IJCS | Volume 33, Nº2, March / April 2020

187 actually met his father but created his own story from reports of others and his imagination, and touchingly illustrates an approach of heart failure disease and heart transplantation through a child’s eyes. In The heart and the bottle , a girl full of life and energy keeps her heart in a supposedly safe place – a bottle – after a great loss, which is represented in the book by an empty chair. In the story, one day, the girl felt very insecure as she found the chair empty. The girl then thought the best thing to do was to put her heart in a safe place, “just for a while.” She put her heart in a bottle, which she hung around her neck; “it seemed to fix things”, thought the girl. But since then, the girl stopped paying attention at the sea, and even forgot the stars... the bottle started to become heavy, “but at least her heart was safe.” Many years later, as she strolled on the beach, she meets a child, “curious about the world” as she herself used to be. The child asked her things she couldn’t answer anymore, not without her heart. At that point she decides to rescue it from the bottle but did not know how to: she tried to saw the bottle, to throw it from a great height, she used a stick... but nothing worked. But the “little girl, still curious about the world thought that maybe there was a way.” Her little hand managed to take the heart out of the bottle and “the chair was no longer empty”. This is beautifully illustrated in the book. We have been used the image of the empty chair with students and health professionals in a technique called visual literacy: 9 after the analysis of the image for a few minutes, participants are asked to write a text from a trigger phrase. In our case, the excerpt “the presence of absence” is used as the trigger in the dynamics. Conclusion In these four children’s books, the heart has been associated with topics little addressed in children’s literature: heart attack and infarction, the dichotomy emotional heart and biological heart, heart failure and heart transplantation, death and mourning. The use of this material in medical undergraduate programs can help promote a broader viewof the impact of any of these events on someone’s life, especially a child. Considering that cardiovascular diseases are the leading cause of death in our country and that, unlike most of developed countries, they affect younger adults, their economic and social consequences may be more traumatic in a family’s life. Maybe simple and poetic texts have the power to expand the perception of these conditions and their impact, by touching sensitive aspects of medical practice, and stimulating a critical posture in all the readers. Author contributions Conception and design of the research: Mallet A, Geovanini F, Andrade L, Kestenberg D. Obtaining financing: Mallet A. Writing of the manuscript: Mallet A, Geovanini F, Andrade L, Kestenberg D. Critical revision of the manuscript for intellectual content: Mallet A, Geovanini F, Andrade L, Kestenberg, D. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Bolsa Produtividade – Universidade Estácio de Sá - RJ. Study Association This study is not associated with any thesis or dissertation work. 1. Saramago J. The largest flower in the world. S o Paulo: Companhia das Letrinhas; 2001. 2. Charon R. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA.2001; 286(15):1897-902. 3. Charon R. Narrative medicine: honoring the stories of illness. NewYork: Oxford University Press; 2006. 4. Charon R, Dasgupta S, Hermann N, Irvine C, Marcus ER, Col n ER, Spencer D, Spiegel M. The principles and practice of narrative medicine. New York: Oxford University Press; 2017. 347 p. 5. Huainigg FJ; Ballhaus V. Daddy's heart is outside the compass. S o Paulo: Editora Scipione; 2010. 6. Lopes J, Marques CC. Hearts tomillions. Lisboa(Portugal):Editora Livros Horizonte; 2018. 7. Taylor M. The man's heart of popp.[Internet] {Cited in 2019 Jun 10]. Available from: www.marcotaylorautor.com 8. Jeffers, O. The heart and the bottle. S o Paulo: Editora Salamandra; 2012. 9. Capeloa Gil I. Literacia visual. Estudos sobre a inquietude das imagens. Lisboa:Edições 70;2011. References Mallet et al. A different heart in children`s literature Int J Cardiovasc Sci. 2020; 33(2):185-187 Viewpoint This is an open-access article distributed under the terms of the Creative Commons Attribution License