Knock-knock, heart! How to make friends with the most tireless organ and what will happen if you don’t do this - Johannes Hinrich von Borstel. About the book “Knock, knock, heart! How to make friends with the most tireless organ and what will happen if you don’t” Johannes Hinrich von Bohr
Johannes Hinrich von Borstel is the author of a wonderful book that tells about the work of the human heart. This organ can truly be called tireless, because it never stops working. If we assume that the average person lives 70 years, then during this time we can count about three billion heartbeats! However, few people think about this; most often people do not think at all about how to take care of their heart.
This book is written for everyone interested in how to improve their well-being and who wants to learn more about one of the most important organs of our body. The information in the book is presented in simple language, so that even those who do not have special knowledge about human anatomy can understand it. Everything here is concise, clear and to the point.
From the book, readers will be able to learn about how the heart works, how it does its job, and what changes in it with age. It tells how alcohol and junk food affect the heart, what happens during sports and sex. It describes what the heart does while we eat or sleep.
Everyone knows that you need to lead a healthy lifestyle, but these words are so familiar that no one pays attention to them anymore. The book will make you take your heart more seriously and will give you an understanding that not all stress is acceptable, just as its absence is undesirable. It even touches on the theme of unrequited love and heartbreak. Is it possible to die from suffering? Readers can find answers to many questions in this book.
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Johannes Hinrich von Borstel
Herzrasen Kann Man Nicht Mahen
© by Ullstein Buchverlage GmbH, Berlin. Published in 2015 by Ullstein Verlag
© Yurinova T. B., translation into Russian, 2016
© Grunina P. A., illustrations, 2016
© Design. LLC Publishing House E, 2016
Dedicated to Mihi
Preface
Each of us has a rough idea of what a heart attack is. This is an extremely dangerous condition. In most cases, it is accompanied by chest pain, the person lacks air, and sometimes a heart attack completely leads to the fact that the heart completely refuses to fulfill its task, which is to pump blood through the vessels. In general, nothing good, because the heart muscle works to ensure that our body (all its most remote parts, from the scalp to the little toes) is provided with blood rich in nutrients, and above all, oxygen. As you know, we cannot live without this.
If you interrupt the flow of blood from the heart to the brain even for a few seconds, the effect will be like being hit on the head with a club: a person will lose consciousness, and his thinking center will then most likely become like pudding. Our brain cannot tolerate a lack of oxygen. This is why the heart beats - sometimes faster, sometimes slower (and sometimes it seems that it stops altogether) - on average 100,000 times a day. And each time, contracting, it moves approximately 85 milliliters of blood, that is, 8500 liters per day. To transport such an amount of liquid, an entire fuel tanker would be needed. Impressive performance!
It was because of the heart attack that I never saw my grandfather Hinrich. He died more than ten years before I was born - he fell from chest pain and could no longer breathe. Every time I looked at the large black and white portrait that hung in my grandmother’s room, I wondered: what might our communication with my grandfather be like? But in the photos in family albums he looked so healthy!
I didn’t understand how such a “trifle” could fatally strike such a person. That is why, from an early age, I devoured every book that came into my hands that had at least something about the human heart and its failures. My parents encouraged my interest by providing me with more and more reading materials, and gradually I became seriously interested in the processes occurring in the human body. Then I decided that when I grew up, I would study natural sciences and medicine. I definitely wanted to become a researcher, and maybe a doctor (the backup plan was a street musician), so I not only read books, but also collected everything that gave me a more accurate idea of \u200b\u200banatomy, from the skeleton of a mouse to the shell of a turtle.
Our heart moves about 8,500 liters of blood per day. It would take a fuel tanker to transport that amount of liquid!
At the age of 15, I decided to put my books aside during the school holidays and go to practice at a veterinary clinic. Worried, I dialed the phone number. “Tut-tu-tu,” sounded at the other end of the line. Four beeps, five... My tension grew with every second. Seven, eight beeps. When I had already lost hope, they finally picked up the phone. A woman's voice greeted me in a business-like, impartial manner.
“Hello,” I said stuttering. – Am I right, this is a veterinary clinic?
- Yes. What's the matter?
I pulled myself together.
– My name is Johannes von Borstel. I'm looking for a place where I can do an internship during school holidays and...
I was interrupted:
-What class are you in?
– I turned fifteen and I go to the ninth grade.
The other end took a deep breath:
“I’ll tell you right away: you have little chance of getting into our practice.” In our clinic there are urgent cases when it is necessary to open the dog once or twice. You're too young to witness something like this.
Too young? I think no. Too much blood? Maybe. This is exactly what I wanted to know. This is exactly the kind of experience I wanted to gain: I wanted to look at what is under the skin, to see with my own eyes what is happening inside us mammals. So how can I get this opportunity? All that remained was to search further.
I contacted several other institutions, including the local hospital, the emergency surgery department. And two days later I received the cherished letter. They took me to practice! I couldn’t even believe it, especially since we were talking about emergency medicine! At the time, I had no idea what that piece of paper would mean to me. And it turned out to be nothing more than an entrance ticket to the most exciting period of my life at that time.
The night before the first day of practice, I couldn’t sleep: too many thoughts were flashing through my head. Pictures of hectic everyday life in the emergency room arose before my mind's eye, I imagined gods in white robes who fearlessly treat any illness, bleeding wounds... What kind of cases will happen tomorrow? What will my tasks be? What if I make a mistake? Will a cruel failure befall me already on the first day - what if someone dies because of me? I had no idea about working in an emergency room. I had no training behind me, except for the first aid course I took...
- Johannes! Immediately here! Why didn't you follow?! - thundered throughout the waiting room.
"Oh no! – I thought. - I ruined everything. And this is on the very first day.” Following the call, I hurried along the corridor, entered the room from where, according to my assumptions, the voice was coming, foreshadowing trouble, and saw a tragic picture. One of the doctors and his assistant stood in front of me, seething with rage, and looked at me reproachfully. Obeying the inexorable force of gravity, the drops fell to the floor and collected in a solid puddle.
- You ruined everything: he disappeared! Now you can't save anything.
I nodded guiltily and looked away shyly: I overestimated myself. The doctor's instructions came out in a clipped staccato:
- Remove the pigsty. The boss will come now. He shouldn't see this. He won't be happy.
The assistant nodded in agreement, and both left the room. I put on gloves, grabbed a roll of paper towels, and tore off a few to throw at the scene of the disaster. When the roll ran out and there was no end in sight to the flood, I also added a towel on top.
Just as I was about to throw the package into the trash bin, the head doctor suddenly appeared next to me.
- Johannes?! Is there coffee? Where's the coffee?
He grinned when he saw the soaking wet bundle in my hands.
“Fifteen minutes...” I babbled. - I need to put it on.
The first mistake of my career: I loaded the coffee machine incorrectly and turned it into a gargoyle continuously spewing coffee grounds.
“Aha,” I thought, “a successful inauguration. What will I tell the people in the break room now, how will I resolve the situation?”
– You’ll have to do without coffee this time during the break. It’s okay, and it’s better for your health,” I said encouragingly a few minutes later, smiling hopefully at the whole honest company. After all, I'm in a hospital, so my argument should be clear to everyone.
What did I learn that day? The easiest way to turn friendly hospital staff into an angry mob is to deprive them of their coffee. And the second mistake I made on the first day of work: I was too clever and showed off. No wonder I became public enemy number one for everyone. Later, I baked cocoa cupcakes for them to compensate.
During my entire practice, I did not make a single serious mistake that would affect patients, and this is due to the fact that new responsibilities were assigned to me gradually, and after good preparation. That is, at first it was not about treating gaping wounds, stopping heavy bleeding or dealing with other difficult cases. Before I was allowed to do this kind of work, I underwent intensive training, and most importantly, gained experience.
Johannes Hinrich von Borstel
Knock-knock, heart! How to make friends with the most tireless organ and what will happen if you don’t do this
Johannes Hinrich von Borstel
Herzrasen Kann Man Nicht Mahen
© by Ullstein Buchverlage GmbH, Berlin. Published in 2015 by Ullstein Verlag
© Yurinova T. B., translation into Russian, 2016
© Grunina P. A., illustrations, 2016
© Design. LLC Publishing House E, 2016
* * *
Dedicated to Mihi
Preface
Each of us has a rough idea of what a heart attack is. This is an extremely dangerous condition. In most cases, it is accompanied by chest pain, the person lacks air, and sometimes a heart attack completely leads to the fact that the heart completely refuses to fulfill its task, which is to pump blood through the vessels. In general, nothing good, because the heart muscle works to ensure that our body (all its most remote parts, from the scalp to the little toes) is provided with blood rich in nutrients, and above all, oxygen. As you know, we cannot live without this.
If you interrupt the flow of blood from the heart to the brain even for a few seconds, the effect will be like being hit on the head with a club: a person will lose consciousness, and his thinking center will then most likely become like pudding. Our brain cannot tolerate a lack of oxygen. This is why the heart beats - sometimes faster, sometimes slower (and sometimes it seems that it stops altogether) - on average 100,000 times a day. And each time, contracting, it moves approximately 85 milliliters of blood, that is, 8500 liters per day. To transport such an amount of liquid, an entire fuel tanker would be needed. Impressive performance!
It was because of the heart attack that I never saw my grandfather Hinrich. He died more than ten years before I was born - he fell from chest pain and could no longer breathe. Every time I looked at the large black and white portrait that hung in my grandmother’s room, I wondered: what might our communication with my grandfather be like? But in the photos in family albums he looked so healthy!
I didn’t understand how such a “trifle” could fatally strike such a person. That is why, from an early age, I devoured every book that came into my hands that had at least something about the human heart and its failures. My parents encouraged my interest by providing me with more and more reading materials, and gradually I became seriously interested in the processes occurring in the human body. Then I decided that when I grew up, I would study natural sciences and medicine. I definitely wanted to become a researcher, and maybe a doctor (the backup plan was a street musician), so I not only read books, but also collected everything that gave me a more accurate idea of \u200b\u200banatomy, from the skeleton of a mouse to the shell of a turtle.
Our heart moves about 8,500 liters of blood per day. It would take a fuel tanker to transport that amount of liquid!
At the age of 15, I decided to put my books aside during the school holidays and go to practice at a veterinary clinic. Worried, I dialed the phone number. “Tut-tu-tu,” sounded at the other end of the line. Four beeps, five... My tension grew with every second. Seven, eight beeps. When I had already lost hope, they finally picked up the phone. A woman's voice greeted me in a business-like, impartial manner.
“Hello,” I said stuttering. – Am I right, this is a veterinary clinic?
- Yes. What's the matter?
I pulled myself together.
– My name is Johannes von Borstel. I'm looking for a place where I can do an internship during school holidays and...
I was interrupted:
-What class are you in?
– I turned fifteen and I go to the ninth grade.
The other end took a deep breath:
“I’ll tell you right away: you have little chance of getting into our practice.” In our clinic there are urgent cases when it is necessary to open the dog once or twice. You're too young to witness something like this.
Too young? I think no. Too much blood? Maybe. This is exactly what I wanted to know. This is exactly the kind of experience I wanted to gain: I wanted to look at what is under the skin, to see with my own eyes what is happening inside us mammals. So how can I get this opportunity? All that remained was to search further.
I contacted several other institutions, including the local hospital, the emergency surgery department. And two days later I received the cherished letter. They took me to practice! I couldn’t even believe it, especially since we were talking about emergency medicine! At the time, I had no idea what that piece of paper would mean to me. And it turned out to be nothing more than an entrance ticket to the most exciting period of my life at that time.
The night before the first day of practice, I couldn’t sleep: too many thoughts were flashing through my head. Pictures of hectic everyday life in the emergency room arose before my mind's eye, I imagined gods in white robes who fearlessly treat any illness, bleeding wounds... What kind of cases will happen tomorrow? What will my tasks be? What if I make a mistake? Will a cruel failure befall me already on the first day - what if someone dies because of me? I had no idea about working in an emergency room. I had no training behind me, except for the first aid course I took...
- Johannes! Immediately here! Why didn't you follow?! - thundered throughout the waiting room.
"Oh no! – I thought. - I ruined everything. And this is on the very first day.” Following the call, I hurried along the corridor, entered the room from where, according to my assumptions, the voice was coming, foreshadowing trouble, and saw a tragic picture. One of the doctors and his assistant stood in front of me, seething with rage, and looked at me reproachfully. Obeying the inexorable force of gravity, the drops fell to the floor and collected in a solid puddle.
- You ruined everything: he disappeared! Now you can't save anything.
I nodded guiltily and looked away shyly: I overestimated myself. The doctor's instructions came out in a clipped staccato:
- Remove the pigsty. The boss will come now. He shouldn't see this. He won't be happy.
The assistant nodded in agreement, and both left the room. I put on gloves, grabbed a roll of paper towels, and tore off a few to throw at the scene of the disaster. When the roll ran out and there was no end in sight to the flood, I also added a towel on top.
Just as I was about to throw the package into the trash bin, the head doctor suddenly appeared next to me.
- Johannes?! Is there coffee? Where's the coffee?
He grinned when he saw the soaking wet bundle in my hands.
“Fifteen minutes...” I babbled. - I need to put it on.
The first mistake of my career: I loaded the coffee machine incorrectly and turned it into a gargoyle continuously spewing coffee grounds.
“Aha,” I thought, “a successful inauguration. What will I tell the people in the break room now, how will I resolve the situation?”
– You’ll have to do without coffee this time during the break. It’s okay, and it’s better for your health,” I said encouragingly a few minutes later, smiling hopefully at the whole honest company. After all, I'm in a hospital, so my argument should be clear to everyone.
What did I learn that day? The easiest way to turn friendly hospital staff into an angry mob is to deprive them of their coffee. And the second mistake I made on the first day of work: I was too clever and showed off. No wonder I became public enemy number one for everyone. Later, I baked cocoa cupcakes for them to compensate.
During my entire practice, I did not make a single serious mistake that would affect patients, and this is due to the fact that new responsibilities were assigned to me gradually, and after good preparation. That is, at first it was not about treating gaping wounds, stopping heavy bleeding or dealing with other difficult cases. Before I was allowed to do this kind of work, I underwent intensive training, and most importantly, gained experience.
Follow the head doctor, learn how to make dressings, measure blood pressure and count the pulse, train on colleagues, fill out documents on the computer and assist in the treatment of minor wounds - this is what the trainee’s everyday life looked like. In addition, after each work shift, the boss gave me a short lesson - he explained the cases we encountered that day and talked about the treatment strategies used. He had the talent to explain complex things in such a way that even I, who did not have a medical education at that time, could understand everything.
I soon learned how to stitch wounds. Well, yes, I started with bananas. First of all, I realized that wounds do not have to bleed. And, perhaps most importantly, I realized that good treatment is inseparable from attentive care. The boss always noticed patients whose mood left much to be desired and gave them a smile. In addition, he was a good adviser, and not only in matters of medicine.
With constant patience, he explained to me the structure of the human body - from the skin to the internal organs. And here I again encountered my great “medical” love - the heart. I listened with reverence to the stories about the heart muscle and the structure of the chambers of the heart. The chief talked about the times when he worked at the Ambulance, about heart attacks and how to properly treat a diseased heart. And the more I learned, the more I was fascinated by this small – fist-sized – bundle of energy that is in our chest. It was then that I fell hopelessly in love: my heart was inflamed with love for heart.
In this book we will go on a long journey to the human heart. First, we will learn how the heart is born and grows and what theater, loops and ears have to do with this. I want to show you that our vascular system is similar to the German autobahn: there are wide sections and traffic jams. You will see how clearly the work of the heart is organized and how processes occurring in the atria and ventricles can get out of control. In addition, you will find out what exactly happens to our heart if we smoke like a steam locomotive, or like to go to McDonald's, or regularly drink a couple of glasses of vodka. I will tell you why in emergency medicine, although they do not resort to esoteric methods, they are still forced to guess with tea leaves.
You'll learn which diseases weaken our hearts and get some tips on heart-healthy eating. We will find out whether the Easter Bunny would have had a healthier heart if he had been a vegan, why medieval pharmacists sometimes did not hesitate to taste the urine of patients and why the Jacob sisters – not the only “deadly quartet”.
After that we will go on vacation, which will turn out to be an undertaking with an unpredictable outcome. The site of action is the atria; yes, some young vacationers often over-exert their hearts instead of allowing them to rest. We will find out what a healthy heart rhythm depends on, what affects it, and what medicine can do to treat its disturbances. And here, in particular, we will get acquainted with the most radical method that can restart our heart. I mean resuscitation.
It is necessary for those whose heart has stopped. And to prevent this from happening to you, we’ll talk about an excellent preventive measure - sex, because it strengthens the body and supports the immune system, which can be called the defensive army of our body. We will take a close look at the little warriors of this system, and at the same time we will understand why sport is not murder. In the meantime, let's go over the blood and its components and deal with blood pressure.
And then the fun begins: you and I will learn how our psyche and butterflies in the stomach affect the heart. Is it possible to die from a broken heart? Of course, you should not underestimate your own self-healing abilities. But modern medicine also has some means to fix a broken heart - from replacing spare parts to installing a completely new engine.
These are the stops – one more exciting than the other – that we will make while exploring the heart. So, go ahead: the journey begins!
Chapter 1. Loop in the heart. How our heart is born, how it is structured and how its transport routes function
The world's longest theatrical play
“Boo-boom, bu-boom, bu-boom, bu-boom, bu-boom...” The sound of a beating heart. Day after day, it energetically carries out its extremely important work. It knocks continuously, whether we are awake or asleep; it beats from the first day of our life until our last breath. But what happens to our motor between these two events, that is, during life? Actually, nothing particularly complicated.
I love theater very much, and so it occurred to me that everything that happens to the heart over the average 80 years of life is like a classic drama in five parts. The first act is an introduction, from the second act the action increases. In the middle of the drama - in the third act - it reaches its climax. Then the action tragically goes downhill. And the fourth act, in which things go from bad to worse, is followed by the denouement in the fifth act - the inevitable disaster that ends the play.
The curtain is raised - the real drama of the heart begins.
Act One: The Unborn Heart
In the theater, the first act most often begins with the introduction of the characters. Let me introduce: the embryonic heart rudiment. Just a clump of cells. Very soon after the fertilization of the egg, that is, from the moment when the complex process of embryo development begins, the foundation for a beating heart is laid. However, what can be seen after three weeks still has little to do with a functioning heart. While this is a rather inconspicuous accumulation of cells, the so-called cardiogenic plate. It forms two branches, which then develop into tubes.
At the same time, the pericardial sac is formed, and then the cardiac apparatus continues to develop in it. Subsequently, it surrounds the adult heart. The tubes located inside it grow together and form a large heart chamber. The chamber lengthens and eventually bends. And although the result is nothing like tying shoelaces, the process is called tying a bow.
However, the development of our heart does not end there either: then it acquires “ears”, with which, however, it cannot hear. A sort of prop, like the plush bunny ears that bridesmaids love to wear at bachelorette parties before the wedding. The exact purpose of these “ears,” which are nothing more than protrusions of the atria, is unknown. It is only known that they are responsible for the release of a hormone that promotes the excretion of urine. So the heart not only pumps blood, but also helps us relieve minor needs.
Meanwhile, almost a whole month has passed since fertilization, and the cardiac apparatus is now divided into zones of the atria and ventricles. The rudiments of heart valves and a septum are formed, which separates the right and left halves of the heart. However, the septum does not close completely until a few days before the baby is born. Moreover, an oval-shaped opening, or foramen ovale, remains between the atria for a short time. Through it, blood flows from the right atrium to the left, and then further into the fetal body. The question is, why? The reason is simple: the fetus cannot breathe on its own. Therefore, pumping blood through the lungs, which is very troublesome, makes no sense. A simplified version is quite sufficient.
What results from this development is packed with muscle on the outside and hollow on the inside (reminiscent of one former governor of California).
Act Two: Newborn Heart
The heart of a newborn is very different from the heart of an adult. It is the size of a walnut and works much faster. It knocks up to 150 times per minute, that is, about twice as fast as an adult’s - and this is without any sport. The reason is that the heart is still very small and moves only a little blood with each contraction. But since it now functions independently, the foramen ovale closes a few days after the baby is born. The right half of the heart pumps blood in a small circle to the lungs, and the left half pumps blood into the newborn’s body.
In theatrical drama, at this stage the first conflict is usually already outlined. The same thing happens with the heart. If something went wrong during its development, it manifests itself immediately after birth. Prenatal diagnosis is very good in our latitudes, but, unfortunately, it is imperfect. When listening to a sick child's heart, the doctor often recognizes murmurs that indicate a heart defect.
The most common defect is a ventricular septal defect, in which there is a hole in the dividing septum between the two ventricles (read about this on page 242 in the section “Leaky Heart”). And then, in the worst case scenario, the child’s life begins with heart surgery. But it all depends on the size of the hole. Small ones can overgrow without any therapy at all, and if the newborn is full of strength, then, as a rule, there is no serious danger to his life. The main thing is that the child’s organs receive enough oxygen. If this is so, adults, and above all the little one himself, can breathe a sigh of relief for now.
Act Three: Strong Heart
A healthy heart of a 20-year-old person beats 60 to 80 times per minute. If it is well trained, then at rest it can beat much slower. At the same time, this bundle of muscles is filled with energy. The best way to understand what a heart looks like from the inside is to cut it open and look inside. I found this anatomical experience extremely fascinating, but this option, of course, is not for everyone.
The heart of a newborn is much smaller than that of an adult, and beats much faster - up to 150 times per minute. A healthy 20-year-old's resting heart rate is 60–80 beats per minute.
Let's try to look at the structure and function of the heart from the point of view of red blood cells. Doctors call them red blood cells, a term that refers to the many cells in our blood that contain the red pigment hemoglobin. The main task of red blood cells is to deliver oxygen from the lungs to all cells of the body, and in the opposite direction - carbon dioxide to the lungs.
So now you are an Erythrocyte. Imagine that you are about to transport carbon dioxide bound to hemoglobin through a blood vessel from some organ (say, from the brain) to the heart. In this case, you are in one of the veins. The fact is that all the vessels through which blood flows to the heart are called veins, and those that drain blood from the heart to the organs are called arteries. After passing several branches, you find yourself in the superior vena cava - a vessel that is adjacent directly to the heart. There, laden with carbon dioxide, you are caught up in the flow and end up in the right atrium. Don't hesitate: this is not a joyride - you have an important mission!
This is what the human heart looks like from the inside
On the way from the right atrium to the right ventricle, you pass through the heart valve, more precisely the tricuspid valve, which doctors also call the tricuspid valve because it consists of three cusps (the Latin word cuspis means “point” or “sail”). If you left the right atrium through this valve, then in a healthy heart there is no way back for you. Heart valves work on the principle of a valve: they open only on one side, in one direction. In this way, they reliably prevent blood flow from the right ventricle from flowing back into the atrium. So in a healthy heart, blood always flows in one direction, rather than splashing back and forth between the ventricle and atrium.
Eventually, you leave the right ventricle through the next valve, the pulmonary valve, which leads towards the lung. After passing through it, you find yourself in the pulmonary artery, which is also called the pulmonary artery. Thus, it becomes clear that the often used expression “veins transport low-oxygen blood, while arteries transport oxygenated blood” is nonsense. After all, carbon dioxide is still with you, that is, you are “poor in oxygen.” And yet you swim straight into the artery. In this regard, I repeat: blood flows through arteries from the heart, and through veins - to the heart. However, there are small exceptions to this rule, for example in the liver area.
Once in the lungs, you perform your first mission as a red blood cell - you give up carbon dioxide and instead refuel with oxygen so that with a new load you begin the journey back to the heart through the pulmonary vein (!). There you, together with your brothers, flow into the left atrium, and then through the third valve into the left ventricle of the heart, the last one on your way. This valve, located between the left atrium and the left ventricle, is called bicuspid (bicuspid) or mitral because its shape resembles a bishop's miter.
The left ventricle is a kind of bodybuilding champion: it is far superior to the other cavities of the heart in terms of the thickness of the muscle wall.
After all, its wall must produce strong pressure in order to ensure constant movement of blood and deliver it to the most remote corners of the body.
Next, your path lies through the last valve (aortic valve) into the main artery - the aorta. It forms a complete loop around the heart, from which branches extend to the head and arms. The aorta then extends further into the abdominal cavity, where it divides into smaller and smaller branches to deliver fresh blood to all organs and tissues.
Important
The main purpose of red blood cells is to carry oxygen from the lungs to all the cells of the body, and then transport carbon dioxide from them back to the lungs.
So, we have approached the climax of the heartfelt drama. Everything functions, the heart and blood vessels seem to be a strong, indestructible system. But a tragic turning point is already in sight.
After 25 years, the first deposits appear on the walls of the coronary arteries (they supply blood to the heart muscle itself). Nothing serious yet, but it is here and now that the foundation of a serious disease is being laid - atherosclerosis, also known as vascular calcification. It is the main precursor to the two most common causes of death worldwide - myocardial infarction and stroke. Gradually, the deposits thicken and clog the vessels - at first partially, and over time sometimes completely (as happens with limescale in the plumbing system).
When this happens to the coronary arteries, smaller or larger areas of the heart muscle begin to receive less nutrition and oxygen, which is why they change. This is the infamous myocardial infarction. Areas that lack nutrition are transformed into a kind of scar tissue, which ceases to actively participate in the heartbeat. But everyone knows that a team is only as strong as its weakest player. As a result, the heart loses strength and endurance.
In theatrical drama, the action always slows down before the big ending. In the case of a heart attack, medicine takes on the role of brake. To delay the inevitable catastrophe, or even better, to prevent it altogether, you can prescribe medications or, for example, conduct a course of treatment through a cardiac catheter (using a thin probe inserted into the coronary artery), and at the same time change the patient’s living conditions in this way to relieve stress on the heart and, if possible, reduce the risk of heart attack.
The first deposits on the walls of the coronary arteries appear after 25 years. Over time, they can develop into atherosclerosis - the main precursor to heart attack and stroke.
Act Five: Old Heart
Chest pain. My heart skips a beat. By placing a stethoscope on your chest, you will no longer hear “boom, boom, boom, boom.” Now you hear something like “boo... boomm, boo-boo-boom, boom, boo-boom.” Shortness of breath and weakness begin. After almost a century of continuous beating, the heart is exhausted and works with difficulty. Now it is experiencing its third heart attack. It pumps blood with less and less force. In a last effort, it once again tries to speed up, to squeeze everything possible out of itself. But in vain. The heart no longer functions properly - it only twitches briefly and uncoordinated and eventually stops.
The inevitable end of the drama is approaching. Predictable, but still tragic.
Yes, each of us, of course, will experience cardiac arrest someday. However, while it is still beating, it should not be a drama. On the contrary: a kind-hearted life is akin to a cheerful performance. At the end of the comedy, the heart will also stop, but until that moment the person at least laughs a lot and lives a full, rich life.
And here's the good thing: each of us is able to make sure that the heart stops as late as possible. And in a favorable situation, problems with the heart and blood vessels will not overshadow our existence.
Humor is the first step in the right direction. Life, of course, can sometimes be a very serious thing, but when you smile, it becomes easier. Try laughter therapy. Or go to YouTube, search for "Quadruplets Laughing" and watch four twins laughing.
Only hypochondriacs tend to mistake minor symptoms for signs of fatal diseases. No one is immune from this annoying habit: neither me, nor you, nor all of us. But it is important to remember that, as a rule, a person is initially healthy. Fortunately, this also applies to the heart. And if strange sensations appear somewhere in the body, then most often they signal not a rare disease that will destroy you overnight, but something very, very harmless. As my favorite proverb says: “If you hear the clatter of hooves outside your window, then most likely it is not a zebra.” A person usually has few obstacles to his personal happiness and physical health. And yet I sometimes get pleasure simply from listening carefully to my own heart.
Next, your path lies through the last valve (aortic valve) into the main artery - the aorta. It forms a complete loop around the heart, from which branches extend to the head and arms. The aorta then extends further into the abdominal cavity, where it divides into smaller and smaller branches to deliver fresh blood to all organs and tissues.
With rare exceptions, most of us are healthy to begin with. This means that almost every person is able to protect his heart from disease and take care that problems with the heart and blood vessels do not overshadow his life.
Heart Valve Poker
I lie in bed and listen to my heart beat. It's beating a little harder than usual because I swam a few laps in the pool before going to bed. I look at my watch: 19 strikes in 15 seconds. I calculate: 4 multiplied by 19 is the same as 19 multiplied by 2 and again by 2. Or twice 38, that is, 76 beats per minute. I look down and see how my chest moves with every heartbeat.
Like any practicing doctor, I always have a stethoscope at hand and listen to myself. “Boo-boom, bu-boom, bu-boom, bu-boom.” I just turned 25 years old. My heart has made this sound approximately 900 million times already, fully aware of its duty and unwaveringly committed to the task of keeping me alive. Thank you, dear heart, for doing this monotonous work for me.
But if you listen more carefully, you will discover this: the work of the heart is not so monotonous at all. It doesn’t just thump like bass in a speaker: “Boom, boom, boom, boom,” - not at all. It seems that you can hear a kind of echo: “Boo-boom, boo-boom, boo-boom.” A heartbeat is not only a contraction of the entire heart, but also a time-coordinated, harmonious play of the muscles of the atria and ventricles, as well as the closing and opening of the heart valves.
Current page: 1 (book has 14 pages total) [available reading passage: 4 pages]
Johannes Hinrich von Borstel
Knock-knock, heart! How to make friends with the most tireless organ and what will happen if you don’t do this
Johannes Hinrich von Borstel
Herzrasen Kann Man Nicht Mahen
© by Ullstein Buchverlage GmbH, Berlin. Published in 2015 by Ullstein Verlag
© Yurinova T. B., translation into Russian, 2016
© Grunina P. A., illustrations, 2016
© Design. LLC Publishing House E, 2016
* * *
Dedicated to Mihi
Preface
Each of us has a rough idea of what a heart attack is. This is an extremely dangerous condition. In most cases, it is accompanied by chest pain, the person lacks air, and sometimes a heart attack completely leads to the fact that the heart completely refuses to fulfill its task, which is to pump blood through the vessels. In general, nothing good, because the heart muscle works to ensure that our body (all its most remote parts, from the scalp to the little toes) is provided with blood rich in nutrients, and above all, oxygen. As you know, we cannot live without this.
If you interrupt the flow of blood from the heart to the brain even for a few seconds, the effect will be like being hit on the head with a club: a person will lose consciousness, and his thinking center will then most likely become like pudding. Our brain cannot tolerate a lack of oxygen. This is why the heart beats - sometimes faster, sometimes slower (and sometimes it seems that it stops altogether) - on average 100,000 times a day. And each time, contracting, it moves approximately 85 milliliters of blood, that is, 8500 liters per day. To transport such an amount of liquid, an entire fuel tanker would be needed. Impressive performance!
It was because of the heart attack that I never saw my grandfather Hinrich. He died more than ten years before I was born - he fell from chest pain and could no longer breathe. Every time I looked at the large black and white portrait that hung in my grandmother’s room, I wondered: what might our communication with my grandfather be like? But in the photos in family albums he looked so healthy!
I didn’t understand how such a “trifle” could fatally strike such a person. That is why, from an early age, I devoured every book that came into my hands that had at least something about the human heart and its failures. My parents encouraged my interest by providing me with more and more reading materials, and gradually I became seriously interested in the processes occurring in the human body. Then I decided that when I grew up, I would study natural sciences and medicine. I definitely wanted to become a researcher, and maybe a doctor (the backup plan was a street musician), so I not only read books, but also collected everything that gave me a more accurate idea of \u200b\u200banatomy, from the skeleton of a mouse to the shell of a turtle.
Our heart moves about 8,500 liters of blood per day. It would take a fuel tanker to transport that amount of liquid!
At the age of 15, I decided to put my books aside during the school holidays and go to practice at a veterinary clinic. Worried, I dialed the phone number. “Tut-tu-tu,” sounded at the other end of the line. Four beeps, five... My tension grew with every second. Seven, eight beeps. When I had already lost hope, they finally picked up the phone. A woman's voice greeted me in a business-like, impartial manner.
“Hello,” I said stuttering. – Am I right, this is a veterinary clinic?
- Yes. What's the matter?
I pulled myself together.
– My name is Johannes von Borstel. I'm looking for a place where I can do an internship during school holidays and...
I was interrupted:
-What class are you in?
– I turned fifteen and I go to the ninth grade.
The other end took a deep breath:
“I’ll tell you right away: you have little chance of getting into our practice.” In our clinic there are urgent cases when it is necessary to open the dog once or twice. You're too young to witness something like this.
Too young? I think no. Too much blood? Maybe. This is exactly what I wanted to know. This is exactly the kind of experience I wanted to gain: I wanted to look at what is under the skin, to see with my own eyes what is happening inside us mammals. So how can I get this opportunity? All that remained was to search further.
I contacted several other institutions, including the local hospital, the emergency surgery department. And two days later I received the cherished letter. They took me to practice! I couldn’t even believe it, especially since we were talking about emergency medicine! At the time, I had no idea what that piece of paper would mean to me. And it turned out to be nothing more than an entrance ticket to the most exciting period of my life at that time.
The night before the first day of practice, I couldn’t sleep: too many thoughts were flashing through my head. Pictures of hectic everyday life in the emergency room arose before my mind's eye, I imagined gods in white robes who fearlessly treat any illness, bleeding wounds... What kind of cases will happen tomorrow? What will my tasks be? What if I make a mistake? Will a cruel failure befall me already on the first day - what if someone dies because of me? I had no idea about working in an emergency room. I had no training behind me, except for the first aid course I took...
- Johannes! Immediately here! Why didn't you follow?! - thundered throughout the waiting room.
"Oh no! – I thought. - I ruined everything. And this is on the very first day.” Following the call, I hurried along the corridor, entered the room from where, according to my assumptions, the voice was coming, foreshadowing trouble, and saw a tragic picture. One of the doctors and his assistant stood in front of me, seething with rage, and looked at me reproachfully. Obeying the inexorable force of gravity, the drops fell to the floor and collected in a solid puddle.
- You ruined everything: he disappeared! Now you can't save anything.
I nodded guiltily and looked away shyly: I overestimated myself. The doctor's instructions came out in a clipped staccato:
- Remove the pigsty. The boss will come now. He shouldn't see this. He won't be happy.
The assistant nodded in agreement, and both left the room. I put on gloves, grabbed a roll of paper towels, and tore off a few to throw at the scene of the disaster. When the roll ran out and there was no end in sight to the flood, I also added a towel on top.
Just as I was about to throw the package into the trash bin, the head doctor suddenly appeared next to me.
- Johannes?! Is there coffee? Where's the coffee?
He grinned when he saw the soaking wet bundle in my hands.
“Fifteen minutes...” I babbled. - I need to put it on.
The first mistake of my career: I loaded the coffee machine incorrectly and turned it into a gargoyle continuously spewing coffee grounds.
“Aha,” I thought, “a successful inauguration. What will I tell the people in the break room now, how will I resolve the situation?”
– You’ll have to do without coffee this time during the break. It’s okay, and it’s better for your health,” I said encouragingly a few minutes later, smiling hopefully at the whole honest company. After all, I'm in a hospital, so my argument should be clear to everyone.
What did I learn that day? The easiest way to turn friendly hospital staff into an angry mob is to deprive them of their coffee. And the second mistake I made on the first day of work: I was too clever and showed off. No wonder I became public enemy number one for everyone. Later, I baked cocoa cupcakes for them to compensate.
During my entire practice, I did not make a single serious mistake that would affect patients, and this is due to the fact that new responsibilities were assigned to me gradually, and after good preparation. That is, at first it was not about treating gaping wounds, stopping heavy bleeding or dealing with other difficult cases. Before I was allowed to do this kind of work, I underwent intensive training, and most importantly, gained experience.
Follow the head doctor, learn how to make dressings, measure blood pressure and count the pulse, train on colleagues, fill out documents on the computer and assist in the treatment of minor wounds - this is what the trainee’s everyday life looked like. In addition, after each work shift, the boss gave me a short lesson - he explained the cases we encountered that day and talked about the treatment strategies used. He had the talent to explain complex things in such a way that even I, who did not have a medical education at that time, could understand everything.
I soon learned how to stitch wounds. Well, yes, I started with bananas. First of all, I realized that wounds do not have to bleed. And, perhaps most importantly, I realized that good treatment is inseparable from attentive care. The boss always noticed patients whose mood left much to be desired and gave them a smile. In addition, he was a good adviser, and not only in matters of medicine.
With constant patience, he explained to me the structure of the human body - from the skin to the internal organs. And here I again encountered my great “medical” love - the heart. I listened with reverence to the stories about the heart muscle and the structure of the chambers of the heart. The chief talked about the times when he worked at the Ambulance, about heart attacks and how to properly treat a diseased heart. And the more I learned, the more I was fascinated by this small – fist-sized – bundle of energy that is in our chest. It was then that I fell hopelessly in love: my heart was inflamed with love for heart.
In this book we will go on a long journey to the human heart. First, we will learn how the heart is born and grows and what theater, loops and ears have to do with this. I want to show you that our vascular system is similar to the German autobahn: there are wide sections and traffic jams. You will see how clearly the work of the heart is organized and how processes occurring in the atria and ventricles can get out of control. In addition, you will find out what exactly happens to our heart if we smoke like a steam locomotive, or like to go to McDonald's, or regularly drink a couple of glasses of vodka. I will tell you why in emergency medicine, although they do not resort to esoteric methods, they are still forced to guess with tea leaves.
You'll learn which diseases weaken our hearts and get some tips on heart-healthy eating. We will find out whether the Easter Bunny would have had a healthier heart if he had been a vegan, why medieval pharmacists sometimes did not hesitate to taste the urine of patients and why the Jacob sisters 1
The Jacob Sisters are a popular German quartet that rose to prominence in the 1960s and have been performing until recently; The older and younger sister died one after the other from heart disease. – Note lane
– not the only “deadly quartet”.
After that we will go on vacation, which will turn out to be an undertaking with an unpredictable outcome. The site of action is the atria; yes, some young vacationers often over-exert their hearts instead of allowing them to rest. We will find out what a healthy heart rhythm depends on, what affects it, and what medicine can do to treat its disturbances. And here, in particular, we will get acquainted with the most radical method that can restart our heart. I mean resuscitation.
It is necessary for those whose heart has stopped. And to prevent this from happening to you, we’ll talk about an excellent preventive measure - sex, because it strengthens the body and supports the immune system, which can be called the defensive army of our body. We will take a close look at the little warriors of this system, and at the same time we will understand why sport is not murder. In the meantime, let's go over the blood and its components and deal with blood pressure.
And then the fun begins: you and I will learn how our psyche and butterflies in the stomach affect the heart. Is it possible to die from a broken heart? Of course, you should not underestimate your own self-healing abilities. But modern medicine also has some means to fix a broken heart - from replacing spare parts to installing a completely new engine.
These are the stops – one more exciting than the other – that we will make while exploring the heart. So, go ahead: the journey begins!
Chapter 1. Loop in the heart. How our heart is born, how it is structured and how its transport routes function
The world's longest theatrical play
“Boo-boom, bu-boom, bu-boom, bu-boom, bu-boom...” The sound of a beating heart. Day after day, it energetically carries out its extremely important work. It knocks continuously, whether we are awake or asleep; it beats from the first day of our life until our last breath. But what happens to our motor between these two events, that is, during life? Actually, nothing particularly complicated.
I love theater very much, and so it occurred to me that everything that happens to the heart over the average 80 years of life is like a classic drama in five parts. The first act is an introduction, from the second act the action increases. In the middle of the drama - in the third act - it reaches its climax. Then the action tragically goes downhill. And the fourth act, in which things go from bad to worse, is followed by the denouement in the fifth act - the inevitable disaster that ends the play.
Why am I ranting here?
The curtain is raised - the real drama of the heart begins.
Act One: The Unborn HeartIn the theater, the first act most often begins with the introduction of the characters. Let me introduce: the embryonic heart rudiment. Just a clump of cells. Very soon after the fertilization of the egg, that is, from the moment when the complex process of embryo development begins, the foundation for a beating heart is laid. However, what can be seen after three weeks still has little to do with a functioning heart. While this is a rather inconspicuous accumulation of cells, the so-called cardiogenic plate 2
The term “cardiogenic” comes from the Greek word kardia, meaning “heart,” and from the ancient Greek genesis, meaning “generation, formation.” (Hereinafter, except where otherwise noted, notes from the author.)
It forms two branches, which then develop into tubes.
At the same time, the pericardial sac is formed, and then the cardiac apparatus continues to develop in it. Subsequently, it surrounds the adult heart. The tubes located inside it grow together and form a large heart chamber. The chamber lengthens and eventually bends. And although the result is nothing like tying shoelaces, the process is called tying a bow.
However, the development of our heart does not end there either: then it acquires “ears”, with which, however, it cannot hear. A sort of prop, like the plush bunny ears that bridesmaids love to wear at bachelorette parties before the wedding. The exact purpose of these “ears,” which are nothing more than protrusions of the atria, is unknown. It is only known that they are responsible for the release of a hormone that promotes the excretion of urine. So the heart not only pumps blood, but also helps us relieve minor needs.
Meanwhile, almost a whole month has passed since fertilization, and the cardiac apparatus is now divided into zones of the atria and ventricles. The rudiments of heart valves and a septum are formed, which separates the right and left halves of the heart. However, the septum does not close completely until a few days before the baby is born. Moreover, an oval-shaped opening, or foramen ovale, remains between the atria for a short time. Through it, blood flows from the right atrium to the left, and then further into the fetal body. The question is, why? The reason is simple: the fetus cannot breathe on its own. Therefore, pumping blood through the lungs, which is very troublesome, makes no sense. A simplified version is quite sufficient.
What results from this development is packed with muscle on the outside and hollow on the inside (reminiscent of one former governor of California).
Act Two: Newborn HeartThe heart of a newborn is very different from the heart of an adult. It is the size of a walnut and works much faster. It knocks up to 150 times per minute, that is, about twice as fast as an adult’s - and this is without any sport. The reason is that the heart is still very small and moves only a little blood with each contraction. But since it now functions independently, the foramen ovale closes a few days after the baby is born. The right half of the heart pumps blood in a small circle to the lungs, and the left half pumps blood into the newborn’s body.
In theatrical drama, at this stage the first conflict is usually already outlined. The same thing happens with the heart. If something went wrong during its development, it manifests itself immediately after birth. Prenatal diagnosis is very good in our latitudes, but, unfortunately, it is imperfect. When listening to a sick child's heart, the doctor often recognizes murmurs that indicate a heart defect.
The most common defect is a ventricular septal defect, in which there is a hole in the dividing septum between the two ventricles (read about this on page 242 in the section “Leaky Heart”). And then, in the worst case scenario, the child’s life begins with heart surgery. But it all depends on the size of the hole. Small ones can overgrow without any therapy at all, and if the newborn is full of strength, then, as a rule, there is no serious danger to his life. The main thing is that the child’s organs receive enough oxygen. If this is so, adults, and above all the little one himself, can breathe a sigh of relief for now.
Act Three: Strong HeartA healthy heart of a 20-year-old person beats 60 to 80 times per minute. If it is well trained, then at rest it can beat much slower. At the same time, this bundle of muscles is filled with energy. The best way to understand what a heart looks like from the inside is to cut it open and look inside. I found this anatomical experience extremely fascinating, but this option, of course, is not for everyone.
The heart of a newborn is much smaller than that of an adult, and beats much faster - up to 150 times per minute. A healthy 20-year-old's resting heart rate is 60–80 beats per minute.
Let's try to look at the structure and function of the heart from the point of view of red blood cells. Doctors call them red blood cells, a term that refers to the many cells in our blood that contain the red pigment hemoglobin. The main task of red blood cells is to deliver oxygen from the lungs to all cells of the body, and in the opposite direction - carbon dioxide to the lungs.
So now you are an Erythrocyte. Imagine that you are about to transport carbon dioxide bound to hemoglobin through a blood vessel from some organ (say, from the brain) to the heart. In this case, you are in one of the veins. The fact is that all the vessels through which blood flows to the heart are called veins, and those that drain blood from the heart to the organs are called arteries. After passing several branches, you find yourself in the superior vena cava - a vessel that is adjacent directly to the heart. There, laden with carbon dioxide, you are caught up in the flow and end up in the right atrium. Don't hesitate: this is not a joyride - you have an important mission!
This is what the human heart looks like from the inside
On the way from the right atrium to the right ventricle, you pass through the heart valve, more precisely the tricuspid valve, which doctors also call the tricuspid valve because it consists of three cusps (the Latin word cuspis means “point” or “sail”). If you left the right atrium through this valve, then in a healthy heart there is no way back for you. Heart valves work on the principle of a valve: they open only on one side, in one direction. In this way, they reliably prevent blood flow from the right ventricle from flowing back into the atrium. So in a healthy heart, blood always flows in one direction, rather than splashing back and forth between the ventricle and atrium.
Eventually, you leave the right ventricle through the next valve, the pulmonary valve, which leads towards the lung 3
"Pulmo" means "lung" in Greek.
After passing through it, you find yourself in the pulmonary artery, which is also called the pulmonary artery. Thus, it becomes clear that the often used expression “veins transport low-oxygen blood, while arteries transport oxygenated blood” is nonsense. After all, carbon dioxide is still with you, that is, you are “poor in oxygen.” And yet you swim straight into the artery. In this regard, I repeat: blood flows through arteries from the heart, and through veins - to the heart. However, there are small exceptions to this rule, for example in the liver area.
Once in the lungs, you perform your first mission as a red blood cell - you give up carbon dioxide and instead refuel with oxygen so that with a new load you begin the journey back to the heart through the pulmonary vein (!). There you, together with your brothers, flow into the left atrium, and then through the third valve into the left ventricle of the heart, the last one on your way. This valve, located between the left atrium and the left ventricle, is called bicuspid (bicuspid) or mitral because its shape resembles a bishop's miter.
The left ventricle is a kind of bodybuilding champion: it is far superior to the other cavities of the heart in terms of the thickness of the muscle wall.
After all, its wall must produce strong pressure in order to ensure constant movement of blood and deliver it to the most remote corners of the body.
Next, your path lies through the last valve (aortic valve) into the main artery - the aorta. It forms a complete loop around the heart, from which branches extend to the head and arms. The aorta then extends further into the abdominal cavity, where it divides into smaller and smaller branches to deliver fresh blood to all organs and tissues.
Important
The main purpose of red blood cells is to carry oxygen from the lungs to all the cells of the body, and then transport carbon dioxide from them back to the lungs.
Our heart is a tireless worker. Without stopping for a second, it knocks and knocks: on average, over 70 years it runs almost 3 billion times. And all so that we can live for our own pleasure. In return, the heart asks for almost nothing; the only thing that is required of us is to take care of it. But how exactly? The most popular answer will look something like this: you need to eat right, exercise, give up bad habits, avoid stress... Alas, these general phrases are so ingrained in our teeth that we just brush them aside.
And then, how can a love of fast food or a glass of beer harm the heart? Do you really want to understand? Then read this book. If you think about it, we know very little about the heart, its work and problems. To correct this omission, cardiologist Johannes Hinrich von Borstel wrote his book.
Characteristics of the book
Date written: 2015
Name: Knock-knock, heart! How to make friends with the most tireless organ and what will happen if you don’t do this
Volume: 250 pages, 29 illustrations
ISBN: 978-5-699-88786-6
Translator: T. B. Yurinova
Copyright holder: Eksmo
Preface to the book “Knock, Knock, Heart”
Each of us has a rough idea of what a heart attack is. This is an extremely dangerous condition. In most cases, it is accompanied by chest pain, the person lacks air, and sometimes a heart attack completely leads to the fact that the heart completely refuses to fulfill its task, which is to pump blood through the vessels. In general, nothing good, because the heart muscle works to ensure that our body (all its most remote parts, from the scalp to the little toes) is provided with blood rich in nutrients, and above all, oxygen. As you know, we cannot live without this.
If you interrupt the flow of blood from the heart to the brain even for a few seconds, the effect will be like being hit on the head with a club: a person will lose consciousness, and his thinking center will then most likely become like pudding. Our brain cannot tolerate a lack of oxygen. This is why the heart beats - sometimes faster, sometimes slower (and sometimes it seems that it stops altogether) - on average 100,000 times a day. And each time, contracting, it moves approximately 85 milliliters of blood, that is, 8500 liters per day. To transport such an amount of liquid, an entire fuel tanker would be needed. Impressive performance!
It was because of the heart attack that I never saw my grandfather Hinrich. He died more than ten years before I was born - he fell from chest pain and could no longer breathe. Every time I looked at the large black and white portrait that hung in my grandmother’s room, I wondered: what might our communication with my grandfather be like? But in the photos in family albums he looked so healthy!
I didn’t understand how such a “trifle” could fatally strike such a person. That is why, from an early age, I devoured every book that came into my hands that had at least something about the human heart and its failures. My parents encouraged my interest by providing me with more and more reading materials, and gradually I became seriously interested in the processes occurring in the human body. Then I decided that when I grew up, I would study natural sciences and medicine. I definitely wanted to become a researcher, and maybe a doctor (the backup plan was a street musician), so I not only read books, but also collected everything that gave me a more accurate idea of \u200b\u200banatomy - from the skeleton of a mouse to the shell of a turtle.
Our heart moves about 8,500 liters of blood per day. It would take a fuel tanker to transport that amount of liquid!
At the age of 15, I decided to put my books aside during the school holidays and go to practice at a veterinary clinic. Worried, I dialed the phone number. “Tut-tu-tu,” sounded at the other end of the line. Four beeps, five... My tension grew with every second. Seven, eight beeps. When I had already lost hope, they finally picked up the phone. A woman's voice greeted me in a business-like, impartial manner.
“Hello,” I said stuttering. - Am I right, this is a veterinary clinic?
Yes. What's the matter?
I pulled myself together.
My name is Johannes von Borstel. I'm looking for a place where I can do an internship during school holidays and...
I was interrupted:
What class are you in?
I turned fifteen and am in ninth grade.
The other end took a deep breath:
I’ll tell you right away: you have little chance of getting into our practice. In our clinic there are urgent cases when it is necessary to open the dog once or twice. You're too young to witness something like this.
Too young? I think no. Too much blood? Maybe. This is exactly what I wanted to know. This is exactly the kind of experience I wanted to gain: I wanted to look at what is under the skin, to see with my own eyes what is happening inside us mammals. So how can I get this opportunity? All that remained was to search further.
I contacted several other institutions, including the local hospital, the emergency surgery department. And two days later I received the cherished letter. They took me to practice! I couldn’t even believe it, especially since we were talking about emergency medicine! At the time, I had no idea what that piece of paper would mean to me. And it turned out to be nothing more than an entrance ticket to the most exciting period of my life at that time.
The night before the first day of practice, I couldn’t sleep: too many thoughts were flashing through my head. Pictures of hectic everyday life in the emergency room arose before my mind's eye, I imagined gods in white robes who fearlessly treat any illness, bleeding wounds... What kind of cases will happen tomorrow? What will my tasks be? What if I make a mistake? Will a cruel failure befall me already on the first day - what if someone dies because of me? I had no idea about working in an emergency room. I had no training behind me, except for the first aid course I took...
Knock-knock, heart! How to make friends with the most tireless organ - Johannes Hinrich von Borstel (download)
(introductory fragment of the book)
