Walk on Water

This week I read a book that thrilled, scared, frustrated, and awed me all at once. It is called Walk on Water by Micahel Ruhlman. It is about a pediatric congenital heart surgeon, Roger Mee, who currently practices at Cleveland Clinic. He is one of the best of the best. A friend of Randy's recommended it and I wasn't sure if it was something I wanted to read or if it was something I should avoid at all costs. I took it to work with me on a long flight and I thought I would give it a chance, but I took another book just in case. I could not put this book down! Ok, I did so I could do my work, but every spare second I got I was reading it. I am not sure if it was because of Justin's surgery or if it was just because the writing was so good. I would venture to guess that it was part of both things. The story is about both Roger Mee and his career in pediatric cardiac surgery, and also the development of congenital heart surgery.

Heart defects are more common than Down syndrome, according to this book, in about 1-2% of births. Not all require surgery, and not all are severe, but that is a really high percentage! The book recounts how some of the more "simple fixes" were developed, like to fix PDAs and ASD and VSD. And how surgeons first used the heart/lung bypass machine, the discovery that makes open heart surgery even possible. The first "bypasses" were using other live people! So many amazing discoveries that we owe to the bravado and unabashed pride with which we credit many of the best doctors and surgeons. It was hard for me to swallow to think that the attitude of "I am the best, I can do no wrong" actually has helped in the field of medicine. One doctor scheduled two landmark surgeries for the same day thinking that if he attempted only one and it failed, he would never be allowed to try again. But if he tried two and one succeeded, he would be allowed to continue. His first patient died and the second one lived! I was awed to learn that a doctor tested on himself his theory that a catheter could be inserted in a vein in a leg and end up in the heart. He stopped when he felt it touch his heart!

The part that scared me to my core was that Dr. Mee does many surgeries a year to fix "botched" jobs. Some of them were true difficulties that any surgeon would face and have trouble correcting. But others were simple ASDs or Tetralogy of Fallot that should have been straightforward and instead were attempted by an unqualified or ill-prepared surgeon. And what gets me is that the parents are not made aware of their choices or alternatives! When statistics are quoted, a surgeon will quote the very best stats, either national stats or personal stats, whatever will get him the job. When they say that a transplant is the only alternative, they don't explain how involved the life-long care that is required. The book describes a hospital in which the cardiologists stopped referring patients to their own surgeons because of their poor results. One family came to Dr. Mee after a botched job and she said, "I never heard of Dr. Mee. I never knew this was an option." Even in the very toughest cases, like transposition of the great arteries or hypoplastic left-heart syndrome, which are best handled by the best of the best, are being attempted in sub-par hospitals because parents don't know! In the book the author quotes doctors as saying, "It's a crime." Wouldn't you want the best for your child? And yet parents don't even know how to find the best. They aren't told there are surgeons with better results or more experience. A hospital in Michigan said that they get referrals from Cleveland all the time, and yet Cleveland has Dr. Mee, who has been summoned by foreign royalty to operate on their children.


Today there are some defects that are still offered "compassionate care" and death because the surgery, and more often surgeries, are so risky and challenging for even the best surgeons. I am thankful for the positive outcome that we had for Justin, and yet I want everyone who ever plans to have children to read this book just so they know! The risks are high, but when it's a child, and sometimes a baby, a slim chance may be all there is. Please share this information and this book with whomever you think would benefit. I feel like I didn't ask our surgeon the right questions, and I considered myself fairly well-informed. In a pressure situation, with little time for processing, I can't imagine how anyone without advance knowledge could possibly know any better. Prayer is the first and best answer in every situation, and this book makes that abundantly clear to me.