On the wonder and why of an echo.

echo 8This morning I watched an echocardiogram. It was not the first echo I’d attended. In my years as a medical interpreter at the Children’s Hospital of Philadelphia, I’ve been through at least a dozen of them with my Russian-speaking patients, but every time I see it happen I am awed at this wonder of medical science.

An echocardiogram is an ultrasound of the heart. A technician puts a couple stickers and some gel on your chest and gently presses against your skin a rounded wand the size of a child’s fist. Then a computer screen before her comes alive with images and sounds: a beating, wriggling heart you don’t notice inside you, now on display – every chamber and valve, every detail, movement, and bulge of muscle. She watches and zooms in and out, freezing images for a cardiologist to read later, marking spots on the stills in the gallery she is creating. She can look at the outside of the heart or inside, from every direction. She turns on the Doppler, and we can see the flow of blood: different colors for each direction, coming and going, pooling and swirling, red and blue, yellow, green… She turns on the sound, and we can hear the noises of the rib cage’s world: sighing and rubbing, rhythmic sniffling and bubbling of the blood, flapping and muffled thumping. Each chamber has its own rhythm, its own sound, its own life. At the bottom of the screen, a jagged green line of the electrocardiogram is running in sync with the squirming, writhing, jumping, never-stopping images above. Your heart. It never rests. Not ever, not for a minute from womb to grave.

As the technician was working her magic with a practiced hand, I was watching the screen and marveling at what we can do. What amazing things we have learned about the world, about ourselves, what intricate technology we have created – and now, with a brush of a wand, we can look inside a person’s heart. And I was thinking about what drives us to invent. Because human civilization is filled with mind-boggling achievements, but I stand in awe most often before those of creative arts, of pure, unadulterated science, and of medical science: achievements driven by discovery and by compassion.

echo 4

Of course, all things are connected. The internet and GPS technology that now so pervade our peaceful lives – and save lives every day – are brainchildren of the military. On the other hand, countless lives are sacrificed in animal experimentation for the sake of advancing our medicine. Without laboratory animals, we would not have a fraction of life-saving means we have today, maybe not even the echocardiogram. Some things may seem free of darkness, but they are not. We are the sum total of our civilizations’ histories, our mistakes and triumphs, our decisions and sacrifices, and no good we’ve done is untainted by the evil that helped birth it. Still, this morning I watched one human being use a machine stunningly complex to record every aspect of another human’s beating heart, and she did it for no other reason than to help someone be well. It is the only reason for the existence of the machine, for the existence of the technician’s job, for the existence of the hospital. In a momentarily poetic confluence of science and metaphor, I was present there to see through to the very heart of human progress.

They say that the visible world is a surface, underneath which we must see with our hearts. More than one culture of the past has revered the blind, who had no choice but to rely on the ways of seeing the rest of us must fight our instincts to access. This is an eternal adage of mystics everywhere, from Jesus to the Buddha, all places and times. Saint-Exupery wrote in The Little Prince, “One sees well only with the heart. The essential is invisible to the eye.”

little prince 1

I think, maybe, part of our challenge is the awareness of boundaries and solidity of things, and the presumption of personal space. We get over 90% of our information visually, we snap-capture our surroundings, and we think we know: this thing looks reliable because it looks solid; this person looks safe because he looks familiar; it’s empty around because it’s transparent. We can’t see anything, and we say, “There’s nothing there.” Because we can see so much. Most of the time, we have this sense of security in our worlds, but it’s a false sense. That’s why people fear the dark. We think we move things and avoid things and so we can predict things, but we don’t really know. We think we are separate from things because they come into and out of view, but we are not separate. We are droplets in the same flowing stream.

Have you ever tried closing your eyes for an extended period of time and listening to the world? If you haven’t, try it. Not just a few seconds but at least 10 minutes. Then again, maybe longer. You will discover that the soundscape of reality changes when it is not moderated by the eyes, by distance and direction and the satisfying of our reflex to look when a new sound intrudes on our predictable safety of known proximity. You will discover new sounds in familiar places you’ve never noticed before, a pronounced and subtle detail, new backgrounds that have always been there, and an ability to make out little intricacies of foreground. You will encounter little puzzles and ponder stories behind voices and progressions, and the world will come alive again unseen but understood better and more deeply. And you might discover an unsung kind of courage: an ability not to look when you don’t know what you’re hearing. It’s a vulnerable state to be in, a state of dissipating boundaries.

Have you tried exploring other senses in the same way? With no eyes and no ears, just touching? Temperatures and textures, shapes unseen, a whole universe of curves and bulges, angles cool and smooth, rough, prickly, changing and fixed, unsteady and secure, welcoming, dangerous, begging, tired? Smell and taste?

Can you imagine the world underneath all that? The senses yet undiscovered?

echo 2

When mystics say that true sight is not in the eyes, they are not talking about extra-sensory perception. When ancient teachers say we must see with our hearts, they are definitely not talking about ultrasounding one. But I think these things too are connected. They too lead to the same place. Because they are really talking about quieting down the chaos and vanity of the surface world and seeing through to what’s important, to the heart of things – heart to heart – where, underneath the surface of solid objects and empty spaces, the great river of Love is filling reality, carrying the droplets that we are, and there aren’t really any boundaries between us, there aren’t any empty spaces.

It’s about compassion, isn’t it? We are talking about some sense of oneness and grandeur and wonder of all things, of what’s important, of what’s truly good. It is this 6th sense that is connection beyond our habitual senses, when our hearts find themselves beating in unison with some great soundless beat of the universe. It is the vision of the heart that moves us to fill voids, to bring water to nations in drought, dialogue to war zones, and bread to the homeless. It is the vision of the heart that moved us to invent echocardiogram so we could see all the way through to each other’s hearts and, should they be in pain, fix them. It is the vision of the heart that never sleeps – like the heart, unlike our other senses. Seeing with the heart, we can always see well.

the little prince 1


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1 comment

    • Len on May 12, 2014 at 19:46
    • Reply

    What you are painting here Evelyn Underhill in her book Practical Mysticism (1914) in a way describes as the first stage available-to-all-level of mysticism–“nature mysticism.” I try to seize it every waking moment–and in my dreams…?

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