Book Review – The Story of a Heart by Rachel Clarke

About the Book

This is the unforgettable story of how one family’s grief transformed into a lifesaving gift. With tremendous compassion and clarity, Dr Rachel Clarke tells the story of a girl, a boy and the heart they share.

In doing so she explores a history of remarkable medical innovations, stretching back over a century and involving the knowledge and dedication not just of surgeons, but of countless physicians, immunologists, nurses and scientists.

Format: Paperback (288 pages) Publisher: Abacus
Publication date: 5th June 2025 Genre: Nonfiction

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My Review

The Story of a Heart is not just the moving story of Keira and Max, one of whom is destined to die and the other destined to live, but also a fascinating insight into the medical advances that have led to the possibility of successfully transplanting a heart from one person to another, such as respirators, tissue matching and drugs to prevent rejection. However, as the author makes clear, the process is still fraught with risk and uncertain outcomes, the average life expectancy after receiving a heart transplant being only 14 years.

The author’s description of the heart as ‘a toiling, tireless, muscular miracle’ is just one of the striking images in the book. I liked the way she drew attention to the ‘metaphorical richness’ of the heart. ‘Hearts sing, soar, race, burn, break, bleed, swell hammer and melt. They can be won or lost, cut or trampled, and hewn from oak or stone or gold.’ As she points out, such is the heart’s centrality to the English language, its definition in the Oxford English Dictionary runs to 15,000 words.

I particularly enjoyed the sections describing the intricate logistics and the many people involved in the delicate process of moving a heart from the donor to recipient in an optimum condition and in sufficient time to allow it do its life-saving work. The book demonstrates how much of a team effort this is but also that the people involved never lose sight of the fact this is a precious gift that has come about as a result of a person’s death. One of the many moving scenes in the book is Keira’s father waiting outside the hospital to see the box containing her heart being loaded into an ambulance for its onward journey. Another is when a moment of silence is observed by the surgical team before they begin organ retrieval.

The author briefly touches on the ethical dilemmas surrounding transplant surgery given that there are always more patients awaiting a transplant than there are organs available, and that the healthiest organs are likely to be those of a young person. At its most abhorrent, there are countries in the world where organs are for sale.

As you read The Story of the Heart prepare to be moved to tears, to be uplifted by the courage of the individuals involved and to marvel at the skill and dedication of medical professionals, as well as the pioneering individuals responsible for developing technology that seemed unimaginable at the time. The book demonstrates that the NHS at its very best is a remarkable institution and one that we would do well to cherish.

Tackling a difficult, complex subject with clarity and sensitivity, and just about steering clear of sentimentality, The Story of a Heart is a well-deserved winner of the Women’s Prize for Nonfiction 2025.

This was a book club pick (by me) and I’m delighted to say everyone throughly enjoyed the book, including one person who has personal experience of the journey the book depicts.

In three words: Moving, informative, inspiring
Try something similar: Heart: A History by Sandeep Jauhar

About the Author

Dr Rachel Clarke is an NHS palliative care doctor and the author of three Sunday Times bestselling non-fiction books. The most recent of these, Breathtaking (2021), was adapted into an acclaimed television series, broadcast on ITV in 2024. It reveals how she and her colleagues confronted the height of the Covid-19 pandemic. Dear Life (2020), depicting her work in an NHS hospice, was shortlisted for the 2020 Costa Biography Award and longlisted for the 2020 Baillie Gifford Prize. Your Life in My Hands (2017) documents life as a junior doctor.

Before going to medical school, Rachel was a broadcast journalist. She produced and directed current affairs documentaries focusing on subjects such as Al Qaeda, the Iraq War and the civil war in the Democratic Republic of Congo. She continues to write regularly for the Guardian, Sunday Times, New Statesman and Lancet among others, and appears regularly on television and radio. Inspired by a visit to Ukraine during the conflict in late 2022, Rachel founded a UK-registered charity, Hospice Ukraine, which supports the work of local palliative care teams in Ukraine. (Photo/bio: Publisher author page)

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