By Dr R Neerunjun Gopee
Professor Mach, head of Cardiology at the Hopitaux Universitaires de Geneve, was here at the beginning of the week to give a series of talks on the causes, diagnosis and treatment of heart attacks, as also the rehabilitation of the patient afterwards. Essentially, an acute heart attack, which is commonly known locally as crise cardiaque, is caused by a sudden obstruction in one of the arteries that supply the muscle of the heart with blood.
The heart is like a pump that sends blood to the rest of the body, and a major heart attack can result in death.
By now all of us in Mauritius are aware that what are known as the NCDs (Non-Communicable Diseases) are the most common diseases here, and that nearly 50% of the deaths in the island are due to diseases of the circulation and the heart which are included in the NCDs. Because ‘prevention is better than cure’ a major effort has been on to prevent these diseases in the first place. Through massive campaigns, the population at large is advised and encouraged to remain healthy by eating correctly and doing enough physical exercise, along with avoiding smoking and abuse of alcohol. It is too well known that it is not easy to change people’s habits and behaviour, and in spite of all the advice given the majority of people, alas, do not pay much attention to their health until it is too late.
That is why doctors face a non-stop upward struggle to deal with these diseases and their complications As is the case in medicine in general, doctors are continuously trying to reduce the numbers of deaths caused by any disease, and have over the years devised many techniques to diagnose heart disease as early as possible, and to treat them using latest technologies which are evolving very rapidly. Fortunately, nowadays there are methods to remove the obstruction in the artery of the heart before it has done too much damage, and Prof Mach had the opportunity to elaborate on this.
Nevertheless, however advanced the developments and treatment, there will always be deaths – this is the inescapable reality of life. And that is why, perhaps, Prof Mach ended his first talk in a light vein by quoting that ‘life is a sexually transmitted disease with 100% mortality’ – for we all have to die one day, from whatever cause, like it or not! There is here an analogy with the transmission of the other group of diseases known as communicable or infectious because they are ‘transmitted’ by microbes, for example, the common cold, or cholera which has broken out as an epidemic in Haiti after the recent cyclone and has led to hundreds of deaths.
On the other hand, there is also a play on words and concepts: in what biologists call the higher organisms life is ‘transmitted’ from parents to offspring by means of sexual reproduction, in contrast with other forms of life (such as microbes) which multiply without engaging in sex as we know it, but we will not delve further into this aspect for the time being. The reference to life as a ‘disease’ is of course a medical perspective, and may shock many of us. However, if we take a hard look, even as laymen with the barest notion of medicine, we must accept that we are confronted with a quasi-infinite number and variety of diseases against which we have to constantly battle.
Both at the level of whole populations and from an individual viewpoint, the spectre of disease looms large all the time, even if it remains in the background. And when it strikes, it can truly devastate even if it does not kill immediately. One’s life course can be brutally and radically altered by disease that affects either oneself or the family. The moment we are born, death starts following on our heels, and can overtake us any time – and yet we persist in thinking that someday we will conquer physical death, and our bodies will remain immortal.
What for, physical immortality? — whether here or elsewhere. Won’t we surely be bored to death? There are scientists who are pursuing serious work on ageing, and it seems that there are indications that some day human life may be prolonged to hundreds of years. None of us alive today will be there to witness this miracle, and we cannot even imagine what it would be like to live that long, and how we will occupy our time. Still, it is an interesting line of research.
To come back to what Prof Mach said, there are of course other than purely medical perspectives on life, and thank goodness for that, otherwise we may end up being too pessimistic! Although, come to think of it, this viewpoint can also emanate from other disciplines. I had a friend who was doing a master’s in English literature, and one evening I wandered into his room. He was in a pensive mood, and after he came out of his reverie, the first words he uttered to me were, ‘you know, life is a hole.’ I was in a rather more cheerful mood myself, and wanted to share some jokes and relax after a long day’s work at the medical school and the hospital.
No chance, for my friend followed up with, ‘as a medical student and future doctor, you should know better and accept that what I have said is true.’ He was older to me, and with due respect I requested him to explain what he meant. ‘Ah,’ he continued, ‘can’t you see? We come out of a hole, we breathe through two holes (our nostrils), we eat through a hole in our face, we see through two holes in our eyes, we excrete through two holes, and when we die we are put into a hole – we leave the world in a hole.’ He finished with almost a flourish, as if he had casse ene grand paquet – so I thought afterwards. ‘Well,’ I told him, ‘what you have said is no doubt true, but from there to think of life as merely a hole…’
I do not remember what turn the conversation took afterwards, but I must say that this person tended to look at the darker side of life most of the time, and kept away from the more pleasurable leisure activities of student life such as going for a good meal in a restaurant, participate in outings or attend dance parties on occasions, and so on.
However, we will no doubt all agree that life can be beautiful, and that it does not take a lot – of money or material possessions — for it to be so. The best formula for a happy and successful life is ‘plain living and high thinking.’ If we can do that, we can take the definition of life by Prof Mach in our stride, and confront our ‘100% mortality’ with serenity.
* Published in print edition on 12 November 2010