Publication Date: 1st December 2020
Publisher: Green Heron Productions
Page Length: 341 Pages
Genre: Historical Fiction / Medical Fiction
A gifted young surgeon. One of the 20th century's boldest inventions. And the unconquerable, fragile, and amazing human heart.
As one of two dozen teams worldwide performing congenital heart surgeries in the middle 1950s, Alec Serafeim and his best friend, Pete O'Neill, excel in an unforgiving field where the line between life and death is eyelash thin. But while Pete is satisfied with all they have accomplished, Alec aches to do more. Desperate to save more children, he also wishes to be remembered for something other than his mental breakdown ten years earlier.
Alec's opportunity arrives via a chance to join the race to perform Australia's first open-heart surgery using total cardiopulmonary bypass. Swept up in the competition, with a heart-lung machine cobbled together in the hospital basement, Alec charges ahead with surgery on a gravely ill child over Pete's misgivings.
But the heart, for all its amazing strength, is a fragile organ. And when events conspire to shatter Alec's heart, he is left questioning everything. With sick children's lives hanging in the balance, as well as his career as a surgeon, he must find a way to cope with his fallibility--if he hopes to finish what he started.
Set in a fictionalized version of Perth, Western Australia in 1956, The Stars That Govern Us is a captivating, poignant, and unforgettable medical - historical novel set against the backdrop of the development of the heart-lung machine and the birth of open-heart surgery.
Be transported back to 1950s Australia in The Stars That Govern Us, where heart surgeons are competing against nature, disease, and each other, to perform the country’s first successful open heart surgery using cardio-pulmonary bypass.
In The Stars That Govern Us by J.R Alcyone, we meet fictional surgeons Alec Serafeim and Pete O’Neill, two ‘chalk and cheese’ specialists in congenital heart surgeries in the university hospital of Perth, Australia, in the 1950s. This is a dangerous and complicated field, where life and death hangs by the proverbial thread, but the two men have risen to the top despite their own obstacles. Despite being a perfectly-choreographed team in the operating theatre, the best friends differ in one key driver: ambition. Whilst Pete would be content to continue working at their current (highly successful) level, Alec has dreams of pushing their boundaries even further, saving the lives of even more children, and cementing their names in medical and surgical history by being the first team to perform their country’s first open-heart surgery, using cardio-pulmonary bypass.
They have the skill for it, Alec is sure of that, but what they lack is the technology: a heart-lung machine, to keep oxygenated blood moving around the patient’s body whilst the operation is taking place. Reading about a working design in his medical journals, Alec sees a way of bringing his dreams to reality, and with one specialist part ordered in from an already-successful medical team, he works on creating his own version of the machine.
The machine is rough and ready, cobbled together in the basement of the hospital, but initial tests on animals are successful, and their managers approve them to continue the work, which leads them to their next challenge: selecting the right child to the first such surgery in Australia. There are strong arguments from both Alec and Pete, but during another operation, Pete is taken out of the equation, suffering his own illness, leaving Alec distraught, and on his own. The tension during Pete’s hospitalisation, and the subsequent operation is palpable, and there were moments I found myself holding my breath.
This is neither a field (medical) or era (1950s) that I know anything about, or have read any fictional accounts of before, but I was intrigued by the introduction, and ended up absolutely enthralled. Although it is still a dangerous field of medicine, with so many advances in modern equipment, understanding and drugs, it’s hard to completely imagine a world where such things were tentative and new. But with detailed descriptions of the atmospheres and personalities present within the operating theatre, as well as going through some of the detail of the operations themselves, it really does feel like we are standing over the shoulders of Alec and Pete as they make the minute-by-minute decisions to get through such difficult work.
There are heart-breaking and worrying moments throughout the book (this is a hospital full of sick people, after all, and very sick children at that), but the pioneering spirit and Alec’s determination ring true throughout. What also comes across are the very human natures of the two surgeons. Pete, although a war hero, is content to work at their current level, helping the children they can, but he is also a workaholic, putting his own health at risk in the process. And Alec suffers with problematic and sometimes debilitating mental health issues, including major anxiety spirals. The men are very different, but their friendship is entirely believable, and both are drawn to do and be the very best they can.
For a few moments in the book, I was struck with the thought that Alec and his life seemed almost too perfect; there’s the beautiful wife, the wonderful child, the ability to excel at anything he turned to hand to. And yet, there’s a ‘roundness’ to him, through his strong desire to help the children on his ward, and his anxiety as to whether he has the means to do so. His despair at the loss of a patient is very real too.
Although the majority of the book naturally centres around the hospital itself, there is a strong sense of time and place throughout, drawing us into the 1950s, and the coastal city of Perth. I was lost in the story, and didn’t feel jarred from this at any point. Likewise, the university, hospital and characters in the story may be largely fictional, but the detailed Historical Note at the end of the novel places them firmly into reality, providing the background to surgeons they mention being inspired by, such as Americans John Gibbon, and Clarence Walton ‘Walt’ Lillehei, the latter who genuinely did make the design of his heart-lung machine available so others could manufacture their own, as well as advising where key components could be purchased, and inviting surgeons in his field to visit and watch him work.
Highly recommended for fans of medical fiction, the history of medicine, or those looking for something different in their historical fiction.
Review by Jennifer C. Wilson.
The Coffee Pot Book Club.
J.R. Alcyone writes historical and literary fiction for readers who enjoy character-driven fiction. She is a graduate of Baldwin-Wallace College, where she majored in history and philosophy and minored in literature and political science, and the Cleveland-Marshall College of Law, where she was managing editor of the Cleveland State Law Review. A practicing attorney in the area of warranty and consumer rights law, Jen lives a short distance from Lake Erie in northeastern Ohio. When she is not writing or taking pictures, she enjoys studying the American Civil War and running
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