Reading Hearts

. . . Just as the image of a word on paper can instantaneously conjure up powerful emotions (positive or negative), so to a cardiologist a second's glimpse at an echo image conveys volumes of information about the patient's disease and prognosis. The echo images that I see add in some unfathomable way a richness and another dimension to my thinking and imagination about the patient and myself.

~ Joseph A. Gascho*

Cardiologist Joseph A. Gascho, M.D., reads pictures — echocardiograms ("echoes") — for a living. When he's not seeing, listening to, or examining patients to learn how well or how poorly their hearts are working, Gascho is making pictures of his own and linking the images he creates to poems he writes. 

Gascho is a story-teller — on and off the job.

During office hours, Gascho listens to stories his patients tell him. He reads stories captured in the black and white and gray (and sometimes color) of patterns produced by high-frequency sound waves directed to and reflected back from hearts being tested. After looking at the still or moving pictures on a computer, he writes explanations to help give patients and their doctors a clue to a man's inability to catch a breath, a woman's swollen ankles, a grandfather's chest pain, a teenager's heart giving off the sound of whoosh instead of whish.

Later, after his white coat has come off, Gascho re-sees, re-reads, and re-writes the pictures and words in his mind, transforming them in his imagination. He conjures new stories with the camera's eye and through his own; he writes new stories with words drawn from his own questions about his patients and himself.

Like seeing a heart beating in an open chest cavity, Gascho's images can stun and his words move. And they are prompts: When we look at and read those images and words, we filter them to make them our own, to imagine our narrative of blues and reds and yellows pulsing on a screen, dipping, rising, falling flat before rising again.

Recently, at Penn State Milton Hershey Medical Center in Hershey, Pennsylvania, and, earlier, at Parrot Cafe in Lancaster, Gascho's work was the subject of an exhibition, Diastole**. Diastole, Gascho says on his Website, "occurs not just in the heart but in our lives as well. Diastole is all around us, if we are open to seeing it!" (Diastole 6, right; published with permission)

Gascho has two Websites: Gascho Photography and Joseph Gascho Photography. I've selected as highlights these favorites of mine:

✶ Diastole: Color Doppler

✶ Diastole 9 (seen above, left; republished with permission)

✶ Meditation: Rain Drops

✶ Sky (viewable as individual images or as slideshow)

✶ Land & Sky: Maryland Barn

A few other Gascho images are here, where you can see one of his diastole images paired with a poem. The image and poem have been selected for publication.

Take a peek, then come back and let me know what your favorites are. You might even want to write a story or a poem about seeing diastole up close.

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All images property of Joseph Gascho. Copyright © Joseph Gascho. All Rights Reserved. Diastole 6 and Diastole 9 published with permission.

* Joseph Gascho, "Echos of a Doctor's Heart" in Journal of Medical Humanities (2009), 30:201-205.

** Diastole alternates with systole to form pulse; it's the part in the heart's rhythmic cycle when the heart relaxes and is filled with blood.

I thank Jan Phillips for bringing Dr. Gascho's work to public attention.


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