As a child Westaby watched two of his grandparents die slow painful deaths; his grandfather from heart failure and his grandmother from a cancer which left her to suffocate. This experience has clearly directed his career and his desires to help those who would otherwise be written off. He says you need to be objective as a surgeon, but he never comes across as uncaring.

It's amazing how far medicine has come in just a few generations. Who would have thought artificial hearts can and do work. The ability for a truly rested heart to regenerate is eye-opening and makes you wonder why we can't be doing this for more people.

The hearts seem to take quite a beating, both through life and surgery. There's young people struck down in their prime by viruses and undetected genetic weaknesses. There is trauma and those who have just reached the end of their heart's functioning. One pregnant woman is determined to keep her baby despite medical advice to the contrary, Westaby being the only one who will risk surgery on her.

The introduction does explain the basic function and structure of the heart, however if you have very little knowledge of anatomy, biology or medicine you might struggle to follow some of the cases. He does go into quite a bit of detail on each surgery, which some also might find gory.

Like Henry Marsh, Westaby has become disgruntled with an NHS bogged down in bureaucracy. It's only briefly mentioned at the end, but you can sense his frustration with the system in some of the cases. Who thinks it makes sense to send senior surgeons on courses to learn CPR? And the death list! Some government idiot decided to name and shame surgeons who have deaths on their operating tables. Seriously ill people will die sometimes. This just deters surgeons from taking risks, risks that could save lives. Most people given a chance of a slow and painful death or a risky surgery, would rather have the surgery. Instead they are filled with drugs and sent home to die.

This book shines a light on how harsh the "postcode lottery" can be. Westaby raised charitable funds to help patients in his Oxford hospital and he also had the expertise there, something a lot of hospitals just don't have, not through any fault of their own. Despite Oxford being a centre of excellence for heart surgery, they were not a transplant centre and therefore they got no NHS funding for the very pumps Westaby had trailblazed. He might be able to fix you, but the device he needed just wasn't always available.

Marsh and Westaby are likely the last of the pioneering NHS surgeons. Politicians would rather create lists and targets and 7 day GPs that no one has asked for. Why would any skilled doctor want to work in an environment where they are prevented from doing what's best for their patients?

This review makes the book sound moanier than it is. It just triggered my personal anger over the slow demoralisation of the NHS. In fact it's really quite uplifting in what we can achieve will the right will. The sacrifices made by medical staff are always appreciated.

Review copy provided by publisher.