The Source of All Things

by Reinhard Friedl

  She blew the bangs from her forehead and placed Jakob on her tummy. His face reddened a little, and he breathed more calmly. There was no other sound. He was safe now, and he sensed that. Lying on the mother’s tummy is called “kangaroo care.” This skin-to-skin contact is best for both mother and newborn. Their body temperature, breathing, and heartbeat once again align.

  The all-purpose glue of love

  The connection between mother and child is one of the closest relationships that exists in life. Science and psychology call this relationship “bonding.” This term means something like “adhesion.” Parents, especially mothers, are thus glued to their children. Scientists avoid the word “love,” perhaps because it is so immensely powerful and multifaceted in its meanings. Scientists prefer definitions, as with them one can compartmentalize the endlessly complex world into manageable little concepts. In the world of science, parents don’t love their children—rather, they are glued to them.

  The glue consists mostly of genes that are responsible for certain types of behavior, and of a variety of hormones. The most exhilarating ingredient in this magic potion is the love hormone oxytocin. For nearly 100 years it was believed that oxytocin was produced only in the brain. But for a few years now, we have known that the heart, too, produces the love hormone, and does so in rather effective dosages.12 This hormone not only makes our heart start to beat, it is also important for its further development into a big, strong heart. That is why a little fetal baby heart produces even more oxytocin than an adult’s big one. The heart’s oxytocin can unfold its effects independently of the influences of the brain. It even seems to be the case that the heart can stand in for the brain and produce love hormones when the latter’s production decreases.13 Whatever the thing we call love may be, it really touches me that (purely biologically speaking) it is not only the brain that is an organ of love, but also the heart. The love hormone, after all, influences our feelings, our approach to relationships, and our choice of partners. It not only serves as the starter for the motor of life, but also connects us to other hearts. But flexibly, not adhesively. That is an important distinction. In our hearts, every exertion is followed by relaxation, and in nature every connection is followed by separation.

  The nearer the due date, the more oxytocin the mother produces—which awakens her maternal heart.14 Simultaneously, the baby’s heart, too, distributes more and more oxytocin. And now something hugely interesting happens. This sweet hormone intoxication leads to the two of them being able to let go of each other—the high oxytocin level triggers the contractions! Isn’t that astounding? Doesn’t it teach us a lot about the wisdom of nature? Love also means giving someone their freedom when the time comes. Oxytocin therefore really deserves to be called a love hormone. It connects us and also gives freedom and space for one’s own breaths. And as with the heart and with all oscillating biological systems, relaxation follows exertion.

  * * *

  Jakob and his mother were now literally imbued with oxytocin, a state that also relieves pain, soothes the memory of an exhausting birth, and creates feel-good sensations in the brain.

  * * *

  Some researchers conclude that the mother’s brainwaves can synchronize themselves with the heartbeat of the baby—without them touching each other, only through the mother giving her attention to the child. They suspect the electromagnetic fields of both organs influence each other.15 Looking at Jakob, I now even had the impression that his heartbeat was casting a spell over the brainwaves of everyone who was present. I relaxed, and the paramedics relaxed as well. I did something I rarely do as an emergency doctor … in fact I had never done it before. Nothing. I waited and honored the moment. Jakob looked nice and rosy and apparently felt good. My eyes now sought out the pale face of the father, who had held his wife’s hand the whole time, bravely and quietly. Having experienced the births of my own children, I was able to imagine what he had been through. Now he had recovered somewhat and wanted to help a little: to cut the umbilical cord to separate for good that which had already been separated. His hand was shaking so badly I had to guide it. What was the state of his own oxytocin distribution at that moment? We know today that fathers, too, produce oxytocin when they touch their prematurely born babies.16 And little Jakob was now out in this world.

  “Everything went well after all,” the father said to me. “Why do we still have to go to the clinic?”

  “To be safe,” I explained. “At the clinic, Jakob will be thoroughly examined again.”

  “Should I pack a bag for these two?”

  “Yes, please,” I said, and I too packed something—Jakob in a thermal blanket. A little king in his golden coat.

  Heart to heart

  He was close to his mother’s heart for the first car ride of his life. The skin-to-skin contact saw the oxytocin level of mother and child rise further and stay elevated.17 We sped through the night. As we were nearly the only ones on the road on this mild soccer evening, I switched the sirens off. Only the blue light threw its flitting shadows against the long alleys of windswept trees. The rough coastal winds had made these trees grow crooked. “Who rides so late through night and wind?” Goethe’s nightmare poem crept into my brain. “My father, my father, do you not hear, what earl king whispers into my ear?” What the hell were these lines doing in my head? Everything was fine! Jakob and his mother were wrapped in warm blankets. I had both hearts in my view on a monitor. Jakob’s life before birth had become his life after birth. He had left the element of water in his mother’s womb and had surfaced to the thin ocean of air that coats our planet. It was a different, exposed, alien world for him—but one thing had remained the same: he could hear his mother’s heartbeat. That calmed him. During breastfeeding, too, it is not only milk that relaxes babies, it is also the familiar ba-boom which reaches their ears. The ba-boom is reminiscent of the time in the womb. Newborn babies have an excellent memory of their mother’s voice and heart sounds. It is almost unimaginable today that until fairly recently people believed the brain of a newborn baby was completely inoperative, as it was unfinished—empty, so to speak. But Jakob had as many brain cells at birth as an adult: about 100 billion. However, his brain weighed only a quarter of an adult’s, as the nerve fibers were not isolated and not yet connected.18 His brain was thus not fully developed and did not yet facilitate little Jakob’s thinking and understanding. Medical professionals call this state “devoid of cognitive function.”

  * * *

  Some children are born without cerebral hemispheres. Neuroscientist Björn Merker describes the life of such children in a hugely interesting scientific piece entitled “Consciousness without a cerebral cortex: A challenge for neuroscience and medicine.” Such children have an illness called hydranencephaly and are awake and conscious. The skull’s shape remains normal, and the absence of the cerebral hemispheres is often not noticed at first. They only have a brain stem, and after a few months it becomes obvious how badly disabled these children are. However, they can live for years or decades with good care. They communicate with their environment in a simple way. They are particularly able to express their feelings. They rejoice, they laugh, and when they don’t like something they cry and become sad. They are excited, sometimes curious, and they can have a favorite toy. In short, they are conscious without a cerebrum. Their whole existence and their heart must play a role here, as these children have feelings and they love. What do they love with if they do not have a cerebral cortex? Scientists increasingly believe that primary consciousness develops on the basis of nerve impulses that originate in the whole body. They have their origin in all our cells and organs and, of course, in the heart.19

  * * *

  How does Jakob recognize his mother’s voice and heartbeat? And where is his understanding for the code of her heart located? Hardly in his immature brain alone, even though some scientists believe the brain’s parts are ready to the degree that a simple form of consciousness could develop.20 That is controversial�
�but the colleagues only consider the brain and overlook the fact that the heart is fully developed. Even more, it is fully and directly responsible for its life; it has its own small nervous system and has for weeks communicated with the mother’s heart, long before the brain can hold as much as a single thought. Is the heart therefore a special organ of knowledge and consciousness? Based on our observations of children without a cerebrum and on the heart communication of newborns with immature brains, I would deem this possible. I would describe this consciousness as “heart consciousness,” or scientifically as cardio-cognitive experience. In this, I see more than an extension of the well-known theories of neurocognitive consciousness—of which heart consciousness is the origin!

  * * *

  The brain governs our bodies—that is modernity’s idea of humans. However, a baby’s first heartbeat is not controlled by the brain, because at that moment it is not yet developed. Rather, it is the other way around. A functioning heart that can transport blood and nutrients is the prerequisite for the development of the brain. When the heart is already developed, the development of the cortex is barely beginning, in the eighth week. An EEG can detect the first sporadic brainwaves in the brain stem from the twelfth week of pregnancy and in the hemispheres of the cortex from the twentieth. The heart has long been fully developed by then and is used to monitor fetal well-being (eighty-fourth day). With the growth of the nervous system, the heart is the first fully developed organ that sends its signals to the first brain cells. Subsequently, the brain really explodes: 40,000 synapses per second develop from the thirty-fourth week onward.21 The voice of the heart thus contributes decisively to the development of the brain. There are only a few locations in the world where one can create a fetal magnetoencephalogram, which measures the little brain’s electromagnetic waves. In this way, researchers record the first tender brainwaves; these, too, change with the mother’s heartbeat.22

  * * *

  I am guessing that science has a few more surprises in store for us in this field. An intelligent brain will not forget the voice of the heart and will remain connected with it. The heart’s ba-boom is not a side noise occurring when the heart valve closes, nor an acoustical aid for a doctor’s diagnosis, but our first cradle music, our first voice, and our life’s first language. The first thing we hear is the beat of life. One could say that the first thing babies learn—or, better, do—is listen to the heart. Why, oh why, do we so often lose this ability in the course of our lives? It seems to be suppressed with the continuing growth of our brain by what we view as the brain’s “higher” cognitive functions. Thinking, planning, acting, doing. They are wonderful abilities, but by themselves, separated from the heart, they lead us further and further away from ourselves, from our source and our origin. Away from who we really are.

  Hearts know more than we think

  With relief I saw the brightly lit clinic appear after the last turn. I was noting Jakob’s current results in my emergency protocol when he opened his big, blue eyes for a second. He looked at me as if I were from another planet. Penetratingly. Without expression. And yet as though he were looking deep inside me. Then he closed his eyes again. It was the first time after his birth that his eyes encountered light rays. In the womb it is mostly dark. A newborn baby’s vision is blurry, they see shades of gray. They can only recognize things when they are close. What is important to them is sensing with their skin, and listening to the hearts and voices of the people they are attached to. Even if it sounds a little trite, the things that are most important for a newborn baby are invisible to their eyes. Jakob was pure sensation, comparable to a state of deep meditation. Newborns, they say, have a pure heart. I am convinced that what is meant by this is their freedom from thoughts, judgments, and memories.

  The nature of consciousness is one of the biggest mysteries of the universe. Sometimes when one does not find any definite answers, it is advisable to go back to the origin. To where it all began, to our procreation, to our first heartbeats, to our birth, and the first days of our lives. It was there that I had found a gently sparkling diamond whose argumentative hardness could withstand many discussions. Hearts can synchronize themselves very early in life, and we are able to literally be like a heart. And when one heart recognizes the other, this immediately influences our consciousness. Even when one is born without a cerebrum. One can only truly know something—not believe and not think, but know—with one’s whole heart.

  * * *

  In the clinic, Jakob was received by pediatric nurses and doctors. Before I handed over the little king in his golden coat, I listened to his heart one last time. Ba-boom, ba-boom, ba-boom …

  THE HEART IN THE INCUBATOR

  There are cases I will never forget as long as I live. Jakob’s is one of them. But he was not my smallest patient, Maria was. Where I come from she would have been called a “hatchling.” Born in the twenty-fifth week of pregnancy, she weighed only 580 grams. Her heart made a machine noise. ShSh-ShSh-ShSh-ShSh—like the locomotives in old Sherlock Holmes films, or the steam engine belonging to my childhood friend Johann. He was a doctor’s son and had this gadget I was really keen on. Unfortunately we were only allowed to play with it when his father was at home. “It is dangerous and could explode,” we had been warned. I wished for nothing more than a steam engine of my own. But it cost more than 100 marks and was far too expensive. Not even my grandma could be persuaded, but at least she had an idea how to take my mind off it. “Come with me, I want to show you something. We have hatchlings again.” She opened the big heavy latch to the hen house and let me slip past her long skirt into a mysterious world of golden-yellow flakes on two legs with orange beaks. The little bundles were huddling close to each other but also constantly on the move. Above them was the sun of the heat lamp so they wouldn’t jitter. Temperature needs to be regulated very carefully for both newborn chickens and newborn humans. They rely on warmth, ideally their mother’s. As a progressive “hen mom,” my grandma hatched the eggs in an incubator and warmed the hatchlings under the lamp.

  * * *

  A few decades later, little Maria lay before me in an incubator. Very soon we would operate on her. She seemed to me like a delicate plant in a greenhouse. My colleague Yücksel, who would be my assistant, used a different metaphor. What he saw reminded him of half a meatloaf sandwich—a description that outraged a medical student who worked in the intensive care unit, until she realized that Yücksel was teasing her. He was known to never miss a chance to flirt.

  * * *

  Yücksel wanted to get a cappuccino before the operation. We had about forty-five minutes. “One for you, too?” he asked me.

  “No thanks.” I stepped closer to the incubator and whispered: “You poor hatchling.” Such children incite tender mercy, as my grandma would have said. Maria’s skin was delicate like freshly curdled milk, her blood vessels gleaming blueish underneath. Tiny electrodes were attached above her heart, which would need to be placed elsewhere when we opened her chest. The child was a premature little human being, weighing just over half a kilogram. She was not yet able to breathe by herself; she got her oxygen through the tiny lens tube that protruded from her mouth and went down the windpipe. Next to the respirator stood several small blinking medication pumps that dribbled life-sustaining substances into tiny catheters. Above it all towered a monitor, bigger than the child, which told me two things: her blood pressure was alarmingly low, and her blood had too little oxygen. Maria still had the circulation of a child whose home is the womb. A fetus lying in amniotic fluid cannot breathe. Its blood, flowing from the heart, bypasses the lungs via a special blood vessel. This vessel, the ductus arteriosus (ductus Botalli), was the problem. It had not closed after the birth—which happens automatically within hours or days with healthy newborns. For Maria, several attempts to do so with medication had failed. She became bluer and bluer, weaker and weaker, suffering from a wrong connection from the aorta back to the lung. Medical professionals call this a left-to-right shun
t, and it causes a steam-engine noise. The ductus is a rather large vessel, and its failure to close meant Maria’s blood did not reach her organs, as it should, but was circling between heart and lung. Too much blood in the lung impedes oxygen circulation in the alveoli. Pressure is too high in pulmonary circulation, while for the circulation in the rest of the body it is too low. Maria had not been in this world for long and was very, very sick and more delicate than a raw egg. The slightest tremor could cause her tender blood vessels to burst, as had already happened once; the little one had already suffered a cerebral hemorrhage. That was why Yücksel and I had come to the children’s clinic with our mobile operation team, in order to carry out the required intervention.

  * * *

  Our pediatric nurse, Huyen, was preparing Maria for the operation.

  “What is a hatch—,” she asked, as she was always looking to learn new German words. She had been in Germany only four years, but her vocabulary was already impressive. I explained it to her while she lifted Maria from the incubator and placed her under a large heat lamp. We would also operate under the lamp.

  “Hatchling,” repeated Huyen as if to commit it to memory, and it sounded nice the way she said it. Yücksel thought so too, having returned wrapped in a coffee cloud, but he didn’t know what it meant. Huyen explained it to him. Then Yücksel told us about the challenges of Kurdish poultry-raising: birds of prey. He spread his arms, planted himself in front of Huyen and whispered, grimacing in a threatening way: “They don’t only take chickens away but little children too!”