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Book review: A cardiac surgeon on life and death in OT

Stephen Westaby, who decided to become a heart surgeon after watching a hole-in-the-heart surgery on a black & white TV at age seven didn’t stop till his hand got permanently disfigured.

books Updated: Feb 02, 2018 12:28 IST
Sanchita Sharma
Doctors doing an open heart surgery.
Doctors doing an open heart surgery.(Getty Images)

Operating rooms are the battlefields where epic wars against disease are strategized and fought with lasers and scalpels and where lives are on line at every moment. Such high stakes are what make the cathartic immersion into dramatic life and death situations in television medical drama series -- House, ER, Grey’s Anatomy, Scrubs and M*A*S*H, to name a few –massively popular even among those who start hyperventilating at the sight of a blood from a pinprick. Television viewers can switch off at will, but doctors encounter real-life gore and traumatic stress in the operating-room carnage for days, years and decades.

The brain was Woody Allen’s “second-favourite organ”, but it was the heart for author Stephen Westaby, a pioneering heart surgeon at the John Radcliffe Hospital in Oxford. “Well, other people’s hearts. I liked to watch them. Stop them. Repair them and start them up again. In my younger days, I had been an artist... I simply shifted from brush on canvas to scalpel on flesh. More hobby than a job. More pleasure than a job. It was something I was good at,” writes

Westaby, who decided to become a heart surgeon after watching a hole-in-the-heart surgery on a grainy black & white television at age seven didn’t stop till his hand got permanently disfigured.

The now battle-scarred surgeon observes that clinical detachment is crucial for doctors to stay the course when faced with death. He first encountered what he later termed “determined detachment” early on in his career that over the years accrued more than 11,000 surgeries. After watching a patient die on the operating table during an open-heart surgery for the first time, what stuck Westably was the determined way the surgeons walked away from the patient they had tried to save but lost. The image stayed with him as he realized that doctors needed several degrees of separation from the clinical outcomes to cope with the inevitable loss of life despite their best efforts.

Despite promoting detachment, Westaby comes across as compassionate in his narrative that includes many of the lives he saved and the rare ones he lost, to offer “a glimpse at the edges of mortality where we operate – where breath becomes life.”

Open Heart: A cardiac surgeon’s stories of life and death on the operating table

By Stephen Westaby

Basic Books

Rs 1,458