Breathless: A Transplant Surgeon's Journal

Breathless: A Transplant Surgeon’s Journal is the story of the establishment of the world’s first lung transplant program at the Toronto General Hospital as seen through the eyes of one of its chief architects, Dr. Thomas R.J. Todd. Although the simultaneous transplantation of the heart and lungs was well-established by the early 1980s, the transplantation of one or both lungs without the heart was considered dangerous and perhaps impossible. Dr. Todd recounts how he and his peers worked tirelessly to prove that lung transplantation could work, often devoting hours to the project after a full day of surgery. After some early and tragic failures, in 1983 the Toronto General team performed the first single lung transplant in the world. This exciting – and unexpected – success secured both prestige and funding for Dr. Todd and his colleagues, and established Toronto General as a world leader in thoracic surgery. The world’s first double lung transplant followed in 1986, and the program thrived for well over a decade. In the late 1990s, budget cuts had altered the program for the worse, and after a few institutional shuffles the book closes with Dr. Todd departing for greener pastures.

Although such a brief synopsis of Breathless may make it sound like a stale institutional history, it is in fact equal parts insider’s history, autobiography, and medical drama. The story is composed almost entirely of anecdotes drawn from Dr. Todd’s long career, recounted both from memory and journal entries. Unfortunately, the narrative is not strictly chronological, and on occasion we lurch back and forth through time as Dr. Todd is suddenly reminded of a tangentially related story. Also, although the prose is generally quite readable, Dr. Todd does have a tendency to be overly wordy. Fortunately, the quality of the anecdotes makes it worth the occasional discomfort. Breathless contains tales of heartbreaking deaths, heated rivalries between surgeons and institutions, and manages to find comedy in the most unlikely of places—the story of a team of surgeons riding shotgun in a police car with sirens blaring, roaring through downtown Toronto at 160 km/h with a donor lung stored dubiously in a black garbage bag full of ice cubes, for example. Anyone interested in medical dramas, modern Canadian history, or old-fashioned storytelling will find something here to enjoy.