Doctor's Prizewinning Book Finds Meaning in Life and Death
Before retraining as a doctor at the age of 29, she worked as a television journalist and documentary maker, reporting from war zones including the Gulf and Congo.
Since qualifying as a doctor in 2009, she has specialised in palliative care and become one of the UK's most acclaimed nonfiction authors.
Dr Rachel Clarke
Clarke's writing draws deeply on both her clinical and personal experiences.
Her first book, Your Life in My Hands (2017), recounted life on the NHS front line as a junior doctor.
In Dear Life , she explored her work in palliative care and the death of her GP father from cancer.
Breathtaking , written during the pandemic, laid bare the grim realities inside COVID wards.
Her latest, The Story of a Heart , tells the true story of a heart transplant from 9-year-old Keira, who died in a car crash, to 9-year-old Max, who received her heart. The account has won Clarke the 2025 Women's Prize for Non-Fiction, for what the judges described as 'a clear-sighted and vital exploration into the human experience behind organ donation.'
Medscape UK asked Clarke about the process of writing The Story of a Heart :
Clarke: Access was amazingly straightforward. Both Max and Keira's families were very keen to participate in something that might end up increasing awareness of donation and getting people having a conversation with their families about donation.
I was really conscious of the fact I'd be asking them to relive what was obviously an incredibly traumatic time. And I would be entrusted with one of the most personal and poignant stories that anybody has the misfortune to go through in their lives — the death of their child.
Rachel Clarke's book won the Women's Prize for Non-Fiction 2025
I approached them with the same moral standards as I try to apply in my work as a doctor. I explained they could absolutely trust me and if at any point they changed their minds — right up to publication — they could do so, and I'd throw it away.
I couldn't write the book unless they felt I had done their story justice. One of the main reasons I wanted to write the book was that I could see the value of what could come out of it.
You've written four bestsellers. Do you write to inform the public about medicine or to highlight NHS issues?
I very strongly regard my writing as a natural extension of being a doctor.
When you specialise in palliative medicine, as I do, you are incredibly conscious of the harm and the suffering that can stem from fear and taboos around dying and conversations that don't happen because people are afraid to have them.
Writing about that is a way to benefit patients.
All the books I've written have tried to shed light on aspects of medicine and being a doctor that are poorly understood or misrepresented. That includes death and dying, what it was like in the COVID wards, or what it's like to choose to donate your child's organs.
In my first book, I also explored what it's really like to be a professional who has to balance all their feelings and emotions, and the desire to do good, with the essential requirements of objectivity and dispassionate detachment that we need to do our job as doctors.
How do you manage your time as an author and a palliative care doctor?
With some difficulty! I split my time — 50% as a clinical doctor and 50% as a writer — which means I always juggle the two.
It's an incredibly privileged position to be in, to have two jobs that I love so much. Genuinely, I feel being a doctor helps my writing and being a writer helps my medicine.
Fundamentally, the core of both professions is very similar: It's about caring about people, listening very attentively to their stories, and trying to communicate them to other people clearly.
You were a TV journalist after university and didn't go to medical school until you were 29. Are you glad you didn't go straight into medicine?
I think it's helped me incredibly. I'm not even sure I would have survived medical school if I'd gone aged 18, as I was a sheltered teenager who'd experienced nothing in life.
However, with 10 years' experience in the big wide world under my belt, I just had more understanding of what human beings go through in their lives.
Why did you specialise in palliative care?
I'm naturally somebody who hates bullying in all its forms. I hate people being marginalised or silenced — and I think, historically to some extent, palliative care patients fit that description.
I once heard a consultant tell a patient they had cancer, and in an aside to us juniors, said to 'put them in the palliative dustbin.' That disgusted me so much.
I felt it was incredibly problematic that patients could be treated with such derision because they no longer warranted a surgery, and I wanted to do something about that.
I love my work and think palliative medicine is the very opposite of depressing.
I meet patients who so often are showing the best of human nature: They are courageous, dignified, and loving, and I feel privileged to do the job I do.
With that in mind, where do you stand on the assisted dying debate?
I've been relatively active in the public debate about this.
If assisted dying is going to be legalised in the UK, which I think it almost certainly will be, I know there's a real danger that people are going to choose the path of assisted dying when actually they have been denied the path of proper, decent palliative care.
I say that with a lot of experience. I'm afraid that as palliative care is so badly funded, we are going to enter a new world in which the NHS doesn't provide adequate palliative care for a patient, but will fund their death — which seems an absolutely dystopian direction the UK is about to travel in.
What else concerns you about the NHS at the moment?
The mismatch between the care that we are capable of providing patients versus the care they need is gaping.
We have the 10-Year Plan and strategies to address that, but it's not clear to me how on earth that gap is going to be met in the absence of increased funding.
We've heard an awful lot from Wes Streeting about his three main priorities: analogue to digital, treatment to prevention, hospital to community. Fine in theory, but it's just a sound bite unless it's backed with funding.
It's an ambitious plan, but at the same time we are laying staff off — and that's madness.
So, would you encourage young people to go into medicine as a career?
I very sadly know of very few doctors who'd want their children to follow them into medicine, and I think that is tragic.
I am endlessly lucky, and I love my job.
These days, you are coming out £100,000 in debt through paying for your medical degree; you are earning a salary that is, in real terms, much lower than it used to be, and you have no job security.
All of that is atrocious.
It's also the case that valuing the expertise that a medical education provides you with is being really denigrated in the NHS at the moment.
Doctors are being substituted, for example, by physician associates and other groups as well. Is it really the case that somebody who isn't a doctor at all can do the same job of diagnosis and management?
I'd argue most definitely not, but that seems to be the direction of travel.
What's next for you? Have you ever thought of going into politics?
One-hundred percent not, as I like to say what I believe, and I like to be able to express myself with integrity and honesty and not tow a party line. I'm not constitutionally built like that.
Clinically, I will carry on doing my palliative care, doing lots of teaching and training, and I hope to carry on writing as well.
Medicine is such a fascinating form of human activity.
In a hospital, all of human life is there, but it's even more concentrated and dramatic.
Hospitals are more full of huge feelings and life-changing events than any other arena of human life. And so it's endlessly fascinating to explore them in print.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Forbes
2 hours ago
- Forbes
Do Employers Have A Rational Fear Of Hiring Disabled Staff?
Sir Charlie Mayfield, a stalwart of the UK business community and advisor to Liz Kendall, Work and Pensions Secretary, has recently been quoted in The Times stating that employers have a 'rational' fear of hiring disabled staff. During his review of workplace sickness, Mayfield concluded that adapting work to staff with health problems was a huge issue that required employers to change, but suggested extra duties on businesses were not the answer. He said: "We've got a large amount of legislation which places requirements on employers and it's partly because of that that a lot of employers see it as risky to employ disabled people. And so quite rationally, they don't, even though we all know that's not the right outcome." The context for these comments is one in which 2.5 million UK workers are permanently off sick, and 8.7 million workers identifying as disabled. There's been an increase of 800,000 people too unwell to work since 2019, which is unsustainable for workers, their life outcomes and financial stability as well as the national economy. Rights Versus Reality? So are Mayfield's comments and his discovery report for the Department of Work and Pensions yet another stick with which to beat disabled people? Or are his remarks click bait headlines, papering over some well reasoned insights which need to be surfaced, understood and addressed? Mayfield commented on the rise in Employment Tribunals and the extra duties on UK businesses: The present approach "pitches rights against reality. If someone's ill and they have a fit note, there's a stand-off almost between that person and their employer, who could be part of the solution. We need to move from a position where too much of this is about risk and fear, to one where we humanise this and encourage people to be talking of finding solutions." The adversarial narratives that exist between communities of lived experience and employers has swiftly deepened in recent years, with each group finding very different sources of advice online and increases in perceptions of conflict and unfairness from all sides – employee, colleague and employer. However, read deeper into the report, and Mayfield is recommending an incentivisation approach to disability employment (the proverbial 'carrot', rather than the legislative 'stick'). Crucially, he recommends that employers intervene early when someone is struggling, rather than lagging in the provision of adjustments or support. Indeed, failure to provide timely intervention is a frequent cause of employment tribunals, with compensation up to £230,000 in one recent case. A shift in responsiveness would be very welcome by the disabled and neurodivergent community and it seems pretty logical. Government support and incentives for early intervention seem rational, but we will need to think carefully about what to provide. Early Intervention Guidance Advice on disability adjustments for individuals from the government service Access to Work or in-house / private Occupational Health is routinely a first port of call for employees and employers respectively. Access to Work has been a lifeline for employees over the past few decades, and has funded services and equipment that exceeds the budgets of many small businesses. However, it has become so log jammed that there is a community pressure group now set up to raise awareness of the problem founded by Dr Shani Dhanda. Occupational health services can be excellent and provide or signpost the specialist advice needed. But costs have spiralled with a clinical, 'assessment first' provision when there are so many referrals. There's a lack of filtering so those with the greatest needs are getting the same level of intervention as those who need a simple set of strategies or some software. Some of the occupational health companies are delivering the same services that they recommend, which is a structural conflict of interest and risks driving up costs - this practice is banned in Access to Work and Disabled Students Allowance, for example. So while we're telling employers to do more, faster, we will also need to be clear about the 'how' and the 'what'. With grand policy gestures and an increasingly litigious atmosphere, the needs of the businesses risk being overlooked and on that note, Sir Mayfield's comments are on point. Advice on adjustments for health and disability needs to be a collaboration between employer and employee. An assessment should consult both parties, and review what the individual needs in relation to the resources available. For example, a higher cost burden might be acceptable for a larger business than a small business. Safety critical roles might not have as much flexibility as a standard role. It is therefore not possible to list reasonable adjustments for each physical, emotional or cognitive difficulty. These can act as guidance, but not definitive entitlements. The policy and specialist support environment is going to need to become more sophisticated, and more responsive to balancing needs and addressing conflict, unfairness and unreasonable requests / restrictions. This is not a straightforward ask. Needs-led models How can employers find good advice in a complex and risky environment? The needs-led model is a good alternative to the medical model, relying more on practical support than clinical diagnosis. At work, we don't need to know the cause of back pain to know that a first port of call is a desk assessment or moving and handling review. Improving knowledge of functional, everyday difficulties and potential scaffolding is within the grasp of HR with the occasional advice of specialists where needed. Up-skilling employer confidence and competence is a potential avenue to improving outcomes, particularly in the areas of emotional regulation and cognition-dependent task performance where the challenges and the solutions are not visible. Knowing what to provide can be a pragmatic, low-cost conversation – research indicates that the cheapest or free adjustments are typically the most welcome, and that employees prefer the ability to personalize rather than passively receive an off-the-shelf allocation. As the population ages, the disability inclusion problem is not going to go away. Employers who are not developing a straightforward and accessible pathway to inclusion – at the company and individual level – will remain at risk of employment tribunal losses. This isn't a question of rights versus reality, it is a question of taking charge of a business need versus sticking your head in the sand. The rational fear of tribunals can be replaced by a rational approach to managing a large and growing cohort of disabled employees. Given the urgency of resolving the problem at the national level, now is a great time to start a strategic workforce plan.
Bloomberg
2 hours ago
- Bloomberg
Hackers Steal Passwords From UK's NHS With Sneaky Malware Tool
Ambulances parked outside the emergency department at the National Health Service's Royal Liverpool University Hospital in Liverpool, UK.
Yahoo
4 hours ago
- Yahoo
Glasgow hospice funding plea as it reveals £755k shortfall
A GLASGOW hospice has begun a fundraising campaign after revealing it faces a shortfall of more than three quarters of a million pounds. The Prince and Princess of Wales Hospice in Bellahouston Park is hoping 'the local community' will support its Vital Care Appeal. Chief Executive Rhona Baillie said: 'We provide free specialist palliative and end-of-life care to 1200 new patients and their families each year, both at the hospice at Bellahouston Park and in patients' own homes. 'We're doing everything we can to keep our costs to a minimum. We run our services efficiently, we're innovating with our fundraising, and we make every pound count. 'But despite our efforts, a significant funding gap remains.' (Image: Colin Mearns/Newsquest) The hospice is predicting a £755,000 shortfall in funding, citing the rise in demand for its services, patients' more complex needs and rising costs as the main pressures. Ms Baillie said that 'with local government funding just 30 per cent of running the hospice, the remaining 70 per cent comes from fundraising and donations' and added: 'We're not in crisis yet, but we need to act and that's why we are turning to our friends in the community for help.' Kirsty with her dad, Robert (Image: PPWH) Kirsty Dolan, 22, is supporting the appeal following the death of her dad, Robert, in the hospice in 2021. Robert was diagnosed with Parkinson's when he was 48 and Kirsty, who was only 10 at the time, along with her mum and older sister, became carers for him. In 2021, he visited the hospital for inpatient care. READ NEXT: Seeds of trees which survived Hiroshima help create new Glasgow garden Glasgow pupil heading for top art school after exam success 'We'll use King's Honours to keep battling for our Glasgow community' 'He had developed supranuclear palsy and needed specialist care,' said Kirsty. 'He was in the IPU for about a week where he just received the very best care you could imagine. 'We got to spend as much time with him as we could, and we even got to bring our dogs in for a visit. When he was nearing the end of his life, we all stayed over at the hospice in the family rooms so we could be close.' Kirsty also received support from the hospice's Family Support Service. 'I was really struggling,' she said. 'I was at breaking point. I emailed the hospice and the Family Support Service got in touch – and I have to say, it changed my life. "The team worked with me over a period of time and just helped me see things differently. ' It really was a lifeline, and I needed that support so much.' Glasgow Times readers helped raise the £21m needed for the new hospice, which opened in 2018, through our Brick by Brick Appeal. For more information on the Vital Care Appeal visit or call 0141 726 2660.
