Heart failure, according to a recent study, is a “global pandemic affecting at least 26 million people worldwide and is increasing in prevalence.” One of the biggest challenges is that fully successful treatment requires heart transplantation of healthy hearts from cadavers, not from living bodies, as is the case with transplanting all other human organs. Complicating things further, donors must match numerous physical attributes of the heart recipient – blood type, tissue characteristics, weight, age. Moreover, even those patients for whom matches are found, the prognosis is not always favorable. Given these difficulties, it is not surprising, perhaps, that it is dramatically harder to find donor hearts for babies. Infants who are healthy have a very low mortality rate – at least in developed nations – and the hearts of those who are unhealthy are unusable.

I learned these facts while researching treatments for heart failure, a topic I felt prompted to undertake because of the high incidence of heart disease in my own family (my father recently underwent successful open heart surgery in October, performed by my uncle, who is a cardiac surgeon). It was while conducting research at a hospital in Istanbul that I first encountered intensive care units (ICUs) for babies with heart failure. I was shocked by what I saw and by what I felt – fear, desperation, and anxiety. Here were tiny new human beings, whose freshness in the world usually connotes hope for a bright future, but almost all of them would not exist in the world for more than one year. I saw not only how these baby patients were in far more dire circumstances than adult cardiac patients, but how the hopes of the infants’ families, unlike my own for my father and other adult family members, were so minimal. I knew I wanted to pursue these research findings and personal feelings in my work.

As a heart patient in ICU, a baby is attached to 7 different machines to keep them alive. As I continued my research at the hospital, I recorded the sounds of these 7 machines, each of which serves a different purpose. For example, one is used for feeding, another for heartbeat monitoring, another for measuring body temperature (some of these provide ambient sound in my installation). The purpose of the machines is to keep the babies alive, but the doctors, nurses, and parents know that the vast majority of the infants will not survive, regardless of what is done for them. Their day-to-day experience of heart disease, which most of us rarely think about in our day-to-day lives, means waiting for death.

In addition to pointing to this futility, I wish to point to feelings of hope, minimal but real, through the symbolism of the olive pit – or seed, as we call it in Turkish. In Turkey, olive seeds symbolize infancy (both the seeds and babies’ hearts are small and fragile, but they are expected to grow to full size), as well as immortality and endurance (many olive trees live for over 400 years, but most babies with heart disease live for only 1). A baby’s heart weighs approximately 25 grams. The scales in my installation, on whichI’ve placed 25 grams of olive seeds, evoke just how much hangs in the balance for those dealing with in fan the art disease. Observers of this installation are encouraged to take 25 grams of olive seeds in to their hands to feel the weight of a baby’s heart.

As part of my research at the hospital, I arranged for an MRI video to be taken of an olive that could serve as a metaphor for the life of a baby. In one installation, I project this video in a circle of light, the circular shape suggesting that of an image seen through a microscope. I used seven IV bags to draw attention to the same number of machines that it takes to support the lives of babies with heart failure. As each bag represents a different machine used for life support, I added to the bags some food, some water, and other liquids to support the life of the small olive tree at the base of the projection.

Babies with heart disease have great difficulty breathing after the surgeries they undergo, but their parents can help them take a breath. In another installation, viewers can watch and hear one of the family members repeatedly hitting the back of a baby very hard. What at first looks and sounds like physical abuse is precisely the opposite, as it may be the only hope for the baby to keep breathing.In order to make this video more sculptural, and thus part of our everyday three-dimensional world, I chose to cover it with a bed sheet.

Gianluigi Savares and Lars H. Lun, “Global Public Health Burden of Heart Failure,” Cardiac Failure Review 3(1): April 2017: 7–11.