When Death Becomes Life: Notes from a Transplant Surgeon

by Joshua D Mezrich

Overview

“Although When Death Becomes Life is about courage and innovation and dedication, it is foremost a book about hope…. This monumental and enthralling history of one of modern medicine’s most rousing triumphs is a definitive testament to that hope, and to the brave physicians and patients whose sacrifices made it possible.”
   — New York Journal of Books

A gifted surgeon illuminates one of the most profound, awe-inspiring, and deeply affecting achievements of modern day medicine—the movement of organs between bodies—in this exceptional work of death and life that takes its place besides Atul Gawande’s Complications, Siddhartha Mukherjee’s The Emperor of All Maladies, and Jerome Groopman’s How Doctors Think.

At the University of Wisconsin, Dr. Joshua Mezrich creates life from loss, transplanting organs from one body to another. In this intimate, profoundly moving work, he illuminates the extraordinary field of transplantation that enables this kind of miracle to happen every day.

When Death Becomes Life is a thrilling look at how science advances on a grand scale to improve human lives. Mezrich examines more than one hundred years of remarkable medical breakthroughs, connecting this fascinating history with the inspiring and heartbreaking stories of his transplant patients. Combining gentle sensitivity with scientific clarity, Mezrich reflects on his calling as a doctor and introduces the modern pioneers who made transplantation a reality—maverick surgeons whose feats of imagination, bold vision, and daring risk taking generated techniques and practices that save millions of lives around the world.

Mezrich takes us inside the operating room and unlocks the wondrous process of transplant surgery, a delicate, intense ballet requiring precise timing, breathtaking skill, and at times, creative improvisation. In illuminating this work, Mezrich touches the essence of existence and what it means to be alive. Most physicians fight death, but in transplantation, doctors take from death. Mezrich shares his gratitude and awe for the privilege of being part of this transformative exchange as the dead give their last breath of life to the living. After all, the donors are his patients, too.

When Death Becomes Life also engages in fascinating ethical and philosophical debates: How much risk should a healthy person be allowed to take to save someone she loves? Should a patient suffering from alcoholism receive a healthy liver? What defines death, and what role did organ transplantation play in that definition? The human story behind the most exceptional medicine of our time, Mezrich’s riveting book is a beautiful, poignant reminder that a life lost can also offer the hope of a new beginning.

Product Details

ISBN-13:	9780062656216
Publisher:	HarperCollins
Publication date:	01/07/2020
Edition description:	Reprint
Pages:	384
Sales rank:	266,340
Product dimensions:	5.20(w) x 7.90(h) x 1.00(d)

About the Author

A graduate of Cornell Medical School, Joshua Mezrich, MD, is an associate professor of surgery in the division of multi-organ transplantation at the University of Wisconsin School of Medicine and Public Health.

Table of Contents

Note from the Author ix

Milestones in Transplantation xi

Part I Out of Body

1 A Perfect Organ 3

2 Puzzle People 11

Part II The Making of a Transplant Surgeon

3 The Simple Beauty of the Kidney 35

4 Skin Harvest 53

5 Kidney Beans: Making Kidney Transplant a Reality 67

Part III Expanding the Horizon Beyond the Simplicity of the Kidney

6 Open Heart: The Invention of Cardiopulmonary Bypass 103

7 Hearts on Fire: Making Heart Transplant a Reality 130

8 Sympathy for the Pancreas: Curing Diabetes 163

9 Prometheus Revisited: Liver Transplants and Thomas Starzl 178

Part IV The Patients

10 Jason: The Secret Is to Live in the Present 209

11 Lisa and Herb: Should We Do Liver Transplants for Alcoholics? 222

12 Nate: The Selection Meeting, or Who Gets an Organ and Why? 239

13 Michaela: We Are All the Same on the Inside 255

Part V The Donors

14 As They Lay Dying 271

15 Healthy Donors: Do No Harm 292

Part VI Today and Beyond

16 Complications 309

17 Xenotransplantation: From One Species to Another 322

18 So, You Want to Be a Transplant Surgeon? 329

Acknowledgments 343

Notes 349

Selected Bibliography 357

Index 359

Editorial Reviews

In his eloquent and illuminating new book, this dedicated doctor and elegant writer weaves stories from his own awe-inspiring work into a history of the medical advances that have made the extension of many lives possible.

The Entertainment Report

A fascinating examination of our bodies’ organs and the intimacy of their placement and replacement. Joshua Mezrich weaves in the history, ethics, and technical grit of how doctors and patients navigate this miraculous second chance at life.

Danielle Ofri

An extraordinary and deftly-crafted combination of medical history and personal memoir, When Death Becomes Life should be a part of every community, college, and university library collection.

Midwest Book Review

Dr. Mezrich clearly loves the field he has chosen and wants us, his readers, to love it too. Although he has “demystified” the complicated issues, he has left us with the wonderment and incredible humanity that shine through in the transplant field, and crafted an incredibly down-to-earth read through his own journey of doubts and triumphs. When Death Becomes Life is compelling and remarkable.

Nancy Ascher

In this highly accessible look into the world of modern transplantation, Dr. Mezrich proves himself to have innate creativity, conveying a surgeon’s genuine emotion without becoming maudlin and portraying both the triumphs and failures of the transplant field. With When Death Becomes Life, Mezrich succeeds in giving the reader a glimpse of how a cacophony of human experience can become a harmonious triumph of medical science.

Allan D. Kirk

With When Death Becomes Life, Joshua Mezrich has performed the perfect core biopsy of transplantation—a clear and compelling account of the grueling daily work, the spell-binding history and the unsettling ethical issues that haunt this miraculous lifesaving treatment. Mezrich’s compassionate and honest voice, punctuated by a sharp and intelligent wit, render the enormous subject not just palatable but downright engrossing.

Pauline Chen

Moments of humor nicely balance the pages and pages of thriller-like action, as Mezrich and his colleagues fly cross-state to receive organs and save the lives of people who are hours from death. Those stories will pound that heart you have, as you’re introduced to heroes who gave their lives in research, and heroes who gave their lives to strangers in need.

Marco Eagle

Although When Death Becomes Life is about courage and innovation and dedication, it is foremost a book about hope…. This monumental and enthralling history of one of modern medicine’s most rousing triumphs is a definitive testament to that hope, and to the brave physicians and patients whose sacrifices made it possible.

New York Journal of Books

10/22/2018
Mezrich, a University of Wisconsin School of Medicine and Public Health surgery professor, delivers an attention-grabbing and candid look at human organ transplantation. Often pulse-quickening, sometimes stomach-churning, and always immersive, Mezrich’s descriptions of the complicated, time-sensitive process of transferring livers, kidneys, and other healthy organs from deceased donors to recipients use examples from his own work as a transplant surgeon. Numerous, well-integrated asides on the evolving trial-and-error of organ transplant, from the early days in the late 19th century through advances made during WWII and after, complement his personal stories. In addition to being up-front about the fear of making a mistake during surgery—“It needs to be perfect. Otherwise the patient will pay a huge price, the donor won’t have given the gift of life, and you will be woken in the middle of the night by a shrill pager”—Mezrich describes the emotional attachment that can form between donor families and donor recipients. He notes how one patient, having received a heart from a young woman killed in a car accident, celebrates her donor’s birthday each year, “almost as if it were her own.” Success through perseverance is this book’s main theme, and Mezrich does a commendable job sharing his death-to-life experiences in a vital field. (Jan.)

Publishers Weekly

When Death Becomes Life braids unflinching medical history with frank clinical memoir. . . . there are no demigods in the world of transplant, just especially ambitious and unquesy humans.” — Wall Street Journal

“[A] no-holds-barred narrative. . . . A visceral tale of hearts and bones, surgical bravura, and the “web of transplantation” that binds people who might never meet.” — Nature

“A fascinating examination of our bodies’ organs and the intimacy of their placement and replacement. Joshua Mezrich weaves in the history, ethics, and technical grit of how doctors and patients navigate this miraculous second chance at life.” — Danielle Ofri, M.D., Ph.D., author of What Patients Say, What Doctors Hear

“An outstanding memoir by a transplant surgeon who combines an autobiography and operating room dramatics with an equally engrossing history of his profession.... Medical memoirs have become a significant genre over the past two decades, and this one ranks near the top, in a class that includes the best.” — Kirkus Reviews (starred review)

“A valuable account of a key chapter from medical history. Mezrich moves smoothly between the different strands of his narrative, with the historical material as accessible as the autobiographical.” — BookBrowse

“An extraordinary and deftly-crafted combination of medical history and personal memoir, When Death Becomes Life should be a part of every community, college, and university library collection.” — Midwest Book Review

“In his eloquent and illuminating new book, this dedicated doctor and elegant writer weaves stories from his own awe-inspiring work into a history of the medical advances that have made the extension of many lives possible.” — The Entertainment Report

“[When Death Becomes Life] sheds light on a critical area of medicine, one that’s ready for advancements, innovations and breakthroughs. . . . provid[ing] a fascinating look at the realities of transplantation today.” — CSL Behring

“An attention-grabbing and candid look at human organ transplantation... Success through perseverance is this book’s main theme, and Mezrich does a commendable job sharing his death-to-life experiences in a vital field.” — Publishers Weekly

“Skillfully stitching medical memoir to medical history, transplant surgeon Joshua Mezrich shares stories of patients and donors, provides profiles of pioneers in the field of organ transplantation, and serves up some self-examination. . . . [An] enlightening transplantation chronicle.” — Booklist

From the Publisher

Skillfully stitching medical memoir to medical history, transplant surgeon Joshua Mezrich shares stories of patients and donors, provides profiles of pioneers in the field of organ transplantation, and serves up some self-examination. . . . [An] enlightening transplantation chronicle.

Booklist

[A] no-holds-barred narrative. . . . A visceral tale of hearts and bones, surgical bravura, and the “web of transplantation” that binds people who might never meet.

Nature Lib

When Death Becomes Life braids unflinching medical history with frank clinical memoir. . . . there are no demigods in the world of transplant, just especially ambitious and unquesy humans.

Wall Street Journal

[When Death Becomes Life] sheds light on a critical area of medicine, one that’s ready for advancements, innovations and breakthroughs. . . . provid[ing] a fascinating look at the realities of transplantation today.

CSL Behring

A valuable account of a key chapter from medical history. Mezrich moves smoothly between the different strands of his narrative, with the historical material as accessible as the autobiographical.

BookBrowse

[A] no-holds-barred narrative. . . . A visceral tale of hearts and bones, surgical bravura, and the “web of transplantation” that binds people who might never meet.

Nature

Skillfully stitching medical memoir to medical history, transplant surgeon Joshua Mezrich shares stories of patients and donors, provides profiles of pioneers in the field of organ transplantation, and serves up some self-examination. . . . [An] enlightening transplantation chronicle.

Booklist

When Death Becomes Life braids unflinching medical history with frank clinical memoir. . . . there are no demigods in the world of transplant, just especially ambitious and unquesy humans.

Wall Street Journal

★ 2018-10-02

An outstanding memoir by a transplant surgeon who combines an autobiography and operating room dramatics with an equally engrossing history of his profession.

In his first book, Mezrich (Surgery/Univ. of Wisconsin School of Medicine and Public Health) avoids standard-issue jokes about motorcyclists who don't wear helmets but reminds readers that, except for the occasional live donor, a tragedy usually precedes every transplant. "Someone who had just died had saved the life of someone he had never met," he writes, "and we were the ones that made it happen." The author touches all bases with a masterly hand. He trained as a surgery resident, undergoing the usual mixture of servitude and inspiration. He graduated to a fellowship, during which skill and satisfaction increased with no decrease in the workload. Readers will share the author's exhilaration at the end of a procedure when, for example, the clamps are released, blood flow turns a new kidney pink, and urine flows out before his eyes. At intervals, the author digresses, offering a cogent history of transplants. These sections will enthrall most readers save animal rights proponents, who will recoil at the myriad of animals sacrificed along the way. However, plenty of human recipients also died miserably, except for the rare identical twin, in the decades before doctors realized that they required immunosuppression. About half died during the 1960s and '70s, when surgeons used early versions of anti-rejection drugs. After the first effective immunosuppressant, cyclosporine, was approved by the Food and Drug Administration in 1983, success rates exceeded 90 percent. As a result, transplanting many organs has become routine. Still, recent doctor-authors give equal time to failures, so Mezrich recounts plenty of painful experiences.

Medical memoirs have become a significant genre over the past two decades, and this one ranks near the top, in a class that includes arguably the best, Henry Marsh's Do No Harm (2015).

Kirkus Reviews