Last Night in the OR

July 15, 2015
A memoir of a high-achieving surgeon. Retired transplant surgeon Shaw was a protege of Thomas Starzl, "the father of liver transplantation," when the specialty was considered radically reckless. Despite youthful doubts, the author decided that "working on the real frontiers of transplantation was a far more glorious pursuit than playing it safe." Starzl's harsh pedagogical manner ("Don't hinder me, help me") informs the tone of these clipped, anecdotal chapters, which provide a good sense of an elite surgeon's development and attitude. As he writes of the team's typical late-night helicopter arrival, "I suppose it was all so glamorous [but] mostly I worried about being disliked for our hubris." Shaw trained in Starzl's Pittsburgh-based program and then established his own transplant center in Nebraska, noting that demand for their innovations grew once Medicare approved the procedure. The author portrays the surgeon's high-pressure lifestyle as grueling and surreal, depicting his first two marriages as casualties and discussing the invisible toll taken on his father, a revered general surgeon. Mainly, as the title suggests, Shaw focuses on the drama of the operating room, recalling both successful and failed transplants in terse, graphic terms: "I wanted to tell him that we pumped on her chest off and on for more than an hour...until finally I saw that everyone was standing back staring at me." He suggests that if surgeons hold laypeople at a remove, they are their own harshest critics: "Yes, shit happens, but it's still your fault. You're the one who has to be better, smarter, more careful." Shaw's lean prose is lucid on technical aspects and moves briskly, more so than in some late-career memoirs, and he offers insights into medical professionals' private perspectives as well as a sobering sense of human fragility and the scientific strides taken to counter it. A bracing, unusual personal narrative that should appeal to aspiring physicians as well as to those considering the "big questions" around high-risk surgery.

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September 1, 2015

This memoir by retired transplant surgeon Shaw describes his experiences from his beginnings in medicine as a student to becoming a prominent transplant surgeon and opening a world-renowned transplant center in Nebraska. Most of the stories focus on specific surgical encounters with patients and his interactions with fellow surgeons throughout his career. Shaw also intersperses stories from his childhood and growing up with a father who was a general surgeon. Overall, the book reads like a collection of short vignettes about the doctor's surgical experiences over the years. Though each vignette is well written, absorbing, and allows readers a view into the world of transplant surgery, the narrative as a whole doesn't flow well. Additionally, some parts are difficult to follow chronologically. VERDICT Despite issues with flow, this book will appeal to those interested in surgery and in particular liver transplant surgery and its history.--Dana Ladd, Community Health Education Ctr. & Virginia Commonwealth Univ. Libs., Richmond

Copyright 2015 Library Journal, LLC Used with permission.

Starred review from August 1, 2015
What kind of person becomes a transplant surgeon? What type of personality is required for such a grueling, high-stakes occupation? Retired surgeon Shaw bluntly spells it out in his memoir: I was a beast and I daily walked up to the brink and jumped in, ripping and tearing and slashing and screaming, always crawling out the other side. He confesses to being superstitious, preoccupied with worst-case scenarios, and suffering from an anxiety disorder. He writes about his upbringing, extensive medical training, failed marriage, a medical-malpractice lawsuit, personal health scares, and of course, replacing lots of livers. Shaw holds nothing back as he describes bravado and fear, pride and humility, fatigue and adrenaline rush. His sundry collection of often-opposing emotions on display makes him genuine and affable. He has a wild side that includes hang gliding in Utah and donning hip waders and a plastic apron for particularly bloody cases in the operating room. Shaw's style of writing captures the surrealism of a powerful profession devoted to swapping diseased and dying human organs for perfectly good ones obtained from newly dead donors: I looked at the empty grotto where the liver had once lived and saw nothing but an impossible situation. Intense and illuminating.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)