Author and journalist Michael Ruhlman's fascination with people at the top of their professions, who seek perfection in themselves and those around them, led a friend of his to refer him to Dr. Roger Mee, the head of pediatric cardiothoracic surgery at the Cleveland Clinic and one of the world's best heart surgeons. Ruhlman spent two months shadowing Dr. Mee, his colleagues and assistants in the OR and the PICU (pediatric intensive care unit), and the parents who entrusted him with the lives of their very sick children. The children chronicled in Walk on Water are young infants born with complex congenital heart defects, who are gravely ill and have been referred to Dr. Mee in a last ditch effort to save their lives. Ruhlman observes and effectively describes the preoperative angst and despair of the parents, the drama during these babies' difficult surgeries, which are fraught with unforeseeable challenges and unexpected consequences, and the occasionally uncertain postoperative recovery of the sickest patients. Ruhlman also attempts to understand and describe what makes Mee and other leading pediatric cardiac surgeons and heart centers as good as they are, and compares them to other surgeons and centers who have markedly higher perioperative and postoperative morbidity and mortality rates. He also gives the reader a history of pediatric cardiothoracic surgery, by depicting the leading surgeons and groundbreaking procedures that permitted the field to make tremendous advances over the past 75 years. Unfortunately, the author is not as successful in these goals. He does portray Mee as a complex man, who is perceived by his peers as arrogant and difficult, but a man who beats up on himself and becomes depressed whenever he doesn't live up to his lofty standards, and looks forward to a time when his services are no longer required. He also paints a compelling portrait of Mike Fackelmann, the physician assistant and right hand man to Mee, whose presence in the OR is invaluable to the great surgeon. However, Ruhlman frequently gets caught up in the cowboy mentality of the all male enclave of cardiothoracic surgeons, whose descriptions of themselves and Mee as God like figures and star athletes were repetitive and often in poor taste, and detracted from the far more effective narratives of the main characters in the book. Ruhlman's lack of medical training is most apparent when he attempts to describe the surgical procedures, which made these sections boring and overly lengthy. Walk on Water is an interesting but somewhat disappointing look into the field of pediatric cardiothoracic surgery and the career of one of its leading practitioners. The excellent narratives of those featured in this book are diminished by the author's lack of detailed medical knowledge of the pathophysiology of complex congenital heart defects and his tendency to repeat points that were previously covered. Ruhlman is to be commended for tackling a difficult topic, and I would marginally recommend this book for anyone who is interested in this field.