Professor gets to the heart of what makes us tick

An adjunct professor of social medicine at the University of North Carolina School of Medicine (not a physician; his doctorate is in comparative literature), Carter is the author of a previous book on a humanist's encounter with human anatomy . During a one-semester teaching/research appointment at the University of Montana at Missoula , he researched this book, largely at the International Heart Institute of Montana , based at St. Patrick Hospital and Health Sciences Center .

The book has three main elements. First, Carter's continuing education in the physiology (and pathology) of the heart from elite surgeons at the heart institute. Second, an exploration in several essays of the manifold meanings of "heart" in language, culture, society, and literature. Third, a rich and voice-filled presentation, based on extensive interviews, of four seriously ill heart patients.

In these encounters, the identity of the heart as seat of human essence is most literally felt. Michael is a 27-year-old athlete with a congenital valve defect that is to be repaired with the Ross procedure , a delicate and radical operation. Kay is a middle-age single woman with cardiomyopathy -- her heart muscle has been damaged by a virus -- who must learn to live with limitations and uncertain future. A third patient, a 51-year-old Episcopal priest, had angioplasty for severe coronary artery disease and was forced to rearrange his life and habits to fight the return of the illness. The last is a 91-year-old man with a history of stroke and hypertension, still holding on to life, prayerful and grateful.