September 29, 2025 • 43 mins
Two of the country’s most ambitious surgeons join forces to make Houston, Texas the new cardiovascular capital of the world. Dr. Michael DeBakey and Dr. Denton Cooley’s complementary talents make them a surgical dream team. But a friendly rivalry turns them from close colleagues to fierce competitors.
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
Archival Materials Courtesy of: Special Collections, University of Rhode Island Library; and G. Wayne Miller, author of "King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery"
Additional Archival Materials Courtesy of: "March of Medicine" (NBC 1954); Johns Hopkins Medical Archives; Vanderbilt University; "Something the Lord Made" (HBO 2004); American Academy of Achievement; "DeBakey" (Dr. Tony Herring and the Texas Scottish Rite Hospital for Children 2016); and the Society for Vascular Surgery
Additional Music & Stock Media Provided by: StockMusicCom / Pond5; Music Bed; Premium Beat; Storyblocks; Artlist; APM; Envato Market; Tribe of Noise; Incompetech; Podcast Music; and Hollywood Edge
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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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. It's nineteen forty four. Jim
(00:24):
Crow looms large over Baltimore, Maryland. Marriage between an interracial
couple is punishable by up to ten years in prison.
Public schools are segregated by race, as our restaurants, hotels,
and parks. Johns Hopkins School of Medicine, located in a
Victorian RedBrick hospital complex that looms over East Baltimore, won't
(00:46):
admit its first black student for another eighteen years. And
yet a young black man working in a research laboratory
at Johns Hopkins is about to pave the way for
the future of cardiac surgery.
Speaker 2 (01:01):
Vivian Thomas a very skillful surgeon and could carry out
all of these procedures on assistant that night, take the
normal surgeon two or three assistants to help them through.
Speaker 1 (01:14):
Vivian Thomas ran the animal lab for Hopkins Surgical chief
Alfred Blaylock. Thomas was a master surgeon, but he never
operated on a human patient. He was paid little more
than a janitor's wages. To make ends meet, he'd moonlight
as a bartender at Blaylock's parties, mixing drinks for the
very same medical students he trained during the day. Nearly
(01:37):
a decade before Minnesota surgeons John Lewis and Walt Illa
High operated on the living heart, Vivian Thomas and Alfred
Blaylock pioneered a treatment for one of the most fatal
heart defects.
Speaker 2 (01:49):
We became almost overwhelmed with congenital heart cases of tetralogy
I Fellow.
Speaker 1 (01:54):
Tetrology of fullow is a complex of four different heart
defectsves infants of oxygen, turning their skin bluish gray. In
most cases, it kills them. It was one of the
few female doctors at Johns Hopkins, a pediatric cardiologist named
Helen Tausig, who had the groundbreaking idea to sidestep the defect.
Speaker 3 (02:19):
What if you could create.
Speaker 1 (02:20):
A shunt, a small pathway connecting two of a child's
arteries to allow some blood to flow directly to the
lungs without first passing through the defective heart. It wasn't
quite open heart surgery, and it wouldn't fix the defect
for good, but it might just allow these kids to
live long enough for someone else to invent a permanent cure.
(02:42):
Helen Tausig's idea wasn't taken seriously until she shared it
with Alfred Blaylock, who assigned it to Vivian Thomas, and
Thomas got to work.
Speaker 3 (02:52):
For months, he toiled.
Speaker 1 (02:53):
In the lab, perfecting the procedure that would come to
be known as the Blaylock Tausig shunt, named for Alfred
Blaylock and Helen Tausig. As a black lab worker without
a medical degree, Vivian Thomas was not credited for his contribution.
(03:14):
In the fall of nineteen forty four, a baby girl
named Eileen Saxon was admitted to JOHNS Hopkins. Eileen suffered
from tetralogy filow. She struggled to breathe even inside an
oxygen tent. Her skin and lips were blue, and at
fifteen months old, she weighed just nine pounds. Eileen was dying.
(03:39):
Her only shot at revival was the experimental Blaylock Tausig shunt,
but there was a problem. Neither Blaylock nor Tausig knew
how to perform the procedure. Only Vivian Thomas did. Early
on November twenty ninth, Eileen was rushed into an oar
on the top floor of the hospital. Vivian Thomas assumed
(04:01):
he wouldn't be welcome in the room. In nineteen forty
four and for a long time to come, surgery was
the exclusive domain of white men, but Alfred Blaylock couldn't
operate without him.
Speaker 2 (04:14):
Emerits and Vivian Thomas stood behind him, and doctor Blaylock
would ask Vivian questions all the time over his shoulders.
If didn't shall do it this way, that's the why.
Speaker 4 (04:24):
You know.
Speaker 1 (04:26):
Thomas was given a stool so he could see over
Blaylock's shoulder with an overhead view of the operating table.
He talked the chief of surgery step by step through
the technique he developed. When the operation was over and
the clamps removed from Eileen's blood vessels, Blaylock and Thomas
watched with amazement as the girl's sickly blue skin turned
(04:47):
a healthy pink.
Speaker 3 (04:52):
You did well in there, Vivian, Thank you.
Speaker 5 (04:56):
He performed a next in surgery, doctor, Yes, I think
I did.
Speaker 1 (05:06):
In two thousand and four, HBO dramatized the Eileen Saxon
surgery in the film Something the Lord Made, starring Yasin
Bay and Alan Rickman. This Blue Baby operation saved the
lives of thousands of children and opened the door to
all future cardiovascular procedures. Vivian Thomas would be an old
(05:27):
man before he was recognized for his achievement. In the meantime,
he trained a generation of surgeons. His greatest pupil was
a smooth talking, strikingly handsome Texan doctor Denton Cooley.
Speaker 2 (05:43):
I felt so grateful that I was part of the team,
but I was right in the middle of it, and
that therefore I had an obligation to carry on that legacy.
Speaker 1 (05:54):
Cooley was twenty four when he assisted in the first
Blue Baby operation. His surgical train under Thomas and Blaylock
set him on a path to become the greatest technical
surgeon the world had ever seen. It also fueled his
fierce competitive streak, which would send him headlong to the
most famous feud in medical history. Formoso's Studios, This is
(06:23):
Cardiac Cowboys, a podcast about life, death and innovation. In
the American heartband episode two, Ready Fire Aim Here's writer
(06:45):
and executive producer Jamie Napoli.
Speaker 3 (06:48):
In nineteen fifty one, Detton Cooley could have written his
own ticket to any hospital in the country. He'd performed
blue baby operations at Johns Hopkins, commanded an army hi
hospital in Austria, and spent a year training under the
eminent British surgeon Russell Brock. So it might have seemed
like a step backward when the thirty year old hotshot
(07:09):
surgeon accepted a job at the long undistinguished Baylor College
of Medicine in Houston, Texas. But for Denton Cooley, Houston
was home. Not only that Baylor's surgical department was quickly
making a name for itself on the national stage. That
was thanks to Cooley's new boss, a brilliant, ambitious, and
(07:30):
uncompromising chief of surgery by the name of Michael de Bakey.
Denton Cooley rarely encountered anyone man or woman who didn't
instantly fall under the spell of his genteel Texas charm.
Now he was putting that charm to good use. To
succeed at Baylor, he'd need to win over DeBakey. He
started by moving his wife, Louise and their young daughter
(07:52):
Mary into a house down the street from the DeBakey family.
Speaker 4 (07:56):
I always found him to be extremely charming.
Speaker 3 (08:00):
That's doctor Debake's eldest son, Michael, who recalls Cooley's efforts
to always keep his wits about him in the presence
of his new boss. Even in relaxed social settings.
Speaker 4 (08:10):
My parents frequently gave small dinners or cocktail parties for
the staff, and I always remember Denton would come in
and he said, fix me a glass of club soda
with ice, and then he said, point me a little
bit of coke in there so that it looked like
Scotch and soda, and then he would under around drinking that.
Speaker 3 (08:29):
With Doctor Debake. However, Cooley's charisma hit a brick wall.
Speaker 4 (08:35):
Yeah, I've forgotten who it was. It said that Dasha
Debaki puts tabasco on everything, including his words, and that's
probably true. He was hell on wheels in the hospital.
He could look at you and melt you.
Speaker 3 (08:50):
The Baky. Biographer Craig Miller recounted the story of Denton
Cooley's first day at Baylor. As Cooley pulled into the
hospital parking lot, the Baky spotted the golf clubs in
the back of his car. Get rid of those things, son.
The baky snapped in his Louisiana drawl, You're not going
to need them while you're here. Later that afternoon, as
(09:15):
the Houston heat climbed into the nineties, Cooley followed the
chief of surgery on patient rounds. At six foot four,
Cooley towered over the short stature of DeBakey, and yet
he found it difficult to keep up with the man.
DeBakey was tireless, power walking from room to room and
building to building, jogging upstairs rather than stopping to wait
(09:37):
for an elevator. He was perpetually in a race against
the clock. God helped the young doctor who got in
his way.
Speaker 6 (09:45):
There is an aspects of me that maybe he can
be described as intolerant. I'm intolerant of stupidity.
Speaker 3 (09:53):
That's an archival recording of doctor DeBakey.
Speaker 6 (09:56):
There's just absolutely no place for carelessness, and there's no
plays for making mistakes, because even the smallest mistake can
lead to a bigger mistake and bigger complication.
Speaker 3 (10:08):
De Bakey's temper was legendary. He would hammer his staff
with insults for the slightest error, from blocking his light
during an operation to hitting the wrong button on an elevator.
They tuned me out one time.
Speaker 5 (10:21):
We were going to the eighth floor Methodist and I
was tired of instead of punching ATA hit seven.
Speaker 3 (10:28):
That's Houston cardiac surgeon, doctor Bud Fraser. It was just
a mistake that making. He said, you're a mistake. And
here's a mistake. For Denton Cooley, who had world famous
surgeons practically lining up to mentor him, DeBakey's attitude was
an unwelcome surprise. Cooley followed behind as the entourage of
(10:52):
doctors headed into the black section of the racially segregated
Jefferson Davis Hospital, named for the president of the short
lived Confederacy. They arrived at the room of a forty
six year old patient.
Speaker 7 (11:06):
We had this African American guy named Joe Mitchel who
had a luritic aneurysm in his essending a order.
Speaker 3 (11:15):
The aorda is the largest of the blood vessels. It's
an artery that carries oxygen rich blood directly from the
heart out to the rest of the body. An aneurysm
occurs when the aorda begins to bulge at a weak spot,
its wall grows thin and frail. Imagine an over inflated balloon.
(11:36):
If the balloon bursts, blood rushes out into the chest cavity,
oftentimes killing the patient. In nineteen fifty one, one of
the only accepted treatments was to simply delay the aneurysm's
eventual rupture by wrapping it in cellophane. But this was
(11:56):
not a permanent solution.
Speaker 7 (11:58):
It was busy out through the chest and you see
the pole sason. Doctor de Bakey said, well, we have
a new member here of our staff, doctor Cooobey.
Speaker 3 (12:08):
What would you do to that aneurism?
Speaker 7 (12:10):
And he expected me to say I'd put some wire
and then try to cover it with sell a fan.
And I said, so, I think I would just exercise aneurism.
Speaker 3 (12:22):
To excise or surgically remove the aneurysm, as Cooley suggested,
was unheard of. Cooley had improvised similar procedures during his
residency at Johns Hopkins, but this was his first day
at a new hospital. He didn't have the team or
the tools to execute what he just suggested. The young
(12:44):
hotshot surgeon was showing off and de Bakey called him
on it.
Speaker 7 (12:48):
He said, well you tomorrow morning he won.
Speaker 4 (12:52):
Just like that.
Speaker 3 (12:53):
The operation was scheduled for the following day. Cooley was
keenly aware of the fact that he'd just been handed
the rope to hang himself, but he wasn't one to
back down from a challenge. At least until that moment,
(13:15):
life had been pretty damn good to Denton Cooley. He
was born into Houston High society, the son of a
wealthy dentist and the grandson of a developer nicknamed the
father of Houston Heights. At the University of Texas at Austin,
(13:42):
Cooley walked onto the varsity basketball team and then led
the Longhorns to win the Southwest Conference Basketball championships. Buckwheat Cooley,
as his teammates called in, was blessed with movie star
looks and a confident charm. He might have been taken
for Kennedy if only he were a few inches shorter.
(14:04):
At Johns Hopkins Medical School, Cooley worked hard to shed
the jock stereotype, graduated first in his class, and yet
it was his jockside that opened the first of many
doors for his career. Here's Cooley's daughter, doctor Louise Cooley Davis.
Speaker 8 (14:21):
There was a tennis court in the quadrangle of the
hospital and Daddy decided to go out and play tennis
instead of going on rounds with Blaylock.
Speaker 3 (14:31):
In nineteen forty three, a year before the first Blue
Baby operation, doctor Alfred Blaylock was already renowned for his
innovative research into the circulatory condition of shock.
Speaker 8 (14:43):
And outcomes. Blaylock, with his entire entourage following behind him,
and stop and watch my father play tennis. And my
father's first thought was I'm in deep trouble here. He's
going to know that I cut out of my rounds
and I'm going to be kicked.
Speaker 9 (14:57):
Back to Texas.
Speaker 8 (14:59):
And instead Blaylock asked him if he knew how to
play ping pong, because Blaylock had a lake house and
really wanted someone to play ping pong with him. So
instead of it turning into a disaster, it turned into
a really lucky introduction.
Speaker 3 (15:15):
Cooley's friendship with Blaylock put his career on a fast track.
After the landmark Eileen Saxon operation, Blaylock began letting Cooley
take the lead on some of his Blue Baby cases,
and for good reason. It turned out Cooley's dexterity on
the basketball and tennis courts translated to the oar he.
Speaker 10 (15:34):
Would tie knots inside of a matchbox with his fingers,
and he had no wasted motion whatsoever.
Speaker 3 (15:42):
That's trauma and cardiovascular surgeon doctor Kenneth Maddox so.
Speaker 10 (15:47):
Smooth, fast, precise. It was a symphony to watch.
Speaker 3 (15:54):
With a potent mix of ambition, once in a generation, talent,
and undeniable good luck.
Speaker 10 (16:00):
Luck.
Speaker 3 (16:00):
Cooley's rise was meteoric. His mounting successes brought him, in
nineteen fifty one, into the orbit of Michael de Bakey.
On the morning of July twelfth, DeBakey strode quickly toward
the oars at Jefferson Davis Hospital. It was now Cooley's
(16:21):
second day at Baylor, and he'd already begun operating on
forty six year old Joe Mitchell. DeBakey knew the young
surgeon was in over his head and would need a
more experienced hand to take over. The only question was
how deep a hole Cooley had dug for himself. It
was entirely possible DeBakey was already too late. De Bakey
(16:43):
went straight for the scrub sink, and then he stopped.
There was no sign of panic in the or as
de Bakey turned and stepped toward the operating table, he
found the handsome, drawling young Texan with a big smile
on his face. What was the status of Missus Mitchell's aneurysm,
DeBakey wanted to know.
Speaker 7 (17:05):
Over there in the specimen basement.
Speaker 3 (17:08):
The excised aneurysm lay in a bucket several feet away,
and Cooley was already sewing up the patient's a order.
Speaker 7 (17:16):
That was I think the first time that he really
appreciates the fact that we could operate directly on the order.
Speaker 3 (17:24):
For most of Michael de Bakey's life, he'd been the
best at everything he pursued. A genius academic and surgeon
with an unparalleled work ethic, he struggled to maintain a
staff that could measure up to his expectations. But this
was new, a young, overly confident surgeon showing DeBakey up
(17:44):
on his second day of work. Cooley was claiming this
was the first anneurism repair of its kind anywhere in
the world. In that moment, DeBakey had to make a
decision whether to treat Cooley as a peer or as
a threat. In stark contrast to Houston native Denton Cooley,
(18:08):
the good old boy, the ultimate insider. Michael Debake's life
was largely defined by his outsider status. Born to Lebanese
immigrants in Lake Charles, Louisiana, he quickly picked up on
the fact that his family didn't look or act like
their neighbors.
Speaker 4 (18:27):
Well, I do think that growing up dead, as well
as his brother and his sisters all felt left out.
They were essentially immigrants into South Louisiana, and they certainly
weren't part of the old Louisiana.
Speaker 3 (18:42):
Rather than trying to fit in, DeBakey resolved to stand out.
He worked nearly twenty hours a day, seven days a week.
Speaker 4 (18:52):
He was gone every morning from six am, and he
was back at the house eight thirty or nine at night,
sometimes later. And when he was at home, he was
locked in his study, working on papers or dictating. And
I know that my mother was very upset frequently, and
I overheard her say, maybe your children would be better
(19:13):
off his patients, because then they get more time with you.
Speaker 3 (19:17):
When DeBakey was offered to head up surgical department at
the Baylor College of Medicine in nineteen forty eight, he'd
already cemented his reputation as an unstoppable force as a
medical student at the prestigious Two Lane University, he invented
a roller pump that would become an essential component of
the heart lung bypass machines of the future. During World
(19:39):
War II, Debaki developed the Auxiliary Surgical Groups to improve
medical treatment for soldiers on the front line, which would
later evolve into the mass units that would play a
key role in all army operations for the next sixty years.
And he co authored a series of papers on the
correlation between smoking and lung cancer, a position that made
(20:01):
him deeply unpopular within the tobacco growing South, But DeBakey
had little interest in popularity. The result of his fanatical
work ethic was that by nineteen forty eight, De Bakey's
future shown blinding bright, and he didn't imagine the swampy
oil town of Houston, Texas would have any part of it.
(20:23):
Here's doctor DeBakey again.
Speaker 6 (20:24):
But at that time Baylaw College of Medicine had no
teaching hospital, no service, no n ice grants, and it
was really living almost from day to day.
Speaker 3 (20:37):
The first two times DeBakey was offered a position at Baylor,
he turned it down.
Speaker 6 (20:42):
I thought it was a pretty third grade school and
I'd already turned down three jobs up in the East
from good school.
Speaker 3 (20:50):
De Bakey's mentor at TWU Lane urged him to reconsider.
Baylor may have been a medical backwater, but it was
something else too, a blank canvas. Like the crude oil
being guzzled up from beneath the Houston dirt, Baylor was
raw material waiting to be refined. However, de Bakey saw
fit in Houston. DeBakey could build an empire and he
(21:15):
would be its sole sovereign.
Speaker 4 (21:18):
At that time, oil and gas and construction with the
big moneymakers in Houston, there were people who were making
money that they didn't know what to do with.
Speaker 3 (21:28):
The first step in building an empire is raising the funds.
Speaker 4 (21:32):
Dan had a bedside charm that he used to turn on.
He wouldn't send a bill to a very wealthy guy,
and the guy would call up and say, doctor de baky,
I haven't gotten your bill yet, and he would say, well,
don't worry about it. Well, no, I want you to
send me a bill. So he said, well, look, if
you want to make a donation, fine, instead of you know,
a bill for two thousand dollars, the guy ended up
(21:53):
with a donation for twenty thirty thousand.
Speaker 3 (21:58):
Thanks to his military contacts from the war, DeBakey began
rapidly expanding his domain. Long before his first day on
the job.
Speaker 6 (22:07):
The Veterans Administration was about to build a hospital right
next door to the old Navy hospital. So I spotlighted
a complete waste of money, and I got a call
from Director of the VA saying that can you organize
puschannel to take it over?
Speaker 4 (22:23):
I just moved in.
Speaker 3 (22:25):
A few days after taking over the old Navy hospital,
DeBakey convinced the Board of Trustees chairman to bring the
local city county hospital under his authority as well.
Speaker 6 (22:36):
So I had two teaching hospitals, by the way, That's
what kept me in.
Speaker 3 (22:40):
Rather than settling for the doctors Houston had to offer,
Tobaki looked elsewhere. He was openly elitist, a fact that
didn't win him many friends within the local medical community.
He traveled the country, using money and charm to lure
the best American surgeons to Houston. Surgeons like Denton. Over
(23:04):
the next two decades, Debaki would come to see Cooley
as a rival and as a threat to the empire
he'd built at Baylor But on July twelfth, nineteen fifty one,
as he watched the young surgeon swiftly and gracefully stitch
up a patient's damaged aorta, saving his life, DeBakey saw
something else in Cooley. He'd found a workhorse, a man
(23:28):
who could operate faster and better than any surgeon he'd
ever met. Together, DeBakey and Cooley began repairing aneurysms, which
treated at any other hospital in the world would have
proved fatal. The following year, they took their technique one
step further by patching damaged blood vessels with tissue taken
(23:50):
from corpses called homographs.
Speaker 10 (23:53):
Doctor debake was always looking at different approaches. He would
sometimes call a biomedical engineer into the room and say,
this needs an upside down backwards approach, and so he
might pause to look for a better way.
Speaker 3 (24:12):
After treating scores of aneurysm cases using human tissue, DeBakey
recognized that this, too, was not a permanent solution. Houston
had no shortage of corpses throughout the fifties. It was
known as the murder capital of the country, and yet
maintaining a ready supply of differently sized homographs. Proved difficult.
(24:33):
Once again, DeBakey needed to find a better way.
Speaker 6 (24:43):
As soon became apparent that we really needed something that
was sought of on the shelf, so we began doing
experimental work on some substitute.
Speaker 3 (24:53):
DeBakey liked to tell the story of his discovery of
the ideal fabric for the first synthetic aortic graft. He
was shopping for nylon at a department store when he
stumbled upon a new material called dacron.
Speaker 6 (25:07):
I looked at the material, you know, and felt it,
and it felt good. I liked it, and I would
take two sheets and cut them to the woods that
I wanted and I saw leach is when you did that,
if you go it too.
Speaker 3 (25:24):
DeBakey brought his dacron tube back to the lab, where
it would soon replace the need for human tissue, jump
starting the field of reconstructive arterial surgery and saving countless lives.
At least that's the way de Bakey told the story.
His son Michael, has a different recollection.
Speaker 4 (25:42):
That's not true that that's a story that was propagated
by a lot of the people who worked with Dad.
I was upstairs in my parents' bedroom watching television and
dad came in and he said, by the way, do
you happen to have any wash and wear material.
Speaker 3 (25:58):
At his father's urging, Mike retrieved a pair of boxer
shorts he'd recently purchased at Brooks Brothers.
Speaker 4 (26:04):
He said, this is dacron, and he literally pulled my
mother's sewing machine out of the closet, took a pair
of shears, and he cut two y shaped objects out
of the shorts, and he sewed them together. And they
had it prepared for the following day to have it
used in a dog And I never got those shorts replaced.
Speaker 3 (26:26):
Boxer shorts are no Debaky's dacron graft was a game changer.
In the summer of nineteen fifty five, he and Cooley
took their wives across the Atlantic for a lecture tour
to share their groundbreaking techniques with some of the top
surgical mines in Europe. The two men were diametrically opposed
in nearly every way, which meant that for a time,
(26:48):
they complimented each other perfectly. Cooley churned out operations with
machine like speed and precision, while Debaky innovated, fundraised and
promoted their work tirelessly. As a result, by the mid
nineteen fifties, Baylor's reputation was exploding. Here's doctor Maddox again.
Speaker 10 (27:09):
Prior to this era, we really didn't have any way
to treat aneurysms in Suddenly we had some tools, we
had some instruments, and there were a lot of backlog
of people. So it was an exciting time.
Speaker 3 (27:24):
If you had a heart defect, you went to Minneapolis,
and if you had a problem with your arteries, you
came to Houston. When Albert Einstein's aortic aneurysm began to
rupture in nineteen fifty five, it was Michael DeBakey who
got the call. Working as a team, DeBakey and Cooley
were rapidly transforming Baylor into the aneurysm repair center of
(27:47):
the world. Pine Bluff, Arkansas, nineteen fifty four, a thirteen
year old old boy fell from an ice truck and
was crushed underneath. Miraculously, Calvin Richmond survived, but he was
(28:12):
left with a rare traumatic heart defect. The force of
the truck tore three holes in the boy's heart, The
largest of them was the size of a nickel. If
Calvin was to have any chance of reaching adulthood, he'd
need to have these holes patched up, and there was
only one doctor in the world who could help him.
Speaker 11 (28:36):
At the University of Minnesota, doctor C. W. Lilla High,
the surgeon who kept in the research team and actually
performed the operation that spells hope at last for the
children formerly so do.
Speaker 3 (28:48):
In the years since the tragic case of Gregory Gliddon,
Walt Lillehigh had performed thirty five more open heart operations
using controlled cross circulation with about a seventy five percent
access rate. Once the object of derision and scorn for
his radical ideas, Lilla High had become his department's golden boy.
Speaker 12 (29:08):
Waldland was the only place that was doing okahat churgery
at that time.
Speaker 3 (29:14):
That's an archival recording of doctor Gilbert Campbell, who worked
alongside Lilla High at the University of Minnesota. In March
of nineteen fifty five, thanks to a Little Rock fundraising campaign,
Calvin and his mother, Mattie were flown to Minneapolis on
an Arkansas Air National Guard plane.
Speaker 12 (29:33):
This lady came up from Pine Bluff with Calvin Rick.
They were just a teenager, he was a knice looking
kids and a night at person.
Speaker 3 (29:44):
The Richmonds were African American. Unlike Pine Bluff, Arkansas, Minneapolis
was not legally segregated. However, the city's population was over
ninety eight percent white. Calvin and Maddie suddenly found themselves
in an extreme minority. Their race would come to play
an outsized but unstated role in Calvin's medical treatment.
Speaker 12 (30:09):
I think she was just a little bit fearful of
what might happen a lot of black people, and the
certain that some white people too are not too anxious
to undergo general anaesthasia and operations and so forth.
Speaker 3 (30:25):
American medicine is stained by a horrific legacy of white
doctors exploiting people of color, and so it's little surprise
that Mattie Richmond, a mother of twelve and a widow,
didn't trust the U of M doctors to risk her
life for the sake of Calvin's operation. Without Mattie, acting
(30:45):
as her son's heart lung donor Lilla High turned to
the Minneapolis prison population. He'd convinced inmates to volunteer for
operations in the past, but in the case of Calvin Richmond,
he had no such luck. With the boy's time running out,
little High came to Maddie with a last resort, a
procedure never before tested on a human patient. Here's Minnesota
(31:09):
heart surgeon doctor Sarah Shumway.
Speaker 9 (31:12):
Gilbert Campbell had done a number of studies in animals,
and they used a dog lung, and the dog lung
acted as an oxygenator so they could see exactly where
the holes were located. It was a wild thing to
try to do.
Speaker 12 (31:28):
I'd never used it on a hamlet one during some
other operate. I tapped into a vein and returned it
good to make sure it would work. Don't expect to
find them and inner debate in the wilderness. You know
we're flowing new ground.
Speaker 3 (31:46):
Little High's personal motto was ready, fire, aim, In other words,
act first, make adjustments later. He began preparing to attempt
Gilbert Campbell's dog lung techniqueeen year old Calvin. On March
(32:09):
twenty third, nineteen fifty five, Calvin Richmond was wheeled into
ther his chest was cut open and his heart exposed.
Rather than using a human donor to oxygenate the boy's
blood during surgery, Lilihigh connected Calvin's blood vessels to a
dog's lung, which was suspended on a stand and heated
(32:31):
to body temperature. Lila High opted for a country dog
because the lungs of city dogs were often coated in soot.
Speaker 13 (32:40):
They ran his blood through it while they stopped the heart,
opened it and fixed this traumatic defect, and then closed
the heart.
Speaker 3 (32:48):
That's cardiac surgeon, doctor Chip Bowman.
Speaker 13 (32:51):
That would be very controversial now, I mean impossible. But
the boys alive because of it, you know, And that's
all all cared about.
Speaker 3 (33:01):
Trading a dog's life for a boys. The procedure was
grotesque by any standard, but it worked. The day after
the operation, Calvin was up and joking with the nursing staff.
Within a month, he was on his way back to Arkansas,
his whole life ahead of him, and Walt Lillaheigh, having
(33:22):
finally earned the trust of the U of M hospital administrators,
was on a roll. He was entering the most creative
and wildly productive period, not just in his life, but
in the life of any surgeon in history.
Speaker 13 (33:37):
He couldn't be bothered by what other people thought. Maybe
to a fault, I guess genius of this type doesn't
come in plain vanilla packages.
Speaker 3 (33:47):
Lolahai made for an unlikely celebrity, though he was quietly
intense and introverted. The man had a flare for the dramatic.
Speaker 14 (33:55):
He loved dressing for attention.
Speaker 3 (33:59):
That's seeable. She's a nurse who worked with doctor Lillihigh.
Speaker 14 (34:02):
He was known for having flamboyant clothes. He would wear
a dinner jacket and everybody else would be in their
sports jacket.
Speaker 3 (34:13):
Five years had passed since Lila High's debilitating cancer operation,
and something in him had changed. Here's an archival recording
of Lila High's protege, doctor Richard Duwall.
Speaker 15 (34:29):
He developed an incredible capacity for alcohol. He would drink
enough to put four or five people under, but he
never showed it. He went through a well of a
lot at that time, so I think this probably changed
his mental attitude of live today.
Speaker 3 (34:47):
Lillahi lived and operated at a breakneck pace. He'd work
in the o rs and the animal labs until late
in the evenings and then often drove straight to a
local jazz club. He left little time for Ka and
their young family.
Speaker 16 (35:04):
In many ways, we were raised by my mother. She
was the one who was at the football games and
all the events and such.
Speaker 3 (35:11):
That's Walt and k Lilla High's son, doctor Craig Lilihigh.
Speaker 16 (35:14):
There were resident parties or different parties and nightclubs that
he'd been at, but there were times when he clearly
wanted to be away up in his office. I don't
know when he slept. He seemed to be up at
all hours of the night in the study, and he'd
walk in there and.
Speaker 3 (35:29):
The lights would be on. He was wide awake. Now,
with his sudden flash of stardom, the demands on Lili
High's time were greater than ever before. In nineteen fifty five,
Lila High was asked to speak at a meeting of
(35:50):
the American Thorassic Association in Houston. The conference was held
at the Shamrock Hilton, across the street from the Baylor
College of Medicine. Denton Cooley was in the audience that day.
He watched as this sharply dressed surgeon with an oddly
tilted neck took the stage.
Speaker 14 (36:09):
Walt was invited everywhere to give talks.
Speaker 3 (36:13):
That's nurse cea ballman again.
Speaker 14 (36:16):
I thought he was a wonderful speaker, but he would
always just speak a little bit longer than you would
hope he would.
Speaker 3 (36:27):
Walt Lillehigh presented a film of his cross circulation technique.
Despite the procedure's success, its unseemliness still tended to provoke
a mixed reaction, but Denton Cooley was captivated. Here's doctor Alilihigh.
Speaker 15 (36:42):
I had the honor of showing Denton the inside of
the living human heart for the first time you ever
saw it.
Speaker 3 (36:49):
He said, it was like viewing through against heaven. As
he watched Lillihigh on stage, seemingly impervious to any and
all criticism, Cooley saw something that he craved desperately for himself.
Here was a man living and working on the edge.
Lilahigh wasn't just breaking rules, he was writing his own
(37:10):
rule book. By the middle of nineteen fifty five, Cooley
and DeBakey had performed two hundred and forty five aneurysm
repairs between them, and Cooley was living up to his
promise as an unflagging workhorse.
Speaker 4 (37:29):
My father was.
Speaker 8 (37:30):
We call him the ever ready battery Man because he
truly was always always working.
Speaker 3 (37:36):
That's doctor Louise Cooley Davis again.
Speaker 8 (37:38):
I guess with you know, playing basketball and knowing how
to run up and down the court, we have to
be very disciplined.
Speaker 3 (37:45):
But over the last year, Cooley's power dynamic with debake
had started to grade on him. Here's medical historian and
plastic surgeon, doctor Gerald Imber.
Speaker 17 (37:56):
No one manipulated the press as effectively as debaking And
here is a guy named Cooley who's a far better surgeon,
faster surgeon, more efficient surgeon, certainly an easier guy to
get along with, and he wanted to be out of
DeBakey's shadow.
Speaker 3 (38:15):
Cooley always felt he was marked for greatness. He saw
himself as an innovator on par with his mentors, but
he would never live up to that promise if he
spent the rest of his career fixing aneurysms for doctor DeBakey.
Now he was ready to make his own seminal contribution
to the field. If debake wasn't going to support his ascension,
(38:35):
Cooley would have to blaze his own trail. In June,
Cooley and his colleague doctor Dan McNamara flew to Minnesota
to watch Walt Lillahi in action. Ioha came to pick
him up.
Speaker 5 (38:52):
It was a customed then, as probably is still for
the visitors to be treated the night before their visit.
Speaker 3 (38:59):
That's doctor Dudd Frasier again.
Speaker 5 (39:01):
So they were supposed to go out to some nice restaurant,
which Coolly anticipated and everything. Instead of going to a
nice restaurant, they go to a road house outside of Minneapolis,
you know, dancing girls and all of that.
Speaker 3 (39:21):
Doctor McNamara took off early, leaving Cooley to party late
into the night with the insatiable lillahih.
Speaker 5 (39:29):
One of the things Cooley told me, he said, You've
got to always remember, never never drink was Walt Lilaha.
Speaker 3 (39:35):
You can never keep up with him. Cooley woke up
late the next morning, hungover and exhausted. He and McNamara
rushed to the University Hospital where Lilla High was scheduled
to perform a VSD repair. At nine point thirty, a
half hour after the appointed time, Lila High finally turned up.
Speaker 5 (40:00):
He went out to the scrubber sink and was splashing
cold water in his face, and the nurse came out
and broke an amal nitrate under his nose, the old
boxer routine, and he go ahead, He did the case.
Speaker 3 (40:13):
And killed his head.
Speaker 5 (40:14):
Is a pretty surgery they were seeing, but it was.
Speaker 3 (40:18):
What happened later that day that really left an impact
on Cooley. He and McNamara were treated to a tour
of Lili High's lap, where they saw a prototype that
would be laughed out of any medical conference. This was
what Lili High was truly excited about. It looked like
(40:38):
his cross circulation set up on steroids, a tangle of
coiled hose, a Sigma motor pump, plastic tubes suspended on stands,
and a blood reservoir. The whole apparatus cost about thirty dollars.
To macnamara, it looked like the work of a madman.
To Koley, it felt like looking into the future. This
(41:02):
radical heart lung bypass machine represented everything Kooley had been
waiting for. If he could just replicate it back in Houston,
it would grant him access to the new and wild
frontier of open heart surgery and all of its endless
possibilities for innovation and glory. This was his chance to
(41:23):
step out of Michael de Bakey's shadow, out of Alfred
Blaylock's shadow, and onto the cutting edge. Denton, Cooley, and
the city of Houston were about to enter the heart race.
Speaker 1 (41:45):
On our next episode, a devastating turn of events forces
Walt the Laid to rethink open heart Surgery and in Houston,
Denton Cooley's swift rise plunges him into a battle of
egos with his boss and mentor Michael DeBakey, next time
on Cardiac Cowboys.
Speaker 3 (42:13):
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
(42:33):
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
Paul Johnson. Our composer is David Mansfield. Our cover artwork
(42:58):
is designed by Alexander Smith. Archival materials courtesy of Special Collections,
University of Rhode Island Library and g Wayne Miller, author
of the Walt Lilla High biography King of Hearts, The
True Story of the Maverick who pioneered open heart surgery.
For more information on the first cardiac surgeons, check out
(43:18):
doctor Gerald Imber'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. It's nineteen forty four. Jim
(00:24):
Crow looms large over Baltimore, Maryland. Marriage between an interracial
couple is punishable by up to ten years in prison.
Public schools are segregated by race, as our restaurants, hotels,
and parks. Johns Hopkins School of Medicine, located in a
Victorian RedBrick hospital complex that looms over East Baltimore, won't
(00:46):
admit its first black student for another eighteen years. And
yet a young black man working in a research laboratory
at Johns Hopkins is about to pave the way for
the future of cardiac surgery.
Speaker 2 (01:01):
Vivian Thomas a very skillful surgeon and could carry out
all of these procedures on assistant that night, take the
normal surgeon two or three assistants to help them through.
Speaker 1 (01:14):
Vivian Thomas ran the animal lab for Hopkins Surgical chief
Alfred Blaylock. Thomas was a master surgeon, but he never
operated on a human patient. He was paid little more
than a janitor's wages. To make ends meet, he'd moonlight
as a bartender at Blaylock's parties, mixing drinks for the
very same medical students he trained during the day. Nearly
(01:37):
a decade before Minnesota surgeons John Lewis and Walt Illa
High operated on the living heart, Vivian Thomas and Alfred
Blaylock pioneered a treatment for one of the most fatal
heart defects.
Speaker 2 (01:49):
We became almost overwhelmed with congenital heart cases of tetralogy
I Fellow.
Speaker 1 (01:54):
Tetrology of fullow is a complex of four different heart
defectsves infants of oxygen, turning their skin bluish gray. In
most cases, it kills them. It was one of the
few female doctors at Johns Hopkins, a pediatric cardiologist named
Helen Tausig, who had the groundbreaking idea to sidestep the defect.
Speaker 3 (02:19):
What if you could create.
Speaker 1 (02:20):
A shunt, a small pathway connecting two of a child's
arteries to allow some blood to flow directly to the
lungs without first passing through the defective heart. It wasn't
quite open heart surgery, and it wouldn't fix the defect
for good, but it might just allow these kids to
live long enough for someone else to invent a permanent cure.
(02:42):
Helen Tausig's idea wasn't taken seriously until she shared it
with Alfred Blaylock, who assigned it to Vivian Thomas, and
Thomas got to work.
Speaker 3 (02:52):
For months, he toiled.
Speaker 1 (02:53):
In the lab, perfecting the procedure that would come to
be known as the Blaylock Tausig shunt, named for Alfred
Blaylock and Helen Tausig. As a black lab worker without
a medical degree, Vivian Thomas was not credited for his contribution.
(03:14):
In the fall of nineteen forty four, a baby girl
named Eileen Saxon was admitted to JOHNS Hopkins. Eileen suffered
from tetralogy filow. She struggled to breathe even inside an
oxygen tent. Her skin and lips were blue, and at
fifteen months old, she weighed just nine pounds. Eileen was dying.
(03:39):
Her only shot at revival was the experimental Blaylock Tausig shunt,
but there was a problem. Neither Blaylock nor Tausig knew
how to perform the procedure. Only Vivian Thomas did. Early
on November twenty ninth, Eileen was rushed into an oar
on the top floor of the hospital. Vivian Thomas assumed
(04:01):
he wouldn't be welcome in the room. In nineteen forty
four and for a long time to come, surgery was
the exclusive domain of white men, but Alfred Blaylock couldn't
operate without him.
Speaker 2 (04:14):
Emerits and Vivian Thomas stood behind him, and doctor Blaylock
would ask Vivian questions all the time over his shoulders.
If didn't shall do it this way, that's the why.
Speaker 4 (04:24):
You know.
Speaker 1 (04:26):
Thomas was given a stool so he could see over
Blaylock's shoulder with an overhead view of the operating table.
He talked the chief of surgery step by step through
the technique he developed. When the operation was over and
the clamps removed from Eileen's blood vessels, Blaylock and Thomas
watched with amazement as the girl's sickly blue skin turned
(04:47):
a healthy pink.
Speaker 3 (04:52):
You did well in there, Vivian, Thank you.
Speaker 5 (04:56):
He performed a next in surgery, doctor, Yes, I think
I did.
Speaker 1 (05:06):
In two thousand and four, HBO dramatized the Eileen Saxon
surgery in the film Something the Lord Made, starring Yasin
Bay and Alan Rickman. This Blue Baby operation saved the
lives of thousands of children and opened the door to
all future cardiovascular procedures. Vivian Thomas would be an old
(05:27):
man before he was recognized for his achievement. In the meantime,
he trained a generation of surgeons. His greatest pupil was
a smooth talking, strikingly handsome Texan doctor Denton Cooley.
Speaker 2 (05:43):
I felt so grateful that I was part of the team,
but I was right in the middle of it, and
that therefore I had an obligation to carry on that legacy.
Speaker 1 (05:54):
Cooley was twenty four when he assisted in the first
Blue Baby operation. His surgical train under Thomas and Blaylock
set him on a path to become the greatest technical
surgeon the world had ever seen. It also fueled his
fierce competitive streak, which would send him headlong to the
most famous feud in medical history. Formoso's Studios, This is
(06:23):
Cardiac Cowboys, a podcast about life, death and innovation. In
the American heartband episode two, Ready Fire Aim Here's writer
(06:45):
and executive producer Jamie Napoli.
Speaker 3 (06:48):
In nineteen fifty one, Detton Cooley could have written his
own ticket to any hospital in the country. He'd performed
blue baby operations at Johns Hopkins, commanded an army hi
hospital in Austria, and spent a year training under the
eminent British surgeon Russell Brock. So it might have seemed
like a step backward when the thirty year old hotshot
(07:09):
surgeon accepted a job at the long undistinguished Baylor College
of Medicine in Houston, Texas. But for Denton Cooley, Houston
was home. Not only that Baylor's surgical department was quickly
making a name for itself on the national stage. That
was thanks to Cooley's new boss, a brilliant, ambitious, and
(07:30):
uncompromising chief of surgery by the name of Michael de Bakey.
Denton Cooley rarely encountered anyone man or woman who didn't
instantly fall under the spell of his genteel Texas charm.
Now he was putting that charm to good use. To
succeed at Baylor, he'd need to win over DeBakey. He
started by moving his wife, Louise and their young daughter
(07:52):
Mary into a house down the street from the DeBakey family.
Speaker 4 (07:56):
I always found him to be extremely charming.
Speaker 3 (08:00):
That's doctor Debake's eldest son, Michael, who recalls Cooley's efforts
to always keep his wits about him in the presence
of his new boss. Even in relaxed social settings.
Speaker 4 (08:10):
My parents frequently gave small dinners or cocktail parties for
the staff, and I always remember Denton would come in
and he said, fix me a glass of club soda
with ice, and then he said, point me a little
bit of coke in there so that it looked like
Scotch and soda, and then he would under around drinking that.
Speaker 3 (08:29):
With Doctor Debake. However, Cooley's charisma hit a brick wall.
Speaker 4 (08:35):
Yeah, I've forgotten who it was. It said that Dasha
Debaki puts tabasco on everything, including his words, and that's
probably true. He was hell on wheels in the hospital.
He could look at you and melt you.
Speaker 3 (08:50):
The Baky. Biographer Craig Miller recounted the story of Denton
Cooley's first day at Baylor. As Cooley pulled into the
hospital parking lot, the Baky spotted the golf clubs in
the back of his car. Get rid of those things, son.
The baky snapped in his Louisiana drawl, You're not going
to need them while you're here. Later that afternoon, as
(09:15):
the Houston heat climbed into the nineties, Cooley followed the
chief of surgery on patient rounds. At six foot four,
Cooley towered over the short stature of DeBakey, and yet
he found it difficult to keep up with the man.
DeBakey was tireless, power walking from room to room and
building to building, jogging upstairs rather than stopping to wait
(09:37):
for an elevator. He was perpetually in a race against
the clock. God helped the young doctor who got in
his way.
Speaker 6 (09:45):
There is an aspects of me that maybe he can
be described as intolerant. I'm intolerant of stupidity.
Speaker 3 (09:53):
That's an archival recording of doctor DeBakey.
Speaker 6 (09:56):
There's just absolutely no place for carelessness, and there's no
plays for making mistakes, because even the smallest mistake can
lead to a bigger mistake and bigger complication.
Speaker 3 (10:08):
De Bakey's temper was legendary. He would hammer his staff
with insults for the slightest error, from blocking his light
during an operation to hitting the wrong button on an elevator.
They tuned me out one time.
Speaker 5 (10:21):
We were going to the eighth floor Methodist and I
was tired of instead of punching ATA hit seven.
Speaker 3 (10:28):
That's Houston cardiac surgeon, doctor Bud Fraser. It was just
a mistake that making. He said, you're a mistake. And
here's a mistake. For Denton Cooley, who had world famous
surgeons practically lining up to mentor him, DeBakey's attitude was
an unwelcome surprise. Cooley followed behind as the entourage of
(10:52):
doctors headed into the black section of the racially segregated
Jefferson Davis Hospital, named for the president of the short
lived Confederacy. They arrived at the room of a forty
six year old patient.
Speaker 7 (11:06):
We had this African American guy named Joe Mitchel who
had a luritic aneurysm in his essending a order.
Speaker 3 (11:15):
The aorda is the largest of the blood vessels. It's
an artery that carries oxygen rich blood directly from the
heart out to the rest of the body. An aneurysm
occurs when the aorda begins to bulge at a weak spot,
its wall grows thin and frail. Imagine an over inflated balloon.
(11:36):
If the balloon bursts, blood rushes out into the chest cavity,
oftentimes killing the patient. In nineteen fifty one, one of
the only accepted treatments was to simply delay the aneurysm's
eventual rupture by wrapping it in cellophane. But this was
(11:56):
not a permanent solution.
Speaker 7 (11:58):
It was busy out through the chest and you see
the pole sason. Doctor de Bakey said, well, we have
a new member here of our staff, doctor Cooobey.
Speaker 3 (12:08):
What would you do to that aneurism?
Speaker 7 (12:10):
And he expected me to say I'd put some wire
and then try to cover it with sell a fan.
And I said, so, I think I would just exercise aneurism.
Speaker 3 (12:22):
To excise or surgically remove the aneurysm, as Cooley suggested,
was unheard of. Cooley had improvised similar procedures during his
residency at Johns Hopkins, but this was his first day
at a new hospital. He didn't have the team or
the tools to execute what he just suggested. The young
(12:44):
hotshot surgeon was showing off and de Bakey called him
on it.
Speaker 7 (12:48):
He said, well you tomorrow morning he won.
Speaker 4 (12:52):
Just like that.
Speaker 3 (12:53):
The operation was scheduled for the following day. Cooley was
keenly aware of the fact that he'd just been handed
the rope to hang himself, but he wasn't one to
back down from a challenge. At least until that moment,
(13:15):
life had been pretty damn good to Denton Cooley. He
was born into Houston High society, the son of a
wealthy dentist and the grandson of a developer nicknamed the
father of Houston Heights. At the University of Texas at Austin,
(13:42):
Cooley walked onto the varsity basketball team and then led
the Longhorns to win the Southwest Conference Basketball championships. Buckwheat Cooley,
as his teammates called in, was blessed with movie star
looks and a confident charm. He might have been taken
for Kennedy if only he were a few inches shorter.
(14:04):
At Johns Hopkins Medical School, Cooley worked hard to shed
the jock stereotype, graduated first in his class, and yet
it was his jockside that opened the first of many
doors for his career. Here's Cooley's daughter, doctor Louise Cooley Davis.
Speaker 8 (14:21):
There was a tennis court in the quadrangle of the
hospital and Daddy decided to go out and play tennis
instead of going on rounds with Blaylock.
Speaker 3 (14:31):
In nineteen forty three, a year before the first Blue
Baby operation, doctor Alfred Blaylock was already renowned for his
innovative research into the circulatory condition of shock.
Speaker 8 (14:43):
And outcomes. Blaylock, with his entire entourage following behind him,
and stop and watch my father play tennis. And my
father's first thought was I'm in deep trouble here. He's
going to know that I cut out of my rounds
and I'm going to be kicked.
Speaker 9 (14:57):
Back to Texas.
Speaker 8 (14:59):
And instead Blaylock asked him if he knew how to
play ping pong, because Blaylock had a lake house and
really wanted someone to play ping pong with him. So
instead of it turning into a disaster, it turned into
a really lucky introduction.
Speaker 3 (15:15):
Cooley's friendship with Blaylock put his career on a fast track.
After the landmark Eileen Saxon operation, Blaylock began letting Cooley
take the lead on some of his Blue Baby cases,
and for good reason. It turned out Cooley's dexterity on
the basketball and tennis courts translated to the oar he.
Speaker 10 (15:34):
Would tie knots inside of a matchbox with his fingers,
and he had no wasted motion whatsoever.
Speaker 3 (15:42):
That's trauma and cardiovascular surgeon doctor Kenneth Maddox so.
Speaker 10 (15:47):
Smooth, fast, precise. It was a symphony to watch.
Speaker 3 (15:54):
With a potent mix of ambition, once in a generation, talent,
and undeniable good luck.
Speaker 10 (16:00):
Luck.
Speaker 3 (16:00):
Cooley's rise was meteoric. His mounting successes brought him, in
nineteen fifty one, into the orbit of Michael de Bakey.
On the morning of July twelfth, DeBakey strode quickly toward
the oars at Jefferson Davis Hospital. It was now Cooley's
(16:21):
second day at Baylor, and he'd already begun operating on
forty six year old Joe Mitchell. DeBakey knew the young
surgeon was in over his head and would need a
more experienced hand to take over. The only question was
how deep a hole Cooley had dug for himself. It
was entirely possible DeBakey was already too late. De Bakey
(16:43):
went straight for the scrub sink, and then he stopped.
There was no sign of panic in the or as
de Bakey turned and stepped toward the operating table, he
found the handsome, drawling young Texan with a big smile
on his face. What was the status of Missus Mitchell's aneurysm,
DeBakey wanted to know.
Speaker 7 (17:05):
Over there in the specimen basement.
Speaker 3 (17:08):
The excised aneurysm lay in a bucket several feet away,
and Cooley was already sewing up the patient's a order.
Speaker 7 (17:16):
That was I think the first time that he really
appreciates the fact that we could operate directly on the order.
Speaker 3 (17:24):
For most of Michael de Bakey's life, he'd been the
best at everything he pursued. A genius academic and surgeon
with an unparalleled work ethic, he struggled to maintain a
staff that could measure up to his expectations. But this
was new, a young, overly confident surgeon showing DeBakey up
(17:44):
on his second day of work. Cooley was claiming this
was the first anneurism repair of its kind anywhere in
the world. In that moment, DeBakey had to make a
decision whether to treat Cooley as a peer or as
a threat. In stark contrast to Houston native Denton Cooley,
(18:08):
the good old boy, the ultimate insider. Michael Debake's life
was largely defined by his outsider status. Born to Lebanese
immigrants in Lake Charles, Louisiana, he quickly picked up on
the fact that his family didn't look or act like
their neighbors.
Speaker 4 (18:27):
Well, I do think that growing up dead, as well
as his brother and his sisters all felt left out.
They were essentially immigrants into South Louisiana, and they certainly
weren't part of the old Louisiana.
Speaker 3 (18:42):
Rather than trying to fit in, DeBakey resolved to stand out.
He worked nearly twenty hours a day, seven days a week.
Speaker 4 (18:52):
He was gone every morning from six am, and he
was back at the house eight thirty or nine at night,
sometimes later. And when he was at home, he was
locked in his study, working on papers or dictating. And
I know that my mother was very upset frequently, and
I overheard her say, maybe your children would be better
(19:13):
off his patients, because then they get more time with you.
Speaker 3 (19:17):
When DeBakey was offered to head up surgical department at
the Baylor College of Medicine in nineteen forty eight, he'd
already cemented his reputation as an unstoppable force as a
medical student at the prestigious Two Lane University, he invented
a roller pump that would become an essential component of
the heart lung bypass machines of the future. During World
(19:39):
War II, Debaki developed the Auxiliary Surgical Groups to improve
medical treatment for soldiers on the front line, which would
later evolve into the mass units that would play a
key role in all army operations for the next sixty years.
And he co authored a series of papers on the
correlation between smoking and lung cancer, a position that made
(20:01):
him deeply unpopular within the tobacco growing South, But DeBakey
had little interest in popularity. The result of his fanatical
work ethic was that by nineteen forty eight, De Bakey's
future shown blinding bright, and he didn't imagine the swampy
oil town of Houston, Texas would have any part of it.
(20:23):
Here's doctor DeBakey again.
Speaker 6 (20:24):
But at that time Baylaw College of Medicine had no
teaching hospital, no service, no n ice grants, and it
was really living almost from day to day.
Speaker 3 (20:37):
The first two times DeBakey was offered a position at Baylor,
he turned it down.
Speaker 6 (20:42):
I thought it was a pretty third grade school and
I'd already turned down three jobs up in the East
from good school.
Speaker 3 (20:50):
De Bakey's mentor at TWU Lane urged him to reconsider.
Baylor may have been a medical backwater, but it was
something else too, a blank canvas. Like the crude oil
being guzzled up from beneath the Houston dirt, Baylor was
raw material waiting to be refined. However, de Bakey saw
fit in Houston. DeBakey could build an empire and he
(21:15):
would be its sole sovereign.
Speaker 4 (21:18):
At that time, oil and gas and construction with the
big moneymakers in Houston, there were people who were making
money that they didn't know what to do with.
Speaker 3 (21:28):
The first step in building an empire is raising the funds.
Speaker 4 (21:32):
Dan had a bedside charm that he used to turn on.
He wouldn't send a bill to a very wealthy guy,
and the guy would call up and say, doctor de baky,
I haven't gotten your bill yet, and he would say, well,
don't worry about it. Well, no, I want you to
send me a bill. So he said, well, look, if
you want to make a donation, fine, instead of you know,
a bill for two thousand dollars, the guy ended up
(21:53):
with a donation for twenty thirty thousand.
Speaker 3 (21:58):
Thanks to his military contacts from the war, DeBakey began
rapidly expanding his domain. Long before his first day on
the job.
Speaker 6 (22:07):
The Veterans Administration was about to build a hospital right
next door to the old Navy hospital. So I spotlighted
a complete waste of money, and I got a call
from Director of the VA saying that can you organize
puschannel to take it over?
Speaker 4 (22:23):
I just moved in.
Speaker 3 (22:25):
A few days after taking over the old Navy hospital,
DeBakey convinced the Board of Trustees chairman to bring the
local city county hospital under his authority as well.
Speaker 6 (22:36):
So I had two teaching hospitals, by the way, That's
what kept me in.
Speaker 3 (22:40):
Rather than settling for the doctors Houston had to offer,
Tobaki looked elsewhere. He was openly elitist, a fact that
didn't win him many friends within the local medical community.
He traveled the country, using money and charm to lure
the best American surgeons to Houston. Surgeons like Denton. Over
(23:04):
the next two decades, Debaki would come to see Cooley
as a rival and as a threat to the empire
he'd built at Baylor But on July twelfth, nineteen fifty one,
as he watched the young surgeon swiftly and gracefully stitch
up a patient's damaged aorta, saving his life, DeBakey saw
something else in Cooley. He'd found a workhorse, a man
(23:28):
who could operate faster and better than any surgeon he'd
ever met. Together, DeBakey and Cooley began repairing aneurysms, which
treated at any other hospital in the world would have
proved fatal. The following year, they took their technique one
step further by patching damaged blood vessels with tissue taken
(23:50):
from corpses called homographs.
Speaker 10 (23:53):
Doctor debake was always looking at different approaches. He would
sometimes call a biomedical engineer into the room and say,
this needs an upside down backwards approach, and so he
might pause to look for a better way.
Speaker 3 (24:12):
After treating scores of aneurysm cases using human tissue, DeBakey
recognized that this, too, was not a permanent solution. Houston
had no shortage of corpses throughout the fifties. It was
known as the murder capital of the country, and yet
maintaining a ready supply of differently sized homographs. Proved difficult.
(24:33):
Once again, DeBakey needed to find a better way.
Speaker 6 (24:43):
As soon became apparent that we really needed something that
was sought of on the shelf, so we began doing
experimental work on some substitute.
Speaker 3 (24:53):
DeBakey liked to tell the story of his discovery of
the ideal fabric for the first synthetic aortic graft. He
was shopping for nylon at a department store when he
stumbled upon a new material called dacron.
Speaker 6 (25:07):
I looked at the material, you know, and felt it,
and it felt good. I liked it, and I would
take two sheets and cut them to the woods that
I wanted and I saw leach is when you did that,
if you go it too.
Speaker 3 (25:24):
DeBakey brought his dacron tube back to the lab, where
it would soon replace the need for human tissue, jump
starting the field of reconstructive arterial surgery and saving countless lives.
At least that's the way de Bakey told the story.
His son Michael, has a different recollection.
Speaker 4 (25:42):
That's not true that that's a story that was propagated
by a lot of the people who worked with Dad.
I was upstairs in my parents' bedroom watching television and
dad came in and he said, by the way, do
you happen to have any wash and wear material.
Speaker 3 (25:58):
At his father's urging, Mike retrieved a pair of boxer
shorts he'd recently purchased at Brooks Brothers.
Speaker 4 (26:04):
He said, this is dacron, and he literally pulled my
mother's sewing machine out of the closet, took a pair
of shears, and he cut two y shaped objects out
of the shorts, and he sewed them together. And they
had it prepared for the following day to have it
used in a dog And I never got those shorts replaced.
Speaker 3 (26:26):
Boxer shorts are no Debaky's dacron graft was a game changer.
In the summer of nineteen fifty five, he and Cooley
took their wives across the Atlantic for a lecture tour
to share their groundbreaking techniques with some of the top
surgical mines in Europe. The two men were diametrically opposed
in nearly every way, which meant that for a time,
(26:48):
they complimented each other perfectly. Cooley churned out operations with
machine like speed and precision, while Debaky innovated, fundraised and
promoted their work tirelessly. As a result, by the mid
nineteen fifties, Baylor's reputation was exploding. Here's doctor Maddox again.
Speaker 10 (27:09):
Prior to this era, we really didn't have any way
to treat aneurysms in Suddenly we had some tools, we
had some instruments, and there were a lot of backlog
of people. So it was an exciting time.
Speaker 3 (27:24):
If you had a heart defect, you went to Minneapolis,
and if you had a problem with your arteries, you
came to Houston. When Albert Einstein's aortic aneurysm began to
rupture in nineteen fifty five, it was Michael DeBakey who
got the call. Working as a team, DeBakey and Cooley
were rapidly transforming Baylor into the aneurysm repair center of
(27:47):
the world. Pine Bluff, Arkansas, nineteen fifty four, a thirteen
year old old boy fell from an ice truck and
was crushed underneath. Miraculously, Calvin Richmond survived, but he was
(28:12):
left with a rare traumatic heart defect. The force of
the truck tore three holes in the boy's heart, The
largest of them was the size of a nickel. If
Calvin was to have any chance of reaching adulthood, he'd
need to have these holes patched up, and there was
only one doctor in the world who could help him.
Speaker 11 (28:36):
At the University of Minnesota, doctor C. W. Lilla High,
the surgeon who kept in the research team and actually
performed the operation that spells hope at last for the
children formerly so do.
Speaker 3 (28:48):
In the years since the tragic case of Gregory Gliddon,
Walt Lillehigh had performed thirty five more open heart operations
using controlled cross circulation with about a seventy five percent
access rate. Once the object of derision and scorn for
his radical ideas, Lilla High had become his department's golden boy.
Speaker 12 (29:08):
Waldland was the only place that was doing okahat churgery
at that time.
Speaker 3 (29:14):
That's an archival recording of doctor Gilbert Campbell, who worked
alongside Lilla High at the University of Minnesota. In March
of nineteen fifty five, thanks to a Little Rock fundraising campaign,
Calvin and his mother, Mattie were flown to Minneapolis on
an Arkansas Air National Guard plane.
Speaker 12 (29:33):
This lady came up from Pine Bluff with Calvin Rick.
They were just a teenager, he was a knice looking
kids and a night at person.
Speaker 3 (29:44):
The Richmonds were African American. Unlike Pine Bluff, Arkansas, Minneapolis
was not legally segregated. However, the city's population was over
ninety eight percent white. Calvin and Maddie suddenly found themselves
in an extreme minority. Their race would come to play
an outsized but unstated role in Calvin's medical treatment.
Speaker 12 (30:09):
I think she was just a little bit fearful of
what might happen a lot of black people, and the
certain that some white people too are not too anxious
to undergo general anaesthasia and operations and so forth.
Speaker 3 (30:25):
American medicine is stained by a horrific legacy of white
doctors exploiting people of color, and so it's little surprise
that Mattie Richmond, a mother of twelve and a widow,
didn't trust the U of M doctors to risk her
life for the sake of Calvin's operation. Without Mattie, acting
(30:45):
as her son's heart lung donor Lilla High turned to
the Minneapolis prison population. He'd convinced inmates to volunteer for
operations in the past, but in the case of Calvin Richmond,
he had no such luck. With the boy's time running out,
little High came to Maddie with a last resort, a
procedure never before tested on a human patient. Here's Minnesota
(31:09):
heart surgeon doctor Sarah Shumway.
Speaker 9 (31:12):
Gilbert Campbell had done a number of studies in animals,
and they used a dog lung, and the dog lung
acted as an oxygenator so they could see exactly where
the holes were located. It was a wild thing to
try to do.
Speaker 12 (31:28):
I'd never used it on a hamlet one during some
other operate. I tapped into a vein and returned it
good to make sure it would work. Don't expect to
find them and inner debate in the wilderness. You know
we're flowing new ground.
Speaker 3 (31:46):
Little High's personal motto was ready, fire, aim, In other words,
act first, make adjustments later. He began preparing to attempt
Gilbert Campbell's dog lung techniqueeen year old Calvin. On March
(32:09):
twenty third, nineteen fifty five, Calvin Richmond was wheeled into
ther his chest was cut open and his heart exposed.
Rather than using a human donor to oxygenate the boy's
blood during surgery, Lilihigh connected Calvin's blood vessels to a
dog's lung, which was suspended on a stand and heated
(32:31):
to body temperature. Lila High opted for a country dog
because the lungs of city dogs were often coated in soot.
Speaker 13 (32:40):
They ran his blood through it while they stopped the heart,
opened it and fixed this traumatic defect, and then closed
the heart.
Speaker 3 (32:48):
That's cardiac surgeon, doctor Chip Bowman.
Speaker 13 (32:51):
That would be very controversial now, I mean impossible. But
the boys alive because of it, you know, And that's
all all cared about.
Speaker 3 (33:01):
Trading a dog's life for a boys. The procedure was
grotesque by any standard, but it worked. The day after
the operation, Calvin was up and joking with the nursing staff.
Within a month, he was on his way back to Arkansas,
his whole life ahead of him, and Walt Lillaheigh, having
(33:22):
finally earned the trust of the U of M hospital administrators,
was on a roll. He was entering the most creative
and wildly productive period, not just in his life, but
in the life of any surgeon in history.
Speaker 13 (33:37):
He couldn't be bothered by what other people thought. Maybe
to a fault, I guess genius of this type doesn't
come in plain vanilla packages.
Speaker 3 (33:47):
Lolahai made for an unlikely celebrity, though he was quietly
intense and introverted. The man had a flare for the dramatic.
Speaker 14 (33:55):
He loved dressing for attention.
Speaker 3 (33:59):
That's seeable. She's a nurse who worked with doctor Lillihigh.
Speaker 14 (34:02):
He was known for having flamboyant clothes. He would wear
a dinner jacket and everybody else would be in their
sports jacket.
Speaker 3 (34:13):
Five years had passed since Lila High's debilitating cancer operation,
and something in him had changed. Here's an archival recording
of Lila High's protege, doctor Richard Duwall.
Speaker 15 (34:29):
He developed an incredible capacity for alcohol. He would drink
enough to put four or five people under, but he
never showed it. He went through a well of a
lot at that time, so I think this probably changed
his mental attitude of live today.
Speaker 3 (34:47):
Lillahi lived and operated at a breakneck pace. He'd work
in the o rs and the animal labs until late
in the evenings and then often drove straight to a
local jazz club. He left little time for Ka and
their young family.
Speaker 16 (35:04):
In many ways, we were raised by my mother. She
was the one who was at the football games and
all the events and such.
Speaker 3 (35:11):
That's Walt and k Lilla High's son, doctor Craig Lilihigh.
Speaker 16 (35:14):
There were resident parties or different parties and nightclubs that
he'd been at, but there were times when he clearly
wanted to be away up in his office. I don't
know when he slept. He seemed to be up at
all hours of the night in the study, and he'd
walk in there and.
Speaker 3 (35:29):
The lights would be on. He was wide awake. Now,
with his sudden flash of stardom, the demands on Lili
High's time were greater than ever before. In nineteen fifty five,
Lila High was asked to speak at a meeting of
(35:50):
the American Thorassic Association in Houston. The conference was held
at the Shamrock Hilton, across the street from the Baylor
College of Medicine. Denton Cooley was in the audience that day.
He watched as this sharply dressed surgeon with an oddly
tilted neck took the stage.
Speaker 14 (36:09):
Walt was invited everywhere to give talks.
Speaker 3 (36:13):
That's nurse cea ballman again.
Speaker 14 (36:16):
I thought he was a wonderful speaker, but he would
always just speak a little bit longer than you would
hope he would.
Speaker 3 (36:27):
Walt Lillehigh presented a film of his cross circulation technique.
Despite the procedure's success, its unseemliness still tended to provoke
a mixed reaction, but Denton Cooley was captivated. Here's doctor Alilihigh.
Speaker 15 (36:42):
I had the honor of showing Denton the inside of
the living human heart for the first time you ever
saw it.
Speaker 3 (36:49):
He said, it was like viewing through against heaven. As
he watched Lillihigh on stage, seemingly impervious to any and
all criticism, Cooley saw something that he craved desperately for himself.
Here was a man living and working on the edge.
Lilahigh wasn't just breaking rules, he was writing his own
(37:10):
rule book. By the middle of nineteen fifty five, Cooley
and DeBakey had performed two hundred and forty five aneurysm
repairs between them, and Cooley was living up to his
promise as an unflagging workhorse.
Speaker 4 (37:29):
My father was.
Speaker 8 (37:30):
We call him the ever ready battery Man because he
truly was always always working.
Speaker 3 (37:36):
That's doctor Louise Cooley Davis again.
Speaker 8 (37:38):
I guess with you know, playing basketball and knowing how
to run up and down the court, we have to
be very disciplined.
Speaker 3 (37:45):
But over the last year, Cooley's power dynamic with debake
had started to grade on him. Here's medical historian and
plastic surgeon, doctor Gerald Imber.
Speaker 17 (37:56):
No one manipulated the press as effectively as debaking And
here is a guy named Cooley who's a far better surgeon,
faster surgeon, more efficient surgeon, certainly an easier guy to
get along with, and he wanted to be out of
DeBakey's shadow.
Speaker 3 (38:15):
Cooley always felt he was marked for greatness. He saw
himself as an innovator on par with his mentors, but
he would never live up to that promise if he
spent the rest of his career fixing aneurysms for doctor DeBakey.
Now he was ready to make his own seminal contribution
to the field. If debake wasn't going to support his ascension,
(38:35):
Cooley would have to blaze his own trail. In June,
Cooley and his colleague doctor Dan McNamara flew to Minnesota
to watch Walt Lillahi in action. Ioha came to pick
him up.
Speaker 5 (38:52):
It was a customed then, as probably is still for
the visitors to be treated the night before their visit.
Speaker 3 (38:59):
That's doctor Dudd Frasier again.
Speaker 5 (39:01):
So they were supposed to go out to some nice restaurant,
which Coolly anticipated and everything. Instead of going to a
nice restaurant, they go to a road house outside of Minneapolis,
you know, dancing girls and all of that.
Speaker 3 (39:21):
Doctor McNamara took off early, leaving Cooley to party late
into the night with the insatiable lillahih.
Speaker 5 (39:29):
One of the things Cooley told me, he said, You've
got to always remember, never never drink was Walt Lilaha.
Speaker 3 (39:35):
You can never keep up with him. Cooley woke up
late the next morning, hungover and exhausted. He and McNamara
rushed to the University Hospital where Lilla High was scheduled
to perform a VSD repair. At nine point thirty, a
half hour after the appointed time, Lila High finally turned up.
Speaker 5 (40:00):
He went out to the scrubber sink and was splashing
cold water in his face, and the nurse came out
and broke an amal nitrate under his nose, the old
boxer routine, and he go ahead, He did the case.
Speaker 3 (40:13):
And killed his head.
Speaker 5 (40:14):
Is a pretty surgery they were seeing, but it was.
Speaker 3 (40:18):
What happened later that day that really left an impact
on Cooley. He and McNamara were treated to a tour
of Lili High's lap, where they saw a prototype that
would be laughed out of any medical conference. This was
what Lili High was truly excited about. It looked like
(40:38):
his cross circulation set up on steroids, a tangle of
coiled hose, a Sigma motor pump, plastic tubes suspended on stands,
and a blood reservoir. The whole apparatus cost about thirty dollars.
To macnamara, it looked like the work of a madman.
To Koley, it felt like looking into the future. This
(41:02):
radical heart lung bypass machine represented everything Kooley had been
waiting for. If he could just replicate it back in Houston,
it would grant him access to the new and wild
frontier of open heart surgery and all of its endless
possibilities for innovation and glory. This was his chance to
(41:23):
step out of Michael de Bakey's shadow, out of Alfred
Blaylock's shadow, and onto the cutting edge. Denton, Cooley, and
the city of Houston were about to enter the heart race.
Speaker 1 (41:45):
On our next episode, a devastating turn of events forces
Walt the Laid to rethink open heart Surgery and in Houston,
Denton Cooley's swift rise plunges him into a battle of
egos with his boss and mentor Michael DeBakey, next time
on Cardiac Cowboys.
Speaker 3 (42:13):
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
(42:33):
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
Paul Johnson. Our composer is David Mansfield. Our cover artwork
(42:58):
is designed by Alexander Smith. Archival materials courtesy of Special Collections,
University of Rhode Island Library and g Wayne Miller, author
of the Walt Lilla High biography King of Hearts, The
True Story of the Maverick who pioneered open heart surgery.
For more information on the first cardiac surgeons, check out
(43:18):
doctor Gerald Imber's book Cardiac Cowboys, The Heroic invention of
heart surgery.
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