“In 2017, a nine-year-old girl from Devon was involved in a car crash that left her with a catastrophic brain injury,” said Fiona Sturges in The Guardian. Knowing the person Keira was – someone who’d go “out of her way to rescue insects in distress” – her family immediately asked if she could donate her organs. Meanwhile, another nine- year-old lay on a hospital bed in Cheshire, “painfully thin and being kept alive with a mechanical heart pump”. Max’s heart had become “dangerously enlarged” after he’d developed acute cardiomyopathy; he and his family knew that only a transplant could save his life.
“In ‘The Story of a Heart’, Dr Rachel Clarke writes about the feat of modern medicine that allowed Keira to give life to Max by donating her heart.” Her book is many things: “a tender account of two families linked by tragic circumstances”; the race-against-time tale of the “transfer of a human organ from one body to another”; a history of the surgical innovations that made this possible.
Written in “evocative, empathetic” prose, it’s a work of startling power. By the time I’d finished it, “I was in pieces”. Known for her dispatches from the medical front line (notably “Breathtaking“, about working in a Covid ward), Clarke skillfully blends the “arresting and the informative”, said Isabel Hardman in The Spectator.
The story of Keira and Max keeps spooling back: to the first human heart transplant in South Africa in 1967, performed by Christiaan Barnard; to the development of life-support machines in the 1950s. Such diversions enrich rather than disrupt her story.
She also intelligently unpicks the ethics of organ donation, said Kate Womersley in the FT. Should donating be seen as an act of “radical kindness”, or a civic responsibility? What regulations can ensure a “transplant does not become a transaction”? Combining drama, scientific precision and “characteristic warmth”, this is Clarke’s “finest book yet”.
The word “heart-rending” doesn’t begin to cover many aspects of this story, said Helen Rumbelow in The Sunday Times. We see Max, “in the prison of his hospital bed”, telling his parents that he no longer wants to live. We see Joe, Keira’s father, standing outside the ambulance bay as his daughter’s heart – newly cut from her chest – “speeds away from him for ever”.
Nothing, of course, can make up for his loss, but the transplant does at least give “Keira’s death meaning”. Months later, Joe visited a now recovered Max, and put a stethoscope to his chest. “The ba-boom ba-boom of his daughter’s heart sent him a Morse code of love.”