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High on a hilltop in the city of Edinburgh in 1874, the kindly and eccentric Dr. Madeleine indulges her love for mending people. She serves as a midwife to prostitutes and other desperate women, and houses their babies until she can find adoptive homes for them. For those with other health complaints but insufficient funds to afford a "qualified" physician, Dr. Madeleine also exercises her offbeat medical skills, fashioning prosthetic limbs and assorted parts from wood, metal, and other handy materials. On the coldest day in the history of the world, a young woman shows up on Dr. Madeleine's doorstep, brokenhearted and on the brink of giving birth. But when Little Jack emerges from the womb on this bleak and frigid day, something is terribly wrong: Jack has been born with a frozen heart.

The eccentric healing woman must act quickly to save the tiny baby's life. Dr. Madeleine's keen mechanical finesse unites with the jumble of miscellaneous objects cluttering her surgery, and she conjures a brilliant solution on the spot. Cutting open the newborn's chest, the doctor embeds a wooden cuckoo clock in the cavity, intertwining its gears with the vessels of Jack's little frozen heart. She winds the device, which soon sets the heart beating to a clockwork rhythm. When she stitches him up, Dr. Madeleine leaves the hands of the clock protruding from his chest; each morning, Little Jack must be wound with a key to keep his heart beating.

As none of the couples who come to Dr. Madeleine's house looking to adopt a baby are interested in taking a boy with a clock in his chest, Jack is there to stay. Highly protective of the delicate, mechanically enhanced child, Madeleine never sends Jack to school, and he leads a sheltered existence in the house on the hill until his tenth birthday. On that day, while on an outing in the streets of Edinburgh, Jack has a chance encounter with a little singing girl that changes the course of his life.

With a whimsical setup like this, the listener might have high expectations for an engaging and fanciful adult fantasy story. Unfortunately, The Boy with the Cuckoo-Clock Heart does not shape up that way. Jack's instant infatuation with the little singing girl, Miss Acacia, becomes an all-consuming obsession, one that leads him out of Edinburgh and across Europe, as well as into adulthood, heart ticking away all the while. Rather than meeting with grand adventures and memorable characters on his journey, however, Jack merely pursues, catches up with, and fights for the love of Miss Acacia, who seems to be such a shallow, petulant diva that the reader wonders why he bothered. Echoes of Pinocchio and the Tin Woodman are unavoidable, as Malzieu hammers home the idea that being the owner of a "real heart" brings both joy and pain.

The extraordinarily talented Jim Dale works hard to imbue this chilly story and its unappealing characters with some charm. The warmth and energy of his voice do what they can, but ultimately fail to thaw the tale's hard, frozen heart.

Sarah Trowbridge reads (and listens) compulsively, chronically, and eclectically. She is a public librarian in a suburb of Atlanta, Georgia.