Methodist Journal

IN THIS ISSUE

Nutritional Supplements and the Heart

Vol 15, Issue 3 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Dietary Supplements: Facts and Fallacies

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RECOGNITIONS

Drs. Raizner and Cooke Take the Lead in Special Issue on Supplements

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REVIEW ARTICLES See More

Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids

Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment

Coenzyme Q10

Red Yeast Rice for Hypercholesterolemia

Inorganic Nitrate Supplementation for Cardiovascular Health

Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?

Cardiovascular Risk of Proton Pump Inhibitors

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Snoopy’s Heart: A Case of Complete Congenital Absence of the Pericardium

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 15, Issue 3 (2019)

Article Full Text

POET'S PEN

East Coker

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Article Citation:

Young JB. East Coker. Methodist DeBakey Cardiovasc J. 2019;15(3):231-2.



East Coker

I. (First Verse)

In my beginning is my end. In succession
Houses rise and fall, crumble, are extended,
Are removed, destroyed, restored, or in their place
Is an open field, or a factory, or a by-pass.
Old stone to new building, old timber to new fires,
Old fires to ashes, and ashes to the earth
Which is already flesh, fur and faeces,
Bone of man and beast, cornstalk and leaf.
Houses live and die: there is a time for building
And a time for the wind to break the loosened pane
And to shake the wainscot where the field-mouse trots
And to shake the tattered arras woven with a silent motto.

V. (Last Verse)

Home is where one starts from. As we grow older
The world becomes stranger, the pattern more complicated
Of dead and living. Not the intense moment
Isolated, with no before and after,
But a lifetime burning in every moment
And not the lifetime of one man only
But of old stones that cannot be deciphered.
There is a time for the evening under starlight,
A time for the evening under lamplight
(The evening with the photograph album).
Love is most nearly itself
When here and now cease to matter.
Old men ought to be explorers
Here and there does not matter.
We must be still and still moving
Into another intensity
For a further union, a deeper communion
Through the dark cold and the empty desolation,
The wave cry, the wind cry, the vast waters
Of Petrel and the porpoise. In my end is my beginning.

—T.S. Eliot

 

Excerpt from “East Coker” from THE COMPLETE POEMS AND PLAYS, 1909-1950 by T.S. Eliot. Copyright © 1950 by T.S. Eliot, renewed 1978 by Esme Valerie Eliot. Reprinted by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

 

In my beginning is my end. In my end is my beginning.

News of Notre-Dame de Paris burning spread around the world like an unchecked California wildfire. When I got the text from my youngest son, an inveterate news hound, my immediate thought was a photo of us in the cathedral’s plaza in front of the iconic twin towers. So many have one of those. I flicked on the live news feed and watched as the inflamed spire crumpled. It was disturbing—just as it was to watch the Camp Fire (aptly named) destruction of Paradise, California last November. One haunting photograph of the Paris fire showed the burning roof aflame like a roaring campfire, with the Eifel Tower shrouded in smoke, lurking ghost-like in the distance.

An estimated 13 million people visit Paris each year to view this magnificent Gothic structure, and the fire surely sparked memories of pilgrimages, sacred and otherwise, to this site. The immediate response committing massive amounts of cash to restore, rebuild, or fashion anew the 856-year-old landmark sparked its own firestorm of criticism: Why can’t that amount of capital be raised to fix the woes of the world? But my thoughts turned to the cycle of life. After all, spring blossoms were emerging, and for some Catholic faithful the fire seemed an ironic twist to the beginning of Easter weekend as fears of total destruction emerged. I then remembered a favorite poem of mine, “East Coker” from T.S. Eliot’s Four Quartets, published in 1943, a time of a different conflagration.

The wonder of poetry is that it allows us to personally interpret a poet’s words. Often, it turns out, the message is not what the poet was trying to say. No matter; words, when strung together, can have many meanings. The two stanzas extracted here are the first and last of the poem, with, arguably, the most important lines being the first and last. For me, as with Eliot some say, there was a spiritual theme to the poem, as the lines reflected the cycle of life. Beginning life meant that it would inevitably end. And so the cathedral surely had a beginning and it will surely have an end. But can a building, or village like East Coker, have a heart and soul and beginning and end? Perhaps that is where those 13 million annual visitors come into play. They make the cold stone and stunning artistry come alive.

“East Coker” also speaks of this…the rise and fall of an English countryside village. It makes me think of the rise and fall (and rise) of our rustbelt cities, including Cleveland, Detroit, and Pittsburgh as well as the Northern California gold country ghost towns, which rose and fell but generally did not rise again. Eliot’s writing to me often seems morose and brooding, as can be seen in many parts of “East Coker.” But it captures the cycle of life brilliantly. Cleveland, Detroit, and Pittsburgh have risen again, to some extent. And so will Notre-Dame de Paris.

Fascinating will be the debate of restoration, rebuilding, or recreating the edifice. Cities crumble the same way but can come back renewed with distinction. Though Cleveland, Detroit, and Pittsburgh collapsed in the same fashion, they did not rebuild in the same way. Nor will the cathedral. For everything about Notre-Dame de Paris to remain the same, everything about it must change. I believe that is at least one thing T.S. Eliot was trying tell us with “East Coker.” The cycle of life means that for everything to stay the same, everything must change. See what you think.

 

James B. Young, MD
Chief Academic Officer, Cleveland Clinic
Professor of Medicine and Vice-Dean for Cleveland Clinic Academic Affairs
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Section Editor, Poet’s Pen, Methodist DeBakey Cardiovascular Journal

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