The Doppler Epiphany

By Posted in - Life on December 2nd, 2017 veins and arteries of the human body

I work with the human body, but I must admit I’m not as well-versed in anatomy as I would like to be. I listen with my hands and can feel some amazing things – when a muscle needs a strong press to let go, for example, and when it just needs to be held, quietly. I can feel tension and emptiness, can sense where a body is over-controlled or being ignored, where it needs to wake up and where it needs to release. I can feel these things, but I can’t always tell you the Latin name for the place I’m touching.

Not being familiar with such terms, and having a penchant for metaphor, means that when I am exposed to medical vocabulary and concepts, I’m often amazed by the poetry of it all.

Not long ago, I had to have a Doppler done of my veins (routine, no worries). I spent 45 minutes in the appropriately named waiting room. There seemed to be just one harried receptionist and one equally harried doctor conducting the tests. It was a late November afternoon turning into evening, cold, the streetlights coming on. There was an undercurrent of nervousness among the other people waiting. They weren’t here for the poetry; looking at their own insides was a necessary evil. Finally I was ushered into the examining room, told to undress and wait. I perched on the edge of an upholstered chair, wondering about the hygiene, trying to hold my naked toes just above the cold tile floor (good for the abdominals). But after several minutes, my abs gave up. I put my socks back on.

Eventually the doctor rushed in and apologized. “A man fell down, I had to look after him. We’re understaffed,” she added, in case it wasn’t obvious.

She motioned me to the other side of the room where the equipment was. A Doppler is basically an ultrasound, like the ones performed on pregnant women. They spread some of that really pleasant cold gel on you, then rub the area of interest with a smooth probe roughly the size and shape of an electric razor. The probe sends soundwaves into your body, which bounce off of your innards and send an echo back through to the machine, creating an image. It’s similar to the way a bat uses echolocation, sending calls out to its surroundings and making a kind of map based on what comes back to it.

The best part is that you can watch – and listen. If you’ve seen a fetus in the womb and listened to its heartbeat on an ultrasound, you’ve had the deluxe version of the experience. My circulatory system is small potatoes by comparison. But we take what we can get, and on that day, I saw and heard my veins, and was awed.


The art of noise

I was full of questions.

I know that arteries carry oxygen-rich blood away from the heart and out to the rest of the body, and that veins bring the oxygen-poor blood back to the heart. This exam was supposed to look at my veins. So how did that work?

“How does the machine distinguish between the veins and the arteries?” I asked the doctor, whose stress was palpable and impervious to my wonder.

“The machine does not distinguish anything,” she clipped. “I do the distinguishing. I choose where to point the machine.” To underline this, she pressed the probe just a bit harder against my flesh, all the while clicking on the console, taking still photos and typing in names and measurements. I kept my questions to myself after that, just lay back and dropped into that amazing inner world. It was like being in a submarine. Fuzzy white lines and bright pop-art reds and blues bloomed out of the darkness on the screen. Melodious names appeared in yellow letters as the doctor typed them out: the seductive saphenous, intriguing iliac, punky popliteal – veins that she would compress, then release, to make sure they were flexible and healthy. At one point she turned on the sound and I heard a kind of pulsing whoosh. We were eavesdropping on my body, pinging back the roar from this hidden universe that I carry around with me – that is me — yet keeps its own time, has its own networks and vessels and interior sound and logic that carry on whether or not I am there to consciously witness them.


What’s in a name?

Were the early anatomists trying to be poetic? I suspect that, given the almost Biblical task of naming specific parts of the human body, the ancients were mostly pragmatic in their choices. Most terms are based on the location, function, and comparison to similar parts within the body. Some include the name of the discoverer, such as the Circle of Willis, a vascular circuit which is chugging along at the base of your brain as we speak, named after English physician Thomas Willis (1621-1675).

Occasionally we might wonder if someone was having a laugh. A dear friend of mine, a medical editor, was recently taken aback by the term “malar festoons,” which refers to excessive swelling at the upper edge of the cheekbone, commonly known as under-eye bags. “Festoons,” she lamented, “as in swagging up your porch for a Fourth of July parade. But on your face.”

But sometimes it seems people observed how the inner world mirrors the outer one, and labelled parts accordingly. And so we have, for example, the geography of veins: they form arches, meet at junctions, run off into tributaries….

Whatever the case may be, it’s worth exploring these origins. Take the greater saphenous vein: the longest vein in the body, running from the top side of the big toe all the way up to the groin. The generally accepted source of its name is the Greek safaina, meaning “evident.” But ancient Arab physicians knew that, while the vein is quite visible at the ankle, it dives like the Loch Ness monster as it nears the heart. And so they called it el safin, “the concealed” (safoon in Hebrew). Surgeons today who look at the veins in your upper thigh and rely on the popular translation would naturally assume that they are seeing the “evident,” or saphenous vein, when in fact they’re looking at its tributaries. Knowing that the name really means “concealed” can affect varicose-vein treatment and other surgical decisions.


It ain’t over til it’s over

The Doppler was brief. At some point the doctor ripped long swaths of stiff paper towel from a roll, handed me a wad so I could wipe off the gel, and left the room without even saying the exam was finished. It was like the aftermath of a depressing sexual encounter. I might have been indignant, but I’d glimpsed a happy secret that the doctor’s stress could not diminish: the healthy whoosh of blood in my veins. And it’s still going on as I write this. And it’s going on in you, as you read. Take a breath and ponder: your circles and festoons, your arches and tributaries. They may not be perfect, and they will not last forever – much like the world you see when you look outward.

When we see a fetus in the womb or a child being born, we think about the miracle of life. When does it stop being miraculous?

It doesn’t. Listen: you are that miracle.




Elaine Konopka is the founder of The Attentive Body in Paris, offering private sessions in attention-based bodywork and pain management. Her latest series of monthly workshops combines conscious breathing and writing for wellbeing to explore life’s juicy themes. Join her on Sunday, December 17th for Invent/ory.

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(4) awesome folk have had something to say...

  • Grace R Caputo - Reply

    March 5, 2018 at 20:25

    How crummy of me to only now — MONTHS late — get to this delightful blog post and see that I am quoted therein! I do not deserve it.
    I have been putting off reading your emails as they come in so I can savor them when I don’t feel like I should be working (and I rarely sit in front of my computer when Im not working). Today I was lured in by knowing that one little blog post wouldn’t take me from my appointed rounds for THAT long, only to find myself having four to read, every one worthy of slow consideration and reflection, but I gobbled them down like Haribo peaches, my candy of choice. The bag is empty almost immediately and I’m reaching for more.
    Thank you, friend, for being so wise and clever and for having such a good heart and for sharing it with us.

    • Elaine - Reply

      March 5, 2018 at 22:35

      Ah good. I thought maybe you just didn’t like the quote! I’m honored to be the Haribo peaches of your blogging world. I’m probably easier on the teeth to boot. Thanks for reading, Grace, as always.

  • Greg - Reply

    December 8, 2017 at 20:14

    Beautifully written and reflected. I recently attended my father’s echocardiogram appointment and watched in wonder at the monitor , as well. Thankfully, the technician was less rushed and warmer than the experience you had with your physician. I love your question, “When does it (life) stop being miraculous?” Thanks for making us stop, watch and listen!

    • Elaine - Reply

      December 8, 2017 at 20:45

      Ah yes, then you know the feeling, Greg — “Wow, so that’s what’s going on in there!”
      May your technicians always take their time.
      Thanks for reading, and commenting.

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