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Charles R. Morris - The Surgeons: Life and Death in a Top Heart Center

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M ORE PRAISE FOR BOOKS
BY C HARLES R. M ORRIS

The Surgeons

An ambitious account of the complicated interplay among health care economics, policy and those individuals whose professional lives drive the medical system. Morris fully immerses himself, and the reader, in the complexities of health care. In the final chapters of the book, Morris steps back, superimposing his clinical observations upon the larger issues of health care policy and economics. His chapter on the controversies surrounding aprotinin, an antibleeding agent often used in cardiac surgery, is particularly impressive. What ultimately brings clarity to this bookand hope for health care reformare the stories Morris delivers along the way.

Pauline W. Chen, New York Times Book Review

The stories are insightful and filled with verve. There is the electrifying late-night harvest run to secure a donor heart, the day-today frenzy of a heart surgeon in training, and the poignant death of a child from a failed heart transplant. (The entire kit of marvels mustered by cardiologists and surgeons in three states had not been up to the task of saving her.)

Wall Street Journal

By embedding himself in a frontline unit, Charles Morris has captured the real-life stories of cardiac surgeons and their patients. Told with the drama and pace of television fiction, this book offers an unprecedented look at the surgeons who hold our hearts in their hands.

Paul Offit, author of Vaccinated: One Mans

Quest to Defeat the Worlds Deadliest Diseases

Poignant and extraordinary.

Herald (Glasgow)

Charles Morris has written an astute book of enormous importance: an inside look at cardiac surgery as done in a great university medical center, written by an outsider so keenly observant, of such understanding and perceptiveness, that he has earned the frank trust and cooperation of the very surgeons whose work he scrutinizes with such perceptive eyes and ears. This is a book worthy to take its place alongside the works of such physicians as Jerome Groopman and Atul Gawande, and such social scientists as Renee Fox and Charles Bosk.

Sherwin Nuland, author of The Art of Aging:

A Doctors Prescription for Well-Being

[Morris] writes like the best professor you ever hadno dumbing down, presenting complex material in an engaging manner with just the right story at just the right time. If the term public intellectual did not exist, it would have to be invented for Morris. The Surgeons takes on all the key issuesthe increasing costs of medical care, the differences between American medical care and that of other Western nations, suggestions for improving American medical care, the roles of the pharmaceutical industry and the F.D.A., the conflicts over the best way to test and measure drugs and medicines and hospitals. In unison with earlier public intellectuals now regarded as sagesGalen, Aristotle, MaimonidesMorris reminds us that good medicine can flourish only in a good society.

James R. Kelly, America

From detailing the workings of the hearts chambers and valves to the bald economics of cardiac surgeryMorris masterfully breaks down complex jargon, procedures and policies for a lay audience.

Publishers Weekly

The Trillion Dollar Meltdown: Easy Money, High Rollers, and the Great Credit Crash A New York Times Bestseller

How we got into the mess were in, explained briefly and brilliantly.

New York Times Book Review , Editors Choice

An absolutely excellent narrative of the horror that we have in the credit markets right now.

Paul Steiger

The first big book on the credit crunch. This provocative book isa well-aimed opening shot in a debate that will only grow louder in coming months.

Economist

The Tycoons: How Andrew Carnegie, John D. Rockefeller, Jay Gould, and J. P. Morgan Invented the American Supereconomy

Engaging and credible.

Washington Post

Makes the reader feel like a time traveler plopped down among men both vicious and visionary. Looks back with clarity at the Big Bang of the American boom.

Christian Science Monitor

The Cost of Good Intentions: New York City and the Liberal Experiment, 19601975

This is the most complete, lucid, and thoughtful chronicle yet written about the citys fiscal crisis. But by tracing what city officials thought was happening, as well as what was really happening, Mr. Morris has produced something more, a meticulous case study of good intentions gone awry.

Steve Weisman, New York Times Book Review

A LSO BY C HARLES R. M ORRIS

The Trillion Dollar Meltdown: Easy Money, High Rollers, and the Great Credit Crash

The Tycoons: How Andrew Carnegie, John D. Rockefeller, Jay Gould, and J. P. Morgan Invented the American Supereconomy

Money, Greed, and Risk: Why Financial Crises and Crashes Happen

American Catholic: The Saints and Sinners Who Built Americas Most Powerful Church

The AARP: Americas Most Powerful Lobby and the Coming Clash of Generations

Computer Wars: The Fall of IBM and the Future of Global Technology (with Charles H. Ferguson)

The Coming Global Boom

Iron Destinies, Lost Opportunities: The Arms Race between the United States and the Soviet Union, 19451987

A Time of Passion: America, 19601980

The Cost of Good Intentions: New York City and the Liberal Experiment, 19601975

THE SURGEONS

Life and Death in a Top Heart Center

C HARLES R. M ORRIS

Picture 1

W. W. NORTON & COMPANY

NEW YORK

The illustrations on Chapter 10 are from Mayo Clinic Heart Book, Second Edition, by Bernard J. Gersh. Copyright 1993, 2000 by Mayo Foundation for Medical Education and Research. Reprinted by permission of HarperCollins Publishers.

Copyright 2007 by Charles R. Morris

All rights reserved

For information about permission to reproduce selections from this book, write to Permissions, W. W. Norton & Company, Inc., 500 Fifth Avenue, New York, NY 10110

Production manager: Anna Oler

Library of Congress Cataloging-in-Publication Data
Morris, Charles R.
The surgeons : life and death in a top heart center / Charles R. Morris.1st ed.
p. ; cm.
Includes bibliographical references.
ISBN: 978-0-393-07302-7
1. Columbia University Medical Center. 2. HeartSurgeryNew York
(State)New YorkHistory. 3. Heart surgeonsNew York
(State)New YorkBiography. I. Title. [DNLM: 1. Columbia University Medical Center. 2. Academic Medical
CentershistoryNew York CityPersonal Narratives. 3. Thoracic
SurgeryhistoryNew York CityPersonal Narratives. 4. Cardiac Surgical
ProceduresNew York CityPersonal Narratives. 5. Health Policy
trendsNew York CityPersonal Narratives. WG 28 M875s 2007]
RD598.M579 2007
617.092dc22
[B]

2007024227

W. W. Norton & Company, Inc. 500 Fifth Avenue, New York, N.Y. 10110
www.wwnorton.com

W. W. Norton & Company Ltd. Castle House, 75/76 Wells Street, London W1T 3QT

For Kathleen, Jenn, and Hiro

CONTENTS

PREFACE

I BECAME INTERESTED IN WRITING ABOUT HEARTS after running across a snippet of data showing that the United States now spends more on treating and repairing hearts than on new passenger carsa straw in the wind, it seemed, that warranted further exploration.

Id been intermittently involved in health care businesses and have occasionally written on health care policy issues, but I had no preconceived idea for a book, except that I wanted to learn as much as I could about the heart industry.

In the course of talking to people in the field, a lawyer friend, Joe Bartlett, who has been deeply involved in medical issues, offered to introduce me to Craig Smith, the chief of the heart and lung surgery division at Columbia-Presbyterian hospital in New York City. It is a premier cardiac surgery center, and the countrys largest heart transplant center by a substantial margin.

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