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An Exciting Read
on October 6, 2010
This is a splendid volume, partly because it's written from a distinct vantage point: David Cooper a cardiac surgeon. It's an enjoyable read that gives a spicy account of the evolution of the specialty of cardiac surgeon by a man who was personally acquainted with many of the major players in this exciting saga.
It's organized chronologically. Chapter one leads off with an 1896 quote from New York physician B. F. Sher¬man, "The road to the heart is only 2 or 3 cm in a direct line, but it has taken 2400 years to travel it." In thirteen more chapters Cooper traces the meandering path of the specialty by con¬centrating on the lives and accomplishments of the 33 men and one woman (Helen Taussig) who contributed to the development of this ever-expanding field.
Cooper writes for a mixed audience - laymen and those trained scientifically, including physicians - and his text will appeal to both. Having almost become a cardiac surgeon myself, I was familiar with the facts of many of the milestones of the field. Cooper presents them well, including closure of a patent ductus (by Robert Gross in Boston in 1938); development of the heart lung machine (by John Gibbon, Jr. in 1953); the use of hypothermia (both the total body concept of Wilfred Bigelow in 1952 and the 1957 cardiac saline slush method of Norman Shumway); the first cardiac transplant (by Christian Barnard in 1967) and the implanting of the first artificial heart (by Denton Cooley in 1969). These and many other accounts of significant historical events are related in a readable, limpid style, a pleasant blend of biography and scientific synopsis.
But there is an additional, sparkling facet to Cooper's writing that enhances its appeal: he is a masterful interviewer. Over a period of twenty years, Cooper conversed with most of the men who were major players in this saga, or spoke with those who had trained under them. His account is full of interesting and amusing anecdotes. He includes three dozen black-and-white photographs of the various pioneers, and he supplements the snapshots with memorable verbal sketches of them, gleaned from the interviews.
Cooper asked most of those he interviewed several revealing questions. Did they get the recognition they deserved? (Most felt they had.) How did these early pioneers - whose very sick patients often did not survive - deal with death when many of their patients died as new techniques were being perfected? Belying the myth of the heartless, calloused surgeon, most experienced a dark night of the soul if they lost patients. But they persevered, and mortality rates fell as they gained ex¬perience. Cooper comments (pg 406): "Making errors of judgment, facing death on the operating table and agonizing over whether you have performed a surgical procedure adequately can all be very painful forms of `hell' to the surgeon. The lesson that heart surgeons quickly learn is, as Winston Churchill said, `If you are going through hell, keep going.' Heart surgery is not a career for someone who lacks courage, persistence, and tenacity."
The text is also pep¬pered with spicy, revealing comments. For example: Surgeon Norm Shumway attended a banquet celebrating the career of Minneapolis surgeon C. Walton Lillehei - who early on persevered in spite of the death of many of his sick patients, and whose high-flying and chaotic life style led to an investigation by the IRS. Shumway likened Lillehei to Al Capone, saying: "He killed a lot or people, but the government could only get him on unpaid taxes."
The 430 page text is supplemented by a selected bibliography and a comprehensive index. Those who read Open Heart will come away with a new appreciation of the sterling accomplishments and varied personalities of those who developed and made commonplace this once verboten branch of surgery. At $19.43 from Amazon, it's worth buying.