A Memoir and a Meditation on a Vital Organ

At a young age, Jeff Kosky was diagnosed with a congenital bicuspid valve defect—his heart didn’t function properly. The persistent back-and-forth between hospital visits escalated into an internal struggle between hope and anxiety. For Kosky, this instability formed a deep existential uncertainty about the philosophy of healing and what it truly means to have a heart. His memoir deepens these philosophical explorations by weaving together personal narrative and the experience of living with a chronic heart condition to ask fundamental questions about human existence: What does it mean to lose a heart?
Kosky begins by chronicling his childhood experience with his heart defect, showing how the condition shaped his identity and worldview. This journey led him to theology and philosophy, such as St. Augustine, who links one’s spiritual and physical identity to the heart. In Confessions, Augustine explores paradoxes such as the need to open and even wound the heart in order to heal the soul. Kosky expands on these ideas within the biomedical world of surgery, asking what it means to cut open the chest while trying to preserve the self. For him, the heart isn’t just functionally important, it spiritually and symbolically sustains our sense of self. A heart defect, then, imposes more than just physical limitations; it carries emotional and existential weight.
Drawing from the philosophical minds of Kierkegaard, Nietzsche, Marion, and Weil, Kosky ultimately invites readers to live with “heartfulness”: to be emotionally present, vulnerable, and grateful. Acknowledging and honoring the heart—both as organ and metaphor—is, he admits, an ongoing process. Nevertheless, his memoir is a beautiful reflection on the power of the body and its deep connection to our spiritual being.
Jeffrey Kosky has been a professor at Washington and Lee University since 2003. He earned his bachelor’s from William’s College and his PhD from the University of Chicago’s Divinity School. In addition to this novel, he has written “Arts of Wonder: Enchanting Secularity.
Reviews and Endorsements of this Publication include:
“Kosky has written a book unlike any other I know. In this meditation on having, losing, and regaining his heart, he sometimes wears his heart on his sleeve, sometimes scrutinizes it from a distance. He tells a philosophical story that creates a space in which you, too, can meditate on what happens to your heart for as long as it beats, until it stops.” – Lars Svendsen, author of A Philosophy of Hope
“Jeffrey L. Kosky has a congenitally hurt heart. When that hurt became acute, surgery saved him—but for how long, and to what end? He engages those questions with a blend of intimacy and unsparing introspection that recalls Augustine’s Confessions. Have you, like me, survived heart surgery? This is a book for us. And even if you haven’t, it will do your heart a world of good.” – Jack Miles, Pulitzer Prize–winning author of God: A Biography
For more information on this publication, click here:
For more of “On the Lived Theology Reading List,” click here. To engage in the conversation on Facebook and Twitter, @LivedTheology, please use #LivedTheologyReads. To sign up for the Lived Theology newsletter, click here.