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If you like Denton Cooley's story, you might also like:
Tenley Albright,
Keith Black,
Benjamin Carson,
Paul Farmer,
Judah Folkman,
Willem Kolff and
Thomas Starzl

Denton Cooley's recommended reading: Miss Susie Slagle's

Teachers can find prepared lesson plans featuring Denton Cooley in the Achievement Curriculum section:
Frontiers of Medicine

Related Links:
Texas Heart Institute
PBS

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Denton Cooley
 
Denton Cooley
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Denton Cooley Interview (page: 6 / 9)

Pioneer of Heart Transplants

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  Denton Cooley

Dr. Cooley, your speed as a surgeon is world-renowned. To what do you attribute that?

Denton Cooley: I think it's having a game plan. I know what I want to do, and I try to think through the easiest, the best, the quickest way to get there. I try to do everything gracefully, and minimize the number of motions. What is the quickest way to get there? A straight line is the shortest distance between two points, and I try to use that concept in getting things done.

You also have a great reputation for keeping cool under pressure. How did you learn that, and was that something that you realized early on was important?

Denton Cooley Interview Photo
Denton Cooley: I don't know how I learned that, but I figure it had something to do with my athletic experience. At the most critical point in crucial games, you have to be in total command of your faculties. I don't like to see surgeons get frantic when something crucial comes up. I've found that I can solve such problems much better if I keep cool. When I'm cool, I can get my team to stay cool and confident. Then we get the best effort, even at those critical times.

Was there a time when you were a little hot headed? Did you have to teach yourself to calm down, or were you always like that?

Denton Cooley: I've always calm, I think. I've never been a temperamental type. I like to be a team player. I want to be captain of the team, and I think a good captain is someone who has everyone behind him and supporting him. There's an old war story about second lieutenants who abuse their soldiers. When they go over the top, more of the new second lieutenants get shot in the back than get shot in the chest. I don't want my team to think ill of me. And I want them to feel like I'm there to help them, and that I will stand behind them, even when they make a mistake.

You mentioned working as a team, and you have made an analogy between a surgical unit and a sports team. How are they similar?

Denton Cooley: A surgical unit is a team. When we do one of these operations, we may have three or more surgeons at the operating table. I try to be fair with everyone, and not overly critical. I realize many of my assistants are very learned. and if they were already accomplished surgeons, they probably would not be assisting at the operating table. I try to be a good teammate, and a good leader,

In a lot of ways, surgery is a team sport, isn't it? You have to be able to work with people.

Denton Cooley: It is, yes.


I have visited many operating rooms around the country, and seen many really celebrated surgeons in the operating room. The ones that I admire the most are those who maintain a sort of even pattern of behavior, who treat their assistants and nurses well, and don't have flights of temperament or anger, and that sort of thing. To me, it just reflects their insecurity. I just don't believe that that's the way -- the pattern -- that I want to follow. I have five junior surgeons who are my associates, and none of them are temperamental. I selected them all because I liked their behavior in the operating room. In another institution, right here in our medical center, the surgeons are highly temperamental, and there are all sorts of histrionics going on in the operating room. You don't see that at the Texas Heart Institute.

[ Key to Success ] Integrity


I'd rather come here for my heart surgery. It must take a very healthy ego to have the courage to open up another person's heart. Is that the case, do you think?

Denton Cooley: Well, ego is a funny word. I think that might be part of it, but it's still a matter of self-confidence. You develop that as you gain more and more experience.

I think surgeons are perhaps a little more egotistical than the average doctor. So much praise is heaped upon you, because of the dramatic aspects of surgical procedure, as opposed to overcoming other types of illness. The doctor may have accomplished just the same thing, but by a slower process.

Is that uncomfortable? All that adulation from patients and colleagues and students?

Denton Cooley: Sometimes it is, but it's also a great feeling of reward for what you've done. I rather enjoy it.

How do you prepare for surgery? Is there a certain mind set?

Denton Cooley Interview Photo
Denton Cooley: I like to think through what we're going to do, and try to anticipate what will be presented at the time of an operation. In anticipating things, I develop a game plan that helps me perform the operation in the simplest and most direct manner.

Do you prepare yourself psychologically for an operation? Do you have to brace yourself, or is it just routine?

Denton Cooley: It depends on the nature of the operation. If it's a particularly risky one, I do try to prepare myself. For an operation like the first heart transplant we did here in 1968, I was determined that my part of the procedure was going to be done in the best possible manner. All through the operation, I was telling myself to do my best. Some operations are more or less routine, so you're not under so much pressure.

So during the transplant, for example, you're kind of coaching yourself as you go along.

Denton Cooley: That's right. So much goes into doing a transplant operation. All the way from preparing the patient, to procuring the donor. It's like being an astronaut. The astronaut gets all the credit, he gets the trip to the moon, but he had nothing to do with the creation of the rocket, or navigating the ship. He's the privileged one who gets to drive to the moon. I feel that way in some of these more difficult operations, like the heart transplant. I got all the glory for doing the heart transplant, but actually, the technique of implanting the heart is not that difficult. People believe that anyone who can transplant a heart is some sort of magician, a special, gifted surgeon. Whereas now we know that any surgeon can do a heart transplant. Any of our resident surgeons who are in training can do the procedure. In the early years, I think transplant surgeons were glorified beyond reason.

Dr. DeBakey, how important is risk in your work? Sometimes you do have to take chances. How often do you have to proceed without absolute evidence?

Michael DeBakey: You do have to take some risks. For example, when I did the first operation for stroke, that was the first successful enterectomy. This was in 1953. We had no experimental model to go by. Technically, we had already proven that you could do an enterectomy, you could separate the plaque from the artery. So all we had was the evidence that had been built up previously, showing that these lesions were associated with strokes, and that patients who had died of strokes, were all found to have these lesions. There was a good correlation. Therefore the suggestion from all of these studies was that if you could remove that, you might prevent someone having a stroke.


I had to take the risk on the first patient I did. He happened to be from Lake Charles, a bus driver who was having what we call TIA's, transient ischemic attacks. And these attacks would occur in such a way that there wasn't enough blood going to that part of the brain, and he would get partially paralyzed, temporarily, and have to stop, when he was driving a bus. He finally realized he couldn't continue doing that. So his doctor sent him over here for us to look at. Not with that idea of doing this, but rather to see if there was anything we could do to help him. And I finally decided that this was the thing to do, and I talked with him about it, and explained to him it had never been done. But I said, you know, I think this is -- I explained to him what was involved, that the operation was a relatively simple technical procedure. And I think maybe because I was from Lake Charles too, he had confidence in what I said, and he submitted to it. Agreed. And it fortunately proved very successful. In fact, he lived 19 years after that, died of a heart attack. Never had any more transient ischemic attacks.


So you do have to accept some risk sometimes.


I had the same experience with the first patient I operated on for an aneurysm of the thoracic aorta in the chest. This was a man from Arkansas, and he was having a lot of pain, because this thing was ballooning out, pressing on structures. So I explained to him that we had done this in the abdomen, but nobody had ever done it successfully in the chest. I thought the same principles would apply. And he finally submitted, I think mostly because he was in such severe pain. He wanted anything to get some relief. Fortunately it was successful. And so he became a pioneer in lending his efforts to getting this done. That started us on the whole course of getting aneurysms in the chest. As time went on, we developed techniques for all aneurysms of the aorta.


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This page last revised on Sep 29, 2010 18:05 EDT
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