Historically Speaking: Broken Hearts and How to Heal Them

Modern medicine confirms what people have known for thousands of years: heartbreak is more than a metaphor.

The Wall Street Journal

September 30, 2023

A mere generation ago, “heartbreak” was an overused literary metaphor but not an actual medical event. The first person to recognize it as a genuine condition was a Japanese cardiologist named Hikaru Sato. In 1990, Dr. Sato identified the curious case of a female patient who displayed the symptoms of a heart attack while testing negative for it. He named it “Takotsubo Syndrome” after noticing that the left ventricle of her heart changed shape during the episode to resemble a takotsubo, a traditional octopus-trap. A Japanese study in 2001 not only confirmed Sato’s identification of a sudden cardio event that mimics a heart attack but also highlighted the common factor of emotional distress in such patients. It had taken the medical profession 4,000 years to acknowledge what poets had been saying all along: Broken Heart Syndrome is real.

The heart has always been regarded as more than just a pump. The Sumerians of ancient Mesopotamia, now part of modern Iraq, understood it performed a physical function. But they also believed it was the source of all emotion, including love, happiness and despair. One of the first known references to “heartbreak” appears in a 17th century B.C. clay tablet containing a copy of “Atrahasis,” a Babylonian epic poem that parallels the Old Testament story of Noah’s Ark. The words “heart” and “break” are used to describe Atrahasis’s pain at being unable to save people from their imminent doom.

The heart also played a dual mind-body role in ancient Chinese medicine. There was a great emphasis on the importance of emotional regulation, since an enraged or greedy heart was believed to affect other organs. The philosopher Confucius used the heart as an analogy for the perfect relationship between the king and his people: Harmony in the latter and obedience from the former were both essential.

Heart surgeon Daniel Hale Williams. ILLUSTRATION BY THOMAS FUCHS

In the West, the early Catholic Church adopted a more top-down approach to the heart and its emotional problems. Submitting to Christ was the only treatment for what St. Augustine described as the discomfort of the unquiet heart. Even then, the avoidance of heart “pain” was not always possible. For the 16th-century Spanish saint Teresa of Avila, the agonizing sensation of being pierced in the heart was the necessary proof she had received God’s love.

By Shakespeare’s era, the idea of dying for love had become a cliché, but the deadly effects of heartbreak were accepted without question. Grief and anguish kill several of Shakespeare’s characters, including Lady Montague in “Romeo and Juliet,” King Lear, and Desdemona’s father in “Othello.” Shame drives Enobarbus to will his heart to stop in “Antony and Cleopatra”: “Throw my heart against the flint and hardness of my fault.”

London parish clerks continued to list grief as a cause of death until the 19th century, by which time advances in medical science had produced more mechanical explanations for life’s mysteries. In 1893, Daniel Hale Williams—founder of Provident Hospital in Chicago, the first Black-owned hospital in the U. S.—performed one of the earliest successful heart surgeries. He quite literally fixed the broken heart of a stabbing victim by sewing the pericardium or heart sac back together.

Nowadays, there are protocols for treating the coronary problem diagnosed by Dr. Sato. But although we can cure Broken Heart Syndrome, we still can’t cure a broken heart.

Historically Speaking: Beloved Buildings That Rose from the Ashes

From ancient Rome to modern London, great structures like Notre Dame have fallen and been built again

The Wall Street Journal, May 2, 2019

A disaster like the Notre Dame cathedral fire is as much a tragedy of the heart as it is a loss to architecture. But fortunately, unlike most love affairs, a building can be resurrected. In fact, throughout history communities have gone to remarkable lengths to rebuild monuments of sacred or national importance.

There is no shortage of inspirational examples of beloved buildings that have risen from the ashes. The Second Temple was built in Jerusalem in 515 B.C. following the destruction of the First by King Nebuchadnezzar II of Babylonia in 586 B.C.; Dresden’s Baroque Frauenkirche was faithfully rebuilt in 2005, after being destroyed by bombs in 1945.

Often the new structures are exact replicas, as with Venice and Barcelona’s opera houses, La Fenice and Gran Teatre del Liceu, both of which were rebuilt after suffering devastating fires in the 1990s. If France decides to rebuild Notre Dame according to the principle “as it was, where it was,” the skill and technology aren’t lacking.

In other cases, however, disasters have allowed for beloved landmarks to be reimagined. The Great Fire of Rome in 64 A.D. led to a revolution in architectural styles and techniques. After Hagia Sophia cathedral was torched during riots in Constantinople in 532, the Byzantine Emperor Justinian asked his architects Anthemius and Isidore to build something bold and impressive. It was risky to change such a renowned symbol of the Eastern Roman Empire; moreover, for security and financial reasons, the work had to be completed in just six years. Still, the result dazzled Justinian, who exclaimed when he saw it, ‘‘Solomon, I have outdone thee.” Almost a thousand years later, following Constantinople’s fall to the Turks in 1453, Sultan Mehmet II had a similar reaction and ordered Hagia Sophia to be turned into a mosque rather than destroyed.

Sir Christopher Wren, who rebuilt St. Paul’s Cathedral in London, was not so lucky in the reactions to his creation. The Great Fire of 1666 had left the medieval church in ruins, but there was little appetite for an innovative reconstruction and no money in the Treasury to pay for it. Wren endured setbacks at every turn, including a chronic shortage of stone. At one point, Parliament suspended half his salary in protest at the slowness of the work, which took almost three decades and spanned the reigns of five monarchs.

The reason for the delay became clear after the finished building was revealed to the public. Inspired by drawings of Hagia Sophia, Wren had ignored the approved design for a traditional reconstruction and quietly opted for a more experimental approach. Ironically, many of his contemporaries were appalled by the now iconic great dome, especially the Protestant clergy, who deemed it too foreign and Catholic-looking. Yet Wren’s vision has endured. During the German bombing of London in World War II, St. Paul’s was the one building that Winston Churchill declared must be saved at all costs.

It is never easy deciding how to draw the line between history and modernity, particularly when dealing with the loss of an architectural masterpiece. There isn’t always a right answer, but it may help to remember Churchill’s words: “We shape our buildings and afterwards our buildings shape us.”

Historically Speaking: Insuring Against Disasters

Insurance policies go back to the ancient Babylonians and were crucial in the early development of capitalism

The Wall Street Journal, February 21, 2019

ILLUSTRATION: THOMAS FUCHS

Living in a world without insurance, free from all those claim forms and high deductibles, might sound like a little bit of paradise. But the only thing worse than dealing with the insurance industry is trying to conduct business without it. In fact, the basic principle of insurance—pooling risk in order to minimize liability from unforeseen dangers—is one of the things that made modern capitalism possible.

The first merchants to tackle the problem of risk management in a systematic way were the Babylonians. The 18th-century B.C. Code of Hammurabi shows that they used a primitive form of insurance known as “bottomry.” According to the Code, merchants who took high-interest loans tied to shipments of goods could have the loans forgiven if the ship was lost. The practice benefited both traders and their creditors, who charged a premium of up to 30% on such loans.

The Athenians, realizing that bottomry was a far better hedge against disaster than relying on the Oracle of Delphi, subsequently developed the idea into a maritime insurance system. They had professional loan syndicates, official inspections of ships and cargoes, and legal sanctions against code violators.

With the first insurance schemes, however, came the first insurance fraud. One of the oldest known cases comes from Athens in the 3rd century B.C. Two men named Hegestratos and Xenothemis obtained bottomry insurance for a shipment of corn from Syracuse to Athens. Halfway through the journey they attempted to sink the ship, only to have their plan foiled by an alert passenger. Hegestratos jumped (or was thrown) from the ship and drowned. Xenothemis was taken to Athens to meet his punishment.

In Christian Europe, insurance was widely frowned upon as a form of gambling—betting against God. Even after Pope Gregory IX decreed in the 13th century that the premiums charged on bottomry loans were not usury, because of the risk involved, the industry rarely expanded. Innovations came mainly in response to catastrophes: The Great Fire of London in 1666 led to the growth of fire insurance, while the Lisbon earthquake of 1755 did the same for life insurance.

It took the Enlightenment to bring widespread changes in the way Europeans thought about insurance. Probability became subject to numbers and statistics rather than hope and prayer. In addition to his contributions to mathematics, astronomy and physics, Edmond Halley (1656-1742), of Halley’s comet fame, developed the foundations of actuarial science—the mathematical measurement of risk. This helped to create a level playing field for sellers and buyers of insurance. By the end of the 18th century, those who abjured insurance were regarded as stupid rather than pious. Adam Smith declared that to do business without it “was a presumptuous contempt of the risk.”

But insurance only works if it can be trusted in a crisis. For the modern American insurance industry, the deadly San Francisco earthquake of 1906 was a day of reckoning. The devastation resulted in insured losses of $235 million—equivalent to $6.3 billion today. Many American insurers balked, but in Britain, Lloyd’s of London announced that every one of its customers would have their claims paid in full within 30 days. This prompt action saved lives and ensured that business would be able to go on.

And that’s why we pay our premiums: You can’t predict tomorrow, but you can plan for it.

WSJ Historically Speaking: Secret Agents, From Babylonian Tablets to James Bond

Daniel Craig in the latest James Bond film, ‘Spectre’ PHOTO: COLUMBIA PICTURES

Daniel Craig in the latest James Bond film, ‘Spectre’ PHOTO: COLUMBIA PICTURES

James Bond may have won the hearts and wallets of audiences world-wide—“Spectre,” the latest movie in the series, opens Friday after shattering box-office records in the U.K.—but armchair experts have always grumbled that Ian Fleming’s world of spies is too exciting to have any relationship to reality or history.

The critics are wrong. Fleming, who died in 1964, packed his books and plots with real historical allusions, beginning with the secrecy classification “for your eyes only.” The origins of the term go back to the Mesopotamians.

The oldest known classified document is a report made by a spy disguised as a diplomatic envoy at the court of King Hammurabi, who died around 1750 B.C. in Babylon. The spy smuggled the object—marked “This is a secret tablet” on the front—to his handlers in the Kingdom of Mari. Shortly after being found in the 20th century, the tablet and its translation went missing, vaulting it to the top rank of wanted secret files. Continue reading…