News & Features » News and Features

Heart Felt

How much do you want to know about your internal organs?


I realize this as I watch a circular white machine move steadily over my chest, making the sort of throbbing hum I usually associate with the working parts of the spaceships on "Star Trek."

As I lie on a motorized examination table, arms stretched over my head, electrodes stuck to my chest, a stream of electrons rockets past my body and, in the form of X-rays, bounces back up through my ribcage.

I am here in this office building off Forest Avenue because the machine involved, an electron-beam cardiac tomography scanner, is the first of its kind in Virginia, and journalists love firsts.

But really I am here because I want to see my heart. I want to see it because it is famously the source of love, of courage, of some element of our souls. I want to see it because more songs, good and bad, have been written about the heart than about any other human organ except possibly one.

Also, I want to see my heart because I have had a nervous relationship with it since 1997, when I was assigned to go to a sleep clinic and be tested and write about the experience.

The sleep-center part of my assignment went fine. But much to my surprise, the sleep-clinic doctor, a kindly gentleman, called me three days later. He told me he had been examining my electrocardiogram and had seen something. An anomaly. Something "didn't seem quite right," he said. This phrase reverberated in my head for some time.

He referred me to a cardiac specialist to take a closer, more expert look. He also urged me to secrecy. If the insurance companies got wind of this, he said, it could have unfortunate repercussions on my coverage. The cardiologist had agreed to see me off the books, as it were, as a favor to the sleep-center doctor.

For the week before my appointment with the heart specialist I told no one about my heart that wasn't "quite right." I developed a profound awareness of my heart. I felt it skip, repeatedly. I felt … twinges. I felt unusually short of breath, and fretted.

Finally, I visited the cardiologist. He took a look at the scribbled line of my test strip, then shook his head.

My heart sank.

"You're fine," he said. He smiled.

These days, this sort of experience is not at all unusual. Ever since there have been doctors, doctors have wanted to see what is going on inside the body. But until the 20th century the only way to get a hint was to, well, open it up and take a look.

Things have changed, obviously. The medical-imaging industry has exploded since Professor Roentgen discovered X-rays in the early 1900s. And that is especially true in the last 25 years.

In the 1970s, X-ray machines were refined into CT, or computed tomography, scanners. Coupling the CT scanner with the computer has allowed people to take a detailed look at body parts with great ease and relatively low cost.

People love the CT scans. There are more than 30,000 scanners today. If you're willing to pay a few hundred bucks, getting a full-body CT scan can be as easy as going to the mall.

This has proven to be a mixed blessing. While private companies market the CT scans as a way for people to gain peace of mind, they can have the opposite effect.

"You may find out things that you don't want to know, that you can't do anything about," says Jonathan Moreno, head of the Center for Biomedical Ethics at the University of Virginia. "You may find out that you have deteriorating joints. You may find out that you have impending osteoarthritis. You know, the sorts of things that are part of normal decline."

And this is bad? Could be, Moreno says, especially if you feel bound to do something about those findings.

"Almost any procedure," Moreno points out, "carries risk. … So you have the procedure and find out there's nothing really wrong. Now you've spent money. You've undergone stress to yourself and your family. You've put yourself at risk from the procedure."

Of course, scans can also find early signs of cancer that can be caught in time. Or they could show signs of arteriosclerosis that could be reversed with proper care.

The problem — and Moreno's point — is that you don't know which result you'll get.

The complexities of this will get even more complicated as detection systems get more sophisticated. Private genetic scanning is around the corner. What would you do if you found out you carry a gene for, I don't know, cystic fibrosis? Or breast cancer?

This is what I am thinking as I get off the scanning bed. I am visiting Intecardia Lifecare Imaging, which opened last month. The office is built around an electron-beam scanner made by General Electric Co. There are only about 160 of these GE scanners in the world, including ones at Johns Hopkins and the Mayo Clinic.

Intecardia, a business so new that it hasn't yet installed coat hooks on its doors, intends to use its scanner in Richmond to scan hearts for signs of heart disease.

Heart disease is the No. 1 killer in the country, so Intecardia should have plenty of customers. Scans start at $495; people pay cash, because most insurance companies don't cover the cost.

The technician who performs my scan, Linda Dawson, shows me on a computer screen how my heart looks. She rolls her computer mouse, and the 33 images of sections of my heart scroll one after another, like a flipbook, so the screen gives us a roller-coaster ride through my coronary arteries.

My heart shows no sign of trouble, no buildup that could indicate heart disease, Dawson says. In fact, my heart scores extremely well.

I'm done. The whole process, from filling out forms to examining my own internal organs, has taken maybe 10 minutes.

I talk to Dawson for a few minutes. In the few weeks she's been scanning people's hearts with the EBT machine, Dawson says, she's been impressed by how little you can tell about someone's internal health by looking at their outsides.

Someone looks healthy, exercises a lot, eats right — arteries full of buildup. Someone else, fat, bad diet — arteries clean and glistening. You just never know, she says. You just never know. S

Add a comment