Open Heart: The Radical Surgeons Who Revolutionized Medicine, David K.C. Cooper
Article first published online: 22 AUG 2011
© 2011 The Author Journal compilation © 2011 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 11, Issue 9, page 1993, September 2011
How to Cite
Madsen, J. C. (2011), Open Heart: The Radical Surgeons Who Revolutionized Medicine, David K.C. Cooper. American Journal of Transplantation, 11: 1993. doi: 10.1111/j.1600-6143.2011.03715.x
- Issue published online: 29 AUG 2011
- Article first published online: 22 AUG 2011
Open Heart: The Radical Surgeons Who Revolutionized Medicine , , Kaplan Publishing , 2010 .
Surgical procedures and specialties evolve in a cyclical fashion. First, there is the discovery or inception phase, when bold surgeons make exciting new advances that ultimately save lives. Next, is the commodity phase, when the procedure/specialty is refined, perfected and made safe for everyone. Finally, comes the obsolescence phase when another new discovery renders the original procedure/specialty obsolete and the cycle starts again. Although cardiac surgery may well be in its commodity phase, there has been no other specialty in the field of surgery with such an intense and audacious inception.
In Open Heart, cardiac transplant surgeon and scientist, David K. C. Cooper, relives the raucous beginnings of cardiac surgery through the eyes of “the radical surgeons who revolutionized medicine.” And radical they were, cutting through beating hearts to blindly grasp and remove bullets (Harken), connecting the circulation of a sick child to a parent who then functioned as the child's “heart-lung machine” (Lillehei) or transplanting a chimpanzee heart into a dying man (Hardy). These feats transcended the mere bold.
Through face-to-face interviews with these daring surgeons or their trainees, Cooper records colorful vignettes, little known anecdotes and private recollections that combine to illuminate the true character of these great men and their era. Some names, Christiaan Barnard, Michael DeBakey and Denton Cooley will be familiar, others not. However, all the men profiled in this book had one thing in common, a burning passion to make real contributions to their field despite the odds and despite the risks, not only to their patients but to their own careers and personal lives.
Take Robert Gross who is credited with starting the field of cardiac surgery when he successfully closed a patent ductus arteriosus in 1938. Gross’ chief at the time, William Ladd, had expressly forbidden him from performing the operation so Gross waited until Ladd was out of town before doing the procedure. Gross was subsequently fired. Three decades later, another surgical great, Denton Cooley waited until his boss, Michael DeBakey, was out of town to implant the first artificial heart. Cooley was subsequently fired.
Though risks to one's career were substantial, risks to the patients were greater. The mortality figures for some of these early procedures were numbingly high. In a now famous one-liner, Norman Shumway compared Walt Lillehei to Al Capone because of the many patients who had died during or after undergoing heart surgery by Lillehei. The courage of these surgeons to persevere in the face of such dire statistics was second only to the bravery of their patients for accepting the risks and proceeding. From 7-year-old Lorraine Sweeny, the first patient to have a patent ductus closed in 1938, to Louis Washkansky, the first recipient of a human heart transplant in 1967, to Barney Clark, the first living recipient of an artificial heart in 1982, these patients were as much the heroes as their surgeons.
Risk also extended to personal lives. Few families could withstand the perfect storm of their husband's or father's relentless ambition, total devotion to work and countless hours in the hospital. Many of these great men's lives, unfortunately, ended sadly.
However, the advances made by these pioneers truly changed the medical landscape. For their discoveries, Cooper makes sure credit is appropriated accurately and fairly. By way of example, he rightly points out that Alfred Blalock's pulmonary artery shunt, which saved thousands of “blue babies” with tetralogy of Fallot, had as much to do with the insightful pediatric cardiologist, Helen Taussig, and talented laboratory technician, Viven Thomas, as it did with Blalock.
Open Heart is a rich oral history of the “golden age” of heart surgery and a valuable addition to the literature. Cooper's writing brings the men and their accomplishments to life. If there is one criticism to be levied, it is that the author sometimes seems obligated to find fault. When describing John Gibbon, the father of the heart-lung machine, he states, “To a large extent, he seems faultless and unblemished, although, as we shall see later, there may have been at least one small chink in his otherwise perfect armor.” Nonetheless, Open Heart is an enjoyable and exciting read for those interested in cardiac surgery and surgical pioneers who have changed the world.