At the beginning of Dr. Seuss’ “How the Grinch Stole Christmas,” the green, pot-bellied, feline-faced Grinch is a bitter, foul-tempered misanthrope whose heart is “two sizes too small.” In the middle of the story, he plots to steal all the Christmas gifts in Whoville and toss them from a cliff. At the end, having learned that stealing the presents does not destroy the Whos’ fellowship and joy, he begins to see the deeper meaning of the holiday. He has a change of heart, and when he returns their gifts, his heart grows three sizes.
As a physician, I know that heart size matters. Having always assumed that bigger muscles are better muscles, in medical school I was surprised to learn that cardiomegaly, the medical term for a large heart, is in fact a sign of —most commonly an indicator of heart failure, a condition that afflicts nearly 6 million U.S. adults. The heart gets bigger because, as its ability to pump blood begins to decline, it allows its muscle fibers to be stretched more, like a spring, in order to recoil with greater force.
