Instructions for a Secondhand Heart


By Tamsyn Murray

Formats and Prices




$12.99 CAD



  1. ebook $9.99 $12.99 CAD
  2. Hardcover $17.99 $23.49 CAD

This item is a preorder. Your payment method will be charged immediately, and the product is expected to ship on or around December 5, 2017. This date is subject to change due to shipping delays beyond our control.

A moving novel about grief, guilt, and the unpredictability of love, for fans of Everything, Everything and All the Bright Places.

Jonny knows better than anyone that life is full of cruel ironies. He’s spent every day in a hospital hooked up to machines to keep his heart ticking. Then when an organ donor is found for Jonny’s heart, that turns out to be the cruelest irony of all. Because for Jonny’s life to finally start, someone else’s had to end.

That someone turns out to be Neve’s twin brother, Leo. When Leo was alive, all Neve wanted was for him (and all his glorious, overshadowing perfection) to leave. Now that Leo’s actually gone forever, Neve has no idea how to move forward. Then Jonny walks into her life looking for answers, her brother’s heart beating in his chest, and everything starts to change.

Together, Neve and Jonny will have to face the future, no matter how frightening it is, while learning to heal their hearts, no matter how much it hurts.

Features select graphic novel illustrations from Jonny’s sketchbook.




Last summer, my heart stopped for three and a half minutes.

When they got it going again, the muscle was damaged and didn’t work properly. So now I have this machine plugged into me, keeping me alive. It’s called a Berlin Heart and you can actually see my blood being pumped along its tubes into these two little round things and then back into my body, which is gross but fascinating. Sometimes, when I can’t sleep, I pretend I’m Iron Man and the Berlin Heart is my arc reactor. I know, tragic, right? I’m almost sixteen, the oldest patient in the hospital to have one—all the others are little kids, or even babies. On a good day, I might sketch them as hard-core X-Men characters. On bad days, they remind me that I’m dying.

Being under a death sentence sucks. If you were a smart-ass, you might point out that everyone is dying, but trust me, I’ll be doing it sooner than most. I’ve spent more than half my life in the hospital, and every day I get closer to shooting the breeze with Death.

What I really need is a new heart. But it’s not like you can just pick one up online. No, you have to wait for someone who matches you to die. Then you have to hope they’re on the Organ Donor Register. If they’re not, it’s up to their family to decide whether to donate any organs that are still up to the job. Not everyone says yes, so there’s a massive waiting list. And that’s why I think I’ll be dead soon, although I don’t ever say that around my family. Deep down, we all know it’s pretty much a given—I’ve got this really rare blood type, which reduces the chances of finding a match even more. But we pretend that’s not how it is.

My best friend at the hospital is called Emily—aka my only friend these days, because there’s only so long you can expect your healthy friends to stick around before you slip gradually out of their minds. Em’s got acute myeloid leukemia and they’re not sure she’s going to make it, either. The hospital psychologists we have to see each week told us to make a list of things to do when we get well—the opposite of a bucket list—because they reckon it helps to stay positive. Em and I did ours together. It has stupid stuff on it like Meet Sam Claflin (that’s hers, not mine—she’s got posters of him everywhere) and Meet comic legend Chris Claremont at London Super Comic Con, ’cause if you’re going to dream, you might as well dream big. But there’s some not-so-crazy stuff on there, too, things most teenagers take for granted, like going to the cinema or moshing at a gig. I’d like to do the whole cinema experience with Em—loading up on snacks, getting annoyed at the people who talk, appreciating the action on a big screen. Not like on a date, obviously; I’ve never fancied Em. She’s just someone I can talk to when I feel down, someone who gets what living under a death sentence is like—no one understands you like another hospital kid. It’d be nice to share some good times with Em, too.

So here I am, killing time and waiting for exactly the right person to die in exactly the right way. Sometimes I wish the surgeons could remove my real heart and leave me with this artificial one forever. Then I wouldn’t feel so guilty about wishing for a tragedy to happen to someone I’ve never met. I’d be genuinely heartless then, instead of only feeling like I am.

The truth is, I’m not Iron Man. I’m just a boy with no future.



Leo stands poised on the shingle beach, his body angled toward a stack of boulders cowering at the base of the limestone cliffs, daring me to run. I scowl and decide to ignore him. Leo might be my twin but we’re totally different, inside and out. He’s bright and boisterous, like a half-grown Labrador, all big brown eyes and golden hair and enthusiasm—fifteen going on five. Whereas I’m more like a feral cat—wild and inclined to scratch if anyone gets too near. And of course, Leo’s popular; everyone loves him, especially the moronic girls at school. Not that I want to be liked, especially, and certainly not by them. But people do a double take when they find out we’re twins, as though they can’t believe we’re even related. It’s like he nicked all the good stuff while we were in the womb—all the charm and confidence and luck—and I got what was left.

He flashes a teasing grin my way. “What’s the matter, little sister? Scared I’ll beat you again?”

Little sister. He says that a lot, like those three minutes make him Gandalf or something. Mum lifts her sunglasses, pushing her coppery hair off her face, and glances back and forth between us. She’s smiling, but there’s anxiety behind her eyes, as though she senses the rage bubbling under my skin. Sometimes I wonder if she reads my mind. I hope for her sake she doesn’t. It’s a dark place these days.

Her forehead crinkles into a frown and I feel bad. This holiday is her attempt at a reboot, a way of forcing us to get along. It’s meant to be a reminder of the sun-drenched beach adventures of our childhood, when the two of us spent the days playing pirates and exploring rock pools, and the nights squashed side by side in our tiny camper bunks—inseparable. Then we got older and the cracks began to appear. Leo became the family golden boy—ace soccer star, A-plus student, and everybody’s friend. No matter how hard I tried, I was never as good. Once I’d fallen into his shadow, I couldn’t find my way out; eventually I stopped trying and decided to embrace being the difficult one.

My eyes settle on the sea, sparkling in the midafternoonheat haze, and the man walking his dog along the frothing surf. I should make the effort and pretend I’m not actually a seething mass of resentment.

My stomach churns as I consider the options. Play nicely or pick a fight? Mum’s tension is obvious now, and I feel sick, as though everyone’s happiness hinges on what I do next. Fight or flight, they call it in science, the body’s reaction to stress, and Leo definitely stresses me out. I don’t really hate him, but I can’t say I like him, either.

“Don’t be a jerk all your life, Leo,” I say, turning away.

“Neve!” Mum exclaims, sounding disappointed as she fires a dismayed look Dads way. Out of the corner of my eye, I see Leo’s smile falter. And in that split second, when his shoulders droop in defeat, that’s when I run, speeding past him in a spray of pebbles. He lets out a yell of surprise, and then I hear him crunching after me.

He’s close. I can hear his breath ragged in my ear, a gurgle of laughter underneath it. But for all his boasting, we’re a pretty even match; he’s big, but I’m speedy, and the precious few seconds’ head start I have is enough to keep me in the lead. The breeze sends my hair streaming out behind me and tickles my face, at the same time my muscles stretch and sing. I realize with a jolt that I’m actually enjoying myself. I don’t do sports. In fact, I don’t really do anything, so I’m amazed my body knows how to react. But it feels good. Heaving in a deep breath, I urge my legs to move faster and focus on my goal. I have to win. I have to.

The rocks are close now—I can see they’re wet and half covered in seaweed. Something brushes the back of my faded Smiths T-shirt—Leo’s fingers. And that’s about right, too—everyone thinks he’s Mr. Perfect, but he’s not above a bit of cheating to get what he wants. Not this time, though. Another burst of determination shoots through me and I power forward. With a grunt of effort, I reach out and slap a waist-high boulder with my hand.


He crashes into the back of me, sending me sprawling over the rock and knocking what little breath I have left from my lungs. Briny seawater slops over my feet and the hard jagged rock edge jabs under my rib cage. I let out a surprised Oof of pain.

His weight lifts, allowing me to push myself up and glare at him.

“Sorry,” he pants, stepping back with an unrepentant grin. “Couldn’t stop.”

“Yeah, you could,” I say, shaking the water off my Converse. “Loser.”

He tips his head, acknowledging the truth. “Okay, you won. But I bet you can’t beat me to the top!”

God, he really is a five-year-old. He means the top of this cluster of rocks, which is bigger than it seemed from the other side of the beach, jutting over our heads in a mini-mountain beneath the clifftop. They’re jumbled together every which way, the razor-sharp edges dressed with slick seaweed and algae. I hesitate.

“Of course, if you’re too scared…”

He leaves the words hanging in the heat, knowing as well as I do that he doesn’t need to finish the sentence. Inextricably tangled up in my resentment and irritation is a tiny spark of competitiveness I can’t quite extinguish, the need to prove something. Sometimes it’s a battle in my head, like beating him to the last Pop-Tart. Today, it’s this, and I can see from his face that he thinks he’s already won.

“Let’s make it interesting,” I say, my mind searching for a way to get the upper hand. “If I win, I get your guitar.”

I don’t actually want it, I just want to threaten something he loves. He fancies himself as a musician, reckons he’ll make it one day, and no one is allowed to touch his precious Fender. I honestly think he loves it more than his girlfriend, Sophie. The threat has the desired effect, anyway—his eyes narrow. “Get lost, Neve. Like you’d know what to do with it.”

A gust of wind whips my hair across my face and I taste sand as I lick my lips. “Now who’s scared?”

We stare at each other and something flashes between us; pride, understanding? It’s gone before I can work out what it is. But I know Leo won’t back down.

“All right. And if I win, you have to get down on your knees and admit that I am awesome.”

The realization that I literally have nothing he wants rubs salt in an already open wound. Twin spots of humiliation burn my cheeks. “It’s never going to happen, but okay.”

He fires a mocking smile my way. “Ready to lose?”

My legs tense once more, and this time there’s an added tingle. I nod.

“On your mark, get set, go!”

He’s off, white Vans scrambling over the slippery surface as he scales the boulders immediately in front of us. My gaze travels sideways and I spot an easier, flatter route. I jog a few meters to the right and start to climb.

At first I think I’ve made a mistake. Leo is much higher than me, and I feel like I’m going sideways instead of up. Then he stops, surveying the rocks above him. Lip curling, I concentrate on my own path. Behind us, there’s a faint shout. I glance back to see Mum and Dad heading our way. Mum has her arm in the air, waving, and I can imagine her worried expression. All the more reason to hurry, I decide; she’s bound to make us come down when she gets nearer. Leo looks my way, grinning, and I guess he’s thinking the same thing. We both climb faster.

We’re almost level when I notice him pause again. My strategy is paying off; the top boulder is in sight and the rocks ahead of me look like an easy climb. Leo stands still, his feet precariously balanced on one side of an evil-looking ridge, and I can see why he’s stopped. There’s a gaping hole between where he stands and the next rock. If he wants to beat me, he’ll have to jump.

His eyes flicker downward, as though he’s considering backtracking. A surge of triumph rushes through me; if he does that, there’s no way he can win.

“Sucks to be you, Leo,” I call across to him, scaling the stone with the kind of spidery skill that would put Peter Parker to shame. “How much do you think your guitar will fetch on eBay?”

He scowls and scans the rocks with more urgency. Laughing, I maneuver past the last obstacle in my way and clamber onto the top of the rocks. Below, I hear a grunt. I look down just as Leo clears the gap and grips onto the rock above. But there’s something wrong. I see panic on his face. His fingers scrabble in the half-dried seaweed and his feet scratch against the stone, struggling to hold his weight. He hangs there, almost floating. Without a thought, I throw myself down flat and thrust out a hand to grab him. My fingers grip his, and in a whoosh of relief, I’ve got him. But a second later he slips through my grasp and I’m holding thin air. He starts to drop. My terrified gaze locks onto his as he falls, almost in slow motion. Then there’s the sickening crunch of bone on rock and his eyelids snap shut.

He lies unmoving. I watch red blossom against the gray-black boulder where his head rests. And somewhere, somebody starts to scream.



Mum is hovering at my side, the way she does most days, her face tired and careworn. She looks older than her fifty-five years, something she can thank me for—I’ve worried her for most of my life. I know they’d almost given up on a baby by the time I came along, so it seems too cruel that the one they got was faulty. Dad looks old, too, although they both try to keep in shape. Dad used to run marathons. He doesn’t anymore; my illness eats up so much of his time.

I shake my head. “No thanks.”

She reaches out to take a grape from the bag on my table. “These are good. Want one?”

This time I turn away. “No.”

Sometimes my mother drives me insane. Dad is here less, so he doesn’t get on my nerves as much. To be fair, most of the time they’re pretty good at picking up when I want to be alone and they wander off to the cafeteria, but Mum obviously has her irritation detector switched off today. One of the worst things about spending 24-7 in the hospital is that it’s a bit like being on Big Brother, but without the Z-list status and shopping tasks—there’s always someone who wants to “take a quick look” at you, poking and prodding like you’re a laboratory experiment. And everyone on your ward knows everything about you, even the little kids; there’s no such thing as privacy. We have this traffic light system over our beds to let people know if we feel like being sociable—a green card means “party on,” amber means “tread carefully,” and red means “do not disturb,” which my mother usually ignores. Em’s is red a lot because the chemo makes her vom, but she sometimes makes an exception for me. That’s when I dig out my funniest jokes, because it turns out laughter really is the best medicine. I know hearing Em laugh always makes me feel better.

“I see Manesh has gone home,” Mum says, clearly determined to get me talking. “Such a lovely family. I’m glad things worked out for them.”

Manesh is the nine-year-old boy who, until this morning, occupied the bed opposite mine. Things get pretty intense on the ward—the families lean on one another for support, and celebrate the successes just as hard as they mourn the losses. It was touch and go with Manesh for a while, so I can’t begrudge him his happy ending. It’s not as though he’s the first kid on the ward to get a transplant before me; the common blood groups are easier to match up with donors, although the hearts need to be the right size. Even so, I can’t manage much more than a grunt in reply.

“Nick says you’re at the top of the transplant list,” Mum persists. “It’ll be your turn next.”

Nick is my transplant coordinator and he’s been telling me I’ll get a heart soon for so long that I don’t believe him anymore. My immune system is sensitized, which means it would attack some tissue types, so the doctors can’t do anything until the right heart comes up, and every day I spend on my Berlin Heart increases my chances of having an infection or a stroke. Blood is pretty clever stuff, it knows when it’s outside of the body, and it doesn’t like it. So the blood in the Berlin Heart tries to clot. If that happens, the chamber has to be changed for a new one. One day, the stroke could be severe and I’ll run out of chances.

“It’s not really up to Nick,” I reply, turning to look at my mother. “He’s not God.”

She smiles, indulging my grumpiness like she always does. “It’s your turn next. I know it is.”

I want to scream then, because she knows no such thing. My mum has a degree in staying cheerful, and mostly it’s easier to go along with her. But sometimes—just sometimes—I wish she’d drop the “Everything Is Awesome” act and face the truth: she doesn’t have to worry about what to get me for Christmas. But then I look into her eyes and see how much she needs to believe, and all my irritation drains away.

“Maybe just one grape,” I say, reaching for the bag.

Em stops by after tea.

“What’s going on with you today?” she asks, sitting down next to my bed and arranging her drip stand. “Too cool for school?”

She grins as she says it, showing me she’s not being snarky, and I see her lips are red and sore-looking with ulcers. You’d think being sick means we get out of lessons and stuff, but no such luck. The hospital has its own school, although we don’t have to go every day if we don’t want to. Sometimes, if you don’t feel well, a teacher comes to you for a bit instead. It’s not as horrific as it sounds; pretty much everyone who works at the hospital is cool. My favorite person is a nurse called Femi, who brings me the coolest manga comics ever. I’ve shown him some of my own drawings and he reckons I’m good enough to maybe get a job as an illustrator someday. I haven’t bothered to point out that “someday” will probably never happen.

“You know how it is.” I look at Em. “I didn’t fancy it.”

I don’t mention that I’ve felt weird all day, sluggish and weary and unsociable. I haven’t even felt like drawing—my sketchbook lies unopened on the bed. Em and I have a pact—total honesty—but she has it worse than me most of the time and I don’t want to moan.

She knows me too well, though. “What? Is it another infection?”

The Berlin Heart means I have open wounds in my chest where the tubes come in and out of my body, so infection is never far away. But I don’t think that’s it; I don’t feel feverish or shivery, which are the usual dead giveaways. I just feel… old. “It’s probably nothing,” I say, trying my hardest to sound casual. “What did I miss today?”

She refuses to be sidetracked. “I’m calling Femi.”

“No,” I say, sitting up so fast it makes my head spin. “Don’t.”

“Then tell me what’s going on.”

I lie back on my pillow. “Do you ever wonder whether it’s worth it? All this treatment?”

She stares at me like I’ve grown another head. “Of course it is.”

Ordinarily, I’d agree. But Manesh going home has bothered me more than I want to admit; it’s like his good fortune has reminded me how bad my own chances are. So I’ve been thinking about dying. I’ve been thinking about it a lot. “It feels like I’m running out of luck, Em.”

“Bull,” she says briskly. “You’re going to outlive me.”

The confidence in her voice makes me smile in spite of myself. It’s total crap, of course; after all the chemo she’s been through, every cell in her body has been nuked—the mutated ones must have surrendered by now.


Em gets up, touches a cool hand to my forehead. “This isn’t like you. Are you sure you’re not ill?”

It takes a minute for the ridiculousness of what she’s just said to sink in, then we both explode into laughter. “God, I’m such an idiot,” she manages eventually. “Sorry.”

We cackle like hyenas until Femi pokes his dark head around the curtain. His eyes dance when he sees us laughing. “What’s so funny?”

Em waves him away. “You had to be there.”

“It was obviously a good joke,” he says. “And you know the rules about good jokes.”

Femi has the most amazing full-bellied laugh and loves nothing better than to share it, so his rule is that good jokes have to go on the notice board. But this wasn’t the kind of joke anyone else would laugh at—like Em says, you had to be there. “Sorry, Femi,” I say. “It’s a private joke. No one else would get it.”

He nods. “You two are good for each other. It makes my heart glad to see you laughing.” His gaze comes to rest on my sketchbook. “Have you been drawing, my friend?”

“Not today,” I tell him, and reach for the manga book on my bedside table. “I finished the comic you brought me, though.”

Em squints at the title. “Fairy Tail? Really?”

Femi and I exchange a look. Em doesn’t get our shared obsession with manga. In fact, she doesn’t really get my comic obsession, period. Femi does, though. We’ve secretly agreed that if Em doesn’t want to go to London Super Comic Con with me when we’re better, then he will. If I’m completely honest, I’m kind of hoping Em ducks out of it—she’s great, but Femi knows every X-Men plotline inside out and backward.

“Ah,” he says, stepping forward to take the comic. “You will need Return of the Dragons! next. Natsu faces his greatest challenge yet. I will bring it tomorrow.”

“Thanks,” I say.

“No problem,” he replies, his face splitting into a grin. “Make sure you get some rest, you two.”

He vanishes behind the curtains. Em yawns and gets to her feet. “I should be going, too,” she says, pushing her stand toward the gap. “See you tomorrow, yeah? Try not to die in the night.”

I smile, because it’s another one of our private jokes. “You too.”


I DON’T REMEMBER A LOT OF WHAT HAPPENS immediately after the accident. I know I get down from the rocks somehow, and the man walking his dog races over to help my white-faced, panic-stricken mother, but I couldn’t tell you anything he does. And I know my father calls the emergency services, with shaking fingers that take three attempts to dial the numbers, but only because he tells me so afterward. I remember seeing the air ambulance land on the stony beach, and watching the paramedics take care of Leo, but the seconds right after I hear his head smack into the unyielding rock are dark in my mind.

They work on him for half an hour, thirty long minutes of hushed medical jargon, while we look on in helpless silence. Dad holds my hand, squeezing hard, but I don’t complain. Leo doesn’t open his eyes once. Part of me expects one eyelid to flicker back, for him to grin when he sees our stressed faces. But another part of me, the bit that wonders how much blood someone can lose before they’re in serious trouble, worries that we won’t see him laugh again for a long time. And I curse myself for agreeing to his stupid dare; if I’d refused, we’d be on our way back to the cottage by now. I wish I’d taken another route up the rocks, that he hadn’t felt the pressure to win and taken a crazy risk. I even wish it was me lying pale and still, except I’d never have had the nerve to try the jump in the first place.

Mum goes with Leo in the helicopter. I think Dad wants to go as well, but there isn’t room for all of us, and someone has to move the car from the beachside parking lot. So he shakes the hand of the man with the dog and promises to let him know how Leo gets on. We drive to the hospital in silence. I see and don’t see the countryside flash by, the speedometer creeping up and up as Dad takes the corners faster than he should. A film of unreality covers everything, like I’m observing events through dusty glass. My scratched hands, folded tightly around Leo’s battered phone, don’t look like my own. They don’t feel like part of me. Nothing does.

At the hospital, we’re ushered in to meet Mum. She’s in a waiting room, her hair wild and her cheeks colorless, with a nurse at her side. They’re talking as we walk in.

“No news yet,” Mum says as Dad wraps her in a hug. “They’re assessing him now.”


  • "Pumps out grief and joy like the beating of a heart. A sweet, yet gut-wrenching novel that'll keep you turning pages."—Adi Alsaid, author of North of Happy and Let's Get Lost

  • "Save some [tissues] for Instructions for a Secondhand Heart... Jonny and [Neve] inspire confidence that they will overcome their obstacles; you would have to have a heart of stone not to root for them."—The Guardian

  • "Romance fans will revel in Jonny and Neve's intensity."—BCCB

  • "British author Murray explores teen illness and death realistically...Readers should find it easy to cheer on these two misfits who are figuring how they fit in and fit together."—Publishers Weekly

  • "Neve and Jonny are emotionally complex, vulnerable protagonists who help each other face realities they never dreamed they'd see."—Horn Book

  • "Told in alternating viewpoints, this heavy-hitting story covers life, death, romance, friendship, loyalty, and much more. Readers will enjoy the emotionally realistic storyline."—School Library Connection

  • "Their tentative journey feels fresh. Jonny's hospital experiences include a friendship with a girl battling cancer, and the book includes his drawings of her alter-identity as Chemo-Girl. This will appeal to readers drawn to romances featuring ill teenagers, such as (naturally) John Green's The Fault in Our Stars (2012)."—Booklist

On Sale
Dec 5, 2017
Page Count
320 pages

Tamsyn Murray

About the Author

Tamsyn Murray spent her childhood moving around a lot throughout England. At eighteen she left home to go to university in London and now lives in Hertfordshire. When she’s not working or writing, she can be found singing and dancing with her local amateur dramatics society. She has one daughter and one son and several pets.

Learn more about this author