Cardiometry

Darren, in a neat shirt and slacks, with an ID lanyard around his neck, a bright red chevron that signifies his membership of the cardiometrical brotherhood – they are still mostly men – Darren will pass a plastic-covered sensor over your upper left chest, where your heart is supposed, in the sense of thought, to be. (We can only know for sure if we open your chest and look, which we prefer not to do unless absolutely necessary. We can feel, and listen, and infer. Something beats, something throbs and pulses among the tissue and bone and other organs, intimately implicated in all the processes of your life. We isolate it and call it the heart so that we can study it. Who knows if we really understand it?)The sensor is attached by a cable to a device that looks like a child’s laptop computer, a bright, chunky plastic machine marked with the logo of Darren’s particular school of the brotherhood – CardioTronic, BioTronic, MedTronic, those inter capped words with a clacking calculus that entered the language suddenly and unbidden out of the marketing departments of the business schools of the late twentieth century, magical words that are strangely reassuring in their lack of specific referrant, free-floating signifiers that we are able to attach all kinds of meaning to.

When the sensor has passed over the heart region of the chest it established a connection, magically it seems, so that many subjects, particularly the elderly, people with memories of earlier times, refer to it as a “wand” with uncanny frequency, even though this word is never used by the cardiometrists, who call it a “stone” among themselves due to its shape, which is like a large sea-tumbled pebble from a distant northern shore, and its heft, which is considerable and belies the plasticky exterior.

Once the connection has been established the machine begins its reading and recording of the heart’s events, and a long chart of paper with a fine black tracery printed on it issues from a slot, almost invisible, in the side.

Darren gathers each of the printout’s concertina folds into a neat fan. He scans the pages with deep concentration, interpreting the trace of your heart. Mostly the traces are unremarkable: the gentle rise and fall of the graph marks the easy rhythms of some love that has lasted a lifetime, or a particular spike that Darren can interpret – from its shape and intensity – as the surge of pride at a loved one’s achievement: maybe a grandchild has scored the winning goal in an important game; Darren will read from the trace whether you saw the game yourself, or merely had it recounted to you (and by whom).

The science of cardiometry is inexact; Darren must proceed by inference and interpretation. He builds up an impression of your heart’s history, a layering of traces against events that accumulates, sediments, gives him something to measure each point against.

Mostly your heart’s trace has been uneventful between one session and the next, but sometimes Darren will see something, a sudden alteration in the rhythm and intensity that alerts him to a dramatic life event. “In October,” he might say, counting back along the line on the graph with a forefinger. “Something happened?” You might prefer not to say, but the heart itself can’t dissemble, and the machine can only read what is there. Maybe a loved one has died. Darren will see the tightening of sadness that you felt like a terrible clenching in your chest; and then the slow progress of your mourning, a flat line of deadened feeling with periodic troughs of depression and hopelessness.

Sometimes Darren finds surprising bursts of joy, even in older subjects, and the printout will show the oscillations of some uncertain but pleasant emotion: a man whose heart had settled into the easy joys and sorrows of his life is suddenly knocked sideways by some new passion; he has found something, or more likely met someone, who excites him in a way he had almost forgotten was possible. The trace of his heart opening, unexpectedly, is unmistakeable, as unmistakeable as the wobbles of uncertainty that accompany it, and the shadow line of the strange, beautiful fear that he is about to lose himself again when he thought he was dead to such intensity of feeling.

Darren reads the recent history of the heart with his stone, what you might call the news; but Alison will probe more deeply. Her job is to look at the old wounds and scars and understand how they might be blocking your heart, or, more dangerous, threatening to stop it altogether. She dresses more austerely than Darren, in simple black, which allows her to disappear into the semi-darkness of the chamber where she works, which is lit only by a small pool of light from a desk lamp and the subdued glow of the imaging screen.

Alison Glides around the chamber, silently, preparing the apparatus, which is larger and more diffuse; you will be attached by wires leading from pads pressed into the skin of your arm as you recline on your side in a position that always makes Alison think, momentarily, of a decadent Roman emperor on his chaise. She works with a smooth, plastic wand that patients call a probe but that Alison and her sisters – they are almost always women – call a “bone” among themselves, due to its long shape and knobbly ends and pale non-colour, like the weathered femur of some long-extinct grazing animal that once roamed a distant steppe.

They call the scars clots, hazy shadows that ghost the image on the screen, shifting into and out of focus as Alison works the bone into the cleft under your left breast. Unlike Darren, Alison and her sisters are mostly silent, speaking only when necessary: “This might feel a little uncomfortable,” as she presses the bone into the softness under your ribs. 

Where are the clots and what are they blocking? Alison’s eyes are clear and bright in the gloom, fixed on the screen as she works the bone against you. Her work lasts longer than Darren’s, and reclining in the semi-darkness you might doze, but the heart beats and the bone probes, and Alison searches for the marks of your special darknesses.  #

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