Michael DeBakey: Cardiovascular surgeon whose innovations revolutionised the treatment of heart patients
Monday 14 July 2008
Michael DeBakey was the world's most innovative heart surgeon. A high-flier from his student days, he was one of the first surgeons to operate on the heart, performing 60,000 operations over 70 years with exceptional skill and judgement. He operated on world leaders including presidents John F. Kennedy, Lyndon B. Johnson and Richard Nixon, Boris Yeltsin, The Duke of Windsor, King Hussein of Jordan, the Shah of Iran and stars such as Marlene Dietrich.
The pioneer of pumps for heart-lung machines, of coronary artery grafting and of blood vessel repair, he also invented the US Army's surgical field hospitals, well known from the television series M*A*S*H, which took the surgeons to the injured men rather than vice versa. He helped to establish the Veterans Administration chain of hospitals to care for retired soldiers; and to form the US National Library of Medicine, which is now an open-access source of medical information available worldwide.
He was born Michel Dabaghi, the son of French-speaking Lebanese Christian immigrants, with his name later anglicised to Michael DeBakey. His father established rice farms, estate agencies and drugstores, where Michael kept the books. The family lived mainly on fish they caught, and fruit and vegetables they grew themselves – a recipe for a healthy heart. His parents took Michael to the public library every week, where he was so taken with the Encyclopaedia Brittanica that his parents bought him a set. He was a good saxophonist, and his mother taught him to sew, a useful skill for a surgeon.
He did his BSc, graduating in 1929, at Tulane University, New Orleans, and started at medical school a year before he finished. After graduating MD in 1931 he stayed to do his surgical training as intern and resident; there was no heart surgery in those days and nothing could be done for heart patients. "If a patient came in with a heart attack, it was up to God," he recalled. As a 23-year-old student he invented the roller pump, which two decades later became an essential component of heart-lung machines, because it provided a pulsed blood flow.
DeBakey went to France and Germany on postgraduate fellowships to the universities of Strasbourg and Heidelberg, before returning to Tulane University, aged 29, as Lecturer in Surgery, a post he held for 11 years. During this time, from 1943 to 1946, he was seconded to the US Surgeon General's office; for the last year he was director of the surgical consultants division and in 1945 received the US Legion of Merit.
From Tulane he went in 1948 to Baylor University Medical College in Houston, Texas, as Chairman of the Surgery Department, which he remained until 1993, when he was 85. From 1969 until 1979 he was President of the college and was Chancellor from 1979 until 1996, when he "retired" with the title of Chancellor Emeritus, although he kept on working.
Between 1950 and 1953 he developed a graft for arterial surgery using Dacron (a type of polyester; he had wanted nylon, but the shop didn't have it in stock), making it into a tube on his sewing machine at home. In 1953 he performed the first removal of a blockage in a neck artery, and in 1956 the world's first patch-graft angioplasty. Around this time he did the first aneurysm repair. In 1963 he was the first to use interactive telemedicine—now widely used by the US army, so that an expert in America, for instance, can supervise surgery in Iraq. In 1966 DeBakey was the first successfully to use an artificial partial heart on a patient who was too ill to be weaned from a heart-lung machine after open-heart surgery. In 1968 he performed the first of 12 heart transplants. In the past few years, working with Nasa engineers, he had refined an assisting device, a tiny pump, for patients with dying hearts. It is one-tenth of the size of current versions and will reduce the need for transplants.
DeBakey ensured he learned under the surgeons he most admired, and later himself attracted the best trainees. One was Denton Cooley, who became an outstanding surgeon. They worked together on an artificial heart, developing it in calves. Cooley was the first to implant it in a patient, and didn't tell DeBakey or the hospital ethicists, who censored him. DeBakey was furious and the ensuing quarrel lasted 38 years; they made it up last year. The patient was given a heart transplant five days later but died after a further 36 hours.
Honours too numerous to list were heaped upon DeBakey, and a school, hospital, medical centre and university department are named after him. He campaigned for causes he cared about: Medicare health insurance, animal experimentation and the establishment of the National Library of Medicine in the United States. The library's publications are now publicly available online. It lists 488 papers by him, starting in May 1945 and continuing until last month. It probably misses many earlier papers. He didn't charge his super-rich patients, who included Aristotle Onassis and Stavros Niarchos, but asked them to donate to the Foundation for Medical Research, which promotes animal experiments; his own research was mainly on dogs. The foundation gives $2m annually to Baylor University and funds the DeBakey journalism award, which highlights the benefits of animal research.
In 1974 DeBakey said that he had performed the first coronary bypass surgery 10 years earlier but had not reported it. His critics said that he exaggerated his role in many innovations. He certainly enjoyed publicity and spoke openly of his celebrity patients. He met his second wife at Frank Sinatra's house. Many of his colleagues were afraid of him because of his quick temper, but outside the hospital he was regarded as gentle, with his soft Louisiana accent.
DeBakey published three textbooks on cardiovascular surgery, a book on its history, a collection of essays on ageing, and three popular books on heart health and diet. A keen photographer, he also illustrated a children's book on kittens. He kept several dogs as pets.
He ate sparingly, never took exercise, and regarded retirement as bad for the heart. In old age he could still fit into his wartime service uniform. He slept for five hours a night, working at home in the early mornings and late evenings. A recent medical check showed that he had the body of a man 20 years younger and until recently he had himself been a hospital patient only twice.
In 2006 he suffered a torn aorta, a condition for which he had pioneered the repair. He at first refused surgery but was persuaded by colleagues, and afterwards was glad. The oldest person to undergo the procedure, he spent eight months in hospital afterwards, before resuming work, which he continued until days before he died.
Michel Dabaghi (Michael Ellis DeBakey), surgeon: born Lake Charles, Louisiana 7 September 1908; Instructor, Department of Surgery, Tulane University 1937-40, Assistant Professor of Surgery 1940-46, Associate Professor of Surgery 1946-48; Chairman, Department of Surgery, Baylor College of Medicine 1948-93, Professor of Surgery 1948-68, Distinguished Service Professor 1968-81, President 1969-79, Chancellor 1979-96 (Emeritus), Olga Keith Wiess Professor 1981-2008, Director, DeBakey Heart Center 1985-2008; President, DeBakey Medical Foundation 1961-2008; Surgeon-in-Chief, Ben Taub General Hospital, Houston 1963-93; married 1936 Diana Cooper (died 1972; two sons, and two sons deceased), 1975 Katrin Fehlhaber (one daughter); died Houston, Texas 11 July 2008.
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