SMALL: LIFE AND DEATH ON THE FRONT LINES OF PEDIATRIC SURGERY
By Catherine Musemeche, M.D.
Published in 2014 by Dartmouth College Press.
Reviewed by Laura D. Sanders.
Anyone who has experienced the thrill of five tiny baby fingers holding onto one adult finger will appreciate this book. In this history of the first sixty years of pediatric surgery, author and board certified pediatric surgeon, Catherine Musemeche, interweaves her own surgical experiences and those of other physicians as she shares the difficulties and dilemmas of surgery in tiny spaces, involving even tinier veins and organs.
Dr. Musemeche also gives fascinating background on the invention of precision (read “very tiny”) surgical tools, often designed by surgeons or engineers on the fly to meet an emergency need; and on the development of prenatal diagnostic tools such as medical ultrasound and fetascopy, as well as surgery-enabling procedures such as pediatric heart-lung bypass.
She discusses ethical issues surrounding the development and approval of innovative surgeries and treatments, such as those that arise when surgery on an in-utero baby also means surgery on the mother in order to reach the child, or when cost-benefit ratios for prenatal surgery cannot be justified to a hospital administrator or governing board, and the need to consider what, if any, consequences the child may experience later in life if prenatal or pediatric surgery is done.
In the middle chapters the author addresses issues of older children such as childhood obesity, pediatric cancer, and trauma injuries. She tells the heart-warming story of how one surgeon reduced the need for pediatric trauma surgery in Harlem by starting a grassroots program to build neighborhood playgrounds.
In its final chapters the book gives a predictive peek at the future of pediatric surgery and new and developing solutions to fetal abnormalities, such as tissue-engineered organs.
Full of graphic details, this book is not for the faint-hearted, and perhaps should not be given to parents currently facing a pediatric surgery situation. But for those interested in medical history or who want to understand more about a pediatric surgery experience from decades past, this book may shed some light on the subject, as well as increase appreciation for the brave surgeons who led the way in the field and whose major intent was and is, to save small lives.
Laura D. Sanders is an editor and writer who resides in Austin and has been a member of the Writers’ League of Texas for several years. She enjoys bringing out the best in others’ writing. Website: www.lauradsanders.com
