Denton Cooley Interview (page: 8 / 8) Pioneer of Heart Transplants	Print Interview

Dr. Cooley, what do you think is the next great frontier is in medicine? You have, as you said, been privileged to take part in so many of the great innovations in heart medicine. What's coming up?

Denton Cooley: I think that we are getting closer to solving the problem of malignancies and cancer. And I think that we will probably see some real advances made in that direction in the next decade. I think that, as far as my specialty is concerned, most of the exciting things have been done. We have had so many procedures now to do to the heart, that now we may perfect what we are doing some, but no real exciting breakthroughs like transplantation, open heart surgery, or the artificial heart. I think that most of the publicity and excitement has gone. I think the real practical advances we can look forward to are better methods of diagnosis, enhanced of course, by computers. So computerization pretty soon will be a more standard thing, like x-rays and other things. And it will make the future much better in this field of diagnosis of disease.
[ Video ] Low High    [ Audio ] Quicktime	[ Key to Success ] Vision

If there was some mystery that you personally could solve in the future, what would that be?

Denton Cooley: I would like to understand more about the function of the heart muscle. Why is it the heart muscle sometimes just refuse to work? If we could understand how the muscle functions. we could restore the failing muscle, or at least we might be able to develop the medication that gets the most work from it. I would like to participate in the development of such a wonder drug.

I think you're uniquely qualified to give advice on how to sustain a healthy heart - how to avoid getting on your operating table. What are the key factors?

Denton Cooley: You should avoid those things we know are harmful. Today, everyone seems to understand that tobacco is harmful in any form, and that alcohol can also be a poison if used to excess. At the same time, our lifestyles are often not healthful. As a society, we tend to overeat. I don't believe obese people eat all high-fat foods, but I do believe they eat too much food. Obesity, in my opinion, is the scourge of our society. In addition, we don't get enough exercise to keep our bodies toned. Much of what happens to us, unfortunately, is due to heredity. You can't do a great deal about that. Fortunately, there are factors we can control. We have to begin educating our children at an early age about the effects of nutrition and exercise. on our health.

Do you ever eat bacon and eggs?

Denton Cooley: Yes. I must confess that I don't watch my diet very strictly. However, I do watch how much I eat, and I'm the same body weight as when I was in college and played basketball, and I intend to keep it that way. It may take more self-discipline, but I believe appropriate body weight can be maintained.

You seem to have a lot of self-discipline. How much sleep do you get?

Denton Cooley: On average, about four and a half hours a night.

That's enough?

Denton Cooley: I'm probably sleepy a lot of times, but usually that's enough. Now that I've gotten older, I take maybe 20 or 30 minutes on the couch in my office after having my soup and yogurt for lunch. That seems to be adequate for me.

Has your wife been an important support for you?

Denton Cooley: Yes, she has. She's kept my family together, and she's been very supportive of my life. She is the daughter of a surgeon, so she knew what she was getting into when we got married. We've been married for some 43 years now and we're still together. I still enjoy a good family life, with my daughters and their children. I hope I can live long enough to see some of my great-grandchildren, which is a possibility. Unfortunately, I got married a little late, when I was 29 years old. People who were married when they were teenagers often get to see their great-grandchildren. I had a patient the other day who had several great-great-grandchildren!

Looking back, do you think there's anything you would have done differently?

Denton Cooley: Nothing of great importance. I've had some financial reverses, and it's always easy to second guess that. I was, perhaps, overly ambitious, and got involved in certain financial enterprises that met with disaster when we had a recession in this area. That was a mistake I wish I hadn't made. I believed I knew what I was doing. I realize now that I was just as vulnerable as so many other people who got involved. But none of these problems were important to my professional career.

Does the work itself, or the results of your work provide the greatest reward for you?

Denton Cooley: I think it's about 50/50. I enjoy work. I think work is a privilege. I don't understand people who say they have nothing to do. When I get up in the morning, I appreciate the fact that people are waiting for me to show up, and that I might be able to help someone. I think that is really a privilege. It keeps you alive, spiritually.

Can you describe the day that you did the first American heart transplant.

Denton Cooley: I was aware that Christiaan Barnard in South Africa had done two transplants, one of which was successful, and Norm Shaumway at Stanford had done one which was not successful. We were poised to do one.

We were having a difficult time finding a donor. As a matter of fact, I was over in Shreveport, Louisiana, giving a lecture to the medical society, and was telling them that we were not yet in the transplant business, and had no foreseeable opportunity to do a transplant. I got a telephone call from Houston, saying they had a donor. So I got on an airplane and came back to Houston and did the transplant that night at two o'clock in the morning, after I'd told the reporters over there that we weren't involved in transplantation. Some of them were very upset when the news came out that we had done the first transplant.
[ Video ] Low High    [ Audio ] Quicktime

It was an exciting thing to do. My team of doctors was here in Houston making arrangements for the donor and the operation, while I was flying back from Shreveport. After the operation, I was catapulted to a level of notoriety I had never known before.

Who was the donor?

Denton Cooley: The donor was a teenage girl with a self-inflicted gunshot wound to the head. It was a suicide attempt.

Could you describe the transplant procedure? One more question, and then we will liberate you from this. How do you open somebody up and remove a heart?

Denton Cooley: First, we have to bypass the patient's heart and get the recipient on the heart/lung machine, very much like we do for any open heart operation.

We take out the heart. Remove the heart mostly, the ventricles, and the heart valves. And then you have an open chest there, with just these various chambers exposed. We, in another operating room, will take out the heart and bring it over, and with sutures, just suture the two atria together. Those are the upper chambers of the heart. And we suture the two main arteries, the pulmonary artery, and the aorta, together. And then when you start the blood flowing back into the aorta, it gets into the coronary arteries, and that starts the donor heart, to its normal function. And that's the whole scenario.
[ Video ] Low High    [ Audio ] Quicktime

You've perfected the heart by-pass just in my lifetime. That went from being a tremendously risky surgery, to almost routine. How did you make such a dramatic advance in such a short time?

Denton Cooley: There's been an evolution of techniques. We realized that you could by-pass obstructions in the coronary system. But before that, we had to find some way to substitute for the heart function. Once the heart/lung machine was developed we had one problem solved. Then we needed a method of seeing which part of the artery was obstructed. With the development of arteriography, we had our method. With those things behind us, and with some of the experience we'd had with bypassing arterial obstructions in the legs, we learned to bypass obstructions in the coronary arteries. Today, coronary artery bypass is the most commonly performed open heart operation.

How many lives do you think have been saved by coronary artery bypass surgery?

Denton Cooley: It's hard to say. In our own institution, we've done more than 40,000 coronary by-pass operations, and we continue to do about 100 a month.

Twenty years ago, many of these people would have died.

Denton Cooley: That's right. They may have also been severely handicapped by chest pains, angina pectoris. After a bypass operation, most patients are relieved of that very disabling symptom, and can return to their normal activities.

How much satisfaction do you get from knowing that you've saved lives?

Denton Cooley: That's the real reward for any heart surgeon, I think, knowing that you've saved someone's life. Nothing can compare with that. That's the richest reward anyone can have.

One last question. What advice would you give to people coming up in this field?

Denton Cooley: If you want to become a surgeon, you have to accept a life of dedication and of service. You must be prepared to make your work number one priority in everyday life, and apply yourself fully to the welfare of your patients.

Thank you for all your time. I know your work will be appreciated for many, many years to come.

Denton Cooley Interview, Page: 1   2   3   4   5   6   7   8