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  Vol. 20, No. 19  Previous Table of Contents Home  Next October 15, 1998 

A Lifetime of Imagination and Dedication
Dr. DeBakey in Surgery

When he was a boy in Lake Charles, La., Michael E. DeBakey discovered the Encyclopedia Britannica in the local library. He was enthralled with the set of books. Because the Britannica could not be borrowed from the library, Michael's father purchased an entire set. By the time Michael, his brother and sisters were in high school, they each had read the entire set of Britannica volumes plus their usual weekly library book. The children excelled in school. Michael skipped a grade.

For Dr. DeBakey, time is precious. As he has done since he was a boy, he rises at 5 a.m. to read and write. He lives just five minutes from the Texas Medical Center in the same house he purchased in 1948 when he came to Houston to join Baylor University College of Medicine.

Michael's parents were first generation immigrants. His father was a pharmacist and owned a drugstore. He was also a businessman with other interests: rice farming, real estate and construction. The family's Episcopal church was an integral part of their lives. The children's parents instilled in them not just the love of reading and studying, but the values of honesty, compassion, courtesy and independence.

Photograph
Dr. DeBakey performing bypass surgery live on the "Today Show", Sept. 30, 1998.

Recently, on live national television, Dr. DeBakey was interviewed while performing a double bypass heart operation. The program host remarked in wonder how steady the 90-year-old surgeon's hands were. Dr. DeBakey's hands have always been sure. When he was a boy, his mother taught the neighborhood girls how to crochet and knit and how to cut a pattern and use a sewing machine. The young Michael looked on and learned these arts himself. And with his hands, he played music - first the piano and then the saxophone. At Tulane University he played the sax in the marching band and taught himself the fingering of the clarinet so he could play in the University orchestra.

It was at Tulane in the early 1930s that the young medical student met Dr. Alton Ochsner, who would become his mentor. Dr. Ochsner invited DeBakey to work in his laboratory, and he was very impressed with the young man's use of his hands and his technical wizardry. In his senior year, DeBakey devised a modified roller pump that mimicked the heart's pulse wave; he saw that the pump would greatly assist in blood transfusions and went around New Orleans doing thousands of transfusions. The roller pump would become the critical element of the heart-lung machine. Dr. Ochsner strongly encouraged DeBakey to consider surgery as a specialty and suggested he go to Europe, which was a wonderful training ground then. After completing his surgical residency at New Orleans' Charity Hospital in 1935, the young Dr. DeBakey studied in Strasbourg, France, with Dr. Rene Leriche and in Heidelberg, Germany, with Dr. Martin Kirschner. He learned both French and German. He worked alongside his professors during some of the first vascular surgeries ever performed. He returned to Tulane in 1937 as an instructor of surgery under Dr. Ochsner.

Dr. DeBakey felt it was his duty to enlist at the outset of World War II, even though his colleagues at Tulane pleaded that he be declared "essential" at the medical school. Dr. DeBakey served in the Surgeon General's office, at first preparing reports and preparing the Surgeon General's surgical reports. His papers about chest wounds and vascular injuries led to great interest in the idea of treating soldiers closer to the battle-field rather than transporting them great distances to hospitals. The mobile Army surgical hospitals (MASH units) were an outgrowth of Dr. DeBakey's work at the Surgeon General's, and these units saved thousands of lives later in the war and in wars that followed. A similar concept would be established in America's urban centers with the creation of trauma centers at major hospitals. In fact, the first certified trauma center in the United States was established in 1949 at Jefferson Davis Hospital in Houston, Baylor University College of Medicine's major affiliate hospital, and a surgical service headed by Dr. DeBakey.

Two other immense contributions resulted from Dr. DeBakey's service in World War II. The Surgeon General's library was in disarray. Worse, it was not being properly cared for. The stacks were crowded and the roof leaked. Dr. DeBakey was convinced that the library - a "national treasure," he called it - should be taken from the army, put in a new building and housed close to the National Institutes of Health (NIH) where the nation's medical research activities were centered. He worked skillfully with members of Congress, the Army and the NIH to get a bill through allowing for the creation of the National Library of Medicine. Today the library has over 6.2 million books, journals, technical reports, microfilms and audiovisual materials.

Shortly after Dr. DeBakey came to Houston in 1948, President Truman suggested that the Navy hospital be turned over to the Veterans Administration. Dr. DeBakey embraced the idea and became actively involved in this new system which would treat military personnel returning from the war and continue treating them with systematic follow-up. His commitment to the Houston Veterans Administration hospital was critical to his staying in Houston.

Dr. DeBakey declined the first offer that Baylor University College of Medicine made to him in 1948. On his first visit to Houston that year, he learned that the medical school had no hospital affiliation. The school sent its medical students on rounds at the city-county public hospital, Jefferson Davis, located several miles away on Allen Parkway west of downtown. The attending physicians were all family practitioners; Dr. DeBakey was the only board-certified surgeon in Houston. He realized it would be impossible to conduct a surgical service in a system where the patient had at least two attending physicians. It was a short time later that the Houston Navy hospital sought his help.

During this first year in Houston, Dr. DeBakey was admitting his private patients to Hermann Hospital and The Methodist Hospital, an old building located on Main Street close to downtown. His relationship with the Methodist administration and nurses grew warm. The hospital's administrator, Ted Bowen, allowed Dr. DeBakey to create a new type of ward at the hospital, an intensive care unit with nurses specially trained by the surgeon and cardiologists on staff. It was a radical idea, so radical in fact that within weeks other surgeons were asking Dr. DeBakey if their patients could be admitted to his unit. In 1953 the hospital decided to move to a new facility in the Texas Medical Center.

Photograph
Dr. DeBakey, at home sewing a Dacron artificial artery, 1953.

The years 1953-54 marked a turning point in cardiovascular surgery. Working at home on his wife's sewing machine, Dr. DeBakey constructed the first Dacron artificial artery to replace the damaged segments of artery. In 1953, Dr. DeBakey began operating on the aorta, and in a series of operations he brought heart surgery into a new age. He completed the first successful removal and graft replacement of an aneurysm (a swelling caused by weakness in the artery wall) on the descending aorta. Also in 1953, Dr. DeBakey performed the first successful endarterectomy, or removal of a blockage of the carotid artery, the main artery of the neck which carries blood to the brain, demonstrating an effective treatment for stroke. In early 1954, he performed a successful resection and graft on the ascending aorta, using a heart-lung machine developed in his laboratory. Later in 1954, he performed another successful resection and graft on the section of the aorta which curves over the top of the heart. He had shown that the diseases of the aorta could be successfully treated by surgery.

In the early 1960s, Dr. DeBakey determined the concept behind coronary bypass. He knew that sections below and above the diseased portion of vessel were normal; by bypassing the blocked section, normal blood flow could be restored and a fatal heart attack would be prevented. He performed the first successful coronary bypass using a large vein from the leg to bypass a damaged area between the aorta and coronary arteries.

Photograph
Dr. DeBakey and President Lyndon Johnson, 1964.

In the early 1960s, Dr. DeBakey began a warm relationship with President Lyndon Johnson. The President tried to persuade him to join his administration as Secretary of Health, Education and Welfare, but the surgeon respectfully declined and offered instead to serve as a consultant. Dr. DeBakey worked a great deal on legislation with the President and legislators. Knowing that Medicare would be of benefit to the elderly, he supported it and encouraged President Johnson to get the legislation passed; it was very unpopular with many other physicians. Johnson became his patient, and secretly came to Houston for examinations.

Dr. DeBakey's statesmanship was very much in evidence in 1968. Baylor University College of Medicine was in a financial crisis. He proposed that the college of medicine separate itself from Baylor University in Waco and establish a board of trustees composed of Houston business and civic leaders. With the support of the university and the Southern Baptist Convention, the medical school received a charter from the State of Texas. Dr. DeBakey became the school's first president and, with a new and committed board of trustees, $30 million was raised and the school's debt cancelled. Dr. DeBakey began recruiting some of the nation's most talented physicians, researchers and administrators to the school. Twenty years after he came to what he would later call a "third-rate school" he was now head of a medical college that was destined to become one of the very best in the nation.

- Roger Widmeyer

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