"I didn’t sleep a wink – I just looked at her all night. I was so proud of her – she was so beautiful. I was, and am, so proud to call her my daughter." These are the powerful words of Eleri James describing the moment she slept alongside her beloved daughter Beca Mai in intensive care.
Beca tragically died six days after she was involved in a crash on the A478 between Narberth and Penblewin in Pembrokeshire on August 20, 2021. She died on August 26 aged 23. The crash – which Eleri, a staff nurse at Glangwli Hospital, believes happened due to Beca having a medical episode behind the wheel – saw her Vauxhall Corsa cross the carriageway and collide with a lorry.
Beca was airlifted to the University Hospital of Wales in Cardiff but doctors told her family the impact of the crash would have left the qualified teacher severely brain damaged. As a result of the prognosis Eleri and her two sons Llion, 31, and Tegid, 28, made the heartbreaking decision to bring her treatment to an end.
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However before she sadly passed away Beca's family honoured her wish to donate her organs and are now encouraging other families to do the same. Beca's kidneys and pancreas saved two people who had been on the transplant list for more than 18 months and her heart has been stored to help others at a later date. One of her kidneys was donated to a young girl in her 20s while her other kidney as well as her pancreas was donated to a 42-year-old mother. Her heart will also be able to help up to four other people as the valves can be used as well as the tissue. "My sons and my only wish was that a young person could be saved and young children – because Beca lived for helping young children – were able to get their mother back through her organs," said Eleri.
Almost a year to the day since Beca tragically died Eleri reflected on the "hardest day" of her life and how she "will never stop celebrating" her "angel daughter". Beca had recently completed her teaching qualification and had been accepted as a Year One teacher at Narberth Primary School. She had worked as a teaching assistant for five years along side her studies at the University of Wales Trinity St David and "adored" children and teaching. Tragically she died before she was able to take up her first teaching post although was able to teach at the school during the last week of the summer term following the completion of her PGCE qualification.
On the day of the crash she had been preparing her classroom ahead of the new term. "She'd been in on Thursday, August 19, arranging her classroom and Nia Ward, the headmistress at the time, told her at the end of that day: ‘Your classroom is perfect, you don’t need to come back before the start of September’," said Eleri.
"But Beca being Beca hadn’t realised that schools don’t provide writing materials for pupils and that it was down to the parents to provide these. Beca being the perfectionist and obviously concerned about this visited The Range on the morning of August 20 to pick up 26 pencils, 26 rubbers, and 26 little pots.
"She rang me and I said: 'Why do you have to go in today now? Go in a bit earlier on your first day' and she said: 'No Mam, what if one of the children forgets his or her pencil case on the first morning? They’d be devastated and I don’t want that to happen.' Her last act of kindness that day was to place a pencil and rubber at each pupil's chair."
Beca phoned her mother at 4.30pm to let her know that she was about to leave the school and that she also had a really bad headache. "It turned out that she hadn't eaten or drank that day and Beca informed me that she had been rushing about too much all day. I insisted she drank a pint of water before leaving the school. That was the last conversation we ever had."
Beca was due to meet Eleri and Eleri's partner Tim at Beca's new house in Carmarthen at 5.30pm. She had only moved in three days earlier. When Beca didn't turn up and wasn't answering her calls Eleri started to suspect something had happened. Tragically the crash happened at around 5pm.
"Me and my partner Tim were there waiting to put a wardrobe up but she wasn't answering her phone so we decided to go to Tenby first and arranged by text to visit her on our journey home. We were on our way to Tenby and my phone rang and it was a member of Tim's family contacting me to say the police were at our farm wanting to speak to me," Eleri said.
"He said the police were on the farm. I’d worked for the police for 17 years and it was two colleagues who I knew well that had come to the farm. One of them had been Beca’s manager when she was working in New Look so knew Beca really well. They couldn't speak to me on the phone, they couldn't say anything, they just had to see me face to face.
"One of them suggested we meet in the B&Q car park and I heard another officer in the background say: ‘That’s the wrong side of the road’ and that’s when I knew we were heading for the Heath hospital. From that instant, being a nurse and having worked with the police, I just knew we needed to be on the correct side of the carriageway to get to Cardiff quickly."
Eleri said she managed to get hold of her son Tegid but not Beca nor Llion so she was wracked with worry wondering "which one it was". She said: "I didn’t know until we got to the meeting place which child had been involved. That's when we were informed by the that Beca had been involved in a horrific car accident."
Beca was airlifted to the trauma centre at the University Hospital of Wales Cardiff while Eleri and Tim were driven up in the police vehicle. Beca was taken immediately to the emergency unit. "The neurosurgeons told us on day one that they shouldn’t really have flown her up because she was essentially dead at the scene. But the officer that arrived at the scene first was a friend of mine and she said: ‘You’ve got to save her life – she’s Eleri's daughter' and I think maybe that was the persuading factor."
Eleri said that physically Beca had no visible marks on her body from the neck down and that her head and brain had sustained the most trauma in the crash – so much so that more than 150 clips were placed in her scalp. However surgeons knew that the damage to her brain was irreversible.
"We were told after only 24 hours of arriving at the intensive care unit that Beca was severely brain damaged and should she survive she would be severely brain damaged. And that’s when we decided we’d stop treatment and that was a decision by me and the boys. By day two they told us that the top half of her brain had died."
One of Beca's wishes was to donate her organs so ,despite stopping treatment, the staff at the hospital had to keep her body functioning while transplant surgeons came to Cardiff and those ready to receive the donations were matched and contacted. They weaned her off medication for those six days until she was able to go into theatre for organ removal.
"[The doctors] inserted a probe between her skull and brain to measure the intracranial pressure. A normal reading should be less than 20 but by day five her intracranial pressure reading was over 170. Basically her brain was pressing on her skull so much. They considered a craniotomy to relieve the pressure but they knew she was terminal so decided against that. Going through surgery would have been too much for her. We just wanted her to be comfortable.
"There was a lot of decisions we had to make as a family. As a nurse I have been with many families when they have had to make difficult decisions before now but this was all about my daughter.
"I’ve helped thousands and thousands of patients over the years but I couldn’t make my daughter better. That is the hardest thing any mum or nurse could go through.
"The crucial part in all of this was that her heart could have stopped at any time during those six days. But it didn’t. She was as determined a person as ever to see this through. She went into theatre on a ventilator because it was my wishes that the boys would not see her not breathing. I witnessed the brain functionality test where they check all of the brain functions and then of course turned the machine off for 10 seconds and her chest didn’t rise. And that was the hardest thing for me. I had to witness the test otherwise I wouldn't be happy to be just told that my daughter was brain stem dead.
"I’m quite spiritual and I go to see a medium and one of the questions I asked Beca was could she hear what was being said by her bedside because it was never good news. And she said: 'It was only my body there Mami. I died at the scene'. The 20th [of August] to me is the day she died."
In the six days that Beca was in intensive care Eleri said she didn't leave her side for more than an hour at a time. She praised the staff at the hospital saying they gave to her "a gift she would never forget" and that was when they let Eleri sleep in bed with her beloved daughter before she died.
"The hospital staff were incredible. The facilities for families were poor but that wasn’t the staff's fault. I cannot fault the care she had – it was absolutely amazing. However the welfare of the staff was a concern of mine and their welfare fund was given a substantial boost from family and friends of Beca following her passing.
"One gift they gave to me, which I will be forever grateful for, is that they let me lie with her. I went in one evening, two days before she was taken down to theatre, and they said to me: ‘Would you like to lie beside her in bed?’ and I said: ‘I would love to’. Along with my sons Llion and Tegid and his girlfriend Lowri my partner Tim was an amazingly supportive partner to me and a fantastic stepdad to Beca.
"Believing I was going to lie in a bed alongside her I was surprised to be given the opportunity to sleep right next to her in her hospital bed. I didn’t sleep a wink. I just looked at her all night. She was still as beautiful as ever in my eyes despite all her facial injuries and head swelling. I was so proud of her not only as a caring human being but also as a precious daughter loved by her family and an abundance of friends who all miss her terribly."
On August 26, at around 7am, Beca was taken into surgery and the family said their final goodbyes. Around two hours later they got the call to say she had died. The family had to wait six days between arriving at the intensive care unit and the surgery due to the need to reduce all the sedatives and undertaking the brain functionality test and of course the logistics of getting all necessary parties in the right place for organ donation.
Eleri said: "There are only five transplant surgeons in the whole of the UK who could do this and they had to all gather in the same location where the organs are being removed. They also had to organise the matching of and contacting of the suitable recipients on the transplant waiting lists. The organ transplant team and our co-ordinator Tori were all amazing people working tirelessly around the clock to achieve their aim and goal of saving lives through successful transplants.
"Tegid read out an eulogy at her bedside and I did a short speech thanking the intensive care staff for the excellent care she received and thanked the theatre staff who were about to take her into theatre for the care Beca was about to receive. We knew her going down to theatre would be the last time we would see her breathing and they let us know about two hours later that she was no longer with us."
Despite the trauma Eleri and her family have been through she said she wants to see Beca's death as a positive influence on others to also consider donating their organs as well as "shouting from the rooftops" about how brilliant a person Beca was. Beca would have turned 24 in May this year and since passing this milestone Eleri said she has "renewed energy".
"All my children and I have discussed [organ donation]. It's a no-brainer for us. Beca and I had actually had the conversation three weeks before the crash about organ donation because for the new job she needed her driving licence to complete the medical forms for Pembrokeshire County Council which required her driver licence number and of course the donor badge was on it.
"I believed I would go before her and I said: ‘I’m hanging on to my eyes’ and Beca said: ‘Flipping heck yeah I’d need my eyes up in heaven wouldn’t I?’. So that was a bit ironic as only three weeks later I’m telling them: 'Everything but her eyes.'
Eleri said she wants more people to consider organ donation as an option as well as respecting family members' wishes after they have died. "Even if a person has chosen to donate the family more often than not make the decision after death that they don’t want their family member's organs to be donated – they go against the decision of the individual at that vital time," she said.
"As a nurse of 37 years I didn’t realise how few people donated organs and how many people there are on the transplant waiting list. That to me is absolutely ludicrous. There’s a girl at the moment looking for a kidney and I have put myself forward as a live donor as I only need one kidney to function normally." According to organdonation.nhs.uk there are currently more than 6,000 people in the UK waiting for transplants.
"Both people who had Beca’s organs had been on the waiting list for 18 months-plus. And that was since being on the transplant list – they could have been having dialysis three or four times a week for God knows how many years prior to transplant. So giving those children their mother back and not spending days upon days on dialysis was our dream and that happened," said Eleri.
"Her liver was split into three and went as far as the recipient hospitals but the three surgeons felt that the liver was not of the quality that would give the recipients the maximum quality of life following transplant. In effect seven recipients were on the other end waiting – it was only when they went in to remove the organs they realised that some organs were damaged too badly during the collision to be considered for transplant.
"Her heart can be stored. The heart can go and help at least four patients. The valves can be used, the tissue can be used – both for research but also to redevelop heart tissue – so there is a prospect there of helping three further people. As it stands at the moment about six patients have or will have benefited from her donations."
Approaching the first anniversary of her death Eleri said she feels just as close to Beca as she always has done and feels honoured to have been able to spend 23 years with her. "She will live on in everybody’s hearts – she always will.
"But since her birthday, the first without her of course, I want to shout out about how much of an amazing person she was. I know many people already know about her but there are some people that don’t and I could shout from all the rooftops what a wonderful daughter she was to me. She still is. She will be my daughter for life. She will never be left out of any celebrations. I’ve got this renewed energy. I will make sure her legacy will live on in all of us that knew her and others that weren't fortunate enough to meet her on earth.
"She was an absolute delight of a daughter and my best friend. I thrive on the fact that I had her for 23 years of my life. I was privileged to have her by my side. That’s what keeps me going. For nine of the last years it was literally me and her as a duo because the boys had already left home. She was my rock.
"The fact that Beca was so caring in life, she was so caring also after life. And to me that’s the biggest gift anyone can give."
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