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Mary is running around her hospital bed, playing with dolls, crayons and toy stethoscopes (or the real thing if she can get her hands on one). She giggles mischievously, tripping and falling as she evades her mother’s playful swipes and our attempts to examine her. Mary is a regular source of joy on the morning ward round and seemingly a picture of health. That is of course, apart from the two large-bore cannulae exuding from her chest, plunged deep into her malfunctioning heart. Assisting with every contraction, she depends on her ‘Berlin Heart’ (a type of ventricular assist device) to deliver the majority of her systolic output. Mary has dilated cardiomyopathy and has been on the ward for several months now, awaiting a heart transplant. No one knows when this will come.