Before my 19-year-old son di3d, he donated his heart to an 18-year-old girl — after the transplant, her mother handed me a letter from my son that began, “Mom, there’s something you need to know about her.”

That was the thing that had got into me by then. That a nineteen-year-old had been handled — by the system, by the paperwork, by a girl who needed a heart.

She let me say all of it. And then she said something that took the legs out from under me.

“Mrs Deane. I turned him down.”

The first time he asked, in the October, she said no. She told him it was a great deal of process, that it was very often refused, and that spending his last months on forms for something that might not happen was not, in her clinical opinion, a good use of them.

And he said: “What’s a better one?”

And she said she did not have an answer for that. And she has thought about it since, she said, more than she would like.

“He asked me twice more,” she said. “The third time he brought a folder. He’d printed the criteria off himself and gone through them line by line and written what evidence we’d need next to each one.”