At 91, Dr. Michael DeBakey continues to pursue full time the remarkable diversity of interests that long ago catapulted him to the heights of the medical profession. His stamina nearly equals his list of accomplishments: He performed the first successful coronary bypass operation in 1964, made the first Dacron artery grafts in the 1950s using his wife’s sewing machine, and has led work on artificial heart-assist devices since the early 1960s. Still an active researcher, much of his recent work has been in his role as a “medical statesman,” pushing for public access to medical libraries and fighting to protect doctor-patient trust in an era of managed care. DeBakey, chancellor emeritus of Baylor College of Medicine in Houston, was in Chicago recently to accept the Global Conference Institute’s Healthcare Humanitarian Award.
Q: You performed quite a few groundbreaking operations before anyone else was willing to do them. How did you make the decisions to go ahead?
A: I think the first thing you need is the feeling that what you’re going to do is in the best interests of the patient. You follow the so-called Golden Rule from the Bible, and that is that you do unto others as you would like them to do unto you. I have always felt that what I recommend to a patient I would recommend for myself.
When I did the first aneurysm resection, this is 1952, at that time we did not have an ethics committee to evaluate the procedure. We had to determine that for ourselves. We were the committee–I was the committee. And I decided on the basis of the experimental data I had that it could be done safely.
Q: Was the same thing true when you did the first successful coronary bypass?
A: Oh, yes. Some people were quite critical of my doing it, saying it was probably unethical. Two years before the first case we had published a paper summarizing our experimental work in animals. And I said in the paper that we really needed to do more research before trying it in people, because we only had a 50 percent one-year success rate, and we had to do better than that.
But the first case was a desperate situation, a patient who was about to die on the table. And we were just lucky. We did what we had been doing in dogs–we took a vein out of his leg and put it in the heart.
Q: A lot has been written about personality conflicts you had with doctors in Houston and elsewhere–some clashes of egos. Do you think it takes a strong sense of yourself to take the kinds of professional risks you have?
A: I think you have to be sort of convinced you’re right. I’ve been criticized for a number of things and had to stand my ground. For example, organized medicine and the American Medical Association were strongly opposed to Medicare when President Kennedy first introduced it and was trying to get support. And I openly disagreed with organized medicine–I thought it was a very good thing, the whole concept. And I think that more of that sort of thing is needed to support those who can’t afford medical care. I mean, they are our fellow human beings, and in general we are a compassionate society. But I was very severely criticized at the time for being a renegade.
It’s interesting because since then the AMA has given me several of their highest awards. They obviously now don’t think I’m such a renegade.
Q: Surgeons have come a long way since you did your first bypass; now 366,000 people each year get that operation. Is that your biggest legacy?
A: It’s really only one part. The really pioneering work I did was restoration of circulation, including use of a bypass, in arteries and particularly the aorta. I did the first successful operations on aneurysms of the aorta. Before that, those patients all died of ruptured aneurysms. Einstein died of a ruptured aneurysm.
Q: Who are some celebrities you’ve treated?
A: There was Marlene Dietrich. She was a lovely patient. Her main complaint was that she was having trouble with the circulation in her legs.
Fortunately she had a good result. And she gave me an autographed picture of herself, in a very slinky outfit–sort of an ermine thing, long but with a slit on the side, showing off her legs. She said, “This is what you did.” [laughs]
And I operated on the Duke of Windsor. He had an aneurysm of the aorta, and he came down with his wife to Texas. Everything went very well. Someone asked him why he came to Houston. His answer was very simple. He said, “I came to see the master.”
Q: You also treated Boris Yeltsin, then president of Russia. What was he like as a patient? Did he take your medical advice?
Q: Yes, he has taken advice, and he responded very well as a patient. But he had difficulty in his official position with avoiding alcohol, because he had to make toasts.
Q: At times it seems you’ve struggled against a basic impulse among doctors, who can be a pretty conservative lot.
A: Yeah, I think that’s probably true. Generally doctors tend to be conservative, and it’s understandable. I think where I may differ from the average physician is that I have a very deep concern with societal issues. If sanitation in the community isn’t good, I think I should be out there saying look, you’ve got to do something about sanitation.
That’s why I supported Medicare so strongly. And I would support universal health insurance too. But I have to admit, I don’t know how to pay for it.
Q: One of your accomplishments was leading the movement in 1949 to establish the National Library of Medicine, now the largest medical reference in the world. But you stole that library from Chicago, didn’t you?
A: As a matter of fact you’re quite right about that [laughs]. They made a great effort at the AMA to move the library near their headquarters here in Chicago. But I felt that it belonged at the National Institutes of Health [in Bethesda, Md.]. It could have been here, no question about that. But I wanted the library to be continuously supported by Congress, and that meant it had to be a monument they could see. It’s one of the greatest libraries in the world.
Q: And now it’s an impressive presence on the Web too. Anyone can access Medline for free.
A: That’s right. The last time I was on the library’s Board of Regents several years ago, I made a great effort to change the policy, and to make any citizen able to get anything they want out of the library. Because I felt it was a national treasure. It belongs to the people.
Q: What are the biggest remaining challenges for the treatment of heart disease?
A: The ultimate goal of any medical advance is to prevent the disease. To do that, you’ve got to find the cause. Most problems in the cardiovascular arena come from arteriosclerosis, but we don’t know what causes it. We talk about cholesterol and high blood pressure as risk factors, but that’s not the cause of the disease.
So we’ve gotten into research on a virus as the cause of arteriosclerosis. There is a virus that causes what’s called Marek’s disease in chicks, and it looks rather like our arteriosclerosis. We know that’s caused by a virus. We did quite a bit of work on viruses at Baylor, and other labs around the world have also been working on it. All of them had pretty much the same experience, and that is that there seems to be some relationship with a virus, but we can’t find the virus itself.
Q: How much work do you do these days?
A: I still get in the operating room from time to time, but not as much as before. I used to be in there all day. I’m still working every day. I usually get started in the morning by 7 o’clock.
I’m particularly involved right now with a little artificial heart pump I developed with NASA engineers. It’s based on electromagnetic activity that turns a little turbine, which pumps the blood. It’s very simple–there are no valves. We’re testing it now in Europe, and we’re applying to the FDA this month to get approval for clinical trials in this country. One of my main objectives now is to hopefully live long enough to see this pump used widely in patients.
Q: Has anyone ever suggested you slow down?
A: I get this a lot from my friends. Some of them call up and want me to give a lecture for them or something like that, and at the same time tell me I need to slow down. But not for them. [laughs]
I suppose I’ll have to slow down sometime, when the good Lord forces me to. But if you’re physically capable of going about your work, I don’t see any reason not to use that. I think that’s what life’s about. There are so many intellectual challenges that face you, the worst thing is you can’t get to all of them.
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An edited transcript
