Intelligence Squared Podcast Summary

Episode: Women’s Prize-winner Rachel Clarke in conversation with Rob Delaney (Part One)

Date: December 21, 2025
Host: Intelligence Squared
Guests: Rachel Clarke (palliative care doctor, author, Women’s Prize winner), Rob Delaney (actor/comedian, host), Coco Khan (moderator, author)

Episode Overview

This deeply moving live episode features Dr. Rachel Clarke, palliative care physician and acclaimed author, discussing her 2025 Women’s Prize-winning book, The Story of a Heart. The conversation, moderated by Coco Khan and hosted by Rob Delaney, takes place at the Kiln Theatre with members of the families involved in the heart transplant at the center of the story present in the audience. Through personal testimony, medical history, and ethical reflection, the episode explores themes of loss, hope, altruism, and the life-saving miracle of organ donation, focusing on the true story of a young girl whose donated heart saved the life of another child.

Key Discussion Points & Insights

The Origin of The Story of a Heart

• Rachel Clarke describes first encountering the story in 2017 through news coverage about Max, a boy in desperate need of a heart transplant. Max’s story became entwined with that of Kira, the donor, and their families when Kira’s mother recognized her daughter’s heart had saved Max.
  • "That set off a train of events that led to Kira's family meeting Max's family. And one by one, with a stethoscope, they listened to her heart beating inside the chest of this beautiful little boy whose life Kira had saved." (Rachel Clarke, 08:17)
• Rachel was compelled to write the book to capture an extraordinary example of human altruism: "That right there is everything that human beings are capable of, that is us at our best." (Rachel Clarke, 08:54)

Ethical Responsibility & Approach to Telling the Story

• Rachel approached both families with utmost care, prioritizing consent and trust:
  • “If anybody was to entrust me with a story that was as sensitive as that, they had to know they could trust me completely… if they changed their mind, we would throw away that manuscript.” (Rachel Clarke, 10:04)
• She visited Kira’s home, which was filled with reminders of her vibrant life, reinforcing the gravity and beauty of the story.

Introducing Kira & Max: Lives Before Tragedy

• Kira: Known for extraordinary kindness, a love of animals, and boundless energy. “Her dad said to me… she was so soft that if she walked past a snail, she had to pick it up and rescue it and put it in a jam jar because she didn't want anyone stamping on it by mistake.” (Rachel Clarke, 13:11)
• Max: Mischievous, energetic, technology-obsessed—a prankster and football fanatic.

Tragedy Strikes: Kira’s Accident & the Sibling Experience

• Kira sustained irreversible brain injuries in a car accident, a sudden tragedy during the summer holidays.
• Special attention is paid to the siblings—Kira’s sisters Caitlin and Keely—who showered her with love and joy in her final days.
  • “These girls came in and basically love bombed the hell out of this room and bombarded sleeping apparently sleeping little Kira with love and joy… She felt like she was walking into this bath of love. It was just pure love.” (Rachel Clarke, 19:23; 20:18)

The Miracle and Complexity of Organ Donation

• The story underscores the multitude of people and precise interventions required for a successful transplant—down to the chance presence of a junior doctor at the accident scene who performed vital CPR.
  • “If that hadn't have happened, her organs would not have been oxygenated and she would have died at the roadside. And Max... that probably never would have happened.” (Rachel Clarke, 22:32)
• Highlights the NHS’s capacity for extraordinary, coordinated action in a crisis, involving “literally hundreds of people” working towards the transplant. (Rachel Clarke, 23:49)

Medical History: Stitching Hearts & Surgical Innovation

• Fascinating recount of Alexis Carrel, whose quest to suture blood vessels was inspired by the death of the French prime minister—a triumph shared with Madame Le Roudier, a master embroiderer who taught him delicate technique.
  • “He ended up winning the Nobel Prize for medicine for working out how to stitch together blood vessels… which obviously should have been shared by Madame Le Roudier.” (Rachel Clarke, 31:07)

Writing Process: Balancing Emotion, History & Structure

• Rachel discusses weaving personal, medical, and historic timelines, using history to give readers “respite” from the emotional intensity.
  • “The historical story was almost a way of enabling the reader to… come out of this intense clock ticking, everything becoming more and more urgent.” (Rachel Clarke, 33:11)
• On writing emotionally laden narratives: “You had to almost live with uncertainty in a way that, as a good obsessive compulsive doctor, I found really difficult.” (Rachel Clarke, 35:06)

Reporting the Story: Finding Voices Within the NHS

• Rachel’s journalistic background helped her track down all staff involved, but only after full family consent. Many NHS staff had never spoken deeply about their role in such stories before and found the experience cathartic, especially when dealing with the loss of a child:
  • “All healthcare professionals… you have to put your emotions to one side. You can't be crying as a doctor if you're supporting somebody who's sick… But you're still human beings and it still affects you.” (Rachel Clarke, 39:16)

Notable Quotes & Memorable Moments

• Rachel Clarke:

  • “That right there is everything that human beings are capable of, that is us at our best. That is the miracle of altruism. That is the start of every transplant.” (08:54)
  • “If I couldn't write a book that they felt happy with, then it shouldn't be a book that was published.” (10:26)
  • “She [Kira] was just vivacity. She was a little kid full of the joy of living and other people and this gorgeous world around her.” (13:43)
  • “These girls [Kira’s sisters] came in and basically love bombed the hell out of this room and bombarded sleeping apparently sleeping little Kira with love and joy… It was just pure love.” (19:23; 20:18)
  • “He ended up winning the Nobel Prize for medicine for working out how to stitch together blood vessels. They're very fragile. If you stick anything into them, they start to clot.” (31:07)
  • “I discovered it was very important to let go… You had to almost live with uncertainty in a way that, as a good obsessive compulsive doctor, I found really difficult.” (35:06)
  • “Everybody involved just knows the enormity of this gift that a family is making to try and bring good from a bad situation. And it’s humbling and it’s amazing. You know that you’re in the presence of the best of human nature.” (39:47)

• Coco Khan:

  • “One of the things that touched me most about your book was the love that you showed Kira and Max's siblings… it's important to not forget about them.” (16:46)

Key Timestamps

• [06:25] Rachel discusses how the story first appeared in the news and her emotional reaction.
• [09:58] Rachel describes her careful, ethical approach in requesting family permission to write the story.
• [12:34] Introduction to Kira and Max, their personalities, and their lives before illness and tragedy.
• [15:06] The events of Kira’s fatal car accident are recounted.
• [18:01] Exploring the sibling experience and how Kira's sisters handled her hospitalization.
• [21:46] The serendipity and complexity of a successful organ donation process.
• [29:30] Medical history: How surgeons learned to stitch blood vessels—crediting women’s expertise in embroidery.
• [32:43] Discussion of structuring the narrative with timelines and emotional pacing.
• [34:36] Rachel reflects on the role of editors, her husband, and the challenge of writing emotionally intense nonfiction.
• [37:47] The process of reporting, ethics of consent, and emotional interviews with NHS staff.

Final Thoughts

This episode is testament to the power of storytelling rooted in compassion, medical science, and ethical care. Rachel Clarke and the host team offer listeners a glimpse into both the medical miracle and the emotional toll of organ donation, highlighting the unsung heroism of families and NHS staff. The intertwining of personal narrative, technical insight, and historical context brings depth and humanity to a story that resonates with audience members and listeners alike.

End of Part One Summary
[Questions from the audience and further reflections expected in Part Two.]