Denton Cooley, the fastest heart surgeon

Dr. Gabe Mirkin

Dr. Gabe Mirkin

Heart surgeon Denton Cooley, who died on November 18, 2016 at the age of 96, was better than his peers in just about everything he did.  He founded the Texas Heart Institute in 1972, where he and his team performed 

• almost 120,000 open heart operations, 

• 258,000 cardiac catheterizations and 

• 270 heart transplants.  

He wrote more than 1,400 scientific papers and 12 books.  

On May 3, 1968, Cooley performed the first human heart transplant in which the patient survived more than a week.  The following year, he performed the first implantation of an artificial heart in a human and did 22 heart transplants. He was the first surgeon to successfully remove pulmonary embolisms (clots in lungs) by squeezing the lungs.  He made many innovations in treating congenital heart defects in infants and developed new artificial heart valves. 

Early Life and Education

Cooley grew up in a prosperous suburb of Houston, the son of a successful but alcoholic dentist.  At 6’4″ in high school, he was a star on his basketball, tennis and golf teams and was at the top of his class academically. He won a basketball scholarship to the University of Texas and in 1941, he was the best player on their team that won the Southwest Conference championship.  He was graduated with highest honors and won a Phi Beta Kappa Key.  He  played bass in a performing musical group, and maintained this passion — along with golf and tennis — throughout his life. 

After college, he began his medical studies at the University of Texas in Galveston, but his family physician encouraged him to transfer to world-famous Johns Hopkins, where he continued into a surgical residency.  After being appointed chief resident of surgery, he assisted Dr. Alfred Blalock in the groundbreaking surgery to correct the “Blue Baby” congenital heart defect.  In 1950 he worked in London with world-famous heart surgeon, Lord Russell Brock and doubled the number of cases performed on that service. In 1951, at the age of 31, he returned to Baylor in his Houston hometown to begin a fractious 18-year relationship with Michael Debakey, the most famous heart surgeon of all time.  Together, they developed groundbreaking treatments for aortic aneurysms.  

The Most Famous Rivalry in Medicine: Debakey vs Cooley 

In the 1950s, when I was a medical student at Baylor, the most famous heart surgeons in the world were Debakey and Cooley and they were as different as day and night:   

• Debakey preceded most experiments on humans with animal experiments. Cooley often did his research directly by operating on people. 

• Debakey was a deft politician and policy maker.  At Baylor, he was chairman of the department of surgery, then president, and then chancellor.  He was also instrumental in establishing medical policies in the United States and throughout the world.  Cooley concentrated on surgery. 

• In his quest for perfection, DeBakey terrorized everyone. I remember seeing him slap an elevator operator for not picking up his entourage at 6:00 AM quickly enough.  Cooley was calm and controlled. 

• Debakey did not include Cooley in his plans to develop a total artificial heart or his transplant program. 

The Blow-Up

In April 1969, Cooley became the first surgeon to implant a total artificial heart in a man when no donor heart was available.  DeBakey was out of town at the time.  The artificial heart kept the patient alive for 64 hours until a donor heart became available, and Dr. Cooley then replaced the artificial heart with the donor’s heart.  The patient died a day after the second operation.

The artificial heart had been developed by Debakey, and Cooley used it without getting DeBakey’s permission.  Debakey was furious that Cooley would get credit for this “first,” but told everyone he was afraid that Cooley’s actions would cause research funds from the National Institute of Health would be withdrawn. The American College of Surgeons, the National Heart Institute and Baylor University all sided with DeBakey and blamed Cooley for unethical conduct. Cooley was forced to resign from Methodist Hospital where Debakey held sway. Lawyers for the patient’s widow filed a multi-million dollar malpractice suit against Cooley, but it was eventually dismissed by the federal courts.  For the next 40 years, DeBakey refused to talk to Cooley or even to refer to him by name.  

Probably the Fastest Surgeon Ever

Denton Cooley

Denton Cooley

In 1972, Cooley established the Denton A. Cooley Cardiovascular Surgical Foundation and performed as many as 25 heart operations in a single day at his 29-story Texas Heart Institute building in Houston. 

Dr. Cooley believed that the length of an operation had an impact on its  success, so he became an exceptionally fast surgeon.  Colleagues said that his individual movements were slow, but everything was perfect the first time so no time was wasted doing things over.  Bud Frazier, Cooley’s associate surgeon, said, “Cooley did 15 surgeries a day and most didn’t last more than 20 minutes.  He was four times as fast as most, twice as fast as the next fastest. There’s not a surgeon alive today who could do what he could do.”   At age 50, he was the only surgeon ever to have done more than 1200 bypass surgeries and 10,000 open-heart operations. He oversaw as many as 30 operations daily and corrected many of the most difficult cases himself.  He personally repaired about 12,000 aortic aneurysms.  

He developed new surgical techniques which, combined with his speed, allowed him to perform “bloodless open-heart surgeries” that could be done on patients such as Jehovah’s Witnesses, whose religious beliefs prevented them from receiving another person’s blood.

Confidence: A Desirable Trait in a Heart Surgeon

To survive his early shyness that came from a childhood with a destructive alcoholic father, he worked harder than everyone else to become a brilliant student and  a brilliant surgeon.  He said, “I always felt that I did well as a student because I lacked confidence.”  Even though his father was financially successful as a dentist, Cooley’s exposure during his childhood to abuse and constant bickering between his parents made him insecure, particularly about money.  During his surgical training he earned money by donating blood regularly.  In spite of making tens of millions of dollars as one of the world’s foremost surgeons, he risked everything on precarious real estate deals that went bust and forced him to declare bankruptcy at age 68 in 1988. 

People who need heart surgery have a high risk of death, and many of the patients did die.  The family of one patient who died sued Cooley, and during the trial, the prosecuting lawyer  asked him if he considered himself to be the best surgeon in the world.   He said, “Yes”.  The lawyer then asked him, “Don’t you think that’s being rather immodest?”  He replied, “Perhaps, but remember I’m under oath.”

Reconciliation with DeBakey

in 2007, Cooley wrote to DeBakey, “As time passes, I have a growing desire to meet with you and express my gratitude for the influence you have had on my life and career . . . Especially, I am grateful for the opportunity you provided me more than 50 years ago to become established at Baylor and to be inspired by your work ethic and ambition.”  Just before DeBakey’s death (at age 99), he accepted honorary membership in the Denton A. Cooley Cardiovascular Surgery Society with a handshake from Cooley.

He Never Retired

In 2003, The University of Texas built the Denton A. Cooley Pavilion next to its basketball arena.  Cooley received the Presidential Medal of Freedom from Ronald Reagan in 1984 and the National Medal of Technology from Bill Clinton in 1998.  He stopped performing surgeries at age 87 but never retired; he was working in his office  at his Texas Heart Institute just a few days before his death. 

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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