Altman, Lawrence K. "The Doctor's World: The Fued," New York Times, 27 November 2007,


Altman, Lawrence K. "The Doctor's World: The Fued," New York Times, 27 November 2007,
pp. F1, F6.

What may be medicine's most famous feud and certainly one of its longest-lived has
apparently ended.

It involved two of the world's greatest heart surgeons, Dr. Michael E. DeBakey and Dr. Denton
A. Cooley. As partners, they pioneered operations at Baylor Medical College and Methodist
Hospital in Houston in the 1950s that have stood the test of time.

But for 40 years, until a surprise reconciliation a month ago, these men with Texas-size egos
exchanged few words, even on those rare occasions when they were in the same room.

Dr. DeBakey is now 99; Dr. Cooley is 87. Characteristically, they take starkly different views of
the schism, with Dr. Cooley calling the short distance between their operating rooms "a
demilitarized zone," and Dr. DeBakey denying implausibly, many say that there even was a
feud.

The breach began in 1960, when Dr. Cooley left Dr. DeBakey's practice at Methodist and moved
the few hundred yards to St. Luke's Hospital, where he later established the Texas Heart
Institute. But it was an incident in 1969 that turned the rift into a full-blown feud.

It happened when Dr. Cooley, without approval from Dr. DeBakey or Baylor, commandeered an
artificial heart from his former partner's lab and implanted it in a patient at St. Luke's.

Over the years, Dr. DeBakey has called that first-ever use of a total artificial heart a theft, a
betrayal, unethical and "a childish act" to claim a medical first. Dr. Cooley defended the implant
as a desperate, if ultimately unsuccessful, act to save a life.

The American College of Surgeons censured Dr. Cooley. Baylor and the National Institutes of
Health, which paid for the research to develop the artificial heart, ordered investigations.
Baylor's report was not made public, and the government's findings cannot be found,
spokeswomen for both institutions said.

The furor led Dr. Cooley to resign from Baylor.

The annals of medicine are full of feuds. For example, Dr. Robert C. Gallo, then of the National
Cancer Institute in Bethesda, Md., and Dr. Luc Montagnier, of the Pasteur Institute in Paris,
battled over credit for the discovery of the AIDS virus. The dispute had to be settled at the
highest levels, with a resolution that declared the scientists co-discoverers coming in a joint
announcement from President Ronald Reagan and the French prime minister, Jacques Chirac.

Still, the DeBakey-Cooley feud is hard to top, not just for longevity but for the sheer drama of the
incident that set it off.

In those days, cardiac surgery was in many ways in its infancy. It was only in 1966 that Dr.
DeBakey had been the first to successfully implant a partial artificial heart a left ventricular
assist device in a patient.

As Dr. DeBakey, Dr. Cooley and others succeeded in operations that only a rare predecessor had
dared to try, the need for a device that could pump for both ventricles a total artificial heart
became more apparent.

The urgency became even greater in 1967, with the first human-to-human heart transplant in
South Africa. That created the need for mechanical devices as a bridge to transplant, if not for
permanent use.

The artificial heart was developed in Dr. DeBakey's lab at Baylor, with funds from the National
Heart Institute. It was a half-pound device of plastic and Dacron, linked by plastic tubes to a
bedside control console.

How Dr. Cooley obtained the device is not exactly clear. But this much is undisputed: On April
4, 1969, Dr. Cooley implanted it in Haskell Karp, 47, from Skokie, Ill. Dr. Cooley had help from
Dr. DeBakey's artificial-heart technician, Dr. Domingo Liotta, who was said to have been
frustrated by the limited time that he contended Dr. DeBakey put into the project.

The machine kept Mr. Karp alive for three days, longer than any animal in which it had been
implanted. Dr. Cooley then issued a call for a human heart and transplanted it, according to Ruth
SoRelle, a Baylor medical historian. Mr. Karp lived 36 more hours.

Dr. DeBakey had never sought approval to use the device in a patient, for lack of good
experimental evidence that it worked even in calves. He learned about Dr. Cooley's implant from
colleagues in a meeting at the National Heart Institute.

Shocked and embarrassed that he knew nothing about the implant, Dr. DeBakey flew to Houston
and began an investigation, saying Dr. Cooley's unauthorized use of the device broke federal
rules and jeopardized Baylor's grants. (Dr. DeBakey was chancellor of the medical college.)

As Dr. DeBakey recalled in an interview last March, he refused to testify in the litigation that
followed; he did not want his rival to be found guilty. "Much as I regretted what he did," Dr.
DeBakey said, "I didn't think vengeance would solve anything."

"He wanted to be able to say he was the first one to use an artificial heart in a patient," Dr.
DeBakey added. "I never quite understood it other than his ambition was almost uncontrolled. I
mean, you don't let your ambition get you in trouble."

Even after their reconciliation last month, Dr. DeBakey said that Dr. Cooley had "disappointed
me with his ethics" and "poor judgment" in doing the implant, which was "a little childish."

Dr. Cooley, in an interview this month, said he "was justified" in what he did. In 1969, he added,
he was performing more heart operations each year than Dr. DeBakey or anyone else, and so he
considered himself "the appropriate person to do the first implantation of an artificial heart."

Dr. Cooley recalled that a lawyer had once asked him during a trial if he considered himself the
best heart surgeon in the world.

"Yes," he replied.

"Don't you think that's being rather immodest?" the lawyer asked.

"Perhaps," Dr. Cooley responded. "But remember I'm under oath."

In the interview this month, Dr. Cooley said patriotism had also played a part: "It just sounds a
little bit supercilious," but "I did not want the Russians to beat us, as they had with Sputnik."

(The first total artificial heart intended for permanent use was implanted in 1982 at the University
of Utah; the recipient survived 112 days. Largely because of the furor surrounding the Baylor
implant, the Food and Drug Administration and a university ethics committee took elaborate
steps before approving the experimental use of the device. The agency has now approved
marketing of newer versions of such devices.)

The heart surgeons' reconciliation came a few days after Dr. DeBakey received the highest
civilian award from Congress, its Gold Medal, for a host of towering achievements: he innovated
surgical operations, helped to create the mobile military army surgical hospitals, or the MASH
units, and was instrumental in molding the Veterans Administration medical system. In a
ceremony Oct. 27 at St. Luke's, Dr. DeBakey and Dr. Cooley warmly shook hands as Dr.
DeBakey accepted a lifetime achievement award from the Denton A. Cooley Cardiovascular
Surgical Society. Its members are mainly former trainees of Dr. Cooley, and the meeting was
arranged shortly before the Congressional award.

A video of the meeting shows Dr. Cooley stepping down from the stage and kneeling next to Dr.
DeBakey, who sat in a motorized scooter. Their words were cordial, even jovial. "It must be a
heavy burden," Dr. Cooley said in presenting the award, "for one person to be honored by a
Congressional Gold Medal and membership in the Cooley Society all in one week."

Dr. DeBakey said that since the United States Mint made the Congressional medal of pure gold,
he assumed the Cooley award was the same. Dr. Cooley replied with a chuckle that his was 14
karat.

There was no mention of the artificial heart episode.

It was a moment many doctors had been waiting for. National surgical leaders had long tried to
arrange a meeting, only to have plans collapse at the last minute when Dr. DeBakey canceled,
said Dr. Kenneth L. Mattox, a DeBakey trainee who is chief of staff at Ben Taub General
Hospital in Houston. He added that he and other organizers of the October meeting did not alert
reporters, partly to avoid the potential embarrassment of another no-show, and that they did not
know until the last minute whether Dr. DeBakey would appear.

Dr. Cooley, too, had sought a similar meeting for decades. In an interview last March, he asked
this reporter to set up a meeting with Dr. DeBakey. Responding to that request, Dr. DeBakey
called the very idea of a feud "a journalistic fabrication" but then declined the offer, saying such
a meeting would only perpetuate the fabrication.

After the reconciliation, he said in an interview that "there was no reason to consider him an
enemy" and "we have never had any bad words," although "we haven't had very much in the way
of communication."

Dr. DeBakey, who had a reputation for terrorizing co-workers who failed to meet his standards,
has mellowed in recent years. He said he had decided to accept the award because "it just seemed
to be a very kind thing that they did, and I should also be kind and accept it graciously."

Dr. Cooley said the reconciliation should be good news for both surgeons' hospitals and the
Baylor Medical College. As they expand their facilities, he explained, many wealthy people with
friends on both sides of the "rivalry, even enmity," have had difficulty choosing where to donate.

"This may reassure them that our mission in our careers is similar, all for the betterment of
humanity and for the institutions where we work," he said. "The feud's over, but I don't
anticipate that Dr. DeBakey and I will be warm close friends henceforth. But I'm sure both of us
are going to go through the balance of our lives promoting the institutions to which we are
connected."

Dr. DeBakey is rehabilitating from major emergency surgery in February 2006 to repair a torn
aortic aneurysm a chest operation that he and Dr. Cooley had developed a half-century earlier.
Dr. George Noon, one of Dr. DeBakey's trainees, performed the surgery at Methodist Hospital.
Dr. DeBakey remains mentally sharp and can walk for limited, though increasing, distances.

The illness provided Dr. Cooley with another opportunity to seek a rapprochement .

"Why carry on this so-called animosity into our graves?" Dr. Cooley said in an interview.

Soon after Dr. DeBakey went home from the hospital, Dr. Cooley said, he stopped by Dr.
DeBakey's house unannounced. Dr. DeBakey's wife, Katrin, told him that Dr. DeBakey had not
had a good day and was not available.

Dr. Cooley said he then wrote to Dr. DeBakey and explained that he wanted "a few minutes to
pay my respects or at least reminisce about some of the events in our careers" and gave assurance
that he "would be sure to make an appointment."

Dr. DeBakey said in March that he knew Dr. Cooley had come by and sent a letter, but that he
had not replied.

In the reconciliation meeting, Dr. Cooley told Dr. DeBakey he regretted that they had become so
distant and hoped that the "temporary truce or cease-fire" they had reached in their "rivalry" and
"small battle" would become permanent.

Dr. DeBakey said in March that although Dr. Cooley "may have considered me a rival, I never
considered him a rival" because "I had all the patients I could handle and all the honors I could
take care of."

"He kind of suffered from the fact that I was considered more prestigious than he was," Dr.
DeBakey said.

Dr. DeBakey said that Dr. Cooley was "one of the best cardiovascular surgeons" he had ever
seen, and that "almost all of my firsts were associated with him in those pioneering times."

"If I had to have a serious operation other than what I had," Dr. DeBakey added, "and I didn't
have a man like George Noon or one of my own people, he'd be the man I would like to do the
operation because I have such great confidence in his surgical talent."

Dr. O. H. Frazier, a cardiac surgeon at the Texas Heart Institute who trained under both Dr.
DeBakey and Dr. Cooley, was among those who said they regarded the reconciliation as tentative
until Dr. DeBakey's society, as expected, reciprocates in honoring Dr. Cooley at its annual
meeting next spring.

"I do hope it will stick then," Dr. Frazier said.