Wednesday, 20 November 2019

Nuland bk

“The left ventricle, the most powerful part of the cardiac pump and the Source of the muscular strength that nourishes every organ and tissue of the body, is injured in virtually every heart attack—each cigarette, each pat of butter, each slice of meat, and each increment of hypertension make the coronary arteries stiffen their resistance to the flow of blood.”

“Although nowadays less common, such scenes are sometimes still enacted. A professor of cardiology recently wrote me: “There are many patients with terminal, intractable congestive heart failure whose final hours—or days—of life are made uncomfortable and even miserable by their drowning, while physicians can only watch helplessly, and use morphine for sedation. It isn’t a pleasant exit.” Not only the heart itself but the long-range damage inflicted by soggy, anemic tissues has plenty of other ways to kill. Eventually, the abused organs themselves fail. When the kidneys or liver are gone, so, too, is life. Kidney failure, or uremia, is an exit for some cardiac patients and so, on occasion, is inadequacy of liver function, frequently signaled by the appearance of jaundice.”

“Although the kidney is the most significant part of the urinary tract to develop changes with age, the bladder, too, is affected. The bladder is essentially a thick balloon whose wall is made of flexible muscle. As it ages, the balloon loses its distensibility and can no longer hold as much urine as before. Old people need to urinate more frequently, and this is the reason my grandmother got up once or twice each night to grapple in the dark with her coffee can.”


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