Anyone who has a heart
...and who isn’t overly squeamish will be gripped by this surgeon’s brutal but humane account of life and death at the cutting edge
Fragile Lives Stephen Westaby HarperCollins €15.99 ★★★★★
There is no getting away from doctors: even the healthiest of us will eventually encounter them. But there are many different ways of being a patient. Some recoil from a stethoscope as though it were a rattlesnake, while others are fascinated by arcane medical knowledge.
The latter group will be captivated by Stephen Westaby’s memoir. Professor Westaby is a pioneering heart surgeon at the John Radcliffe Hospital in Oxford in southeast England, a veteran of thousands of operations over 35 years.
Cardiac surgery is an extraordinary mixture of brutality and delicacy, and there is no shortage in Westaby’s book of both exquisite knifework and buckets of blood.
Medicine was not an obvious career for the boy born in Lincolnshire on July 27, 1948. Westaby’s father worked for the local co-op and the family lived in a council house. But as a child he saw a documentary that would shape his future. Your Life In Their Hands reported an exciting medical innovation: surgeons in the US had closed a hole in the heart using a new piece of equipment known as a heart-lung machine. ‘Right then I decided that I would be a heart surgeon,’ he writes.
As a medical student he had an encounter that would haunt him. From an observation dome, he looked down on a heart operation that was not going well and the battle for life was lost.
The patient Beth, was a mother in her 20s. ‘Beth taught me a very important lesson – all heart surgery is a risk. Surgeons don’t look back. We move on to the next patient, always expecting the outcome to be better, never doubting it,’ Westaby writes. His gripping account of performing surgery is not for the squeamish. There are fountains of blood, and a novel solution to the problem of loo breaks during surgery – a length of rubber tubing that feeds into his boots. Of course, among the triumphs are harrowing stories of failures, personal and professional, with which all surgeons have to live. One of Westaby’s saddest cases came desperately close to success. He was asked to operate on a baby with a rare abnormality: the position of all his abdominal organs, including his heart, was reversed. The only way to remove a benign tumour from the child’s heart, he concluded, was to ‘chop out the boy’s heart from his chest and, with it lying on a kidney dish full of ice, operate on it on the bench’. This he did, and succeeded in restarting the baby’s heart but postoperative complications were too severe for the child to survive. ‘This is cardiac surgery,’ he concludes sadly. ‘Another day at the office for me, the end of the world for [the child’s mother].’
Alongside his compassion for his patients is a burning fury that some of them should have been let down by bureaucracy, rather than surgery.
‘No physical ailment was as debilitating as hospital bureaucracy, not being able to operate, no beds, not enough nurses, junior doctors on strike… Bury the blame-andshame culture and give us the tools to do the job.’