Story of a Heart

July 15, 2024
A British doctor explores how organ donation and transplant permanently intertwined the lives of two families. Max Johnson, a 9-year-old "soccer-playing, tree-climbing, play-fighting force of nature," was the last person anyone thought would need an organ transplant. However, when a virus invaded his body and fatally damaged his heart, Max took his place on a list of British children awaiting organs. Clarke, author ofBreathtaking andDear Life, shows how the heart of another life-loving 9-year-old, Keira Ball, found its way into Max's chest just in time to save his life. A little girl who loved horses, Keira was in a car accident that severely injured her mother and brother. Paramedics resuscitated her heart, but tests later revealed that Keira's injuries had left her brain-dead. As her grief-stunned father struggled to comprehend his loss, an older sister made the preternaturally compassionate suggestion that Keira's organs be donated. Clarke follows the path of Keira's heart from its listing with the UK's Organ Donation and Transplant Hub to its perfectly executed surgical retrieval, made just as Max underwent the surgery that would allow him to accept a new heart. Interweaving other stories about surgeons like Clarence Walton Lillehei and Christiaan Barnard, who advanced "heart transplantation from a state of wild speculation into sober reality," the author also examines the moral and emotional complexities that surround organ donation itself. Max survived to live the teenage life Keira did not, yet as Clarke makes clear, that difficult surgery ultimately provided palliative care rather than the restoration of a normal lifespan. Thoughtful and sensitive, this book not only illuminates a little-discussed topic but also reveals that just as medical science has wrought miracles, it has also raised "profound questions about what it means to be alive." A poignantly celebratory tale.

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Starred review from July 29, 2024
Physician Clarke (Breathtaking) offers a profoundly moving account of how a pediatric heart transplant changed organ donation laws in Britain. In 2017, nine-year-old Keira Ball suffered a “catastrophic brain injury” as the result of a car crash. At her older sister’s insistence, Keira’s heart was donated to Max Johnson, a nine-year-old whose heart had been weakened by illness. The families eventually struck up a correspondence and successfully campaigned together to make organ donation an opt-out system in the U.K. Clarke’s impressive reporting offers a fly-on-the-wall account of how Keira’s heart made its way to Max (“Gloved hands cranked at stainless steel—it takes brute force to prize a rib cage apart. Max’s heart, once exposed, was slack and gargantuan”). Clarke also weaves in fascinating medical history, chronicling the development of ventilators during the 1950s polio epidemic and the first heart transplant, which was performed by an ill-prepared South African surgeon in 1967. However, the main draw is the heartrending story of how two families forged a path through tragedy (a particularly affecting scene describes how at the families’ first meeting, the Johnsons brought a stethoscope so the Balls could listen to Keira’s heart). A tearjerker that doubles as a first-rate medical history, this is a marvel. Agent: Clare Alexander, Aitken Alexander Assoc.