The Surgeons: Life and Death in a Top Heart Center

by Charles R. Morris

An over-the-shoulder look at a major heart surgery center, with gripping accounts from the OR to the boardroom. Americans now spend more money on hearts than on new passenger cars. To understand this remarkable trend, Charles R. Morris "embedded" himself with a surgical team at New York-Presbyterian Hospital in New York City, one of the world's premier cardiac surgery and transplant centers. Given unprecedented access, Morris witnessed sophisticated operations and observed the tense meetings where surgeons relentlessly criticize their own performance. In thrilling detail, Morris recounts a late-night against-the-clock "harvest run" to secure a precious transplantable organ; the heart-breaking story of a child's failed transplant; a trainee surgeon's brutal daily regimen; and much more. Along the way, Morris documents the fifty years of research and hundreds of millions of dollars that have been expended on creating a reliable mechanical heart, and he steps back to reflect on how doctors think and how they judge each other, what is really driving health care costs, and the future of health care policy in America.

Genres: Medical, Medicine, Nonfiction

336 pages, Hardcover

First published October 17, 2007

About the author

Librarian Note: There is more than one author in the Goodreads database with this name. This profile may contain books from multiple authors of this name.

See also:

Charles R. Morris

Reviews

[Julie · Rating 5 out of 5]

written by someone who knows nothing about medicine, it offers a great perspective for anyone who wants to know how cool cardiothoracic surgery is, how medicine works at a HUGE institution

[Allyson Dyar · Rating 4 out of 5]

I want to first start off this review by saying that this is a well-written book. The bits of the book that I enjoyed I really enjoyed, the other parts (mostly the financial stuff), I didn't find as interesting.

This isn't the fault of the author, I'm just not much into finance. Yeah, I know. I should be, but honestly, reading about financial stuff isn't what I'm about and a good portion of this book discusses the financial side of running a hospital, developing medical devices, etc. This just isn't my bag.

What I did enjoy is following the heart surgeons of the famed Columbia-Presbyterian hospital in New York City. One of the surgeons is Doctor Mehmet Oz who currently has a daytime show intermixing good medical advice with that of a dubious nature.

This book is great if you want a good feel of what cardiac surgeons do and what it takes to run such a prestigious program.

I give this book a solid 4/5 stars. Well worth reading if the subject interests you.

[Amy M · Rating 3 out of 5]

I was excited to read this book when I first saw it on Amazon.com, but I have to say that it only held my interest up until the last half of it. The chapter where they started talking about money, finances, policy and all that other boring hospital management stuff that had nothing to do with heart surgery and heart anatomy in general, I debated whether or not to stop reading at that point but I hate abandoning a book before I even finish it so I chose to just barrel through it until the end. Of the first half of the book that I enjoyed, I really loved how detailed the surgery scenes were and the author's observations about the surgeons themselves and how they did things. It totally has inspired me for my own writing since one of my romance characters is a famous heart surgeon. I did a lot of highlighting in my book so I can note this stuff later for possible surgeon scenes I write about him. If you are interested in the mechanics of heart surgery or a cardiophile like me, I recommend just reading the first four chapters. But there is also a touching story about a little girl named Erika that is really worth reading too. And of course an appendix chapter detailing how the heart works as a structure. I'm glad I picked up this book. Just wish there was more in depth surgery chapters and less about politics, health care, money and policy statistics stuff.

[Amy · Rating 3 out of 5]

More like a 3.5. It's a bit old and so plenty of medical technology has changed in 10 years. I would have enjoyed more congenital cases, obviously, but still the first 3/4 was good and interesting. The final chapters on policy and money were boring to me. My favorite part of the book was the line, "Johnathan Chen, a razor-sharp surgeon, ...." - my surgeon who did my valve replacement in 05 when Hailey was born.

[Michelle · Rating 2 out of 5]

Started off as an interesting read but turned into a read of too much technical jargon. If you enjoy reading case studies, this is not the book for you.

[Jim Gleason · Rating 5 out of 5]

Embedded within America’s busiest heart transplant center, Columbia-Presbyterian hospital in NYC, for almost a full year, journalist and historian, Charles Morris offers us amazing insight into the inner workings of a cardiac center as well as candid thoughts from the medical professionals working there. Equally amazing is that the center not only gave him unlimited access to literally everything there – surgeries, closed-door meetings, late night organ recovery runs, candid conversations with staff at all levels, critical outcome reviews, patient personal interviews – but allowed him freedom to write this book without any preview or restrictions on what he could report. As such, we are privy to both their successes and failures, first hand accounts of life saving surgeries and human mistakes that resulted in death, reflections by world renowned cardiologists as they face the challenges of their trade with the youngest of newborns and oldest of the aging who at death’s door place their lives in the hands of such talent. These reflections cover both patient events and the state of medical science today.

Morris goes beyond just his observational reporting, building on insights gained from this unique partnership and opportunity to offer fact based in-depth discussion with full chapters devoted to several current issues affecting the world of medicine. Topics treated include “a very short history” of heart surgery; a detailed description of the organ donation process (supported by his first hand experience accompanying a recovery team through the donation surgery and later into the resultant transplant surgery itself); the medical training process for doctors; the future of heart surgery; the financial side of medical practice and medical centers; a critical evaluation of the statistical reporting for drug testing as used for approving new drugs; and a dissertation on national health care policy. What makes these topics such interesting reading is how Mr. Morris supports the discussion with insights gleamed from experiences and conversations during his year of living in this particular center’s multifaceted environment that pushes the cutting edge of cardiac practice in so many ways, providing leadership and improved techniques that impact patients and practice worldwide. In that final chapter, looking beyond the forces driving health care’s expansion and the implications on the national economy, he shares his thoughts on important managerial and policy challenges and potential financial solutions. These speculations are supported with many facts and statistics that make for a thought provoking brain workout, but an interesting read on multiple levels in the process. Be prepared to be fascinated by the human insights into the exciting world of cardiology and then inspired to think on the big picture level with these well thought out and equally well presented ideas.

This 317 page book includes an excellent 2000 line cross referenced Index, Note pages (20) that expand and add many more references to other supporting documentation for each chapter’s content, as well as an Appendix that graphically details how the heart works and yet another describing the New York State Cardiac Hospital Rating System. Taken altogether, this serves as an excellent research resource. Whether for research or general reading, I highly recommend this book to patients and medical professionals interested in learning about, or involved with, the workings of a medical center and its highly specialized yet very human world of cardiac surgery. Through this gifted author’s eyes and words you will experience an exciting environment of heart reality that very few ever will first hand.

see this and more than a hundred other organ donation/transplant related books - many with my personal reviews - at http://www.trioweb.org/resources/book...

[Vimaris · Rating 5 out of 5]

Mr. Morris is given an extraordinary opportunity to witness heart surgery in Columbia Presbyterian Med Center. He not only observes high risks heart transplants or both adult and peds, but he also gets to "learn" from the gifted, steady & stalwart hands of doctors Craig Smith, Mehmet Oz, Jan Quaegebeur, & their team of "super-fellow" MDs, anesthesiologists, perfusionists, PAs, OR nurses & cardiac nurses. The book is not only gives a brief glimpse into the mastery of cardiothoracic surgery, but includes very real consequences its failures- return surgeries in already high risk patients, the double heartbreak of unsuccessful transplant in a peds case, for examples. Mr. Morris also gives us insight into where the specialty is moving - cardiac radio-intervention/surgeon is the product of the cardiac and radiology specialty: minimally invasive cardiac procedures to open arterial blockages vs open chest or "on pump" CABGs.
Morris also discusses the shortcomings despite all the technical & medical wizardry. Its is a risky surgery with high mortality, hence the weekly Mortality & Morbidity (M&M) conferences. The specialty also relies research on while it comes under the fire of the very research which questions known established practice (ie studies of approtinin use in surgery).
Finally, Morris also addresses familiar issues of money & health care policy, practice standardization, & the medical industrial complex & its myriad payers & players; and brief paragraphs on medicare/medicare. The book was published in 2008, but leaves us with the heaviest, & most haunting question in everyone's mind - can we do better?

[Kristin · Rating 3 out of 5]

This book was split right down the middle, the first half being the kind of book I like, talking about interesting cases as the author observed the workings of the cardiothoracic surgery department at Columbia-Presbyterian Medical Center in NY. Written in 2008, a lot of the new technologies and things on the horizon have since become standard practice by 2022, but it was interesting to read about the innovations and the patients who benefited, across a wide range of subspecialties. The second half of the book showed the author's business background, as he delved into relevant, but less intriguing to the scientist in me, topics like insurance reimbursement, the influence of device manufacturers on surgeons, and the role of Big Pharma, especially when it comes to building and reporting studies. I wish it would have been more of a 75%/25% balance because I was missing the patient stories by the end of the book and would have liked the chapters focused outside the operating room to be intermingled amongst the ones inside. That said, with the 50/50 split, I understood not jumping back and forth like that, and I'm glad he put the patient stories first, because I might not have continued if the regulatory chapters were first.

[Mitchell Rubiano · Rating 5 out of 5]

At first I was worried that this book wouldn't be great because it wasn't a doctor who was writing the book; however, I was blown away by how detailed Charles was with this book.

Really, an fantastic read. I loved learning about what life was like for heart surgeons. A must-read for anyone who is into medicine.

On top of that, this book also had some very emotional moments. The one that stands out is the chapter on Erika Maynard. It was such a sad story, and I felt so bad for Erika. I don't want to spoil the details of the story, so I'll just say that it's very emotionally moving and I feel horrible for Erika's family as well. That's not easy to go through as a family.

[Tim Blackburn · Rating 4 out of 5]

Behind the Scenes at a Leading Heart Hospital

This book was on the technical side regarding the gamut of heart procedures that are routinely performed, however it was an excellent read. I use the word "routine" not to imply that cardiac procedures are simple because this books clearly brings home the point that even a "minor" cardiac procedure is anything but "routine" and simple. The insight in the book brings a new appreciation of the amazing progress medicine and surgery in particular has made in the past 50 years. Solid scientific non-fiction that is both entertaining to read and educational.

[Erica Palmer · Rating 3 out of 5]

Reads like a college persuasive essay, but interesting if you have a special interest in the subject of heart disease. I’m glad it included an anecdotal story of a child with heart disease, but wish it would have gone deeper into the science and prognosis of those kids born with congenital heart defects. Would be interesting to read an updated version of the book now that this one is years out of date.

[Flicka · Rating 4 out of 5]

I am interested in many things medical, especially in heart related treatments and technology. This book was a quick and interesting read for me. I also enjoyed the comments the author included on health care issues in the USA. It is a bit out of date (written in 2006-2007), but still worthwhile to me. I even know one of the star cardiac surgeons mentioned later in the book! He dated my SIL for 6 months.....small world. :-)

[Rita Ciresi · Rating 4 out of 5]

A well-written account of shadowing some of the nation's premier cardiac surgeons. The case studies are interesting and the author does a great job of explaining complex medical procedures to a lay audience. If you're a fan of docudramas such as HOPKINS and BOSTON MED, this is a great book to delve into.

[MKF]

DNF - I was expecting a book of stories based on the cases of a heart surgeon from his career. Instead the author is some business journalist or something who researched surgeons. So besides mentions of a few cases the book is focused on the famous surgeons at the hospital, the health care system, and politics. So I had to mark this DNF.

[Tisho Jessop · Rating 3 out of 5]

Interesting content but it was too technical for me. I much prefer the people stories (patients and doctors) and those were here too but there were times where it was just too many terms and technical details for me to absorb.

[James Human · Rating 1 out of 5]

More about the national health situation in the US and very little about the actual heart surgeons and their amazing skills.
Also very out of date as at March 2018.

[Margie · Rating 3 out of 5]

Some parts interesting and educational but other parts not

[Sara Goldenberg · Rating 2 out of 5]

Wasn't great

[Toby Zidle · Rating 4 out of 5]

Good Book, Well-written, But (By Now) Somewhat Dated

Let me start off by disclosing that my profession is the abstraction of cardiothoracic surgery data at a university teaching hospital in Texas.

I find the book fascinating in most areas of discussion of what really happens behind the scenes in cardiac surgery. The dedication of surgeons and staff is tremendous. The complexity of surgery is well-illustrated. Advances in surgical techniques and medical devices are indicated.

The shortcomings cannot be blamed on author Charles Morris, but arise from the passage of time. New surgeries: aortic replacements, MAZE for fibrillation, minimally invasive surgeries, new methods for preserving the life of harvested donor organs, etc. I'd have liked more discussion of post-operative complications and their treatments.

Most of all, I miss any discussion of the role of the Society of Thoracic Surgeons and its work in quantifying surgical risk/mortality.

In summary, the book is very readable and enlightening. Well worth four stay.

[Terri Ann · Rating 5 out of 5]

The Surgeons provides a fine basic understanding for the layperson of the workings of an academic surgical practice. Morris lived in the Columbia cardiothoracic division for 6 months, observing, surgery, meetings, attendings, residents, practice, and billing. I found the story quite compelling and learned some interesting information about certain surgeries. It helps be to be better at my job to more deeply understand the motivations and actions of surgeons. I really appreciated the stories Morris tells about specific patients and procedures. In the end, I thought the discussion of billing practices and healthcare policy felt a little tacked on, as though he didn't have as thorough an understanding of billing as he did of the procedures themselves, but the discussion was adequate. Highly recommended for anyone whose wondered what it's like to be a surgeon. Will be on my shelf next to Atul Gawande.

[Yuliya · Rating 5 out of 5]

Being a huge Grey's anatomy fan, I loved the book. I liked it that the author is not the doctor himself, so the way he talks about medicine (and there is a very informative appendix with drawings and explanations of how the heart works) is easy to understand and follow.
The author organized the book in a great way - he would start by telling about an operation/procedure that he witnessed and then talk about the history and/or issues related to this surgery. I also enjoyed meeting the doctors and patients.
This book is a must for potential medical students or just people who are interested in medicine.

[Kelly]

This was a really fun read for me because it's about Columbia-Presbyterians cardiothoracic surgery department! I shadowed Dr. Q in an ASD repair on a 2 mo. old, I've gone on transplant runs with some of the other docs, and if my NIH grant had come through I would have done a summer internship with Dr. Hsu. It gave me a good, basic, easy refresher on some important public health issues and had a nice personal twist that made it even more interesting.

[Gary Hoffman · Rating 5 out of 5]

I read this after I had fairly serious surgery and just before I had open heart surgery. It helped me understand surgeons and even helped me communicate with them better. As anyone who has been on the receiving end of serious medical care knows, surgeons are a special lot, and not always the easiest people for patients to get information from. Understanding where they are coming from certainly helped.

[Alice Weaver · Rating 5 out of 5]

AMAZING. This detailed in internal look at what goes on in open heart surgeries is mind blowing. At the same time it helped my family and I get through a major life crisis with realistic expectations. Thank you, thank you, thank you! We held this by our mother's bedside throughout her surgery passing the book from family member to family member. Your honesty and candor gave us comfort.

[g-na · Rating 2 out of 5]

Another book I picked up to satisfy my need to read case studies about patients, doctors, and life in the medical profession. Unfortunately this book had few case studies, and too much babbling about politics and health care.

[Kerry · Rating 2 out of 5]

I found the first 2/3 of this book very interesting. The last part was very hard to follow. It was like reading his personal notes that hadn't been organized into any topical format.

[Diana · Rating 3 out of 5]

This was an eye opening book.

[Hillary · Rating 3 out of 5]

I love this type of book, so I liked this one, but it wasn't really any special example of the genre.

[Kimberly Atkinson · Rating 3 out of 5]

An interesting look at what goes on in a cardiac surgical unit.

[Pilar · Rating 5 out of 5]

Fascinating. Wonderful writing.