3
How the hog, one of God’s most interesting creations, got involved in the surgery on my heart is a long story. After we had set a date for my appointment with the man with the knife, the doctors sat me down to discuss one remaining question.
We know we want to put in a new aortic valve in your heart, they said, but we don’t know which type.
Which type? You mean this is like going into Baskin-Robbins and trying to decide between almond toffee and chocolate marshmallow? I wouldn’t know an aortic valve if it walked up and bit me on the leg. What is this business with types?
I had a feeling when the discussion began that this little matter wouldn’t be simple. It wasn’t. I will attempt to decipher for you what the doctors attempted to explain to me.
In the first place, valve replacement isn’t something that has been going on for years as my senior doctor had explained when I was trying to weasel my way out of having the operation in the first place.
Twenty-five years ago, the man had said, they would have put me on some pills and then we all would have sat around and waited for my heart to get the size of my head, which would have been around the time it would have stopped beating, a situation terribly hazardous to one’s health.
Finally, somebody did invent an artificial heart valve and procedures whereby it could be inserted in place of the one the patient came with. The first valves were mechanical and were constructed of totally artificial materials, such as plastic.
They were better than no replacement valves at all, but there were problems. Patients with the mechanical valves faced the possibility of such complications as blood-clotting, which could lead to such unpleasant situations as strokes. So, it was necessary for patients with mechanical valves to take anti-coagulants to avoid the clotting, but thin blood isn’t such a terrific idea, either. The biggest plus for mechanical valves was they were durable.
There obviously have been improvements in mechanical valves over the ensuing years, but the dangers of clotting and stroke and the matter of taking blood thinners indefinitely have remained.
“Little boogers will last just about forever,” one of my doctors said, “but if we put one of those in you, I’d hate to see you dragging a foot around because of a stroke somewhere down the road.”
I can understand doctors when they talk like that. Dragging a foot around isn’t exactly my style.
Fortunately, I had another choice. A decade or so ago, researchers had the bright idea of attempting to develop a valve made from animal tissue. In the beginning, I suppose they tried taking valves from all sorts of animals and testing them to use in the human heart.
I would have started with elephants. When is the last time you’ve heard of an elephant dropping dead with a heart attack? I would have stayed away from nervous animals like those monkeys you see at the zoo who can’t sit still and make those awful screeching noises.
I probably would have never thought of hogs. Hogs make all sorts of noises, too, like they’re having trouble breathing; they don’t get out of the mud or away from the food trough long enough to get any exercise; and then there is the matter of their smell.
When I was growing up in Coweta County, Georgia, a lot of people raised hogs. You could always tell which of your classmates had hogs at their house by noticing if there were empty seats around them in the classroom.
The Rainwaters raised hogs. Nobody would ever take a seat next to a Rainwater child in school because it was difficult to pay attention to what was the average per annum rainfall in Ethiopia and fight off the distinct odor of swine at the same time. Claude Rainwater, who was in my class, even had a pet hog, which he occasionally rode to school. The hog’s name was Lamar. Claude would tie Lamar to a small tree in the school yard and Lamar would wait patiently until school was out and then Claude would ride him home again.
One day, Claude came to school without Lamar. He was in tears.
“What’s the matter, Claude?” the teacher asked him.
“It’s my pet hog,” said Claude. “Daddy won’t let me ride him to school anymore.”
“Why is that?” the teacher continued.
“Daddy said he was going to have puppies.”
Perhaps they should have told us less about the rainfall in Ethiopia in those days and spent at least a little time on why hogs don’t have puppies, and even if one did, why it certainly shouldn’t be named Lamar.
I was very surprised when my doctors told me my other choice for a new valve was one that would be taken from a hog. Only they didn’t say “hog valve,” they said “porcine valve,” which is the same thing. Hog. Porcine. They both grunt and eat things the dogs won’t touch.
The advantage a valve taken from a hog would have over a mechanical valve, they explained, was the hog valve reduced the possibility of dangerous clotting and also required no blood thinners. Hog valves and human valves, they said, were very much alike.
I waited for the catch. The catch, they said, was the question of the durability of the animal tissue valve.
“It won’t last as long as a mechanical valve?” I asked.
“How many fifty-year-old hogs do you know?” was the answer.
Specifically, the porcine valves have been in use for something like ten years, and those implanted in the beginning have exhibited a tendency to wear out.
“What happens if one wears out? I asked further.
“A second operation for a new one.”
I did some quick arithmetic. I’m thirty-five. I plan to live out my years. I’ll take seventy-five and call it even.
At one operation to put in a new valve every ten years, that’s four operations to go. At that rate, I could wipe out a small hog farm like the Rainwaters’ by myself.
Plus, there was the consideration of something out of a hog being placed inside my body. I mentioned some of the things that worried me about hogs, their snorting and labored breathing, their diet, their acute laziness, and their smell.
Despite all that, however, I have always had a voracious appetite for barbecue and even fancy myself as quite the expert on the subject. What would happen to me with hog in my heart?
Every time I’d pass a barbecue restaurant, my eyes would fill with tears?
Barbecue. My thoughts raced back to the integral part it has played in my life.
There was the annual Fourth of July Barbecue in my hometown. The churches went in together and bought some hogs and then the menfolk would sit up all night before the Fourth and barbecue the hogs over hickory smoke in an open pit, which doesn’t take a great deal of work once the hogs are cooking, so the menfolk had a lot of time to sit around and talk, mostly about the Bible.
They would talk Revelation for a time, which always spooked me, and then they would get along to something like Deuteronomy.
The Fourth of July Barbecue drew people from as far away as Newnan, LaGrange, and Hogansville. One year, a man from North Carolina was passing through and stopped in to partake.
He asked for cole slaw.
“What for?” somebody asked. “There’s plenty of stew and light bread.”
“I want to put it on my barbecue,” the man from North Carolina said.
I learned my first rule about barbecue that day. You don’t put cole slaw on it. I think that’s in Deuteronomy somewhere.
Somebody pulled a knife on the man and he got back in his car and went back to North Carolina.
After I left home, I roamed freely about other parts of the country, and I can to understand several truths about barbecue:
— The best barbecue is served in the state of Georgia. In Texas, they barbecue beef, which isn’t barbecue at all, and neither is goat, which is stringy. I wouldn’t even put cole slaw on barbecued goat our of respect for the cole slaw.
— The best barbeque is found in family-run operations. Harold Hembree, who runs Harold’s Barbecue in Atlanta, can’t even count the number of cousins and nieces and nephews working for him. There are three generation of Sprayberrys cooking and serving at Sprayberry’s in Newnan, Georgia. Sweat’s is a family operation in Soperton, Georgia, and it was Jim Brewer’s father-in-law who first started Fresh-Air in Jackson, Georgia, fifty-one years ago when he served off a sawdust floor. “When it’s a family working together,” says Jim Brewer, “things get done right.”
— If there are religious posters on the wall, you can usually count on the barbecue’s being good. Harold’s is a perfect example.
— Good barbecue restaurants rarely serve beer, as good as beer is with barbeque. “Mama won’t allow it here,” is why Harold Hembree doesn’t serve beer at his place. “You’ll lose your family trade,” says Jim Brewer of Fresh-Air.
— If a restaurant specializes in something besides barbecue, the barbecue probably won’t be any good. You can serve other things, just don’t brag on it. Jack Sweat in Soperton is still amazed at the time a family of Yankees headed for Florida stopped by his place and ordered fried shrimp.
— Georgia barbecue restaurants are careful what kind of bread they serve with their meat. Normally, it’s thin buns for sandwiches, and white bread for plates. Harold’s toasts white bread over an open flame for sandwiches and serves cracklin’ cornbread with its plates. I think Harold will go to heaven for his cracklin’ cornbread.
— Brunswick stew is too complicated to get into. Everybody has a different idea about how it should be cooked and what it should contain. “We even get ’em who complain unless the stew’s been cooked in a hog’s head,” says Jim Brewer.
— Sauce: Ditto. In Georgia alone there are hundreds of varieties of sauces. If the meat is good, the sauce will be, too.
— It is important to put up a sign in a barbecue restaurant that says “No Shoes. No Shirt. No Service.” That will add class to the place by keeping out people from Texas and North Carolina.
My doctors assured me the installation of a porcine valve into my heart would have no effect upon my taste and desire and enjoyment for good barbecue.
“You might have some other problems, though,” said one.
“What’s that?” I asked.
“You might want to go out and root for truffles occasionally,” he laughed.
“And you might crave watermelon rinds and corncobs,” said another.
“What you really have to watch,” a third chimed in, “is every afternoon about four o’clock, you might get this strange desire to go out and make love in the mud.”
Doctors stay inside too much, I think.
Aside from the questions of the durability of the valves and the barbecue thing, there were a couple of other concerns.
I wondered where they kept the hogs who were kind enough to donate their valves for people in my condition.
You know the outrage we have over the slaughter of baby seals. They go out and hit those baby seals in the head with a lead pipe or something, and people are up in the air about that everywhere.
I was afraid they kept the hogs in a pen out behind the hospital. I’ve been prepared for surgery and the doctor says to an orderly, “Leon, go out to the hog pen and get me a valve.”
Leon goes out the hog pen with a two-by-four and whomps a hog on the head and they take out his valve.
The doctors assured me nothing like that took place, which was a relief. Hogs have feelings, too, I expect.
I considered the question of porcine versus mechanical valve for about a minute.
MECHANICAL: I couldn’t get the idea of dragging a leg very far out of my mind.
PORCINE: So it wears out in ten years. At least I wouldn’t have to take the blood thinners and worry about a stroke. And medical science moves so swiftly. In ten years, who knows? Maybe they would come up with a solution where you just take a pill.
There was just that one other thing I wanted to know after the decision was made to install the porcine valve.
“It’s just a little thing,” I said.
“Shoot,” said one of the doctors.
“Do the pigs that give up their valves have names?” The doctor said he would check.
“Do you have a preference of a name for your donor?” he asked.
“Not really,” I answered. “Just as long as it isn’t Lamar.”