ANOTHER HERO HAS DIED

July 13, 2008, 12:27AM
Dr. Michael DeBakey: 1908-2008
Houstonian called the 'greatest surgeon of the 20th century' dies at 99
By TODD ACKERMAN and ERIC BERGER
Copyright 2008 Houston Chronicle

Dr. Sherwin Nuland, medicine's best-known historian, was visiting with Dr. Michael DeBakey three years ago when the then-96-year-old surgeon left the room to attend to some business.

Taking advantage of the moment to tour the room's extensive collection of memorabilia — the honors, photographs and mementos from an illustrative career that spanned eight decades — Nuland stopped to reflect on two antiquarian charts of the history of medicine.

"As I studied the charts, it occurred to me that no face on them was any more important in the history of medicine than DeBakey himself,'' said Nuland, a retired surgeon at the Yale University School of Medicine and author of Doctors: The Biography of Medicine. "I can't think of anyone who's made more of a contribution to the field of medicine.''

Michael Ellis DeBakey — internationally acclaimed as the father of modern cardiovascular surgery and considered by many to be the greatest surgeon ever — died Friday night at The Methodist Hospital in Houston. He was 99.
Methodist officials said DeBakey died of natural causes. He was taken to the hospital after his wife, Katrin, called 911, and he was pronounced dead shortly after arriving, said Dr. Marc Boom, executive vice president of Methodist.
DeBakey is to lie in repose within the rotunda of Houston City Hall from 10 a.m. to 3 p.m. Tuesday, officials at Baylor College of Medicine said. Funeral services are planned for Wednesday.

Chancellor emeritus of Baylor College of Medicine and a surgeon at Methodist since 1949, DeBakey trained thousands of surgeons. During his career, he estimated he performed more than 60,000 operations. His patients included the famous — Russian President Boris Yeltsin and movie actress Marlene Dietrich among them — and the uncelebrated.

"He was a great contributor to medicine and surgery," said Dr. Denton Cooley, president and surgeon-in-chief at the Texas Heart Institute in Houston and a former rival of DeBakey.

"But he left a real legacy in the Texas Medical Center and at Baylor College of Medicine, where he's brought so much attention," Cooley said. "Together, we were able to establish Houston as a world leader in cardiovascular medicine."
Dr. George Noon, a cardiovascular surgeon and longtime partner of DeBakey's, said he "single-handedly raised the standard of medical care, teaching and research around the world. He was the greatest surgeon of the 20th century, and physicians everywhere are indebted to him for his contributions to medicine."


DeBakey almost died in 2006, when he suffered an aortic aneurysm, a condition for which he pioneered the treatment. He is considered the oldest patient to have both undergone and survived surgery for it.

He recovered enough to go to Washington earlier this year to receive the Congressional Gold Medal, one of the nation's two highest civilian honors.
He remained vigorous and was a player in medicine well into his 90s, performing surgeries, traveling and publishing articles in scientific journals. His large hands were steady, his hearing sharp. His personal health regimen included taking the stairs at work and a single cup of coffee in the morning.
DeBakey's death was mourned by the leaders of Methodist and Baylor.
Methodist President Ron Girotto said: "He has improved the human condition and touched the lives of generations to come. We will greatly miss him."
Baylor President Dr. Peter Traber added: "He set a standard for pre-eminence in all areas of his life that those who knew him and worked with him are compelled to emulate. And he served as a very visible reminder of the importance of leadership and giving back to one's community."

Built a reputation
DeBakey was born in Lake Charles, La., in 1908, a month before Ford began making Model Ts and a quarter-century before the discovery of bacteria-fighting drugs. While still in medical school, he developed the roller pump for the heart-lung machine. DeBakey invented many of the procedures and devices — more than 50 surgical instruments — used to repair hearts and arteries.
He is widely credited with laying the foundation for the Texas Medical Center in Houston by recruiting doctors and researchers and giving the city an international reputation for leading-edge health care. He was a maverick, running afoul of the Harris County Medical Society for insisting that surgeons be certified by the American Board of Surgery. At the time, it was common for general physicians to operate.

"DeBakey built a department of surgery at Baylor and at The Methodist Hospital, which was to become one of the most celebrated in the world, a galaxy of young stars," the late author Thomas Thompson wrote in 1970 in Hearts: Of Surgeons and Transplants, Miracles and Disasters Along the Cardiac Frontier. "In a city where 25 years ago there was practiced medicine of the most mediocre sort, there sprung up in a swampy area 6 miles south of downtown ... one of the handful of distinguished medical centers in the world."
DeBakey invented and refined ways to repair weakened or clot-obstructed blood vessels using replacements made from preserved human blood vessels and, later, with artificial ones. He is credited with the first successful surgical treatment of potentially deadly aneurysms of various parts of the aorta. In 1939, he co-authored one of the earliest papers linking smoking and lung cancer.

During World War II, while he served in the Office of the U.S. Surgeon General, DeBakey's work led to the development of mobile surgical hospitals, called MASH units. He helped President John F. Kennedy lobby for Medicare; he recommended creation of the National Library of Medicine, subsequently authorized by Congress. In 1963, DeBakey won the Lasker Award for Clinical Research, considered the U.S. equivalent of a Nobel.

"At times he could act like the meanest man in the world. He didn't let you breathe," said Dr. John L. Ochsner of New Orleans, who trained under DeBakey and whose father, Dr. Alton Ochsner, was DeBakey's mentor at Tulane University School of Medicine.
"The thing that made him so mad all the time was he was trying to conquer the world, and every minute was so important to him. He didn't have time for frivolity at all," he said.

Two sides
Patients and their families saw him otherwise.
To them, DeBakey was a healer with quiet authority who seemed to work miracles. Enfolding a patient's hands in his, the patient's face would relax, some recalled.
He was pained by the breakup in 2004 of the 50-year marriage between Baylor and Methodist, which dissolved over disagreements about the future of the institutions. DeBakey said the breakup made no sense and hurt both parties. Friends described him as "heartbroken" about the split. In an interview earlier this year, DeBakey said the description was not inaccurate.
In 2003, his MicroMed DeBakey LVAD was implanted in a 10-year-old girl, the youngest patient in the world to receive the device, which boosts the heart's main pumping chamber. In 2004, a child-sized version became available for children as young as 5. DeBakey had developed the device in collaboration with heart surgeon Noon and NASA.
In his prime — and it was an unusually lengthy prime — DeBakey, with his sharp-nosed profile and dark-brown eyes, had the power to intimidate and awe his acolytes. In surgery, DeBakey was famous for his withering remarks, delivered in a velvety Louisiana drawl, directed at the anxious and ambitious residents operating alongside him.

John Ochsner recalled how, if an operation was going slowly, DeBakey might ask, ''Am I the only one here doing anything?"
Or a clumsy resident might prompt DeBakey to say, ''Do you have two left hands?"
DeBakey's trainees cringed at his criticism, but among themselves they recounted the barbs in a sometimes dead-on imitation of the revered surgeon. Ochsner, now chairman emeritus of the Department of Surgery at Ochsner Clinic in New Orleans, said DeBakey's stern manner came from a desire to prepare his students for the demanding career ahead.

Family life
DeBakey was the eldest of five children born to Lebanese immigrants Raheehja and Shaker Morris DeBakey.

Shaker Morris DeBakey was a businessman and pharmacist in Lake Charles who invested in real estate and rice farming. Michael DeBakey grew up with his brother and three sisters in a large house with maids, butlers and gardeners.
The DeBakeys ate healthy foods — fresh vegetables, fresh fruit, seafood, rice and beans. They didn't smoke or drink. At dinnertime, the family chatted about things that happened at the drug store or the doings of politicians who sought out Shaker's advice.

"You could not get a word in edgewise until one of our parents announced who had the floor," DeBakey recounted to a reporter in 1997. "It was very stimulating."
On Sundays after services at their Episcopal church, the DeBakeys would take clothing to a nearby orphanage. One time, the giveaway bundle included DeBakey's favorite cap. When the youngster protested, his mother sat him down and said: "You have a lot of caps. These children have none." "It made a great impression on me," he said.

DeBakey's mother also taught him one of his future career's essential skills — sewing. He would help her repair items headed for the orphanage. He also learned to tat, using a little bobbin to make lace. Years later, in the 1950s, DeBakey would introduce artificial arteries made from Dacron; he sewed the prototype on his wife's sewing machine, using fabric purchased at Houston's downtown Foley's.

He went to medical school at Tulane after graduating as valedictorian from his high school class. During his senior year in medical school, he developed the roller pump, a device that two decades later became a crucial component of the heart-lung machine used on patients during open-heart surgery.

'A work of art'
As a surgery resident at New Orleans' Charity Hospital, DeBakey caught his first glimpse of a living human heart — pink and pulsating in the chest of a knifing victim.
''I saw it beating, and it was beautiful, a work of art," DeBakey said in 1987. ''I still have an almost religious sense when I work on the heart. It is something God makes and we have yet to duplicate."

Later, at Charity Hospital, DeBakey experienced a potentially catastrophic near-miss — he accidentally punctured a patient's aorta — which gave him an appreciation for the steadying influence of his mentor, Alton Ochsner.
He and Ochsner were operating in an amphitheater with a full audience of visiting surgeons. DeBakey was on one side of the patient, Ochsner on the other. DeBakey was attempting to lift up the aorta, which had been weakened by infection "when I suddenly realized, with a gripping terror, that I had entered the aorta."
DeBakey whispered this to Ochsner, who calmly instructed DeBakey to leave his finger over the hole. Ochsner stitched it up, and no one realized a near-fatal accident had occurred.

During the late 1930s, DeBakey married his first wife, Diana, a nurse he met in New Orleans. They had four sons: Michael, Ernest, Barry and Denis. When DeBakey came to Houston in 1948 to head Baylor's surgery department, he moved his family into a home near Rice University, only five minutes from the Texas Medical Center, so he wouldn't waste time commuting. He never moved from that home.
Diana DeBakey died of a heart attack in 1972. They had been in Mexico for a medical meeting, staying with a close relative of the president of Mexico. They ate well and stayed up late, and when the DeBakeys returned home, Diana was complaining of an upset stomach.

At that time, gastrointestinal problems were not widely recognized as a heart attack symptom in women. When her discomfort worsened, DeBakey had her admitted to the hospital to find out what was wrong. While DeBakey was in surgery on someone else, he got a call that there was an emergency. When he reached his wife's bedside, she had died.

Three years after her death, DeBakey married German film actress Katrin Fehlhaber, whom he met through Frank Sinatra. They had a daughter, Olga.

Health-conscious
The workaholic DeBakey rarely slept more than five hours a night, awaking at 5 most mornings to write research papers or read medical journals. He rarely drank, never smoked, ate sparingly — mostly salads, late in life — and didn't watch television. He spent much of his adult years in light-blue scrubs and wore a pair of gleaming-white cowboy boots for the operating room.

In 1948, when DeBakey came to Houston, he had turned the Baylor job down twice. The fledgling school had moved to Houston from Dallas just five years earlier, and Baylor students were scattered all over the city doing their clinical rotations, a situation that didn't appeal to DeBakey. He finally was persuaded to come when Hermann Hospital promised the school a 20-bed surgical service, according to Ruth SoRelle's history of Baylor,

The Quest for Excellence.
The Hermann deal fell through, and DeBakey nearly left. But the Truman administration asked DeBakey to transfer Houston's Navy hospital into a Veterans Administration hospital, an idea championed by DeBakey that evolved into the national VA system. There, DeBakey's students started the city's first surgical residency program.
One of the most talked-about events of DeBakey's life was his legendary feud — more Arctic freeze than hot-tempered spat — with Cooley, his one-time close collaborator.
DeBakey hired Cooley in 1951 after the Houston native finished his training at Johns Hopkins University School of Medicine in Baltimore.

In 1965, DeBakey participated in a federally funded program to design an artificial heart.
Within a few years, he had a device that some physicians felt was ready for human trials, but DeBakey believed it needed more work.
Then, to international acclaim in 1969, Cooley performed the first implantation of an artificial heart into the chest of 47-year-old Haskell Karp, a dying heart surgery patient. Karp lived with the heart in his chest 65 hours before dying shortly after a heart transplant.

A bitter feud
Cooley's fame was quickly tarnished after DeBakey said the heart was identical to one under development in the Baylor labs and that Cooley had used it without permission.
Cooley said he and Dr. Domingo Liotta, who also designed artificial hearts in DeBakey's lab, had built the heart privately and that he had no choice but to use the heart because the patient's life was in jeopardy.

After the incident, the American College of Surgeons voted to censure Cooley, and, amid a dispute with the trustees of Baylor, Cooley resigned from the institution.
The two men stopped collaborating and rarely spoke. DeBakey changed his focus and decided funds would be better spent developing pumps to assist failing hearts. Such devices became the mainstream treatment for patients with failing hearts.

The episode ''stole DeBakey's shot at a Nobel Prize," Methodist heart surgeon Mike Reardon said in 2004. ''What Mike needed was one crowning event to make him a candidate. And that was going to be the artificial heart."
The two buried the hatchet last year. Cooley inducted DeBakey into his surgical society, and DeBakey accepted, telling his former colleague he was touched by the gesture.

Earlier this year, DeBakey returned the favor, granting Cooley membership in his surgical society.

In April, when DeBakey was given the Congressional Gold Medal, Cooley made the trip to Washington, too.
"I feel a sadness over his passing," Cooley said. "It represents the end of an era. We were at one time colleagues, and then we were competitors, and then finally we restored our friendship."

A fight against death
For a man who outlived most of his peers, DeBakey seemed unphilosophical about death, appearing to view it as a personal enemy.
Losing a patient put him in a black mood and set his mind spinning with thoughts of what he might have done differently.

''You fight (death) all the time, and you never really can accept it," he once said. ''You know in reality that everybody is going to die, but you try to fight it, to push it away, hold it away with your hands."
DeBakey was preceded in death by his sons Houston lawyer Ernest O. DeBakey, who died in 2004, and Barry E. DeBakey, who died in 2007; and a brother, Dr. Ernest G. DeBakey, who died in 2006.

In addition to his wife, Katrin, and their daughter, Olga, DeBakey is survived by sons Michael DeBakey of Lima, Peru, and Denis DeBakey of Houston; and sisters Lois and Selma DeBakey, both medical editors and linguists at Baylor.
todd.ackerman@chron.com
eric.berger@chron.com