Welcome back to See Naples and Die 2-
Positive Health For All krishnanlogamuthu
0004-VIII after your Calm, peaceful days /
Halcyon days wished by me at the end
of the last page.

The Halcyon is a Greek legendary bird –
the equivalent of present day European
Kingfisher bird. The ancients believed
that the Halcyon birds (unlike other birds
making their nests in burrows dug by
them in river banks / lake shores etc.),
made a floating nest in the Aegean Sea
with the fish bones ejected by
themselves after digestion and had
the power to calm the waves while
brooding their eggs – males shared,
with their females, the chore of
brooding the eggs in daytime while
the females had to do it by themselves
at nighr. Halcyon had the power to
calm the waves (Hence the phrase
“Halcyon days” meaning “Calm,
peaceful days”.) while brooding her
eggs.The source of the belief in the
bird’s power to calm the sea
originated in a myth recorded
by Ovid. The story goes that
Aeolus, the ruler of the winds,
had a daughter named Alcyone,
who was married to Ceyx, the king
of Thessaly. Ceyx was drowned
at sea and Alcyone threw herself
into the waves in a fit of grief.
Instead of drowning, she was
transformed into a bird, Halcyon
(modification from her original
name Alcyone, and carried to
her husband by the wind.
Fourteen days of calm
weather were to be expected
when the Halcyon was
nesting – around the winter
solstice, usually 21st or 22nd
of December – beginning on
the 14th or 15th of December.

Halcyon calming the waters of
the Aegean Sea reminds me
of us – the brain(y?) surgeons –
calming the brain and the
heart to facilitate complicated
surgical operations on the
brain – like clipping Giant
Basilar Top Aneurysms and
the heart surgeons calming
the heart only – cardioplegia –
intentional and temporary
cessation of cardiac activity,
(i.e. to stop the heart from
beating) and employing Heart
Lung Machine aka Extra-
corporeal Circulation aka
Cardiopulmonary bypass
(CPB) aka “The Pump” used
from 1951 in Open-Chest Open
Cardiotomy / Closed Heart
operations such as Cardiac
valve repair and / or
replacement (aortic valve, mitral
valve, tricuspid valve, pulmonic
valve), Repair of large septal
defects (atrial septal defect,
ventricular septal defect,
atrioventricular septal defect),
Repair and / or palliation of
congenital heart defects
(Tetralogy of Fallot,
transposition of the great
vessels), Repair of some
large aneurysms (aortic
aneurysms, cerebral aneurysms)
Pulmonary thrombo-
endarterectomy, Pulmonary
thrombectomy and, of course,
Transplantation (heart
transplantation, lung
transplantation, heart – lung
transplantation) – in most of
which CPB was a must
but also in Coronary artery
bypass surgery, where it has,
since the 1990s, been replaced
slowly and gradually but not yet
completely by “off-pump /
beating heart bypass surgery”;
the long and hideous sternum
(breastbone) – splitting cuts
being replaced by the much
smaller cuts of Minimally
invasive surgery and even
just 3 small holes for the
most recent robot-assisted
heart surgery; this is where
a machine – Robot ( a
real – life descendant of the
reel – life fictitious Daleks
of BBC’s “Doctor Who”)
is used to perform surgery
while being controlled by
the heart surgeon. The
main advantage to this
is the size of the incision
made in the patient.
Instead of an incision
being at least big enough
for the surgeon to put his
hands inside, it does not
have to be bigger than
three small holes for the
robot’s much smaller
hands to get through.
Also the long cuts from
groin to ankle for
harvesting the graft /
conduit vessel – the Long
/ Great Saphenous Vein
(L SV / GSV) [the terms
“safaina” (Greek, meaning
“manifest,” “to be clearly
seen”) and “el safin”
(Arabic, meaning “hidden
/ concealed”) have both
been claimed as the
origin for the name of
the vein, “saphenous”]
are replaced by a few
small holes through
which vascular
endoscopes are passed
and the vein is harvested
endoscopically, using a
technique known as
endoscopic vessel
harvesting (EVH).
The recent, safer
modifications of
Coronary Artery
Bypass Graft (CABG)
surgery for the killer
Coronary Artery Heart
Disease (CAHD) were
necessitated by the high
risks and complications
of the older (CPB – like)
methods – including
1. the albeit rare deaths
on the operation table due
to massive blood loss /
fatal ex-sanguination
if a CPB circuit line
becomes disconnected;
2. the less rare deaths
on the table from clotting
of blood in the circuit – or air
inadvertently entering the
CPB circuit producing
air embolism – clot and or
air can block the circuit
(particularly the
oxygenator) or send a
clot into the patient and
fatally damage the
heart and / or the brain;
3. the rare Immediate
post – operative deaths
due to blood loss from
leaking / defective
suture lines and the Acute
Respiratory Distress
Syndrome; 4. the
Capillary leak syndrome and
Reperfusion Injury (the tissue
damage caused when
blood supply returns to the
tissue after a period of
ischemia or lack of oxygen.
The absence of oxygen and
nutrients from blood during
the ischemic period creates
a condition in which the
restoration of circulation
results in inflammation and
oxidative damage through
the induction of oxidative
stress rather than restoration
of normal function); 5. At
least a few survivors
suffered brain damage
leading to coma
(Unconscious state),
delirium (A temporary
state of mental
confusion and fluctuating
consciousness), paralysis,
speech disturbances etc.,
lung necrosis (breathing
troubles, blue skin
(cyanosis), blood in
sputum), kidney
damage, limb
gangrene etc.,
6. Blood cells in the Blood
may get physically
damaged – hemolysis –
when pumped through
the CPB leading to liver
/ kidney damage and the
resultant mortality and
morbidity; 7. Many survivors,
including celebrities like
former U.S. President
Bill Clinton and Vice-
President Dick Cheney,
have suffered the very subtle
Postperfusion syndrome
(aka Pumphead) – a
constellation of subtle
neurocognitive defects
including short term memory
impairment, stilted speech,
depression, confusion,
vision problems.and
diminished hand – eye
coordination, altered sex
drive, lessened inhibitions,
other personality changes,
defects associated with
attention, concentration,
problem solving, fine
motor function, and speed
of mental and motor responses.
Studies have shown a high
incidence of neurocognitive
deficit soon after surgery, but
the deficits are said to be
often transient with no
permanent neurological
impairment. The heart – lung
blood circulation system
and the connection surgery
itself release a variety of
debris into the bloodstream,
including bits of blood cells,
tubing, and plaque. For
example, when surgeons
clamp and connect the
aorta to tubing, resulting
emboli may block blood
flow and cause mini strokes.
Other heart surgery factors
related to mental damage
may be events of hypoxia,
high or low body temperature,
abnormal blood pressure,
irregular heart rhythms, and
fever after surgery.

As opposed to CPB CABG,
Beating-heart CABG surgery
has the following advantages:
•Better preservation of heart
function; •Better survival rate,
especially among high-risk
patients; •Reduced hospital
stay; •Quicker recovery;
•Less chance for heart
rhythm, kidney, or liver
complications
•Reduced risk for
neurological injury, including
stroke and memory
complications.

Even for diagnosing Coronary
artery disease, some risky
procedures are slowly being
given up in preference for
newer safer methods. The
risky treadmill ([sic] dreadmill)
test, where you are made to
run at speeds you are never
used to or will never have to
in your life to diagnose stress –
inducible ischemia and where
some feeble unsteady ones
have slipped and fallen to
fatal injuries, seems to have
no justification. After the
arrival of the much less risky
intravenous 64 slice CT
coronary angiography, why
would anybody offer the
older, unsafe groin /
elbow arterial puncture
catheter angiography
which has produced
1. catheter – dislodged
emboli carried in
circulation to blood vessels of
brain, heart, kidney, limbs etc.,
and block them producing
iatrogenic (= physician –
induced) strokes (Brain
Attacks), heart attacks,
kidney damage, limb gangrene
requiring amputation!; 2. clot
blockage of the punctured
major artery resulting in limb
gangrene, claudicating
(limping) pain etc.,; 3. neeedle
damage to and blockage of
adjacent veins leading to
varicose veins, limb swelling
(oedema) etc.,; 4. Needle
damage to adjacent major
nerves resulting in gnawing
nerve pain, numbness and
even paralysis!

Maybe I have disproportionately
but not wantonly highighted the
bad sides of heart surgery. But
that is sensational journalism –
aka blogging – Heard of,
“When a dog bites a man,
that is not news, because
it happens so often. But if a
man bites a dog, that is news!”
attributed to New York Sun
“It Shines for All”, editor
John B. Bogart (1848 –
1921) also to Charles
Anderson Dana (1819 –1897),
New York Sun editor and
part-owner between 1868
and 1897) and also to
Alfred Harmsworth, 1st
Viscount Northcliffe of
Saint Peter / the Isle of
Thanet (1865–1922), a
British newspaper and
publishing magnate, an
early pioneer of tabloid
journalism, primarily
appealing to the popular
taste – as in the 12th century
German proverb, “Whose
bread I eat, his song I sing!
Wessen Brot ich esse, des
Lied ich sing”! Alfred
Harmsworth, who had
achieved enough and
more ambitioned for more
and followed, “Hitch your
wagon to a star!” by the
bewitching writer Ralph
Waldo Emerson’s
(1803-1882) book called
Society and Solitude –
Chapter entitled “Civilization”,
but without knowing the
wisdom of the statement
made 80 years later by the
late Ronald Wilson Reagan
(1911 – 2004), the 40th
President of the United
States (1981–89), “It’s
true hard work never killed
anybody, but I figure, why
take the chance?”, vigourously
followed Henry Wadsworth
Longfellow’s (1807 –1882)
motivational poem,
“The heights by great men
reached and kept
were not attained by sudden flight,
but they, while their companions slept,
were toiling upward in the night.”,
toiling upward sleepless night
after night, literally burned
midnight oil and the candle
at both ends, Alfred
Harmsworth of course, failed
to achieve the unachievable –
Megalomania – and literally
went to the stars – died of a
nervous breakdown / broken heart –
at the “young” age of 57, young
for men of his stature in that era!
Hard work did not kill him but the
inevitably associated tension killed!
This proves the old saying,
“those whom the gods love
die young” in the Greek
mythologic story of Trophonius
aka Trofonio and also
“uem di diligunt, Adolescens
moritur” (he whom the gods
favour, dies young) Plautus
Bacchides l. 817; “Most happy
be they and best belouid of god,
that dye whan they be young”
1546 W. Hughe Troubled
Man’s Medicine B8V;
“Whom god loueth best,
those he taketh sonest”.
[1553 T. Wilson Art of Rhetoric
40V]; “Those that God loves,
do not live long.” [1651 G.
Herbert Jacula Prudentum no.
1094]; “‘Whom the gods love
die young’, was said of yore,
And many deaths do they
escape by this.” [1821
Byron Don Juan iv. xii.].
In stark contrast with this
was the saying “Those
whom the gods love grow
young!” by Oscar Fingal
O’Flahertie Wills Wilde
(1854 – 1900), Oscar Wilde
for short, an Irish writer and
poet, a compatriot and
contemporary of George
Bernard Shaw (1856 – 1950)
who was also an Irish playwright;
despite writing, “Those whom
the gods love grow young!”,
Wilde preceded George Bernard
Shaw in death – presumably
gods did not love Wilde –
Wilde’s compatriot commoners
and law – makers also did not
love Wilde – they arrested him,
tortured him, banished him,
exiled him, expatriated him
and repatriated him till he
had a nightmare. “I dreamt
that I had died, and was
supping with the dead!”
and soon afterwards died
of cerebral (Brain) meningitis,
syphilitic according to some
but pyogenic (pus – forming /
suppurative) from an old
suppuration of the right ear
(“une ancienne suppuration
de l’oreille droite d’ailleurs
en traitement depuis
plusieurs années”) and / or
a surgical intervention,
perhaps a mastoidectomy;
he died penniless and a
destitute in an alien land –
France – in Paris at the tender
age of forty-six!

I am not a maverick social
critic / whistle blower like
Ivan Illich or a fire brand like
Jan Rapoport to stir and fish
in troubled waters!

Let me continue with
Halcyon’s calm waters in the
next page!

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About Loga muthu krishnan

I am a 70 year old Neurosurgeon just started Non-Profit blogs under WordPress, Google Bloggerspot, webs.com, Facebook, http://logamuthu.tumblr.com/etc., entitled "Positive Health For All" disseminating useful health information free of cost over the internet(Absolutely NO promotions of persons (including me), brands, hospitals, books etc.,). My blogs are:https://krishnanlogamuthu.wordpress.com/, http://gtieve.blogspot.com, http://logamuthu.webs.com/ http://logamuthu.tumblr.com/ http://www.facebook.com/logumuthu.krishnan

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