Thursday, April 28, 2011

Book Review: Breathless

The history of lung transplantation is inexorably linked to the University of Toronto in the 1980s and the surgeons and medical team there at that time. The first lung transplant was performed in Mississippi in 1967, and patients with end-stage lung disease started receiving successful heart-lung transplants at Stanford and Pittsburgh in the early 1980s, but Toronto developed the procedures of single and double lung transplants as they're done today. The names of Drs. Joel Cooper, Alec Patterson, and Griff Pearson are mentioned most as the pioneers, but another member of this team, Dr. Thomas Todd, has documented the history of lung transplantation firsthand in his book Breathless: A Transplant Surgeon's Journal.

Breathless is almost a Midnight's Children of lung transplantation; when the first lung transplant in Toronto is performed, Dr. Todd is a senior resident still in training, and when the field is mature, Dr. Todd is retiring. In between, he takes on the roles of doctor to many lung transplant patients, donor surgeon traveling the country to procure lungs, a position at another hospital, and finally the director of the thoracic surgery department in Toronto. Compared to many books by physicians, he doesn't focus extensively on the medical details of his experience, but does a great job telling the stories of the hospital environment, the politics, and the patients. Some of the stories are inspiring (the first patient's recovery), some are frustrating (departure of the pioneering surgeons), and some are funny (a patient's question of "Can we have sex?").
One downside of the book is that the author's role was somewhat outside the historical limelight, so it's sometimes challenging to connect the stories he tells with the history of lung transplants as it's usually reported. He also takes some diversions into the non-transplant work of a general thoracic surgery service, but I found these to be interesting as well. Overall, this book provides a very interesting account of the history of lung transplantation and how it became the field it is today.

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