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Maylis de Kerangal:Réparer les vivants (UK: Mend the Living; US: The Heart)

As you can see from the two English-language titles, the English one is a literal translation of the French while the US one uses a one word title but one which is highly relevant to the subject.

The book opens with the main character, Simon Limbeau. He is asleep but the focus is not on his sleeping, his dreams or, indeed, who he is but on his heart, whose activity is described in some detail. He is woken by an alarm. It is early on a cold Sunday morning but instead of sleeping in as he would normally do, he and two friends are off surfing as, apparently, dawn is a good time for surfing. We get a good description of their surfing and afterwards they set off home. We do not know why – indeed the author does not seem to know why but she speculates on possibilities – but the van crashes head first into a telegraph pole. We get the details of the police report – speeding, possible black ice. one person not wearing a seat belt and so on.

It is at this point that we meet the doctor whose name is Revol. He has just started the shift and we can see that he is very efficient for he checks up on all the other patients he has there are. There are a few, some in quite desperate situations. We also learn about his background and that for him a key factor is that he was born in 1959 when various events happened but again, for him, the most important was a scientific one when ttwo French scientists redefined death. It used to be the death was when the heart stopped functioning, but they have reasoned that it is when the brain stops functioning regardless of what the heart does. This of course is going to be a key in this story. He starts examining the data on Simon and at the same time we learn that Simon’s mother has been informed and that she drops off her daughter with a neighbour and rushes to the hospital. (She and her husband are separated but live fairly close to one another.)
We now follow her interactions with the hospital and with the doctor. She meets the parents of the other two boys at the hospital and, while they are both injured, they will recover. She has trouble getting in touch with her husband by phone and eventually does and he arrives at the hospital. Both of course are totally devastated and we learn their reactions in considerable detail. The doctor, Revol, carefully and gently explains the situation to them and the news is not good. Simon has brain damage and it is irreversible. At the moment he is only kept alive by machines.

We also meet Thomas Remige who deals with the organ transplant issues and the nurse, Cynthia Owl. As with the other characters, we learn a bit about them. We first meet Thomas when he is completely naked and singing. He is a very keen singer, as we learn. As for Cynthia, it is only her second day on the job and we learn about her various problems, particularly romance. Once they have seen the doctor, they then moved to Thomas who explained the situation to them and asked their permission to use their sons organs or transplant. Not surprisingly this comes to something as a shock to them and they drive away to discuss the matter but finally agree to it. We also learn the source of the French/English title. It is quoted by Revol and comes from Chekov’s play Platonov which he has never seen: What shall we do, Nicholas? Bury the dead and mend the living.

We now follow the whole complicated procedure of what is called harvesting which involves his heart, his kidneys and his liver with each organ destined for a different recipient in a different part of the country. Inevitably, we focus on the heart which is destined for a patient in Paris under the control of a doctor called Harfang it means snowy owl.) Again we learn about him and particularly keenness for competitive cycling.

The organisation of harvesting – the term they use – of the various organs is also fascinating. For the heart we follow Virgilio, a trainee doctor who is clearly of Italian origin but living and working in Paris. We learn about his life, including his messy love life, with a girlfriend who seems to enjoy throwing uncooked pizzas at him. He is also a keen supporter of the Italian national football team who are playing that night against France near the hospital and he’s of course very keen on following the result but will be unable to do so as he has to go and harvest the organ.

He and an assistant , Harfang’s daughter, set off in a special charter plane and are met by a special car and go to the hospital where Simon’s body is and we follow the entire procedure of harvesting various organs, including a certain amount of rivalry between the different hospitals who are collecting different organs. It is all done very quickly and smoothly and again they go back in special vehicles and of course caught up in the crowd leaving the football match, but Virgilio is very happy to learn that Italy win the match.

The whole operation is set up by the time the heart arrives. Claire, who is recipient of the heart is all prepared and we have learned about her previous life. She is a translator, translating Brontë sisters and she has three adult sons who are helping her. She has had one previous false alarm. When the heart turned out to be unsuitable on arrival which was a course quite disconcerting for her. And inevitably we learn quite a bit about the procedure and indeed history of heart transplantation..

This book had considerable acclaim in France and it is easy to see why. Firstly it is a fascinating account of the whole procedure involved in harvesting and transporting organs, which I suspect most people who have little no medical training have any idea about. Secondly, of course as always to de Kerangal tells a whole slew of interesting stories regarding the key characters, both dead and alive.

Publishing history

First published in 2014 by Gallimard
First English translation in English in 2016 by Maclehose Press
Translated by Jessica Moore