After being diagnosed with a serious heart condition and undergoing life saving surgery, Bernie made this work as a simulation of the human heart which takes at least two people to complete the experience. One person winds the heart pump in an antechamber, another operates the clockwork recorder and the third person observes the bouncing, breathing, beating and gurgling mechanisms in the inner chambers.

While Etiology of Innocence is based on Bernie's personal health experiences, the starting point for the installation was an engraving of Marey's 1871 heart simulation machine and his studies of how the blood flows around the body.