HOW DEATH BECOMES LIFE: NOTES FROM A TRANSPLANT SURGEON | JOSIE

How Death Becomes Life is a fascinating book which is beautifully written by Joshua Mezrich. It manages to explore an area of medicine that is largely undiscovered and underappreciated: organ transplant surgery and how it came to be. In short, the book discusses the remarkable journey of transplantation from Carrel's ground-breaking method of joining blood vessels to Mezrich's own experience of holding someone's life in his hands (literally), and the importance of the doctor-patient relationship in the donation process.

I thought this book covered a wide range of bases as it explores transplantation from its very start to its developments today. I also am fascinating in medicine and surgery as it is the career I wish to pursue so it was a enthralling read in my particular field of interest too.

Dr Joshua Mezrich is a leading transplant surgeon and studied at Cornell `university Medical College in 1997. Since then he has worked in many US hospitals and specializes in solid organ transplantation.

How Death Becomes Life covers the history of organ donation and the beginning of transplant surgeries. What particularly interested me was Alexis carrell’s study of joining together two blood vessels - vascular anastomosis. This interested me because it is the very basis of surgery which I am extremely fascinated in. Carrell did lots of experiments to test out his method and started mainly in dogs legs. In 1906, the Carrel patch was created when Carrel cut out a vessel with a rim of aorta to make it bigger. He also discovered the importance of Asepsis (absence of bacteria). I really enjoyed reading about this as it is such a big and important part of medicine today and it is extraordinary to think there was a time without this. Washing out battle wounds in WW1 was to be the beginning of sterilising in surgeries today.

Another area that interested me was the development of the Heart Bypass machine. In 1930, Jack Gibbon believed there was a better way to do heart surgery than closed surgery, so thought of the idea of a support or pump for humans. He created a device to oxygenate blood and allow flow out and back into the body. The pump system allowed CO2 to diffuse off and O2 to be pumped back in through a catheter and into the aorta. The pump created turbulence in its flow which increased the oxygenation of the blood. It was tested many times and was rarely a success. Unfortunately, Gibbon gave up after 3 patients died.

However, the idea was thought innovative by many other scientists who then worked on or around Gibbon’s model. In the 1950s, C Walton Lillehei instead decided to use a donor as he believed Gibbon’s work was too complicated. This was successful but other scientist knew it was perhaps unethical. John Kirklin and Richard DeWall created a simple machine where blood was bubbled in at bottom and Willem Kolff eventually finalised the machine using ideas from the dialysis machine.

This shows how many brains it takes to finalize a product, and even know it is still being developed as science is every changing and improving. This development is very fascinating because it shows how each scientist worked off each other and it took a very long time to get to the product we have today. It also teaches perseverance and determination in new experiments.

Not only does this book cover practicalities and history, but it taught many valuable lesson which I will take into my future career and life. It teaches that preparation is key to success. This is ultimately true and vital in surgeries but also applies to life outside of medicine.

Mezrich also discusses the delicate balance of transplantation. If the patient is too sick, they will not be allowed on the list as they are unlikely to survive the surgery. However, if the patient isn't sick enough, they will take a back seat to someone who is closer to death but still well enough to have a fighting chance of surviving the surgery. Thus, it is a fine line and a difficult one to judge. This also becomes very difficult in explaining to patients and their families which Mezrich also discusses.

Not only is it difficult to explain the situation of a transplant and whether an organ is available but perhaps even more challenging is discussing the outcome.

Mezrich explores the bitter-sweetness of transplantation as the donor is not physically with the family, but lives on in the bodies of the people that their organs saved. With the unforgiving sadness of death other lives may be saved. Mezrich tells of a daughter who died in car crash. The tragedy of her death resulted in her saving 7 lives. Mezrich describes the moment of the patient’s mother using a stethoscope to listen to her daughters beating heart in the chest of the man she saved.

This part of the book was possibly my favourite. I was very emotional as it is an extremely heart-breaking story, but you can see the gratitude of the families which the patient saved. It really made me think and I ended up doing a lot more research into organ donation and I also registered to be an organ donor as I believe that it is so important to be able to help other people even when you may no longer be around.

In my research I discovered that organ donation is to be changed to an Opt-Out system from Spring of this year (2020). I am thrilled to hear this news as it has been trailed in other countries which very successful results and more lives being saved as a consequence.

I absolutely adored this book and would recommend it to anyone whether you are interested in organ transplantation or not as Mezrich teaches lessons which can be taken into all walks of life. I also believe it is a very important area of study which needs to be talked about more as in doing so, you could save many more lives.