SEEING the paramedics’ grim expressions and hearing the terrified whimpers coming from inside the ambulance, heart surgeon Stephen Westaby knew the situation was bad.
But it was only when he clambered through the vehicle’s doors and saw the impaled teenage girl lying under a blood-soaked sheet with a fence post jutting out of her body that he realised this patient would die.
Tom Pilston – The Times
The girl, a law student like his daughter, had been riding a motorbike when she swerved to avoid a deer, veered off the road and smashed through the wooden fence into a field.
And taking her cold, clammy hand as she lay on her side in the ambulance, Westaby quickly realised the stake sticking out of her body had burst through her liver.
“She was left skewered like meat on a kebab stick,” says the famous British heart surgeon, dubbed the ‘world’s best’, who was working as a young consultant at the time.
Staring into her ‘pleading brown eyes’, Westaby asked the teen her name, before she tearfully murmured six words he knew were accurate: “I’m going to die, aren’t I?”
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“At that point I ceased being the surgeon because I knew she was right,” the married father-of-two, now 71, writes in his new book, The Knife’s Edge, released last week.
‘I’m going to die, aren’t I?’
“For her last agonising moments on Earth I could only comfort her.”
Taking on the role of ‘substitute’ dad, Westaby gently held the girl’s head then told her she would be put to sleep and when she woke up, the stake and her pain would be gone.
Not long after, the teen’s eyes rolled back and she slipped away.
“Whatever blood she had left in her circulation was pouring out over me. But I didn’t mind. It was a privilege to be there with her,” he adds.
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Speaking to Sun Online from his Oxfordshire home, Westaby says he believes kindness is “imperative” when you’re faced with dying patients.
“When I know death is inevitable I think any way that you can be kind to people should be used,” he tells us.
The surgeon, who lives with wife Sarah and their pet dog, treated around 11,000 patients during his extraordinary career before hanging up his scalpel three years ago.
‘People always died in heart surgery’
Westaby estimates that at least 300 of his patients died – including a man who bled out all over the theatre floor in a “gruesome” tragedy.
He tells us that he ‘”detested” every single one of the deaths, saying: “I never really wanted anybody to die and people always did in heart surgery.”
But because most deaths in surgery are “wholly impersonal” – with patients covered by drapes – he says his most haunting experiences were in trauma cases, like that of the girl.
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Recently, the UK’s trauma teams have been faced with a knife crime epidemic, with last year being London’s bloodiest in almost a decade with 135 homicides.
And although Westaby typically found knife injuries “predictable and easy” to deal with during his career, he says many victims don’t even make it to hospital.
“The trauma units are doing a difficult job trying to save a lot of people,” he tells us, describing the ongoing epidemic in the capital as “regrettable”.
“The main thing to do is to get the patient to hospital as quickly as you can and not try to treat it on site.”
‘Toddlers would take their teddies to the mortuary’
For knife wounds, Westaby had a plan of action – cut open the chest, find the haemorrhage, sew up the bleeding points, then pump in blood to refill the circulation.
“Such cases always provoked an adrenaline rush, but usually involved young, healthy tissues to repair,” he writes in his book.
As well as dealing with trauma cases and incredibly sick heart patients, Westaby – who became a heart surgeon after seeing his granddad die from heart failure – has had to tell countless parents that their children have died during his career.
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While working as a surgical trainee, he would see toddlers walk in through the hospital doors, clutching their mum’s hand and their favourite teddy bear.
All too often, these teddies would end up accompanying the youngsters to the mortuary fridge.
Back then, Westaby had the devastating task of telling little ones’ anxious parents that their children hadn’t made it, walking slowly towards them with his shoulders dropped.
He rarely had to speak for them to know their child had died.
With his “bad news” expression leaving no room for doubt, the parents would draw a sharp, shocked breath then break down – with some turning hysterical.
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But while their grief over their loss would go on endlessly, Westaby would “file his sorrow in the out tray” the moment he turned and walked away from them.
At the time, death rates in heart surgery were high – and as he started taking on and losing his own patients, Westaby tragically became used to the process.
But decades on, he says he was deeply affected by all the deaths he witnessed.
“I hated having to go and give parents bad news,” recalls the surgeon.
“We’d get toddlers in clutching a teddy bear and eventually they’d be escorted off to the mortuary with it. We had to learn to be very thick-skinned.”
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‘We cover the patient up to cut off emotional connection’
He adds that he “absolutely” cared about the thousands of patients he operated on in later years – but, as a professional, had to go into “objective mode”.
“When we go into theatre to operate on a heart we cover the patient up,” he explains.
“We use a saw to expose the heart. I used to cut off altogether any sort of emotional connection with the patient and go into objective mode.”
Westaby compares repairing a sick heart to opening a car bonnet and fixing the engine – except with the first, you’re working against the clock and life is at risk.
During surgery, he would temporarily stop patients’ hearts to operate on them, with a heart-lung machine completely taking over the function of their heart and lungs.
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“When you stop a heart you take away its blood supply,” he tells us.
“The longer you’re operating on a patient the less likely they are to pull through.
“You have to operate and get it done.”
Of course, things don’t always go as hoped – with Westaby sometimes faced with sudden and relentless blood spurts, cardiac arrests, and plummeting blood pressure.
And when someone did die, he had to walk away and focus on the next sick patient.
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Now, after retiring from surgery aged 68, Westaby continues to try to save lives.
He is working with Professor Sir Martin Evans on producing genetically-engineered stem cells that can remove scar from the hearts of adult heart attack patients, as well as developing the next generation of British artificial hearts, which are “working well in laboratories”.
“I have two jobs and they’re going very well,” he says.”It’s just as exciting [as active surgery] because at the end of the day, we do what we do for the patients.”
‘Workers within the NHS remain disillusioned’
However, he fears the NHS could pose an issue with the new developments.
“The trouble with the things I’m developing is they cost a substantial amount of money,” he says.
He believes political correctness has taken hold of the health service – and that it should support innovation, regardless of the cost.
“We are putting in billions of pounds to transform the NHS, but no one ever notices where this money goes or what it achieves,” he writes in his book.
“So we – the workers within the system – remain disillusioned.”
The surgeon says he is a great supporter of the service – but wants it to ‘improve from the situation it’s in, for the sake of both patients and workers.
At present, he says ‘business-like’ NHS staff don’t have time for the ‘touchy-feely stuff’.
“Yet there are times and situations when kindness helps,” he says.
- The Knife’s Edge: The Heart and Mind of a Cardiac Surgeon by Professor Stephen Westaby, published by Mudlark, is available now
