Still Reading Stephen Westaby

Summer continues. The days are long. Self’s favorite time of day is after dinner, when the heat is dissipating. Around 8 p.m. It’s still light.

Self’s reading has slowed with the warm weather. Today she’s on Chapter Nine of Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table: Westaby is doing a heart transplant on a 10-year-old boy named Stefan. The doctors begin surgery when they get word that “the donor heart had left Harefield” and “would arrive in Oxford in thirty minutes.”

It arrives. The assisting doctor, Marc, “started to trim the donor heart,” which was “from a live person with a normal brain.”

(In parts, this book reads like a horror story — Westaby seems to have a taste for the gruesome detail)

It was time to cut out Stefan’s own sad heart and make ready for the new one. Out it came. The empty pericardium was a curious sight. No heart. It must have been scary when Barnard did it for the first time. Like a car without an engine under the hood.

Then, the implantation:

Any donor heart is slippery and wet. Not easy to hold in position.

My treacherous imagination takes over.

Stay tuned, dear blog readers. Stay tuned.

“The Dreaming Spires”

Self is still on Ch. 7 of Stephen Westaby’s Open Heart. It’s a very gripping chapter. Everything unfolds in Oxford, hence “the dreaming spires” (repeated twice in this chapter, the editor must have really liked the expression).

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  • It was almost 8:00 a.m. The summer sun shone brightly on the dreaming spires. I left Katsumata to close the chest and went to warn the ICU about the impending arrival. Something different. For the next twelve hours, Julie’s critical period, she would have no pulse.

As Westaby explains in the previous paragraph, pulse “was much less important than blood flow . . . it didn’t matter whether the blood had pulse or no pulse in it. Flow was the key.”

Further on Julie’s condition:

  • Her kidneys had quit. She would need dialysis for a few days. And she was a little yellow. The liver was suffering as well. By most criteria, she had been dead. But we hoped she would live now. Good or what?

Self would say Julie just won the Lotto. Because Westaby was paged, and because he was willing to come in despite not being on call.

He goes to the patient’s anxious family and they can read his expression: despite “mask dangling down and blood on my theater shoes, I looked pleased.”

Whew! What an event! Like a real battle, and the outcome: “Julie was still alive.” The doctor’s not sure about brain damage, though.

Stay tuned, dear blog readers. Stay tuned.

 

The AB-180, 1997 Prototype

From reading Sheryl Recinos’s harrowing memoir of surviving on the streets as an under-age runaway, to Stephen Westaby’s memoir of his most wrenching heart cases.

Sheryl Recinos ended up a doctor (amazing), but that part is not in her memoir, Hindsight: Coming of Age on the Streets of Hollywood. (Maybe there will be a sequel? Self hopes so)

Stephen Westaby’s memoir, on the other hand, describes his work as a member of the team that produces the first artificial heart.

Ch. 7, Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table

It took the team five years to produce a spinning blood pump the size of a bicycle bell, weighing just half a pound . . . First called the AB-180, it was intended to support the circulation for up to six months . . . It was so simple that one of the technicians attached a prototype pump to his garden hose and drained his fish pond with it.

The first English “guinea pig” for the AB-180 was a 21-year-old woman who had contracted “viral myocarditis, a viral illness like a cold, but when it involves the heart, it can be fatal . . . a desperate situation for a vivacious young woman who had been normal the week before.”

As self told Dearest Mum many years ago: Dying has nothing to do with age.

Look at self’s older sister, dead of streptococcal pneumonia at 34.

Look at Dearly Departed Sister-in-Law Ying, who died at 38 of leukemia which had been diagnosed less than a year before.

In Westaby’s memoir, Julie’s “leg was already blue — pouring out lactic acid.”

Self was the person who received her sister’s autopsy from Lenox Hill Hospital. Her parents couldn’t bear to read it, so self did. It listed her sister’s cause of death as sepsis. Blood poisoning. 11 days earlier she had presented at Lenox Hill’s emergency room, complaining of a bad cough.

As Westaby writes, “most patients with viral myocarditis get over it.”

As most patients with streptococcal pneumonia, what self’s sister contracted, probably do.

Self can tell you she never, ever expected her sister to die that year. That it happened so close to Christmas made all subsequent Christmases into depressing occasions. In fact, a Christmas present her sister had mailed from New York arrived in California three days after she had passed.

11 days. That’s all it took to move a healthy young woman, a mother of three, to illness and then death. That was time enough, though, for self to fly to New York. Time enough for her parents to fly in from the Philippines.

In Westaby’s book, “the doctors scrubbed with haste. What was more important now? Survival or sterility?” He grabs a scalpel and runs the blade “straight through, hard onto the bone.” He runs “the saw up the sternum.” As Julie’s “heart was stopping, I kept moving . . . ” He gathers Julie’s “flickering little ventricles” into his fist and hand-pumps.

Stay tuned, dear blog readers. Stay tuned.

 

Books/ The Economist, 9 February 2019

As dear blog readers can tell from the date, self has a whole pile of Economists to catch up on.

Today is Sunday and the sun is shining and she’s made good on her goal to spend most, if not all, of today reading.

She’s on the 9 February 2019 Books section, and there’s a review of a really interesting book:

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Another book reviewed in this issue (though not positively, lol) is Let Me Not Be Mad, by A. K. Benjamin. Sadly, The Economist does not warm up to its unreliable narrator, but self confesses to being intrigued by this excerpt, quoted in the review:

  • I walked over London Bridge in rush hour, faces thronging around me, and diagnosed each one in an instant: Psychosis . . . Depression . . . Lewy Bodies . . . Panic . . . Depression . . . Sociopathy . . . OCD . . . Cynophobia . . . Panic . . . Guam’s. Everybody has something, and now there’s a name for it, even if it’s fear of having something, of going insane, aka dementophobia.

Stay tuned, dear blog readers. Stay tuned.

 

CHARLIE CHAN IS DEAD, Vol. 1

For the workshop this weekend, re-reading some old stories to show different ways of writing memoir. In particular, thinking of a story called Lenox Hill, December 1991, which Jessica Hagedorn included in the anthology Charlie Chan is Dead.

When Jessica contacted self to solicit a piece, self had nothing, nothing, nothing.

Her sister had died just the month before. She did keep a diary, though.

The diary became the story. The first story in what later become a cycle of grief stories: Mayor of the Roses (Miami University Press)

For a while, a course called Ethics in Medicine, taught at the University of Pennsylvania Medical School, included the story in their syllabus.

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Stay tuned, dear blog readers. Stay tuned.

The Opioid Issue, Prairie Schooner (Vol. 92, No. 4), Guest-Edited by Glenna Luschei

from the introductory essay, Pandora’s Box, by Glenna Luschei:

  • I talked to our contributors Michael Harris and Ray Murphy about physical and mental pain as a genesis of addiction. Where was so much pain coming from? That is a question I am still asking. Some of our poets address it. In a letter Ray Murphy wrote, “Virtually all of my writing about opiates stems about writing from injury. I never address opiates as a recreational drug. Be interesting to see how many other submissions you get that come out of injury and pain, and then progress into dependency and possibly full-blown addiction. Opiates are at once remarkably versatile and one-dimensional. There is no end to the topic.” Yes, I feel that opiate addicts are like canaries in the coal mine, as the addicts are the indicators in our society of the pain we are suffering. In a previous century, addiction to drugs like laudanum may have been connected to mystical vision, as R. T. Smith conjures in his narrative, Sergeant-Major Perry on Sullivan’s Island.

— San Luis Obispo, July 2018

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New Year, New Issues: Prairie Schooner and Calyx

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Just Arrived: Sunday, 6 January 2019

SPREAD THE WORD.

#amreading: The New York Review of Books on Oliver Sacks (21 May 2015)

You will notice, dear blog reader, that all the magazines self has been quoting this week are three years old. That is because 2015 is the last year she had much leisure time. She thinks it’s a very good sign that she saved all these past issues of New York Review of Books. Like she knew, she’d be getting back to them one day. Even if that day was three years later.

Moving on.

Oliver Sacks is no longer with us. Nevertheless, his ouevre remains. Jerome Groopman, in his review of Oliver Sacks’s memoir On the Move: A Life, quotes Sacks’s description of himself:

of “vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.” A talented student drew a contrast with Ivan Ilyich, who was passionless and shaped his behavior to strictly conform to others’ expectations. Tolstoy judged Ilyich’s life as “most simple and most ordinary and therefore most terrible.”

Which is why self is sharing this photo (taken at the San Carlos Auto Pride carwash):

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Stay tuned, dear blog readers. Stay tuned.

#amreading #amwritingfantasy: Inspired by Ian McEwan’s SATURDAY

The first time self read Saturday, by Ian McEwan, was in 2009. She only knows for sure because she did a Search on this blog. And up it popped, complete with spoilers.

But, since she believes she has more time to appreciate reading while she’s in Ireland, she’s going to give Saturday another go.

Amazing how ‘interior’ it is. Also amazing: that it’s about a surgeon. And she just got through reading Do No Harm, by neurosurgeon Henry Marsh. She swears, that’s just coincidence.

What Saturday‘s already succeeded in doing, even though self is only a few pages in: it’s gotten her to add a few more lines to the story she began three days ago, after arriving at the Tyrone Guthrie Centre in Annaghmakerrig. Working title: Transporter 2118

“As a matter of fact . . . ” I thought, but why mince words when she could read minds.

Tu-an Ju rose from the bed.

Oh. I didn’t realize she was that tall.

Looks like the transporter might have a problem.

lol

Stay tuned, dear blog readers. Stay tuned.

 

DO NO HARM: p. 171

Self just joined a Doctors Book Club. So she can participate in the book club discussion on Do No Harm. She even sent a link to her nephew, William. The one who got married in September. The one who works at Columbia-Presbyterian.

Henry Marsh is doing his round of the spinal theatres. In one theatre, he asks the operating: “Why such a large incision? And why are you using the big bone rongeurs?”

Marsh goes over to the operating table.

“I’ll have a look.”

He picks up “a pair of forceps and” looks into the wound. “A long shiny white thread, the thickness of a piece of string — four or five inches long — came up out of the wound . . . ”

“Oh Jesus fucking Christ!”

SELF (Flapping her hands about): OH NO The student’s just cut someone’s spinal cord.

Marsh: The “registrar had completely misunderstood the anatomy and opened the spine at the outer end rather than the inner edge of the spinal canal and hence had immediately encountered a nerve root, which, even more incomprehensibly, he had then severed.”

Stay tuned, dear blog readers. Stay tuned.

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