How Is Your Heart?

heartAccording to the chart, a new patient being discussed in the weekly team meeting had a “rapid apical pulse.”

One of our chaplains softly asked, “Could someone explain what an ‘apical pulse’ is?”

Saved by a chaplain!! I was glad someone as befuddled as me had asked about that medical term.

Several nurses responded, and soon at least two clueless people learned that taking a patient’s pulse with the stethoscope’s drum (or chestpiece) placed properly over the heart provides medical professionals with the loudest and most distinctive reading. This is called the apical pulse. Checking the wrist is known as a radial pulse and pressing fingers (gently, please) against the neck detects the carotid pulse.

The heart beats and blood flows. There is sound, faint or strong. There is movement, slow or fast. Hearing the heart’s work is one of the oldest ways for discerning health. One of my first memories of trips to the doctor involved a lab-coated person uncurling the stethoscope from around his neck (when I was young, it was always a man in a white coat) and listening to my heart. Some doctors warmed the drum before touching my skin. Some—brrrr!—did not. Whether thoughtful or thoughtless about bare skin meeting cold metal, the doctor then listened to my heart, to the flow of my life.

Our hospice patient had a dangerously fast apical pulse rate. It was one of the most obvious symptoms that her/his body had become vulnerable. The chart chronicled numerous other health issues, but the pulse was—quite literally—the loudest.

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During high school and college, I played quite a bit of basketball. Though never good, I enjoyed the game. Once, alone on an outdoor court at college, probably avoiding studying for an exam, a player joined me. Night was coming. The air was cooling. Though I didn’t know him, we played one-on-one in the lingering light. We didn’t shoot around for long, less because of darkness and more because my new companion proved to be an excellent player. He launched a jump shot: swoosh, score! He drove by me to the basket: swoosh, score! After my humiliation, we chatted while our sweat dried. He shared about his defensive strategy: “Always watch the chest area when you guard a player. Don’t focus on the ball. Ignore the head and hands. You can fake with every part of your body except the chest.”

Ah, the chest, the home of the heart, and the spot where the apical pulse rate is loudest.

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I’m not a medical person. By background I’m an ordained minister and amateur writer. I don’t experience and evaluate the world through stethoscopes or by analyzing white blood cell levels.

I wear my heart on my sleeve. I know the value of heart-to-heart talks. I believe that where your heart is, there your treasure will also be. I trust good-hearted friends and wonder why some people are so hard-hearted. My heart breaks if someone is hurting. I’ll cry at a heartfelt speech.

Yup, I’m a metaphor man. Figurative speech is my gig. Sure, if I wielded a stethoscope, with its (warm, please) drum correctly positioned over a patient’s heart, I could declare, “Your heartbeat is loud.” Or fast. Or slow. Or faint. But I wouldn’t know what my observations meant for the current and future health of a person.

But I’d want to ask any hospice patient, or family caring for someone with a life-threatening illness, how is your heart?

Who do you need to have a heart-to-heart chat with? Then, talk!

Where is your heart broken? Don’t keep it a secret.

What lifts up your heart and helps you make it through the day? Chose to make time for that.

The radial, carotid, and apical pulse give clues to a patient’s at-this-moment condition. After the chaplain’s question and a nurse’s answer, I understand a bit more about the various places and ways to obtain information about the flow of blood. With a stethoscope or a compassionate question, the heart is a spot that reveals our true health.

In other words, you can fake with every part of your body except . . . the heart.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. Nicely written. I am a metaphor man as well … and a chaplain. This article touched my heart, not literally, but metaphorically and figuratively. Will be sharing it with the team. Thank you.

    • For the religious we call it the “soul”. Non-theists acknowledge the human spirit.

      I think that I read somewhere that scientists “suspect” that this is real but have never localized this element of humanity to either the brain or the heart. Yet many people will swear to its existence.

      Larry, as a followup to this beautiful article can you help people understand (at least a little) this phenomena? I know that “faith” is the easy answer, but can you expand further? Thanks

      – Michael

      • Michael:

        Thanks for the comments. I will give you my usual response when someone suggests I write on a particular subject: perhaps it’s something you need to write about and wrestle with!!

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