Journal of the Practice of Cardiovascular Sciences

: 2019  |  Volume : 5  |  Issue : 2  |  Page : 116--117

The knife's edge: The heart and mind of a cardiac surgeon

Raghav Bhargava 
 Department of Internal Medicine, Wrexham Maelor Hospital, Wrexham, United Kingdom

Correspondence Address:
Dr. Raghav Bhargava
Wrexham Maelor Hospital, Wrexham, LL13 7TD
United Kingdom

How to cite this article:
Bhargava R. The knife's edge: The heart and mind of a cardiac surgeon.J Pract Cardiovasc Sci 2019;5:116-117

How to cite this URL:
Bhargava R. The knife's edge: The heart and mind of a cardiac surgeon. J Pract Cardiovasc Sci [serial online] 2019 [cited 2023 Mar 27 ];5:116-117
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Full Text

Author : Prof. Stephen Westaby

Language : English

Published by : Mudlark (April 30, 2019)

Price : INR 599

Pages : 320 pages

ISBN-10 : 0008285810

ISBN-13 : 978.0008285814


This book follows the award-winning bestseller Fragile Lives by the same author. The Knife's Edge is a much darker and emotional memoir. It portrays Prof. Westaby's modest beginnings, his struggles to succeed, and the lifelong relationships he made with the doyens of modern heart surgery. He also mentions how the specialty is looked at by socialized medical healthcare systems such as the National Health Service and the prevailing attitudes toward the surgical profession as a whole.

The titles of the chapters of this book are befitting to the emotional turmoil a cardiac surgeon faces. It begins with family followed by sadness, risk, hubris, perfectionism, joy, danger, pressure, hope, resilience, and misery and ends with fear.

The author conveys the personal qualities that one requires to operate on the heart, something that was seen as the “final frontier.” To be a cardiac surgeon, apart from unstinting work ethic, great determination, and manual dexterity, the courage to fail is the last hurdle. The author then describes a freak rugby accident to his head in medical school that gifted him qualities to be a heart surgeon. He was both disinhibited and ruthlessly competitive. Those same features are also associated with psychopathy, but he never lost his empathy toward his patients.

He also describes some dire cases on which he operated against all the odds. One of the most striking cases was the emotional distance required to operate on his classmate from the university. Despite not being the on-call surgeon, he not only operated with success but also was one of the first to use tissue glue to approximate the dissected layers of his friend's aorta.

He also mentions several innovations and techniques that others thought would never succeed. Learning from its originator and his previous boss, Donald Ross, Westaby performed the complex and intimidating Ross's procedure for the first time in the world on a baby. He also devised a rescue technique of emptying an ailing left ventricle with an assist device in a patient with endocarditis. He worked all over the globe – United States of America, Hong Kong, and Saudi Arabia. Apart from refining his trade, he also learned how heart disease and major operations are viewed in different parts of the world. These experiences made him more humble and less detached from his own family.

When he went to America, he was working with the best surgical scientist in the world – John Kirklin – with whom he solved why cardiopulmonary bypass machines were not saving lives after heart surgery. The schedule in America was unrelenting, and every death was reviewed with a fine-tooth comb. This is where Westaby perfected his skills and made his long association with mechanical circulatory support systems.

After a 40-year-long career and having operated on >11,000 hearts, it would possibly make him the best heart surgeon produced in Britain.

This title is a must in any ones bookshelf interested in understanding the emotions a specialty such as cardiothoracic surgery evokes, knowing every operation risks a life. It is also a perfect conclusion to the author's first book, Fragile Lives, which left readers wanting to know how the human side of heart surgery, i.e., cardiac surgeons have evolved.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.