Fragile Lives: a medical memoir review

I read books by people in medicine for several reasons. One is that my own father is a surgeon – oral and maxillofacial, namely the mouth, jaws and face – and surgeons are such a homogenous breed that reading their memoirs feels like glimpsing his mind.

I never felt a drive to go into medicine like my parents, but the human body has always fascinated me as much as the natural world. I deal well with gore, probably thanks to the period in my childhood when my family all used the same computer, and my father had a habit of leaving photographs from his operations open on the desktop. The red and purple landscapes were impossible to make sense of. One time, when my father got his first digital camera, he showed me a video of a fat, shiny artery pulsing away oblivious to its exposure to the air.

Medical memoirs, like nature writing, are big in the book world right now. Some, like Atul Gawande’s unmissable Being Mortal, are only semi-memoir in that their vignettes are used to power the argument of the book. Others, like the publishing phenomenon Do No Harm by the eminent brain surgeon Henry Marsh, are devoted wholly to a series of particular patient cases and operations.

Do No Harm is a wondrous eye-opener; Fragile Lives is a gut-wrenching adrenaline rush.

The latter is the latest memoir, this time about heart surgery and written by another member of the retired-eminent-surgeon club, Stephen Westaby. They run, drive fast, and use the f-word a lot.

Like my father.

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, 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.

Fragile Lives is published on 9th February.

9780008196769

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