Ruth Powys rushed to hospital to be with him after he fell outside a New York hotel in the early hours of Wednesday.
Ruth, 36, had been in a little-known relationship with the Duchess of Cornwall’s brother since 2009.
She was among friends who were with the conservation campaigner during his final minutes on life support at Manhattan’s Bellevue hospital. Ruth, who helped run his charity Elephant Family, described Mark as “everything, my inspiration in life – he gave me everything I had, he’s everywhere I look”.
Fighting back tears she said: “I had my hand on his heart. We’d been together on and off for many years after Mark was divorced.
“We were not together at this moment. I had moved to New York to try to separate myself from him but we had the deepest love, we were full of love for each other.”
I had my hand on his heart. We’d been together on and off for many years after Mark was divorced
The charity worker had gone home after a happy evening during which Mark hosted a charity Faberge egg auction, raising £1million to help save endangered Asian elephants.
The striking blonde had been with him since his divorce from Clio Goldsmith. Last night the office of the New York medical examiner revealed he died of a fractured skull.
A statement read: “Cause of death: blunt impact head trauma with skull fracture and subdural haematoma. Manner of death: accident.”
Mr Shand had co-hosted the charity auction before going on to a party at the Diamond Horseshoe nightclub. He left at 1am and went to the exclusive Gramercy Park Hotel where, around an hour later, he went outside to have a cigarette and fell, striking his head on the pavement.
The freak accident was captured on CCTV. He was taken to hospital and his relatives, including the Duchess of Cornwall, who is in Scotland, were informed by telephone.
Ruth told how Mark had struggled to come to terms with their 25-year age difference. She said: “We were trying to separate but it was a difficult thing to do, to try to move on. He wanted me to find someone my own age. Our relationship was low key. We shared a passion for elephants, we had the same spirit.”
She added: “My work now is to continue his legacy.”
Her tribute came as his nephews Tom Parker Bowles and Ben Elliot arrived in New York to bring their uncle’s body home to the UK.
Camilla’s son Tom wrote on Twitter last night: “A massive thank you for everyone’s lovely words about our late, great uncle Mark Shand. Deeply appreciated.”
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