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The heart of the matter

Heart doctor Michael Henein steps back to consider the unseen and unique wonders of the human body’s design.

Professor Michael Henein is a consultant cardiologist, and a Professor of Cardiology at Umea University, Sweden.

A model of a human heart on a short stand.
Photo by Jesse Orrico on Unsplash.

Shakespeare famously asked:

“What a piece of work is a man, how noble in reason, how
infinite in faculties, in form and moving how express and admirable, in action how like an angel, in apprehension how like a god! the beauty of the world, the paragon of animals—and yet, to me, what is this quintessence of dust?

Humans may be complex, capable of great heroism and deep depravity, yet it is worth stopping for a moment to look at the human body and mind to marvel in what we have become, and how we are made.

The visible design of the human body points out common features shared along with other members of the animal kingdom. Examples of these features are: two eyes, two ears, two nostrils, one mouth and four limbs, attached to a body and head. Detailed study of different seen parts of the body may, however, show some differences. For example, the presence of fingers and nails, hair distribution as well as a developed tail. While most members of the animal kingdom have teeth and a tongue, those two could also vary in their number and size, respectively, according to different species. Genetic investigations have shown that we humans share 99 % of our genes with animals, suggesting that our “earthly” component shares a common origin. Indeed, the twenty first century scientific findings match what is written in the Genesis story of creation, a story written over 3,500 years ago, well before genetic sciences came to light.

Creatures great and small

As for morphological differences between animal species, it is difficult to naively conclude why some are wild while others are man-friendly-even if the wild ones have different shapes, design, dietary habits, body size and life span.  Other important observed features of the members of the animal kingdom are that they are all born, they all age, then ultimately die.

If we are to look at the unseen features of the members of the animal kingdom, we can again identify similarities. For example, all have a gastrointestinal tract, a cardiovascular system, a reproductive system, a respiratory system, a urinary system and much more. While these systems may differ slightly between species, the overall structure and function achieve similar purposes.  For example, heart speed is faster in small animals like rats compared to big ones like elephants who have very slow hearts. Likewise, the respiratory system and the number of respiratory cycles per minute are significantly faster in running animals compared to the sedentary and slowly moving ones. Finally, the number of offspring also differs in different species, being just one at a time in big animals like elephants and horses, and many offspring in small animals like rabbits and mice. Such paradox between the number of offspring and animal size makes you think of the important determining role of the activity of those animals.

Unseen wonders

Now to turn to the rest of the animal kingdom and the unseen features of the human body. To start, let us look at the amazing functions of the human brain and its various functions. When humanity is sometimes described as the crown of creation, such a description is based on the superiority of human brain function and skills. Its sophisticated structure and how vital centres are created deep in the skull, to be protected from traumas, make you marvel. Also, the brain controls the different functions of the whole body, with its sensory and motor activities, various vital system functions including the lungs and the heart, all endocrine glands’ function, in addition to various receptors and centres that allow utmost precision and accuracy in everything we do. An example of this kind of precision is a doctor feeling a vein or an artery with the tip of a finger to insert a needle or a musician moving a finger a few millimetres while playing a violin, to produce the exact sound needed. Furthermore, the integrated function of human muscles, nerves and spinal cord is also amazing, let alone the synapsis between the nerve endings and muscle bundles, the chemicals secreted in them which allow electric stimulus transmission from the nervous system to achieve the motor function and desired movement.

The human brain also has the unique feature of storing knowledge. Of course, we should not ignore the importance of the training and programming ability of human brain. We learn how to drive a car, how to play games, how to study, how to operate safely on a sick patient.  Such acquired skills are quite limited in other members of the animal kingdom. Moreover, the human brain has the unique ability to invent, discover, improve and correct errors it identifies.

Another very unique feature of human brain is its ability to conduct speech, a feature of humans that is under-developed in other members of the animal kingdom. While most animals can make noise and sounds, only humans can articulate words, sentences and even sing very complex songs. This unique ability seems to be the underlying mechanism behind the development of languages which are based on the human ability to talk and transmit information and knowledge by words and phrases.

The unseen brain has allowed human life to develop over time, building skills and achievements from generation to generation. Millennia ago, humans lived in huts together with animals, and now they build houses and palaces to live in. Centuries ago, we used donkeys, horses and camels to travel but now we use cars, trains, ships and airplanes. Our ancestors burned wood and coal to cook and to warm but now we use electricity to do these.

When we look carefully at the unseen parts of the human body, we also realize that we cannot alter any of it, despite the scientific advances made over the years. We can understand what harms our body and take measures to avoid it. Out of the ability of our brain to discover and invent, we have now produced science-based means for curing various diseases. Consider how we can replace a dysfunctional heart valve or a mobility-limiting joint. These inventions have resulted in a better quality of life, alleviating of symptoms, even helping to avoid early death, in some cases such as heart disease and cancer. 

The heart of the matter

Another unseen source of life in humans is the heart. This fist-size organ is so complex in its structure and function. Recent scientific advances have enabled us to study heart function in milliseconds, hence the development of pacemaker treatments. They have also allowed clear imaging of the inside of the heart and the identification of pathologies, developments that guide practitioners to the optimum treatment of heart conditions. Recent discoveries have also allowed us to better understand how people develop coronary artery disease and how the pathology starts at the innermost layer of the arteries, particularly in individuals carrying significant risks for atherosclerosis including, smoking, high blood pressure, diabetes, high cholesterol and obesity. Amazingly, obesity has been shown to be the strongest underlying cause of other risk factors, hypertension, diabetes and hypercholesterolemia. So, nature cannot be blamed in many of these patients but our own patterns of behaviour. Science has shown that walking at least 5,000 steps each day, complying with the design of our body, reduces the likelihood of developing coronary artery disease by 15 per cent.

The unseen physiology of the rest of our body systems and the interaction between systems make us wonder how we are made.  A rise of our body temperature by one degree due to a bug infection affects all body systems from the brain to the heart. A virus which cannot be seen by the most powerful microscope can destroy our lungs and cause premature death, as was the case with COVID-19 and others.

Finally, human inventions in the form of powerful microscopes have allowed scientists to study the human cell, which is the smallest living component of our body.  Such small cells cannot be replicated in any factory in the twenty-first century, despite the vast scientific developments that surround us. You'll be surprised to learn how complicated and meticulously fine-tuned a human cell is and also how it functions, connects with other cells and other parts of the body. An example of this is the interaction between body minerals, calcium, sodium and potassium with heart and muscle individual cells. Such a function is critically controlled by many factors such as time, electric stimulation and pressure differences producing remarkably harmonious contractions and relaxation of the muscles without missing a beat.

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6 min read

Is the Premier League too much of a good thing?

A weary look ahead to the new season.
Four footballers stand arms crossed looking expectant and confident.
Premier League.

Well, it’s the time of year again when my emotional well-being is governed by the weekly performance of Liverpool Football Club. Yes: the Premier League is back!  

The start of a new season is usually abuzz with the excitement of possibilities. So many questions, so many possible outcomes. What will life look like after Jürgen Klopp? Will we win the league? Will we ever sign a defensive midfielder? This should be an exciting time for any football fan; a time of hope, of daring to believe this really is your year. 

So, why does the start of the season fill me with such dread this year?  

Normally as the season starts, I know when all the games are; who Liverpool are playing, where, and when. I’ve watched Liverpool’s pre-season friendlies to see if we’ve changed formation or made tactical tweaks. I’m up to date with all the players bought and sold by clubs across the league.  

Not this year. This year the season has caught me completely off guard and I’m finding the prospect of yet another year of football hard to process. I was invited to join a work fantasy football league this week and, honestly, the thought of it made me want to cry.  

When did the sport I love so much begin to feel like such an obligation? Why does being a football fan feel like such hard work? 

I think I’m just tired of football. No, not tired. Fatigued. Exhausted.  

Or, more accurately, football itself – the sport – is fatigued. As though it’s been drained of all enjoyment. 

As television, rather than sport, football inevitably lives in the aftermath of the ‘HBO effect.’ 

There are all sorts of reasons for this. To start with one of the more obvious ones, Video Assistant Referees (VAR) have turned football into a glorified science project. It’s now a common occurrence for matches to be stopped for extended periods while three men in a portacabin miles away from the game pull out their CGI rulers. All to determine if an attacker has a toenail offside, so they can gleefully disallow a goal and congratulate themselves on a job well done. The line between ‘being right’ and ‘doing right’ is blurred more than ever as commentators bemoan the increasing gulf between ‘the laws of the game’ and ‘the spirit of the game.’  

The standard and nature of refereeing in English football certainly isn’t helping my enjoyment of it. But it’s only part of a wider problem.  

But there’s a truth about football that many football broadcasters and organizations don’t want to face. 

Football is now primarily a televised commodity - content. Most football fans across the globe engage with the sport primarily through a screen, rather than at a stadium. As television, rather than sport, football inevitably lives in the aftermath of the ‘HBO effect.’ 

Prestige HBO shows like The Sopranos, The West Wing, The Wire, Game of Thrones (and countless others besides) have shaped the landscape of TV and, by extension, the culture around us. No longer confined solely to HBO, there seems to be, at any given moment, at least one TV programme you simply have to be watching if you’re going to keep up with the cultural conversation. If you’re not watching, you’re left behind. 

This is the context in which football finds itself in 2024. No longer sport, but drama. And drama that begs to be discussed. A series of prompts for those sought-after ‘water-cooler moments’ that dominate conversation throughout the week. “That was never a red card!”  “We were robbed!” Competitive sport boiled down and reduced to a series of controversies and talking points.  

Because football is more television content than sport now, these controversies are not just discussed in the immediate context of the match in question. No, all week between games, key moments and decisions are slowed down, dissected, viewed from multiple angles, pulled apart. 

I watch matches, and then watch people talk about the matches I’ve watched, until there’s another match to watch. There is simply too much football, and too much talking about football. All in service of football as television. 

On top of this, the matches themselves are only becoming more frequent. This year, the Champions League will have an extra two games in the group stage. 

And then there’s international football. This summer alone, there has been the Euros and the Olympics and, during breaks in the Premier League, players represent their nations in friendlies, World Cup qualifiers, and Nations’ League games (the competition literally no-one asked for).  

This is to say nothing of proposals for a 39th Premier League game played abroad and an expanded Club World Cup from 2025 (again, neither of which fans seem to be clamouring for). 

And all these matches are taking place within this context of football as television content. There’s not just more football, but there’s more football to talk about, more contentious refereeing decisions, more player mistakes and tactical battles to unpick.  

But there’s a truth about football that many football broadcasters and organizations don’t want to face. Loads of it is really boring.  

There’s no guarantee anything of actual interest will happen in any given football match. Goals in football are relatively scarce compared to other sports. Liverpool beat Manchester United 7-0 a few years ago and it was heralded as borderline divine intervention. If a rugby match finished 7-0, fans would be asking for a refund.  

Authentic mundanity will always be more compelling than manufactured drama. 

That’s one of the beautiful things about the beautiful game; it’s authentic. There are no pre-written storylines, and no perfect endings or twists set in stone. It’s real life. Like real life, it can often be mundane.  

That should be no surprise, really. At the end of the day, football is a game we humans created to pass time and have fun. Like all sport, football is human flourishing in practice. By this I mean that, through playing sports, we get a glimpse into what it is we’ve been put here to do: to enjoy our existence. It is an expression of communal joy found in delighting in the physicality of our nature as created beings. When we take it too seriously or make too much of it, we obscure that fundamental truth to which it points, even at its most mundane. That we are creatures created to flourish and find joy in our creatureliness.  

Authentic mundanity will always be more compelling than manufactured drama. In its endless pursuit to inject drama into the sport so it can compete as television, football has lost the mundanity and authenticity that makes it so compelling.   

All of this has been somewhat lost in contemporary football and goes some way to explaining why the thought of yet another season of endless debates, drama, and analysis of the sport I love makes me feel rather exhausted. I just want to watch some people kick a ball.  

So, what are my hopes for this Premier League season? It might sound counterintuitive, but if there was less football and less football drama in my life, that would do for me. Failing that, I’ll take a Liverpool treble.