When Death Becomes Life: Notes from a Transplant Surgeon

Summary (from the publisher): 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.

Review: I received an uncorrected proof copy of this book from HarperCollins.

Part memoir from a transplant surgeon on his experiences in the field and part history of the practice of transplantation, this book strikes the delicate balance of conveying a wealth of information on the movement of organs between bodies while also keeping the human element of the patients' stories very present. Throughout the book, Mezrich covers multiple types of transplants including kidney, liver, heart, pancreas, and skin, but also spends time discussing the ethical issues behind this medical practice, the extraordinary gift provided by the donors, and the devastating tragedies that occur when transplants don't succeed. 

It was a unusual choice to blend his own personal experiences dealing with patients with historical coverage of transplants in the nineteenth century, but it did give the book a much more personal feel than a standalone history. However, while the history sections in each chapter did help me learn a lot about transplantation's origins, I enjoyed the personal memoir sections far more. Mezrich is able to transport his reader into the operating room to see the challenges and setbacks that can occur and into the waiting room with the family as they wait for their loved one. By sharing individual stories of patients, he brings the medical practice to life and helps illuminate the desperation that fueled early research. 

There were parts of this book that were hard to read. There are many, many patient deaths shared within the pages of this book, both of donors and those hoping to receive successful donations. The history of transplantation is one littered with desperately ill patients hoping against hope that this new practice will buy them some time. For many, it was a false hope, but at least their losses led to many successes in Mezrich's lifetime for many of the patients he treats. I also felt sympathy for surgeons who sacrifice so much for the sake of their patients. Mezrich's account is full of references to being away from his children and operations performed in the middle of the night. As he says, "I often have the feeling that my job is to fix people with illness so they can go back out and live their lives, do things that I would love to do but don't have time to" (339). 

Mezrich also does an excellent job of tackling many of the ethical issues associated with transplant, including how to define death, who is deserving of a transplant, and how much risk a healthy person should be allowed to take to save someone else. This book was an excellent example of medical history done right with the added bonus of personal experiences being shared by someone who works in the field and has a very nuanced understanding and appreciation for the complexity of what he does. 

Stars: 4