A Heart That Flew In on a Ship: Metaphor as a Bridge to Healing
My acquaintance with the National Medical Research Center named after V.A. Almazov began not with creativity, but with an ordinary visit. I came for a routine cardiology consultation. Before the appointment, I read about the center and realized that behind its walls, stories unfold on a far greater scale than my own. It is one of Russia’s leading cardiac centers, where heart transplants are performed even on very young children.
When I first learned that hearts are transplanted here to little children, my breath literally caught. It was a strange, almost physical sensation: a mixture of primal horror at the fragility of life and dazzling admiration for the human ability to give continuation to another person. In that moment I understood that medicine here has long crossed the boundaries of pure science and borders on a sacred act—one that requires not only a scalpel, but also the right words.
I imagined a child who was waiting. Not for a toy or a holiday, but for the very right to keep breathing. This feeling — a piercing ache mixed with enormous respect for science and for people—became the spark for new work.
I began writing a collection of stories and fairy tales addressed to children who are seriously ill and spend long periods in hospital. Dry medical language is powerless in the face of a child’s fear and the feeling of losing control over one’s own body. The first tale was dedicated to children who had undergone, or were about to undergo, a heart transplant.
Before I could explain it to myself, I realized I needed to explain it to a child. And the only language a child can truly bear is the language of story.
The New Heart
A story about change and acceptance
(A Little Heart Named Tick)
This is a story about a new heart. But to understand it, we must first meet the little heart named Tick who lived before.
Once upon a time, in the Land Beneath the Ribs, there lived a tiny but very brave hero. His name was Tick. He was a true Heart—round and pulsing, with a cheerful spirit and a strong rhythm: tick-tock, tick-tock!
For many years Tick worked hard, helping his little Human, a boy named Leo, run, laugh, jump and dream. But one day Tick grew tired. He had been beating bravely for a long time, yet he felt his strength slowly slipping away.
“Don’t worry, Leo,” Tick whispered softly one quiet night. “I have done my best. Someone very special will come soon to help us continue the journey…”
And so, on a gentle evening, a glowing airship floated into the Land Beneath the Ribs. A new guest had arrived. He, too, was a heart—but different. His name was Tock. He had come from a faraway, radiant place, carrying the love and hopes of another family.
“Hello!” said Tock warmly. “I haven’t come to replace Tick, but to carry on his brave work. May I stay and beat together with him?”
In his dreams, Leo nodded. Tock gently took his place, and from that moment on, inside Leo’s chest once again echoed the steady, familiar sound: tick-tock, tick-tock. The world seemed a little brighter.
Tock was kind, strong, and wonderfully attentive. He knew how to beat faster when Leo laughed, how to slow down when Leo felt sad or scared, and how to stay steady when Leo needed courage. Sometimes, at night, he told Leo quiet bedtime stories—tales he had once heard in other hearts where he had lived before.
Leo didn’t know exactly where Tock had come from. But he could feel it—this heart had arrived with love. And now, within him lived not one but two gentle heroes: Tick, who began the journey with all his heart, and Tock, who carried it forward with care and strength.
The End. (…and the heart keeps on beating)
Why This Works: Story as a Bridge
Children experience heart transplantation differently from adults. For them, it is not only physical rehabilitation but also a profound identity crisis: “Who am I now if someone else’s heart is beating inside me?”
For a child, the heart is not an organ — it is a companion. A rhythm they live inside. The metaphor in the tale performs several important therapeutic functions at once:
- Legitimization of fatigue. We allow Tick (and the child) to be tired. This removes feelings of guilt and shame.
- Reduction of anxiety. Organ replacement is presented as a kind relay of goodness rather than a catastrophe.
- Preservation of wholeness. In the end, both hearts live inside. Tick did not disappear — he gave the beginning, and Tock continued the path. The child keeps the continuity of their own story.
It is often thought that a fairy tale is a way to escape reality. For a seriously ill child, it is the opposite. The fairy tale becomes the most honest form of truth. It does not hide the illness, but translates it from the language of medical catastrophe into the language of meaning and heroic journey. To say “you will have an organ replaced” is to state a breakdown. To say “Tock is flying to you to continue Tick’s journey” is to recognize the child as the hero of a great adventure.
Story as Therapy for Parents
Parents in the cardiac center are “hearts on the outside.” While they hold their child’s hand, their own inner storm often rages. The fairy tale becomes a safe space where one can speak about the fear of death and the joy of new life without naming them with frightening words.
Fear is not a failure. It is a form of love that has nowhere to go.
When a mother’s or father’s voice trembles while reading, it is not weakness—it is part of healing.
A Note for the Heart Outside
Words for the One Who Holds the Hand
Just being here is already an act of courage. You are reading this story together. Maybe your voice trembles, maybe you are exhausted, maybe fear lives somewhere deep inside — yet you are still here. That is already love.
Children don’t need you to be endlessly strong and perfect. They need your presence. Even if you sit in silence. Even if you don’t have all the answers. You are not alone. And with this story, we hope a little more warmth and light finds its way into your evenings.
Discussion Questions
For Children:
- Why do you think Tick grew tired?
- What helped Tick not to feel sad?
- Who is Tock and why did he come?
- If you had your own magical heart-friend, what would it be like?
- What makes you feel strong when you are very tired?
For Parents (additional):
- Which images in the story resonated with you most?
- How do you experience the moments when your child is “tired”?
- What does “continuing the journey” mean for your family?
Conclusion
For children who spend long weeks and months in hospital, the walls of the ward become almost the entire world. The author’s task is to push those walls back, even a little. I believe that when metaphor helps consciousness accept change, the body responds more readily. After all, hope is also a rhythm. Tick-tock. Life goes on.
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About the Author
Anatoly Loginov is a writer, educator, and clinical psychologist based in Saint Petersburg. His essay, “The Narrow Neck of Being,” appeared in the 15th‑anniversary issue of Asymptote (USA), where the editor‑in‑chief described it as a “tour de force.” His fiction has been published or is forthcoming in Space and Time Magazine, FlashFlood (UK), Flash Phantoms, Foofaraw Press, and the Kazakh literary journal Dactyl. He is the author of several educational and popular science books.