Delving into the World of "Pain": Understanding, Experiencing, and Reacting to “Pain”

The Broken-Hearted Beast

The entire field of neurocardiology can be divided into three categories: 1) the brain’s effects on the heart (such as Takotsubo cardiomyopathy), 2) neurocardiac syndromes such as hypertrophic cardiomyopathy in Friedreich ataxia and 3) the heart’s effects on the brain, such as the cardiac origin of embolic stroke [1].The broken–heart syndrome or Takotsubo cardiomyopathy is a perfect example of the intimate relation between the brain and the heart as it mimics an acute coronary syndrome and can even result in sudden unexpected death [2]. It is an example of major cardiac pathologies seen in emotional and neurological catastrophes, such as subarachnoid bleeding and cocaine-related death, and is due to severe overactivity of the sympathetic limb of the autonomic nervous system leading to cardiac myofibrillar degeneration [1]. The central role of the autonomic nervous system in the regulation of cardiac function has also resulted in the introduction of neuromodulation to effectively improve cardiac function.A relatively underestimated example of the heart’s effects on the brain is the link between dysfunction of the heart and the brain. This may become a very important health care problem in the near future, as both cardiac dysfunction and progressive loss of cognitive functioning are prominent features of ageing. The apparent lack of appreciation of the link between cardiac and brain (dys)function is probably due to the monodisciplinary approach by cardiologists and neurologists and by the reductionist approach of modern medical research. Yet it is time for a more integrative view to the heart-brain connection as recent data indicate that cardiovascular conditions contribute to cognitive impairment [3]. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547419/]

The Fog Horn blew. And the monster answered. A cry came across a million years of water and mist. A cry so anguished and alone it shuddered in my head and my body. The monster cried out at the tower. The Fog Horn blew. The monster roared again. The Fog Horn blew. The monster opened its great toothed mouth and the sound that came from it was the sound of the Fog Horn itself. Lonely and vast and far away. The sound of isolation, a viewless sea, a cold night, apartness. That was the sound. "Now," whispered McDunn, "do you know why it comes here?" I nodded. "All year long, Johnny, that poor monster there lying far out, a thousand miles at sea, and twenty miles deep maybe, biding its time, perhaps a million years old, this one creature. Think of it, waiting a million years; could you wait that long? Maybe it's the last of its kind. I sort of think that's true. Anyway, here come men on land and build this lighthouse, five years ago. And set up their Fog Horn and sound it and sound it out towards the place where you bury yourself in sleep and sea memories of a world where there were thousands like yourself, but now you're alone, all alone in a world that's not made for you, a world where you have to hide. "But the sound of the Fog Horn comes and goes, comes and goes, and you stir from the muddy bottom of the Deeps, and your eyes open like the lenses of two-foot cameras and you move, slow, slow, for you have the ocean sea on your shoulders, heavy. But that Fog Horn comes through a thousand miles of water, faint and familiar, and the furnace in your belly stokes up, and you begin to rise, slow, slow. You feed yourself on minnows, on rivers of jellyfish, and you rise slow through the autumn months, through September when the fogs started, through October with more fog and the horn still calling you on, and then, late in November, after pressurizing yourself day by day, a few feet higher every hour, you are near the surface and still alive. You've got to go slow; if you surfaced all at once you'd explode. So it takes you all of three months to surface, and then a number of days to swim through the cold waters to the lighthouse. And there you are, out there, in the night, Johnny, the biggest damned monster in creation. And here's the lighthouse calling to you, with a long neck like your neck sticking way up out of the water, and a body like your body, and most important of all, a voice like your voice. Do you understand now, Johnny, do you understand?" The Fog Horn blew. The monster answered. I saw it all, I knew it all--the million years of waiting alone, for someone to come back who never came back. The million years of isolation at the bottom of the sea, the insanity of time there, while the skies cleared of reptile-birds, the swamps fried on the continental lands, the sloths and sabre-tooths had their day and sank in tar pits, and men ran like white ants upon the hills. The Fog Horn Blew. "Last year," said McDunn, "that creature swam round and round, round and round, all night. Not coming too near, puzzled, I'd say. Afraid, maybe. And a bit angry after coming all this way. But the next day, unexpectedly, the fog lifted, the sun came out fresh, the sky was as blue as a painting. And the monster swam off away from the heat and the silence and didn't come back. I suppose it's been brooding on it for a year now, thinking it over from every which way." The monster was only a hundred yards off now, it and the Fog Horn crying at each other. As the lights hit them, the monster's eyes were fire and ice, fire and ice. "That's life for you," said McDunn. "Someone always waiting for someone who never comes home. Always someone loving some thing more than that thing loves them. And after a while you want to destroy whatever that thing is, so it can hurt you no more." The monster was rushing at the lighthouse. The Fog Horn blew. "Let's see what happens," said McDunn. He switched the Fog Horn off. The ensuing minute of silence was so intense that we could hear our hearts pounding in the glassed area of the tower, could hear the slow greased turn of the light. The monster stopped and froze. It's great lantern eyes blinked. Its mouth gaped. It gave a sort of rumble, like a volcano. It twitched its head this way and that, as if to seek the sounds now dwindled off in the fog. It peered at the lighthouse. It rumbled again. Then its eyes caught fire. It reared up, threshed the water, and rushed at the tower, its eyes filled with angry torment. "McDunn!" I cried. "Switch on the horn!" McDunn fumbled with the switch. But even as he switched it on, the monster was rearing up. I had a glimpse of its gigantic paws, fish-skin glittering in webs between the finger-like projections, clawing at the tower. The huge eye on the right side of its anguished head glittered before me like a cauldron into which I might drop, screaming. The tower shook. The Fog Horn cried; the monster cried. It seized the tower and gnashed at the glass, which shattered in upon us. McDunn seized my arm. "Downstairs!" The tower rocked, trembled, and started to give. The Fog Horn and the monster roared. We stumbled and half fell down the stairs. "Quick!" We reached the bottom as the tower buckled down towards us. We ducked under the stairs in the small stone cellar. There were a thousand concussions as the rocks rained down; the Fog Horn stopped abruptly. The monster crashed upon the tower. The tower fell. We knelt together, McDunn and I holding tight, while our world exploded. Then it was over and there was nothing but darkness and the wash of the sea on the raw stones. That and the other sound. "Listen," said McDunn quietly. "Listen." We waited a moment. And then I began to hear it. First a great vacuumed sucking of air, and then the lament, the bewilderment, the loneliness of the great monster, folded over upon us, above us, so that the sickening reek of its body filled the air, a stone's thickness away from our cellar. The monster gasped and cried. The tower was gone. The light was gone. The thing that had called it across a million years was gone. And the monster was opening its mouth and sending out great sounds. the sounds of a Fog Horn, again and again. And ships far at sea, not finding the light, not seeing anything, but passing and hearing late that night must've thought: There it is, the lonely sound, the Lonesome Bay horn. All's well. We've rounded the cape. [Fog Horn, ?]

 

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