刀锋人生：打开心外科医生的心

by Stephen Westaby, 斯蒂芬·韦斯塔比, 高天羽 (Translator)

心外科医生，有着开胸换血、起死回生的神秘力量，但也是活生生的人，也经受着所有人都有的核心情绪——大部分时候。

一次诡异的运动事故，冥冥中将韦斯塔比塑造成了全球领军级的心外科医生之一。“我从打蔫的紫罗兰，变成了无拘无束、胆大自负的混蛋。我变得对压力免疫，成了习惯性的冒险者，始终渴求着刺激，像一块磁铁似的，把高风险病例吸到身边，并陶醉在和死神的竞赛之中。”

而又一个寒冷冬日，孩子的拯救和降生，“帮我改变了对生命的看法，也将我塑造成了一个更优秀的外科医生——我变成了比过去好得多的人，也重又明白了爱能带来欢腾、喜悦。”

透过韦斯塔比的心路剖白和自我反思，读者将看到一场场生命的冒险，一次次爱的悲欢，以及现代心外科那扣人心弦的全部故事——“它们正是在我这一生中渐渐铺陈开的，能够参与其中，我很自豪”。

Genres: Medicine, Nonfiction, Medical, Science, Memoir, Biography, Audiobook

248 pages, Kindle Edition

First published March 18, 2019

Reviews

[Dr. Appu Sasidharan (Dasfill) · Rating 5 out of 5]

Summary


What is the most astounding quality needed to become a great Cardiac Surgeon? Is Surgery a specialty only for straight-A students? This book, written by Stephen Westaby, who, during his prodigious career, operated on over 11,000 patients, becoming one of the world's top and pioneering heart surgeons, gives all the answers to the above questions regarding Cardiac Surgery.



Three interesting things we can learn from this book
1) Conflicting commitments that a Doctor will have to face in his/her life
The medical Profession is where they will have to face conflicting commitments both in Professional and personal life. In this book, the author says conflicting situations where he promised to spend time with his children but had to break that promise due to the emergency call he got from the hospital, which he had to attend. Here prioritizing the need to attend the patient over the children does not mean a lack of commitment of the Doctor to the family. It involves priorities, responsibility, and duty. These value-based priorities help us to choose one commitment over the other, without any guilt. Even though Doctors are paid handsomely, their families have to behave sensibly in such situations and allow the Doctor to prioritize the patients in such emergencies. I know it well as both my parents are also Doctors and I have been in this sitch loads of times when I was a kid.

2) Doctors marriages
Doctors, especially Surgeons, have to deal with grueling unpredictable work schedules. How does this knackering schedule affect their family life? This has been an essential topic of discussion for a long time. The book called Doctors' Marriages: A Look at the Problems and Their Solutions by Michael F. Myers deals with this topic in depth. Stephen Westaby is also discussing this vital topic scrupulously in this book

"I was a backstreet kid from Scunthorpe who had married his childhood sweetheart from his local grammar school. Caught up in this whirlwind of ruthless ambition, things changed, and marriage became an unintended casualty. I was ashamed of this, but I knew many Surgical teams where many members were having an affair. Grim in reality that the staff of the television soaps glamourizes adultery. So widespread was the problem that the Johns Hopkins Hospital carried out the study of divorce as an occupational hazard in Medicine. The younger their Residents were when they married, the higher their divorce rate."

I didn't write the above two paragraphs with the excerpts from this book in this review to discourage any fervent candidates who want to be a doctor. The world always wanted good doctors, especially in the current pandemic crisis. We have to first manage our expectations about becoming a Doctor, recognizing the challenges associated with it. If we are more realistic in our approach to this noble Profession acknowledging the obstacles, we can ultimately become the paragon of perfection that drove us to Medicine in the first place.

3) What are the qualities that a Good Surgeon should possess?
Stephen Westaby describes what all qualities a Good Surgeon should possess in multiple parts in this book.

1) Manual Dexterity, ambidexterity, and ability to draw (These three qualities are the ones which the author believes that made him a great Cardiac Surgeon as he calls himself as 'never been a straight-A student')

2) Good Teamwork

3) Good communication skills especially with patients, Doctors from other departments like Physicians, Anaesthetists, and other members of the Surgical team

4) Sagacious disposition

5) Ability to adapt to the unexpected complications during the Surgery and showing composure to tackle it

6) Good physical and mental stamina to stand on your feet for long hours and to deal with stress-related with Surgeries

7) Good leadership skills

8) Experience and willingness to learn new Surgical techniques and get updated regularly

9) Willingness to make sacrifices

10) Ability to maintain the ideal work life balance


My favourite three lines from this book
"Eventually that I learned that the ability to take risks is an indispensable part of human psychology. Victory and war depends on risk takers and recklessness. Hence the adage, "Who dares wins." Risk taking is the world's principal drive of progress. But it requires a particular character type. One defined by courage and daring, not reticence and prudence."

" Cardiac Surgery is like quicksand. Once in it, you're sucked deeper and deeper, and I struggled to leave the hospital in case something remarkable happened, and I missed it."

"From a Surgical perspective, small children with congenital defects in their tiny hearts are far more challenging to operate on than grown ups. So our cerebral cortex and brain stem to fingertips axis have to be finely honed. Our empathy button also needs to be on the off position, if only temporarily. We all are subjected to transmitted anxiety, whereby someone else's fear are transmitted to our own mind. Body language, wobbly words, and avert display of emotion all figured in this process. To maintain objectivity, the Paediatric Surgeons Psyche requires an invisible brick wall to deflect the misery, terror, and panic vibes. This shouldn't be interpreted as callous or psychopathic because it's not. Quite simply, the ability to resist the pressure of these emotions emanating from others is an acquired defense mechanism without which we couldn't do the job."

Rating
5/5 This is one of the most engrossing Medical Memoirs dealing with the field of Cardiac Surgery .

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[Petra X · Rating 5 out of 5]

Review How far would a vegan go? If on the operating table the doctor needed to use heparin, to thin their blood and stop it clotting, and then later, to reverse that effect protamine, would they have given advance directives not to use drugs derived from or tested on animals? Heparin is made from cow's guts, and protamine from salmon sperm? Or would they put their life and health first?

A moral and practical conundrum. A little baby is dying but would fully recover if her heart valves were replaced. There is no bed for her. A child is brought in with a crushed skull and brain dead and will not be ventilated so there will be a bed for the baby whose operation has been put off twice already.

No one has spoken to the parents of the child who is brain-dead about organ donation. If they do and the parents agree to it, it will tie up the bed for at least 24 hours and the baby who needs her heart valves replaced will likely die. Should the doctor talk to the parents about organ donation or use the bed to save the dying baby?

He does speak to the Sister about it, and she replies, "Do you want the bed or don't you? That route could take us well into tomorrow." And nothing more is said. A tough call, the known-living who can be helped against the unknown, I don't know which is morally best.

This was an interesting and thought-provoking book, a book that challenged me, from a surgeon who could equally well be a writer. I would read anything the author wrote.

[Sonja Arlow · Rating 4 out of 5]

3.5 stars

When I was about 8 my local GP diagnosed me with a heart murmur, all I can remember was suddenly being the center of attention and the tests that followed. My mother was assured I would grow out of it, and thankfully I did. But these memories came back while reading about REAL life-threatening heart complications, particularly in children.

More often than not I complain that medical memoirs feel slightly dumbed down and could do with a bit more technical rigor however with this memoir the technical aspects made me put down the book at the 75% mark and indulge in a day of lighter reading before picking this up again.

The author is an eloquent storyteller and there were many tidbits I found fascinating. I already knew Jehovah Witness patients refuse blood transfusions during surgery however how does a heart surgeon overcome this…. With a fascinating machine that basically repurposes your own lost blood during surgery and recycles it back into your body.

The book also touches on the history of groundbreaking heart surgeries from the 1970s to present, so I found it odd that Christ Barnard, the South African doctor that performed the first heart transplant was not mentioned at all.

And as with every NHS book I have ever read the author complains about the way its managed, how it’s structure can do a lot of harm to the patient as well as the doctor.

This is definitely worth the read but be prepared, its not always an easy book for a layman to get through.

[Rebecca · Rating 3 out of 5]

(2.5) In this somewhat tepid follow-up to Fragile Lives, Westaby’s bravado leaves a bad taste and dilutes the work’s ostensibly confessional nature. He has a good excuse, he argues: a head injury incurred while playing rugby in medical school transformed him into a risk taker. It’s widely accepted that such boldness may be a boon in a discipline that requires quick thinking and decisive action. So perhaps it’s no great problem to have a psychopath as your surgeon. But how about a sexist? Westaby’s persistent references to women staff as “lady GP” and “registrar lady” don’t mitigate surgeons’ macho reputation. It’s a shame to observe such casual sexism, because it’s clear Westaby felt deeply for his patients of any gender. And yet any talk of empathy earns his derision. It seems the specific language of compassion is a roadblock for him. The book is strongest when the author recreates dramatic sequences based on several risky surgeries. Alas, at its close he sounds bitter, and the NHS bears the brunt of his anger. Compared to Fragile Lives, one of my favorite books of 2017, this gives the superhero surgeon feet of clay. But it’s a lot less pleasing to read.

(My review is in the September 6th issue of the Times Literary Supplement.)

[Laura · Rating 5 out of 5]

As with Fragile Lives, I couldn’t wait to read this exciting book chronicling yet more tales of paediatric heart innovations at the hospital I have worked at myself for several years now. As both a nurse and an avid reader, this is just the type of book I love to lose myself in. With the author living in a neighbouring village just six miles from my own, this felt like a very personal read for me.

Knifes Edge covers lots of important and interesting topics, notably the authors examination of how the traits of a heart surgeon are akin to psychopathy - a fascinating subject. Later in the book the author touches on more personal subjects, such as his own experiences caring for his ageing mother and as a patient himself at a nearby private hospital (the reason for not using “our” hospital is discussed, and frankly justified).
Although the author repeats throughout the book how surgeons cannot inherently allow themselves to feel empathy for their patients (or they would never get past their first death), there are plenty of examples whereby the authors obvious care for his patient is shown.

I had one gripe with this book. There are of course references to many different professions and colleagues throughout; but I note the author often refers to female colleagues using their gender as a predecessor to their job role, which wasn’t necessary. Example: instead of simply saying “the cardiology registrar” it was “the lady cardiology registrar” or “the female GP”. I also noted he failed to use this technique when describing his nursing teams - should we assume all nurses are female? Logically of course we know this isn’t true. I failed to find any particular area when the author noted the gender of a colleague who was male before describing his role. While I absolutely believe women in medicine should be given as much attention as their male counterparts, I just felt the author placed too much emphasis on the fact he - shock horror - had a highly trained expert female colleague. Its 2019 and casual sexism has no place in modern society or our NHS.
His exasperation of “clueless” nurses was a little unnerving as well. As the husband of a nurse, I would have expected to see some more emphasis on the nurses role both in theatres and in the precarious aftercare and critical hours following surgery.

With all that being said, this is an excellent book and I would not hesitate to recommend it to anyone who has used or worked for the NHS.

[Iain Snelling · Rating 2 out of 5]

Some of his character flaws were caused by a rugby accident, he argues, but knowing that, and presumably having an editor, means he wants to present himself as a disrespectful and sexist caricature. I’m sure he is every but as good a surgeon as he presents, but I prefer my heroes with at least some humility.

[Baljit · Rating 4 out of 5]

After reading Fragile Lives this book was on my TBR list. This book is more personal that his first novel. Westaby delves into his early years as a kid from Scunthorpe who played hard on the rugby field, sustained his share of bumps and bruises and he credits his cracked skull with a change in personality- which helped him in his surgical career. While head injuries have resulted in changes in cognitive function and temperament, the path to being a cardiac surgeon is just due to damn hard work and long hours and he was no stranger to this. In that era there was no regulated hours for trainee surgeons, one just got cracking on when a patient presented and the more experience one gained the more you learnt.
I am particularly fascinated by his rant on the NHS. Consultants of Westaby’s era have seen the rot set in and the systemic deterioration, it’s no wonder they feel cynical about the system. There is a brain drain from U.K. hospitals and more trainees from developing countries are running the hospitals before moving on to greener pastures.

[Amy Young · Rating 4 out of 5]

Sorry Westaby but you do come across as a prick - this isn’t necessarily bad, it was fascinating to read and the comments on the NHS were perspective altering. Would recommend

[Ardon · Rating 4 out of 5]

This is probably the first book on medicine/surgery that I have read which almost immediately drew a parallel with The Right Stuff. There is a certain romanticism with which Professor Westaby discusses how he built up his skills as an open heart surgeon, joining a club consisting of only those righteous few with qualities and skill to pursue this incredibly challenging career. It reminded me a lot of how fighter pilots in the 1960s used to approach their careers, constantly pushing themselves to be among those righteous few who would be selected by NASA for space programmes.

In a similar lieu, Professor Westaby communicates his strong sense of pride in his work and his quest to become better and better, but, at times, this does cross over into arrogance. This becomes particular prominent in the instances when he belittles colleagues for having the audacity to take time off to rest.

I suppose this is in part because Professor Westaby was part of the surgical old guard, who I have encountered before on clinical placements. This group tends to suggest that medical school and surgical training are too easy on people, and that the long hours and austere working conditions they faced were selection pressures to ensure that only the best remained (and indeed, this is a point he does make in certain chapters)

While I would argue that this would select for the most resilient within a group, I am not convinced this strategy necessarily yields the best long term outcomes for physicians or their patients. Indeed, a recent systematic review showed that sleep deprivation in surgeons was associated with statistically significant reductions in surgical performance (whether this had direct impacts on morbidity or mortality was not discussed, but it would be a reasonable corollary). Furthermore, sleep deprivation in surgeons was associated with a higher risk of mental health conditions such as depression.

Given the historical stigma within the medical profession against physicians with these conditions, it is unsurprising that perhaps this went unnoticed during Westaby’s time, due to physicians fearing ostracism from their peers after seeking help. Furthermore, there is no dearth of evidence which supports the hypothesis that well timed breaks are important for building up complex skills such as carrying out complex surgeries (as detailed in Hidden Potential: The Science of Achieving Greater Things, Peak: Secrets from the New Science of Expertise, and so many other books).

However, I did really appreciate the candour in Professor Westaby’s final chapter, as he ruminates on the fundamental problems with the NHS and systematically deconstructs the arguments for and against changing its underlying structure.

[Clare Malone · Rating 5 out of 5]

Professor Westaby operated on my son when he was 12 years old. He saved my sons life as he was extremely poorly with a heart condition called Severe Aortic Stenosis. It was a really difficult time for my son and all of us but I am so very grateful to this amazing man. He personally rang me after my sons operation to tell me that it had been a success and that my son was going to be ok, the relief was immense.

I thoroughly enjoyed reading his second book, I am yet to read his first Fragile Lives but I will be reading that as soon as it comes back into my local library.

Huge praise for Professor Stephen Westaby.

[Charlotte · Rating 3 out of 5]

Two memoirs by NHS doctors in a row, though very different people, agree on one thing: the NHS is not doing too well these days.
It's interesting that people who are both passionate and good at their jobs in all stages of their careers feel forced out of the NHS.
There were some very detailed stories of heart surgery which was pretty interesting, and a lot of musings with varying degrees of interest to me.
Westaby is quite a bit of a "good old boy", and I frequently found his personality somewhat grating, but despite that I have a lot of respect for what he has done professionally in his life. I'm fascinated by people who so clearly put their jobs above all else, and when they have jobs like this, also grateful. Interesting insights, but sometimes I found it a little dragging.

[Ulrika · Rating 3 out of 5]

A very interesting book about the experiences of a heart surgeon working for the NHS. Unfortunately, I found the author pretty unlikeable....very arrogant and seemingly proud of that fact. The book is peppered with compliments about himself, but if you ignore those bits then the rest of the book is fascinating (if you like medical books).

[Kerrie-louise Lister · Rating 5 out of 5]

Fantastic book, open, honest, empathetic, emotional , so truthful of how I think we all feel in the NHS , tells it as it is with all the emotion and frustration but brutal and truthful fact of what’s happening and it’s effecs on both staff and those who need it equally .

[eunice · Rating 4 out of 5]

3.9/4

thought provoking story about characteristics that shape a surgeon, shocking changes in his life, the experience he has are truly one of a kind. l it kind of makes me hesitant about this area of med, the detachment and ruthlessness !!

pov: “grim reaper tirelessly stalked the hospital corridors with his scythe hopping for me to screw up. sometimes i did, mostly i didn’t, but i never let anyone go without a fight.” “ autobiography is only to be trusted when it reveals something disgraceful. A man who gives a good account of himself is probably lying since any life when viewed from the inside, is simply a series of defeats.”

[Ruchika Pahwa · Rating 4 out of 5]

The Knife’s Edge is a beautifully crafted book by an equally crafty cardiac surgeon, Professor Stephen Westaby. As its caption suggests, it’s truly an account of the heart and soul of a cardiac surgeon who deals with the ups and downs of life, every single moment at work. You’ll see the sacrifices and pains behind that routine of multiple mind-boggling surgeries that are handled under extreme pressure by surgeons, yet with great precision. Sometimes, their hands are tied; sometimes, their times are.

I also appreciate the way the author has raised his questions on the working of a healthcare system that he believes to be lacking in advanced equipment and resources required for a job that is considered to be the toughest in the professional domain. It was sad to learn about the conditions in which critical heart surgeries of infants and adults take place when the system is unable to provide for the best, which it is surely able to achieve with such talented nursing personnel and surgeons.

Some compassion for the sufferers and a slight change in administrative mindset can avoid many dangers, fears and risks to the ‘precious’ life. Suffering is never a good sight to witness, whether by patients’ families or their surgeons.

This book not just covers the author’s professional cases but also his personal life that sometimes displays the shades of sadness, fear and misery and the feelings of joy on other occasions. I feel life is never normal when death becomes a regular part of it. I was moved by the incidents like those of Sophie and Oliver, the little patients who came back from the clutches of death, simply because their surgeon forever believed in hope and in magic at times when he strove constantly to achieve perfection.

While it’s advantageous to be aware of the basics of anatomy and medical procedures when you read this book, the life stories, thoughts and experiences of Prof. Westaby are worth cherishing, especially when the book is so well edited and supported by a glossary of medical terms. Go for it any day, guys!

[N.otabene · Rating 4 out of 5]

Life changing story of a remarkable surgeon, Professor Stephen Westaby . Where a rugby accident changed his life forever. From a shy introverted kind to a brave,risk taking and slightly narcissistic behaviour that complement the triad needed for a surgeon.

There's so much things happened behind closed door that we didn't know or will never know unless it is told. Same goes to the operation theatre. And the NHS itself. So many political, money thingy and selfishness involved that stained the quality of the healthcare workers there.

'my life was never my own' . Once you embarked the journey on medical line, there's no turning back. Everything you do, is for the patients benefit.

This books give me insights on how it will be once you graduated medical school. What to expect from the hospital and managements , the empathy towards families waiting for their child's surgery , the drama in between and everything happened inside the hospital.

Also , how the tables turned when once famous surgeon had to be the patient himself. How it is to be the one who stay and watched rather than doing it on his own.

[John Callen · Rating 3 out of 5]

Interesting. Thought provoking. Pleased I read it.
Obviously a remarkable surgeon … in many ways. There were times I didn't like Mr Westaby very much though. I wondered how much he liked himself too. Episodes that highlighted both his brilliance and his accident-induced lack of self doubt, palled a little - about two-thirds through. One surgical goal-mouth save after another. It might have been helpful if the glossary was at the front! But he makes some excellent points about the state of the NHS. That said, his lack of self doubt made me wonder about ops that failed and the benefits or otherwise of all those surgical interventions.
Like I said, thought provoking.

[Hannah Mc · Rating 4 out of 5]

Some jarring reading, what strength it must take to be a heart surgeon dealing with emergencies, dying patients including children.

Westabys memoir of his life as a heart surgeon is insightful, and incredibly interesting, his sadness at the failing NHS we all know of is relatable, once the best health service in the world, now on its knees.

All I can say is what a remarkable man, an amazing life, I can’t imagine how strong and calm you must be to operate in such desperate and dire conditions.

[Emma · Rating 4 out of 5]

Really interesting to follow a surgeon right through to how he left the job. I did enjoy the more personal look at the hard cases and near misses and it gave a little bit of hope to hear the success stories. My issues lay in the fact he refers to any female colleague as a 'lady' registrar / consultant etc. and occasionally some of the technical descriptions of the surgeries become a little repetitive. However, I did enjoy this book and was intrigued by the repeated references to the emotional traits of surgeons and particularly to his brain injury affecting his personality.

[Emma Cook · Rating 4 out of 5]

Can't give this 5 stars because of the insufferable, constant reference to "lady GPs", "lady SHOs", "lady professors", as though (a) Westaby couldn't fathom this as a possibility, or (b) he thinks the reader can't imagine a female doctor off their own back... (Also I wonder which editor could have missed this)

However, it was refreshing to read someone give an honest reflection on working for the NHS, and his work is undoubtedly inspirational.

[Sheila Howes · Rating 4 out of 5]

Earlier in the year I read and enjoyed the author's first part of his memoirs (Fragile Lives), and found it very emotional. This was also a difficult read - but this time it was difficult because of the author's final moments in the NHS. It is worth reading as a cautionary tale.

[mrs m a toghill · Rating 5 out of 5]

Brilliant

Another compelling read from prof westaby thank you for your honesty. Enjoyed fragile lives but this is so much more candid and loved it

[Andy Bradbury · Rating 4 out of 5]

It seems Professor Westaby is as talented with a pen as he was the surgical knife.

I thoroughly enjoyed this book and found it before I knew about his first, Fragile Lives, which I'll go on to read this year too.

Each chapter is a story within itself, talking us through the journey of a patient (or two) and the overlying feelings that the story evokes.

For a man who's brain was altered at a young age because of a Rugby accident meaning fear was absent throughout most of his life, he clearly still noticed the emotions and wellbeing of his patients and family members and it seems like he was a truly extraordinary surgeon who's hugely passionate about our NHS and the need for it to get back on track.

My only critique would be that the book finished on such a sour note about the NHS. I do understand Professor Westaby has no desire for the "touchy feely" side of things however finishing in such a way left a sour note - perhaps the intention.

The Knife's Edge did open my eyes to the broken system, a system I haven't had to use really in the past 10+ years and so I'm grateful for the insight, however some education about what we could do as a reader or some insight into what's being done to turn the system around. As a now-motivated reader I would have immediately done something on putting this book down to throw my support behind it.

Regardless, this was an excellent book and I've recommended it to several people and hope I get to meet Professor Westaby in the coming years as I'm now keeping my out for him at TedX lectures and the like.

I can't wait to read Fragile Lives.

[Rutuja Ramteke · Rating 4 out of 5]

💕The Knife's Edge By Stephen Westaby
I am a person who loves perfection though it's really not possible to gain perfection all the time but at least you can try. Being a doctor, can never be easy and I mean it though I am not but I have seen them struggling and trying to cope up. Stephen Westaby, is one of them whom I got to know a much more better through this book. I think it must be very hard to work in operation theatres, scrubs and masks all around the increasing tension, the on time decision making, success, failure and the sound of the ECG machine. This book is more or less a memoir and we can't say a personal one but definitely it focuses on his own career of 35 years as a cardiac surgeon.
.
The best part is the flow of words, his thoughts and how he represented each and everything. I couldn't cope up with the starting but this book inspired me in alot of ways. I consider myself luckt to read it. I consider this as one of my most amazing reads in the non-fiction genre of this month and I am really looking forward to read more such inspiring books by the author. The only thing I didn't like was, the book makes you feel lost at times and you will have to try ro search the exact meaning the author is wanted to convey, but ya, I will highly recommend it. It's a worthy read.
.
Rating: 3.8🌟

[Anil Dhingra · Rating 4 out of 5]

Dr Westaby practised heart surgery in Britain and elsewhere for over 40 years. This is a tell-all book of his growth as a person and as a cardiac surgeon. It is written in 2019, fairly recent. He retired at the age of 68.
Coming from a lower socioeconomic strata he struggled to mix with public school students and played a lot of games to fit in. It was an injury to his head during one such game that his frontal lobe got damaged and all his inhibitions went away making him bold, daring, aggressive-- all traits required for a good surgeon. This is a remarkable story of a good outcome of a bad accident.
Graduating in 1966, Dr Westaby found a system which was just developing and gave scope for innovation in surgery. He took full advantage of this.
He describes in details the challenges he faced in tough cardiac surgery cases especially paediatric patients. He took chances, travelled to learn and teach, all very fascinating.
His stories as a failed good father, fears when he himself becomes a patient and the anger at the limitation of the NHS as a health provider are interesting to read.
A book for doctors. Non medicos may find the book a bit too technical at times.

[Archer Wei · Rating 3 out of 5]

OK， here I am and want to speak some harsh words. People usually be more kind to heroes for their brilliant work, even if they have a lot of unbearable flaws in personality or the way they work.
Like Westaby's last book, this one also focuses on his successful portfolio but adds some personal events to explain why he became such a triumphant and arrogant man. He believes that these kinds of characters help him in his career, and what he discards such as self-doubt, compassion and modesty play a useless role in surgeons' work. He uses his wonderful achievement to enhance credibility, however, what he tries to escape can not be ignored: surgeons are not gods, they have many moments of failure and powerlessness. What about these moments? The only thing surgeons can do is sympathy and comfort, don't forget the saying"To Cure Sometimes, To Relieve Often, To Comfort Always".
It is undeniable that Westaby is an old-fashioned hero with a great career and reputation. We all hope to meet such a skilled doctor when we are sick, but what about personal growth and medical perspectives? eww……talk later.

I am an English learner and if you find any grammar problems or something like that, do tell me, thank you.

[Zack · Rating 5 out of 5]

A work of art

The knifes edge by Stephen Westaby is a truly eye opening account of the realities of working in the NHS and healthcare as a whole.

Westaby is not only open and honest about his experiences with a head injury caused by playing rugby when he was younger, but he also shines a light on the challenges of being a heart surgeon, how it can affect a surgeons relationships as well as his own experiences with fear when some of his loved ones faced medical emergencies.

As someone who works in healthcare i find Westaby's caring nature, especially to those with down syndrome and learning disabilities to be extremely heart warming and to hear someone so desperate to help those who most others wouldnt is truly amazing!

The knifes edge also shines light upon the downfall of the NHS over time and just how understaffed the NHS is.

By far my my favourite qoute from this book would have to be, "Fragile lives made better. But we shouldn't have to jump through hoops for that privelege". As Stephen remenices over the times when he was a surgeon and saw patients leave the hospital feeling better after fighting for they're health.

This book is truly a work of art and I must say that Westaby is a truly talented and inspirational individual!

[Julie Hudson · Rating 5 out of 5]

This book read like a thriller - I was desperate to get to the end of each chapter to see whether or not the patient made it. I found it fascinating that the author had a brain injury in his twenties that led to a change of his personality which he felt gave him the necessary confidence / bravado / arrogance / psycopathic tendencies to be a successful heart surgeon. There were some truly horrific cases that seemed like lost causes and it was only the dedication and determination of the author and his teams that saved (and pretty much brought back fromt he dead) many patients.

The last chapter highlights the fact that there has been a great reduction in the number of cases per year that a surgeon can carry out and that there is a lot more time spent reviewing and analysing rather than operating. The author has lost faith in the NHS as the priority has become cost justification rather than saving lives and that health professionals are so pushed to the limits that there is no longer time for proper care.

[Munisa P · Rating 4 out of 5]

So basically this book was the next one in my medical literature chronicles spree, and I was finally reading about a heart surgeon, which I had anticipated with lots of excitement.

I can definitely see why Mr. Westaby was one of the most significant figures in the pioneering history of cardiosurgery. He didn't even need to exagerrate or overstate his long impressive career, ambitious discoveries, or essential contributions he made to the fairly new medical field at a time.

To be honest, as someone who was considering UK as a good choice for a country to do my residency in, he made me question the whole system and whether it's really worth going to work there. Now I wonder if things changed towards better since the time Stephen Westaby retired from medicine.

But overall definitely an enjoyable, at times brutally honest, insightful read I would recommend every medical student to give a try.

[Sally · Rating 4 out of 5]

I am ambivalent about this book.

It is immensely readable but the author is not a likeable character. Self-diagnosed as a psychopath, he insists that it is this personality trait (attributed to an assault during a rugby match) that makes him an outstanding surgeon. All the characteristics that do are are lacks: lack of fear, lack of insight, lack of patience. He shows limited empathy, is single minded, sacrifices everything for his own priorities which are usually to complete the latest operation. He is judgmental and regularly tells us that a trainee surgeon “would not make it” often based of showing weaknesses such as physiological needs for sleep etc. It is also clear that he would not give a toss, or indeed anything much coarser, about this opinion.