September 29, 2025 • 55 mins
An ingenious medical device promises to eliminate the need for heart donors entirely. But when accusations of a stolen heart emerge, the simmering tension between Michael DeBakey and Denton Cooley boils over, playing out in courtrooms and headlines across the country.
Presented by: Chris Pine
Written and Narrated by: Jamie Napoli
Executive Producers: Cristina Everett for iHeartPodcasts; Dub Cornett and Jason Ross for OSO Studios; Gerald Imber; Eric A. Rose, M.D.; John Mankiewicz; Joshua Paul Johnson; and Jamie Napoli
Supervising Producer: James A. Smith
Editing and Sound Design by: Joshua Paul Johnson
Composer: David Mansfield Cover Artwork by: Alexander Smith
Production Companies: iHeartPodcasts, OSO Studios, and 13th Lake Media
Production Legal Services: Jacqueline Eckhouse & Mel Pudig, Sloss Eckhouse Dasti Haynes LawCo; and Lincoln Bandlow, Lincoln Bandlow Law
Additional Archival Materials Courtesy of: "The Twentieth Century" (CBS 1966); "Nova" (WGBH Boston & PBS 1988 & 1999); Vanderbilt University; American Academy of Achievement; "DeBakey" (Dr. Tony Herring and the Texas Scottish Rite Hospital for Children 2016); Society for Vascular Surgery; "Meet the Press" (NBC 1966); Associated Press; "Michael E. DeBakey: Profiles in Science" (National Library of Medicine 2015); BBC; "The Heartmakers" (National Educational Television & Radio Center 1969); and the McGovern Historical Center of the Texas Medical Center Library
Additional Music & Stock Media Provided by: EdRecords / Pond5; EpicRecord / Pond5; eitanepsteinmusic / Pond5; Music Bed; Premium Beat; Storyblocks; Artlist; Envato Market; and Podcast Music
This podcast was recorded under a SAG-AFTRA collective bargaining agreement.
For more information on the history of open heart surgery, check out Dr. Gerald Imber's book "CARDIAC COWBOYS: The Heroic invention of Heart Surgery."
Copyright 2025, TTB, LLC. All rights reserved.
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the wild West of American medicine. I'm Chris
Pine in This is Cardiac Cowboys, the gripping true story
behind the birth of open heart surgery and the Maverick
surgeons who made it happen. When the race to perform
a human heart transplant kicked off at the beginning of
(00:21):
the nineteen sixties, Baylor's surgical chief Michael DeBakey was one
of the first surgeons to recognize its limitations. Even if
Doctor's canceled the issue of organ rejection and rewrite the
definition of death, one glaring problem remains. There simply aren't
enough donor hearts to go around.
Speaker 2 (00:39):
There are four hundred thousand Americans that die of heart
failure a year. Expanding the pool is a drop in
the bucket.
Speaker 1 (00:47):
That's cardiovascular surgeon Doctor Billy Cone.
Speaker 2 (00:51):
Lynn Warner Stevenson, a famous cardiologist, says counting on heart
transplantation to cure the woes associated with heart failure is
like counting on the lottery to cure poverty.
Speaker 1 (01:07):
So rather than competing with the likes of Christian Barnard
and Norm Shumway, DeBakey set his sights further into the future,
a future in which a failing human heart can be
replaced with something else entirely. For the last eight years,
debake and his team have been building the world's first
man made heart. Back in nineteen sixty one, DeBakey recruited
(01:34):
a brilliant Argentine surgeon named Dimingo Liota to spearhead an
artificial heart program at Baylor. The two men have spent
the better part of a decade working together toward a
breakthrough that could potentially save hundreds of thousands of lives
every year. Thanks to Debake's extensive lobbying, Liota's research has
been funded with millions of dollars in government grants, and
(01:57):
that's what brings DeBakey on April fourth, nineteen sixty nine,
to Washington, d C. DeBakey checks into the Hay Adams,
a luxury hotel that overlooks the White House. Tomorrow, he's
due at the National Heart Institute in Bethesda, Maryland, to
(02:18):
give an update on his and Domingo Liota's progress. He's
preparing his notes when a call comes in from Houston.
The news he hears doesn't make much sense. Debake's former protege,
Denton Cooley, has just saved a dying man's life by
implanting an artificial heart into his chest. But Cooley doesn't
(02:42):
have an artificial heart program. As far as Debake knows,
Cooley was never much interested in the idea, So how
can he already have a working artificial heart of his own?
At Saint Luke's Episcopal Hospital in Houston and a press
conference is taking place.
Speaker 3 (03:03):
What we have done is to replace the human heart
with a completely mechanical device. The replacement is a total one.
The heart has been removed and the replacement is done
in the cavity in which the heart usually lies.
Speaker 1 (03:18):
Black and white television screens all over the world flicker
with the smiling, handsome face of forty eight year old
Denton Koolie.
Speaker 4 (03:26):
How long do you think you can keep the device
working in the body?
Speaker 3 (03:29):
I see no reason why I wouldn't function for periods
of a month or more. But at the present time
we can look for a week or ten days that
would satisfy my highest hopes.
Speaker 1 (03:43):
Sitting beside Kooley in his white lab coat is doctor
Domingo Liota, Debake's artificial heart expert from Argentina. Cooley is
claiming the two of them developed this device together.
Speaker 5 (03:56):
But how could that be.
Speaker 1 (03:57):
Liota was hired by Debate, his research was paid for
with Debake's grants, and then DeBakey sees a photograph of
Cooley and Liota's invention, and he's stunned. Now he understands
they use the exact same heart. DeBakey will later say
to Life Magazine, they weren't even clever enough to make
(04:18):
it look different. Michael DeBakey feels betrayed. He believes his
work and funding have been stolen by surgeons whose careers
he made. By Denton Cooley, of all people, the man
who once showed up at his doorstep to brace him
for attempting to repair a child's heart defect using Cooley's
(04:39):
coffee pot bubble oxygenator. Worst of all, if it turns
out that Cooley and Liota's device was indeed funded with
Debake's grant money, this operation violated the government's guidelines for
human experimentation, it won't just be devastating to Cooley in
Liota's careers, it could tear down Debates two, along with
(05:01):
the empire he's built at Baylor. FROMOSO Studios, This is
Cardiac Cowboys, a podcast about life, death, and innovation in
the American Heartland episode five, A Man Made Heart. Here's
(05:33):
writer and executive producer Jamie Napoli.
Speaker 5 (05:37):
Back in the nineteen fifties, Michael DeBakey and Danton Cooley
were building their larger than life reputations one surgery at
a time. Thanks to the unparalleled speed and precision of
his surgical work, Cooley was rapidly outpacing DeBakey's heart program.
Between the two surgeons, a competition.
Speaker 6 (05:59):
Was then or later, we began to ask some conflict.
Speaker 5 (06:06):
That's an archival recording of Denton Cooley.
Speaker 7 (06:09):
And doctor de Bacon.
Speaker 6 (06:10):
Might hear that I've removed any organism, I'd probably upset
him to some extent because I hadn't called upon him
for advice in those early days. But one thing after another,
Mike and I began a bit of a rivalry.
Speaker 7 (06:28):
This was a typical father son complex.
Speaker 5 (06:32):
That's cardiothorastic surgeon doctor Don Wukash, who worked with both
Koley and Debatey.
Speaker 7 (06:38):
Doctor Culley got to be around the midlife crisis around
forty years. He wants to have a little separation and
a little self identity, and if the father figure is
unable to let go of control, and the son character
is willing to fight for this independence. You have this break.
Speaker 5 (07:02):
While Cooley remained a faculty member at Baylor, he moved
his clinical practice to the nearby Saint Luke's Episcopal Hospital
and Texas Children's Hospital. He was growing increasingly frustrated with
his old mentor. He often felt unappreciated and left out
of the spotlight. And he didn't approve of Debatey's style
of leadership.
Speaker 8 (07:22):
That felt that he was too abusive of all of
his residents, medical students, and so forth. And I didn't
think I could be permanently involved in that environment.
Speaker 5 (07:41):
On July thirteenth, nineteen sixty two, Cooley showed up to
a joint meeting of the Saint Luke's Episcopal and Texas
Children's Hospital boards with a radical proposal. Here's Denton Cooley's daughter,
doctor Louise Cooley Davis.
Speaker 9 (07:57):
My father said, I am the best pediatric heart surgeon,
and I would like to start my own program.
Speaker 5 (08:03):
A new hospital practically across the street from DeBakey's bail
Or College of Medicine, exclusively dedicated to cardiovascular health. For
branding purposes, Cooley gave it a simple memorable name, the
Texas Heart Institute. Though his initial budget was around four
(08:24):
point five million dollars, the hospital would end up costing
over ten times that.
Speaker 9 (08:31):
He did that with his own moneies, with his own donations,
with his patients donating, several Houston philanthropists donating.
Speaker 5 (08:40):
One of Cooley's largest donors was the chairman of the
Jim Beam whiskey distillery, Harry S. Bloom. After repairing the
wealthy businessman's ruptured aneurism, Cooley pulled a fundraising trick he
must have learned from Debate. He refused to present a
bill for his services, saying I can't put a price
on your life. Overwhelmed by the gesture, Bloom donated one
(09:04):
million dollars toward the creation of the Texas Heart Institute.
Cooley assembled an elite surgical team, many of whom were
so called refugees from Debatey's service. And while Cooley was
beloved by his staff for his affable personality and joke
telling his oars were ruthlessly efficient, he turned cardiac surgery
(09:27):
into something like an assembly line procedure.
Speaker 9 (09:31):
His team would open the chest, prep the bypass, then
my father would walk in and he would actually start
the surgery, and he had five rooms going at one time,
and I think hen associates who were doing the same thing,
so they could take care of thirty five patients a day.
My father never wanted to turn anybody away if they
(09:53):
needed surgery.
Speaker 5 (09:54):
He wanted to find a way to do it.
Speaker 10 (09:57):
There's not a pile of a day that could take
that spirit of Saint Louis and fly across Atlantic and
the curtain. Today they could do fourteen tough cases in
a day and Cooley could do it.
Speaker 5 (10:11):
That's cardiac surgeon, doctor Bud Frasier.
Speaker 10 (10:14):
He was so fast, and I've got his copies of
his operative reports that were all.
Speaker 11 (10:19):
In seconds, seven minutes, fifteen seconds, eight minutes, twenty two segments.
I never saw a one that they were on the
heart long. We seen more than twenty minutes. Maybe the
smooth as silk. He's the best technical servile overlo.
Speaker 5 (10:35):
Cooley performed so many hard operations. The nearby Shamrock Hilton Hotel,
which was constantly packed with his patients and their families,
came to be known as the Cooley Hilton. And while
many of his colleagues struggled to maintain anything resembling a
(10:56):
work life balance, Cooley always made to set aside time
for his family.
Speaker 9 (11:03):
Saturday mornings, we'd zip off to our family farm called
cool Acres, and he'd played tennis with us all day,
we'd played baseball, we'd ride horses, and then Sunday at
three o'clock we'd all pile into the station wagon because
he had to go to the hospital at five o'clock
to make rounds. I never really felt like he was
(11:25):
a surgeon when I was with him.
Speaker 6 (11:27):
He was my dad.
Speaker 5 (11:29):
For Michael DeBakey, on the other hand, finding time for
his wife and sons was more difficult to manage. There
was hardly enough time in the day for sleeping or
commuting to work.
Speaker 12 (11:44):
He was a notoriously fast driver.
Speaker 5 (11:47):
As a young cardiothoracic surgeon at Baylor, doctor Gerald Lourie
would occasionally ride with Debate between hospitals.
Speaker 12 (11:54):
He'd failed the suspension, bought them out, and then we'd
come out of that like the juice of hazard, I
mean literally four wheels in the air.
Speaker 5 (12:04):
DeBakey was in a race against time, obsessively devoted to
the care of his patients, not even totaling his Maserati
could slow the man down.
Speaker 12 (12:14):
One morning, I noticed he had a little glitter in
his hand, like a bunch of little sparkles and trying
to work out what this was. And someone came and said,
like to be the police are here. He had this
maserati and he tried to turn from the center of
the road into the left lane to get into the hospital.
(12:37):
Unfortunately that he'd been t bone. This was the shattered
windscreen that was in his hair, and he just got
out and said, you know, I'm busy, you know where
to find me and come in and started making rounds
with us. So that was kind of the atmosphere at
that time.
Speaker 5 (12:55):
Unlike Denton Cooley, de Bakey's work wasn't limited to oar
and hospital boardrooms. In Washington, d c. He helped establish
the National Library of Medicine. He chaired the President's Commission
on Heart Disease, Cancer and Stroke, and he publicly endorsed
Medicare when it was deeply unpopular.
Speaker 13 (13:16):
President Kennedy wanted to have a television conference in the
Rose Garden with some doctors showing what they supported Medicare
and asked me if I would join.
Speaker 5 (13:26):
That's an archival recording of Michael DeBakey.
Speaker 13 (13:29):
Well, I was the only one up thet When I
got home, I had a psycho telegram from doctors all
over the country calling me a trader, and some I'm saying,
I never referil patients of me. How else are you
going to take care of these poor people?
Speaker 14 (13:43):
Doctor de Bakey was frantically busy with many, many things.
He was flying to Washington periodically to consult with various presidents.
Monday morning, we'd be talking and we mentioned being up
at the White House or meeting over the weekend.
Speaker 5 (13:56):
Early on in his career, DeBakey had learned the value
of self promotion. The more his reputation grew, the more
power he had to affect change around the world.
Speaker 15 (14:08):
Surgeon to the Royalty of Europe and the Royalty of Hollywood.
Speaker 2 (14:12):
Michael E.
Speaker 15 (14:13):
Debaker, master surgeon, but also a politician. Also a man
who stormed through a twenty yard day, a man they
called the Texas Tornado.
Speaker 5 (14:24):
The man they called the Texas Tornado always made time
for celebrity patients, and he never hesitated to drop their
names in presentations and interviews.
Speaker 13 (14:34):
Well, yeah, Eatrick was referred to me, and she gave
me an autograph of herself. I didn't ask for it.
I had gotten to know Frank Sinafa quite well because
I took care of his father. He said, I'm giving
a party for Jack Benj's eightiess birthday.
Speaker 5 (14:50):
In the early nineteen sixties, Debate turned his focus to
a device that promised to revolutionize cardiac medicine.
Speaker 13 (14:57):
With all the fantastic things that you can do today,
what is it you can't do, What is it you
would like to do? We should be able to develop
a mechanical pump well substitute. And I'm convinced this can
be done.
Speaker 5 (15:11):
Debaki had a vision, but it would take a singularly
brilliant and dogged inventor to actually build such a device.
At the National University of Cordova in Argentina, a young
surgeon was hard at work as early as the nineteen fifties.
(15:37):
Domingo Liota, working alongside his older brother Salvador, had been
developing prototypes of the first artificial heart.
Speaker 16 (15:49):
He was kind of Frankenstein what he was doing.
Speaker 5 (15:52):
Patrick Liota is Domingo's youngest son.
Speaker 16 (15:55):
Everybody thought he was crazy, but he wasn't really ahead
of his Stein.
Speaker 5 (16:01):
The idea was crazy Nearly a decade before Christian Barnard
transplanted a human heart for the first time, Domingo Liota
was working to replace the organ with a small implantable pump.
In nineteen sixty one, Liota's radical experiments earned him an
invitation to the Cleveland Clinic, and it was there that
(16:22):
he caught the attention of Michael de Bakey.
Speaker 16 (16:26):
Michael invited him to work for one year, one year
as a fellowship in Texas, and he always said that
was the most important letter he ever had in his life.
That letter makes him feel that he wasn't the right path,
doing the right things.
Speaker 5 (16:43):
Liota stayed at Baylor for much longer than his initial
one year fellowship. His family settled into Houston society, his
kids were enrolled in American private schools, and Domingo Liota
was doing the most consequential work of his career. A
total artificial heart felt within reach. Here's cardiac surgeon, doctor
(17:05):
Bud Frasier again.
Speaker 11 (17:06):
I remember talking to the doctor to Aikia about nineteen
sixty four, and he told me by nineteen eighty there
would be one hundred thousand Americans.
Speaker 12 (17:15):
Was an artificial heart.
Speaker 5 (17:18):
DeBakey threw the full weight of his political influence into
obtaining government grants. In nineteen sixty five, he convinced Congress
to allocate forty million dollars to develop an artificial heart.
Four point five million of those funds would go to
de Baky's program. But with the surge and funding came expectations.
(17:40):
DeBakey felt an urgent pressure to deliver results, and as
much as he loved to herald the arrival of the
total artificial heart, in reality it was still years away
from human application. DeBakey needed something achievable in the short term.
Speaker 13 (17:56):
The total artificial heart was you know, complicated process.
Speaker 5 (18:02):
That's Michael debake again.
Speaker 13 (18:04):
They little much simpler to work on ELVAD, so that
was just one one ventricle.
Speaker 5 (18:11):
The ELVAD, or Left Ventricular Assist Device, was developed by
Domingo Liota as a stepping stone to a total artificial heart.
It was a grapefruit sized pump that could be implanted
in a patient's chest so long as the patient remained
tethered to a compressed air machine. The ELVAD would boost
(18:31):
the beating of their left ventricle, the pumping lower left
chamber of their heart, and while it may have been
a stretch to call the Elvad an artificial heart. Michael
DeBakey hadn't become the Texas Tornado by splitting hairs. In
January of nineteen sixty nine, at the fiftieth anniversary dinner
(18:53):
of the New York Art Association, DeBakey showed off a
model of the device to the audience and announced that
this artificial heart would be ready for human use within
a month. A week later, DeBakey gave the device to
President Lyndon Johnson, who then presented it to Congressman John E.
(19:13):
Fogerty in recognition of his work to allocate funding for
artificial heart research. A few weeks after that, DeBakey again
touted the Elvad when he appeared on Walter Cronkite's The
Twentieth Century series.
Speaker 17 (19:29):
Doctor Michael Ellis Devaki, the world renowned Houston specialist Maam
of the Month American Heart Month.
Speaker 5 (19:38):
So it came as no surprise when photographers and journalists
arrived at Methodist Hospital in Droves waiting to capture the
successful implantation of the world's first artificial heart. De Bakey
stoked the flames of the media frenzy when he delivered
a two hour press conference to introduce the implant team
(19:58):
and concluded the tea is ready. They were just waiting
on the ideal recipient. Sixty five year old retired coal
miner Marcel de Rudder had suffered from heart problems for decades.
(20:23):
In the spring of nineteen sixty six, DeBakey planned to
replace Marcel's diseased mitra valve with a prosthetic one. The
problem was that Marcel's heart had deteriorated to such an
extent that it might not be capable of beating on
its own after the operation. DeBakey presented the dying patient
(20:43):
with an option of last resort. If Marcell's heart could
not be revived, DeBakey wanted to test out the ELVAD.
Speaker 18 (20:52):
I explained to him that we felt quite confident about
it on the basis of our experimental word and that
I thought that it would be a additional value and
reducing the risk of the operation.
Speaker 5 (21:05):
Marcel knew that there was a strong possibility he would
not survive. He told his wife Edna that he was
willing to serve as a guinea pig so that DeBakey
might learn something that would save someone else. On April
twenty first, nineteen sixty six, two days after Debake's press conference,
(21:26):
Marcel de Rutterer was wheeled into anr at Methodist hospital.
Bakey had arranged for the entire operation to be filmed
from overhead and documented in close up by a still photographer,
none other than Life magazine's Ralph Morris, the official photographer
(21:49):
of the Mercury Astronauts. DeBakey implanted the prosthetic valve and
shut off the heart lung machine, but in its weekends date,
Marcel de Rutter's heart refused to regain its rhythm. Just
as DeBakey had anticipated, the ELVAD had become Marcel's only
(22:10):
shot at survival. DeBakey sheared one of Marcel's ribs to
make room for the device, and then he began sewing
the ELVAT into place. Two hours into the operation, Marcel's
heart once again started to beat. After a few panic
(22:33):
filled stops and starts, Marcel was on track for recovery.
DeBakey left the oar and headed straight for a press conference.
Speaker 19 (22:45):
They asked, if it is an extremely difficult operation or
can it be done by surgeons around the world. Oh, certainly,
this is not a difficult operation for any team that
is experienced in cardiovasco surgery, and.
Speaker 5 (23:00):
The papers all across the country ran headlines like artificial
heart patient doing well and artificial heart beats on. Despite
the fact that the heart Marcel de Rudder was born
with was still beating inside his chest. Rarely did the
(23:21):
news coverage mention the name Domingo Liota. Twenty four hours
after the alvat implantation, Marcel de Rudder still had not
regained consciousness. With every hour that passed, it grew likelier
that he'd suffered brain damage during the operation. Debaky resumed
(23:44):
his grueling daily routine, but he spent his nights on
a cot in the ICU to keep close watch of
his star patient. Four days later, after his left lung ruptured,
Marcel de Rudder died.
Speaker 16 (24:02):
Doctor Debake, the object of your heart booster implant was
to prolong the patient's life.
Speaker 15 (24:08):
Since the patient died, why do you say that the
operation was a success.
Speaker 18 (24:13):
Well, I must feedback. The operation was a success on
the basis of the fact that the pump did the
job we wanted it to do. The patient's death was
due to causes beyond our control.
Speaker 5 (24:28):
The response from the medical community was swift and brutal.
DeBakey's peers condemned him for publicizing an untested procedure and
for giving false hope to patients dying from heart ailments,
and a personal letter to DeBakey, doctor Eugene Bricker of
Washington University in Saint Louis characterized his old colleagues behavior
(24:52):
as unethical and a discredit to the profession of surgery.
At Mimonode's Hospital in Brooklyn, doctor Adrian Cantrewitz announced that
he'd implanted a similar device two months prior, but had
refrained from publicizing the operation until he could be certain
of its long term success. We do things differently in Brooklyn,
(25:15):
Caantrowitz said to reporters, I did everything possible to keep
this out of the newspapers. DeBakey took issue with this criticism.
He felt the American public had a right to know
how four point five million dollars of their tax money
was being spent, but he'd learned his lesson when he
attempted another ELVAT implantation less than a month later. He
(25:38):
made no big announcements and held no press conferences. The
patient died within three days, DeBakey again shut out the
press when the opportunity arose for yet another attempt. Esperanza
del vae Vasquez, a thirty seven year old beautician for Mexico,
(26:00):
had suffered from lifelong rheumatic heart disease. The condition had
wreaked havoc on the valves of her heart.
Speaker 2 (26:07):
She had involvement of her aortic valve and her mitro valve.
She needed two valves. It was very uncommon to get
someone through a two valve replacement.
Speaker 5 (26:19):
That's doctor Billy Kohane Again. On August eighth, nineteen sixty six,
de Bakey brought Esperanza into surgery.
Speaker 2 (26:27):
Doctor Debaki said, ring me all that in let's try.
It lowered the pressure in or a left atrium, so
her lungs weren't being beat by pressure and the flow
through her body was dramatically increased.
Speaker 5 (26:44):
Esperanza's heart recovered to such an extent that, after ten
days with the device to baky decided he could safely
remove the elvat.
Speaker 2 (26:53):
He took the device out at bedside. He pulled it
out just a little bit without pulling in out of
the heart. Even I feel a little pinched down. You know,
clamped it, cut it, sewed it off and let it
drop back in and closed the skin over it.
Speaker 5 (27:11):
After a month spent recovering in the Icu, Esperanza was
discharged and returned home to her family in Mexico City,
the first survivor of an Elvad implant. As the Elvad
made headlines around the world, its creator, Domingo Liota, felt
left in the dust.
Speaker 16 (27:32):
They excluded his name from a lot of these presentations.
Sometimes the baker went by himself to these congresses and
presented like it was his idea.
Speaker 5 (27:43):
That's Domingo Liota's son, Patrick Liota. Again, Diveke was the boss.
Speaker 16 (27:49):
He was the guy who can't get the money, and
he was the guy who wanted the credits to.
Speaker 5 (27:54):
As for Liota's dream of implanting a total artificial heart,
he felt it slipping through his fingers. After the success
of the Alvat, it seemed to him that DeBakey had
lost interest in the total artificial heart entirely, and Liota
would do anything to see his dream brought to life.
Speaker 7 (28:25):
Doctor Liota was very depressed because he couldn't even get
an appointment doctor Debaki to show him his herd idea.
Speaker 5 (28:34):
Doctor Don Wukash was working alongside Domingo Liota in the
bail Or animal lab when he witnessed a meeting that
changed the course of history.
Speaker 7 (28:43):
I was there one day when doctor Curny happened to
come by and said, I had to Mingo, what are
you doing? He said, well, I'm working on this artificial heart.
Speaker 5 (28:53):
Fearing the squandering of his life's work, Liota proposed to
Coolly a new partnership. Here's Denton Cooley again.
Speaker 17 (29:02):
I thought and agreed that Nu Lee are at the
time it come to really give it a test, and
the only real test would be to apply it to
a dying patient.
Speaker 5 (29:12):
December nineteen sixty eight marked one year since Christian Barnard's
historic heart transplant operation. In that short span of time,
transplant fever had subsided. Nearly all of Cooley's transplant recipients
had died after their bodies rejected the donor hearts. Leota's
total artificial heart, which was made from synthetic materials and
(29:35):
therefore wouldn't be subject to organ rejection, looked like the
breakthrough Kooley had been waiting for.
Speaker 4 (29:41):
It.
Speaker 7 (29:42):
That was the beginning of the relationship with doctor Kulia
doctor Liota doctor Culli Star recruited him away to work
on weekends and nights on the artificial heart.
Speaker 5 (29:54):
According to Cooley, he and Liota began working in secret
on an altogether new artificial heart. They started with Leota's
original prototype from Argentina and developed it from there. They
hired a Rice University engineer to build a power console
for the device, paid for with funds from Cooley's foundation
(30:17):
and a few small grants. Beginning in January of nineteen
sixty nine, Leota implanted their artificial heart into seven calves
in the Baylor Animal Lab, the last of which lived
for forty four hours. With the device, the two men
concluded that their total artificial heart was ready for human use.
(30:45):
In a room at Saint Luke's Episcopal Hospital, a forty
seven year old man named Haskell Karp was dying. Haskell
had worked as a printing estimator in downtown Chicago until
his career was cut short by severe heart disease. He'd
suffered a series of heart attacks. He had a pacemaker
(31:05):
implanted to combat heart block, and by the spring of
nineteen sixty nine he was unable to do much of
anything besides weight for a miracle. After evaluating Haskell Karp's condition,
Denton Cooley recommended that he undergo a procedure called a
ventriculoplasty to remove the damaged tissue from his heart.
Speaker 2 (31:29):
You'd go on the heart lung machine. You'd cut out
the scar and replace it with a piece of dacron
polyester fabric. It was the size that it used to
be before it ballooned out.
Speaker 5 (31:39):
That's doctor Billy Cohne again.
Speaker 2 (31:41):
Doctor Cooley said, listen, mister Carp, I could try this
operation on you, but I think it's not going to work.
Your heart is too severely involved. If I think, if
I cut away all that scar, your heart's not going
to like it.
Speaker 5 (31:56):
If the operation went south, Cooley's next best option would
be to transplant a new heart into Haskell's chest, but
finding a donor was proving near impossible.
Speaker 17 (32:10):
We were having a more difficult time getting donors, and
here was a man who needed a transplant and needed
it badly and immediately.
Speaker 5 (32:22):
In Haskell Karp. Cooley saw a need for the total
artificial heart. His and Leota's device might buy Haskell a
little time, something the dying man desperately needed. Cooley also
saw an opportunity. This was his chance to push the
field of cardiac surgery forward, to perform a revolutionary new operation,
(32:46):
just like his mentors Alfred Blaylock and Vivian Thomas did
when they pioneered the Blue Baby operation back in nineteen
forty four, just like Walt Lillahei did again and again
throughout the nineteen fifties, and just like Christian Barnard did
a little over a year earlier, making him the most
famous man in the world. Detton Cooley was the best
(33:06):
technical surgeon alive. If anyone could pull this off, it
was him. Cooley was aware that he was inviting the
wrath of Michael de Bakey, but he wasn't going to
let a little rivalry get in the way of changing
the world.
Speaker 17 (33:20):
Well oday is It didn't feel like we needed permission,
And I think if I had sought permission from say,
the federal agency or the hospital with him, I think
I probably would have been denied, and we ever lost
to gold on opportunity.
Speaker 5 (33:36):
As his old friend Walt Lillahyde liked to say, ready
fire aim. On April third, nineteen sixty nine, Cooley met
with Haskell Karp and his wife Shirley to talk over
the plan. He brought with him a rabbi to consult
with the couple and to consent for him. Here's Shirley
(33:59):
Krp explaining the choice her husband faced that day.
Speaker 20 (34:03):
It's so personal. You can't advise anybody, and you can't
take advice from anybody in the situation such as this.
I understood what this decision meant to him, and because
of that, I agreed with him. It takes a strong
(34:26):
person to try to help himself.
Speaker 5 (34:36):
The following afternoon, as Debate's plane took off from the
Houston Hobby Airport headed for Washington, d C. Haskell Karp
was wheeled into surgery. He was pale, sweating profusely, and
gasping for air. His anesthesiologist felt that Haskell would die
(34:58):
right there in the hallway were not for immediate surgical intervention.
Cooley rushed to the oar and prepped for surgery. It
was his fifth heart operation of the day. He opened
Haskell's chest to find a severely scarred organ beating within.
(35:19):
He said he'd never seen a worse looking heart. Though
it was unlikely to work, Cooley dutifully attempted the ventriculo plasty,
removing a whopping thirty five percent of Haskell's left ventricle.
But the heart was beyond saving. Cooley's attempts to shock
(35:39):
and massage it back into rhythm were in vain.
Speaker 21 (35:43):
At the end of the operation, the heart didn't have
much muscle left and he would not come off the pump.
So this this is a room full of people and
you're looking to say, how's Kooley going to get out
of this?
Speaker 2 (35:58):
One.
Speaker 5 (35:59):
Trauma and car radiovascular surgeon doctor Kenneth Maddox was in
the room during the Haskell carp operation.
Speaker 21 (36:06):
All of a sudden, into the room came a big device. Now,
this device turned out to be this artificial heart that
had been developed by Dominico Laota. At the time, we
didn't know that history. We just knew that here came
in something new, and out came the heart.
Speaker 5 (36:27):
Cooley began attaching the device to the blood vessels in
Haskell's chest. Pushing a needle through silicone tubing is much
harder than suturing human tissue, even for the Great Dent
and Cooley, and yet the entire procedure took only about
two hours. They switched on the power console and then
(36:48):
Cooley and Leoda watched intense silence as their total artificial
heart began to work just as much as Showman as
his former mentor, Michael de Bakey. Cooley reported on his
success in a press conference that night.
Speaker 22 (37:08):
The AM news station was on in the kitchen radio
and next thing I knew is that I heard them.
I heard them say my dad's name.
Speaker 5 (37:18):
Marty Karp was just eleven years old at the time
of his father's operation.
Speaker 22 (37:24):
I felt the blood just drained from my body. It
was just surreal. And then I heard the words artificial heart.
It was like being in the middle of a science
fiction movie rather than we.
Speaker 17 (37:38):
Can look for a week or ten days. That was
satisfying my eyes.
Speaker 3 (37:43):
Hope we can't find a donor in that period of time.
Speaker 17 (37:46):
Hopefully the device will carry on for a long apparent time.
Speaker 5 (37:52):
When the press conference was over, Denton Cooley took the
unorthodox step of welcoming a camera crew into the room.
Haskell Karp was recovering, it's greatly great.
Speaker 4 (38:06):
Can we get something for you, Wes spunge?
Speaker 7 (38:12):
Can you say it again? Well, sponge?
Speaker 4 (38:16):
You want a wet sponge? You'd like a drink? Could
you turn the other way, so we can get your pictures.
Speaker 7 (38:21):
Speak louder.
Speaker 4 (38:23):
What can we get for you?
Speaker 17 (38:25):
Spue?
Speaker 4 (38:26):
Are you thirsty? What could you open your eyes for us?
Let's look at the color of your eyes. Open real wide,
look up above your head for us.
Speaker 17 (38:33):
That's it.
Speaker 4 (38:36):
You realize you had your heart operation about twelve hours ago.
Speaker 5 (38:40):
I almost three years to the day since Marcel de
Rudder's Elvat implantation was swept up in a media maelstrom.
The first total artificial heart operation was playing out in
much the same way, but at least in the case
of Haskell carp the publicity was serving a very real purpose.
(39:04):
Leota and Cooley's device was purely a stopgap. Haskell still
needed a heart donor, and Cooley was gambling that the
front page news coverage might help them find one. The
morning after her husband's surgery, Cooley invited Shirley krp out
in front of the cameras.
Speaker 23 (39:24):
Somewhere somewhere, please hear my, please, a please for a
heart for my husband. I see him lying there, breathing
and knowing that within his chest is a man made
implement where there should be a God given heart. How
long can he survive?
Speaker 5 (39:54):
Shirley's please worked almost immediately. The calls began coming in,
but for various reasons, none of the hearts was a
good fit. One donor heart stopped beating while in transit
from East Texas. Several calls came from individuals offering to
end their own lives in order to save Haskells. On
(40:16):
April sixth, with Haskell in critical condition, the hospital received
a promising call from the family of a comatosed woman
in Massachusetts. Within hours, a lear jet was on its
way to pick up the potential donor. Three flights, one
emergency landing, and a frantic ambulance ride across Houston later,
(40:39):
the donor heart was ready to be transplanted. By now,
Haskell Karp had been living with the Leota Cooley device
for sixty four hours, longer than any of the animal
test subjects. Cooley reopened Haskell's ribcage and performed a swift
and elegant transplant. Once again, a human heart was beating
(41:04):
in Haskell's chest. It wasn't long before his health started
to deteriorate.
Speaker 22 (41:14):
Things were going south. Kidney feller and pneumonia were now
the big concern.
Speaker 2 (41:20):
They dumped a bunch of steroids in him and just
really amino suppressed him, and thirty two hours later he
died just too much aminosuppression.
Speaker 5 (41:39):
Four days after his first operation, Haskell Karp was dead,
but the total artificial heart had allowed him to live
long enough to receive a transplant. It was the first
step toward a future where humans could survive with machines
in place of their hearts. And after a career spent
in the show Shadow of Michael de Bakey, Denton Cooley
(42:02):
had finally stepped out into the spotlight. His face appeared
in newspapers and TV news programs. Reporters all over the
world were saying his name, and for a very different reason,
So too were administrators at the Baylor College of Medicine.
(42:22):
Even before DeBakey returned from Washington, d C. The Baylor
Committee on Research Involving Human Beings gathered for an emergency meeting.
Here's doctor Gerald Lourie again.
Speaker 12 (42:36):
I think it was pretty clear that this was an
unauthorized use. This artificial heart was being developed under a
federal government contract, and there were very stringent requirements in
place to ensure that there would be a significant cause
and review at the end of the animal phase before
it was put in a human.
Speaker 5 (42:56):
As for Cooley's claim that the total artificial heart was
an original design distinct from Liota's work at Baylor, Michael
Debake insisted that this was nonsense.
Speaker 13 (43:08):
Now like Cooley had no experience with the artificial line
program at all, didn't do any laboratory work. He was
a good surgeon, but that's all.
Speaker 5 (43:18):
While the Liota Cooley device made use of unique tilting
disc valves, Liota would later admit that he'd taken other
components from his artificial heart work at Baylor, and when
Cooley was asked whether the heart he used was Debate's,
he replied, yes, I guess in effect, I took it.
Cooley continued, I just couldn't let another man die on
(43:41):
the operating room table. When Debake arrived back in Houston
the monday after the operation, his first step was to
form an investigative group to determine whether there had been
(44:02):
a violation of government guidelines and if Baylor could be
held responsible for it.
Speaker 21 (44:09):
Doctor Debake was most concerned about the impact that this
activity might have on all other research and funding coming
from the federal government.
Speaker 5 (44:24):
That's doctor Kenneth Maddox again.
Speaker 21 (44:26):
Theoretically they could removed and killed all federal research. Baylor
was really depending upon that research for financing the school.
Speaker 5 (44:37):
For Denton Cooley, on the other hand, Debate's response felt
less political than personal. Here's doctor Billy Cohne again.
Speaker 2 (44:47):
Doctor debake came back and looked at this as an
absolute betrayal. He closed down the animal lab, fired everybody.
Bud Frasier, actually he was in Vietnam when all this
is going arn and he recounts that being in Vietnam
for a young heart surgeon was probably a safer place
than being in Houston.
Speaker 5 (45:09):
Coolly accused his former mentor of instigating a global smear
campaign against him, compiling a packet of false allegations and
sending them to surgical departments all over the US and Europe.
Speaker 7 (45:23):
It was a personal attack. It was an all out ward.
Speaker 5 (45:28):
That's doctor Don Wukash again.
Speaker 7 (45:31):
Doctor de Bakey had plenty of reasons to be angry.
It hurt. It's not that what was right and what
was wrong they both were playing a little bit dirty pool.
Speaker 5 (45:49):
On April eighteenth, De Bakey's investigative group concluded that the
Liota Cooley total artificial heart had been developed using DeBakey's
grant money, and that implanting it in Haskell Karp violated
the government guidelines. Cooley was censured by the Harris County
Medical Society, the American College of Surgeons, and the National
(46:11):
Heart Institute. Over the next several months, he made a
series of attempts to reconcile with Tobaki, but they were
all either ignored or rejected. On September second, he resigned
from Baylor. Cooley devoted his full energy to building the
(46:32):
Texas Hart Institute. He brought Lioda onto his staff, and
for the next two years it seemed as if the
Haskell Carp fiasco was behind them, but Cooley and Liota's
problems had only just begun. Here's Haskell and Shirley's son,
Marty Karp again.
Speaker 22 (46:51):
When my mother first came back from Houston, she thought
doctor Cooley was a saint. Then some people tried to
like wake her up to reality a little bit. And
not to say that he didn't have the best of intentions,
but I feel like he was being an opportunist, as
here was a situation with a person that really had
(47:11):
little hope.
Speaker 5 (47:13):
In April of nineteen seventy one, Shirley Karp filed a
lawsuit against Cooley and Liota, alleging that she and her
husband had not been fully informed about the artificial heart
or the fact that Haskell was participating in a human experiment.
Speaker 22 (47:29):
Supposedly, he signed papers saying it was okay that if
there was nothing else that could be done in surgery,
that it would be acceptable to do this. My mom
says he would have shared that with her, but I
doubt my father would have shared it with her in
advanced because I'm sure she wouldn't have agreed. You know,
he was making his own decisions.
Speaker 5 (47:51):
For the next year, the trial loomed over Cooley and Liota.
As always, Cooley managed to downplay his anxiety, exuding his
usual self assured charm.
Speaker 9 (48:04):
He never really acted like things were bothering him to
the daughters, or at least not to me. But I'm
sure it was terribly stressful and embarrassing.
Speaker 5 (48:15):
That's doctor Louise Cooley Davis. Again.
Speaker 9 (48:18):
He just kept mushing through going forward because I think
he truly felt like he was trying to do the
best for that patient and for the development of heart surgery.
Speaker 5 (48:38):
On June nineteenth, nineteen seventy two, Cooley and Leota arrived
in federal court for the first day of their trial.
Shirley Karp took the witness stand and testified about her
confusion in the hours before her husband's operation. She felt
the decision was rushed and that Cooley had been impatient
(49:02):
for Haskell to give his consent. Implicit in all this
with the accusation that by operating on Haskell Karp, Cooley
had acted not in his patient's best interest, but in
his own. Cooley strongly objected to these allegations.
Speaker 17 (49:19):
I believe that we as surgeons have an implied contract
with our patients to keep them alive. I think that
it comes to time when the surgeon must assume certain responsibilities,
and if it means taking a risk with his reputation,
I think that he would be neglectful of his duty
(49:39):
if he withdrew from that risk.
Speaker 5 (49:43):
Shirley Karp's case would hinge on the testimony of one man.
As a pre eminent surgeon and a leader in the
field of artificial hearts, Michael de Bakey was perhaps the
only doctor in the world with the qualifications to testify
against Denton Cooley. Not only that he had an ax
to grind. When debake was subpoened as an expert witness
(50:06):
for the plaintiff, he was positioned perfectly to exact his
revenge and deal a death blow to Cooley's career, and
yet he didn't. Speaking privately in the judge's chambers, DeBakey
asserted that he had no special knowledge of the case,
(50:27):
and he refused to offer his medical opinion. Whether it
was due to some lingering fondness for his old protege
or simply a doctor's distaste from olpractice lawsuits, DeBakey had
shown mercy. Without Debaki's testimony, Shirley Carp's case became a
lost cause. The judge delivered a directed verdict that favored
(50:50):
Koli and Liota, and Shirley Carp lost again on appeal.
Michael Debatey and Denton Cooley came face to face once
more before the trial was over. Here's doctor Don Wucash again.
Speaker 7 (51:09):
I remember that be at breaks, sort of a mid
morning breaking the trial. So doctor Curley and I walked
out into the hall and we came to a corner.
Doctor DeBakey turned the corner and there we were. I
was in the middle and it was the most awkward
moment of my whole life. I'm sure it was for
(51:31):
them too. And doctor Debay just lectured doctor Curley and
didn't say anything and kept walking, and doctor Curley did
the same thing. So it was a really a sad
moment in a unfortunate ending for what had started out
with him to be a father's son relationship.
Speaker 5 (51:55):
Despite the promise of the total artificial heart, progress slow
after the Haskell Carp operation. Cardiac surgery was no longer
the lawless frontier it had once been, and Cooley and
Liota had suffered consequences for their experiment that would have
been unthinkable just a decade earlier. Today, the dream of
(52:18):
a fully implanted, permanent, total artificial heart remains just beyond
the horizon. The LVAD, on the other hand, has become
a common life saving measure for patients suffering from heart failure.
Thousands of Americans are implanted with elvads every year. That's
thanks in large part to the pioneering work of doctor
(52:38):
Bud Fraser, a trainee of both Michael DeBakey and Denton Cooley.
After the Haskell Carp operation, DeBakey and Cooley's professional split
forced many of Houston's best surgeons. To choose sides, you
(53:00):
had to make a choice.
Speaker 7 (53:01):
Who do you want to spend the best of your
professional career with. There's not an easy choice.
Speaker 5 (53:08):
In nineteen seventy, Life Magazine printed a cover story titled
A Bitter Feud describing the ongoing war between Doctor Wonderful
Denton Cooley and the Texas Tornado Michael de Bakey. Debaky
and Cooley's relationship had come to an end. Though they
worked just as stone's throw from each other, it would
(53:31):
be nearly four decades for the two men exchanged another word.
Speaker 1 (53:43):
On our next episode, Walt Lilla Haih's years of living
and operating on the edge finally catch up with them,
and Houston Doctor's attempt to bring a decades long feud
to an end next time on Cardiac Cowboys.
Speaker 5 (54:10):
Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios
and Thirteenth Lake Media. We're presented by Chris Pine and
written and narrated by me Jamie Appley. Our executive producers
are Christina Everett for iHeart Podcasts, Dub Cornette and Jason
(54:30):
Ross for OsO Studios. Doctor Gerald Imber, author of Cardiac
Cowboys The Heroic Invention of Heart Surgery. Doctor Eric A. Rose,
John Mankowitz, Joshua Paul Johnson, and myself. James A. Smith
is our supervising producer, editing and sound design by Joshua
(54:51):
Paul Johnson. Our composer is David Mansfield. Our cover artwork
is designed by Alexander Smith. For more information on the
first cardiac surgeons, check out doctor Gerald Dimber's book Cardiac Cowboys,
The Heroic Invention of Heart Surgery.
Welcome to the wild West of American medicine. I'm Chris
Pine in This is Cardiac Cowboys, the gripping true story
behind the birth of open heart surgery and the Maverick
surgeons who made it happen. When the race to perform
a human heart transplant kicked off at the beginning of
(00:21):
the nineteen sixties, Baylor's surgical chief Michael DeBakey was one
of the first surgeons to recognize its limitations. Even if
Doctor's canceled the issue of organ rejection and rewrite the
definition of death, one glaring problem remains. There simply aren't
enough donor hearts to go around.
Speaker 2 (00:39):
There are four hundred thousand Americans that die of heart
failure a year. Expanding the pool is a drop in
the bucket.
Speaker 1 (00:47):
That's cardiovascular surgeon Doctor Billy Cone.
Speaker 2 (00:51):
Lynn Warner Stevenson, a famous cardiologist, says counting on heart
transplantation to cure the woes associated with heart failure is
like counting on the lottery to cure poverty.
Speaker 1 (01:07):
So rather than competing with the likes of Christian Barnard
and Norm Shumway, DeBakey set his sights further into the future,
a future in which a failing human heart can be
replaced with something else entirely. For the last eight years,
debake and his team have been building the world's first
man made heart. Back in nineteen sixty one, DeBakey recruited
(01:34):
a brilliant Argentine surgeon named Dimingo Liota to spearhead an
artificial heart program at Baylor. The two men have spent
the better part of a decade working together toward a
breakthrough that could potentially save hundreds of thousands of lives
every year. Thanks to Debake's extensive lobbying, Liota's research has
been funded with millions of dollars in government grants, and
(01:57):
that's what brings DeBakey on April fourth, nineteen sixty nine,
to Washington, d C. DeBakey checks into the Hay Adams,
a luxury hotel that overlooks the White House. Tomorrow, he's
due at the National Heart Institute in Bethesda, Maryland, to
(02:18):
give an update on his and Domingo Liota's progress. He's
preparing his notes when a call comes in from Houston.
The news he hears doesn't make much sense. Debake's former protege,
Denton Cooley, has just saved a dying man's life by
implanting an artificial heart into his chest. But Cooley doesn't
(02:42):
have an artificial heart program. As far as Debake knows,
Cooley was never much interested in the idea, So how
can he already have a working artificial heart of his own?
At Saint Luke's Episcopal Hospital in Houston and a press
conference is taking place.
Speaker 3 (03:03):
What we have done is to replace the human heart
with a completely mechanical device. The replacement is a total one.
The heart has been removed and the replacement is done
in the cavity in which the heart usually lies.
Speaker 1 (03:18):
Black and white television screens all over the world flicker
with the smiling, handsome face of forty eight year old
Denton Koolie.
Speaker 4 (03:26):
How long do you think you can keep the device
working in the body?
Speaker 3 (03:29):
I see no reason why I wouldn't function for periods
of a month or more. But at the present time
we can look for a week or ten days that
would satisfy my highest hopes.
Speaker 1 (03:43):
Sitting beside Kooley in his white lab coat is doctor
Domingo Liota, Debake's artificial heart expert from Argentina. Cooley is
claiming the two of them developed this device together.
Speaker 5 (03:56):
But how could that be.
Speaker 1 (03:57):
Liota was hired by Debate, his research was paid for
with Debake's grants, and then DeBakey sees a photograph of
Cooley and Liota's invention, and he's stunned. Now he understands
they use the exact same heart. DeBakey will later say
to Life Magazine, they weren't even clever enough to make
(04:18):
it look different. Michael DeBakey feels betrayed. He believes his
work and funding have been stolen by surgeons whose careers
he made. By Denton Cooley, of all people, the man
who once showed up at his doorstep to brace him
for attempting to repair a child's heart defect using Cooley's
(04:39):
coffee pot bubble oxygenator. Worst of all, if it turns
out that Cooley and Liota's device was indeed funded with
Debake's grant money, this operation violated the government's guidelines for
human experimentation, it won't just be devastating to Cooley in
Liota's careers, it could tear down Debates two, along with
(05:01):
the empire he's built at Baylor. FROMOSO Studios, This is
Cardiac Cowboys, a podcast about life, death, and innovation in
the American Heartland episode five, A Man Made Heart. Here's
(05:33):
writer and executive producer Jamie Napoli.
Speaker 5 (05:37):
Back in the nineteen fifties, Michael DeBakey and Danton Cooley
were building their larger than life reputations one surgery at
a time. Thanks to the unparalleled speed and precision of
his surgical work, Cooley was rapidly outpacing DeBakey's heart program.
Between the two surgeons, a competition.
Speaker 6 (05:59):
Was then or later, we began to ask some conflict.
Speaker 5 (06:06):
That's an archival recording of Denton Cooley.
Speaker 7 (06:09):
And doctor de Bacon.
Speaker 6 (06:10):
Might hear that I've removed any organism, I'd probably upset
him to some extent because I hadn't called upon him
for advice in those early days. But one thing after another,
Mike and I began a bit of a rivalry.
Speaker 7 (06:28):
This was a typical father son complex.
Speaker 5 (06:32):
That's cardiothorastic surgeon doctor Don Wukash, who worked with both
Koley and Debatey.
Speaker 7 (06:38):
Doctor Culley got to be around the midlife crisis around
forty years. He wants to have a little separation and
a little self identity, and if the father figure is
unable to let go of control, and the son character
is willing to fight for this independence. You have this break.
Speaker 5 (07:02):
While Cooley remained a faculty member at Baylor, he moved
his clinical practice to the nearby Saint Luke's Episcopal Hospital
and Texas Children's Hospital. He was growing increasingly frustrated with
his old mentor. He often felt unappreciated and left out
of the spotlight. And he didn't approve of Debatey's style
of leadership.
Speaker 8 (07:22):
That felt that he was too abusive of all of
his residents, medical students, and so forth. And I didn't
think I could be permanently involved in that environment.
Speaker 5 (07:41):
On July thirteenth, nineteen sixty two, Cooley showed up to
a joint meeting of the Saint Luke's Episcopal and Texas
Children's Hospital boards with a radical proposal. Here's Denton Cooley's daughter,
doctor Louise Cooley Davis.
Speaker 9 (07:57):
My father said, I am the best pediatric heart surgeon,
and I would like to start my own program.
Speaker 5 (08:03):
A new hospital practically across the street from DeBakey's bail
Or College of Medicine, exclusively dedicated to cardiovascular health. For
branding purposes, Cooley gave it a simple memorable name, the
Texas Heart Institute. Though his initial budget was around four
(08:24):
point five million dollars, the hospital would end up costing
over ten times that.
Speaker 9 (08:31):
He did that with his own moneies, with his own donations,
with his patients donating, several Houston philanthropists donating.
Speaker 5 (08:40):
One of Cooley's largest donors was the chairman of the
Jim Beam whiskey distillery, Harry S. Bloom. After repairing the
wealthy businessman's ruptured aneurism, Cooley pulled a fundraising trick he
must have learned from Debate. He refused to present a
bill for his services, saying I can't put a price
on your life. Overwhelmed by the gesture, Bloom donated one
(09:04):
million dollars toward the creation of the Texas Heart Institute.
Cooley assembled an elite surgical team, many of whom were
so called refugees from Debatey's service. And while Cooley was
beloved by his staff for his affable personality and joke
telling his oars were ruthlessly efficient, he turned cardiac surgery
(09:27):
into something like an assembly line procedure.
Speaker 9 (09:31):
His team would open the chest, prep the bypass, then
my father would walk in and he would actually start
the surgery, and he had five rooms going at one time,
and I think hen associates who were doing the same thing,
so they could take care of thirty five patients a day.
My father never wanted to turn anybody away if they
(09:53):
needed surgery.
Speaker 5 (09:54):
He wanted to find a way to do it.
Speaker 10 (09:57):
There's not a pile of a day that could take
that spirit of Saint Louis and fly across Atlantic and
the curtain. Today they could do fourteen tough cases in
a day and Cooley could do it.
Speaker 5 (10:11):
That's cardiac surgeon, doctor Bud Frasier.
Speaker 10 (10:14):
He was so fast, and I've got his copies of
his operative reports that were all.
Speaker 11 (10:19):
In seconds, seven minutes, fifteen seconds, eight minutes, twenty two segments.
I never saw a one that they were on the
heart long. We seen more than twenty minutes. Maybe the
smooth as silk. He's the best technical servile overlo.
Speaker 5 (10:35):
Cooley performed so many hard operations. The nearby Shamrock Hilton Hotel,
which was constantly packed with his patients and their families,
came to be known as the Cooley Hilton. And while
many of his colleagues struggled to maintain anything resembling a
(10:56):
work life balance, Cooley always made to set aside time
for his family.
Speaker 9 (11:03):
Saturday mornings, we'd zip off to our family farm called
cool Acres, and he'd played tennis with us all day,
we'd played baseball, we'd ride horses, and then Sunday at
three o'clock we'd all pile into the station wagon because
he had to go to the hospital at five o'clock
to make rounds. I never really felt like he was
(11:25):
a surgeon when I was with him.
Speaker 6 (11:27):
He was my dad.
Speaker 5 (11:29):
For Michael DeBakey, on the other hand, finding time for
his wife and sons was more difficult to manage. There
was hardly enough time in the day for sleeping or
commuting to work.
Speaker 12 (11:44):
He was a notoriously fast driver.
Speaker 5 (11:47):
As a young cardiothoracic surgeon at Baylor, doctor Gerald Lourie
would occasionally ride with Debate between hospitals.
Speaker 12 (11:54):
He'd failed the suspension, bought them out, and then we'd
come out of that like the juice of hazard, I
mean literally four wheels in the air.
Speaker 5 (12:04):
DeBakey was in a race against time, obsessively devoted to
the care of his patients, not even totaling his Maserati
could slow the man down.
Speaker 12 (12:14):
One morning, I noticed he had a little glitter in
his hand, like a bunch of little sparkles and trying
to work out what this was. And someone came and said,
like to be the police are here. He had this
maserati and he tried to turn from the center of
the road into the left lane to get into the hospital.
(12:37):
Unfortunately that he'd been t bone. This was the shattered
windscreen that was in his hair, and he just got
out and said, you know, I'm busy, you know where
to find me and come in and started making rounds
with us. So that was kind of the atmosphere at
that time.
Speaker 5 (12:55):
Unlike Denton Cooley, de Bakey's work wasn't limited to oar
and hospital boardrooms. In Washington, d c. He helped establish
the National Library of Medicine. He chaired the President's Commission
on Heart Disease, Cancer and Stroke, and he publicly endorsed
Medicare when it was deeply unpopular.
Speaker 13 (13:16):
President Kennedy wanted to have a television conference in the
Rose Garden with some doctors showing what they supported Medicare
and asked me if I would join.
Speaker 5 (13:26):
That's an archival recording of Michael DeBakey.
Speaker 13 (13:29):
Well, I was the only one up thet When I
got home, I had a psycho telegram from doctors all
over the country calling me a trader, and some I'm saying,
I never referil patients of me. How else are you
going to take care of these poor people?
Speaker 14 (13:43):
Doctor de Bakey was frantically busy with many, many things.
He was flying to Washington periodically to consult with various presidents.
Monday morning, we'd be talking and we mentioned being up
at the White House or meeting over the weekend.
Speaker 5 (13:56):
Early on in his career, DeBakey had learned the value
of self promotion. The more his reputation grew, the more
power he had to affect change around the world.
Speaker 15 (14:08):
Surgeon to the Royalty of Europe and the Royalty of Hollywood.
Speaker 2 (14:12):
Michael E.
Speaker 15 (14:13):
Debaker, master surgeon, but also a politician. Also a man
who stormed through a twenty yard day, a man they
called the Texas Tornado.
Speaker 5 (14:24):
The man they called the Texas Tornado always made time
for celebrity patients, and he never hesitated to drop their
names in presentations and interviews.
Speaker 13 (14:34):
Well, yeah, Eatrick was referred to me, and she gave
me an autograph of herself. I didn't ask for it.
I had gotten to know Frank Sinafa quite well because
I took care of his father. He said, I'm giving
a party for Jack Benj's eightiess birthday.
Speaker 5 (14:50):
In the early nineteen sixties, Debate turned his focus to
a device that promised to revolutionize cardiac medicine.
Speaker 13 (14:57):
With all the fantastic things that you can do today,
what is it you can't do, What is it you
would like to do? We should be able to develop
a mechanical pump well substitute. And I'm convinced this can
be done.
Speaker 5 (15:11):
Debaki had a vision, but it would take a singularly
brilliant and dogged inventor to actually build such a device.
At the National University of Cordova in Argentina, a young
surgeon was hard at work as early as the nineteen fifties.
(15:37):
Domingo Liota, working alongside his older brother Salvador, had been
developing prototypes of the first artificial heart.
Speaker 16 (15:49):
He was kind of Frankenstein what he was doing.
Speaker 5 (15:52):
Patrick Liota is Domingo's youngest son.
Speaker 16 (15:55):
Everybody thought he was crazy, but he wasn't really ahead
of his Stein.
Speaker 5 (16:01):
The idea was crazy Nearly a decade before Christian Barnard
transplanted a human heart for the first time, Domingo Liota
was working to replace the organ with a small implantable pump.
In nineteen sixty one, Liota's radical experiments earned him an
invitation to the Cleveland Clinic, and it was there that
(16:22):
he caught the attention of Michael de Bakey.
Speaker 16 (16:26):
Michael invited him to work for one year, one year
as a fellowship in Texas, and he always said that
was the most important letter he ever had in his life.
That letter makes him feel that he wasn't the right path,
doing the right things.
Speaker 5 (16:43):
Liota stayed at Baylor for much longer than his initial
one year fellowship. His family settled into Houston society, his
kids were enrolled in American private schools, and Domingo Liota
was doing the most consequential work of his career. A
total artificial heart felt within reach. Here's cardiac surgeon, doctor
(17:05):
Bud Frasier again.
Speaker 11 (17:06):
I remember talking to the doctor to Aikia about nineteen
sixty four, and he told me by nineteen eighty there
would be one hundred thousand Americans.
Speaker 12 (17:15):
Was an artificial heart.
Speaker 5 (17:18):
DeBakey threw the full weight of his political influence into
obtaining government grants. In nineteen sixty five, he convinced Congress
to allocate forty million dollars to develop an artificial heart.
Four point five million of those funds would go to
de Baky's program. But with the surge and funding came expectations.
(17:40):
DeBakey felt an urgent pressure to deliver results, and as
much as he loved to herald the arrival of the
total artificial heart, in reality it was still years away
from human application. DeBakey needed something achievable in the short term.
Speaker 13 (17:56):
The total artificial heart was you know, complicated process.
Speaker 5 (18:02):
That's Michael debake again.
Speaker 13 (18:04):
They little much simpler to work on ELVAD, so that
was just one one ventricle.
Speaker 5 (18:11):
The ELVAD, or Left Ventricular Assist Device, was developed by
Domingo Liota as a stepping stone to a total artificial heart.
It was a grapefruit sized pump that could be implanted
in a patient's chest so long as the patient remained
tethered to a compressed air machine. The ELVAD would boost
(18:31):
the beating of their left ventricle, the pumping lower left
chamber of their heart, and while it may have been
a stretch to call the Elvad an artificial heart. Michael
DeBakey hadn't become the Texas Tornado by splitting hairs. In
January of nineteen sixty nine, at the fiftieth anniversary dinner
(18:53):
of the New York Art Association, DeBakey showed off a
model of the device to the audience and announced that
this artificial heart would be ready for human use within
a month. A week later, DeBakey gave the device to
President Lyndon Johnson, who then presented it to Congressman John E.
(19:13):
Fogerty in recognition of his work to allocate funding for
artificial heart research. A few weeks after that, DeBakey again
touted the Elvad when he appeared on Walter Cronkite's The
Twentieth Century series.
Speaker 17 (19:29):
Doctor Michael Ellis Devaki, the world renowned Houston specialist Maam
of the Month American Heart Month.
Speaker 5 (19:38):
So it came as no surprise when photographers and journalists
arrived at Methodist Hospital in Droves waiting to capture the
successful implantation of the world's first artificial heart. De Bakey
stoked the flames of the media frenzy when he delivered
a two hour press conference to introduce the implant team
(19:58):
and concluded the tea is ready. They were just waiting
on the ideal recipient. Sixty five year old retired coal
miner Marcel de Rudder had suffered from heart problems for decades.
(20:23):
In the spring of nineteen sixty six, DeBakey planned to
replace Marcel's diseased mitra valve with a prosthetic one. The
problem was that Marcel's heart had deteriorated to such an
extent that it might not be capable of beating on
its own after the operation. DeBakey presented the dying patient
(20:43):
with an option of last resort. If Marcell's heart could
not be revived, DeBakey wanted to test out the ELVAD.
Speaker 18 (20:52):
I explained to him that we felt quite confident about
it on the basis of our experimental word and that
I thought that it would be a additional value and
reducing the risk of the operation.
Speaker 5 (21:05):
Marcel knew that there was a strong possibility he would
not survive. He told his wife Edna that he was
willing to serve as a guinea pig so that DeBakey
might learn something that would save someone else. On April
twenty first, nineteen sixty six, two days after Debake's press conference,
(21:26):
Marcel de Rutterer was wheeled into anr at Methodist hospital.
Bakey had arranged for the entire operation to be filmed
from overhead and documented in close up by a still photographer,
none other than Life magazine's Ralph Morris, the official photographer
(21:49):
of the Mercury Astronauts. DeBakey implanted the prosthetic valve and
shut off the heart lung machine, but in its weekends date,
Marcel de Rutter's heart refused to regain its rhythm. Just
as DeBakey had anticipated, the ELVAD had become Marcel's only
(22:10):
shot at survival. DeBakey sheared one of Marcel's ribs to
make room for the device, and then he began sewing
the ELVAT into place. Two hours into the operation, Marcel's
heart once again started to beat. After a few panic
(22:33):
filled stops and starts, Marcel was on track for recovery.
DeBakey left the oar and headed straight for a press conference.
Speaker 19 (22:45):
They asked, if it is an extremely difficult operation or
can it be done by surgeons around the world. Oh, certainly,
this is not a difficult operation for any team that
is experienced in cardiovasco surgery, and.
Speaker 5 (23:00):
The papers all across the country ran headlines like artificial
heart patient doing well and artificial heart beats on. Despite
the fact that the heart Marcel de Rudder was born
with was still beating inside his chest. Rarely did the
(23:21):
news coverage mention the name Domingo Liota. Twenty four hours
after the alvat implantation, Marcel de Rudder still had not
regained consciousness. With every hour that passed, it grew likelier
that he'd suffered brain damage during the operation. Debaky resumed
(23:44):
his grueling daily routine, but he spent his nights on
a cot in the ICU to keep close watch of
his star patient. Four days later, after his left lung ruptured,
Marcel de Rudder died.
Speaker 16 (24:02):
Doctor Debake, the object of your heart booster implant was
to prolong the patient's life.
Speaker 15 (24:08):
Since the patient died, why do you say that the
operation was a success.
Speaker 18 (24:13):
Well, I must feedback. The operation was a success on
the basis of the fact that the pump did the
job we wanted it to do. The patient's death was
due to causes beyond our control.
Speaker 5 (24:28):
The response from the medical community was swift and brutal.
DeBakey's peers condemned him for publicizing an untested procedure and
for giving false hope to patients dying from heart ailments,
and a personal letter to DeBakey, doctor Eugene Bricker of
Washington University in Saint Louis characterized his old colleagues behavior
(24:52):
as unethical and a discredit to the profession of surgery.
At Mimonode's Hospital in Brooklyn, doctor Adrian Cantrewitz announced that
he'd implanted a similar device two months prior, but had
refrained from publicizing the operation until he could be certain
of its long term success. We do things differently in Brooklyn,
(25:15):
Caantrowitz said to reporters, I did everything possible to keep
this out of the newspapers. DeBakey took issue with this criticism.
He felt the American public had a right to know
how four point five million dollars of their tax money
was being spent, but he'd learned his lesson when he
attempted another ELVAT implantation less than a month later. He
(25:38):
made no big announcements and held no press conferences. The
patient died within three days, DeBakey again shut out the
press when the opportunity arose for yet another attempt. Esperanza
del vae Vasquez, a thirty seven year old beautician for Mexico,
(26:00):
had suffered from lifelong rheumatic heart disease. The condition had
wreaked havoc on the valves of her heart.
Speaker 2 (26:07):
She had involvement of her aortic valve and her mitro valve.
She needed two valves. It was very uncommon to get
someone through a two valve replacement.
Speaker 5 (26:19):
That's doctor Billy Kohane Again. On August eighth, nineteen sixty six,
de Bakey brought Esperanza into surgery.
Speaker 2 (26:27):
Doctor Debaki said, ring me all that in let's try.
It lowered the pressure in or a left atrium, so
her lungs weren't being beat by pressure and the flow
through her body was dramatically increased.
Speaker 5 (26:44):
Esperanza's heart recovered to such an extent that, after ten
days with the device to baky decided he could safely
remove the elvat.
Speaker 2 (26:53):
He took the device out at bedside. He pulled it
out just a little bit without pulling in out of
the heart. Even I feel a little pinched down. You know,
clamped it, cut it, sewed it off and let it
drop back in and closed the skin over it.
Speaker 5 (27:11):
After a month spent recovering in the Icu, Esperanza was
discharged and returned home to her family in Mexico City,
the first survivor of an Elvad implant. As the Elvad
made headlines around the world, its creator, Domingo Liota, felt
left in the dust.
Speaker 16 (27:32):
They excluded his name from a lot of these presentations.
Sometimes the baker went by himself to these congresses and
presented like it was his idea.
Speaker 5 (27:43):
That's Domingo Liota's son, Patrick Liota. Again, Diveke was the boss.
Speaker 16 (27:49):
He was the guy who can't get the money, and
he was the guy who wanted the credits to.
Speaker 5 (27:54):
As for Liota's dream of implanting a total artificial heart,
he felt it slipping through his fingers. After the success
of the Alvat, it seemed to him that DeBakey had
lost interest in the total artificial heart entirely, and Liota
would do anything to see his dream brought to life.
Speaker 7 (28:25):
Doctor Liota was very depressed because he couldn't even get
an appointment doctor Debaki to show him his herd idea.
Speaker 5 (28:34):
Doctor Don Wukash was working alongside Domingo Liota in the
bail Or animal lab when he witnessed a meeting that
changed the course of history.
Speaker 7 (28:43):
I was there one day when doctor Curny happened to
come by and said, I had to Mingo, what are
you doing? He said, well, I'm working on this artificial heart.
Speaker 5 (28:53):
Fearing the squandering of his life's work, Liota proposed to
Coolly a new partnership. Here's Denton Cooley again.
Speaker 17 (29:02):
I thought and agreed that Nu Lee are at the
time it come to really give it a test, and
the only real test would be to apply it to
a dying patient.
Speaker 5 (29:12):
December nineteen sixty eight marked one year since Christian Barnard's
historic heart transplant operation. In that short span of time,
transplant fever had subsided. Nearly all of Cooley's transplant recipients
had died after their bodies rejected the donor hearts. Leota's
total artificial heart, which was made from synthetic materials and
(29:35):
therefore wouldn't be subject to organ rejection, looked like the
breakthrough Kooley had been waiting for.
Speaker 4 (29:41):
It.
Speaker 7 (29:42):
That was the beginning of the relationship with doctor Kulia
doctor Liota doctor Culli Star recruited him away to work
on weekends and nights on the artificial heart.
Speaker 5 (29:54):
According to Cooley, he and Liota began working in secret
on an altogether new artificial heart. They started with Leota's
original prototype from Argentina and developed it from there. They
hired a Rice University engineer to build a power console
for the device, paid for with funds from Cooley's foundation
(30:17):
and a few small grants. Beginning in January of nineteen
sixty nine, Leota implanted their artificial heart into seven calves
in the Baylor Animal Lab, the last of which lived
for forty four hours. With the device, the two men
concluded that their total artificial heart was ready for human use.
(30:45):
In a room at Saint Luke's Episcopal Hospital, a forty
seven year old man named Haskell Karp was dying. Haskell
had worked as a printing estimator in downtown Chicago until
his career was cut short by severe heart disease. He'd
suffered a series of heart attacks. He had a pacemaker
(31:05):
implanted to combat heart block, and by the spring of
nineteen sixty nine he was unable to do much of
anything besides weight for a miracle. After evaluating Haskell Karp's condition,
Denton Cooley recommended that he undergo a procedure called a
ventriculoplasty to remove the damaged tissue from his heart.
Speaker 2 (31:29):
You'd go on the heart lung machine. You'd cut out
the scar and replace it with a piece of dacron
polyester fabric. It was the size that it used to
be before it ballooned out.
Speaker 5 (31:39):
That's doctor Billy Cohne again.
Speaker 2 (31:41):
Doctor Cooley said, listen, mister Carp, I could try this
operation on you, but I think it's not going to work.
Your heart is too severely involved. If I think, if
I cut away all that scar, your heart's not going
to like it.
Speaker 5 (31:56):
If the operation went south, Cooley's next best option would
be to transplant a new heart into Haskell's chest, but
finding a donor was proving near impossible.
Speaker 17 (32:10):
We were having a more difficult time getting donors, and
here was a man who needed a transplant and needed
it badly and immediately.
Speaker 5 (32:22):
In Haskell Karp. Cooley saw a need for the total
artificial heart. His and Leota's device might buy Haskell a
little time, something the dying man desperately needed. Cooley also
saw an opportunity. This was his chance to push the
field of cardiac surgery forward, to perform a revolutionary new operation,
(32:46):
just like his mentors Alfred Blaylock and Vivian Thomas did
when they pioneered the Blue Baby operation back in nineteen
forty four, just like Walt Lillahei did again and again
throughout the nineteen fifties, and just like Christian Barnard did
a little over a year earlier, making him the most
famous man in the world. Detton Cooley was the best
(33:06):
technical surgeon alive. If anyone could pull this off, it
was him. Cooley was aware that he was inviting the
wrath of Michael de Bakey, but he wasn't going to
let a little rivalry get in the way of changing
the world.
Speaker 17 (33:20):
Well oday is It didn't feel like we needed permission,
And I think if I had sought permission from say,
the federal agency or the hospital with him, I think
I probably would have been denied, and we ever lost
to gold on opportunity.
Speaker 5 (33:36):
As his old friend Walt Lillahyde liked to say, ready
fire aim. On April third, nineteen sixty nine, Cooley met
with Haskell Karp and his wife Shirley to talk over
the plan. He brought with him a rabbi to consult
with the couple and to consent for him. Here's Shirley
(33:59):
Krp explaining the choice her husband faced that day.
Speaker 20 (34:03):
It's so personal. You can't advise anybody, and you can't
take advice from anybody in the situation such as this.
I understood what this decision meant to him, and because
of that, I agreed with him. It takes a strong
(34:26):
person to try to help himself.
Speaker 5 (34:36):
The following afternoon, as Debate's plane took off from the
Houston Hobby Airport headed for Washington, d C. Haskell Karp
was wheeled into surgery. He was pale, sweating profusely, and
gasping for air. His anesthesiologist felt that Haskell would die
(34:58):
right there in the hallway were not for immediate surgical intervention.
Cooley rushed to the oar and prepped for surgery. It
was his fifth heart operation of the day. He opened
Haskell's chest to find a severely scarred organ beating within.
(35:19):
He said he'd never seen a worse looking heart. Though
it was unlikely to work, Cooley dutifully attempted the ventriculo plasty,
removing a whopping thirty five percent of Haskell's left ventricle.
But the heart was beyond saving. Cooley's attempts to shock
(35:39):
and massage it back into rhythm were in vain.
Speaker 21 (35:43):
At the end of the operation, the heart didn't have
much muscle left and he would not come off the pump.
So this this is a room full of people and
you're looking to say, how's Kooley going to get out
of this?
Speaker 2 (35:58):
One.
Speaker 5 (35:59):
Trauma and car radiovascular surgeon doctor Kenneth Maddox was in
the room during the Haskell carp operation.
Speaker 21 (36:06):
All of a sudden, into the room came a big device. Now,
this device turned out to be this artificial heart that
had been developed by Dominico Laota. At the time, we
didn't know that history. We just knew that here came
in something new, and out came the heart.
Speaker 5 (36:27):
Cooley began attaching the device to the blood vessels in
Haskell's chest. Pushing a needle through silicone tubing is much
harder than suturing human tissue, even for the Great Dent
and Cooley, and yet the entire procedure took only about
two hours. They switched on the power console and then
(36:48):
Cooley and Leoda watched intense silence as their total artificial
heart began to work just as much as Showman as
his former mentor, Michael de Bakey. Cooley reported on his
success in a press conference that night.
Speaker 22 (37:08):
The AM news station was on in the kitchen radio
and next thing I knew is that I heard them.
I heard them say my dad's name.
Speaker 5 (37:18):
Marty Karp was just eleven years old at the time
of his father's operation.
Speaker 22 (37:24):
I felt the blood just drained from my body. It
was just surreal. And then I heard the words artificial heart.
It was like being in the middle of a science
fiction movie rather than we.
Speaker 17 (37:38):
Can look for a week or ten days. That was
satisfying my eyes.
Speaker 3 (37:43):
Hope we can't find a donor in that period of time.
Speaker 17 (37:46):
Hopefully the device will carry on for a long apparent time.
Speaker 5 (37:52):
When the press conference was over, Denton Cooley took the
unorthodox step of welcoming a camera crew into the room.
Haskell Karp was recovering, it's greatly great.
Speaker 4 (38:06):
Can we get something for you, Wes spunge?
Speaker 7 (38:12):
Can you say it again? Well, sponge?
Speaker 4 (38:16):
You want a wet sponge? You'd like a drink? Could
you turn the other way, so we can get your pictures.
Speaker 7 (38:21):
Speak louder.
Speaker 4 (38:23):
What can we get for you?
Speaker 17 (38:25):
Spue?
Speaker 4 (38:26):
Are you thirsty? What could you open your eyes for us?
Let's look at the color of your eyes. Open real wide,
look up above your head for us.
Speaker 17 (38:33):
That's it.
Speaker 4 (38:36):
You realize you had your heart operation about twelve hours ago.
Speaker 5 (38:40):
I almost three years to the day since Marcel de
Rudder's Elvat implantation was swept up in a media maelstrom.
The first total artificial heart operation was playing out in
much the same way, but at least in the case
of Haskell carp the publicity was serving a very real purpose.
(39:04):
Leota and Cooley's device was purely a stopgap. Haskell still
needed a heart donor, and Cooley was gambling that the
front page news coverage might help them find one. The
morning after her husband's surgery, Cooley invited Shirley krp out
in front of the cameras.
Speaker 23 (39:24):
Somewhere somewhere, please hear my, please, a please for a
heart for my husband. I see him lying there, breathing
and knowing that within his chest is a man made
implement where there should be a God given heart. How
long can he survive?
Speaker 5 (39:54):
Shirley's please worked almost immediately. The calls began coming in,
but for various reasons, none of the hearts was a
good fit. One donor heart stopped beating while in transit
from East Texas. Several calls came from individuals offering to
end their own lives in order to save Haskells. On
(40:16):
April sixth, with Haskell in critical condition, the hospital received
a promising call from the family of a comatosed woman
in Massachusetts. Within hours, a lear jet was on its
way to pick up the potential donor. Three flights, one
emergency landing, and a frantic ambulance ride across Houston later,
(40:39):
the donor heart was ready to be transplanted. By now,
Haskell Karp had been living with the Leota Cooley device
for sixty four hours, longer than any of the animal
test subjects. Cooley reopened Haskell's ribcage and performed a swift
and elegant transplant. Once again, a human heart was beating
(41:04):
in Haskell's chest. It wasn't long before his health started
to deteriorate.
Speaker 22 (41:14):
Things were going south. Kidney feller and pneumonia were now
the big concern.
Speaker 2 (41:20):
They dumped a bunch of steroids in him and just
really amino suppressed him, and thirty two hours later he
died just too much aminosuppression.
Speaker 5 (41:39):
Four days after his first operation, Haskell Karp was dead,
but the total artificial heart had allowed him to live
long enough to receive a transplant. It was the first
step toward a future where humans could survive with machines
in place of their hearts. And after a career spent
in the show Shadow of Michael de Bakey, Denton Cooley
(42:02):
had finally stepped out into the spotlight. His face appeared
in newspapers and TV news programs. Reporters all over the
world were saying his name, and for a very different reason,
So too were administrators at the Baylor College of Medicine.
(42:22):
Even before DeBakey returned from Washington, d C. The Baylor
Committee on Research Involving Human Beings gathered for an emergency meeting.
Here's doctor Gerald Lourie again.
Speaker 12 (42:36):
I think it was pretty clear that this was an
unauthorized use. This artificial heart was being developed under a
federal government contract, and there were very stringent requirements in
place to ensure that there would be a significant cause
and review at the end of the animal phase before
it was put in a human.
Speaker 5 (42:56):
As for Cooley's claim that the total artificial heart was
an original design distinct from Liota's work at Baylor, Michael
Debake insisted that this was nonsense.
Speaker 13 (43:08):
Now like Cooley had no experience with the artificial line
program at all, didn't do any laboratory work. He was
a good surgeon, but that's all.
Speaker 5 (43:18):
While the Liota Cooley device made use of unique tilting
disc valves, Liota would later admit that he'd taken other
components from his artificial heart work at Baylor, and when
Cooley was asked whether the heart he used was Debate's,
he replied, yes, I guess in effect, I took it.
Cooley continued, I just couldn't let another man die on
(43:41):
the operating room table. When Debake arrived back in Houston
the monday after the operation, his first step was to
form an investigative group to determine whether there had been
(44:02):
a violation of government guidelines and if Baylor could be
held responsible for it.
Speaker 21 (44:09):
Doctor Debake was most concerned about the impact that this
activity might have on all other research and funding coming
from the federal government.
Speaker 5 (44:24):
That's doctor Kenneth Maddox again.
Speaker 21 (44:26):
Theoretically they could removed and killed all federal research. Baylor
was really depending upon that research for financing the school.
Speaker 5 (44:37):
For Denton Cooley, on the other hand, Debate's response felt
less political than personal. Here's doctor Billy Cohne again.
Speaker 2 (44:47):
Doctor debake came back and looked at this as an
absolute betrayal. He closed down the animal lab, fired everybody.
Bud Frasier, actually he was in Vietnam when all this
is going arn and he recounts that being in Vietnam
for a young heart surgeon was probably a safer place
than being in Houston.
Speaker 5 (45:09):
Coolly accused his former mentor of instigating a global smear
campaign against him, compiling a packet of false allegations and
sending them to surgical departments all over the US and Europe.
Speaker 7 (45:23):
It was a personal attack. It was an all out ward.
Speaker 5 (45:28):
That's doctor Don Wukash again.
Speaker 7 (45:31):
Doctor de Bakey had plenty of reasons to be angry.
It hurt. It's not that what was right and what
was wrong they both were playing a little bit dirty pool.
Speaker 5 (45:49):
On April eighteenth, De Bakey's investigative group concluded that the
Liota Cooley total artificial heart had been developed using DeBakey's
grant money, and that implanting it in Haskell Karp violated
the government guidelines. Cooley was censured by the Harris County
Medical Society, the American College of Surgeons, and the National
(46:11):
Heart Institute. Over the next several months, he made a
series of attempts to reconcile with Tobaki, but they were
all either ignored or rejected. On September second, he resigned
from Baylor. Cooley devoted his full energy to building the
(46:32):
Texas Hart Institute. He brought Lioda onto his staff, and
for the next two years it seemed as if the
Haskell Carp fiasco was behind them, but Cooley and Liota's
problems had only just begun. Here's Haskell and Shirley's son,
Marty Karp again.
Speaker 22 (46:51):
When my mother first came back from Houston, she thought
doctor Cooley was a saint. Then some people tried to
like wake her up to reality a little bit. And
not to say that he didn't have the best of intentions,
but I feel like he was being an opportunist, as
here was a situation with a person that really had
(47:11):
little hope.
Speaker 5 (47:13):
In April of nineteen seventy one, Shirley Karp filed a
lawsuit against Cooley and Liota, alleging that she and her
husband had not been fully informed about the artificial heart
or the fact that Haskell was participating in a human experiment.
Speaker 22 (47:29):
Supposedly, he signed papers saying it was okay that if
there was nothing else that could be done in surgery,
that it would be acceptable to do this. My mom
says he would have shared that with her, but I
doubt my father would have shared it with her in
advanced because I'm sure she wouldn't have agreed. You know,
he was making his own decisions.
Speaker 5 (47:51):
For the next year, the trial loomed over Cooley and Liota.
As always, Cooley managed to downplay his anxiety, exuding his
usual self assured charm.
Speaker 9 (48:04):
He never really acted like things were bothering him to
the daughters, or at least not to me. But I'm
sure it was terribly stressful and embarrassing.
Speaker 5 (48:15):
That's doctor Louise Cooley Davis. Again.
Speaker 9 (48:18):
He just kept mushing through going forward because I think
he truly felt like he was trying to do the
best for that patient and for the development of heart surgery.
Speaker 5 (48:38):
On June nineteenth, nineteen seventy two, Cooley and Leota arrived
in federal court for the first day of their trial.
Shirley Karp took the witness stand and testified about her
confusion in the hours before her husband's operation. She felt
the decision was rushed and that Cooley had been impatient
(49:02):
for Haskell to give his consent. Implicit in all this
with the accusation that by operating on Haskell Karp, Cooley
had acted not in his patient's best interest, but in
his own. Cooley strongly objected to these allegations.
Speaker 17 (49:19):
I believe that we as surgeons have an implied contract
with our patients to keep them alive. I think that
it comes to time when the surgeon must assume certain responsibilities,
and if it means taking a risk with his reputation,
I think that he would be neglectful of his duty
(49:39):
if he withdrew from that risk.
Speaker 5 (49:43):
Shirley Karp's case would hinge on the testimony of one man.
As a pre eminent surgeon and a leader in the
field of artificial hearts, Michael de Bakey was perhaps the
only doctor in the world with the qualifications to testify
against Denton Cooley. Not only that he had an ax
to grind. When debake was subpoened as an expert witness
(50:06):
for the plaintiff, he was positioned perfectly to exact his
revenge and deal a death blow to Cooley's career, and
yet he didn't. Speaking privately in the judge's chambers, DeBakey
asserted that he had no special knowledge of the case,
(50:27):
and he refused to offer his medical opinion. Whether it
was due to some lingering fondness for his old protege
or simply a doctor's distaste from olpractice lawsuits, DeBakey had
shown mercy. Without Debaki's testimony, Shirley Carp's case became a
lost cause. The judge delivered a directed verdict that favored
(50:50):
Koli and Liota, and Shirley Carp lost again on appeal.
Michael Debatey and Denton Cooley came face to face once
more before the trial was over. Here's doctor Don Wucash again.
Speaker 7 (51:09):
I remember that be at breaks, sort of a mid
morning breaking the trial. So doctor Curley and I walked
out into the hall and we came to a corner.
Doctor DeBakey turned the corner and there we were. I
was in the middle and it was the most awkward
moment of my whole life. I'm sure it was for
(51:31):
them too. And doctor Debay just lectured doctor Curley and
didn't say anything and kept walking, and doctor Curley did
the same thing. So it was a really a sad
moment in a unfortunate ending for what had started out
with him to be a father's son relationship.
Speaker 5 (51:55):
Despite the promise of the total artificial heart, progress slow
after the Haskell Carp operation. Cardiac surgery was no longer
the lawless frontier it had once been, and Cooley and
Liota had suffered consequences for their experiment that would have
been unthinkable just a decade earlier. Today, the dream of
(52:18):
a fully implanted, permanent, total artificial heart remains just beyond
the horizon. The LVAD, on the other hand, has become
a common life saving measure for patients suffering from heart failure.
Thousands of Americans are implanted with elvads every year. That's
thanks in large part to the pioneering work of doctor
(52:38):
Bud Fraser, a trainee of both Michael DeBakey and Denton Cooley.
After the Haskell Carp operation, DeBakey and Cooley's professional split
forced many of Houston's best surgeons. To choose sides, you
(53:00):
had to make a choice.
Speaker 7 (53:01):
Who do you want to spend the best of your
professional career with. There's not an easy choice.
Speaker 5 (53:08):
In nineteen seventy, Life Magazine printed a cover story titled
A Bitter Feud describing the ongoing war between Doctor Wonderful
Denton Cooley and the Texas Tornado Michael de Bakey. Debaky
and Cooley's relationship had come to an end. Though they
worked just as stone's throw from each other, it would
(53:31):
be nearly four decades for the two men exchanged another word.
Speaker 1 (53:43):
On our next episode, Walt Lilla Haih's years of living
and operating on the edge finally catch up with them,
and Houston Doctor's attempt to bring a decades long feud
to an end next time on Cardiac Cowboys.
Speaker 5 (54:10):
Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios
and Thirteenth Lake Media. We're presented by Chris Pine and
written and narrated by me Jamie Appley. Our executive producers
are Christina Everett for iHeart Podcasts, Dub Cornette and Jason
(54:30):
Ross for OsO Studios. Doctor Gerald Imber, author of Cardiac
Cowboys The Heroic Invention of Heart Surgery. Doctor Eric A. Rose,
John Mankowitz, Joshua Paul Johnson, and myself. James A. Smith
is our supervising producer, editing and sound design by Joshua
(54:51):
Paul Johnson. Our composer is David Mansfield. Our cover artwork
is designed by Alexander Smith. For more information on the
first cardiac surgeons, check out doctor Gerald Dimber's book Cardiac Cowboys,
The Heroic Invention of Heart Surgery.
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