"Open Heart"

British cardiac surgeon Stephen Westaby said, “I was the Winston Churchill of heart surgery. I never, never, never gave up.”

In his book “Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table,” Westaby permits readers to watch over his shoulder as he operates, sharing some of the high and low points of a 35-year surgical career. This book was originally published in the United Kingdom and titled ‘Fragile Lives.”

During his career, Westaby performed more than 12,000 operations, a baker’s dozen of which are described in the book. Although he is primarily a pediatric surgeon, operating on hearts “the size of walnuts,” much of his time away from the operating room has been dedicated to research and development of cardiac assist devices and implantable mechanical hearts for both adults and children.

The narratives about individual patients, their medical histories, detailed descriptions of the surgeries they underwent, their post-operative courses and their eventual outcomes constitute the majority of the book. Not all of these patients fared well; Westaby is as unflinching in describing the poor outcomes as he is exuberant in detailing the good ones.

Interwoven with the medical details are Westaby’s reflections on the difficulty of maintaining the cool detachment required of a skilled technician, yet bringing empathy to interactions with patients and their families. It is a tribute to his honesty that he confesses his occasional inability to rise to the latter task.

Westaby also uses his book as a platform to decry the bean-counter attitude of the United Kingdom’s National Health Service and its allocation of resources for health care. He points out that many of the pioneering procedures described in the book were paid for out of charitable funds, not government ones and would never have taken place if left to the decision of the NHS. He insists that health care decisions are too important to be left in the hands of politicians and bureaucrats and that patients are dying because healthcare resources are misallocated and mismanaged.

Some may find the technical descriptions of the operations too detailed and sometimes too graphic. The author does a commendable job of making these accounts understandable to lay readers without oversimplification. There is also a helpful glossary offering definitions of many of the technical terms used throughout the book

Other readers may find Westaby’s writing style too staccato, riddled with choppy sentences and sentence fragments. He may have anticipated this criticism when he told an interviewer, “If you don’t like my bloody writing come and watch me in the operating theatre—that’s what I’m really good at.”

In “Open Hearts,” surgeon Westaby offers us the opportunity to do just that.