Professor Stephen Westaby has written a powerful and poignant account of life as a cardiac surgeon. He’ll be coming to Chorleywood later this month, to talk medical memories, mechanical hearts and moving on. Lisa Botwright finds out more…
It’s 1955, and a seven year old boy from a council estate in Scunthorpe is sitting in front of his brand new television, mesmerised by a programme about surgery called Your Life In Their Hands. Right there and then, he decides he wants to be a heart surgeon when he grows up. In an irresistible twist, that little boy goes on to star in the very same programme five decades later, by dint of being one of the most internationally respected authorities in his field of cardiothoracic surgery. Countless heart operations and a decade on from his BBC starring role, Professor Stephen Westaby has now written a memoir – Fragile Lives – that reflects on his exhilarating career.
Fragile Lives, as its name suggests, is not an easy read – meeting, as we do, the ghosts of ill-luck dancing between the pages. It’s incredibly compelling, but also deeply moving. The story of a woman fleeing slavery and travelling hundreds of miles on foot to get her baby safely to the Saudi hospital, where Westaby was working at the time, reduced me to tears. Covering just a tiny proportion of the thousands of patients Westaby has treated in his career, the book describes his most landmark or unusual cases – running the gamut from life to death and the horrifying states in-between (the pulse-less man and the locked-in woman, to give you a hint).
Westaby has had such an illustrious career, and transformed so many lives, that when I meet him at his Oxfordshire home and mentally run through the questions I’ve prepared, I’m feeling rather awestruck. What should I ask first? About the life-saving cardiothoracic device (the Westaby tube) he invented, that his peers said would never work? How it feels to pioneer a new type of artificial heart that provides a viable alternative to organ transplants in both adults and children? How it feels to save all those lives that his colleagues (and the NHS) deemed ‘un-saveable’? To be the last, desperate port of call between this life and the next?
What happens, in fact, is that the professor launches straight in to his own anecdote. And then another one. And they’re all fascinating. “Are you catching this?” he says, as I scribble furiously and push my neatly typed, now apparently redundant, questions to one side. Westaby is charming, infectiously enthusiastic, brilliantly clever… but – dare I say it? – a maverick. In the book, he puts his success down to ‘effort, lateral thinking and guts.’ I find him such a force of nature that I venture it’s also an intransigent unwillingness to concede defeat.
Take, for example, an episode where Westaby just happens to come across a woman sobbing in a hospital corridor. Her husband was dying, she’d been told, and there was nothing anyone could do. Westaby disagreed: ‘Mr Clarke was experiencing a bog standard death from a heart attack, the sort that happens to hundreds of patients every day across the NHS.’ When the inevitable didn’t happen, this was only down to Westaby’s ‘grim determination to show that he could still be saved with the right technology’. The right technology is a mechanical, artificial heart, proven by Westaby and his team to extend life as long as a heart transplant will, yet in which the NHS continually refuses to invest. “To put this in context,” Westaby explains to me, “there are currently around 15,000 severely ill cardiac patients in the UK under 60 years of age, yet less than 150 heart transplants will go ahead to save these lives.” The only reason that Mr Clarke is saved is because Westaby stands up to the recalcitrant hospital board and pays for the operation himself, using the charitable funds already raised to launch the technology. “There was a recent public outcry about the NHS refusing to pay for a particular cancer drug known to be successful in trials – but people should also be making a fuss that they can’t get hold of something that will remove the unpleasant effects of heart failure.”
That our lives hang by a thread is both the cover image of the book, and a metaphysical fact, but what is deeply unsettling to learn (or maybe I was too naïve beforehand) is just how much of our biological fate is left utterly to chance: ‘luck’ that when our time comes, we will be taken care of by the right medical team, with the right technology and – depending on the circumstances –the right surgeon prepared to take a risk to save our skin.
Which brings me to another of Westaby’s anathemas: “The decision should never have been made to publish individual surgeons’ death rates,” he says firmly, referring to the process implemented by Health Secretary Jeremy Hunt in 2013. “This is extremely damaging to patients’ safety. If you’re too sick to get through an operation, a [risk-averse surgeon] will find a reason not to operate.” It’s why only 40% of doctors who trained in cardiac surgery in the UK have chosen to remain in here, when up to a whopping 60% now work abroad. “The NHS is too bureaucratic,” Westaby laments. “There is no longer any room for innovation or personal drive. I decided that I could only achieve my potential by walking away…”
He talks more fully about his reasons for retiring in the last chapter of the book, and so I expect to meet a man reflecting on a life well spent, someone slowing down a little – perhaps engaging in the art he loved as a boy, or making up for lost time with his family. (One chapter touches on his regret at not spending time more time with his son and daughter when they were growing up, and he sweetly thanks his wife, Sarah, for ‘putting up with him’.) However, I find someone pouring all the same tenacity into an exciting new start. He’s now the Medical Director of Celixir, a company specialising in stem cell technology. “Isolated foetal stem cells have been shown to regenerate heart muscle,” he enthuses. He’s also aligning prevention with cure, by working on a project to invest in health care campuses, with an emphasis on well-being education. And he’s still focused on making those mechanical, artificial hearts available to all those who need them. At the moment, these panaceas of extended life cost the same as a sports car; Westaby hopes to drive the price down and ultimately make them mainstream, as opposed to a miracle.
He does concede that he’s now a more regular presence in the lives of his two young grandchildren, and that he’s able to “watch a bit of sport”. He’s also able to enjoy a glass of wine in the evening, without worrying that he might be woken a few hours later and called in for an emergency operation. Although, amusingly, he does admit to frequently jumping up in the middle of the night to write down an idea when it pops into his head.
I ask him what that little boy would think, the one who was inspired by a fuzzy black and white TV show all those years ago. “I would never have believed it possible by any stretch of the imagination.”
‘In Conversation with Professor Westaby’ takes place at The Junction, Christ Church, Chorleywood, on Thursday 16 February at 7.30pm. For more information and to buy tickets, visit • chilternbookshops.co.uk/events