A Hole in My Heart (2014), by Rie Charles

This review was first published in Resource Links Magazine, “Canada’s national journal devoted to the review and evaluation of Canadian English and French resources for children and young adults.” It appears in volume 19.5.


Nora will never be happy again. Her mother has recently died, and her father has moved her to Vancouver to be closer to her older sisters, who are studying nursing at St. Paul’s Hospital. The year is 1960, and Rie Charles has nailed the historical moment. My mother graduated from Pen High in 1957, and from St. Paul’s nursing program in 1960. She taught me the “special tight corners and pulling the bottom sheet so hard your fingers almost fall off” (18) that St. Paul’s demanded of their students (my husband still teases me about them…). Like Nora, I was condemned to wear “saddle shoes,” and hated every minute of it, standing out from other students who had more graceful shoes or cooler runners. The foods Nora’s family eats, the clothes they wear, the names of classes at school, the level or responsibility 12-year-old Nora is given babysitting: these all bring back vivid memories. Adults will recognize the historical accuracy, but it is harder to convey the 1960s ethos to young readers today. Charles does a fairly good job, but occasionally over-explains things to the reader. For example, Nora’s cousin Lizzy – in Vancouver for open heart surgery – gushes to Nora when they wake up one morning: “I bet that’s Mum making her special applesauce to go with her usual at-home Sunday morning pancakes” (112). The girls have grown up together in Penticton, and are best friends as well as cousins: Nora would already know intimately her Aunt Mary’s special Sunday breakfast. Nora’s father tells her that he and Nora’s mother “both grew up just up the road from Penticton, in Summerland” (98), but anyone from the Okanagan (which Nora of course was) would know where Summerland is. Other things, too, like the complete elision of the Catholicism of St. Paul’s, or Nora checking the front step for milk in the evening rather than the morning, sit awkwardly with Charles’s poignant presentation of the internal struggles Nora goes through as her family grieves for their mother and worries about Lizzie’s upcoming surgery for Tetralogy of Fallot (“blue baby” syndrome), an experimental procedure at the time.

In the late 1950s, St. Paul’s was a significant player in the nascent field of pulmonary surgery research, one of the few non-university hospitals with a cardiac catheterization lab. As such, St. Paul’s was the site of a number of successful open-heart surgeries, the first performed in 1960 on a 12-year-old girl from Kelowna. It is not clear whether or not this historical moment was the impetus for Charles’s plot. Being able to link such an emotionally successful story with an actual historical incident would increase the power of the narrative, but there are almost certainly social or legal implications in telling the story of someone who is still living… Still, the parallels are real (for example, Lizzie is not the first such patient) and lend veracity to the overall narrative. Nora and Lizzie share a special bond, a friendship that helps them both to weather the uncertainty of Lizzie’s operation at a time when there was a real recognition that she could as easily die as live. This is the strength of A Hole in My Heart: the human players in this drama are honestly drawn and emotionally consistent. Despite the uneven historicity, the difficulties and ultimate success of Nora’s navigating her challenging, constantly changing adolescence make this novel well worth reading.