There’s a reason that people associate love with the heart: they’re both pretty darned complicated and more than a little scary when something goes wrong. But unlike the intricacies of love, we understand most of what goes on in the human heart.

We understand heart disease, the buildup of plaque in the arteries and the impact of cholesterol and high blood pressure. And, when we’ve exhausted all other treatments, we know how to take a diseased heart from a patient and replace it with a healthy one from someone who had the good fortune not to suffer heart disease or a chest trauma. There are scientists hard at work in labs around the world, attempting to grow a human heart with our newfound cloning and DNA mechanisms. It’s amazing.

In the giant building where I work, there are forty-seven elevators in fourteen elevator banks. Three of those banks (eight elevators) are service-designated, ostensibly for the express purpose of patient transport. Ten elevators belong to various clinics and are frequented by outpatients and homeless people who have little else to do but slog around the hospital. Two elevators service an office section, two run back and forth between the street-level and the lobby. That leaves thirty-three elevators that I could, in theory, take to my office every day.

There are four chambers in the human heart: two ventricles and two atria. The left atrium is responsible for coronary blood flow, the heart’s own blood supply. The other three chambers support systemic circulation, pumping approximately 5 liters of blood around the body every minute while at rest. Three hundred liters an hour, over seven thousand liters per day.

Almost ten thousand people come to work on this campus every day. They filter into the medical school, the clinics, the nursing school, the college of pharmacy, the outpatient clinics, and the hospital itself. Approximately four thousand of those people belong in my building. These are the people who, along with the scads of visitors who come bearing flowers and inappropriate gifts, ride my thirty-three elevators.

Over two thousand heart transplants are performed in the United States every year. My illustrious institution claims one of the best heart transplant survival rates in the country, well above the national average.

It blows my mind sometimes to think of all the incredible work that is done in this building. Our surgeons can remove a heart, re-route the patient’s blood through a machine, and in the space of a few hours, perform a delicate revascularization of the most important blood vessels in the body, and give the patient a pre-owned healthy heart. And our elevators are always making scary clunking noises, cutting off the limbs of those who don’t step out of the way in time, and often completely breaking down.

One morning I waited for seven minutes at the elevator that puts me out closest to my office. I heard it moving in the shaft but it never stopped on the main level for me. So I walked down the hall to the next set and was greeted by a friendly sign asking me, as an employee, to please excuse the inconvenience and use a different set of elevators as this one was being upgraded and should be reserved for patients and visitors. The sign had been there awhile and was covered with a visible layer of dust, accented with a cobweb. I turned the corner and wandered to the next bank, now ten minutes late. I pressed the “up” button and immediately three elevators appeared, all heading down. Figuring it would be a short wait, I stayed – there’s only one floor below main for them to go to. One popped back up, stuffed to the gills with stretchers and an x-ray machine. One zoomed past without stopping (why, why?!) and the third one must have sunken into the earth because five minutes later, it still hadn’t reappeared. The other three elevators in that bank of six never made an appearance.

I took the stairs. By the time my heavy bag and I reached my office (seventeen minutes late), my heart was pounding in my chest and it occurred to me that heart surgery ought to be a lot more complicated than elevator maintenance. And it’s odd, isn’t it? One of the best hospitals in the country can turn out such a fantastic success rate in the heart transplant department but can’t get our elevators to stop on the main floor.