasse Tyson?

  Is that right? I don't know that they added extra stomachs to your...

• 19:02Speaker 03

  Yeah.

• 19:03Neil deGrasse Tyson?

  So you got a cow valve. So wow. That's, so, uh, could they, could they have gotten that valve from other animals or it's something about a cow that worked perfectly for you?

• 19:13Speaker 03

  Uh, I was given no choice whatsoever. Uh, and, uh, I have absolute faith in my cardiac surgeon.

• 19:21Neil deGrasse Tyson?

  Was it that a cow valve finally came available?

• 19:24Speaker 03

  I think they actually have fair old stock. Because they, once they carved you up a bit and removed the old bit, and I did ask if I could keep the old one.

• 19:33Neil deGrasse Tyson?

  I don't think they let you keep.

• 19:34Speaker 03

  They won't.

• 19:34Neil deGrasse Tyson?

  Stuff that they take out of you.

• 19:35Speaker 03

  Which is sad.

• 19:36Neil deGrasse Tyson?

  There's something wrong, there's something wrong about that.

• 19:37Speaker 03

  I know, it's mine, couldn't be more mine, could it, really?

• 19:40Neil deGrasse Tyson?

  It could not be.

• 19:41Speaker 03

  But I wanted to take it away and have it set in clear resin. It's just, you know, I also wanted a, a, a video of the operation.

• 19:49Neil deGrasse Tyson?

  They don't give you that either.

• 19:50Speaker 03

  No.

• 19:51Neil deGrasse Tyson?

  Because they want, because the doctors, they want to keep it a secret. In fact, let's get to the bottom of this, let's bring back on Dr. Darryl Hoffman. He's a heart surgeon, at Beth Israel Hospital, here in Manhattan.

• 20:02Speaker 03

  Yes.

• 20:03Neil deGrasse Tyson?

  So, Dr. Hoffman, we have a man sitting to your side, who just underwent open heart surgery, the kind of surgery that you do.

• 20:10Speaker 03

  Yes.

• 20:11Neil deGrasse Tyson?

  Why don't you give people the videotape so they can put it on YouTube? What's, what's going on there?

• 20:15Speaker 03

  Well, in some rare circumstances, you might do that. Most operating rooms aren't equipped to record the entire operation, in this country, there are concerns about medical legal.

• 20:25Neil deGrasse Tyson?

  That is so lame an explanation, because we, people with a video camera will record anything, anytime, anyplace. We even have aliens on tape.

• 20:31Speaker 03

  You're right, and when we try and record operations to teach people, we find out how difficult it is. If you use a head-mounted camera, which is one way to do it, every time you move your head, everyone who's viewing the picture gets nauseous because you move your head so much. Turns out, it's very hard to film an operation accurately.

• 20:48Neil deGrasse Tyson?

  You know, I, I think that's still lame, but, well, I'll, I'll accept it for now because I'm being polite. Glenn, when you got, when you got this operation, did you feel any different coming out of it? Did you feel like, oh, my heart is fresh and lively and I, I have greater capacity for love, because my heart is intact, whereas before, I was heartless? I mean, what?

• 21:09Speaker 03

  No, I, I remain stone, I have a love business.

• 21:12Neil deGrasse Tyson?

  And tell me, what's, what's your profession that, did you, do you have a profession that is not good for the heart? Or, what do you do?

• 21:18Speaker 03

  I'm a, a concert sound engineer, I tour the world with, with rock bands.

• 21:22Neil deGrasse Tyson?

  That, that's, that's, that sounds like code for groupie. Concert sound engineer. You chase groups around?

• 21:28Speaker 03

  No, no.

• 21:29Neil deGrasse Tyson?

  You're not a groupie?

• 21:30Speaker 03

  No, I have groupies, but that's a different thing altogether.

• 21:32Neil deGrasse Tyson?

  Are you a roadie?

• 21:33Speaker 03

  No, I'm not a roadie either.

• 21:35Neil deGrasse Tyson?

  So, do you the ones who trash hotel rooms after concerts?

• 21:37Speaker 03

  If necessary, if they require trashing, of course.

• 21:42Neil deGrasse Tyson?

  You stayed in a hojo? If that's necessary, I see. So, no, I like this valve thing. Dr. Hoffman, do you have preferred valves? What kind of animals do best for valves? Do they go on humans?

• 21:53Speaker 01

  There are different kinds of valves. Broadly speaking, there are valves that are made out of mechanical components and those valves will last forever but require the patient to take blood thinners, which have their own problems. Otherwise valves can be used from pigs, they can be used from the lining of the cow's heart.

• 22:08Neil deGrasse Tyson?

  I would bet not at the Beth Israel Hospital, though. They would not use pig parts.

• 22:12Speaker 01

  No, it's perfectly kosher to use a pig valve to save someone's life.

• 22:16Neil deGrasse Tyson?

  Is that right?

• 22:16Speaker 01

  Absolutely.

• 22:17Neil deGrasse Tyson?

  Good to hear that.

• 22:18Speaker 01

  Other things that you can do, you can actually take a human valve and use it. Of course, the original owner might object, so a valve from a dead human or from a human who's getting a new heart for a heart transplant.

• 22:28Neil deGrasse Tyson?

  And the subject of dead humans, we could have learned about the heart long ago if there wasn't some taboo to prevent you from digging cadavers up.

• 22:34Speaker 01

  You're absolutely right. The Church held certain inviolable beliefs and Galileo and others got locked up and interrogated for breaking those rules. But ultimately, William Harvey, as you point out, in England, discovered the circulation of the heart and then lots of new ideas replaced previous dogma. Experimentation took off.

• 22:54Neil deGrasse Tyson?

  So how would, so medical students, how would they learn?

• 22:58Speaker 01

  In those days, they'd learn from books and the drawings in those books were very inaccurate.

• 23:06Neil deGrasse Tyson?

  I bet if I had a grave robbing business, I'd do, I'd be, do very well.

• 23:09Speaker 01

  Well, absolutely. So even in the 1820s roughly, in Edinburgh, which was one of the leading medical centers in the world at the time, bodies were used for dissection. Students learned by cutting up dead bodies.

• 23:21Neil deGrasse Tyson?

  Is this before there was a day when you would donate your body? No one did that back then?

• 23:25Speaker 01

  Absolutely. There was no presumed donation. And a couple of guys called Burke and Hare would steal bodies from the graves and sell them in the back door of the medical school. Young gentlemen who were not medical students were interested in this and they'd come to the dissection halls as well. And Burke and Hare realized that they needed to increase their business and so they started actually murdering people because there weren't enough usable dead bodies.

• 23:48Neil deGrasse Tyson?

  I hate to laugh, but this is England for you, right? I'm reminded of why we, why we fought a war to get away from you guys. And now here we are again. Yeah, I'm the only one with an American accent on this show. I spotted that too. Glenn, your accent hails from where?

• 24:03Speaker 03

  Manchester, England. I've lived here for 11 years.

• 24:06Neil deGrasse Tyson?

  All I know of Manchester is the football team, soccer team.

• 24:09Speaker 03

  They actually do have two. You were right first time, football, a game played with the feet.

• 24:16Speaker 03

  I do want to answer the question you asked me earlier, do I feel different?

• 24:21Neil deGrasse Tyson?

  Well, we'll have to get back to that because we're about to go to break. Plus, I happen to know that sometimes you can be quite cantankerous. And at the end of the break.

• 24:30Neil deGrasse Tyson?

  What, me? Of course not. We've got to take a quick break, but more StarTalk when we return.

• 25:04Neil deGrasse Tyson?

  This is a special Valentine's Day show on Matters of the Heart. I'm your host, Neil deGrasse Tyson. Welcome back. So, we have with us in the studio, Dr. Daryl Hoffren. He's a heart surgeon, cardiac surgeon. We have also Glenn Wood, a recent recipient of a heart valve, just three weeks ago. He's alive and kicking in the studio. He's a cantankerous Brit who's been in America for 11 years. And we have dinner with him all the time. We're always fighting about something, but they're lovable fights. Glenn, were you cantankerous with the nurses and doctors in the hospital?

• 25:42Speaker 03

  They loved me.

• 25:43Neil deGrasse Tyson?

  Oh, you loved?

• 25:44Speaker 03

  I loved them, believe me. I would marry my surgeon in a heartbeat.

• 25:50Speaker 03

  He's just the most adorable person. He's made me very, very, very alive, and I fully appreciate that.

• 25:56Neil deGrasse Tyson?

  And afterwards, where did you convalesce?

• 25:59Speaker 03

  I went and had the good fortune to stay with a couple of very dear friends out in Montauk.

• 26:06Neil deGrasse Tyson?

  Montauk, the end.

• 26:07Speaker 03

  The end.

• 26:07Neil deGrasse Tyson?

  Yes, the tip of Long Island, which is just called the end.

• 26:10Speaker 03

  Yes, next stop, Portugal. And they looked after me fabulously.

• 26:16Neil deGrasse Tyson?

  And you know, we did our homework on this and we found out who it was that took care of you. It was none other than Claire Schonheimer. And we went and got her and she is in the studio. Claire, welcome to StarTalk Radio.

• 26:28Speaker 04

  Thank you, hello.

• 26:30Neil deGrasse Tyson?

  And what possessed you to take care of Glenn? Because I've been in his company, 10 minutes is pretty much all I can tolerate.

• 26:35Speaker 04

  Looking back on it, I don't know. He was a nightmare. He cried like a girl most days. I was glad when he went home. It was a pain in the arse. He was awful.

• 26:45Neil deGrasse Tyson?

  Well, now, now, you are not a nurse.

• 26:48Speaker 04

  No, and I never will be after that experience. Nightmare.

• 26:52Neil deGrasse Tyson?

  Glenn, what did you do in her home?

• 26:54Speaker 03

  I belched and I was actually completely sweet and loverable.

• 26:59Neil deGrasse Tyson?

  I know he's lying.

• 27:00Speaker 03

  I spent most of the time in bed, I can tell you, which is very nice.

• 27:03Neil deGrasse Tyson?

  Well, let's find out. So Glenn, did your feelings change after this surgery? Were you a different person?

• 27:08Speaker 03

  Well, I am a different person afterwards. I've had this duff heart all of my life.

• 27:14Neil deGrasse Tyson?

  Duff, that's British for bad heart.

• 27:16Speaker 03

  Crapola, yes. I kind of was used to it because it was what I was born with. But it feels like somebody just drove a tractor through your chest when you have this surgery. So for the first couple of days afterwards, no, I felt pretty bloody rough, the truth be known.

• 27:34Neil deGrasse Tyson?

  Bloody, that's a curse word in England.

• 27:36Speaker 03

  But not here.

• 27:37Neil deGrasse Tyson?

  Yeah, here it's just the word bloody. Yeah, okay.

• 27:40Speaker 03

  Seems very appropriate at the moment.

• 27:41Neil deGrasse Tyson?

  Bloody's not in the list of seven forbidden words here.

• 27:44Speaker 03

  I'm going to try and curtail those.

• 27:46Neil deGrasse Tyson?

  So Claire, did you have to, you weighed on him hand and foot presumably?

• 27:49Speaker 04

  No, I am not a natural caregiver. I did nothing. I have to be honest. My husband Dan did all of it.

• 27:54Speaker 03

  And that is the truth.

• 27:54Speaker 04

  And that is the truth. But although I'd love to rag on Glenn for hours, he was actually a good patient. I know, we don't want to hear that, but he was. I mean, the flatulence was a nightmare. The burping was literally shocking at one point. But.

• 28:11Speaker 03

  They said I had to do it.

• 28:13Speaker 04

  He kept, as they say.

• 28:14Neil deGrasse Tyson?

  Well, I have to ask, we have a doctor, Dr. Hoffman, what is with the flatulence and the burping? What is that a normal consequence of open heart surgery?

• 28:22Speaker 01

  Well, it must have been a particularly strange cow and he must have been chewing the cud.

• 28:27Speaker 04

  I was concerned it was simply an excuse.

• 28:30Neil deGrasse Tyson?

  This is the cow part that he got, the cow valve. So we're wondering if the cow flatulence somehow rubbed off.

• 28:36Speaker 04

  Well, the problem was as well, it made him laugh and he's not supposed to laugh. That was when we left.

• 28:40Neil deGrasse Tyson?

  Because laughing puts stress on your, on your.

• 28:42Speaker 04

  He actually has.

• 28:43Neil deGrasse Tyson?

  On your chest cavity.

• 28:43Speaker 04

  A heart shaped cushion they gave him at the hospital, which was dead cute, that he has to hold as a brace. So he would fart and then he'd laugh, then I would laugh, even though it's not funny when men do that at all. But it seemed to be for a moment and.

• 28:58Neil deGrasse Tyson?

  It is if you're in sixth grade, you know.

• 29:00Speaker 04

  Yeah, but you see, there you go.

• 29:01Neil deGrasse Tyson?

  Eleven years old.

• 29:02Speaker 04

  But the best thing was when we were told, when he was leaving hospital and we were told all the things that he was and wasn't allowed to do. Like, you know, no laughing, no drinking, no walking, no this, no that. But he was allowed to have sex of, as of that day.

• 29:17Neil deGrasse Tyson?

  Really?

• 29:17Speaker 04

  So my worry.

• 29:18Neil deGrasse Tyson?

  Sex, but not walking?

• 29:20Speaker 04

  Yeah, no walking.

• 29:21Neil deGrasse Tyson?

  What, what doctor prescribed this?

• 29:22Speaker 01

  An excellent doctor.

• 29:24Neil deGrasse Tyson?

  This is why he wanted to marry your doctor, yes.

• 29:26Speaker 04

  So my fear that he was going to be trawling the baths of Montauk and trust me, you don't want to go there even when you are.

• 29:31Neil deGrasse Tyson?

  I didn't know Montauk had the baths.

• 29:33Speaker 04

  They have.

• 29:33Neil deGrasse Tyson?

  The baths, it's like the baths of Rome.

• 29:35Speaker 04

  No bars, not bars.

• 29:37Neil deGrasse Tyson?

  Oh, bars, excuse me, this is America, Jack.

• 29:39Speaker 04

  You see, we're going to take the colonies back if you carry on speaking like that.

• 29:42Neil deGrasse Tyson?

  Okay, so not the baths, the bars, the bars, the bars of Montauk.

• 29:47Speaker 04

  Bars of, bars of Montauk, looking for talent. So I wouldn't let him out.

• 29:52Neil deGrasse Tyson?

  Oh.

• 29:53Speaker 03

  I didn't inquire whether it was available on my health insurance and they said no, I was curious.

• 29:58Speaker 04

  But isn't that weird, Daryl? Is that normal that you, you're not allowed to do anything except?

• 30:01Speaker 01

  No, absolutely not.

• 30:02Neil deGrasse Tyson?

  Dr. Hoffman, what, what, what do you prescribe after you crack open someone's chest?

• 30:06Speaker 01

  So here's what we tell people. We tell them that by a month after surgery, they should be walking two miles a day. Um, and they're really very, very few.

• 30:14Neil deGrasse Tyson?

  Surely a sex equivalent to that?

• 30:15Speaker 01

  Well, hang on, very few. Very few restrictions.

• 30:18Neil deGrasse Tyson?

  He's done the math, he's done the math.

• 30:20Speaker 01

  How many heartbeats, yeah. So, you're allowed to do anything except heavy lifting, and when patients ask, because we don't tell them this routinely, when they ask about sex, we simply say, "Please wait till you leave the hospital building."

• 30:34Neil deGrasse Tyson?

  So if they've got enough energy to get out of the building, that's good enough?

• 30:39Speaker 01

  That's it.

• 30:40Neil deGrasse Tyson?

  That's the threshold.

• 30:41Speaker 01

  The main reason we want people not to overdo it is because of the mechanical stress on the breastbone. We split the breastbone to get to the heart, and that has to heal up like any broken bone.

• 30:51Neil deGrasse Tyson?

  When you say "split it," you mean cut, hacksaw it open?

• 30:54Speaker 01

  Well, we use a saw, yes, absolutely. A reciprocating saw.

• 30:58Neil deGrasse Tyson?

  What, I don't know what that's...

• 30:59Speaker 01

  A jigsaw.

• 31:00Neil deGrasse Tyson?

  A jigsaw.

• 31:01Speaker 04

  Not really, like a Black and Decker?

• 31:02Speaker 01

  Yes, absolutely.

• 31:03Speaker 04

  That's disgusting.

• 31:04Speaker 01

  A silver Black and Decker.

• 31:05Speaker 04

  No, is it really Black and Decker?

• 31:06Neil deGrasse Tyson?

  You get it right in the local hardware store.

• 31:08Speaker 01

  No, no, it's like most surgical things, it's much more expensive.

• 31:12Neil deGrasse Tyson?

  You would know that the medical profession has a different word for what it is they're using, okay? They're not gonna say it's a Nikita drill, or, so what do you actually call the device?

• 31:20Speaker 01

  The saw.

• 31:21Neil deGrasse Tyson?

  No, no, you lied.

• 31:23Speaker 01

  Give me, nurse, give me the saw. They know exactly what that is.

• 31:26Speaker 04

  And do you have different bits? Do you change the different blades?

• 31:30Speaker 01

  Yeah, actually, there are two...

• 31:31Speaker 04

  Can you bevel?

• 31:32Speaker 01

  There are, no, there are two kinds of blades. There's one kind of blade that we use for anybody who's not had an operation before. If someone's had surgery before, the part can get stuck to the inside, the back of the breastbone, and so then we wouldn't use that same saw.

• 31:46Neil deGrasse Tyson?

  Is that because the healed bone is stronger than regular bone?

• 31:48Speaker 01

  No, no, it's the same strength, but if you don't want to go behind the breastbone, this particular saw that was used on you, that's used on all first-time people, has a little footplate that goes behind the bone, and the saw goes up and down, and that's why it's called reciprocating, and it cuts through the bone, and you start at the bottom and work your way up to the top. But if someone's had an operation before...

• 32:10Neil deGrasse Tyson?

  You don't have that bottom?

• 32:11Speaker 01

  We use a different kind of bone.

• 32:12Neil deGrasse Tyson?

  Okay.

• 32:13Speaker 01

  A different kind of bone saw.

• 32:14Neil deGrasse Tyson?

  I see. So now you, now, I, my image of open-heart surgery is from the movie, uh, what's the movie? All That Jazz.

• 32:22Speaker 01

  All That Jazz.

• 32:23Neil deGrasse Tyson?

  Yes. They use actual file footage, and they have this like cranking device that...

• 32:26Speaker 01

  Yeah, retract it to hold the breastbone open.

• 32:28Neil deGrasse Tyson?

  Yeah, it just feels, I don't even, I can't even, and you just look at this every day.

• 32:33Speaker 01

  The human heart is one of the most beautiful things to look at. When you see that heart beating, I do it every day, and it's still exciting when I see it. The natural development of that is extraordinary. And you know, what's happened to Glenn is that he was born with an abnormal valve. That valve had two leaflets, not three, and over time, the natural stresses caused those two leaflets to stick together and that narrows and so the body is forcing blood through this narrow nozzle. And that's why he was feeling weak and tired and why he feels so energetic after the surgery.

• 33:03Neil deGrasse Tyson?

  So did he, you knew him from before and you knew him after, is he more energetic now?

• 33:07Speaker 04

  It's scary, it's like Glenn on drugs, it really is. I mean, it's really weird. The first thing I noticed when I saw him is I thought he was one of those sort of pale British people with the prison pallor, you know, it's all gray.

• 33:20Speaker 01

  Interesting, I think.

• 33:21Speaker 04

  Interesting, yeah, sort of pale and interesting Glenn.

• 33:23Neil deGrasse Tyson?

  Pale as in complexion?

• 33:26Speaker 04

  Yeah, white as a sheet, really.

• 33:27Neil deGrasse Tyson?

  Okay.

• 33:28Speaker 04

  And when he came out and he looked like Franken-Glen. I mean, he hasn't even shown you the fantastic scar on his jugular, it's awesome. So he's all chopped up and everything, but the color on his skin looked, and do you know what he said the best thing was? He actually put it down to the wash they make you do before your operation, it's like what you did your head.

• 33:47Neil deGrasse Tyson?

  Oh, okay, so, so, so he looks more flushed now?

• 33:50Speaker 04

  Oh, yeah, no, no, he looks really good.

• 33:52Neil deGrasse Tyson?

  He looks more alive, less freshly embalmed.

• 33:55Speaker 04

  Let's not push it too far, don't want his ego sort of, yeah, he looks, he looks all right.

• 34:00Speaker 01

  Potentially more cantankerous.

• 34:01Speaker 04

  Yeah, oh, he's always cantankerous, that hasn't changed.

• 34:04Neil deGrasse Tyson?

  The cantankerous factor is only now enhanced.

• 34:07Speaker 04

  He's got more energy for the cantankerous behavior.

• 34:10Neil deGrasse Tyson?

  Normally, doctor, normally when I think of people going into a major surgery, you think that afterwards they'll be somehow more frail or more, more fragile. But you give the kinds of operations where people have a re, a new literal lease on life. They now, it's, you start the time from zero again.

• 34:27Speaker 01

  Absolutely. If, if this operation is planned and undertaken successfully at the right time, the patient really benefits and the convalescence surprises everyone. We usually get people out of the hospital four or five days after the operation, most people don't expect that and they're pleasantly surprised.

• 34:42Neil deGrasse Tyson?

  In the old days, would you keep him in for a month or something in the old days?

• 34:45Speaker 01

  Ten days usually.

• 34:46Neil deGrasse Tyson?

  Ten, yeah, but now they're, now, when did he leave?

• 34:49Speaker 03

  I was, I was in four days after the surgery, so five days in total.

• 34:53Neil deGrasse Tyson?

  And you walked out four days later?

• 34:55Speaker 03

  I walked out, well, they make you go in a wheelchair, but I was walking two days after the surgery.

• 34:59Neil deGrasse Tyson?

  And you left the hospital after four days?

• 35:01Speaker 03

  Yeah.

• 35:02Neil deGrasse Tyson?

  And that's when he would have had permission by your prescription to?

• 35:05Speaker 01

  Indulge, absolutely. Indulge.

• 35:07Neil deGrasse Tyson?

  We've got to take a quick break, but more Startoff when we return.

• 35:37Neil deGrasse Tyson?

  This is Startoff Radio. Welcome back. Before we get back to my three guests, let me give you some interesting facts about what your heart does in space. You know, there's this parabolic trajectory you can take in an airplane where you temporarily go to zero G. And so you can look at the effects of what happens to your heart rate as you go in and out of zero G. And so it turns out when you transition from one G to two G, your heart rate goes up by about 13 beats per minute. And that's kind of understood because it's pumping against a higher, what's the effective force of gravity. But then, when you go from two G back to zero G, when you're actually weightless, because these parabolic trajectories, you go to higher G, and then it transitions

• 36:20Neil deGrasse Tyson?

  to zero G, because you need to need that buildup in the parabolic trajectory. When it does that, your heart rate drops. It drops. And it can get as low as 20 to 30 beats per minute in zero G. And I find that fascinating. Because obviously, your heart is no longer working against gravity. It doesn't have to work as hard. It's actually, in fact, taking a vacation.

• 36:42Speaker 01

  Yeah, I assume that the blood gets accelerated by the G forces, and the heart may not have to pump for that moment. You worry about astronauts passing out under those circumstances.

• 36:52Neil deGrasse Tyson?

  Well, here's what happens. It turns out, your heart is accustomed to pumping up to your head against gravity. So it's really primed to do that. And when you don't have gravity, it's going to pump in the same way, and it actually over pumps blood up to your head. Well, in space, there wouldn't be, you know, up. It would over pump blood to your head. And so astronauts tend to have this very flushed look about themselves, very sort of plumpy-headed, flushed, rosy-cheeked look. And so, check them out in orbit next time.

• 37:22Speaker 01

  Well, they shouldn't let them be upside down so much.

• 37:27Neil deGrasse Tyson?

  Not only can you not hear anyone scream in space, there is no up or down. So, listen, listen, Dr. Hoffman, nowadays, they, can they, all the people waiting for a new heart, can't they just put in an artificial heart? What happened to the Javik heart?

• 37:44Speaker 01

  Well, the Javik heart's no longer used, and you're right, we've been working for 30 years now to make an artificial heart pump, and there are some significant improvements that have been made in recent years. We still have problems. We don't have the perfect connection device, we don't have the perfect valve.

• 37:59Neil deGrasse Tyson?

  Because you have to, you have to connect plastic-

• 38:02Speaker 01

  To the circulation, right.

• 38:03Neil deGrasse Tyson?

  To, to, to bi- biological material.

• 38:05Speaker 01

  Yeah, and, and you, you know, you need blood thinners to prevent the blood from clotting inside the plastic or metal components of the heart frequently, or other blood thinners. Space actually has contributed enormously to this, particularly in regard to miniaturization and to the power sources and battery technology. So, actually, we've really had a leap forward, and now there are heart pumps that are available quite freely, and, and will be quite likely changing the technology and the approach to the patient with heart failure.

• 38:34Neil deGrasse Tyson?

  So, these aren't completely new hearts, these are auxiliary pieces of your heart that just help it pump without, without incident, is that right?

• 38:40Speaker 01

  There are kinds of mechanical pumps which can be outside the body, and those are like the Javik heart, which you remember, sort of refrigerator that had to be trundled along behind the patient. Now, they're miniaturized, there's still some that go outside the body temporarily-

• 38:53Neil deGrasse Tyson?

  And just to remind people-

• 38:54Speaker 01

  Others are implantable.

• 38:54Neil deGrasse Tyson?

  NASA likes to miniaturize things, because the bigger it is, the more expensive it is to get it into orbit. So, the entire miniaturization in the electronics industry was spawned and stimulated by all of our efforts to go into space, I just want to make that clear, in case anyone, I want to hear, "Thank you, NASA," next time you carry around your-

• 39:13Speaker 01

  Well, you know, certainly thank you, NASA, for this, and the, the artificial heart is, is working, people will have heard that Vice President, former Vice President Cheney has an artificial heart pump-

• 39:25Neil deGrasse Tyson?

  It's been rumored he just has no heart at all.

• 39:28Speaker 01

  Well, he certainly didn't have a human one, he now has an artificial one.

• 39:32Neil deGrasse Tyson?

  Okay, so now I just did a special on PBS Nova, Nova Science Now, we did a segment on they're growing, they're not growing, they're using the scaffold of organs to then affix of pre-existing organs, either from a pig or from some other animal that has a similarly sized heart, but they grow your own tissue onto that.

• 39:56Speaker 01

  So this is the most exciting idea, take a heart, pump some circulation through it, keep it alive, and then change the perfusion fluid to a detergent. The detergent gradually washes out all the cells. What you're left with is the collagen ultrastructure, the scaffolding.

• 40:12Neil deGrasse Tyson?

  This is not of a living person, this is a heart taken out of the body.

• 40:14Speaker 01

  This is a heart taken out of the body of a pig or some other rodent, whatever, maybe a cow.

• 40:19Neil deGrasse Tyson?

  You cleanse it of all its cells.

• 40:21Speaker 01

  You cleanse it of all the cells, and then you change the perfusion solution, and in the perfusion solution, you now introduce stem cells. Those stem cells settle on the surfaces of the collagen, and they get the right signals, not only from the circulating fluid, but also from the physical forces, which then cause them to differentiate into specific cells, some into muscle cells, some into blood vessel lining cells, and the new muscle that forms begins to beat.

• 40:48Speaker 04

  Is that the one where you see it in a box, and then they pour fluid on?

• 40:52Speaker 01

  That's the one.

• 40:53Speaker 04

  And that's really Edgar Allan Poe, isn't it?

• 40:55Neil deGrasse Tyson?

  Yeah.

• 40:56Speaker 04

  I mean, that is...

• 40:57Speaker 01

  It's the most exciting development now, not only for heart surgery, but for other organ reconstruction.

• 41:01Neil deGrasse Tyson?

  So you have an organ on the shelf, and you just pluck it off the shelf, and you won't reject it because it's not another species, it's not even another human heart, it's going to have your own cells?

• 41:09Speaker 01

  You could make it your own, you take out the stem cells from the patient, and you inject them into the circulation, and this ultrastructure, the scaffolding, reforms a living, functioning organ which will not be rejected and could be transplanted.

• 41:24Speaker 04

  It does look like basting, doesn't it? It looks like basting a turkey.

• 41:27Speaker 01

  Well, from the inside.

• 41:28Speaker 04

  From the inside. Can I ask a whale-related question?

• 41:31Neil deGrasse Tyson?

  A whale-related. It better be a whale of a question.

• 41:33Speaker 04

  It is a whale of a question. So this big 2,000-pound whale heart, what's that in real numbers, Glynn? Like, half a bus, one bus? How big is that really?

• 41:43Speaker 03

  Well, it's a ton, isn't it?

• 41:44Speaker 04

  All right, so that's really big.

• 41:45Speaker 03

  It's a heart that weighs a ton.

• 41:46Speaker 04

  Has anyone ever done any surgery, do you think, on a heart that big? Because a cow valve wouldn't cut it, would it? You'd have to stuff the whole cow in.

• 41:52Neil deGrasse Tyson?

  Yeah, that's part of the problem. You need another animal that's the size of you to substitute in.

• 41:57Speaker 04

  Do you think anyone's ever done hearts? Can we ask someone?

• 42:00Neil deGrasse Tyson?

  Okay, so, open-heart surgery on whales? No.

• 42:04Speaker 04

  You haven't personally, Daryl.

• 42:06Neil deGrasse Tyson?

  I've never heard of anyone.

• 42:06Speaker 04

  I feel that this is the way that your career could go from now on. I do.

• 42:10Neil deGrasse Tyson?

  We're winding down on our time. You've been listening to StarTalk Radio. I'm Neil deGrasse Tyson, and as always, keep looking up.