His Heart Whirs Anew

There are few data on the psychology and cognition of cyborgs like Houghton, although "a lot has been reported, anecdotal," according to Timothy Baldwin, the biomedical engineer primarily involved with circulatory support devices at the National Heart, Lung, and Blood Institute. In the United States, there were only 40 implants of permanent ventricular-assist devices in the last reporting year. Most are used to keep people alive until a human heart can be found for transplant. (Houghton's original condition ruled out a transplant.) No one has had one for as long as Houghton. In fact, Houghton's cardiologist reports his six other implant patients are no longer in the running. They all have died.

Robert K. Jarvik, the legendary inventor of the first permanent total artificial heart, strongly doubts Houghton's issues can be laid on the Jarvik 2000 pump.

"It's hard to measure being a human. One thing we do know is that good restoration of blood flow restores health, a good experience of life." Implant recipients "are normal again, restoring physical conditions. How they go on with their lives is what they do, not what doctors do."

He does, however, say he doesn't recommend Jarvik 2000s for heart attack patients. Being an apparently healthy person jogging along one day and the next day waking up as a cyborg would, he acknowledges, present psychological problems.

Nobody has ever measured, even poets, how much a heart can hold.

-- Zelda Sayre Fitzgerald

Medicine has long treated body and mind as a dichotomy, giving especially short shrift to the human spirit, which is so difficult to quantify.

The first human surgery successfully using a machine to imitate the pump-like function of the heart and lungs came in 1953. Subsequently, cardiologists in their locker rooms long gossiped about a side effect they irreverently dubbed "pump head," -- a decline in psychological and cognitive capacity associated with the procedure. It wasn't until decades later, however, that this effect on what it means to be human started being taken seriously in scientific journals. A groundbreaking New England Journal of Medicine report was published in 2001.

Chemotherapy for cancer dates back to the 1940s. However, a psychological and cognitive deficit known as "chemofog" only recently has been getting serious attention as something other than the anecdotes of anxious breast cancer patients.

"Science guys are not attuned to this. People slough it off," notes Arthur Caplan, head of the department of medical ethics at the University of Pennsylvania. Their attitude is " 'You might be more distant? More cold? What do I care?' People who evaluate the devices spin to positive measures, not subjective ones." They think " 'I'm a cardiologist. I save lives. He's still here seven years later but feels disconnected? Sort of mumbo-jumbo-y,' " Caplan says.x

"Psychology is tough. Why is it not explored in any great depth?" asks Adrian Banning, Houghton's cardiologist at the renowned John Radcliffe Hospital in Oxford. "Because I'm a cardiologist, not a psychologist, I guess."

Everybody's at war with different things. . . . I'm at war with my own heart sometimes.