All That Really Matters by David Weill (EXCERPT)

After writing the memoir Exhale: Hope, Healing, and A Life in Transplant, revealing the emotional rollercoaster that is the life of a transplant surgeon, David Weill returns to the operating theater with his debut novel, All That Really Matters!


Joe Bosco is an arrogant, hard-charging transplant surgeon whose ambition knows no bounds. He pursues his job with a “take no prisoners” approach, as saving patients is not just his job or even his passion: it’s his religion. After his surgical residency, he passes on a job offer from Stanford, instead taking a wildly lucrative position at a private hospital in San Francisco where the bottom line is…the bottom line. Joe leaves behind academic medicine, much to the chagrin of his father— a German Jewish Holocaust survivor who is a world-renowned neuroscientist and Nobel Prize winner—and his girlfriend Kate, who sees Joe turning into a different man from the one she met at Harvard Medical School.

Dr. Bosco makes it to the top as a star in the transplant world but soon realizes that the new world he inhabits is fraught with moral and ethical transgressions, some that his partners commit and, eventually, some that he commits. When the hospital administration sides against Joe in an operating room catastrophe, he is isolated and left with a career in shambles, a girlfriend who wants nothing to do with him, and a father who can’t hide his disappointment.

It is not until his life spins out of control that Joe must come to terms with his own failings and find his true purpose in life in the most unlikely of places.


We’ve been lucky enough to snag the following excerpt for our readers!


From All That Really Matters by David Weill (June 2024, Rare Bird Books,) Used with permission.

I creased the blank page, flattening the journal spine one afternoon during my forced time away. Then I wrote.

Let’s face it: expectations are a real bitch, a tyrannical part of the human experience that, frankly, I could do without. And I don’t know which is worse: fulfilling them or not fulfilling them—either way, expectations lead you around by the nose, taunting you to do better, to be better. But expectations—my own, that of others—can’t ever be fully satisfied. They’re an insatiable master that taunts and mocks, all the while laughing hysterically at you—a deep belly, piss all over yourself, kind of laugh.

I closed my journal and left my thoughts there, at least for now.


I watched the commencement speaker anticipate the next name—the graduate with the same last name, the same chin, the same hazel green eyes. Me.

While I waited for my name to be called, forever it seemed, I took in my surroundings for what I suspected would be the last time. After today, I’d be gone. I wasn’t one for alumni events, drunken gatherings spent reminiscing about the good old days, sloppy attempts to recast one’s life in a more favorable light.

Don’t get me wrong. As an experience, college and medical school were fine, if not somewhat predictable—but, for me, a means to an end. Nothing more, nothing less.

But, on this day, nonetheless, I had a close look around. The old brick buildings of Harvard Yard and the Chapel stood guard over the ceremony, silhouetted by the setting sun at the end of a perfect late spring day in Cambridge. The whole proceeding had the musty smell of tradition, further accentuated by an equal mix of aristocracy and academic snobbery.

We graduates were seated on a creaking stage with delipidated wooden chairs and floorboards that threatened collapse at any moment, a platform that looked as though it was constructed for the first Harvard Medical School graduation in 1782.

The students—my classmates—would soon be actual doctors. We had fought and scratched, competed with each other when that was called for and cooperated with one another when that was the best route. But now, it would only be a matter of minutes before we could put an M.D. after our names, so we sat quietly, waiting patiently for what was next, the quality most valued in medical students, obedient little soldiers of a fledgling medical brigade.

After the ceremony began and the perfunctory comments were made—about helping people, giving back to medicine, dedicating oneself to the field—the current medical school dean read the list of graduates one by one. Each new doctor walked up to the podium, smiled, shook hands with the commencement speaker, and right on cue, turned to a photographer who snapped each of their smiling faces, documenting perhaps the last time these accomplished young people would be this happy, or this hopeful.

Now, all but two names had been called, the top student in the class and the second ranked one, or as the class members called the runner-up, the “bridesmaid.” In our graduating class, I was the bridesmaid. And I should say straight away that there was no shame in being second, at least in my mind. After all, I finished ahead of exactly 131 other over-achievers who would sell their mothers to a Mexican drug cartel to occupy my spot. But now I’m sounding defensive, for reasons that will soon become clear.

“And the honor of the second-ranked graduate goes to Dr. Joseph Bosco.”

I sat in the first row near the aisle, but not on the aisle—that was reserved for the top graduate—and smiled ever so slightly at first, but not with any sense of accomplishment or pride. Rising to the occasion, cognizant of the prying eyes fixed on me, I plastered on an obligatory smile—because that was expected.

It was time to do the walk now. I pulled my head up, straightened my back, stood ramrod straight, military style, even though I would be the least likely in the history of mankind to ever be in the military, and walked to the podium to get my diploma, to have my picture taken with the commencement speaker, dear old dad, Dr. Peter Bosco—the former Harvard Medical School Dean and current Tulane University President. And oh—a Nobel Prize winner, the scientist who had untangled the mystery of the amyloid tangles in the brains of Alzheimer’s patients.

As the audience at the graduation ceremony applauded, and the class rose to honor my accomplishment as first runner-up, father and son turned to the camera. And as we smiled, beaming in the moment that at least on the surface looked perfect, Dr. Bosco said to me, the new Dr. Bosco, “Do you know what second place is, son?”

I nodded, the smile still cemented on my face. “Yeah, dad, I do—first loser. Just like you always told me.”

The photographer got the photo he wanted, the one at the right angle and with the right smiles, the photo that would go up on one of the medical school walls, documenting the day the Bosco kid left Harvard Yard for good—and I vowed right then, in that moment, never, ever, to be a bridesmaid again.

From All That Really Matters by David Weill (June 2024, Rare Bird Books,) Used with permission.

All That Really Matters by David Weill was published today June 11 2024 by Rare Bird Books and is available from all good booksellers, including

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