Wednesday, April 17

The surgeon who has saved more than 11,000 patients thanks to a blow to the skull that changed his personality


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Stephen Westaby has operated on more than 12,000 hearts and estimates that he has saved 97% of his patients. In addition, Westaby, currently 73 years old, is also an innovative pioneer, internationally recognized for helping to develop and refine the use of cardiac pumps, artificial hearts, and circulatory support technology to propel blood throughout the body.

Westaby wants these to be put in place not just as a temporary measure before a transplant, but to give a diseased heart time to recover or to provide an alternative to death when a patient is “living dead.”

In his memoirs “Fragile Lives: Life and Death Stories of a Cardiac Surgeon on the Operating Table” and “The Razor’s Edge: The Heart and Mind of a Cardiac Surgeon,” Westaby recounts how “the boy from the street» of Scunthorpe, UK, decided to become a cardiac surgeon at the age of 7driven by seeing on television perform an operation on a hole in the heart.

His grandfather, a steelworker, died at the age of 63 from heart disease. His grandmother died of thyroid cancer soon after. These deaths have been a spur throughout his life.

He was determined to be a surgeon, but something was missing. “Surgeons need the right temperament”Westaby explained in an article in the ‘Daily Mail’ newspaper. “You have to be able to explain the death to bereaved relatives. You have to have the courage to take over from your boss when he gets tired, the guts to accept responsibility for postoperative care of small babies or to face catastrophes in the trauma room, “she says. “I was a shy, modest, unassuming child who was afraid of his own shadow.”

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So much so that when he was offered the opportunity to study at Cambridge, one of the best universities in the world, he turned it down, thinking he would feel out of place. He opted instead for Charing Cross Medical School in London, thinking that he could be more inconspicuous there. So it was. At first, his university life passed without him standing out for better or worse. What he did do was learn to play rugby, which changed his life.

As an 18-year-old medical student who played rugby, he illicitly watched at Charing Cross as a 26-year-old woman called Beth was operated on for a heart weakened by rheumatic fever. She died. A year later, Christiaan Barnard performed the first human-to-human heart transplant. The patient lived for 18 days.

During a rugby match in 1968 he received a blow to the head that fractured the frontal bone of his skull. Not only did he miss the tour with his team, but that could have been the end of his medical career. But the incident had the opposite effect. X-rays revealed a small crack in the frontal bone of the skull. “The head trauma affected the part of my brain responsible for critical reasoning and risk avoidance. This explained my new lack of inhibition, my irritability and occasional aggression.

“The psychologists’ tests showed that I scored high on something called the ‘psychopath personality inventory,’ and the psychologist told me, ‘Don’t worry, most high achievers are psychopaths. Surgeons in particular », relates Westaby about the consequences of his accident. “It was expected to go back to normal when the swelling went down, but luckily for me it didn’t.” What the head injury did was take away his fear and inhibitions. He already had “the full mix of skills for a successful surgeon”: coordination, manual dexterity, and daring. “The last thing you want is to be a scared surgeon.”

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Westaby’s mantra is: “Move forward, learn, try harder.” Innovation, he argues, is the goal, not the results. Since 2013, performance has been measured in “surgeon-specific mortality data.” As a result, she believes heart surgery is too risky for young students today. They are “downtrodden, defensive, unsure of themselves.” In the 1960s, a heart attack caused the death of seven out of 10 patients. Now seven out of 10 survive, but one person with cardiovascular disease dies every three minutes.

The surgeon has lost at least 300 patients during his remarkable career; now retired, he says that he ‘hates’ every death and reveals how he is still desperately trying to save lives. Now, having retired from surgery at the age of 68, Westaby is working with Professor Sir Martin Evans on producing genetically modified stem cells that can remove scars from the hearts of adult heart attack patients, as well as developing the next generation of British artificial hearts, which “work well in laboratories”.

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