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The powerful account of one child's gift to another

Western Mail

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September 13, 2025

Leah McLaughlin on how one family’s decision to donate an organ brought hope amid the darkness of grief

WHAT does it mean to save a life - and what does it cost? In The Story of a Heart, Rachel Clarke answers this not with slogans or sentiment, but with quiet, searing honesty.

This book, which won this year's Women’s Prize for Non-Fiction, is about organ donation, yes, but it's also about family, grief, love, courage, and the astonishing edges of human experience.

At its centre are two children: Max Johnson, a healthy, active nine-year-old whose heart suddenly begins to fail, and Keira Ball, another nine-year-old - vibrant, horse-loving, full of life who tragically dies in a car accident. Ina moment of unimaginable grief, Keira’s parents donate her organs. Her heart goes to Max.

Achild dies. A child lives.

‘That is the simple, brutal, beautiful truth this book never looks away from. But Clarke does more than tell the story of a heart. She immerses us in it ~ every breath, every monitor beep, every unbearable choice.

Tread this as a health services researcher who has spent years working in the emotionally complex, ethically charged, and often hidden world of organ donation. My work explores how families navigate these unimaginable scenarios, particularly in the context of recent legislative change. Clarke’s account captures, with rare precision and compassion, the silences, the emotional labour of clinicians, and the profound weight of choice that families like Keira’s carry.

As both a doctor and a mother, Clarke brings sensitivity to every page. We feel Max's steady decline: the exhaustion, the fear, the silence that descends as even the doctors grow unsure. We witness Keira’s final hours, the heroic efforts to save her, and the moments where unbearable grief oscillates between hope and despair, eventually giving way to a different kind of gift.

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