Excerpts from: Heart Surgery in America: Which Edge of the Knife?

Editor’s Note:

This book is NOW over 99% written and moving into the Editing Phase!

The title of the book is “The Tips of Spears- An Inside Look At Heart Surgery in America”

It is a rendering of the reality, sometimes sad and at times funny, emotional, and clinical vignettes of the many different aspects relating to open heart surgery- from the perspective of a perfusionist. This book is a commentary not only on the intricacies of heart surgery, but openly engages and describes the peaks and valleys of ethical or moral successes and failures.  It highlights moments where lives are saved by the strength of the character of the team- as well as surgical strategies undone by flaws imbued in the highly trained individuals living and breathing this volatile work environment.

Here is an Excerpt from the book 🙂

Which Edge of the Knife?

When it comes to heart surgery, I guess you have to ask yourself which edge of the knife?

Every knife has a different side to each part of the blade that comes into use.

“The point of the surgical blade is in the truest sense of the word, the tip of the spear. If we were going to use a metaphor when discussing open heart surgery and compare that to edges and knife blades in general, the most obvious comparison would be the stoic sharpness of the surgical blade and its relationship to the hand that applies it. Deploying that tip of the blade is the exact moment when a decision makes the cut, that decision delivers that cut, and that decision distinguishes where that cut is to be made. Obviously if it’s your heart that is being operated on, that landing strip is targeted for your chest. That tip of the spear that we are talking about? Well the point isn’t about just how sharp the blade is, more so – it reflects your trust in the surgeon and most significantly, the surgeon’s trust in their team and themselves. Taking it a step a further- it suggests that we ourselves – as members of the team- become the Tips of those Spears…”

It is the quality of the blades and the hands behind them that these stories are about. Not how sharp they are, or whether the blades are shiny, dull, burnished, or any other term that is usually applied to the edge of an instrument that cuts – rather it is the temper of the steel and the composure of the surgeons and the staffs surrounding them that makes these stories what they are – thousands of words to paint a canvas of not just one picture, but a collage of different snapshots taken from many different angles that together brings to us an onion that once it’s peeled – shares with us these stories of heart surgery in America.

Yes, an onion and all that that implies, the things that onions do when they are peeled, they water your eyes, sometimes you cry, they affect you to the point that you become resolute, overcome those tears, wipe away your fears, and dry those eyes to keep on cutting. It may sound like a routine cutting board where your dicing onions while making a salad – but trust me there is no part of this salad that’s going to be a picnic, even though to watch the way hospitals advertise these days – you would think that open-heart surgery is like a walk in the park with everything rosy and shiny, but the truth be told?  It’s not.

Open-heart surgery is still that wild walk in the woods late at night.  You never know what’s around the corner, your eyesight is not quite what it should be because things are kind of hazy, and every heartbeat could very well be your last if whatever that shadow is behind that misting in the trees wasn’t what you or anyone expected or had seen before.

There is no surefire recipe for your heart operation, because just like everything in life, every operation is unique and presents with its own particular bundle of obstacles, bumpy roads, or if you’re blessed, a nice smooth pave way on which to stroll to the finish line – that line being the moment you pass through those hospital doors and are headed home for the day. Hopefully you are walking, but if you’re in a wheelchair well I guess that’s okay, as long as it’s vertical and not horizontal – you should be just fine.

If you’re looking for a book about heart surgery that explains the operation or that helps you figure out how to actually do heart surgery – well this isn’t really a book like that. This is not a how–to novel, it’s not a textbook. There are no tests, multiple choice, essay, or otherwise, after you finish reading this. As the author of this book I am not a doctor or surgeon. I am a cardiovascular perfusionist and I put people on cardiopulmonary bypass for living (theirs and mine). I play a critical role during an open-heart procedure and work with a team of other professionals to ensure your survival. Working as a team we succeed, we fail if we lose our team unity.

This book is about people and what they go through when they have an open-heart operation, or any procedure that could lead to open-heart surgery or variations of that surgical procedure. It’s not just about patients either, it’s a working collage that includes the inside and perspectives of all the people that have to come together to make sure every patient has the best possible surgical outcome when having their heart operated on. Although most people would consider open-heart surgery to be a science, I consider it more of a social interaction of highly trained medical professionals in terms of dealing with their own personalities, their own level of confidence – whether high or low, and how they come together in moments of high stress and manage to overcome any barriers that may prevent them from truly being the best of the best.

Being the best of the best is a given in this arena. You don’t get on our team without a solid college degree at a master’s level or higher, a serious resume, extraordinary recommendations from your peers or educators, and most importantly a high degree of self-confidence and dedication to a purpose that far exceeds the endpoint of your college degree. From the moment a patient enters the doorway into the operating room theater, it becomes just that – a theater. A choreography of clinical activity and precision the goes far beyond any synchronized activity, dance, or ballet that you may have seen in your lifetime.

The only thing I could really compare open heart surgery to would be an extraordinarily well planned out combat mission that has been rehearsed time and time again until every action is based on trained reflexes as opposed to reactive adjustments. We train ourselves to not have to think, so that when the unexpected occurs we can focus all of our attention on the extraordinary event and still manage to function and maintain the tasks that we are simultaneously engaged in as we try to solve or troubleshoot an unexpected occurrence. This is when science becomes an art form. This is what puts chemistry into a team. And this is what gets patients out of the OR alive in situations that they may not have had any expectation to recover from.

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