The Wet Engine: A Heartfelt Book Review

mithra ballesteros
Feb 17 · 7 min read

When my oldest son, Nicholas, was thirteen, he ran in a cross country meet on a very hot afternoon. As he crossed the finish line, he crumpled to the ground. Next to him, another runner was vomiting. That’s how hot it was. The coach helped both of them off the field and into the shade and they were fine.

A month later, during a discussion about extreme weather, I mentioned the incident to my father. I was standing in his kitchen while he cooked salmon under the broiler. He shut the oven door, turned to me, and said, “You need to make an appointment. Tomorrow.”

And as the salmon burned in the oven, my father, a retired pediatrician, explained that any loss of consciousness in a child needed to be investigated. “Take him to a pediatric cardiologist,” he said. “Ask for a stress test.”

My pediatrician back in Wisconsin shrugged off my son’s description of the incident but did an EKG just the same. ”Normal,” I reported back to my dad.

“I said, a pediatric cardiologist!” he hollered at me.

It’s a heck of a story: How it took me forever to get a referral; how I thought about skipping the appointment because Christmas was a week away and I was stressed; how I kept the appointment to appease my dad; how the technician performing the ultrasound left the room to get a physician; how that physician called two more physicians into the room; how that’s when I knew something was wrong.

How my dad — normally very calm in any medical crisis — was rattled by the news.

His grandson had a very rare anomalous right coronary artery. Every time Nicholas exerted himself, the artery became unnaturally compressed by the aortic wall. As he grew bigger and his body put greater need on his heart, the compression increased. Without surgery to correct the anomaly, Nicholas would die on the soccer field or in gym class.

I don’t think about that time if I can help it. We passed through “the vale of fears and tears.” Why would I dwell in such a place when Nicholas is, today, riding his bike to work, passing marshy shores in the pre-dawn hour where gulls startle at the whirring of his wheels.

And then a couple of months ago, I came across “The Wet Engine: Exploring the Mad Wild Miracle of the Heart .” It is a memoir, I guess, written by Brian Doyle. Here is the first paragraph:

My son Liam was born nine years ago. He looked like a cucumber on steroids. He was fat and bald and round. He looked healthy as a horse. He wasn’t. He was missing a chamber in his heart, which is a problem, as you need four chambers for smooth conduct through this vale of fears and tears, and he only had three, so pretty soon he had an open-heart surgery, during which doctors cut him open and iced down his heart and shut it down for an hour or so while they worked on repair.

Doyle’s words transported me to the waiting room on that cold January day fifteen years ago. Then I did the math: Doyle sat in a waiting room the same year. I wasn’t sure I could read this book. But as I think seriously about writing memoir, what kind of a baby would I be not to try.

Little Liam goes through two surgeries before he is two. He will eventually require a heart transplant. It was seven years after his son’s second surgery when Doyle finally sat down to write the story that he said was born out of “roaring terror.” The first lesson I gleaned was that writers need time to process traumatic events.

So as some strange act of celebration or prayer or testimony, let us wander into the wet engine, and apprehend the miracle and study the mystery, and be agog and agape at what has been so wondrously wrought in the meat beneath the bone of your chest.

One of Doyle’s editors assumed from the title that the book was about carburetors, and wanted Doyle to change it. Doyle refused. Doyle refuses to follow many rules. His work is like no other book I’ve read — a small volume of 160 pages, yet the words surprised me over and over again. It begins with Doyle’s son but it is more than an account of one child’s acute health problem. It’s a wonderful, hopeful, crazy tribute to the ole ticker that beats 100000 times a day.

One reviewer wrote, “This book has heart, it has brains, it has guts.” Doyle is Mrs. Frizzle driving a magic school bus through the human body and what a wild ride. In a chapter titled “Heartchitecture,” Doyle describes a long litany of great doctors and scientists who studied the heart, including those who experimented on themselves, sometimes with deadly results.

He covers every kind of heart you can think of: the biological organ, the metaphysical center of spirituality, the poetic symbol for courage. He is effusive like a good Irishman. He is rhythmic like a master rapper. He gets carried away. If you, as a reader, require short sentences to catch your breath, be ready. This book is great cardio. A paragraph on song lyrics goes on for three pages without a single period. Don’t misunderstand me. I’m not complaining. That clever passage is alone worth the $23 price tag.

I was especially charmed by his foray into animals and their hearts. Here is what he says about hummingbirds:

Their hearts are stripped to the skin for the war against gravity and inertia, the mad search for food, the insane idea of flight. The price of their ambition is a life closer to death; they suffer heart attacks and aneurysms and ruptures more than any other living creature. It’s expensive to fly. You fry the machine. You melt the engine. Every creature on earth has approximately two billion heartbeats to spend in a lifetime. You can spend them slowly, like a tortoise, and live to be two hundred years old, or you can spend them fast, like a hummingbird, and live to be two years old.

Doyle said in an interview that his book is a “prayer of gratitude” for his son’s brilliant and gentle physician, pediatric cardiologist Dave McIrvin. Despite McIrvin’s skill, Doyle’s boy is never completely out of the woods and will eventually, sometime in adulthood, require a transplant. At this point, I set aside the book and googled “Brian Doyle and Liam Doyle.”

That is when I came across Brian Doyle’s obituary. He died on May 27, 2017, six months after the discovery of what he called “a big honkin’ tumor.” He was 60.

Author Rebecca Solnit said, “A book is a heart that only beats in the chest of another.” Doyle gave us a hunk of his tissue. This little book with an illustration of a heart on its cover is, in fact, a kind of heart transplant. Doyle’s death completely changed my reading experience. His death changed me.

I decided to think more deeply about what exactly happened to my son and to me. The sound of Nicholas screaming, “Pain! Pain!” before he was fully out of anesthesia changed me. Even now, typing it out for the first time, I’m gulping. Because the mother who sat in the pre-op room, listening to the doctor gently instruct the patient that he should use the word ‘pain’ if he felt any, that mother was hopeful and optimistic, and wholly unprepared to hear the word ‘pain’ hurry out of her son’s mouth, no longer a word at all, but a hummingbird that pierced her, electrified her, woke her up. I am not the mother in the pre-op room anymore. I am not the mother chatting in my dad’s kitchen. After that day in the I.C.U., I became the mother who considers every scenario in terms of what could go wrong, despite the sunshine, despite the seatbelts, despite the long odds.

My son was lucky. His surgeon, Dr. Robert Jaquiss, or “Jake” as he liked to be called, happened to be the leading specialist in this sort of congenital heart defect. How fluky that he was employed at Children’s Hospital of Wisconsin. How funny that his daughter was Nicholas’s friend.

How fortunate that the congenital heart defect did not repeat itself in Nicholas’s three younger brothers.

How blessedly miraculous that my dad insisted we investigate the cause of a fainting episode.

All of these four-leaf clovers added up to a very compelling story. A journalist called me one day. He had heard about Nicholas from his dentist, my brother. Kevin Helliker’s account made the front page of The Wall Street Journal a year after Nicholas’s surgery. By then, Nicholas was playing soccer in high school, his scar beginning to disappear under a chest of hair.

And here I am, fifteen years later, reading a book that sends me traveling back in time, and taking you along with me, folding Nicholas’s story into Liam’s story and Brian’s story. So this is the story of the reading of a book.

And like all good stories, this one has a surprise ending.

When I finished the book, I was sad that there were no more pages, so I read the acknowledgments. There, in the fourth paragraph, a name: the boy who broke my heart in my youth, who sent me crying to my pillow countless nights, whose love I couldn’t hold. This boy who made me realize that life before him was all Barbies on the floor, that love was real but not forever, and when it ended, it hurt. I could see him in a Powderhorn Mountaineering ski vest and painter’s pants, broad-shouldered, golden-haired, laughing with crinkly eyes. That boy. He had grown up to become a professor in Eugene, Oregon, and there was his name, in the back of this heartbreaking book.


This is what Brian Doyle says about that:

When young, we think there will come one person who will savor and sustain us always; when we are older we know this is the dream of a child, that all hearts finally are bruised and scarred, scored and torn, repaired by time and will, patched by force of character, yet fragile and rickety forevermore, no matter how ferocious the defense and how many bricks you bring to the wall.

TPhoto by Renn Kuhnen.

mithra ballesteros

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storyteller, shopkeeper, sufferer of foot-in-mouth disease