I thoroughly enjoyed Professor Westaby's last book "Fragile Lives". But this book simply exposes the force that was his mindset as one of Britain's foremost cardiac surgeons. It is a multi faceted book that thrusts his self confessed psychopathic and narcissistic unconventional style that propelled him towards the professional and popular fame he currently bathes in. It is not a book for everyone as the arrogance on display in the first half of the book is something that even I as a neurosurgical registrar has not come across in such an indulgent manner in an extremely long time.
This aspect of the book is guaranteed to convince most readers to launch this book out of the window and into a public bin. But if you persevere he eventually opens up and grants you an insight into his own world, e.g. the agonising he has over missing the birth of his first child from his first marriage and then almost coming close to missing the birth of his first child from his second marriage keep you hooked.
But it is clear that the book though starting out as a grandstanding pamphlet that only cardiac surgeons risk death (is utter nonsense as other surgical specialties do as well in their own sub-specialty areas and if not immediately in the short and long term futures, e.g. the advances in WHO IV GBMs in the past forty years in neurosurgery has increased but at a pace that is excruciatingly slow that neurosurgeons are all too aware of the eventual mortality and morbidity that each piece of tumour removed vs. left behind can cause) the book capitulates into the usual haunting expressions of understandable rage that many of the Old Guard of surgeons including Henry Marsh scream. And this is that despite their decades of extremely taxing graft for their patients and hospitals that the cost cutting and worse of all applause that cost cutting in the NHS get which compromises patient care is something they cannot do anything about.
This book captures rather succinctly the fact that Britain's best medical graduates are seeing those demanding surgical specialties, e.g. cardiac surgery and neurosurgery, as poor recompense for extortionate medical student debts approaching £80,000 in some cases, an ever isolating scattered on call schedule that does not educate but only infuriates and denigrates and ultimately this results in our nations brightest going overseas.
I can testify that some of the brightest minds from my graduating medical school class do not work in Britain but overseas. The continual smashing of doctors not equipped most of the time to do the job has demoralised the profession. Westaby puts it plainly that the only expanding area of the NHS is hospital managers not nurses, doctors, porters, phlebotomists and so one.
Overall it is a book that I needed to read at about this time in my own training. When you are in a specialty that is a demanding surgical one where you can see in real time the impact your hands has on another human being (and their families) you need to hear on occasion from the Old Guard who talk plainly and decisively. It is his decisiveness which is endearing. And trust me in a surgeon the worst thing is indecisiveness. A decision should adhere to Occam's Razor otherwise patients can die. And those specialties that have devastating blood loss as a daily confounder, e.g. cardiac, neurosurgery and vascular surgery, always have demanded decisive thinkers
Please write another one Prof.
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