John Lysaker connects with Jeffrey L. Kosky’s “From the Heart: A Memoir and a Meditation on a Vital Organ.”
From the Heart: A Memoir and a Meditation on a Vital Organ by Jeffrey L. Kosky. Columbia University Press, 2025. 344 pages.
CHARLES ARROWBY, the protagonist of Iris Murdoch’s The Sea, The Sea (1978), spends most of the novel learning about the “secret vital busy inwardness which is even more remarkable than our reason.” The author has in mind the most basic ways in which we attend and respond to the world, including ourselves. It is telling, however, that something so vital is also regarded as secret. Is it that we, in our inwardness, keep it from others? We might, but Murdoch’s point, even her experience, is that our fundamental and most decisive orientations are often lost to theoretical reflection and cultural inheritance, even (in Cora Diamond’s term) “deflected” by them. Yet the moral of such failures is not to defer to untutored spontaneity. Rather, it is “advisable,” Murdoch argues (in her 1956 essay “Vision and Choice in Morality”), “to return frequently to an initial survey of ‘the moral’ so as to reconsider, in the light of a primary apprehension of what morality is, what our technical devices actually do for us”—and even to us, I would add. But how, and on what terms?
Jeffrey L. Kosky’s From the Heart: A Memoir and a Meditation on a Vital Organ (2025) is a text of recovery, in this and other senses. It “weaves together philosophy, religion, literature, and the arts with a personal narrative told in the context of medicine and medical history to reflect on matters of life and death, the ‘big questions’”—principally, who am I, and how should I be whoever that is? One recovery concerns valve replacement surgery, which Kosky underwent to address a congenital defect, a “bicuspid rather than tricuspid aortic valve.” But another, ventured in part for his students, concerns not losing heart such that one can find a way to follow one’s heart in a heartless world. (Such puns pervade the book.) And still another involves Kosky’s efforts to find a heartfelt language he can rely on to address the big questions with credible replies—replies that, in the manner of Thoreau, lead to a “kind of resolve or determination, not a resolution on this or that.”
En route to these various recoveries, Kosky engages a remarkable range of texts and images in an extended, learned, and deeply personal meditation. Augustine and Nietzsche appear frequently, for example, as does the physiologist William Harvey (1578–1657), who gave us, more than less, the idea that the heart is a pump. One also finds encounters with artists such as Jeff Koons, Yves Klein, Tehching Hsieh, and Christian Boltanski, each of whom is brought into the discussion as a possible source of insight and rejuvenation rather than a mere example of some more general point. It is thrilling when authors allow us to learn from artworks and not just about them. And if some of these names are new to you, know that they were to me as well, and that is one of the joys of the book. It opens doors for further exploration, and in a deceptively effortless way. Kosky never brandishes his learning for its own sake but puts it to work in an inviting manner, even when he is exploring the physiology of the heart or the history of open-heart surgery. I learned much reading this book and can’t imagine that others won’t as well.
It’s hard to write about matters of the heart. Kosky worries about his own prose via a friend, Tria, who tells him his writing, in its “shiny, wonderful and endearing package,” is not unlike Hanging Heart by Jeff Koons, which Kosky finds steely, calculative, even impenetrable. Moreover, through Augustine, Kosky repeatedly tells us that “when matters of the heart are taken up in confessing them, it is in unknowing ignorance […] of how these matters will turn out.” Listening to your heart might end in deflection, for example. Or, and this is Tria’s concern, the ragged might be smoothed over. “How does anyone mouth the fears and uncertainties that come with having a heart[?]” he is thus led to ask.
Kosky faces surgery at 50, and it terrifies him. It also provides his text with its central conceit. Who should he resolve to be in the wake of his operation, which will stop his heart and hand its work over to a machine? Moreover, the procedure will need to be repeated, although he eventually will be too old to undergo it. “My days are numbered,” he realizes.
I was taken aback by this opening gambit, and not because I view the heart as just a pump. Nor do I consider invasive surgeries minor affairs. I, too, would have felt fear, and like Kosky, I see the need for a construct that orients us for future forays. More importantly, I, too, think such a construct needs to circulate where our aspirations meet the world and where the world finds us, as when a loved one’s arrival quickens our heart or we lose it to despair. We are, as Kosky says, a nexus—interactions through and through. And the amazing figurative reach of “heart” recommends it as a name for that nexus, particularly when thickened by the histories Kosky recalls throughout.
Yet, and this was the source of my unease, all days are numbered, and we have always lived through the cooperation of forces beyond our control. One day the earth itself will cease to exist, as the sun does what suns do when they go to die. But my unease is more general than this. When Kosky asks “How does anyone mouth the fears and uncertainties that come with having a heart,” he closes the question with “especially when its constitutive defect is laid bare?” Call me cold, but I am unconvinced that this “especially” is warranted. Matters of the heart arise because we live with and through others, and in a manner that is, to some degree, up to us. Or, in Kosky’s words, in our hands.
But it is also in the hands of others such as surgeons and friends, a thought that Kosky aligns with secularization. And that offers, I think, a more promising line of recovery than the more typical path through encounters with our mortality: “I inhabit the secular condition resolutely and affirmatively when I give my heart to another, find it in the hands of strangers even, in the days before the end of the world and time and therefore without the possibility of a final judgment.” This is more than a wake-up call; it reorients. Harden not your hearts, you who would not lose the world and thereby yourselves.
On Kosky’s terms, this move away from theological registers is not only secularizing but also disenchanting, and his reflections on the matter, woven into rich medical histories, unveil a conundrum. Who am I in the chambers of my heart? (Many have asked their neurologists similar questions.) As Kosky hears it, William Harvey’s modern heart “looks […] less like [a] source of recovery and more like what lets us avoid having to confront the question of recovery.” I concur. The heart that Harvey imagines doesn’t resolve to do anything, let alone while facing questions of how and why. Like the rose, it’s a poor image for those wondering how to go on. And I can see how, for medieval Christians, learning about the physiology of the heart might prove disenchanting, further evidence that our self-image derived from so many false beliefs.
But might the very terms of that learning prove enchanting? Might the theological explanation be the reductive one? Reductionism replaces a complex set of causes with a simpler set, and what could be simpler than a larger-than-life agent authoring it all? Kosky avoids this path, however, confessing: “I am strung out, caught between the doctors and the poets.” I would have liked fewer duck/rabbit reversals (my heart versus that pump) and more inquiry into how to sing the body electric, which calls for its own poetry (A. R. Ammons comes to mind).
But maybe the history of medical progress is what disenchants Kosky, given how many die along the way. He finds that history heartless, even evil, as it progresses relative to various positives, including the surgery that saved his life. Now, one might want to talk about the sacrifices people made to make that history possible, but Kosky properly refuses that dodge given how many never wanted to die so that others might live … longer. And that mood haunts his recovery with a guilt and sadness that refuses to become a prayer of thanksgiving, settling instead into feelings of indebtedness, guilt, luck, and contingency. I very much appreciated his insistence on this point, and the suggestion that we not regard negative affects as completely alien to thanking. “Maybe we shouldn’t be so reluctant to take those feelings on,” he writes, “so eager for therapies that promise a happiness free of them?” Here, then, is a second recovery that I found reorienting. The open heart knows it’s not all good and does not despair.
Circulating through guilt and gratitude, disenchantment and admiration, Kosky seems reluctant to think of his postsurgery resolve in moral terms, even though one answer to the question who am I? proceeds through the kind of life to which I commit. But he doesn’t take that path, although, at certain moments, he does imagine a kind of grace, even humor, that confronts the hardness of life and remains unbowed. Despite “the gravity of the inevitable end, the grave anticipated in every moment of the work; and despite the sadness inside me, the sad weight of the world taken in me—despite it all, a smile rises up” in a “place suspended between laughter and tears where the heart and its grave logic are found to play.”
The deep Nietzschean roots of this thought might explain Kosky’s aversion to moral language. But smiling while doing what? And how? These remain pertinent questions, and they need not be posed with the manifesto-like didacticism that Kosky finds so disheartening in his last chapter. Nor are they reducible to politics, whose rule of law renders us substitutable and so not worth the bother, at least on our own terms. Rather, a recovery of the moral—and this holds for thinkers as diverse as Ralph Waldo Emerson, Simone de Beauvoir, James Baldwin, Iris Murdoch, and Stanley Cavell—unveils precisely those interactions in which we find ourselves in others’ hands and others in ours, and it prompts us to consider how we live as a nexus. Patiently? Generously? Or, like Charles Arrowby, lost to vanity and jealousy? (Note, each can be done smiling.)
Kosky would no doubt tell me: “At its best, religion [and the humanities in general, and his book,] provides a time and space where such questions can be admitted and so owned as constitutive of being human.” Indeed. And that, like the journey this book afforded me, ain’t nothing. But to leave it at that, and to take the heart with you, is to unduly risk heartless replies.
LARB Contributor
John Lysaker is William R. Kenan University Professor at Emory University and director of its Center for Ethics. He is the author of multiple books and scores of articles, most recently Hope, Trust, and Forgiveness: Essays in Finitude (University of Chicago Press, 2023).
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