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A Heart-to-Heart Talk.

A Heart-to-Heart talk

 The faithful old myocardium was sensing trouble;
 Her ATP stores were dwindling rather fast.
 She felt anxious, perturbed, and a little queasy,
 Not knowing how long her energy reserves would last.

 "Perhaps I could carry on like this," she said to herself,
 "As long as I'm not asked to overwork.
 But any further pressure thrust upon me,
 I'll be running amok and go berserk."

 She explained to the congregation of all organs
 That their own lives they could make or mar.
 "I assure you that I'll take care of your basic needs;
 Just make sure that you don't raise the bar."

 And so the kidneys, the brain, liver, and adipose tissue,
 The skeletal muscle from every anatomical site
 Participated in what was literally a heart-to-heart talk;
 They listened carefully to the myocardium's plight.

 She described the skeletal muscle as her "chief tormentor."
 His every command she was obliged to fulfill.
 "Whenever you choose to show your prowess," she accused,
 "I'm the one who ultimately foots the bill.

 After several decades of uninterrupted toil,
 I find it a rather difficult and daunting task
 To pump up blood with the same vigor and vitality;
 My failing health for too long I cannot mask.

 My coronary arteries have become clogged with debris;
 I'm deprived of nutrients and oxygen oftentimes.
 My ischemic tissues sometimes blanch with panic;
 My rhythms go awry and so do my chimes.

 My faithful mitochondrion on which I was heavily dependent,
 The most efficient powerhouse upon whom I could bank,
 Has of late developed a laid-back and lackluster attitude.
 In fact, I suspect that he has joined the enemy ranks.

 I once caught him targeting xanthine dehydrogenase.
 With the help of a protease he got it downsized,
 Causing it to be metamorphosed into a wild isoform;
 When I was reeling under ischemic hypoxia, he got her incised.

 After some anxious moments, my coronaries finally relented;
 The supply of blood after much reluctance they resumed.
 I thought I was saved from the brink of disaster;
 Most of the oxygen my starving mitochondria consumed.

 I thought I could replenish my ATP stores,
 Maybe even stash some of it as creatine phosphate.
 After all, every cloud, however thick, has a silver lining:
 This was a passing storm which would soon abate.

 But to my utter dismay I was surrounded and engulfed
 By these half-baked superoxide and the hydroxyl ions.
 They wreaked havoc and destroyed all my interiors;
 My so-called antioxidants looked like mere pawns.

 My fine architecture was threatened at the very foundation;
 The troponins got ready to be dismantled and cast out,
 All cellular enzymes that I used to guard so zealously,
 And my own creatine kinase forsaking me to join the rout.

 We are all existing in a fool's paradise," she reiterated,
 "Not knowing that we are sailing on treacherous thin ice.
 I don't know how long I'll hold up the crumbling fort.
 If I stutter and trip once too often, it will be doomsday in a

 So, if you feel like the malnourished little Oliver Twist,
 And dare to say, "Please, sir, I want some more," (1)
 Or, if out of pure greed you demand your pound of flesh,
 With a vengeance I'll be forced to settle your score.

 The lessons that I've learnt over my lifetime is that
 In each one of us there is a Dr. Jekyll and Mr. Hyde. (2)
 Even life-giving oxygen could be a double-edged weapon.
 This is the law of nature and cannot be defied."

 The congregation of organs was left gasping;
 They were shaken up by what they had heard.
 They all took an oath to follow the path of moderation,
 For in matters of life and death, the heart had the last word.

(1) Charles Dickens. Oliver Twist. 1839. Chapter 2.

(2) Paraphrased from a 1920 movie Dr. Jekyll and Mr. Hyde, directed by John S. Roberston. See StrangeCase.html and

Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.

Authors' Disclosures or Potential Conflicts of Interest: No authors declared any potential conflicts of interest.

DOI: 10.1373/clinchem.2011.168609

PSG Institute of Medical Sciences and Research, Coimbatore, India.

Usha Anand, Address correspondence to the author at: PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore 641004, TN, India. Fax +91-0422-2594400; e-mail

Received May 12, 2011; accepted June 29, 2011.
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Title Annotation:the Clinical Chemist: Unveiling the Right Side
Author:Anand, Usha
Publication:Clinical Chemistry
Article Type:Poem
Date:Jan 1, 2012
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