Monday, September 3, 2012

Systole and Diastole.

 sys·to·le (sis-to-lee) n.

The rhythmic contraction of the heart, especially of the ventricles, by which blood is driven through the aorta and pulmonary artery after each dilation or diastole. 

di·as·to·le (di-as-to-lee) n.

The normal rhythmically occurring relaxation and dilatation of the heart chambers, especially the ventricles, during which they fill with blood.


The heart muscle contracts. It clamps down and gives momentum to the blood, moving it from atrium to ventricle and out through the aorta. Rhythmically tensing just enough to get things going where they need to go.

And also enough to keep them going.

They call this systole. 

And with systole, a lot of things have to work together. The pressure can't be too much or too little. Too much and the muscle starts to bulk up and will eventually tire out. Too little and the heart has to work double time to make up for it. The valves have to open at the right time and they must open all the way to let the blood through. Then, when it's time for them to close, those same valves need to shut tight and flush so that no blood escapes back to where it just came from. The atria and ventricles must work in concert.

For it all to go right and for us to stay alive, all of these things have to happen in perfect harmony.

But that's not enough.

Each contraction must be followed by a period of relaxation. A time that allows the blood to refill empty ventricles in preparation for the next contraction. Much like systole, this has to happen the right way. The muscle can't be too stiff. The pressure pendulum can't swing too far or too narrow in either direction. One part can't be moving while the rest is relaxing. It all has to be synchronous.

But most of all it has to happen. This period of relaxation must take place.

They call this diastole.

So today, I was just thinking about how work-life balance is a lot like systole and diastole. There can't be too much of either. Or too little.

For me, this is always a work in progress. On some days, I am a systolic all-star. Giving a talk at a conference, teaching on the wards, leading my small group, and revising manuscripts for publication all in the course of one week. I burn that midnight oil; I move and shake and watch things come together. I feel those slaps on my back and they serve as affirmations that I am getting it right and winning.


Sure. Sometimes my systole is so much fun that it tricks me into thinking it's really not that. But--whether it's fun or not--contract too much and it becomes palpable. Balls drop. That overwhelmed feeling starts to creep in. That's when I make myself get that necessary diastole. That time to regroup, refill and prepare myself to pump some more.


Now on the flip side, the relaxation thing can get out of hand for me, too. Just ask the BHE--I'm a master at putting off what I have to do for what I want to do.

Mmm hmmm.

And so. Much like the heart, the goal is to fight to get the right rhythm. Sustained. Rhythmic. Not too fast and not too slow. Not with too much pressure and not with too little. Contract. Relax. Contract. Relax. One and then the other. Not too much of one. Not too little of the other.

Just right.

Last week was a whole bunch of systole. Fun systole, but systole no less. I'm glad to love my work so much that the systole often masquerades as diastole.

So here are some images of my systole from last week. . . .

On 6A with Coach B's awesome daughter-slash-Grady nurse, Jessica!
The first take of my thumbs up for Leah--which looked like I was punching her instead!
Hugging Tammy, one of the best people in all of Grady history.
And of course, my bff David M.

This just made me think of something.

It's not enough to just have diastole. You have to take some time for yourself, yes. But just like the way it's necessary for the atria and ventricles to contract in sync, the same can be said about getting in rhythm with your loved ones. I think it's key to make every effort to line your diastoles up with the diastoles of those most significant to you.

Not every time. But as much as you possibly can.

Yes. Last week was one big ol' systole. But this weekend? Diastole, baby. Irrefutable, indisputable diastole. Three luscious days of it . . . . perfectly coinciding with the refilling periods of the ones who matter the most.

Lake effect sunshine in Georgia sure beats lake effect snow in Ohio!

With the one I love--my BHE.

Enjoying some non-medical literature--loaned to me by my Grady-girlfriend Stacy H.

Rehydration to prevent dehydration.
a face that makes me happy.
Synchronized diastole.

Part kindergartner, part T-rex.

Infectious joy.

Those swim lessons paid off.
Zachary was telling me that he won't forget me when he's a grown man. Swoon.

I believe him.
Their diastole includes electronics--which Mommy doesn't allow on school days.

I don't get it right every time. But sometimes? Man. Sometimes I get it right.

Food for thought:  

How are you doing with your systole and diastole? Are you lining up any of your diastolic moments with those who matter the most? And are they making the same provisions for you?

Happy Labor Day to those celebrating it. And Happy Monday to all o' y'all.


  1. My Fourth year of med school has been all systole; today was my first day off in a week. Thanks for the reminder to take a break . Ps, I also just started reading gone girl!

    1. Yay! I hope it's a perfect day off! As for "Gone Girl" -- isn't the writing just exquisite? I can barely get through from savoring how lovely the writing is. Wow.

  2. Hi there! I've been quietly, stalking your blog and wanted to extend an invitation to you to link up at our Medical Monday bloghop. You're blog is right up our ally! If you want to check it out you can do so at I hope you'll link up!

    1. Thanks for delurking. I'll be sure to check it out. Thanks for the invite and even more thank you for reading!

  3. Sometimes....just sometimes....we are able to tap out a perfect sinus rhythm in our respective lives.

    Maria, fellow Meharrian ( in Aruba !)

    1. OMG, Maria! Aruba! I don't know whether to be jealous that you're there or flattered that you are reading from there. It means that I'm part of your diastole! Yahooo!

      Aruba sound awesome! Have fun and make sure that you don't think about anesthesia, pain or critical care algorithms one single time the whole time you're there!


      Kimberly, fellow Meharrian

    2. Beautifully written and brilliantly illustrated !!!!
      LOVE the photo of you and my Jessie-Bear !!!
      (her Dad)

    3. Hi Coach B's BHE! See my comments under Katie's comment. Think you meant to place this there. And your Jessie-Bear is awesome--loved meeting her after hearing so, so much about her!

  4. I wonder how many other writers could have explained systole and diastole in such a clear way, let alone gone on to relate them so perfectly to work-life balance? Concepts in medicine brought to real life...educational and right on point on this Labor Day weekend. Very glad that your weekend was happy and peaceful and full of time with your loved ones.

    1. I almost added something about asystole (when the heart stops altogether) but that made the post too long. Ha! Thank you for these kind words and for reading.

  5. I can get my body to diastole, but my brain usually has to be threatened with an Ambien.

  6. It makes my heart happy to see two of my favorite people together! I will never forget diastole and systole after that excellent explanation and metaphor. Balance makes the heart grow stronger!!
    Love, Coach B

    1. Awwww! Two for the price of one! Coach B and Mark B? Wow! I will be have to go take more pictures with Jessie! Ha ha ha.

      Now Coach B, your BHE put his comment under another comment as a reply--you'll have to school him on that.

      And I'll have you both know that I walked by Jessie and heard someone call my name. I looked at her and IMMEDIATELY knew who she was. You would think I'd met a celebrity! Ha haha! I am sure that she was like, "Um, calm down. Like, really. Calm down." Ha ha ha. I asked her about married life and she told me she has the BHE, too. I let her know that everyone is welcomed to have their own BHE and that the term was not copywritten.

      ALSO. Can I please say how lovely and confident she is? One can only pray for their kids to grow up that way. I hope mine have such strong self images. I was really in awe. (Jessie, if you're reading this, I apologize for mortifying you.)

      xo, KM

  7. What a perfect explanation. My daughter, who had a complete AV Canal repaired by none other than the famous Dr William Norwood of the Norwood procedure, got married on Friday afternoon. I almost had asystole seeing her and my husband walking down the aisle! Now I am enjoying some diastole at the Jersey shore. Never have I been so tired, except possibly the morning after she was born! Thanks for the lovely post.

    1. Wow! Congratulations, Mary Alice! Enjoy this diastole and savor the reflections upon what I am sure was a perfect event.

  8. I'm trying!

    Happy day back at you --

  9. The long weekend was definate diastole with Celebrate Freedom and an impromptu birthday party. But today is all about PAC's and PVC's. This zig is not zagging. Oh well! Happy Tuesday!


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