I read a new doctor-written book called Extraordinary Hearts by John Elefteriades, who is a cardiothoracic surgeon at Yale.
The book has ten chapters, each about a patient that was in some way significant over the course of Elefteriades’ career.
The opening chapter tells of a miracle—a patient survives a botched surgery that put a hole in her left ventricle. The surgical field is contaminated. The surgeons don’t even inspect their work, so tenuous are the sutures. Elefteriades doesn’t expect her to survive the night. Incredibly, the next morning, she’s awake in bed, eating (breathing tube no longer in place), and asks to see him—to thank him. Turns out she’s someone he knew (his kids’ former school teacher) though he didn’t know it at the time of the operation. It’s a compelling story.
Over his three decade surgical career, Elefteriades has cared for jazz pianist Dave Brubeck (he performed a bypass operation that stayed good for 23 years) and the mega-author Robert Ludlum—who never stopped smoking, even after his cardiac bypass surgery. Elefteriades credits Ludlum with giving him inspiration to try his hand at fiction. (Elefteriades’ has also a published a novel called Transplant that centers around the complicated ethics of that world.)
In addition to bypass surgeries, Elefteriades is an expert in repairs of the aorta and performs heart transplants. He tells tale of Christiaan Barnard, the South African surgeon who performed the first successful human heart transplant—and was apparently a serial philanderer with younger and younger women.
One of the more interesting details that I learned about was ‘deep hypothermic circulatory arrest’ (DHCA), in which a patient’s body is cooled to 18 degrees centigrade (64 degrees Fahrenheit) and circulation and respiration are completely stopped. The patient is held in suspended animation for about 45 minutes, long enough for the surgeons to access the very deep and complex aortic arch and operate on it. Amazingly, after being rewarmed (slowly, so as not to cause blood proteins to denature and solidify), patients awaken with their full faculties and no deficits.