Thursday, July 26, 2018


I reviewed Ticker: The Quest to Create an Artificial Heart (Crown Publishing Group) by Houston's Mimi Swartz for Lone Star Literary Life. Swartz has impeccably woven science, history, biography, and engineering to create an improbably true account of cardiology’s pursuit of medicine’s Holy Grail — a fully implantable artificial  heart.
Mimi Swartz
Ticker: The Quest to Create an Artificial Heart
Crown Publishing Group
Hardcover, 978-0-8041-3800-0 (also available as an e-book and audio-book), 336 pgs., $27.00
August 7, 2018
“The medical and engineering professions were like a couple who were profoundly ill-suited for each other but determined to work together for the sake of the children.”
Heart disease is the number one killer on the planet. It is the leading cause of death of both men and women in the United States, killing approximately 610,000 people in 2017 — one in every four deaths. Approximately twenty-six million Americans have heart disease; 2,150 of them die each day, an average of one death every forty seconds. The solution of choice is a heart transplant, but in any given year there are 2,500 hearts available for 50,000 patients on the waiting list. These are bad odds; and “the person who comes up with a way to replace a failing heart with an artificial one will save countless lives and change the future of humankind.” We are talking another Louis Pasteur, Jonas Salk, or Marie Curie. And, of course, whoever crosses the finish line first will become wealthy beyond most people’s wildest dreams.

Ticker: The Quest to Create an Artificial Heart is the second book from Texas journalist royalty Mimi Swartz. Texans have read her work for decades in Texas Monthly, where she is an executive editor. Swartz’s National Magazine Award–winning work appears in the New Yorker, Vanity Fair, Esquire, Slate, and the New York Times. In Ticker, she has impeccably woven science, history, biography, and engineering to create an improbably true account of cardiology’s pursuit of medicine’s Holy Grail — a fully implantable artificial heart.

Ticker is an education in the development of world-class medical facilities (Baylor College of Medicine, St. Luke’s Hospital, Texas Heart Institute, the Texas Medical Center) that set global standards in the subtropical fever-swamp we like to call Houston. Swartz entertainingly relates the colorful biographies of the independent (insubordinate? hubristic?) titans of cardiothoracic surgery, many of whom called, and call, Texas home (doctors Michael DeBakey, Denton Cooley, Bud Frazier, Billy Cohn). Combine the facilities and the surgeons (and magnetic levitation!) and you get a lesson in the history of cardiology and medical devices. That’s how important Texas has been in the field.

For all of the heart-wrenching pathos expected in stories of people too sick to walk across a room and the families who love them — and there are plenty of these — there is also humor. Swartz is funny and, often, so are her subjects. Dr. Frazier remembers The Incident of the Yucatan Mini Pigs, which occurred when the animal research lab was still on the third floor of St. Luke’s, along with obstetrics and maternity. Also, it’s unnerving how important your home kitchen and local hardware store (not to mention the now-deceased Foley’s department store) have been to the development of assist devices and artificial organs.

Ticker is narrative nonfiction, the art of using literary styles and techniques to tell a factual story — practical and poetic. Swartz excels at cherry-picking among vast amounts of research for the quintessential example of whatever point needs making and by which to extrapolate from the micro to the macro. Facts (the human heart beats around 115,000 times a day) and figures (a healthy heart pumps about two thousand gallons of blood a day) are personalized and analogized. Profound is the correct word for Swartz’s moving descriptions of witnessing heart-transplant surgery. “And then it happens: the new heart begins to take on a richer color as it fills with new blood. It begins to beat,” she writes, “searching for and then finding a normal rhythm, settling into its new home.”

Ticker is beautifully and ingeniously constructed, flowing like a fast-paced science-fiction novel, engendering wide-eyed wonder at a remarkable, smart, compelling, and very human story at the busy intersection of money, politics, law, science, medicine, ethics, and philosophy.

Originally published in Lone Star Literary Life.

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