His Heart Whirs Anew

-- Tupac Shakur

The number of human bionic parts in existence or in the pipeline is accelerating. These include the cochlear implant that for decades has allowed the profoundly deaf to hear, the artificial eye that pipes computer camera signals into electrodes implanted in the retina, the artificial hippocampus (the part of the brain responsible for storing new memories) being developed at the University of Southern California, the artificial tongue being developed at the Luebeck Medical University in Germany, artificial lungs, artificial livers, epileptic seizure predictors and preventers, artificial arms and hands controlled by the nervous system, and the celebrated Acticon Neosphincter -- the artificial anus.

Much of the original artificial heart work was driven by the technological optimism born of the space program. Some of the current work is driven by the idea that our brains and bodies are separate entities. But now, in light of Houghton and other victims of psychological and cognitive trauma after intervention in their bodies, some scientists fear that we are tampering not with a bodily machine but with the human spirit.

"We've got to understand the organs and systems coming into our lives. We haven't paid a lot of attention to the psychological or emotional aspects of thinking of ourselves as bodies," says Arthur Caplan. "People interested in eternal life through body regeneration or organ substitutions" consider humans to be "a brain on top of a complicated bag of water," he says. "Ship that brain elsewhere, and it would still be you. Not true, exactly. Not that we couldn't adjust or adapt. But in some subtle ways, our sense of self -- who we are -- is shaped by our carcasses. Shaped by the containers we drag around.

"People who have their heads frozen to live forever, like Ted Williams -- my view is that if you get your head stuck back on something" that isn't your body, "your identity will be shredded. It isn't you anymore. It could lead to despair and depression, rather than gratitude that you can live forever. If you find yourself embodied in a different way, your perceptions and awareness of the world would be changed."

Heart interventions are numerous. These include quadruple-bypass surgery, coronary stent insertion, coronary balloon angioplasty and the implantation of a cardioverter defibrillator. Vice President Cheney underwent these four procedures in 1988, 2000, March 2001 and June 2001, respectively. His defibrillator was replaced last month.

Without necessarily referring to his heart procedures, longtime friends of the vice president have suggested that they have detected changes in his personality over this time. Brent Scowcroft, the former national security adviser to George H. W. Bush, told the New Yorker, "The real anomaly in the administration is Cheney. I consider Cheney a good friend -- I've known him for 30 years. But Dick Cheney I don't know anymore." However, Scowcroft made no reference to heart interventions. He was unavailable for comment late last week.

Cheney denies that there has been any change in his psychology, saying that if anything happened to affect his thinking recently, it was the events of 9/11. "To suggest I've changed, or my fundamental views of the world have evolved over that time, basically, I don't think that's valid," he said in 2006 when Bob Schieffer on "Face the Nation" confronted him with Scowcroft's observation.

Timothy J. Gardner, the heart surgeon who is president-elect of the American Heart Association and former co-chair of a National Heart, Lung, and Blood Institute panel on neurocognitive changes following cardiac surgery, says that in his view, the study of emotional or cognitive shifts brought on by technological implants is "of course, not nuts."

As a man thinks in his heart, so is he.

-- Proverbs 23:7

Houghton is working on a book called "Cyborg Life." It is based on his professional interviews with more than two dozen people who have faced death and now live with dramatic technological interventions -- from heart machines to chemotherapy.

Houghton's co-author is James J. Hughes, who teaches health policy at Trinity College in Hartford, Conn. He is also the author of "Citizen Cyborg" and is executive director of the Institute for Ethics and Emerging Technologies.

"He's a trooper," Hughes says of Houghton. "Inspiring guy. My kids really dug him."

Houghton's collected narratives, Hughes says, show "the difference between the happy picture -- 'glad to be alive' -- and the long-term sequela of having foreign objects in your body -- those can be a big contrast. A lot of people don't have financial resources. It sucks to be sick and hurting. I don't think we should be sugarcoating the enormous sacrifices these people have been making and will be making into the future. They get benefits out of it, but some find they regret those choices."

The direction of research "takes us from these crude and not entirely satisfactory devices to nanotechnology," Hughes says. Nanotechnology is the creation of man-made objects that are exceedingly small -- down to the level of individual atoms and molecules. Its advocates hope to see millions of robots smaller than a blood cell coursing through our veins in the foreseeable future. These "nanobots" would, among other things, serve as watchdogs, pouncing on things that go wrong -- like the formation of cancer cells.

"Insofar as having a foreign object inside your body changes your sense of identity, Peter is more of the mind that it does," says Hughes. He, however, is an optimist.

"We have adapted to glasses, or pins in your legs if they get broken. Things get normalized. You no longer see yourself as odd or outside the norm. This will happen to all of these interventions."

Whatever the future brings, Houghton says that being snatched from the brink of death and transformed into a poster child for cyborg life while experiencing serious psychological transformations "has been quite an experience."

"A roller coaster.

"Better than being dead, I think.

"Three days out of five."