The Story of a Heart is a beautifully written account of how the lives of two families \u2013 both facing immeasurable suffering \u2013 become inextricably entwined through the donation of a heart from a nine-year-old girl with catastrophic brain injuries to a nine-year-old boy with end-stage heart failure.<\/p>\n
First published in 2024, with compassion and clarity, Rachel Clarke draws readers into the details of the lives of Keira Ball\u2019s family, who made the decision to donate her organs when they realised that she wasn\u2019t going to recover from the injuries she suffered in a car crash which also left her brother Bradley and her mother Loanna seriously wounded. <\/p>\n
\u201cI couldn\u2019t stop thinking about this story when I first read about it in 2017,\u201d explains Clarke, a palliative care doctor and former broadcast journalist.<\/p>\n
The two families had told the story of their meeting to journalist Jeremy Armstrong. This meeting broke all the rules of anonymity, usually sacrosanct in organ donation protocols. It came months after Loanna Ball reached out to Emma Johnson, the mother of Max, after the Ball family received their anonymous letter of thanks.<\/p>\n
In her Facebook message to Johnson, Ball wrote: \u201cI think you may have our daughter\u2019s heart and it\u2019s the most beautiful heart in the world.\u201d<\/p>\n
Max\u2019s identity was already public after the Daily Mirror had earlier told the story of his long wait for a heart transplant as part of its campaign for opt-out rather than opt-in legislation for organ donation. (When the legislation for opt-out organ donation was introduced into Britain in May 2020, the law was called Max and Keira\u2019s Law). <\/p>\n
![\"The](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/06\/5V5C4GD26JB2VOICP7BTPADTVI.jpg\")
The Story of a Heart will bring readers to tears again and again as the details of parents and siblings spending time with their youngest sister before she died are told in parallel to that of a young boy, hanging on by a thread, knowing that he will die without a heart transplant <\/p>\n
Clarke made contact first with Keira\u2019s family, meeting them for several hours, asking them to consider her telling their story. \u201cThey immediately said yes, but I gave them a few months to change their minds. When they didn\u2019t change their minds, I approached Max\u2019s family and the NHS Blood and Transplant,\u201d she explains. <\/p>\n
Therein began four years of research and interviews with family members and key health professionals who cared for both children and worked on the transplant teams. <\/p>\n
The Story of a Heart will bring readers to tears again and again as the details of parents and siblings spending time with their youngest sister before she died are told in parallel to that of a young boy, hanging on by a thread, knowing that he will die without a heart transplant. <\/p>\n
In June, Clarke won the 2025 Women\u2019s Prize for Non-Fiction<\/a> for her extraordinary book. The prize, which complements the long-running Women\u2019s Prize for Fiction, was first awarded in 2024 after research found that female non-fiction writers were less likely to be reviewed (26.5 per cent of non-fiction reviews in national newspapers were allocated to female writers) or win prizes than their male counterparts (one in three prize winners across seven UK non-fiction prizes over the past 10 years were women).<\/p>\n In the story, Clarke writes: \u201cFrom the moment Keira was fatally injured, her heart began a journey so momentous it was scarcely believable. First, there was the emergency chest compressions at the scene of the crash\u2026 Next, the strange metaphysical limbo between life and death as Keira lay in intensive care, warm, flushed, apparently sleeping, yet somehow \u2013 unfathomably – brain dead. Then, the moment when her heart was stilled by an anaesthetist\u2019s drugs so that the surgeons, silently at work within the cave of her chest, no longer faced a moving target.<\/p>\n \u201cFrom there, the light-aircraft dash halfway across the country to deliver the organ, chilled on ice, into gloved and poised surgical hands. Finally, the intricate knitting of the heart\u2019s great vessels into another child\u2019s torso \u2013 and the agonising wait to see if its chambers would resume their vital work.\u201d<\/p>\n As well as telling the personal stories so sensitively, Clarke weaves through the book rich details of medical research and history. Such as the origins of intensive care units or the importance of immunosuppressant medicines or how the heart is the first of our organs to form and the last to die. Or how, one in five children die while waiting for an organ transplant.<\/p>\n She also includes details such as how surgeons will sometimes write up operation notes for teddy bears, used for comfort, distraction and to demonstrate to a child certain procedures. And how a nurse can find time to bring a distraught sibling for a hot chocolate while his younger brother lies in hospital close to death. <\/p>\n Clarke draws readers into the lives of these brave and dignified families sharing a time in their lives when they are at their most vulnerable. \u201cHow Keira\u2019s family in the darkest, bleakest circumstances can summon all their strength to look outwards to save others from the fate that befell them,\u201d she says.<\/p>\n [\u00a0How to be an organ donor: \u2018The surgeon said he wasn\u2019t going to take my kidney out if I wasn\u2019t sure\u2019Opens in new window<\/a>\u00a0]<\/p>\n Keira Ball\u2019s family have since set up the charity, Inspired by Keira, to raise awareness of the importance of organ donation and to support families in the south of England confronting the sudden loss of a child. <\/p>\n And while she chronicles in detail the \u201cthe modern day miracle of transplantation\u201d and the hundreds of health professionals who make it happen, Clarke is also cogently aware that more organs are needed to be donated. \u201cWhen then [UK] prime minster Theresa May brought in the legislation for opt-out organ donations, it was to be called, Max\u2019s Law,\u201d explains Clarke. But, after Max himself said it should be called, Max and Keira\u2019s Law, it was.<\/p>\n Seven years on from his transplant, Max Johnson has just completed his GCSE exams. <\/p>\n Similar legislation to allow opt-out rather than opt-in (ie, assumption that the person agrees to donating their organs unless they have specifically registered their objection to it) was introduced into Ireland in June 2025<\/a>.<\/p>\n \u201cChanging the law has helped but not as much as people thought. Awareness is what counts. Make sure that you have signed opt-in for organ donation on your driver\u2019s licence and tell loved ones what your wishes are and ask your family members and children what their views are on organ donation,\u201d she says. <\/p>\n Because, in spite of the opt-out legislation now in place in Britain and Ireland, ultimately, it\u2019s the family who decides when facing the death of a loved one. \u201cIf that person\u2019s wishes to donate their organs are known, 90 per cent of families will say yes, but if that person\u2019s wishes are not known, only 40 per cent will say yes,\u201d explains Clarke.<\/p>\n Clarke says that studying medicine as a mature student, she has always \u201ccared about patients as people, not just body parts\u201d. She says that she firmly believes stories such as this display such deep humanity, making them an antidote to the depressing newspaper headlines and \u201cdoom scrolling\u201d that we all do. \u201cIt says something very profound about our species,\u201d she adds.<\/p>\n