On Sunday, July 30, 2017, and nine-year-old Keira Ball is on her way to parkour with her mum and brother when two tonnes of truck collide with their car. Even after roadside CPR  and surgery to stem the bleeding, two days later Keira is declared brain-dead, Yer her perfect heart keeps beating on life support.

Her two sisters perform a devotional last rites by painting her nails orange and brushing out her golden hair while their parents are still a patient in intensive care.  Max Johnson, also just nine-years old breathless with heart failure and sworn into despair from waiting 196 days on the NHS transplant list.

Rachel Clarke’s The Story of a Heart, tells with medical precision, as an authoritative voice for those on the NHS frontline and concerned patients who rely on its care.

By framing her book around Keira’s heart, Clarke reveals how a “far-fetched covengence”  of tragic events as well as decades of research, surgical training and ethical debate, together enable the operative feat to take place. For an organ to leave one body and join another require anaesthesia and antisepsis, of course, but also mechanical ventilation, immunosuperssants, knowledge about sewing together blood vessels refined from experimenting on dogs, and even a redefinition of death itself: no longer the moment the heart gives up, but when the brainstem permanently ceases to function. 

NHS crises, and UK’s national Organ Retrieval Service is always on call, orchestrating operations of unthinkable complexity- it’ s hard to  conclude that our healthcare systems irretrievably broken. Algorithmic reliability and a precision focus bordering on pay chopathy , dovetailed with a humanity that can afford  – at expertly weighed moments to bend or even part ways with protocol so that patients are not reduced to “a warehouse of spare parts”.

For many organ donation is the purest expression of human altruism for others it is a civic responsibility, or even logical thrift in 2020,  the Organ Donor Act  was passed shifting donation at death from an opt in to an opt out system. There is a desperate shortage of donors,

Keira’s liver and kidney’s went on to save other lives.The realistic story about the guilt that comes from one person’s future being predicted on another’s fatal misfortune.

Half wishing a tragedy to happen is the appalling dilemma of waiting for a transplant. NHS well placed for the principle of being free at the point of need. 

Nobody in the chain stands to profit financially from any given operation but it does cost the taxpayer dearly.

The Story of a Heart but  Rachel Clarke, Abacus £22, 320 pages.