• By Detcare
  • Posted On September 14, 2018

Two Great Surgeons, one Heart and their famous WAR over it| Detcare

May be medicine’s most famous feud and certainly one of its longest-lived, it involved two of the world’s greatest heart surgeons, Dr. Michael E. DeBakey and Dr. Denton A. Cooley. Their dispute lasted over for decades before finally being settled.

This is how it started:

It began in 1960, when Dr. Cooley left Dr. DeBakey’s practice at Methodist and moved the few hundred yards to St. Luke’s Hospital, where he later established the Texas Heart Institute. Till that time the rift was fine, but it was an incident in 1969 that turned the rift into a full-blown feud.

It happened when Dr. Cooley, without approval from Dr. DeBakey or Baylor, commandeered an artificial heart from his former partner’s lab and implanted it in a patient at St. Luke’s.

Over the years, Dr. DeBakey has called that first-ever use of a total artificial heart a theft, a betrayal, unethical and “a childish act” to claim a medical first. Dr. Cooley defended the implant as a desperate, if ultimately unsuccessful, act to save a life.

The American College of Surgeons censured Dr. Cooley and this furor led Dr. Cooley to resign from Baylor Institute of Health, which in turn ordered further investigation into the incident, the report of which was never published.

In those days, cardiac surgery was in many ways in its infancy. It was only in 1966 that Dr. DeBakey had been the first to successfully implant a partial artificial heart — a left ventricular assist device — in a patient.

The need for a device that could pump for both ventricles — a total artificial heart — became more apparent.

The artificial heart was developed in Dr. DeBakey’s lab at Baylor, with funds from the National Heart Institute. It was a half-pound device of plastic and Dacron, linked by plastic tubes to a bedside control console.

How Dr. Cooley obtained the device is not exactly clear. But this much is undisputed: On April 4, 1969, Dr. Cooley implanted it in Haskell Karp, 47, from Skokie, Ill. Dr. Cooley had help from Dr. DeBakey’s artificial-heart technician, Dr. Domingo Liotta, who was said to have been frustrated by the limited time that he contended Dr. DeBakey put into the project.

The machine kept Mr. Karp alive for three days, longer than any animal in which it had been implanted. Dr. Cooley then issued a call for a human heart and transplanted it, according to Ruth SoRelle, a Baylor medical historian. Mr. Karp lived 36 more hours.

Dr. DeBakey had never sought approval to use the device in a patient, for lack of good experimental evidence that it worked even in calves. He learned about Dr. Cooley’s implant from colleagues in a meeting at the National Heart Institute.

Shocked and embarrassed that he knew nothing about the implant, Dr. DeBakey flew to Houston and began an investigation, saying Dr. Cooley’s unauthorized use of the device broke federal rules and jeopardized Baylor’s grants. (Dr. DeBakey was chancellor of the medical college.)

As Dr. DeBakey recalled in an interview, he refused to testify in the litigation that followed; he did not want his rival to be found guilty. “Much as I regretted what he did,” Dr. DeBakey said, “I didn’t think vengeance would solve anything.”

“He wanted to be able to say he was the first one to use an artificial heart in a patient,” Dr. DeBakey added. “I never quite understood it other than his ambition was almost uncontrolled. I mean, you don’t let your ambition get you in trouble.”

Even after their reconciliation, Dr. DeBakey said that Dr. Cooley had “disappointed me with his ethics” and “poor judgment” in doing the implant, which was “a little childish.”

Whereas Dr. Cooley, in an interview this month, said he “was justified” in what he did. In 1969, he added, he was performing more heart operations each year than Dr. DeBakey or anyone else, and so he considered himself “the appropriate person to do the first implantation of an artificial heart.”

Dr. Cooley, had sought a meeting with Dr DeBakey for decades to resolve the issue. In an interview, he asked the reporter to set up a meeting with Dr. DeBakey. Responding to that request, Dr. DeBakey called the very idea of a feud “a journalistic fabrication” but then declined the offer, saying such a meeting would only perpetuate the fabrication.

The meeting finally happened when Dr DeBakey was awarded Congressional Gold Medal and lifetime achievement award from Denton A. Cooley Cardiovascular Surgical Society, which he accepted.

After the reconciliation, he said in an interview that “there was no reason to consider him an enemy” and “we have never had any bad words,” although “we haven’t had very much in the way of communication.”

Dr. DeBakey had a  major emergency surgery in February 2006 to repair a torn aortic aneurysm — a chest operation that he and Dr. Cooley had developed a half-century earlier.

The illness provided Dr. Cooley with another opportunity to seek a rapprochement .

“Why carry on this so-called animosity into our graves?” Dr. Cooley said in an interview.

Soon after Dr. DeBakey went home from the hospital, Dr. Cooley said, he stopped by Dr. DeBakey’s house unannounced. Dr. DeBakey’s wife, Katrin, told him that Dr. DeBakey had not had a good day and was not available.

Dr. Cooley said he then wrote to Dr. DeBakey and explained that he wanted “a few minutes to pay my respects or at least reminisce about some of the events in our careers” and gave assurance that he “would be sure to make an appointment.”

Dr. DeBakey later said that he knew Dr. Cooley had come by and sent a letter, but that he had not replied.

Dr. DeBakey said that Dr. Cooley was “one of the best cardiovascular surgeons” he had ever seen, and that “almost all of my firsts were associated with him in those pioneering times.”

He further added: “If I had to have a serious operation and if I don’t have one of my own people(trained under me) to perform, then Dr Cooley would be the man I would like to do the operation because I have such great confidence in his surgical talent.”

Later Dr. DeBakey’s society, reciprocates in honoring Dr. Cooley at its annual meeting next spring.

Dr DeBakey died in 2008 and Dr Cooley expired in 2016.

Respect the rivalries that strive to make the innovations to move fast forward for the betterment of medical science and long live the name of the two legends.


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