- Email: [email protected]
Denton A. Cooley, August 22, 1920, to November 18, 2016
OUR SURGICAL HERITAGE
Denton A. Cooley, August 22, 1920, to November 18, 2016 Charles D. Fraser, Jr, MD
MISCELLANEOUS
Texas Children’s Hospital, and Department of Surgery and Pediatrics, Baylor College of Medicine, Houston, Texas
The world lost a medical trailblazer and inspirational humanitarian with the passing of Denton A. Cooley on November 18, 2016. The 28th president of The Society of Thoracic Surgeons, Cooley was an icon of the astounding progress of cardiovascular medicine in the
20th century and a visionary pioneer who shaped modern surgery.
D
Cooley’s time at Hopkins set him on the path to becoming a trailblazer in cardiovascular surgery. Soon after he arrived, he caught the attention of Alfred Blalock, who had recently become the chairman of the Department of Surgery. Blalock’s mentorship had a profound effect on Cooley’s education and career goals and solidified his interest in surgery. A few months after Cooley received his MD degree and became a surgical intern for Blalock, he was present for the first Blalock-Taussig (“blue-baby”) procedure on November 29, 1944 [1]. The historical operation drew a stream of patients to Hopkins, and Cooley’s participation in many subsequent BlalockTaussig operations (as well as other procedures) revealed his surgical abilities. In 1946, Cooley had to put his training on hold when he was called to active duty by the Army Medical Corps. He was assigned to the 124th Station Hospital in Linz, Austria, as a first lieutenant, but with the departure of the other, higher-ranking surgeon-officers shortly after Cooley’s arrival, he soon became chief of surgery. In this post, Cooley saw a wide range of injuries and conditions, and he took advantage of these opportunities to challenge himself and further improve his surgical skills. He was discharged with the rank of captain in the spring of 1948, at which time he returned to Hopkins to finally complete his residency. Soon after Cooley returned to Hopkins, he met Louise Goldsborough Thomas, the head nurse on the main surgical floor of the hospital. After a month of dating, he proposed, and they were married on January 15, 1949. Just over a year later, the couple’s first daughter, Mary, was born. Just as his young family was taking its first steps, Cooley was making some of his first acclaimed contributions to cardiovascular surgery. While performing an emergency case involving an impending rupture of an aorta, Cooley improvised and performed the first direct aneurysm repair [2]. After a young patient with tachycardia had ventricular fibrillation and died during an emergency operation, Cooley developed a defibrillator that ran on alternating current; the device was used in the Hopkins operating room for nearly a decade [3].
enton Arthur Cooley was born in Houston, Texas, on August 22, 1920. His father was a dentist and the son of one of the original developers of the historic Houston Heights community where Cooley spent his childhood and adolescence. Cooley’s mother was a dedicated homemaker from one of the many families who moved to Houston during the Texas oil boom in the first decades of the 20th century. His older brother, Ralph, was his sole sibling and “the best friend [he] ever had.” Cooley graduated from high school in the spring of 1937 and began attending the University of Texas (UT) at Austin later that year. A versatile and talented athlete in high school, Cooley earned a spot on the freshman basketball team and made the varsity team as a sophomore. He became a star player for the team, which won the Southwest Conference championship in 1939. Cooley’s interest in basketball, as well as tennis and golf, would be a lifelong pursuit. During his junior year, he was nominated for and ultimately initiated into the Cowboys, an elite service organization at UT. Although he began his undergraduate education as a predental student, he became increasingly interested in medicine. After receiving an impromptu lesson in wound stitching while visiting a friend of a friend who was working in an overwhelmed emergency room, Cooley decided to switch to the premedical curriculum. In 1941, Cooley received a BA degree in zoology with a minor in English, graduating Phi Beta Kappa and with highest honors. He enrolled at the University of Texas Medical Branch (UTMB) in Galveston and, inspired by Ernst Bertner, his family obstetrician and a founder of the Texas Medical Center, he began studying to become an obstetrician/gynecologist. Fate, however, had other ideas. Shortly after the United States entered WWII in 1941, the Texas legislature began investigating rumors of German sympathizers and spies at UTMB. Concerned that his education might be stalled, Cooley left UTMB and moved to Baltimore to continue at Johns Hopkins Medical School.
Address correspondence to Dr Fraser, Texas Children’s Hospital, 6621 Fannin, Houston, TX 77030; email: [email protected].
Ó 2017 by The Society of Thoracic Surgeons Published by Elsevier Inc.
(Ann Thorac Surg 2017;103:1676–8) Ó 2017 by The Society of Thoracic Surgeons
0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2017.03.001
Ann Thorac Surg 2017;103:1676–8
1677
By the end of that year, he had transplanted 10 hearts, but, like other transplant surgeons, he soon became disenchanted with the procedure because of the inability to mitigate rejection. Even as interest in cardiac transplantation began to fade at the close of 1968, Cooley met with Dr Domingo Liotta, a surgeon from Argentina who had been developing a totally artificial heart at Baylor. The two surgeons further developed the device over the next few months. On April 4, 1969, Cooley decided to use the device as a bridge to transplantation for Haskell Karp, and performed the world’s first totally artificial heart implantation (Fig 1) [7]. Unfortunately, Karp died of sepsis less than 3 days after the operation, but the totally artificial heart did effectively support the circulation. Despite the historical implications of the totally artificial heart implantation, DeBakey was furious with Cooley and critical of how the device was developed. Cooley resigned from Baylor and turned his full attention to developing THI. The two surgical pioneers broke off their relationship, and the silent rift would remain for nearly 40 years before they reconciled in 2007. Although this rift has been portrayed as a bitter “feud” in some accounts, their relationship was more of a rivalry between fierce competitors that helped spur both men to push the boundaries of cardiovascular surgery. In the 1970s, coronary artery bypass grafting became the preferred treatment for coronary artery disease, and Cooley and his associates at THI saw a surge of patients. Their practice drew international recognition and acclaim, and patients from around the world traveled to Houston to undergo bypass surgery and other cardiac procedures at THI over the subsequent decades. Cooley continued to develop new procedures and devices, including techniques for repairing aneurysms and defects and dozens of surgical instruments and products. He contributed more than 1,400 peer-reviewed articles to the medical literature and authored or coauthored 12 books. His many awards and honors include the Ren e Leriche Prize, the highest honor of the International Surgical Society (1967), the Medal of Freedom (the highest civilian award in the United States; presented by Fig 1. Dr Denton Cooley and Dr Domingo Liotta performing the first total artificial heart implantation in April 1969. (Photos courtesy of Texas Heart Institute.)
MISCELLANEOUS
As his residency neared completion, Cooley met Lord Russell Brock when the leading British cardiac surgeon worked with Blalock for a month at Hopkins. Intrigued by Brock’s surgical approach, Cooley sought and was offered the opportunity to work with Brock at the Brompton Hospital for Chest Diseases in London. Cooley moved to London with Louise and Mary in the summer of 1950 and spent the next year working as Brock’s senior surgical registrar. When Cooley returned to the United States, he and his family moved to Houston, where he joined the faculty of the Department of Surgery at Baylor University College of Medicine (now Baylor College of Medicine) under Dr Michael DeBakey, the new chairman of the department. The professional relationship between the future icons of cardiovascular surgery began auspiciously, with both surgeons developing groundbreaking techniques and devices. Unfortunately, disagreements and differences of opinion began to stress the relationship. Soon after Texas Children’s Hospital and St. Luke’s Episcopal Hospital (now Baylor St. Luke’s Medical Center) opened in 1954, Cooley began to transition his practice to the two adjoined hospitals. Cooley’s list of “firsts” grew considerably during his time at Baylor. He performed the first open heart operation in the southern United States in 1956; that operation also involved the first use in Houston of a heart-lung machine to perform cardiopulmonary bypass [4]. Over the next 6 years, Cooley performed 1,430 open heart procedures with a remarkably high rate of success. He developed a reputation for operating swiftly and calmly. In 1961, he introduced the first asanguineous prime solution for the heart-lung machine [5]. The bloodless prime revolutionized cardiopulmonary bypass and also allowed Cooley to operate on patients of the Jehovah’s Witness faith. As the Texas Medical Center continued to grow, Cooley was inspired to form an institution dedicated to cardiovascular disease. In 1962, he founded the Texas Heart Institute (THI) at St. Luke’s. After several years of fundraising, construction for THI began in 1967. In May of 1968, Cooley performed the first successful human heart transplant operation in the United States [6].
OUR SURGICAL HERITAGE FRASER, JR DENTON A. COOLEY, AUG 22, 1920-NOV 18, 2016
MISCELLANEOUS
1678
OUR SURGICAL HERITAGE FRASER, JR DENTON A. COOLEY, AUG 22, 1920-NOV 18, 2016
President Ronald Reagan in 1984), and the National Medal of Technology (presented by President William Clinton in 1999). During his career, Cooley educated 927 cardiovascular fellows and 136 cardiothoracic surgery residents. In 1972, Cooley’s trainees formed the Denton A. Cooley Cardiovascular Surgical Society, and his former residents created the Cooley Hands in 1982. Both societies further surgical education and a global network of surgeons mentored by Cooley, who expounded on the importance of surgical education and training in his presidential address to The Society of Thoracic Surgeons in 1994: “We should try to recapture the spirit of challenge and discovery that pervaded my years as a trainee. We must encourage our surgical residents to think independently and to question the validity of certain so-called truths or time-honored treatment methods, so that we maintain our specialty‘s reputation for progress” [8]. A dedicated family man, Cooley was married to Louise for nearly 70 years before she predeceased him by just a few weeks. He and Louise had five daughters: Mary, Susan, Louise, Florence, and Helen. He adored his many grandchildren and great-grandchildren. Cooley was a physician to the end, always interested in patients, the hospital, and the institute for the heart that he considered the most important achievement of his career. He marveled at how cardiac surgery had advanced and how the Texas Medical Center had grown in his lifetime. He attracted learners, welcoming their interest and ambition and always ready to offer gentle
Ann Thorac Surg 2017;103:1676–8
advice and words of affirmation and encouragement. Cooley’s remarkable legacy will live on in the family he so cherished, the caregivers he proudly worked with and trained, and every beating heart touched by his groundbreaking work. The Section of Scientific Publications at the Texas Heart Institute provided editorial support.
References 1. Cooley DA. The first Blalock-Taussig shunt. J Thorac Cardiovasc Surg 2010;140:750–1. 2. Cooley DA. 100,000 Hearts: a surgeon’s memoir, 1st ed. Austin, TX: Dolph Briscoe Center for American History, University of Texas at Austin; 2012. 3. Cooley DA. Cardiac resuscitation during operations for pulmonic stenosis. Ann Surg 1950;132:930–6. 4. Cooley DA, Belmonte BA, Zeis LB, Schnur S. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surgery 1957;41:930–7. 5. Cooley DA, Beall AC, Alexander JK. Acute massive pulmonary embolism. Successful surgical treatment using temporary cardiopulmonary bypass. JAMA 1961;177:283–6. 6. Cooley DA, Bloodwell RD, Hallman GL, Nora JJ. Transplantation of the human heart. Report of four cases. JAMA 1968;205:479–86. 7. Cooley DA, Liotta D, Hallman GL, Bloodwell RD, Leachman RD, Milam JD. Orthotopic cardiac prosthesis for two-staged cardiac replacement. Am J Cardiol 1969;24:723–30. 8. Cooley DA. Fifty years of cardiovascular surgery. Ann Thorac Surg 1994;57:1059–63.
Denton A. Cooley, August 22, 1920, to November 18, 2016 Charles D. Fraser, Jr, MD
MISCELLANEOUS
Texas Children’s Hospital, and Department of Surgery and Pediatrics, Baylor College of Medicine, Houston, Texas
The world lost a medical trailblazer and inspirational humanitarian with the passing of Denton A. Cooley on November 18, 2016. The 28th president of The Society of Thoracic Surgeons, Cooley was an icon of the astounding progress of cardiovascular medicine in the
20th century and a visionary pioneer who shaped modern surgery.
D
Cooley’s time at Hopkins set him on the path to becoming a trailblazer in cardiovascular surgery. Soon after he arrived, he caught the attention of Alfred Blalock, who had recently become the chairman of the Department of Surgery. Blalock’s mentorship had a profound effect on Cooley’s education and career goals and solidified his interest in surgery. A few months after Cooley received his MD degree and became a surgical intern for Blalock, he was present for the first Blalock-Taussig (“blue-baby”) procedure on November 29, 1944 [1]. The historical operation drew a stream of patients to Hopkins, and Cooley’s participation in many subsequent BlalockTaussig operations (as well as other procedures) revealed his surgical abilities. In 1946, Cooley had to put his training on hold when he was called to active duty by the Army Medical Corps. He was assigned to the 124th Station Hospital in Linz, Austria, as a first lieutenant, but with the departure of the other, higher-ranking surgeon-officers shortly after Cooley’s arrival, he soon became chief of surgery. In this post, Cooley saw a wide range of injuries and conditions, and he took advantage of these opportunities to challenge himself and further improve his surgical skills. He was discharged with the rank of captain in the spring of 1948, at which time he returned to Hopkins to finally complete his residency. Soon after Cooley returned to Hopkins, he met Louise Goldsborough Thomas, the head nurse on the main surgical floor of the hospital. After a month of dating, he proposed, and they were married on January 15, 1949. Just over a year later, the couple’s first daughter, Mary, was born. Just as his young family was taking its first steps, Cooley was making some of his first acclaimed contributions to cardiovascular surgery. While performing an emergency case involving an impending rupture of an aorta, Cooley improvised and performed the first direct aneurysm repair [2]. After a young patient with tachycardia had ventricular fibrillation and died during an emergency operation, Cooley developed a defibrillator that ran on alternating current; the device was used in the Hopkins operating room for nearly a decade [3].
enton Arthur Cooley was born in Houston, Texas, on August 22, 1920. His father was a dentist and the son of one of the original developers of the historic Houston Heights community where Cooley spent his childhood and adolescence. Cooley’s mother was a dedicated homemaker from one of the many families who moved to Houston during the Texas oil boom in the first decades of the 20th century. His older brother, Ralph, was his sole sibling and “the best friend [he] ever had.” Cooley graduated from high school in the spring of 1937 and began attending the University of Texas (UT) at Austin later that year. A versatile and talented athlete in high school, Cooley earned a spot on the freshman basketball team and made the varsity team as a sophomore. He became a star player for the team, which won the Southwest Conference championship in 1939. Cooley’s interest in basketball, as well as tennis and golf, would be a lifelong pursuit. During his junior year, he was nominated for and ultimately initiated into the Cowboys, an elite service organization at UT. Although he began his undergraduate education as a predental student, he became increasingly interested in medicine. After receiving an impromptu lesson in wound stitching while visiting a friend of a friend who was working in an overwhelmed emergency room, Cooley decided to switch to the premedical curriculum. In 1941, Cooley received a BA degree in zoology with a minor in English, graduating Phi Beta Kappa and with highest honors. He enrolled at the University of Texas Medical Branch (UTMB) in Galveston and, inspired by Ernst Bertner, his family obstetrician and a founder of the Texas Medical Center, he began studying to become an obstetrician/gynecologist. Fate, however, had other ideas. Shortly after the United States entered WWII in 1941, the Texas legislature began investigating rumors of German sympathizers and spies at UTMB. Concerned that his education might be stalled, Cooley left UTMB and moved to Baltimore to continue at Johns Hopkins Medical School.
Address correspondence to Dr Fraser, Texas Children’s Hospital, 6621 Fannin, Houston, TX 77030; email: [email protected].
Ó 2017 by The Society of Thoracic Surgeons Published by Elsevier Inc.
(Ann Thorac Surg 2017;103:1676–8) Ó 2017 by The Society of Thoracic Surgeons
0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2017.03.001
Ann Thorac Surg 2017;103:1676–8
1677
By the end of that year, he had transplanted 10 hearts, but, like other transplant surgeons, he soon became disenchanted with the procedure because of the inability to mitigate rejection. Even as interest in cardiac transplantation began to fade at the close of 1968, Cooley met with Dr Domingo Liotta, a surgeon from Argentina who had been developing a totally artificial heart at Baylor. The two surgeons further developed the device over the next few months. On April 4, 1969, Cooley decided to use the device as a bridge to transplantation for Haskell Karp, and performed the world’s first totally artificial heart implantation (Fig 1) [7]. Unfortunately, Karp died of sepsis less than 3 days after the operation, but the totally artificial heart did effectively support the circulation. Despite the historical implications of the totally artificial heart implantation, DeBakey was furious with Cooley and critical of how the device was developed. Cooley resigned from Baylor and turned his full attention to developing THI. The two surgical pioneers broke off their relationship, and the silent rift would remain for nearly 40 years before they reconciled in 2007. Although this rift has been portrayed as a bitter “feud” in some accounts, their relationship was more of a rivalry between fierce competitors that helped spur both men to push the boundaries of cardiovascular surgery. In the 1970s, coronary artery bypass grafting became the preferred treatment for coronary artery disease, and Cooley and his associates at THI saw a surge of patients. Their practice drew international recognition and acclaim, and patients from around the world traveled to Houston to undergo bypass surgery and other cardiac procedures at THI over the subsequent decades. Cooley continued to develop new procedures and devices, including techniques for repairing aneurysms and defects and dozens of surgical instruments and products. He contributed more than 1,400 peer-reviewed articles to the medical literature and authored or coauthored 12 books. His many awards and honors include the Ren e Leriche Prize, the highest honor of the International Surgical Society (1967), the Medal of Freedom (the highest civilian award in the United States; presented by Fig 1. Dr Denton Cooley and Dr Domingo Liotta performing the first total artificial heart implantation in April 1969. (Photos courtesy of Texas Heart Institute.)
MISCELLANEOUS
As his residency neared completion, Cooley met Lord Russell Brock when the leading British cardiac surgeon worked with Blalock for a month at Hopkins. Intrigued by Brock’s surgical approach, Cooley sought and was offered the opportunity to work with Brock at the Brompton Hospital for Chest Diseases in London. Cooley moved to London with Louise and Mary in the summer of 1950 and spent the next year working as Brock’s senior surgical registrar. When Cooley returned to the United States, he and his family moved to Houston, where he joined the faculty of the Department of Surgery at Baylor University College of Medicine (now Baylor College of Medicine) under Dr Michael DeBakey, the new chairman of the department. The professional relationship between the future icons of cardiovascular surgery began auspiciously, with both surgeons developing groundbreaking techniques and devices. Unfortunately, disagreements and differences of opinion began to stress the relationship. Soon after Texas Children’s Hospital and St. Luke’s Episcopal Hospital (now Baylor St. Luke’s Medical Center) opened in 1954, Cooley began to transition his practice to the two adjoined hospitals. Cooley’s list of “firsts” grew considerably during his time at Baylor. He performed the first open heart operation in the southern United States in 1956; that operation also involved the first use in Houston of a heart-lung machine to perform cardiopulmonary bypass [4]. Over the next 6 years, Cooley performed 1,430 open heart procedures with a remarkably high rate of success. He developed a reputation for operating swiftly and calmly. In 1961, he introduced the first asanguineous prime solution for the heart-lung machine [5]. The bloodless prime revolutionized cardiopulmonary bypass and also allowed Cooley to operate on patients of the Jehovah’s Witness faith. As the Texas Medical Center continued to grow, Cooley was inspired to form an institution dedicated to cardiovascular disease. In 1962, he founded the Texas Heart Institute (THI) at St. Luke’s. After several years of fundraising, construction for THI began in 1967. In May of 1968, Cooley performed the first successful human heart transplant operation in the United States [6].
OUR SURGICAL HERITAGE FRASER, JR DENTON A. COOLEY, AUG 22, 1920-NOV 18, 2016
MISCELLANEOUS
1678
OUR SURGICAL HERITAGE FRASER, JR DENTON A. COOLEY, AUG 22, 1920-NOV 18, 2016
President Ronald Reagan in 1984), and the National Medal of Technology (presented by President William Clinton in 1999). During his career, Cooley educated 927 cardiovascular fellows and 136 cardiothoracic surgery residents. In 1972, Cooley’s trainees formed the Denton A. Cooley Cardiovascular Surgical Society, and his former residents created the Cooley Hands in 1982. Both societies further surgical education and a global network of surgeons mentored by Cooley, who expounded on the importance of surgical education and training in his presidential address to The Society of Thoracic Surgeons in 1994: “We should try to recapture the spirit of challenge and discovery that pervaded my years as a trainee. We must encourage our surgical residents to think independently and to question the validity of certain so-called truths or time-honored treatment methods, so that we maintain our specialty‘s reputation for progress” [8]. A dedicated family man, Cooley was married to Louise for nearly 70 years before she predeceased him by just a few weeks. He and Louise had five daughters: Mary, Susan, Louise, Florence, and Helen. He adored his many grandchildren and great-grandchildren. Cooley was a physician to the end, always interested in patients, the hospital, and the institute for the heart that he considered the most important achievement of his career. He marveled at how cardiac surgery had advanced and how the Texas Medical Center had grown in his lifetime. He attracted learners, welcoming their interest and ambition and always ready to offer gentle
Ann Thorac Surg 2017;103:1676–8
advice and words of affirmation and encouragement. Cooley’s remarkable legacy will live on in the family he so cherished, the caregivers he proudly worked with and trained, and every beating heart touched by his groundbreaking work. The Section of Scientific Publications at the Texas Heart Institute provided editorial support.
References 1. Cooley DA. The first Blalock-Taussig shunt. J Thorac Cardiovasc Surg 2010;140:750–1. 2. Cooley DA. 100,000 Hearts: a surgeon’s memoir, 1st ed. Austin, TX: Dolph Briscoe Center for American History, University of Texas at Austin; 2012. 3. Cooley DA. Cardiac resuscitation during operations for pulmonic stenosis. Ann Surg 1950;132:930–6. 4. Cooley DA, Belmonte BA, Zeis LB, Schnur S. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surgery 1957;41:930–7. 5. Cooley DA, Beall AC, Alexander JK. Acute massive pulmonary embolism. Successful surgical treatment using temporary cardiopulmonary bypass. JAMA 1961;177:283–6. 6. Cooley DA, Bloodwell RD, Hallman GL, Nora JJ. Transplantation of the human heart. Report of four cases. JAMA 1968;205:479–86. 7. Cooley DA, Liotta D, Hallman GL, Bloodwell RD, Leachman RD, Milam JD. Orthotopic cardiac prosthesis for two-staged cardiac replacement. Am J Cardiol 1969;24:723–30. 8. Cooley DA. Fifty years of cardiovascular surgery. Ann Thorac Surg 1994;57:1059–63.