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Tim Crouch’s original work – My Arm, An Oak Tree and now this “play for galleries” – begins to suggest that he is not really a theatre-maker as such, but more a conceptual artist who works in the medium of the performed word. Unfortunately, that label conjures up connotations of abstruseness and solipsism that are far removed from what Crouch does. Without pretension, seemingly almost without effort and in a bare hour, his simple words and open, direct approach to the audience encase complex groups of ideas that leave you musing long afterwards.

Here he and his co-performer, Hannah Ringham of Shunt, deliver intercut lines from a single narrator- character that alternate discussion of the character’s art-dealer boyfriend and his wealth with a gradually emerging account of the narrator’s own heart disease. But there is more to it than that. Because the performance takes place in a gallery (amid an exhibition of photographic works by Alex Hartley), the visual element is present even when it is absent from the staging. “Look,” Crouch and Ringham keep saying: look at my flat in Southwark, look at the view ... it sounds like an account of an imaginary exhibition; the one that is on the walls and in the space around them (to which they also occasionally refer) does not clash or conflict with this imaginary visual world so much as set up patterns of reverberation from which more meanings emerge.

Add the themes of art as commerce, as commodity, and we are already in complex territory; add Crouch’s characteristic oblique approach to the reality and illusion of performance, and it becomes more complex still: if we are at once in Southwark and in Edinburgh, in a real and an imagined gallery, if Crouch and Ringham are both a single character, where does the “truth” of the account begin and end? And why that title England?

An answer to the latter question emerges in a second act, more conventionally staged though still in a gallery space. We infer (it is not explained) that the narrator has now undergone a heart transplant, that it occurred abroad (in an Islamic country, we gradually gather), and that he (or she) has returned there to meet the widow of the man whose heart was used in the operation. The semi-echoey style of the first act mutates into a set-up where one performer is the focus character, the other an embassy official translating; we hear how long speeches are distilled into single remarks, how ideas are boiled down and begin to realise that like this encounter, the whole piece – any artwork – is literally a matter of interpretation.

When the matter of nationality emerges it bears no relation to crass little-Englander stupidity, but more subtly enacts the matter of cultural barriers to communication and understanding. Some are physical: “Hard to see how they’re feeling with just the eyes,” says the narrator, referring (we imagine) to the widow’s niqab. Some are intangible, as the widow’s account of her husband’s medical “murder” following his injury in a bomb attack overruns with the narrator’s attempts to show gratitude by presenting her with a valuable work of art. As one of them remarks, you would not know from the outside what a heart is like ... whether it is the organ or the feeling core of a person’s identity.

Almost tangentially, Crouch gives the most compassionate and salient account of difference I hope to see on a Fringe which this year is awash with Middle East-themed work. He also confirms himself as a uniquely engaged collaborator with his audience’s imagination and thought processes. In many ways, this is nothing like theatre as we usually understand it, and yet in crucial elements this is its very essence.

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