An Evening of More Than The Past, Present, Future: Part 1
Yesterday, September 19th was the kick off for the series of lectures at the Continuing Studies program at Rice University. It was at Sewall Hall at the Rice Campus. Dr. Denton A. Cooley, the pioneer of human heart transplant in the United States, still observably sprightly at 87, was the lecturer for the day. He is currently president and surgeon-in-chief at the Texas Heart Institute; program director for the Texas Heart Institute/Baylor College of Medicine Thoracic Residency Program; and chief of cardiovascular surgery at St. Luke’s Episcopal Hospital. Here are some of my notes on this experience.
Dr. Cooley, His Influences, and The People He Worked With
with Dr. Cooley
In 1941, he entered the Texas College of Medicine at Galveston, but soon transferred to Johns Hopkins in Baltimore. His medical education was provided in part by the Army Specialty Training Program. He obtained his M.D. degree in 1944 and remained at Hopkins as an intern, assisting Dr. Alfred Blalock in the first “blue baby” operation, to correct an infant’s congenital heart defect.
Cooley’s extraordinary record in these years attracted both praise and criticism. Many Americans did not accept the end of brain activity as the moment of death, and condemned the practice of removing a beating heart for transplant. In 1969, with no donor heart available for his dying patient, Dr. Cooley took a great risk by implanting an experimental artificial heart. After 65 hours, a human heart became available, and Cooley replaced the artificial heart, but the patient died a day later. Dr. Barnard, the pioneer of heart transplantation, praised Cooley’s decision, but Cooley’s former colleague, Dr. De Bakey was harshly critical.
Texas Medical Center: Past, Present, and Future was both an educational and inspiring overview of how Houston evolved to be one of the world’s renowned medical centers.
And along with Dr. Cooley, among many of those who envisioned a medical center of excellence were Dr. DeBakey
Michael Ellis DeBakey is an internationally recognized and respected physician and surgeon, noted for his pioneering work in the field of cardiovascular surgery, as well as for his innovative research into this and other fields of medicine. He is credited with inventing and perfecting scores of medical devices, techniques and procedures which have led to healthy hearts and productive lives for millions throughout the world. Dacron arteries, arterial bypass operations, artificial hearts, heart pumps and heart transplants are common procedures in today’s medicine…
and Dr. E. W. Bertner, Dr. Cooley’s mother’s obstetrician.
His participation and contribution in medicine and surgery included the opportunity to work with the late Dr. Alfred Blalock, who
did pioneering work on the nature and treatment of hemorrhagic and traumatic shock. He demonstrated that surgical shock resulted primarily from the loss of blood, and he encouraged the use of plasma or whole-blood transfusions as treatment following the onset of shock. This early work on shock is credited with saving the lives of many casualties during World War II.
He also worked with the late Dr. Vivien Thomas, Dr. Blalock’s “invaluable associate,” who was compelled to stand behind the others in the operating theater despite his abilities and contributions because of racial segregation. “This lowered me,” Dr. Cooley said while he showed us a photograph of that theater at Johns Hopkins where he was assisting Dr. Blalock. Looking on were the late Dr. Helen Taussig, a pediatric cardiologist, and Dr. Thomas, visibly behind them.
Vivien T. Thomas was a key player in pioneering the anastomosis of the subclavian artery to the pulmonary artery.The surgical work he performed with Alfred Blalock paved the way for the successful outcome of the Blalock-Taussig shunt.
Taussig remembered listening to a conversation in 1943 between Alfred Blalock and Edwards A. Park. The discussion had to do with the difficulty associated with cross-clamping the descending aorta to repair a coarctation. Park inquired,
Could you not use the carotid artery as a bypass? It is a long, straight artery and there are four vessels to the brain. Wouldn’t it be possible to turn the carotid artery down and anastomose it to the aorta below the coarctation?
Regardless of the variance in the stories recounting the origination of the procedure; it is clear Blalock together with Vivien Thomas, continued to move forward with the problem of providing oxygen to the pulmonary artery. The shunt first tried at Vanderbilt ultimately provided the answer. The operation was first performed on a very ill, high-risk patient in 1944. Although the frail child died months later in a second operation, the child survived long enough to demonstrate the survival of a surgical procedure that would save the lives of tens of thousands of children.
Before he went on with the specifics of his work and that of the institutions, he expressed thanks and recognition to the hospital teams who are invaluable as the surgeons but often forgotten.
Papers, Procedures, Establishments
(will be continued for another day’s post.)