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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: 7 / 9)

Pioneer of Heart Transplants

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  Denton Cooley

Dr. Cooley, for all the accolades that you received for the transplants, they also raised a lot of legal and moral questions. Could you describe some of those controversies, and how you felt about them?

Denton Cooley Interview Photo
Denton Cooley: When cardiac transplantation was first performed by Christiaan Barnard in 1967, it's amazing how little we knew about the true meaning of life. Where does life reside? Is it in the heart, or is it in the brain? Where is it? What is life? That's what got everyone in such a turmoil. That's what brought up all of these moral and ethical issues. How could a man take the heart, a beating heart, out of one individual, and put it in another? No one was concerned about the recipient. You could see why he would like to have a nice, new heart, but what about the donor? At that time, so many people were completely ignorant about brain death. This was the first time it had been pointed out clearly, and in bold print, that there was such a thing as brain death, and that once the brain had been hopelessly destroyed, these other organs, which were still functioning, could be given to someone else.

Many of the moral and ethical issues that we confronted at that time have been almost forgotten over the past couple of decades. It is interesting to me that today, even some countries that are far advanced in technology, such as Japan, still have not done a heart transplant, because certain biases exist in that society. In this particular instance, they're not involved in what we consider educated, 20th century scientific thought. But they'll come around to it. We have broken the ice with our work in this country, and other western societies.

Have you ever had any spiritual conflicts about these tough decisions you've had to make? I know at times you've had to choose between recipients.

Denton Cooley: Yes, that is sometimes a problem. It's a lot of responsibility deciding which individual should get the donor heart. The surgeon must also decide whether the donor organ is suitable, which is a very final decision. The only available donor heart may be of marginal quality. Should you put it into a young person, even though a transplant is the only hope for survival? It's a heavy responsibility.


One of the most trying times in my career was when we did the first heart transplant. We put it into the patient, and wondered whether it was going to work. Suppose it had not functioned? We weren't certain at all that it would function. So that five or ten minutes, while we were waiting for that heart to regain its function, was one of the most difficult times of my surgical career. And I'm sure it's the same with other surgeons who have followed. Now we know that the heart will start up, and that's just part of the knowledge that we have gained through the years.

[ Key to Success ] Courage


In 1969, you engendered more controversy. What made you take the risk of implanting an artificial heart into Haskell Carr. Why was it so controversial?


Denton Cooley: At that time, the interest in heart transplantation was waning somewhat, because people were becoming concerned about rejection. And I knew that we were having more difficult time getting donors. And here was a man who needed a transplant. Needed it badly and immediately, and we were having a difficult time getting a donor for him. I did know that if we used this artificial heart, we could use that as a bridge to transplantation, and it might even stimulate the actual donation of an organ. So, when the time came and things became critical with him, we went ahead and used this artificial heart to keep him alive until we could get a donor heart. And it did keep him alive. Unfortunately, he didn't live very long after he had the heart transplantation, because he died of pneumonia. But nevertheless, it demonstrated that the artificial heart could sustain life.

[ Key to Success ] Vision


In the same way, we had found a year and half earlier that the heart transplant could sustain life.

Why did people have such a big problem with this risk that you took?

Denton Cooley: Same thing as with heart transplantation. Is it justified to take that type of risk with someone, even though he was dying? Other investigators were poised to do it, but no one would do it. The same thing happened with Christiaan Barnard and the heart transplant. A lot of us were ready to do a heart transplant, but somebody had to do it first. Because we were the first to implant an artificial heart, others said it was premature, that we hadn't done enough animal experiments. But there comes a time when you have to say, "This is a desperate situation, and we are justified in taking desperate measures."

Denton Cooley Interview Photo
Dr. DeBakey, you've seen fit, from early in your career, to become involved in public debate of issues in the medical field. Medical research using animals is one of them.

Michael DeBakey: Yes. I have done so with the purpose of trying to direct the public's attention to what I think is important for the public good, no matter what it is. Whether it was a recommendation to the President's Commission on Heart Disease, Cancer and Stroke, for a regional medical program, or for regional medical libraries, or testifying before Congress about animal experimentation.

As far as animals are concerned, I don't think the so-called animal activists have any greater concern for animals that we have. I have ten dogs in my house, and I don't know how many birds. As pets. Even laboratory animals become the pets of the people in the laboratory. We certainly avoid any unnecessary harm or suffering to them. However...


I think it's important to understand that, without doing animal research, you are going to stop doing certain types of research. Cardiovascular disease, for example. Everything that we do in cardiovascular work today is based upon animal research. Without them, we wouldn't be able to do anything that we do today so well. Coronary bypass is a great example. But the replacement of arteries, and grafts, things of that sort, all came from animal research. So to stop animal research, you see, is, I think, a way of saying, "Well, I don't care about any future advances in medicine. Let people suffer." I can't accept that kind of philosophy.


I don't think that's humane either.

Dr. Cooley, in an article, you were referred to as the Chuck Yeager of heart surgeons, and I think that's quite apt. You enjoy pushing the envelope.

Denton Cooley Interview Photo
Denton Cooley: I think that's true. And I like that designation for me, because I do believe that often people are hesitant to take that chance, to take that extra personal risk, in doing something.

You faced lawsuits after the artificial heart implant in 1969.

Denton Cooley: Yes, I did have a lawsuit waged against me, but it was not a very meritorious one, and it was thrown out of court.

In taking risks, one clearly risks alienating people. And even close colleagues. Have you had to develop a thick skin in this field?

Denton Cooley: Sometimes, but I'm not out to win a popularity contest. I want to do what I think is right and proper. Some people will always object, but I can't be too concerned about that.

Dr. Cooley, was it painful for you when you and Dr. DeBakey had this rift?

Denton Cooley Interview Photo
Denton Cooley: In a way it was painful, yes. But I realized, even before we split up, that his personality and mine didn't jibe. It was time for me to go my separate way, and it just happened at that particular time. I don't think we could have spent our entire careers as associates.

Do you think you were both too competitive?

Denton Cooley: It may be. We were both leaders, and you don't need two leaders on the same team. There was an opportunity elsewhere, so I created the Texas Heart Institute. I knew that the Heart Institute was going to be my future.

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