Exhale by David Weill

Exhale: Hope, Healing, and a Life in Transplant
By David Weill, MD
Post Hill Press, 2021

David Weill comes to his memoir Exhale after years directing the lung transplant program at Stanford. During those years, he saw it all: thousand-to-one chances, round-the-clock exertions, heroic staff and experts, trauma-ravaged visiting loved ones, the bleak heroism of the patients themselves. 

Exhale brings that full range of these experiences very effectively to the page. Seen from any vantage point, the process of successfully transplanting a working set of lungs from one human body to another is the stuff of fantasy, so it’s endlessly fascinating to get an insider guided tour of so many aspects of how it’s done. 

The only problem with the book is the tour guide, and anybody who’s ever had a Carlsbad Caverns tour guide who drones on like a canned recording or a Mount Vernon tour guide who openly sneers at obvious questions will know that a bad tour guide can ruin just about anything. Weill attempts to cast his reminiscences as some kind of personal redemption narrative, a story in which he slowly evolves from a bully with a God Complex to a more humbled figure. 

These attempts fail, and the text amply supports the suspicion that they fail intentionally. For every one time the author forces himself to croak out some chestnut of self-effacement, there are ten times when readers get a scene like this:

“You know what’s risky, Donald?” I paused for full effect, took the phone away from my ear, and held the speaker up to my mouth. “Not doing the fucking transplant.” I was now leaning toward the phone, bent at the waist. “Not giving the girl a chance. Now take these fucking lungs, and let’s get it done.”

“I don’t understand why you need to use that language.”

“Look, I’ll talk to my shrink about it. In the meantime, can we possibly get a transplant done?”

The reader has no trace of doubt that many, many such moments happened in the course of Weill’s career, and it’s easy to see that he still loves them, mainly because during them, he’s played by Matthew McConaughey along the strict Hollywood pattern of the raging a-hole who’s a-hole behavior is completely exonerated by the fact that he just cares so much. Readers of this book will have seen that Hollywood pattern hundreds of times, but in a memoir drawn from the real-life experiences of worried patients and dedicated professionals, those readers will universally be repeating “I don’t understand why you need to use that language.” 

When Weill is writing about the backstage exertions of making these medical miracles happen, he’s unfailingly interesting. But when his narrative verges into personal moments, it becomes a protracted and cliche-choked demonstration of the old joke: What’s the difference between God and a surgeon? A surgeon doesn’t think he’s God. 

“This job demands you make a hundred decisions a day,” he writes at one point without the slightest shred of irony, instead just prepping for the battle-weary McConaughay voice-over. And the moments of platitudinous self-evaluation don’t typically come across any more convincing. Time and again readers will come across passages like this one, in which the vigor of Weill’s prose is, to put it mildly, counterbalanced by the fact that he quite obviously doesn’t mean a single word of it:

I was waging a personal war against death, and I thought I should be able to win each and every battle. This way of thinking was a misunderstanding of my place in the world and of my role in the transplant process, but I felt at the time that it helped me be the best transplant doctor I could be. I found that same arrogance, that belief in my ability to control outcomes, had an upside: it served to instill confidence in the patients who put their lives in my hands. But death wasn’t as simple as a referendum on my job performance.

It’s scarcely possible to finish Exhale without feeling very sorry for anybody who’s ever had to work with its author, who comes across as a self-important douchebag at every stage of his personal journey. And that kind of moue of distaste will probably taint the whole of the reading experience. But anybody who’s ever been involved in the mind-boggling drama he relates will find this necessary reading.

Steve Donoghue is a founding editor of Open Letters Monthly. His book criticism has appeared in The Boston Globe, The Wall Street Journal, The Washington Post, and The American Conservative. He writes regularly for The National, The Vineyard Gazette, and The Christian Science Monitor. His website is http://www.stevedonoghue.com.