Читать книгу Fulcrum and Torsion of the Helical Myocardium - Jorge C. Trainini - Страница 6

We leave the stillness of the shore to enter the whirlwind of the river of knowledge. We join in the efforts of those who during four centuries have longed to see beyond the established structure and function of the heart. Some have passed through those waters many years ago; others more recently, but certainly all remained in the uncertainty. The old dogma of the heart that “closes and opens like a fist” endured without allowing fissures. We belonged to another era. As we arrived later, we had other tools, but above all we had the religious faith of science, the doubts of the skeptic, the tenacity of the needy and the strength to find out where that flood that had carried away the old ideas on the structure and organization of the heart was heading.

We met from different places guided by the strange ritual that science has, that of going from mystery to understanding, which is never total or infallible, but which leaves knowledge clearer and more possible. Open to certainty and imagination, to a new level of abstraction. We entered the hypothesis of “Fulcrum and Helical Myocardial Torsion”, some of us earlier, others later. It was not mere chance. It was the need to complete the knowledge from all the necessary angles. We tried to advance in worldwide communion with all who accepted the challenge. This ambition never ceased. The first entry into its waters seemed reckless. Parked in that endless stream of Heraclitus river, we did not allow ourselves to be overwhelmed by the persistence of its waters or by despair. We were afraid of not facing the challenge of understanding how it was structured and what were the motions of that organ that three weeks after conception begins its endless heart beat until returning the being to mystery. Investigations and years followed. We always appealed to effort; science does not conceive primeval ideas without boldness. It must be submitted to tests of loyalty and honesty, of falsifiability. The scientist who cheats commits suicide. Impulses followed, then communications to the centers of knowledge. We often returned to the review, the step forward and the doubts. We have wept too many times. Nature does not reveal its intelligibility spontaneously. At first it seems complex, but it becomes simple by its logic, as long as soul and time devote to it. Thus, knowledge evolves.

Too much time passed in our lives but not for the indifferent river flow that carried us pretending to be the same one that had picked us up. We changed the primitive ideas, discovering them as overlapping sheets, one after the other. Time passed ruthlessly. We often did not notice that drainage in our lives when we were in the middle of the river. We persistently called on another batch of younger scientists to join the task. We never gave up because we never finished the work. Today we can offer what we have achieved, always to the limit reached, since everything keeps on flowing. The hypothesis of the cardiac structure-function achieved through the access to its myocardial intimacy enriches the passion of each of us and also, of those who were before in this river. At one point we established: “The heart is a majestic city/of well-known frontiers/ with its hidden, mysterious/ and unexplored streets.” Having simplified the heart of its apparent complexity brought us closer to the rest of science. To understand and make understanding beautiful, according to Niels Bohr, on how a theory should be.

We did not remain inside the medical art and its own postulates. We used the translational character that science has in its current evolution. No more isolated disciplines, but all together. We understood that an isolated science is not a science. For this reason, despite coming from different techniques, we remained together throughout these years. We advanced along that river flow that sometimes darkened, yet other times was so clear that it reflected our images. At intervals it seemed so reluctant to reveal the mysteries that we plunged into its gloom. We were hurt by the death of our initial companion in this mission, Jesús Herreros, and the inclement events that occurred in others. What strange motivation pursued us not to succumb? We do not know. In everything there is chance and need. They are hidden, unconscious instances, but they guide us. It is the rite of science to uncover some veil of the mystery.

Time was the mandatory step. Nothing could be done by waiting. We tried not to let the advancing knowledge drift between its efforts. Perseverance is the mother of victories. Ultimately, energy is a scale of packages called quanta. With this strategy, steps followed one after the other more frequently, since the elements collected in the research allowed us to go from the unexplored to simplification.

This research has not been intended as a copy of previous experiences. We have advanced into the dark corners of the cardiac structure-function of the heart. As the new acquired knowledge was incorporated, we were allowed to draw a map in those empty spaces. We gradually understood that each conceptual point that was achieved was not arboreal or linear, but that the same finding interconnected into a whole, in a rhizome-like structure. So is the heart.

During the 18th century, knowledge was grouped together. Later, with intellectual progress, it was divided into fragments restricted to different topics. This process separated sciences from their holistic nature, with inappropriate results as each domain was left at the mercy of its own entropy with a lower energy input from the rest of knowledge. In this research we have undertaken, the different disciplines used to this effect were intertwined, just as it is in the universe, to make knowledge coherent. We went further. As the heart is a thermodynamic organ that manages a blood flow, the rhizome went beyond medicine. It advanced on physics, hydraulics, and calculus. Thus, an interrelated knowledge, with its interconnected, crisscrossed inputs and outputs was achieved. Although the tracing of previous experiences always illuminated the meaning of ours, the limit of the structure-function reached on the center of the pulse was considerably widened. The glowing question that arises is: What conclusions can we reach with the equations in the framework of cardiac functioning? The aim was the hope of joining all the partial knowledge in a unified structure-function, relating the magnitudes of the model with the observations. We believe that in this river of knowledge the theory of the rhizome led us to a map of the heart, which always constitutes the eternal return to the amazement of its gift.

Dilemmas and errors do not go against this investigation. It is not feasible to advance and explain new ideas without taking risks even in the most exact sciences, more so in a factual one such as medicine that carries human pain and consciousness in its subject of analysis. We have assumed it without forgetting that the river of knowledge continues to flow, always to the next day. We have been in the middle of its course for a long time, far from the stillness offered by its banks. Now, the tears shed and successes achieved have flowed as part of that river. Perhaps we can return to the shore while other explorers of knowledge enter the new waters that we seek to baptize with dedication and honor. Those that today begin to be the past.

The authors