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One Heart, Two Lives

A study of death, grief and the fine-tuned process of organ donation and transplantation

Read in Ned | July 13, 2017

By Roberta Brown-Jones

In general, I avoid literature that focuses on death, particularly of a child, but when The Heart was recommended to me, I decided to swallow my reluctance and read it anyway. The novel, written by French author Maylis de Kerangal and translated by Sam Taylor, is a study of death, grief and the fine-tuned process of organ donation and transplantation. The book was included on a short list of Bill Gates’s top five books for summer reading. Gates, not usually a fan of fiction, calls The Heart “poetry disguised as a novel,” a fitting description.

The author aptly demonstrates how a tragic event “piercing the fragile membrane that separates the lucky and the damned” immediately places one into an altered state, apart from those who are going about their normal lives.

De Kerangal captures the extreme sorrow caused by the death of a person who is at the height of vitality. Simon Limbres, a boy on the cusp of manhood, opens the novel. Simon’s passion for surfing, which ultimately indirectly causes his death, is described with such precision that the reader can feel Simon’s adrenaline rush as he tackles the waves.

The author’s granularity of language in describing a surf wave with its “whitish, foamy edge, billions of atoms catapulted against each other in a phosphorescent halo” draws the reader into the excitement of the surfing experience and the lure of the sea. Using lengthy sentences, piling on descriptor after descriptor, De Kerangal is a master at providing the picture and feel of each scene she describes.

The book is full of meditations on life, death, and grief, although the story takes place over a mere 24-hour period. Despite the brevity of the narrative, the author packs in a world of experience as she outlines the lives of all involved in the tragedy and its aftermath: parents, sibling, girlfriend, doctors, nurses, organ donation coordinators, and organ recipient.

De Kerangal does not sentimentalize the team of medical workers who ultimately are involved in extracting Simon’s organs for transplantation. Whereas some of the people involved are truly compassionate, others are effective because their egos, discipline, and intellects enable them to put aside the emotions that might distract from their duties.

While there are many mesmerizing passages in the novel, the book also is informative on a factual level about the history of transplants and the strides in medical knowledge gained over time. These include the repositioning of the definition of death from the cessation of the beating heart to the death of the brain, the revolutionary use of immunosuppressants to avoid organ rejection, and the use of artificial hearts.

In addition, De Kerangal outlines the organ donation process. In many countries, organ-donation consent is “opt-out,” meaning consent is presumed unless an individual has specifically registered to decline via an organ donation refusal registry.

Intrigued enough by the opt-in versus opt-out policy question, I researched the subject finding that those countries who use the opt-out policy as their default for organ donations have a dramatically higher rate of organ donations. The U.S. currently has an opt-in system so that only those people who have explicitly registered to be donors will have their organs donated without a relative’s consent upon their death, which leads to many organ-donation recipients being left on waiting lists for months to years depending on the organ needed.

Even if you’re squeamish about the topic of death, The Heart forces the reader to both rejoice in the beauty of life and remember that the thing that binds all of us to the same fate is our own mortality.


Roberta Brown-Jones is a Library Assistant at the Nederland Community Library.