WALK ON WATER

Close-up and personal view of a surgical team at the Cleveland Clinic’s Center for Pediatric and Congenital Heart Diseases.

Ruhlman, who previously explored excellence in craft at the Culinary Institute of America (The Making of a Chef, 1997) and at a Martha’s Vineyard boatyard (Wooden Boats, 2001), shifts his attention to a field where highly developed skill can make the difference between life and death. The author focuses on Dr. Roger Mee, regarded as a man who can “walk on water,” one of the best in his field, and his associates on the surgical team at the Cleveland Clinic, where they daily repair the malformed hearts of babies. Ruhlman was allowed into the operating room to observe intricate procedures being performed on newborn infants undergoing open-heart surgery. To understand what he was seeing, he conducted extensive interviews with doctors, nurses, and physicians’ assistants. To round out his story, he questioned team members to get their personal stories (and their assessments of one another); he also interviewed the anxious parents of the infants whose problems had brought them to the clinic. Dramatic moments abound as unexpected complications cascade into narrowly averted disasters and last-minute heart transplants, and at these moments the expertise that Rulhman admires becomes most apparent. Yet frequently the narrative gets bogged down and the action blurred by overuse of medical terminology (e.g., “residual ventricular septal defect”) and by technical details of more interest to a surgeon-in-training than a layperson. In addition to revealing the prowess of the surgical team at Cleveland, Ruhlman provides a brief history of pediatric heart surgery and presents a disturbing view of the politics of cardiology referrals. Finally, a resource section offers advice for parents faced with making decisions about the care of a child with a congenital heart defect.

A window into an unfamiliar world where excellence is difficult to achieve yet absolutely essential.