This book is more than a diary of a heart surgeon; for it is a compilation of real-life events that shaped the thought and character of one of the most conscientious and leading cardiovascular surgeons that India has produced in this milieu. Performing cardiovascular surgery in the developing world, under the bracket of low and middle-income economies brings forth a wembley of challenges that are unfamiliar to the western world. No, we are not referring to the aetiology of heart diseases but the dire and uncharacteristic challenges that one must fathom in order to mete out qualitative surgical care in the face of unique constraints and abject scenarios.

The publication is a compilation of 52 chapters written in simple English and uncomplicated by medical jargons. It has each chapter in the text alluding to a characteristic memory that left behind an indelible mark on the mind of the author. It may be an understatement to refer to them as anecdotes, for they tell an emotional tale and how that had a bearing on the author’s perspectives towards life. Each chapter is an epoch in the colourful life of this author, and has been carefully titled to cause a subtle tingling of curiosity in the reader as one begins to ruffle through the pages. They capture the essence of the story and are sure to leave a deep impression in the mind of the reader.

The author strikes the balance between easing the subject and emphasising fine points of surgery to the lay public and makes submissions of how this specialty has evolved over time, with errors and trials. He attempts to impress upon the reader of his own learning curve in surgery, including incidents that make and break character in this demanding specialty. Each chapter alludes to the human factor and how a variety of characters influence the care for patients, for good and bad. He does not shy away from highlighting instances when the medical fraternity failed its patients in both action and inaction, and how ethics and morals must guide the surgeon towards what is best for the patient, even if that means showing the compass of conscience towards your seniors from time to time. The reader is bound to share the author’s emotions of anguish, heartbreak, and doom as they read through the pages, as well as share his thought process on some pressing matters that are often in the back-burners of our minds. There is no dearth of humour and laughter-at humanly and out-of-the-world experiences he has to share.

Dr Kumar makes an honest attempt to apprise the reader of the thought and power of silent prayer in instances that reflect the brevity of life in times of crisis when the surgeon is reminded that he is not the master. The reader will appreciate how experiences in surgical life are but just surgery; and more of a cocktail of human factors that must be calibrated for the patient’s collective good. He addresses various social issues that have bothered him throughout his career and how action can correct the course of an event for a formidable change. It is not safe to say that this book is a bedtime companion, for each chapter is sure to stoke your conscience and question your inner voice!

The author of this book is Professor Arkalgud Sampath Kumar, a highly-acclaimed and respected surgeon who headed the Division of Surgery and the Cardiothoracic Sciences Center at the All India Institute of Medical Sciences, India’s premier public healthcare institute in her capital city of New Delhi. Dr Kumar (known as Sam to his colleagues) graduated from Bangalore Medical College and completed his basic surgical and cardiothoracic training from the All India Institute, before serving on its faculty for nearly four decades. He has witnessed the growth of cardiothoracic surgery in India from the front benches and is today well known for his towering contributions to the continued development of this specialty. In a career spanning over five decades, he has performed nearly a thousand-score surgeries in the public, private, and philanthropic sectors both at home and abroad. An astute clinician and academician, he has authored over 150 articles in peer-reviewed international journals of repute and has trained over 100 trainees in cardiothoracic surgery. Dr Kumar has served as the Editor in Chief of the Indian Journal of Thoracic & Cardiovascular Surgery and the Asian Cardiovascular & Thoracic Annals.

Dr Kumar has strongly influenced the progress of cardiovascular surgery, by making seminal contributions to the areas of congenital and valvular heart surgery, through his ingenious and pathbreaking innovations to cut cost and optimise resources in the Indian setting, whilst maintaining standards of excellence comparable to peer units. Dr Kumar popularised the concept of valve repairs and homograft valve banking in South Asia, going on to establish an affordable alternative for thousands of patients suffering from rheumatic valvular heart disease. One amongst the continent’s earliest valve banks was established in New Delhi and is nearing three decades of high-standard-affordable care for our patients. Dr Kumar has aggressively advocated, strived to establish a formidable programme, and has taught hundreds of surgeons both at home and abroad, the techniques of valve repair and the Ross procedures for patients who can benefit from these modalities. He has been a champion for the rights that patients deserve and has extensively authored working papers on this subject and has practically contributed to establishing safety in the conduct of cardiopulmonary bypass.

Dr Kumar proses the balance that life is to be taken just as serious as it shouldn't at times; lest the value of life. There are ample references to the importance of a good relationship between the physician and their patients, students, and the society. The publication is akin to the good old Appalachian folk music; for you never know what tone of emotion is awaiting to hit you next! Dr Kumar may not believe in Dura est manus cirurgi, sed sanans, for he firmly establishes through his work that human emotion is palpable and dialogue more than action is a necessity in the humdrums of clinical practise between the doer and believer.

Leading surgeons seldom articulate factors that define their flash points, and more so what shaped them to be who they are. We strongly recommend this read to all physicians and surgeons; budding and serving, alike.