Heart Metaphors Hit Different Now

Heart-based metaphors are everywhere in our language. Perhaps in all human languages (if you know of a human language where heart-related metaphors are uncommon, please let me know). Culture, combined with a lifetime of good heart health, trained me to think of this all as a flowery way of talking.

Then, my heart health scare (pericarditis) happened.

I noticed it first with pop song lyrics. Singing about heart attacks, breathlessness, how your heart hurts, when you supposedly are singing about romance… well, it weirded me out when while I was reckoning with what a heart attack would mean. This is despite never having a heart attack or shortness of breath.

Pop music mostly comes from young people who, mostly, have no firsthand experience of heart disease. Though pop music lyricists can be any age, they also skew young.

Until recently, I didn’t understand what a biological heart attack was: a blockage in the arteries which supply the heart so severe it cuts off oxygen to parts of the heart, followed by death of heart tissue. The term ‘heart attack’ is thrown around so much that I got used to hearing it and it became awkward to ask what that is. If I learned about it in a middle school biology class, I forgot it long ago, and I can’t think of anywhere else I would’ve learned it. A first aid class taught me to recognize the signs of a potential heart attack in other people, but not what was happening inside.

Admitting this ignorance embarrasses me, since it’s something that I feel like everyone else figured out long before I did.

I feel no shame about not knowing what heart failure was since Warraich says in State of the Heart that even some of his patients who have heart failure don’t understand what it is. It’s also not embedded in our language the same way ‘heart attack’ is because heart failure is a recent phenomenon: before the 20th century, people with heart failure died so quickly they didn’t need a name for the condition. Only recent advances in medicine allow people with heart failure to continue living for a significant period of time. Heart attacks, by contrast, have been around for at least as long as writing, since archaeologists have found written descriptions of heart attack symptoms from thousands of years ago.

Then descriptions of feelings such as ‘my heart hurts’ and ‘my heart feels hollow.’

I have had the physical experience of my heart feeling hollow, and it is bizarre. I had a concern that it could be a warning of something worse, but beyond that, a hollowness in the heart didn’t even feel bad. I understand that when people say things like ‘my heart feels hollow’ they mean that they’re disappointed or something, but from now to me it means confusion. “Why does my heart feel hollow when my chest has no hole?” Suffice to say, that’s a metaphor I’m not using anymore.

As far as heart pain… I’ve only had a little exposure to that, thank goodness. I’m feeling even less now thanks to medication. Some people have felt overwhelming physical heart pain. I can only imagine what that’s like, and hope I never have direct experience. For the lowest levels of chest pain, the pain itself isn’t the main problem—it’s the fear that it’s the tip of the iceberg.

In recent months, during moments of especially high stress, my heart rate has shot up and triggered pain. That’s… a metaphor which became literal. I’m supposed to keep my heart rate below a certain level until I make a full recovery, and I can feel why. This has made me more risk-averse in how I interact with people: I love small talk, but I steer away from controversial topics which stir my passions.

Though I don’t wish this experience on anyone else, I’m oddly grateful. It’s given me a new perspective has made my life richer.