‘We’re spending on sexy AI instead of vaccinating babies’: The Story of a Heart author Dr Rachel Clarke

A world still judging women differently

Clarke is blunt when I ask whether women still struggle to break through in academia and mainstream professional life. “The world we inhabit is still, in 2026, far more patriarchal than many people believe,” she says. “Men and women are still judged by very different standards in all kinds of ways.”

She points to persistent inequities – pay gaps in the UK and, in India, imbalances in who wins non-fiction prizes and who receives larger publishing advances. The pattern, she argues, reflects something broader than individual bias: a cultural tendency to prize male stories more highly than women’s.

“All of these are examples of ways in which male voices and male stories are still prized more highly than women’s,” she says. “And I think that is terrible and wrong.”

It is not a stance she treats as optional or temporary. “I will be a feminist until the day I die,” Clarke says, “because I suspect we will still live in a patriarchal world until the day I die.”

The Story of a Heart tells the extended life of a single human heart, which would change organ donation in the UK for ever. (Source: womensprize.com)

Medicine has changed, but it hasn’t been fixed

Medicine, Clarke says, has evolved dramatically over the last two to three decades. She describes it as less patriarchal than it once was, but she is equally clear that progress has not eliminated misogyny or abuse.

“There are still problems of misogyny, sexual harassment in medicine in the UK,” she says, citing a high-profile case involving a surgeon accused of harassing junior doctors. Even when women speak out, Clarke notes, there can be a reflexive sympathy extended to the perpetrator, an impulse to portray him as the one who has been harmed by the public nature of the allegations.

The work, she insists, is ongoing, and it is collective. “We all owe it to tomorrow’s generation of doctors, nurses, everybody in healthcare to keep fighting to ensure that men and women are treated equally.”

Walking the tightrope between empathy and detachment

The Story of a Heart follows the journey of a single donor heart, beginning with the sudden death of a young girl, Kira, and tracing how her parents’ decision to donate her organs ripples outward.

Clarke documents the medical teams involved in retrieval and transplantation, the recipients whose lives are extended or transformed, and the extraordinary coordination required across hospitals and borders. Interwoven with this clinical precision is the raw grief of a family learning to live after unimaginable loss, and the quiet moral weight carried by doctors who must act swiftly while honouring the humanity of everyone involved.

It is, Clarke says, a story about connection, how one death can generate life, and how medicine operates not just through technology and skill, but through trust, compassion, and responsibility.

When asked about the process of writing such an account when doctors are trained to be detached, she said “When doctors are at medical school, they are often taught to be detached, objective,” she says. “But actually, it’s not as simple as that. Doctors are human beings too.”

In Clarke’s view, medicine is a job built on caring, and suppressing emotion entirely is neither realistic nor healthy. “The greatest challenge in medicine is walking the tightrope between empathy and feeling on the one hand, and objectivity and detachment on the other.”

Too much distance creates hardness; too much feeling can compromise function. “Yes, you have to be detached to a degree or you can’t do your job,” she says. “But if you are too detached, you become very hard and callous.”

She sees a close parallel with writing, especially narrative non-fiction rooted in grief and loss. Interviewing bereaved families requires presence, sensitivity, and control.

“Writing and medicine are very, very similar,” she says. “Both of them are navigating the path between emotion and attachment.”

The obscenity of unequal care

On how not everybody can afford an advanced treatment like a heart transplant, she said: “Isn’t it obscene that some countries will spend millions of dollars on the healthcare of one individual,” she says, “while somewhere else… babies will be dying in their thousands of diseases like malaria, because the countries they live in can’t afford the malaria tablets?”

She worries that international commitments to basic healthcare are weakening, exacerbated by political decisions to reduce funding for major health programmes. “What we can all do… is try to maintain our empathy,” she says, “try to… think about what life is like for people who live in poverty, who don’t get even basic health care.”

She also challenges what is deemed worthy of investment. “We could do a lot more with our money by providing babies with vaccinations,” Clarke says, “rather than spending money on very sexy AI in health.”

“Health prevention [is] always cheaper than trying to correct illness that you can no longer prevent,” she says, pointing to modifiable risk factors such as smoking, exercise, and diet.

“It is very easy to test… for things like high cholesterol,” she says. Screening is “really, really cheap,” and scaled programmes can have enormous impact.

“These measures are well known and very effective,” she says. “But they’re not sexy. And crucially, they are not ways in which entrepreneurs can make money.”

Why doctors must speak up

When ask whether doctors should “stray into politics,” Clarke’s said there is a section that believes that doctors should not stay in their lane but she “profoundly disagrees.”

Politics, she argues, is fundamentally about power, and when power damages health, neutrality becomes abdication. “If we as doctors have a fundamental duty to act in the best interests of patients’ health… then… [we have] a responsibility to speak out when powerful people or institutions or governments… are causing harm to our patients.”

Doctors, she adds, occupy a privileged position. “You have education, status… you have the opportunity to be an advocate for vulnerable people,” she says. “And… you have a duty to speak out.”

Writing through grief—and responsibility

The hardest part of writing The Story of a Heart, Clarke says, was describing a family saying goodbye to their child before her organs were removed.

“I found that very, very hard to write about,” she says. “I cried myself as I was writing that part… As a mother, I thought about how I would feel if it were my child.”

What made it so difficult was responsibility. “Kira’s family had entrusted me with their story,” she says. “I had to do a good job of it.”

Later, Kira’s father told her that he wakes up proud every day, proud of what his daughter achieved.

“The book is helping Kira achieve more,” Clarke recalls him saying. “That made me feel really happy… I felt like I had done a good job.”