Meanwhile, Marianne blames herself for not doing enough to protect Simon from his reckless lifestyle, but she eventually realizes that allowing him to lead his life the way he did was the best thing she and Sean could've done for him. Ultimately, Sean and Marianne allow Simon to be an organ donor, which is a milestone towards their gradual acceptance of his death and moving on. "The Heart" also focuses on the psychology behind the refusal to donate a deceased loved one's organs, even with the knowledge that someone else's life can possibly be saved. Sean, who is the most resistant to donating Simon's organs, expresses his desire to preserve his son's body and is repulsed by the idea of it being cut up and destroyed during the operation. To the Limbres, Simon's body is not merely a large mass of skin, tissue, muscle, and bone; it is a tangible symbol for his life, for his existence on Earth, and for the impacts he made on the lives of those who loved him most. In essence, Simon's body serves as a memorial in dedication to his life, and ruining it would diminish his memory and legacy. Although Marianne and Sean eventually give their consent for Simon to be an organ donor, they refuse to donate his eyes, thus showcasing the symbolic differences between each organ. In 2007, after watching a television report on heart transplantation, Maylis de Kerangal wrote a short piece titled "Swimmer's Heart for Compatible Woman's Body" for "Who is Alive?", a compilation book commemorating the 10th anniversary of the French publisher Éditions Verticales. Over the next five years, de Kerangal experienced personal grief and revitalized her interest in heart transplantation, which inspired her to write about the heart not just as an essential organ in the human body like she did in "Swimmer's Heart for Compatible Woman's Body", but as a source of love, emotion, and humanism. She subsequently began writing "The Heart" in July 2012. While developing and writing the novel, de Kerangal consulted with an organ transplant coordinating nurse at the Biomedicine Agency in Saint-Denis, France, who educated her on the legal aspects of organ transplantation and the process of obtaining consent from family members of the deceased. She then met with an emergency physician at the agency who introduced her to Cristal, a software that stores medical records, serves as a database of patients awaiting organ donations, matches donors with suitable recipients, and protects their identities. Finally, de Kerangal observed an organ transplant operation led by Dr. Pascal Leprince, the head of cardiothoracic surgery at Pitié-Salpêtrière Hospital.