The title alludes to the author's research into altitude sickness, involving storing yak hearts in the kitchen refrigerator. It's one episode in a compelling account of a medical career devoted to Nepal. The author and his family went there in 1969 with BMMF (now Interserve) to work with the United Mission to Nepal (UMN).

It's a lively, often humorous, account of expatriate life among the poor, spiced with comments. Lots of quirky incidents as West meets East: stresses and lifestyle plusses. The story continues after UMN with work as an army doctor and consultancy.

Dickinson insists it's not a 'missionary' book; no accounts of church life, missiology or crosscultural issues. Nevertheless there's a profound underlying mission narrative. In 1969 there were just 500 Nepali Christians, with conversion and evangelism punishable by imprisonment. Today Nepali Christians number 800,000. As in China, a persecuted minority learned to share the faith and grow the church with little outside help. UMN did no visible missionary work; its contribution will only be known in the annals of eternity.

A case study for the western health professional considering service long-term in a resourcepoor context: learn the language, be flexible, do research and get it published, acquire networking skills and, most importantly, love the country and its people.