As a heart patient, I’m hypersensitive to the languages we use to characterize coronary artery disease. Our culture personifies the heart, often as the metaphoric seat of enduring emotion.
A heart is pure, is given freely; it bends and breaks; it never forgets. A heart is San Francisco where you left it, Christmas within, what goes on after the Titanic sinks. A heart is worn on your sleeve, a lonely hunter, made of stone. It’s where home is sweetest, you know he’s right, the thing you gotta have, miles and miles of which the athlete taps, the lover woos. Its cockles warm, its tick-tock trues. A heart is full of moxie, courage, kindness, pluck, deceit, and compassion: your pain in my heart. We have good hearts and brave hearts and cold, cold hearts. Hank sings “Your Cheatin’ Heart” will tell on you, Pascal knows “the heart has its reasons,” and Jimmy Carter confessed to adultery there.
The heart’s hill-and-dale range helps us communicate how to feel, better yet, how to talk those feelings through. The richness of the representation suggests how difficult such expression is. The language of the heart spills into myriad associative descriptions, which both refine and mystify feeling and meaning.
After my father’s first heart attack in 1970, my mother would tell friends who had not heard, that “John had a coronary. But with rest he’s doing much better.” A coronary? Whence this usage? Is it from coronary thrombosis, the phrase for an arterial clot? Is it the site of its pumping turn? How does an adjective which denotes the heart’s arteries convert to a noun that describes its damage? Why is the passage and its blockage the same?
The word coronate means to crown the head of a special person—a royal, a winner, a pope: to coronate bestows the highest honor. The arteries coronate the heart muscle by encircling it and supplying it with blood. No wonder poets praise it. Its metabolic tack is primary to every organ and cell: it should be pedestaled and peaked. And yet how deftly we label this honorific an attack. The point of “my coronary arteries are having a coronary” is to use language to engage the paradox of the heart’s function: That which most sustains human life, our body’s core pulsing organ, is also that which if harmed most effectively ends that life.
This ploy is what language is good at. Language mirrors the intimacy and distance we have with our bodies. Anyone who struggles to portray an illness so a doctor might pinpoint a diagnosis knows this. Chest pain is “an elephant sitting on my chest.” Medically accurate? Hardly. Emotionally revealing? You bet. We use language—evolutionary linguists would say language uses us—to approximate our bodies’ signals and claims. Language allows us the means to tell others what we do not understand but feel intensely.
If we can say how we feel, using the most precise words we can summon—and a caregiver can then recognize our ache—we feel closer to what’s wrong, as though language enacts the feeling.
But with angina (to take its chief symptom) the heart itself is not what hurts: it’s the shoulders, the chest, the upper arms, the neck. It’s the indigestion and nausea. It’s the heaviness. It could be all these things or just one, nastily intensified. The heart must use muscles and tissue and neurological symptoms to tell the mind that the core reactor is shutting down. With my three heart attacks, I never felt the oxygen-deprived death of heart muscles cells. My body told it to me differently, perhaps cruelly so, so I would get help. The heart tells the body to speak up, a more reliable and louder broadcaster than the organ within.
Language is a system whose imprecision best tells the truth about us. Even still, the paradox has its limits. Words are essential; they animate our dilemmas. But we reveal ourselves most trenchantly outside language because language only poorly captures the inner upheavals and multiple messages our bodies enact. Language, though it aims to be, is never as essential or as accurate or as befuddled as we are. Indeed, we fashion words to label conditions like coronary or heartburn or hand-on-heart and perceive we have said something. Even if words successfully describe feelings, they cannot relieve anxiety or alter symptoms.
“Philosophy,” writes Wittgenstein, “is a struggle against the bewitchment of our understanding by the resources of our language.” Language embodies that which it cannot have and will never possess, yet like Narcissus smitten by what he beholds on the lake’s glossy surface falls for what he believes he sees.