The pathologist is doling out defective baby hearts from a dripping plastic tub. A few drops splash onto the student next to me. The pathologist claims it is just water. Water, and dead baby heart juice, that is. All of these baby hearts have congenital defects, and the ones we hold now each have a ventricular septal defect, a big hole in the middle of their heart that killed them. We have been allotted fifteen minutes to study these hearts. The gray mush I hold in my purple, latex-gloved hand looks like a little hummingbird heart; it’s the littlest heart I’ve ever seen, no bigger than my thumb. It takes a while to orient myself around this tiny organ, which has been pre-sliced into thirds to reveal the insides of the ventricles and atria. Attached to my heart are two floppy, spongy lungs, and six inches of aorta, which has been sliced open and splayed flat to reveal its astoundingly smooth interior. In the middle of that tiny heart, indeed we find a tiny hole. The timer rings, our fifteen minutes are up.
We plop our hearts into the tub and pass it along to the group next to ours. We are delivered a new tub of soaking baby hearts, this bunch all with transpositions of the great vessels. Instead of the big aorta coming off of the sturdy left ventricle, the wimpy pulmonary arteries have sprouted instead. The heart I hold has an intact umbilical artery and vein, which run to and from the neonatal heart. At the end of those vessels there hangs a circle of skin, this dead baby’s severed belly button. This skin that once connected mother to child. This skin that the mother perhaps stroked while her baby lived. And maybe still stroked after it died. I am astonished by how skin-like it is. It looks like my skin.
In addition to a bellybutton, this dead baby heart came with a small plastic tag that hangs by a soggy white string. Like a toe tag. It turns out this baby died in 1972. In fact, the pathologist tells us, all the baby hearts are from the 70s. Advanced technology has allowed women to learn much earlier in their pregnancy of possible fetal heart anomalies. If one is discovered, and there is no cure, many women abort. If the faulty heart is fixable, new life-saving surgeries have allowed most of the defective-hearted infants of today to grow into adolescence and adulthood.
These babies from the 70s, however, were not so lucky. Their hearts have since far outlived their bodies. Exhibited for decades now, they are taken from their sopping tubs for two hours of scrutiny and fame during our medical school’s annual congenital heart defect day.
The ashen heart in my hands pumped probably for only a few minutes, the pathologist explains. With the great vessels transposed, oxygenated blood cycles to the lungs, then back to the left heart, then back to the lungs, in parallel with but never to the rest of the body. All the other tissues died a hypoxic death. Timer rings. Next tub arrives.
Columnist
Icahn School of Medicine at Mount Sinai
Katie is a Class of 2016 student at the Icahn School of Medicine at Mount Sinai, in New York City.
Pleural Space
Pleural Space looks at the experiential curriculum of medical school, the many things that are taught and learned that aren’t listed in a syllabus.