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Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table

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An incredible memoir from one of the world’s most eminent heart surgeons and some of the most remarkable and poignant cases he’s worked on.

Grim Reaper sits on the heart surgeon’s shoulder. A slip of the hand and life ebbs away.

The balance between life and death is so delicate, and the heart surgeon walks that rope between the two. In the operating room there is no time for doubt. It is flesh, blood, rib-retractors and pumping the vital organ with your bare hand to squeeze the life back into it. An off-day can have dire consequences – this job has a steep learning curve, and the cost is measured in human life. Cardiac surgery is not for the faint of heart.

Professor Stephen Westaby took chances and pushed the boundaries of heart surgery. He saved hundreds of lives over the course of a thirty-five year career and now, in his astounding memoir, Westaby details some of his most remarkable and poignant cases – such as the baby who had suffered multiple heart attacks by six months old, a woman who lived the nightmare of locked-in syndrome, and a man whose life was powered by a battery for eight years.

A powerful, important and incredibly moving book, Fragile Lives offers an exceptional insight into the exhilarating and sometimes tragic world of heart surgery, and how it feels to hold someone’s life in your hands.

349 pages, Hardcover

First published February 9, 2017

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Stephen Westaby

21 books93 followers

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Displaying 1 - 30 of 582 reviews
Profile Image for Petra X.
2,456 reviews35.5k followers
April 25, 2017
This is one of those books of medical true-life stories, but is more technical than most By the end, I knew a great deal more of the structure of the heart, blood chemistry and why making lots of pee is extremely important.

The author is a very forthright sort of man, and a very empathetic one too. The people he operates on he describes in detail, I felt for him when he lost a patient, I rejoiced with him when his inventions kept people alive. And I held my breath when he operated on a pregnant woman to repair her heart as by now I knew enough of technical details of such operations to appreciate just how difficult it was to put a woman on a heart-lung machine and keep the foetus, who is not on the machine at all, alive.

In the epilogue, he castigates the National Health for publishing the death rates of individual heart surgeons - people are now frightened away of the speciality leaving the field open to foreign surgeons. Operating on extremely ill people who will die without the operation means that some will not survive anyway. And surgeons that take on the most difficult of cases are going to have higher losses than those who routinely replace heart valves in patients who are merely 'at risk'.

The BBC made a tv programme, 'Your Life in Their Hands' and one of the questions asked was one Americans will never be able to appreciate. It was whether the NHS should spend a fortune on keeping a 20 year old heart patient alive? The author answered it by saying should a first world country not spend the money and let the patient die in misery as in third world countries? He could have added 'or in those first world countries that won't pay for its citizens to have these extraordinarily expensive operations with pumps or other implants that can cost as much as a fancy car'. If the country won't pay and the patient can't, it really puts that country and the third world ones that can't pay on the same level, doesn't it?

Profile Image for Mostafa Galal.
177 reviews238 followers
May 24, 2019
كتاب رائع يسرد فيه واحد من كبار جراحي القلب في العالم تجربته الشخصية في التعامل مع مرضى القلب، ومعانقته للموت كل مرة يجري فيها أحد عملياته
الكتاب جيد ليس فقط من الناحية العلمية، بل من الناحية الانسانية أيضاً، بمجرد أن تندمج مع الكتاب حتى تستشعر حزن الكاتب مع مريض يموت بين يديه، وفرحته وهو ينقذ مريض آخر محكوم عليه بالموت، وحيرته في التعامل مع حالة شديدة التعقيد كامرأة حامل أو جنين لا يتجاوز عمره اسابيع ويعاني من مشاكل قلبية متعددة
كتاب مميز اتمنى ترجمته للعربية، مع تقديم شرح مبسط لبعض المصطلحات الطبية التي استخدمها الكاتب حتى لا يضطر القارئ للتوقف عن القراءة عدة مرات والاستعانة بجوجل من أجل فهم المحتوى
Profile Image for India M. Clamp.
301 reviews
March 1, 2022
Death and a surgeons determined walk away from the table is truly a sight to see. In this case it’s British Cardiac Surgeon Stephen Westaby. Reading Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table takes us to the discovery of a little baby with a congenital hole in its heart and how “nascentes morimur” applies.

Repair is cardinal in the life of this surgeon. Within we witness rehabilitation of a mitral valve, a donor heart transplantation and the excavation of a heart tumor. Westaby is confounded with the politics of medicine and how the NHS recommends that rates for success and failure be published for the world to see.

“The crimson fountain hit the operating lights, sprayed the surgeons, soaked the green drapes. Someone murmured “Oh sh..! I was good with my hands (an understatement). The battle was lost…Yet I knew about life and death.”
---Stephen Westaby, MD

Masterfully written and when Open Heart is recited, it rolls off the tongue like prose in its melliferous rhythm narrated by one of the world's leading heart surgeons. If you happen to favor Atul Gawande’s Being Mortal or legendary Henry Marsh’s Do No Harm you have found a read on the same level with added gore and "blut” pooling.

Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table cautions us and is not a clean, prim or proper journey detailing 11,000 surgeries. Stabbings, life and death battles and even the surgeon's hand--now disfigured—tell of hazards commonplace to surgery. Medical students must read. Buy and cry.
Profile Image for Rebecca.
4,109 reviews3,391 followers
September 9, 2019
“We stop life and start it again, making things better, taking calculated risks.” Although the 2017 Wellcome Prize shortlist has only just been announced, this is my early favorite for the 2018 prize (for fiction and nonfiction on a medical theme). What Henry Marsh did for brain surgery in Do No Harm, Westaby does for cardiac surgery with this vivid, compassionate set of stories culled from a long career at the forefront of artificial heart technology.

A working class lad from Scunthorpe who watched his grandfather die of heart failure, he made his way up from hospital porter to world-leading surgeon after training at Charing Cross Hospital Medical School. Each of these case studies, from a young African mother and her sick child whom he met while working in Saudi Arabia in the 1980s to a university student who collapses not far from his hospital in Oxford, is told in impressive depth.

Although the surgery details are not for the squeamish, I found them riveting. Westaby conveys a keen sense of the adrenaline rush a surgeon gets while operating with the Grim Reaper looking on. I am not a little envious of all that Westaby has achieved: not just saving the occasional life despite his high-mortality field – as if that weren’t enough – but also pioneering various artificial heart solutions and a tracheal bypass tube that’s named after him.

Like Marsh, he tries not to get emotionally attached to his patients, but often fails in this respect. “Surgeons are meant to be objective, not human,” he shrugs. But, also like Marsh, at his retirement he feels that NHS bureaucracy has tied his hands, denying necessary funds and equipment. Both authors come across as mavericks who don’t play by the rules, but save lives anyway.

A fascinating read for anyone who enjoys books on a medical theme.

A few more favorite lines:
“We were adrenaline junkies living on a continuous high, craving action. From bleeding patients to cardiac arrests. From theatre to intensive care. From pub to party.”

“‘What ifs’ are no good in cardiac surgery – they simply don’t help.”

“My complete nightmare scenario – body better, brain buggered.”
Profile Image for Jo (The Book Geek).
924 reviews
May 21, 2020
I had just turned 21 when I was told that my Dad had been feeling a little dizzy and breathless at work, and my Mum had pretty much played it down to me, telling me it was angina, and he probably needed some tablets. My Dad went to a routine check up at the hospital three weeks later, where he had a Transesophageal Echocardiography, and what he thought was going to be a swift outpatients in and out job, lead to a weeks stay on the critical care unit, and a further three on the recovery ward. The consultant had found my Dad had an artery that was 96% blocked, and would have been only a matter of time before he would have passed away. He needed an urgent coronary bypass surgery operation, which he had just five hours later, at 12am midnight. To be told that you may lose a parent, and I didn't get to see him before he went in, was ultimately distressing, but I cannot comprehend just how my Dad felt at that moment. Fourteen years later, my Dad is coming up to 70, and have always been truly grateful to the amazing heart surgeons that ultimately saved him.

Dr Westbury was obviously something of a marvel, and was masterful in his work. I think to do a profession such as that, you need to be of a certain character, and I know, that I certainly couldn't do it. Dr Westbury tells us of the many triumphs where his patients of all ages have gone on to live happy and fulfilling lives, but also the tragedies, where lives were lost way too soon. There was much jargon in here, and some of it went over my head, but it made for interesting reading.

I did have an issue with Dr Westbury though, as skilful as he may be, is that is his overall attitude towards the female species was baffling. He referred to a patient as "blonde and pretty", and another patient as "stunningly beautiful" and yet another female patient had apparently had her bum peeking out of the hospital gown because it wasn't done up properly. Dr Westbury just reeked of misogyny and he seemed to be rather egotistical in his manner, which didn't sit too kindly with me.

That said, the book was interesting, and it made me think about my Dad, and what a lucky break he had in life.

Profile Image for Laura.
824 reviews118 followers
January 7, 2018
A brilliant, thought provoking memoir chronicling renowned heart surgeon Westaby as he details his life and career. Starting from humble beginnings, the author challenges the perception that only public schoolboys get to be surgeons.

I was pleasantly surprised to find that the hospital predominately featured in this book was my very own local one - and where I began my own career as a registered nurse in 2012. Although I have not had the pleasure of meeting the author personally, his accounts of “our” hospital life ring true - from the demands placed on the dedicated staff to the bureaucratic issues that underpin medical and nursing practice. I was delighted to find the author repeatedly praised the skill and dedication of the nurses working alongside him, something that I have sadly found to be lacking in other medical based memoirs.

Some of the stories are truly sorrowful, others uplifting in the face of adversity. But that is modern medicine. The author teaches his readers a great detail about cardiology without too much overwhelming medical jargon. Perfect for those interested in the fundamentals of cardiology.

Profile Image for Liz Barnsley.
3,726 reviews1,072 followers
February 28, 2018
I read this pretty much in one sitting - an incredibly emotional, informative and really very addictive memoir here from Stephen Westaby, I now know more about the human heart than I ever could imagine that I would.

A true trailblazer but oddly for a man of this nature and genius not at all egotistical, he came across brilliantly and all the stories he told, all the people he saved and the ones he couldn't will stay with me for a long long time.

Spanning many years and many innovations, "Fragile Hearts" puts life into huge perspective - just how much we rely on the heart to function well was something I had little understanding of, now I am literally going to be thankful for every beat. Doctors are the unsung heroes sometimes, this is the second medical memoir I've read (the brilliant "Do No Harm" from Henry Marsh being the other, which does for the brain what Dr Westaby does for the heart here and I can also highly recommend) and it is a fascinating world that we both see and don't see.

I'm inclined to read more like this. I was utterly enthralled first page to last.

Give it a go.
Profile Image for TL *Humaning the Best She Can*.
2,289 reviews146 followers
September 22, 2017
One of those cases where I was in a funk and just going through OverDrive app, trying to find something different to listen to, that would lift me out of the fog and de-stress me.

This one stood out to me, the fact Westaby was from the UK peaked my interest too. I hadn't listened to someone from that profession who lived outside the USA and it had me very curious. I started listening to it the same night on the way to work.

Slightly disappointed he didn't narrate it himself... only because it is always more interesting (to me anyway) to hear the writer's voice.. but not everyone is meant to be a narrator of audiobooks *shrugs* The narrator here was very good, pleasant voice and I have a crush on his accent haha.

Anyways:
~~~~~
Quick review:
Interesting factor: 5 stars
Writing: 2.5 stars at times, 3 stars at others
~~~~

The cases presented here were fascinating, engrossing, interesting, occasionally heartbreaking and also suspenseful (I occasionally (*cough*fairlyoften*cough*) sped up the narration to finish a tale or two or three before heading into work). Seeing what went on during the operations made me appreciate this profession and the ones who put their patients first.

The bureaucracy/politics of the medical system baffled me on more than one occasion. I shared Westaby's frustrations with it all and wanted to shake these people till common sense popped in their heads. (As my one friend said before... "This is why some people are frustrated with and/or hate the Health profession")

The narrator brings everything to life wonderfully with writing that isn't top notch. Not bad, just awkward and clunky at times... it didn't deter me from going on with the book though. Everything discussed in here more than made up for it me in this case.

I admire him for taking the chances he did... not many would and like he said as well... some or most of these operations may not have happened today. The risks he and everyone took may not have gone over as well either.

Would recommend :)
Profile Image for Kate.
606 reviews579 followers
March 10, 2017
Anyone who reads my blog will know that I rarely, if ever, review non-fiction. It is definitely not my usual genre, but when I saw it pop up on Twitter recently, I was suitably intrigued. I am so SO GLAD I got the chance to read and review Fragile Lives.

Fragile Lives is a memoir written by Stephen Westaby, one of the most well known cardiac surgeons and hugely prolific in his chosen field. A trailblazer from very early on in his career, he continued to pave the way for the use of new and unknown cardiac treatments and apparatus.

I started it Monday morning, and by Monday night I was a ball of emotions upon finishing it. Every chapter is a case story, and every case is heartbreaking yet life-affirming, if that makes sense. I found myself close to tears on more than one occasion on Monday, knowing that these are real people and they were meeting Westaby at possibly the worst moment of their lives.

The details in Fragile Lives are extremely in depth, especially with regards to the surgeries and various diseases/injuries that are discussed in the book. While it was descriptive, it was not by any means difficult to follow. It was very interesting to read about the anatomy of the heart and the various pathologies Westaby writes about.

I can’t do this book justice with my words. It was truly excellent to read. I was compelled to read it, trapped in the intensity of the chapters. When I had to put it down, I immediately wished I was reading it again. That is always a sign of a great book. If you like medicine, with a large dose of humanity, then pick up Fragile Lives.

Highly recommended!

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Profile Image for Mandi Bross.
372 reviews22 followers
Read
December 21, 2018
This book...ugh. I really wanted to like it and honesty thought I would. I loved When Breath Becomes Air and thought this might be similar. Not so much. The author is a retired heart surgeon in the UK, so a lot of the commentary about their healthcare system (NHS) felt disconnected to me. It was very technical and explained medical procedures in great (overly excessive) detail, and I skimmed through some of these descriptions. My biggest complaint about the book, however, is the fact that Westaby just isn't a writer and has little concept of grammatical conventions. Every other sentence was a fragment, and it just became exhausting to read. Many reviews complain about the arrogance of the author, and truth be told, I didn't mind that part. I actually want a surgeon to be a little arrogant about his abilities, but on the flip side, I want an author to be aware of basic conventions of writing.
Profile Image for Kasia (kasikowykurz).
2,391 reviews60 followers
December 8, 2023
Można spokojnie powiedzieć, że jakakolwiek tematyka medyczna to moja lekka obsesja i choć ostatnio wielokrotnie zawiodłam się reportażami/wspomnieniami w tym gatunku, to jednak ciągle wracam i wiecie co?

To było zwyczajnie zajebiste.

Nie wiem, czy kiedykolwiek tak mocno wkręciłam się we wspomnienia lekarza. Fakt, było trochę takich, które mnie zachwyciły, ale ta całkowicie zawładnęła moimi uczuciami, byłam zachwycona każdym aspektem, pełna ciekawości i szacunku do tego człowieka, zarówno jako lekarza z pasją i z powołania, jak i do istoty ludzkiej pełnej empatii i prostej chęci pomocy innym. Kardiologia jako taka nigdy mnie nie fascynowała i choć coś tam wiem, to jednak dostałam temat, po który nigdy nie sięgnęłam, którego się nie spodziewałam, a który okazał się niesamowicie ciekawy. Ze stron książki bije mądrość, pasja, ale też pokora i nawet przez sekundę nie miałam poczucia, że Westaby patrzy na mnie z góry, a wręcz przeciwnie, ten człowiek ofiarował nam całą swoją wiedzę, doświadczenie i serce, zostawiając mnie z uczuciem szacunku, szczerego podziwu i zadowolenia z jakości książki.

Dziękuję, doktorku, za wkład w medycynę i za świetną przygodę.
Profile Image for Jackie Law.
876 reviews
February 7, 2017
“A successful cardiac surgeon is a man who, when asked to identify the three best surgeons in the world, has difficulty in naming the other two.”

Fragile Lives, by Professor Stephen Westaby, is a memoir that is both awe inspiring and heart-rending. It tells the story of the medical career of a man raised in working class Scunthorpe who became a world class, ground-breaking cardiac surgeon before watching his life saving profession being stymied by the NHS bureaucracy that we know today.

The first few chapters cover Westaby’s childhood, inspiration and medical training. Born in the post-war baby boom years he decided young that he wished to be a heart surgeon after watching a television programme, ‘Your Life in Their Hands’, in which American surgeons were able to close a hole in a patient’s heart thanks to the newly created heart-lung machine. Westaby gained entrance to a local grammar school and from there worked towards his dream of medical school. As a teenager he took menial jobs at a hospital, learning as much as he could through observation. His years of medical training at Charing Cross and the Royal Brompton in London brought him to his first surgeries, where he learned that a certain arrogance is necessary for a successful outcome. A surgeon must believe in their own abilities if they are to innovate and thereby save more lives. When a patient is cut open on an operating table the surgeons cannot know exactly what problems they will be required to deal with.

Subsequent chapters look at particular patients whose medical issues Westaby tackled in new ways. Not all of them survive, and those that do are changed.

“extra life is not ordinary life. There’s a price to pay and a second dying to come”

These cases are fascinating if poignant to read. There is an amount of medical detail included but the language used is accessible. Westaby’s confidence in his abilities and willingness to take risks not only saved many of the lives he held in his hands but also led others in his field to do the same. These world class doctors worked together, sharing techniques and outcomes for the good of their patients as well as furthering their own careers.

“For the unfortunate patient, any prospect of survival depends upon having an experienced trauma surgeon at hand. Few are offered that privilege.”

Westaby worked all over the world and experienced many levels of both staff competence and facility provision. When dealing with a patient who will surely die without intervention, risks seem a price worth paying. This is the way, the only way, that new techniques and treatments can be developed.

A cardiac surgeon must retain a certain detachment as they are dealing every day with the dying who often harbour multiple health issues. Success rates matter. The monetary cost of surgery is high and those controlling the purse strings wish to invest only in proven drugs or equipment.

Pioneering surgery is now threatened by the blame culture. Even proven techniques are being rationed due to the focus on cost, whatever the benefit.

“When a surgeon remains focused on helping as many patients as his ability will allow, some will die. But we should no longer accept substandard facilities, teams or equipment. Otherwise patients will die needlessly.”

By the end of his career Westaby had become disillusioned with the NHS. He had watched too many of his patients die due to a lack of drugs and equipment simply because they are deemed too expensive by non medical decsion makers.

“What mattered was keeping down costs. Death comes cheap.”

Inevitably he looks back on his own younger years with a degree of pride and with more regard than he offers today’s trainees. Setting this aside there is a warning to be heeded. It is understandable that cardiac surgeons feel frustrated with the constraints placed on their ability to work effectively. What this means to the individual patients and their families is the difference between life and death.

Those who believe that the drama of medical TV shows is overplayed should read this book. It is a fascinating account of a career that observed and facilitated huge medical innovation. The effect this had on the patients whose cases are included had me in tears of sorrow and joy on more than one occasion. To anyone with an opinion on the value of national healthcare expenditure, this is a recommended read.

My copy of this book was provided gratis by the publisher, Harper Collins.
Profile Image for Mahnoor Asif.
103 reviews56 followers
October 22, 2020
A perfect memoir by a cardiac surgeon.

He covers mostly his professional career and gives very little insight into his personal life. The book is written in such an empathic manner that one could rejoice with the author when a patient is saved. A very detailed account of every case but the author mostly focuses on the surgical procedure. I like the author's approach as a surgeon, he was empathic and at the same time with very tough nerves. This book is a little technical and you can get through it if you have a basic idea of the anatomy and physiology of the heart and lungs.
I feel my heart sinking when I was reading one of the sufferer's stories, Anna a girl who got surgery 5 times for myxoma, a benign tumor lurking each time from a different site in the heart. How painful :'(

Dr. Westaby wrote in his book,

𝘔𝘦𝘥𝘪𝘤𝘪𝘯𝘦 𝘪𝘴 𝘢𝘯 𝘰𝘯𝘭𝘺 𝘱𝘳𝘰𝘧𝘦𝘴𝘴𝘪𝘰𝘯 𝘸𝘩𝘦𝘳𝘦 𝘱𝘪𝘴𝘴 𝘪𝘴 𝘤𝘢𝘶𝘴𝘦 𝘧𝘰𝘳 𝘢 𝘤𝘦𝘭𝘦𝘣𝘳𝘢𝘵𝘪𝘰𝘯”

I laugh at it. Odd but yes doctors do measure pee levels to check out renal function

Overall, this book is a perfect treat for all those curious about cardiac surgery and yearns to read about smart technology introduced in the field of medicine and the cases that Dr. Westaby dealt with.
Profile Image for Chantal Lyons.
Author 1 book56 followers
February 7, 2017
Like many UK readers, I read Henry Marsh's remarkable "Do No Harm". That book is a wondrous eye-opener; "Fragile Lives" is a gut-wrenching adrenaline rush, written by another member of the retired-eminent-surgeon club, Stephen Westaby.

The writing is no-nonsense yet vivid, sparing with its forays into more imaginative territory. A child’s heart looks like a ‘quivering black banana’ after Westaby’s finished trying to make it work again. The straw-coloured fluid that often pours out of a pierced pericardial sac (the sac containing the heart) is ‘heart failure juice’.

The writing, the narration and the subject matter are a perfect recipe for the white-knuckle clutching of the book, lip-biting, eye-stinging, internal groaning when your tube reaches your stop. In short, I was gripped. What I remember of "Do No Harm" is that the brain surgery in it was comparatively much, much calmer than the heart surgery in this book. Seconds matter. Seconds of bleeding or the stillness of a heart make the difference between whether the amount of cells that have died will kill the patient.

You do have to concentrate. There’s a lot of new vocabulary to get used to, but as it’s used repeatedly, it soon becomes familiar. Perdicardium. Electrocautery. Cardioplegia. Perfusion. I sometimes struggled to visualise exactly what Westaby was doing to the heart in the various operations followed in the book. But I got the gist, and I suspect no matter how many books by surgeons I might read in my life, there will always be a magical mystery to the art.

Westaby often describes the torture of empathy and the need for a surgeon to avoid it so that he can stay focused and keep trying to save lives. But his empathy still shines through in every chapter. No more so than in ‘The Girl with No Name’, when Westaby is working in Saudi Arabia for a few months and he must operate on a baby boy whose Somali-born mother was kidnapped and sold into sexual slavery before escaping and walking countless miles holding her dying child before rescue.

I won’t say anything about who lives and who dies in the book, but I will remark on Westaby’s incredible tenacity. He risks dismissal and litigation to yank people back from the brink, and he has what I can only describe as Stephen Hawking-like genius in surgical form. He worked hard to get where he was, too, having been born on a council estate in Scunthorpe and spent summers as a hospital porter before making it into university, the first in his family to do so. It’s a great shame that he’s finally had to retire – precipitated by a growing deformity in his surgeon’s hand as well as aging – but he does end the book with a parting shot at the ‘blame-and-shame’ culture of the NHS that he fears is choking surgical practice.

Oh, and this is my parting comment – make sure you’re on the Organ Donation Register, and make sure your family knows it, should the worst happen.

You could save a life too.
Profile Image for Laura.
1,043 reviews78 followers
February 8, 2018
Book reviews and more on www.snazzybooks.com

I really, really enjoyed this memoir - I fancied something that would make a change from all the fiction I usually read, and this turned out to be the perfect pick.

It's full of fascinating stories, both from Professor Stephen Westaby himself as he takes us through some of the key operations in his career, but there's also a lot focusing on the people going under Westaby's knife and how they felt, what led to them needing surgery (including back stories) and how they fared afterwards. It's a real rollercoaster of highs and lows, with some great results and some which made me feel so sad. I suppose that's all part of operating on something as important as the human heart though! It did make me think, I don't imagine I could ever deal with even half the pressure surgeons are always under, and all the emotions from not just the patients themselves but their partners, friends and families too! What a lot of pressure!

The way the book is written allows someone who is certainly not scientific-minded - ie. me - to understand (and I use the word 'understand' in a loosest possible way) what Stephen Westaby and his team doing and why... (sort of!) It's not such complex language that you can't follow it, and Westaby explains things in a way that makes it a lot clearer and accessible to everyone.

I loved this book. It's interesting, full of emotion, failure but also triumph, and you can really understand the author's passion for his profession. Of course, being on call and having such an amazing career has meant aspects of his personal life have inevitably suffered; Stephen says at one point "While I spent many hours striving to save other people’s children... I never spent enough time with my own.”

I have to admit I felt a bit woozy reading some quite in-depth surgery scenes (not great with lots of blood) but regardless of my squeamishness I found the details fascinating! I also found the details about the NHS so interesting, as his career starts back in the 80's and carries on through to the present day. The NHS is something I'm so passionate about, and there's a very interesting quote towards the end of the book which really makes you think about the system today:
"So what happened to heart surgery in the UK? After multiple hospital scandals the NHS in England decided to publish individual surgeons’ death rates. Now no one wants to be a heart surgeon."

From being a working class boy from Scunthorpe to operating on some of the most high profile cases of heart surgery the world has seen, I felt like I was along with Stephen for the journey - and what a journey! Highly recommended.

* Many thanks to the publisher for providing a copy of this novel on which I chose to write an honest and unbiased review. *
363 reviews8 followers
February 14, 2018
Westaby is an insufferable person. Yet, his arrogance, disregard for hospital politics, and pompous nature makes him an excellent advocate for terminally ill patients who are denied treatment options due to risks involved or simply lack of imagination. I admire many of his bold decisions and applaud his triumph in many pioneer ventricular assist device installations. However, Westaby's self-importance is almost intolerable, just from reading this book! I get that he is great and has saved lives. I get that he has accomplished much what seemed to be impossibilities at the time. But does he expect people to put him on a pedestal, carry him around in a chariot, and bow in his presence? Perhaps he does. That attitude is indisputably reflected in this book. It is only in the last chapter and in the Epilogue Westaby shows some humility and admittance to the limits of his abilities.

I enjoy reading about all the cases in this book. Westaby's writing is not very refined. Nevertheless, his writing style makes reading this book as if he is speaking to the readers directly. It does breaks the barrier of medical technicality and makes these treatment cases more accessible to readers who have not read many medical non-fictions. I really wanted to like this book, but ultimately it's just 2-star book.
Profile Image for mia.
178 reviews24 followers
March 27, 2022
3.5 ⭐️

An interesting and at times completely heart-wrenching read. Stephen Westaby is obviously a truly talented doctor, and it was crazy to read about how many innovative surgeries and treatments he was involved in over the course of his career. Through his writing, you could definitely tell that he has a bit of a big head which became a bit annoying at some points - though any heart surgeon worth their salt probably needs to have a bit of a narcissistic streak in them, with all of those unbelievable procedures they perform every single day. Definitely worth the read for anybody interested in medicine!
Profile Image for Camilla.
30 reviews3 followers
February 5, 2022
Confidence is good. Too much confidence is just plain arrogant and quite frankly dangerous when you work in the medical field.
Westaby sure has owned his confidence and is therefore excused.

As a doctor I truly enjoyed this book and how the patients’ stories were told in a respectful way without loosing that morbid matter-of-fact humor many doctors develop.
4.5 stars from me as it was brilliant but got a bit repetitive at times.
Profile Image for Erica.
23 reviews
September 24, 2023
This incredible book allowed me to delve into the world of heart surgery. While I've had similar feelings when reading other medical books, this one stands out with its unique and memorable stories. It also traces the evolution of heart surgery technology, which adds a meaningful dimension to the narrative.
Profile Image for Ellie.
1,565 reviews291 followers
March 26, 2017
As a child Westaby watched two of his grandparents die slow painful deaths; his grandfather from heart failure and his grandmother from a cancer which left her to suffocate. This experience has clearly directed his career and his desires to help those who would otherwise be written off. He says you need to be objective as a surgeon, but he never comes across as uncaring.

It's amazing how far medicine has come in just a few generations. Who would have thought artificial hearts can and do work. The ability for a truly rested heart to regenerate is eye-opening and makes you wonder why we can't be doing this for more people.

The hearts seem to take quite a beating, both through life and surgery. There's young people struck down in their prime by viruses and undetected genetic weaknesses. There is trauma and those who have just reached the end of their heart's functioning. One pregnant woman is determined to keep her baby despite medical advice to the contrary, Westaby being the only one who will risk surgery on her.

The introduction does explain the basic function and structure of the heart, however if you have very little knowledge of anatomy, biology or medicine you might struggle to follow some of the cases. He does go into quite a bit of detail on each surgery, which some also might find gory.

Like Henry Marsh, Westaby has become disgruntled with an NHS bogged down in bureaucracy. It's only briefly mentioned at the end, but you can sense his frustration with the system in some of the cases. Who thinks it makes sense to send senior surgeons on courses to learn CPR? And the death list! Some government idiot decided to name and shame surgeons who have deaths on their operating tables. Seriously ill people will die sometimes. This just deters surgeons from taking risks, risks that could save lives. Most people given a chance of a slow and painful death or a risky surgery, would rather have the surgery. Instead they are filled with drugs and sent home to die.

This book shines a light on how harsh the "postcode lottery" can be. Westaby raised charitable funds to help patients in his Oxford hospital and he also had the expertise there, something a lot of hospitals just don't have, not through any fault of their own. Despite Oxford being a centre of excellence for heart surgery, they were not a transplant centre and therefore they got no NHS funding for the very pumps Westaby had trailblazed. He might be able to fix you, but the device he needed just wasn't always available.

Marsh and Westaby are likely the last of the pioneering NHS surgeons. Politicians would rather create lists and targets and 7 day GPs that no one has asked for. Why would any skilled doctor want to work in an environment where they are prevented from doing what's best for their patients?

This review makes the book sound moanier than it is. It just triggered my personal anger over the slow demoralisation of the NHS. In fact it's really quite uplifting in what we can achieve will the right will. The sacrifices made by medical staff are always appreciated.

Review copy provided by publisher.
5 reviews1 follower
February 18, 2021
The title sums it up pretty well. A collection of anecdotes from the author's colourful and accomplished life in the field of cardiothoracic surgery.

I knew that having passion in life is what will keep you going, especially in the field of medicine. But Prof Westaby showed that passion alone will only get you so far. The understanding and complete utilization of your strengths, coupled with the will to push boundaries in a world where others are willing to settle for mediocrity are considered essential in putting yourself a cut above the rest.

Profile Image for Anne.
782 reviews
April 3, 2018
This is the story of a cardiac surgeon and the decisions he makes, the outcomes of those decisions and most importantly (for me) the impact of those outcomes. Dr Westaby (Mr Westaby? I'm not sure of the convention) is a real human being who is emotionally committed to his job and his patients. He isn't the aloof, stand offish surgeon refusing to acknowledge the conscious lives of the bodies on his table and the book is very rich because of that. You feel his pain - and his joy - and you learn why decisions are made and how people are effected.

Starting from the beginning of his career, we follow how a person develops into a top cardiac surgeon operating on vulnerable people and inventing new procedures. We understand the frustrations and triumphs and his difficulties of working in the NHS. The book is moving and funny and human and I recommend it. This is a useful addition to the canon of work explaining complex professions and is one of the best I've read.

I was given a copy of the book by Netgalley in return for an honest review.
Profile Image for Anna.
31 reviews1 follower
June 22, 2019
So disappointed in this book. I was really looking forward to it but found it unfortunately rather repetitive and found myself getting bored sometimes. Some of the cases were interesting but as I progressed through the book I started to get tired of it. The writing also wasn’t brilliant.

As a junior doctor, I found the way he wrote about other medical professionals dismissive and rude. He came across as so arrogant, with no recognition of the roles that colleagues have played in his successes. He appeared to expect other medical professionals (e.g GPs, paediatricians) to know as much about cardiac surgery as he does - this was particularly evident in the story about baby Kirsty, and the way he criticised and demeaned colleagues was appalling to me.

I don’t doubt that he is/was an excellent surgeon. But he doesn’t come across as a very nice person.
Profile Image for Alexa Fischer.
20 reviews87 followers
October 27, 2018
Wow. What really struck me about this book was that Westaby wasn't shy about sharing the full depths of his feelings. Like most med-reads, it was well-written with a great range of interesting, unique cases to keep the reader captivated, but this one had raw emotion as other medical books somehow didn't. For example, I was a bit surprised that he would openly admit that he couldn't handle talking to the family; he wasn't afraid to be vulnerable and human in ways that surgeons rarely seem to be.

Each chapter was more or less dedicated to a case, and although they were fascinating, towards the end they began to mush together a bit. There were a few, however, that I think will always haunt me.

This book came highly recommended and it did not disappoint.
77 reviews26 followers
March 17, 2021
A long read, but an undeniably inspiring one. I felt as if I were following Stephen Westaby along his incredibly eventful career as a cardiac surgeon. Being guided through his triumphs and losses; the inevitable soaring highs and sombre lows of his role. Not only did he provide a raw insight into the role of a surgeon, but he clearly painted an image of the realities of mortality. Life really is balanced on a tight rope, hanging above a wide abyss of death. It was truly awe-inspiring to watch surgeons like Westaby (already struggling under the inner moral turmoil that came with a lack of funding and emotional weight that came from seeing people at their most vulnerable) grapple with that tight rope. Sometimes mending it. Sometimes standing by and having to watch it break.
Profile Image for Manar.
48 reviews77 followers
Read
December 30, 2020
This was a tough one but I read it at the right time and I liked it.
For sure it’s not a surgery textbook but a biography and memoir of both Westaby and his patients mixed up with a great insight into the heart and its surgical procedures.
Each chapter has a whole life behind it and each life will teach you something.

I kept thinking about the many factors that play a role in saving one’s life. Patient care need collaboration, not dependence. This happens when everybody plays their role and only their role willfully.
Profile Image for Olwen.
770 reviews14 followers
May 15, 2017
Surgeons seem to be a breed apart. After reading this book I think I understand why they need to be a breed apart. It would require great courage to deliberately pick up that scalpel, knowing that the surgery you're going to do could possibly end someones' life. Then to be able to carry on through the next operation, and the next, and the next, forever, with the same courage.

A most enjoyable read to learn about what does on in the mind of the person wielding the scalpel.
Profile Image for I'.
547 reviews290 followers
March 9, 2018
[b]As I received this book from Netgalley, in exchange for an honest review, the review itself will be written in English as so it is the book. I feel the need to provide an review for its community in the same language it was provided to me. [/b]

I don’t know what I was expecting when I requested the book, but I have thoroughly enjoyed it. I do have to say I do know a bit regarding anatomy and physiology, and I did not expect the author to dive in it so deep on it. I mean, there are even diagrams and drawings explaining bits and bobs about how the heart and circulatory system works from a Doctors point of view. This has been very enjoyable, I loved how detailed some explanations were, mostly regarding surgeries and procedures. Those were my favourite bits. It was interesting but not in a patronizing way of “I know more than you look how cool am I and all the cool things I can do”.

We will follow the author from the main reason he got interested in cardiac surgery, till quite recent in time thoughout a series of surgeries. He will walk us through a series of cases, and patients, that will follow his career and development as surgeon from the most simple to the really challenging ones that will leave you bitting your nails hoping for the best.

It is raw medicine, meaning sometimes it goes really well and everything is amazing, but some others it does not. And I think it was really important to deliver that message as well. Because it is a history of a human being, and only success would have made it boring, dull, and not realistic at all. And well, if it was only failure, he would not have become the eminence he is at the moment in hin field.

Really enjoyable, I loved it and read it in about a couple of days. The chapters are not very long and quite conclusive by themselves, so you don’t have to follow a storyline and you can read a few chapters every now and then and still really enjoy the book. If you’re interested or even curious about the topic, it’s a wonderful read.
Profile Image for Sarah.
60 reviews25 followers
May 14, 2020
This is an incredible compilation. I'm not sure why, but with medicine, despite the fact that you lose more patients than you can save, it's those few survivors that give you the ability to persevere. They make it all matter. It doesn't matter how smart you are, you just need to be smart enough to care more than others, to be more passionate than others. It's tragic that a healthcare system is in the hands of political leaders who usually don't know enough about the preciousness of human life. Its not just the NHS, its a lot of countries' healthcare systems. Its tragic because lives are lost when support was needed.
As medical students in this new age of technology and intense competition we feel so intimidated and unsure. Our lack of experience is irritating to our seniors, and rightfully so. I'm not quite sure we'll stop being irritating and I don't think it helps for us to get upset at being looked down on. Westaby's successes are so inspiring because of how many failures he went through. They made him even more determined to press against the odds.
We all have our challenges. But it shouldn't stop us from always putting the patients first. We need to keep following the stars that led us to the profession in the first place. ❤️
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