I Help Anne Clear Out

As a heart surgeon and a former colleague of Arvind Koshal, I thoroughly enjoyed this review of Transplant: A Cardiac Surgeon’s Story of Immigration & Innovation. I thank the Literary Review of Canada for spotlighting contributions of “compelling people” like Koshal to Canadian medicine by commissioning it. The book offers a candid chronicle of the history of heart surgery in this country, a journey driven by science, skill, and altruism — in other words, the remarkable “human ingenuity” of those who dedicated their careers and lives to providing exceptional care.

I find it noteworthy how cardiac surgery stands out as a unique field that continually pushes the boundaries of innovation and calculated risk — an aspect of the field that may not be fully appreciated by the public. In it, for example, we find the only form of therapy where circulation to the body may be deliberately stopped for a prolonged period — typically under one hour — for a procedure known as deep hypothermic circulatory arrest, to allow the repair of intricate areas near or within the heart. Additionally, this is the sole area of medicine where an intervention with a 200 percent risk of death was designed and routinely performed: it occurred when healthy parents underwent surgery to provide cross-circulation for their child in need of open-heart surgery. For those of us who work in the field, it is truly a privilege. These stories need to be told by legends like Koshal and Thierry Mesana, whose own recent memoir also captures the essence of cardiac surgery in an epic and personally riveting manner.