Mending a Broken Heart: With or Without Cardiogenesis, Living Well with Heart Disease is Spirituall

construction site. After surgeons removed the nail at Beaumont Hospital in Royal Oaks, Michigan, the boy suffered a massive heart attack that destroyed over a third of its beating muscle (CNN, 2003). Normally a young healthy teen-aged heart ejects 65+ percent of its contents with each beat; Dmitris post-attack heart was ejecting just 25 percent and the boy struggled with fatigue and weakness. His doctors knew it would worsen, with the heart eventually dying and requiring a transplant at an early age. Instead, they decided on a procedure that would make medical history. With Dmitris and his parents strong support, the physicians extracted stem cells from the boys own bone marrow an increasingly common procedure in cancer treatment, and one that was easily transferred to this new applicationand planted the cells in the vicinity of the boys dead heart muscle.

To the delight of everyonethe doctors, the parents, and especially to Dmitrithe implanted cells began to grow into new blood vessels and new heart muscle. Cardiogenesisthe process of using a patients own stem cells to create new, and grow usable, heart muscle in the place of dead tissue following a heart attackquickly and quietly moved from the realm of science fantasy to medical fact. In all likelihood, the promise of stem cells (without all the political hype) will stand alongside the human genome project as the twin towers of early 21st century medical research and treatment gain. Dmitris heart is now ejecting 45 percent of its contents, and he began to play basketball again with his friends over this past winter.
The treating doctors are elated at the seeming success of the procedure. Chief cardiologist, Dr. William ONeill, asserted that we are optimistic about Dmitri and the research the hospital has planned to follow- up this fascinating case. Another recent study published in JAMA (Nissen, et al., 2003)the Journal of the American Medical Associationwas about the drano-like effects of a genetically- mutated HDL, the good form of cholesterol, that cleans out LDL bad cholesterol with amazing efficiency. In fact, news reports were giddy with talk of reversing heart disease.

Medical scientists, using a synthetic version of good HDL, were able to reduce fatty artery plaque in just six weeks in patients with heart disease. The surprisingly quick results shattered a long-standing belief that heart disease is a slow-progressing disease that takes a long time to undo. This is clearly on the level of a breakthrough that will have far-reaching implications, pointing the way to rapid treatment for fatty buildups, said Dr. Bryan Brewer, chief of molecular diseases at the National Heart, Lung and Blood Institute. The concept is sort of liquid Drano for the coronary arteries,said Dr. Steven Nissen, a Cleveland Clinic cardiologist who led the study. In the JAMA study, 36 patients having had heart attacks or severe chest pain received weekly intravenous infusions of the substance for five weeks. At six weeks, imaging tests showed the synthetic protein patients had a visible four-eight percent reduction in plaque buildup in their coronary arteries.
There was no significant change in the placebo group. The results were surprising to even the most optimistic supporters of using HDL to treat narrowing of the arteries. The promise of current heart research is so incredible that U.S. News & World Report did a special issue late in 2003 entitled, The End of Heart Disease. Was this journalistic hyperbole? Had a respected newsweekly gone overboard? I dont think so. I think we are on the cusp of an era of miraculous medicine, especially when applied to the ravages of heart disease.

A Deadly Legacy
I will confess to you that I am not a disinterested observer of this amazing research on the heart. You see, I am a heart attack survivor, coming near death much like Dmitri did, and now living with over a third of my heart destroyed after an attack at age 47 (I turned 53 this year). Three years ago, also at age 47, my younger brother Ed died of a heart attacka classic widow-maker event very much like the attack that nearly killed me. (My brother, who became the heart and soul of my family after our father died in 1988, resisted years of pleas to get tested, especially after my heart attack. Tragically, he told my wife that he was never going to go through what I did during my heart surgery. If you live with the risk factors (see sidebar following page), dont wait for the symptoms, please go get tested now! Save yourself and your family a long legacy of grief.)
I nearly died a second time between two open-heart surgeries in five days in 1999 (the first was a quadruple by-pass; the second opened my chest again to drain the blood and fluid in my lungs and heart cavity that I was beginning to literally drown in). During this time, I was also plagued by diabetes and a major depression, and learned that diabetes, depression, and heart disease (the devilish trinity of diseases, as I now call them) go hand-in-hand for many heart sufferers (see sidebar below). At the worst of it, my life was a daily gauntlet of pain, distressful exhaustion, and spiritual anomie. For nearly two years back then, death began to look more and more attractive. Heart disease, you see, is a modern scourge that poisons the lives of the men in my family.
My father (at age 69) and grandfather (67) were felled too early in their lives by heart attacks and cardiovascular disease. My brother and I both suffered heart attacks earlier than anyone we know across the generations. And my son and my deceased brothers two sons worry, at times, about the bad heart legacy that constantly shadows their lives. With over 700,000 deaths annually in the United States, heart disease remains the number one disease killer the number one reason for premature death in America. Depending on how quickly AIDS advances as a global affliction, heart disease is slated to become the worlds number one killer sometime well before mid-century. And it is an equalopportunity gender feller. More women die of heart disease than they do of cancer, though cancerand especially breast canceris more widely feared and much more the media darling as a subject of concern.

Living with Dying
Yet living with the prospect of dying is not all bad. In fact, I can confess to you now that being stricken in the heart has evolved into a great blessing for mein the way of Romans 8:28. I am living out the truth that all things work together for good¦ I am living proof that when there is some hell you must go through in life, God walks every step of it with you. He was thereHe knows all about it and He never left or forsook me. My disease-induced risk of dying facing up to the reality of death and overcoming my denial of itis the key motivational reason for the intimacy that I now enjoy with God. It is an intimacy that, sadly but truly for me anyway, would not have come about unless I had to stare death in the face in a very serious, ongoing way. Some of us, who should be drawn easily by the light, are moved best when we feel constant heat. I hate to confess that I am one of them, but I am grateful that Gods loving grace moves faithfully (and mightily) even in those darkest of places.

After six years of wrestling with God about death and dyingof daily facing the very real prospect of my own N mortalityI can report that God has given me a sure contentment about heaven and a divine peace about dying. In fact, there are still days when I can honestly say that I would welcome going to heaven and being in Gods intimate presence. And on this Earth, I am much more motivated by a presence-seeking life than a purpose-driven life, my opinion. No, I am not suicidal or obsessively morbid about dying. Nor have I reached the place where I am fearless and completely at ease with death (see Johnson, 2004). But I am living consistently now in the rich spiritual fruit that daily facing death in Christ has engendered. Psychologically, my mortality salience has been richly stimulated, as growing numbers of death and dying researchers now refer to Ernest Beckers seminal work on The Denial of Death (1973; see also Ruiz, 2000). I now live in relatively good health, and am much more honest about life and death. I am also more creative, more other-centered, and am learning the joys of being in Christ over doing for God for the first time in my life.

Spiritually, I have learned to count my days and to make much better use of them for God and my kin, for my ministry cause. I live more simply, am less materialistic, am leaner (Ive gone from weighing 235 to 198, on my way to 170), and eat a much better diet. I live welland with the help of ongoing prayer and ten medicines, vitamins, and anti-oxidantsincluding an ongoing script for anti-depressants. However, I always live with the shadow of heart attack deatha shadow that will dog my life from here on to my heavenly home. Nevertheless, this dog is surely being tamed, and is no longer vicious and snarling. God has graciously allowed me glances of heaven, in dreams and visions and meditative prayer visions of paradise that put to shame the best this world could ever offer in the alternative. Furthermore, I am convinced that the process of facing our mortality is a major developmental transition that all of us must face.
And it is one that my fellow boomers will likely fight fiercely in our individual and collective obsession with hanging onto a fading youth and vitality. The youth cult idolatry of aging boomers will consume billions of vain dollars during the next quarter-century, and will not die an easy or peaceful death. Aging and dying will likely be much more a crisis among American boomers than it will be a healthy and dignified life transition. To be sure, I am not yet ready to go to my heavenly home, delightful as that will be when I arrive. There is still too much life I yet want to live and enjoy on this Earth. Most of this desire, I believe, centers around my wife and children, and the legacy I wish to leave them and their children. For if I am to live much past 60 years (or even to 60), and watch my children marry and start families of their own, and participate in my grandchildrens lives, and leave a decent personal and financial legacy for my wife and family, it may well be due to the incredible promise of cardiogenesis and mutated HDL treatment now being realized.

Sign Me Up!
That is why I want to become a heart research subject. I want to tap into this incredible research and experience the benefits of this science now. I dont want to wait ten or fifteen years for this stuff to become standard clinical practiceI may not have that many years to live! And I dont want to be a placebo subjectnot if I can only be in one study anywayI want to be part of an experimental group that actually receives beneficial treatment. Already I can envision the implantation of my own stem cells drawn from my bone marrowwhich is the ethically proper thing to do (and a subject we will tackle in depth in our next CCT)into the dead zone of my heart. I can see, in my minds eye, tiny blood vessels miraculously beginning to grow and implant themselves into the muscle wall. At some point I can imagine God switching on an engine of lifeBANG!, an amazing re-genesis of heart lifeand new cells pregnant with life starting to beat in unison with those that have faithfully maintained their jobs for over 50 years. I can also imagine a syringe full of synthetic HDL being pumped into my arm, where they are immediately absorbed into my bloodstream. Then in my imagination, tiny little micro-razors extend out of energetic moleculesas if in some scifi bio-nanotech moviethat go sweeping along my inner arterial walls.

In my inner ear, I hear them buzzing and grinding through the plaque and cleansing away the deadly build-up of fatty deposits that constantly narrow my streaming fluid of C life. Increasingly, I spend time in prayer and imagining these things every day (see Caine & Kaufman, 1999; a book on Prayer, Faith, and Healing in which Dr. Siang-Yang Tan served as advisor, and many other AACC leaders and members contributed). Clean arteries and a healthy, vibrant heart! The fantasy comes to life and the generational scourge of Ohlschlager menthe long, dark legacy of premature deathis banished forever. In this dream, I reach 70 years and beyond, living with vitality in my familys life and contributing to the causes that God put me on earth to accomplish. I envision living well beyond an age no male in my family has ever reached.
My children live their lives with the confident knowledge that it will not be cut short due to an inescapable legacy of doom. God is glorified! Is this possible? Or is it simply a utopian pipe dream, the foolish fantasy of a man living in denial, whose life will be unavoidably cut short? Look at the evidence! Its happening right now in the science journals and news reports I read nearly every day. Dmitri Bonnville is living proof, and is playing ball again with the joy, I presume, that comes from second chances. Why cant I be a participant? Why cant you? Better yet, why cant we devise a national system where we move from successful experiments to standard clinical practice in months, even weeks, rather than years, even decades. I am ready to sign up for the next clinical trials today! Wheres that consent form?

Lord of Life and Death
Until that day, I endeavor to live as Paul did in Philippians 1: For to me, to live is Christ, and to die is gain. For if I live on in the flesh, this will mean fruit from my labor, yet what I shall choose I cannot tell. For I am hard-pressed between the two, having a desire to depart and be with Christ, which is far better. Nevertheless to remain in the flesh is more needful for you (vv. 21-24). There is no better way to live than to mutually embrace life and death, and to remind oneself and thank God every day for the benefits of both.
The key here is not learning to love deathagain, I am not proposing the embrace of the absurdbut to embrace, instead, the One who is Lord over both life and death. Pastor James Clinton, Tims dad and a by-pass surgery veteran himself, is a great advocate of this daunting, yet unavoidable truth: Since both life and death are very likely events in all of our futures, why not make friends with both and live contentedly? I like that win-win view! I highly recommend it to you and to all your patients and parishioners.
Online counseling is always available to help you out.


George Ohlschlager, J.D., LCSW, is Senior Editor and Writer of Christian Counseling Today and all AACC publications, and is Executive Director of the American Board of Christian Counselors, the AACC-affiliated national counselor credentialing and program accreditation agency. He chairs the AACC Law & Ethics Committee, and maintains a nationwide clinical/ethics/forensic consulting and training practice. George was honored as Consulting Editor to The Soul Care Bible (Thomas Nelson, 2001), and with Tim Clinton, is Executive Editor and co-author of both Competent Christian Counseling (WaterBrook, 2002), and The New GuideBook to Christian Counseling (in press, 2005).