The Surgeons: Life and Death in a Top Heart Center | 
 enlarge | Author: Charles R. Morris
Publisher: W. W. Norton
Category: Book
List Price: $24.95
Buy Used: $5.15
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Rating:  5 reviews
Sales Rank: 185689
Media: Hardcover
Edition: 1
Pages: 256
Number Of Items: 1
Shipping Weight (lbs): 1.2
Dimensions (in): 8.4 x 5.9 x 1.1
ISBN: 0393065626
Dewey Decimal Number: 617.092
EAN: 9780393065626
ASIN: 0393065626
Publication Date: October 29, 2007
Availability: Usually ships in 1-2 business days
Condition: C. Very Clean & neat, book & jacket tight spine, 1 creases page
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Product Description
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.
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| Customer Reviews:
 As a heart patient, I was fascinated! April 19, 2008
R. Kelly Wagner (MD, United States)
1 out of 1 found this review helpful
This is a fascinating book, whether one is a heart patient oneself or not. The hospital in discussion is Columbia-Presbyterian in New York. Morris "embedded" himself there, staying in the cardiac area, attending surgeries sitting in the back near the nurses, attended staff meetings, all that stuff. He opens with a little history of heart surgery and an typical patient. Incidentally, although this is written for a popular audience, he does assume some slight knowledge on the part of the reader - for example, he doesn't stop to define "comorbidity" as in "Like many heart patients, Goldfarb suffers from a variety of comorbidities..." He describes how doctors and nurses "suit up" and create a "sterile field" around the patients, and then pretty much cut-for-cut describes Mr. Goldfarb's heart valve replacement.
He describes the different specializations within cardio-thoracic surgery: it's not just "heart surgeons" in general. There's the bypass specialists, the anesthesiologists, the pacemaker-and-defibrillator surgeons (he doesn't mention it, but in my experience they are usually called electrophysiologists, or EPs), the pediatric specialists.
Of particular interest: the difference between those surgeries in which the patient is put on a heart pump, and "off-pump" surgeries. The various range of outcomes of transplants. He describes a failed pediatric transplant - the patient dies. No avoiding the tough issues. The whole way the transplant process works - he goes along with a "harvest" team to get the heart from a donor, and talks about teams from other hospitals there to harvest other organs from the same donor, and what it's like to have several different teams working on one body.
Of interest to heart failure patients (of which, I am one) would be the discussion of the LVAD, and also the chapter on the development of "cath labs" used by cardiologists, which is something different from cardiac surgeons (if you've had an angiogram, you've been in a "cath lab.")
And there's a big section on "The Problem With Drug Companies" and another on how to determine "best practices" as well as some controversial issues about evaluating different studies on various practices and on rating the hospitals. If you are interested in how statistics are used, and how meta-studies that evaluate the combined results of numerous previous studies can be "gamed" to produce varying results, you'll find this section as interesting as I did. Research studies play a huge part in how the patients get treated, and it's quite useful to know that there are studies, and then there are *studies*.
It's a fascinating book - this barely begins to describe it. He's a good writer, and the book moves right along; we get to know the doctors and nurses as people. He has editorial comment as well as just description of what's going on, and it's useful input for anyone who is following the US's continuing struggle over how we provide health care and to whom.
Interestingly, I also happened, quite accidentally, to recently re-read Lewis Thomas' "The Youngest Science: Notes of a Medicine-Watcher" - which was written about 25 years ago - and it was interesting to compare his descriptions of medical practices and hospital routines from the 1930's and 1950's to Morris's of half a century later. You might find the same pairing of readings equally interesting.
 Well written ER drama and primer on the business of surgery March 10, 2008
D. Parvin (Boston, MA USA)
"The Surgeons" is an interesting read for the ER-Grey's Anatomy drama crowd, but its real value is in the clearheaded analysis of the business model of surgery, drugs, and product placement. A star off for Morris' incomplete but interesting examination of reforming health care economics leaves this at 4 stars.
As one of the few financial writers with a finance background, reformed investment banker-turned-writer Charles R. Morris tends to "get it" in fundamentally understanding both classic liberal economic history and theory - think writing like the Economist, but more in-depth and with a better grasp of both the bigger picture, microeconomics, and especially history. Having previously defended growth in the health care system as fundamentally acceptable, Morris put his money where his mouth was and spent a year shadowing surgeons in cardiac care, not coincidentally one of the highest growth sectors within the industry.
Morris spends the first half of the book largely explaining what the superstars of the "business" actually do, and the cases are gripping enough to satisfy those who want medical drama. These are extraordinarily well-compensated but extraordinarily talented artists whose skills are essentially irreplaceable. More valuable but less entertaining is his business analysis.
The run-of-the-mill heart surgeon is in the process of having his bread and butter procedure be replaced by stents (delivered by interventional cardiologists), and the industry is starting to really focus on the highest margin product rather than the best return on investment. More widely, while out-of-control spending for new procedures and new drugs careen is a major problem, the defacto solution of the insurance companies deciding which ones get adopted isn't good for any of the stakeholders, including the insurers themselves. Finally, while Morris goes after big pharma and device companies for their role in this, he balances it out with a fascinating behind the scenes look at a drug that got a lot of negative press - but that doctors still wanted to use.
A star off, however, as Morris' chapter on what could be done on health care economics on a macro level is quite disappointing given his solid look at the drivers of them; he provides some bullet point solutions but doesn't explain why they'd work. Still, very much worth a read. 4 stars.
"The Surgeons" from a patient's perspective February 1, 2008
K. Davey (Hopewell, Jct., New York United States)
3 out of 3 found this review helpful
With amazing detail, "The Surgeons: Life and Death in a Top Heart Center" provides a view of many behind-the-scene challenges of modern cardiac surgery. I spent four days as a patient in the cardiac unit at New York's Columbia-Presbyterian Hospital while author Charles Morris shadowed surgeons "unrestricted" in the same unit for an entire year.
It is quite fascinating to read what doctors are thinking, feeling and doing while life is literally in their hands. Cardiac surgery is one of the few procedures in which, at every moment, "the patient is at risk of sudden death." As a result of many long years of medical training and incredible sacrifice, cardiothoracic surgeons provide their patients the gift we all crave, longevity and quality of life.
Charles Morris writes a fascinating description of what happens once a heart patient is anesthetized on the operating table. Prep work takes about an hour. The patient is "shaved, and painted almost head to toe with bright red antiseptic; various monitoring leads and hookups are affixed around the body, breathing and imaging tubes pushed down the throat, a flow monitoring catheter is threaded through the jugular vein" into the heart, and a urinary catheter into the bladder. The patient is wrapped with yards and yards of sterile tape and gauze and "eyes are taped shut."
When Columbia-Presbyterian heart surgeon Craig Smith, MD recently opened my chest, the mitral and aortic valves were beyond repair with healed endocarditis and a worn out aortic root. In 8.5 hours of surgery, Dr. Smith skillfully removed scar tissue and replaced both valves with bovine (cow) tissue and the aorta with a 28mm graft.
Although many of the more difficult cases are sent to Columbia-Presbyterian, heart valve surgery is considered "relatively routine." Craig Smith performs about 350 heart operations a year and heads up the largest heart transplant center in the country.
Congratulations to Charles Morris for his eloquence, as he provides heart patients and the public a greater understanding and cardiothoracic surgeons and the medical community a voice.
 My heart be still ... AND healthy!!!! December 23, 2007
Kevin Quinley (Fairfax, VA)
5 out of 5 found this review helpful
Author Charles Morris offers insightful profiles of top cardiac surgeons at a New York area medical center. One gets a sense of the incredible training and sacrifice that goes into being one of these medical virtuosos, who literally hold the lives of patients in their skilled hands.
Morris also provides an interesting discussion of health care economics, making predictions on how America may attempt to address the healthcare crisis what with the aging of the Baby Boomer generation.
Morris' admiration for the surgeons profiled often leaves him awestruck, with a tendency to deify these practitioners. Rolled out as the proverbial whipping boys are the Bad Guys of Big Pharma and Medical Device Companies. The critique tends to obscure the fact that doctors are somewhat willing participants in the promotional schemes used by such firms, but they escape much of the venom that Morris reserves for health care businesses.
"The Surgeons" is an enlightening and thought-provoking book on specialists that you hope you'll never have to see. Take care of your ticker!!
The Surgeons is a fascinating read! November 9, 2007
Mellanie True Hills (Texas)
8 out of 8 found this review helpful
The Surgeons is an intriguing glimpse into the lives and work of the heart surgeons at New York's Columbia-Presbyterian Hospital, one of the world's top cardiac surgery centers.
Author Charles Morris provides an intimate look at the work of these virtuosos who hold lives in their hands every day. We get to know such artisans as Craig Smith, head of cardiothoracic surgery, who is well-known for doing the quadruple bypass on former President Bill Clinton; Eric Rose, a cardiothoracic surgeon and chairman of the Department of Surgery; Mehmet Oz, senior adult cardiac surgeon, well-known author of three New York Times best-sellers, and regular contributor on Oprah; and many others, whose names will be better known as a result of this book.
From his unparalleled access to attend surgeries and meetings, Morris gives us an incredibly insightful view into how these surgeons think. It's a real-world, insider's look at the people, problems, and politics in a major hospital. As an example, he explores the politics between the surgeons and the interventional cardiologists, and talks about how their disciplines are converging.
The book tackles a variety of topics, from how the heart works and the history of heart surgery to health care policy and directions for high tech medicine. It even explores the innovative new business models pursued by Columbia-Presbyterian. An intriguing bit of trivia that Morris reveals is that Thomas J. Watson, former chairman of IBM, made a personal project of financing and developing the heart-lung bypass machine, which is still used today in many open-heart surgeries.
Morris excels at sharing the stories of surgeries and the patients benefiting from them. We get an intimate look at patients that made it and those that didn't. We experience the heart-rending story of four-year old Erika Maynard and her family, a story sure to tear at your heart strings. We get to go with him on a heart transplant run to secure a heart, and then see it transplanted. Morris' writing is so visual, and the stories so real and vivid, that you actually see and feel them.
The Surgeons is a fascinating read!
Mellanie True Hills
American Foundation for Women's Health and www.StopAfib.org
Author, A Woman's Guide to Saving Her Own Life
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