August 2, 2025 • 15 mins
Dr Rachel Clarke is a palliative care doctor with the NHS in the UK, and she's utilised her experience to write several books about the medical industry.
Her bestselling book Breathtaking inspired a tv show and her latest book The Story of a Heart recently won the 2025 Women’s Prize for Non-Fiction.
The Story of a Heart centres on 9-year-olds Max and Keira, and it has been described as story of grief and hope and compassion.
"I came across this story when Max's face appeared on the front page of a newspaper that I happened to read, he looked desperately ill. A few months later, his face appeared again and it was rosy-cheeked and brimming with health."
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Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudgin
from News Talks EDB.
Speaker 2 (00:13):
Doctor Rachel Clark is a palliative care doctor with the
NHS in the UK. She's also the author of some
very successful books based around her career in the medical industry.
Her best selling book Breathtaking inspired a TV show, but
her latest has made her an award winner, and with
very good reason. The Story of a Heart has won
the twenty twenty five Women's Prize for Nonfiction. It centers
(00:35):
on the stories of nine year olds Max and kra
And it's a book about innovation, grief and hope and
it quite literally reduced me to tears. Doctor Rachel Clark
joins me from the UK. Good morning, Rachel, Good morning Rachel.
Why did you want to write about organ donation?
Speaker 3 (00:54):
Well, all the way back to the medical school, I
was completely captivated by organ donation, even though I didn't
become a surgeon, let alone a transplants in myself. I
just thought this idea that we are capable, thanks to
medical science, of removing a warm, living organ from somebody
(01:18):
who has usually very tragically perished, but then we can
send it sometimes hundreds thousands of miles away to another
hospital and save the life of another adult or child.
Completely astonishing. I think that organ donation is just a
triumph really of medical science, and I was always fascinated.
(01:45):
I witnessed some organ surgeries during my training, and then
I came across the story of little Max and Kira
when I had much later specialized in palliative medicine my specialty.
That their story just stopped me in my tracks.
Speaker 2 (02:05):
It is an incredible and it's it's a fantastic way
actually to write a book around organ donation, Rachel, because
there's more to the book than just this story. We
get a lot of medical history and things, and I'll
get to there a little bit later. But and I
hate to use the pump, but they are at the
heart of the story. So can you tell me a
little bit about Mex and Kira.
Speaker 4 (02:26):
Yes.
Speaker 3 (02:26):
So, in the UK a few years ago, in twenty seventeen,
there was a big campaign to change the law around
organ donation to an opt out system. So it's assumed
that you would be happy to consent to all the
donation unless you've said otherwise. And a little boy, Max,
(02:49):
who was nine years old, became one of the children
whose face one day appeared on the front of a
British newspaper as part of that campaign. He had been
waiting for a heart transplant for many, many months. He
was desperately ill, and almost at any moment he was
(03:09):
sick enough to die, and his mum agreed to tell
his story in public in the hope that it would
help change the law, and also maybe people would think
about children and adults like Max and have the conversation
with their loved ones about donation. So I came across
(03:31):
this story when Max's face appeared on the front page
of a newspaper that I happened to read.
Speaker 4 (03:37):
He looked desperately ill.
Speaker 3 (03:39):
Then a few months later his face appeared again, and
now it was rosy cheeked and brimming with health because luckily,
at the eleventh hour he had received a transplant. And
then a few months after that, the extraordinary thing happened.
One day, two families appeared on the front page of
(04:00):
the Mirror newspaper, and Kira, the little girl who had
tragic he died in a car crash and whose heart
saved Max's life. Her mom had worked out from the
publicity that her heart had probably saved Max, and she
got in touch with Max's mum and sent her a
message via social media saying, I think your little boy
(04:23):
has our daughter's heart and it's the most beautiful heart
in the world. And the two moms started communicating, and
that culminated in both families meeting in person, and one
by one, Kira's mom, dad, and siblings all lined up
and listened to her heart with a stethoscope beating inside
(04:44):
the chest of the little boy whose life she'd saved.
And when I read that story, I couldn't think about
anything else. I knew it was one of the most
extraordinary stories I'd ever hear, and that gave me the
idea as a writer to write a book about this
extraordinary journey of Kira's heart. That would be a way
(05:06):
of telling this wonderful, wider story about the medical miracle
nat Is transplantation.
Speaker 2 (05:12):
Kira's family and Kira are quite extraordinary people. They make
the selfless decision at the worst possible moment in their lives.
How do humans find the capacity to deal with the
question of a loved one becoming an organ doner.
Speaker 3 (05:28):
So it is I think the most extraordinary aspect of
this story and indeed, every successful story at the Center
is a family going through the most unimaginable grief devastation.
Often there is a sudden accident, like a car accident,
and this family is having to come to terms with
(05:50):
the fact that someone they love so desperately maybe appears
to simply be sleeping, but because of brain injuries, their
brain has died. They can no longer live. And it
is remarkable how in those times of utter darkness people
have a capacity to draw upon reserves of resilience and
(06:14):
generosity and sheer radical altruism that they might not even
have known they had.
Speaker 4 (06:21):
And that's exactly what Kia's family did.
Speaker 3 (06:24):
So I interviewed both families and all the medical staff
involved in this story, and incredibly, nobody even brought up
organ donation with Kira's family.
Speaker 4 (06:35):
Her sister, a little.
Speaker 3 (06:37):
Girl who was only eleven years old at the time,
called Caitlin, turned to the intensive care doctor and said,
can we donate Kierra's organs? And the doctor said she
had never ever encountered a child asking that question before,
so she was taken aback, but she said, yes, of course,
if that's what you want, And then little Caitlin turned
(06:59):
to her dad and said, Dad, we have to do this.
Kira is such a kind girl, she's so loving, you know,
it's what she would want. And Kira's dad, Joe said, yes,
you are totally right, we must do this. And I
just think that's a in a way, that's an emblem
and microcosm of everything that people are capable of. We
(07:23):
often hear bad news stories. There is so much violence, wars,
worrying stories around the globe. But fundamentally, people can be
and are extraordinary, and very often when they're in the
darkest circumstances themselves.
Speaker 2 (07:40):
For the recipient, this relief that you know, maybe the
only option leaf to save their life is possible as
going a heat, but it comes with their guilt of
knowing that someone else has died and that other people
are suffering. It's tough, isn't it.
Speaker 4 (07:56):
It's really tough.
Speaker 3 (07:57):
And Max, although he was only nine years old, he
understood this terrible arithmetic of of organ donation. For him
to live, someone else would have to die and no recipient,
and no recipient family ever wants a tragedy to happen
(08:19):
to another child, another adult. All they hope is that
if a tragedy happens that family might consider this act
of altruism because it's the only way their loved one
can live. And Kia is a beautiful example of that.
There were two children and two adults whose lives were
saved thanks to Kia and the generosity of her family,
(08:42):
And now every single day her father, Joe told me
he thinks of Kia, and he thinks of what a kind,
gorgeous girl she was, and how proud he is of
her because she has that living legacy. So sometimes, although
this is a story that involves heartbreak, organ donation can
(09:04):
give families a huge amount of comfort.
Speaker 2 (09:08):
In a Max's case, it wasn't end for his family.
It wasn't just the relief of getting the hat. You
then have to get your head around what is going
to happen, which is essentially that surgeons are going to
cut out Max's hat, which is tend to amount to him
dying in place a new one and in hope that
(09:30):
it works. I mean, there is also a lot for
a patient to get the head around, isn't it?
Speaker 3 (09:35):
Absolutely so, I think, And actually it's a lot for
the surgeons as well. So I interviewed Max's surgeons and
everybody Max, his family, his surgeons, they all talked about
the enormity of the surgery. If you think about it objectively,
it almost sounds like science fiction. So first of all,
(10:01):
a major artery and a major vein in Max's body
was connected to a bypass machine that oxygenated his blood
outside the body. And these machines they look like science fiction.
There are kind of mass of wires and tubes. It's extraordinary.
(10:23):
And then you have to literally saw the breastbone in
half and manually pull the rips apart. And then of
course you have to remove the heart. And surgeon are
staring at an empty chest. There is nothing there where
the heart should be. And to all intents and purposes,
(10:45):
unless you successfully stitch the new heart in, you have
killed the child. So everything rests on your skill and
your fingers and all your surgical training, and you have
to keep an utterly cool head under pressure and perform
this vital surgery. And of course that's exactly what successfully
happened in Max's case. But he was very, very frightened
(11:08):
before the surgery, and his family were absolutely terrified. You know,
on tend to hooks, just waiting hour by hour by hour,
hoping the news would be good. And in the old days,
heart transplants were a real lottery, more many more people
died than lived. But today, because the surgeons are so skilled,
(11:32):
the vast majority of people do survive. At least they
certainly survive the surgery itself, but you always have to
worry about rejection of the organ. You take very very
strong and unosuppressant drugs for the rest of your life.
And thankfully Max has thrived and today he is this strapping,
(11:53):
healthy six foot to sixteen year old boy. He's just
done his big exams in the UK GCSE exams and
he's looking forward to probably going to college. And all
of this is thanks to Kira and her family.
Speaker 2 (12:10):
We learn a lot about the history of trainsplants in
the book, which I found really fascinating. But also it
hadn't really occurred to me that there had to be
so many medical advancements before trainsplants were even possible. You
talk about the creation of the ICU or bypass, all
these things. Rachel, It's fascinating.
Speaker 3 (12:28):
Yes, And that was an aspect of writing a book
that I love, delving deeply into the history because always
with medicine, once a breakthrough happens very very quickly. We
take it for granted. So if you think of the
COVID nineteen pandemic, the thing that was frightening was the
(12:48):
idea that there might not be enough ventilators for everybody
with COVID.
Speaker 4 (12:52):
Who needed them.
Speaker 3 (12:54):
None of us thought for a second about the fact
that ventilators have only been in existence since the nineteen fifties.
And one of the stories I tell in the book
is about the invention of ventilators and of intensive care units,
and they all originated from the polio a pandemics and
(13:15):
epidemics that we used to have before vaccination. And the
extraordinary courage really of an individual doctor in Copenhagen in
Denmark who was faced with a little child in front
of him, a little girl who couldn't breathe because polio
had panoraized her muscles and breathing, and he decided to
(13:41):
manually squeeze air into her lungs. And then all of
the medical students in Copenhagen, hundreds hundreds of them, were
enlisted to manually squeezes, bag and mask ventilate. It's called
squeeze oxygen in and out of these poor children who
were paralyzed with polio until they recovered, and that is
(14:05):
what led to the ventilators and the intensive care units
that today save thousands and thousands of people the world over.
So medicine is filled with these extraordinary historical stories which
we don't think about because we take the advances as given,
we've grown up with them, we don't see them as remarkable.
(14:25):
But every one of these advances has an incredible story
behind it.
Speaker 2 (14:31):
Rightl You mentioned the word their courage, and it just
sort of occurred to me that everybody in this book,
that is the one thing they all have in common,
I think, is courage, from the nurses to the surgeons,
to the family members, everybody involved. It kind of sums
up this book beautifully. It is a book full of courage.
Speaker 3 (14:50):
I completely agree with that, because I think courage is
not necessarily choosing to face something that frightens you. Courage
is finding yourself in a situation where you have no
choice and the only thing you can choose uses how
to respond.
Speaker 4 (15:08):
Rachel.
Speaker 2 (15:08):
It is a moving and important story and it's beautifully told.
Thank you so much for your time today. Really appreciate it.
Speaker 4 (15:15):
Absolute pleasure. Thank you.
Speaker 2 (15:18):
That was doctor Rachel Clark, winner of the Women's Prize
for Nonfiction twenty twenty five for her book The Story
of a Heart. It is, Honestly, It's an incredible story.
It's available in all Good bookstores.
Speaker 1 (15:30):
For more from the Sunday Session with Francesca Rudkin, listen
live to News Talks it B from nine am Sunday,
or follow the podcast on iHeartRadio
You're listening to the Sunday Session podcast with Francesca Rudgin
from News Talks EDB.
Speaker 2 (00:13):
Doctor Rachel Clark is a palliative care doctor with the
NHS in the UK. She's also the author of some
very successful books based around her career in the medical industry.
Her best selling book Breathtaking inspired a TV show, but
her latest has made her an award winner, and with
very good reason. The Story of a Heart has won
the twenty twenty five Women's Prize for Nonfiction. It centers
(00:35):
on the stories of nine year olds Max and kra
And it's a book about innovation, grief and hope and
it quite literally reduced me to tears. Doctor Rachel Clark
joins me from the UK. Good morning, Rachel, Good morning Rachel.
Why did you want to write about organ donation?
Speaker 3 (00:54):
Well, all the way back to the medical school, I
was completely captivated by organ donation, even though I didn't
become a surgeon, let alone a transplants in myself. I
just thought this idea that we are capable, thanks to
medical science, of removing a warm, living organ from somebody
(01:18):
who has usually very tragically perished, but then we can
send it sometimes hundreds thousands of miles away to another
hospital and save the life of another adult or child.
Completely astonishing. I think that organ donation is just a
triumph really of medical science, and I was always fascinated.
(01:45):
I witnessed some organ surgeries during my training, and then
I came across the story of little Max and Kira
when I had much later specialized in palliative medicine my specialty.
That their story just stopped me in my tracks.
Speaker 2 (02:05):
It is an incredible and it's it's a fantastic way
actually to write a book around organ donation, Rachel, because
there's more to the book than just this story. We
get a lot of medical history and things, and I'll
get to there a little bit later. But and I
hate to use the pump, but they are at the
heart of the story. So can you tell me a
little bit about Mex and Kira.
Speaker 4 (02:26):
Yes.
Speaker 3 (02:26):
So, in the UK a few years ago, in twenty seventeen,
there was a big campaign to change the law around
organ donation to an opt out system. So it's assumed
that you would be happy to consent to all the
donation unless you've said otherwise. And a little boy, Max,
(02:49):
who was nine years old, became one of the children
whose face one day appeared on the front of a
British newspaper as part of that campaign. He had been
waiting for a heart transplant for many, many months. He
was desperately ill, and almost at any moment he was
(03:09):
sick enough to die, and his mum agreed to tell
his story in public in the hope that it would
help change the law, and also maybe people would think
about children and adults like Max and have the conversation
with their loved ones about donation. So I came across
(03:31):
this story when Max's face appeared on the front page
of a newspaper that I happened to read.
Speaker 4 (03:37):
He looked desperately ill.
Speaker 3 (03:39):
Then a few months later his face appeared again, and
now it was rosy cheeked and brimming with health because luckily,
at the eleventh hour he had received a transplant. And
then a few months after that, the extraordinary thing happened.
One day, two families appeared on the front page of
(04:00):
the Mirror newspaper, and Kira, the little girl who had
tragic he died in a car crash and whose heart
saved Max's life. Her mom had worked out from the
publicity that her heart had probably saved Max, and she
got in touch with Max's mum and sent her a
message via social media saying, I think your little boy
(04:23):
has our daughter's heart and it's the most beautiful heart
in the world. And the two moms started communicating, and
that culminated in both families meeting in person, and one
by one, Kira's mom, dad, and siblings all lined up
and listened to her heart with a stethoscope beating inside
(04:44):
the chest of the little boy whose life she'd saved.
And when I read that story, I couldn't think about
anything else. I knew it was one of the most
extraordinary stories I'd ever hear, and that gave me the
idea as a writer to write a book about this
extraordinary journey of Kira's heart. That would be a way
(05:06):
of telling this wonderful, wider story about the medical miracle
nat Is transplantation.
Speaker 2 (05:12):
Kira's family and Kira are quite extraordinary people. They make
the selfless decision at the worst possible moment in their lives.
How do humans find the capacity to deal with the
question of a loved one becoming an organ doner.
Speaker 3 (05:28):
So it is I think the most extraordinary aspect of
this story and indeed, every successful story at the Center
is a family going through the most unimaginable grief devastation.
Often there is a sudden accident, like a car accident,
and this family is having to come to terms with
(05:50):
the fact that someone they love so desperately maybe appears
to simply be sleeping, but because of brain injuries, their
brain has died. They can no longer live. And it
is remarkable how in those times of utter darkness people
have a capacity to draw upon reserves of resilience and
(06:14):
generosity and sheer radical altruism that they might not even
have known they had.
Speaker 4 (06:21):
And that's exactly what Kia's family did.
Speaker 3 (06:24):
So I interviewed both families and all the medical staff
involved in this story, and incredibly, nobody even brought up
organ donation with Kira's family.
Speaker 4 (06:35):
Her sister, a little.
Speaker 3 (06:37):
Girl who was only eleven years old at the time,
called Caitlin, turned to the intensive care doctor and said,
can we donate Kierra's organs? And the doctor said she
had never ever encountered a child asking that question before,
so she was taken aback, but she said, yes, of course,
if that's what you want, And then little Caitlin turned
(06:59):
to her dad and said, Dad, we have to do this.
Kira is such a kind girl, she's so loving, you know,
it's what she would want. And Kira's dad, Joe said, yes,
you are totally right, we must do this. And I
just think that's a in a way, that's an emblem
and microcosm of everything that people are capable of. We
(07:23):
often hear bad news stories. There is so much violence, wars,
worrying stories around the globe. But fundamentally, people can be
and are extraordinary, and very often when they're in the
darkest circumstances themselves.
Speaker 2 (07:40):
For the recipient, this relief that you know, maybe the
only option leaf to save their life is possible as
going a heat, but it comes with their guilt of
knowing that someone else has died and that other people
are suffering. It's tough, isn't it.
Speaker 4 (07:56):
It's really tough.
Speaker 3 (07:57):
And Max, although he was only nine years old, he
understood this terrible arithmetic of of organ donation. For him
to live, someone else would have to die and no recipient,
and no recipient family ever wants a tragedy to happen
(08:19):
to another child, another adult. All they hope is that
if a tragedy happens that family might consider this act
of altruism because it's the only way their loved one
can live. And Kia is a beautiful example of that.
There were two children and two adults whose lives were
saved thanks to Kia and the generosity of her family,
(08:42):
And now every single day her father, Joe told me
he thinks of Kia, and he thinks of what a kind,
gorgeous girl she was, and how proud he is of
her because she has that living legacy. So sometimes, although
this is a story that involves heartbreak, organ donation can
(09:04):
give families a huge amount of comfort.
Speaker 2 (09:08):
In a Max's case, it wasn't end for his family.
It wasn't just the relief of getting the hat. You
then have to get your head around what is going
to happen, which is essentially that surgeons are going to
cut out Max's hat, which is tend to amount to him
dying in place a new one and in hope that
(09:30):
it works. I mean, there is also a lot for
a patient to get the head around, isn't it?
Speaker 3 (09:35):
Absolutely so, I think, And actually it's a lot for
the surgeons as well. So I interviewed Max's surgeons and
everybody Max, his family, his surgeons, they all talked about
the enormity of the surgery. If you think about it objectively,
it almost sounds like science fiction. So first of all,
(10:01):
a major artery and a major vein in Max's body
was connected to a bypass machine that oxygenated his blood
outside the body. And these machines they look like science fiction.
There are kind of mass of wires and tubes. It's extraordinary.
(10:23):
And then you have to literally saw the breastbone in
half and manually pull the rips apart. And then of
course you have to remove the heart. And surgeon are
staring at an empty chest. There is nothing there where
the heart should be. And to all intents and purposes,
(10:45):
unless you successfully stitch the new heart in, you have
killed the child. So everything rests on your skill and
your fingers and all your surgical training, and you have
to keep an utterly cool head under pressure and perform
this vital surgery. And of course that's exactly what successfully
happened in Max's case. But he was very, very frightened
(11:08):
before the surgery, and his family were absolutely terrified. You know,
on tend to hooks, just waiting hour by hour by hour,
hoping the news would be good. And in the old days,
heart transplants were a real lottery, more many more people
died than lived. But today, because the surgeons are so skilled,
(11:32):
the vast majority of people do survive. At least they
certainly survive the surgery itself, but you always have to
worry about rejection of the organ. You take very very
strong and unosuppressant drugs for the rest of your life.
And thankfully Max has thrived and today he is this strapping,
(11:53):
healthy six foot to sixteen year old boy. He's just
done his big exams in the UK GCSE exams and
he's looking forward to probably going to college. And all
of this is thanks to Kira and her family.
Speaker 2 (12:10):
We learn a lot about the history of trainsplants in
the book, which I found really fascinating. But also it
hadn't really occurred to me that there had to be
so many medical advancements before trainsplants were even possible. You
talk about the creation of the ICU or bypass, all
these things. Rachel, It's fascinating.
Speaker 3 (12:28):
Yes, And that was an aspect of writing a book
that I love, delving deeply into the history because always
with medicine, once a breakthrough happens very very quickly. We
take it for granted. So if you think of the
COVID nineteen pandemic, the thing that was frightening was the
(12:48):
idea that there might not be enough ventilators for everybody
with COVID.
Speaker 4 (12:52):
Who needed them.
Speaker 3 (12:54):
None of us thought for a second about the fact
that ventilators have only been in existence since the nineteen fifties.
And one of the stories I tell in the book
is about the invention of ventilators and of intensive care units,
and they all originated from the polio a pandemics and
(13:15):
epidemics that we used to have before vaccination. And the
extraordinary courage really of an individual doctor in Copenhagen in
Denmark who was faced with a little child in front
of him, a little girl who couldn't breathe because polio
had panoraized her muscles and breathing, and he decided to
(13:41):
manually squeeze air into her lungs. And then all of
the medical students in Copenhagen, hundreds hundreds of them, were
enlisted to manually squeezes, bag and mask ventilate. It's called
squeeze oxygen in and out of these poor children who
were paralyzed with polio until they recovered, and that is
(14:05):
what led to the ventilators and the intensive care units
that today save thousands and thousands of people the world over.
So medicine is filled with these extraordinary historical stories which
we don't think about because we take the advances as given,
we've grown up with them, we don't see them as remarkable.
(14:25):
But every one of these advances has an incredible story
behind it.
Speaker 2 (14:31):
Rightl You mentioned the word their courage, and it just
sort of occurred to me that everybody in this book,
that is the one thing they all have in common,
I think, is courage, from the nurses to the surgeons,
to the family members, everybody involved. It kind of sums
up this book beautifully. It is a book full of courage.
Speaker 3 (14:50):
I completely agree with that, because I think courage is
not necessarily choosing to face something that frightens you. Courage
is finding yourself in a situation where you have no
choice and the only thing you can choose uses how
to respond.
Speaker 4 (15:08):
Rachel.
Speaker 2 (15:08):
It is a moving and important story and it's beautifully told.
Thank you so much for your time today. Really appreciate it.
Speaker 4 (15:15):
Absolute pleasure. Thank you.
Speaker 2 (15:18):
That was doctor Rachel Clark, winner of the Women's Prize
for Nonfiction twenty twenty five for her book The Story
of a Heart. It is, Honestly, It's an incredible story.
It's available in all Good bookstores.
Speaker 1 (15:30):
For more from the Sunday Session with Francesca Rudkin, listen
live to News Talks it B from nine am Sunday,
or follow the podcast on iHeartRadio
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