Dr. Henly begins the interview by describing his medical training and the formative education of the late Dr. Michael E. DeBakey.
Dr. Henly narrates his long association with Dr. DeBakey at the Baylor College of Medicine. He recounts their collaboration
on the surgical treatment of thoracic aneurysms and angina pectoris and describes the challenges of open-heart surgery in
the 1950s. Dr. Henly describes Dr. DeBakey's work on the roller pump and offers observations on Dr. DeBakey's personality
and lifelong emphasis on surgical perfection. Dr. Henly concludes the interview with observations on Dr. DeBakey's legacy
and his impact on the Houston medical establishment.
Number of Image Pages:
61 (2,220,503 Bytes)
2010-07-08 (July 8, 2010)
Henly, Walter S.
Baylor College of Medicine
Interviewer: Gart, Jason
History Associates Incorporated
This item is in the public domain. It may be used without permission.
Oral histories (document genres)
Walter S. Henly, M.D.
Walter S. Henly was born on January 30, 1927, in Greenville, Texas. He received his B.S. in chemistry from the University
of New Mexico, Albuquerque, and his M.D. from Johns Hopkins University School of Medicine in 1947 and 1951, respectively.
Henly interned in surgery at Johns Hopkins Hospital, Baltimore, and served as a medical officer in the United States Naval
Reserve (USNR) during the Korean War. He completed a surgical residency program and thoracic surgery residency at Baylor College
of Medicine in Houston, Texas. Between 1958 and 1986 Henly served in successive research and academic posts at Baylor College
of Medicine. He was appointed clinical professor of surgery in 1994. Henly is the former president of the Houston Surgical
Society and the Houston Heart Association.
Dr. Henly begins the interview by describing his medical training and the formative education of the late Dr. Michael E. DeBakey.
Dr. Henly narrates his long association with Dr. DeBakey at the Baylor College of Medicine. He recounts their collaboration
on the surgical treatment of thoracic aneurysms and angina pectoris and describes the challenges of open-heart surgery in
the 1950s. Dr. Henly describes Dr. DeBakey's work on the roller pump and offers observations on Dr. DeBakey's personality
and lifelong emphasis on surgical perfection. Dr. Henly concludes the interview with observations on Dr. DeBakey's legacy
and his impact on the Houston medical establishment.
Dr. Michael E. DeBakey Oral History Project
Interview with Dr. Walter S. Henly
Conducted on July 8, 2010, by Jason H. Gart
JG: My name is Jason Gart, and I am a senior historian at History Associates Incorporated in Rockville, Maryland. Today's
date is July 8th, 2010, and we are at Methodist Hospital in Houston. Please state your full name and also spell it.
WH: My full name is Walter Samuel Henly, H-E-N-L-Y. The last name is not the English spelling, but it's H-E-N-L-Y.
JG: Terrific. History Associates has been retained by the Digital Manuscripts Program of the History of Medicine Division
of the National Library of Medicine to conduct a series of oral history interviews with prominent cardiologists, cardiac surgeons,
and researchers associated with the late Dr. Michael E. DeBakey. The purpose of this oral history is to capture recollections
for the historical record, and to assist the staff of the National Library of Medicine in developing a Profiles in Science
website on Dr. DeBakey. I want to start, before we get into Dr. DeBakey's career, with your background for a few minutes.
You were born in Greenville, Texas, in 1927?
JG: You attended the University of New Mexico, and you did your medical degree with Johns Hopkins University of Medicine in
JG: What brought you into medicine?
WH: I guess a desire to be helpful. My uncle in Greenville was a general practitioner, and he was always an idol. Matter
of fact, I am named after him. His first name was Walter. During World War II, he delivered every baby born in Hunt County.
I thought he was, perhaps, one of the greatest physicians ever. On my way to Hopkins, I stopped by to see him, and he said
that some day, I would be a better doctor than he was. I received those words with disbelief because I felt like he was one
of the greatest doctors ever. So he was the basic inspiration.
JG: You joined the Baylor faculty as an instructor in 1958, and you become an Assistant Professor of Surgery in 1960.
JG: You had a very long association with Dr. DeBakey. When did that start? And also, what did you know about Dr. DeBakey before
you met him, and what were some of your first impressions?
WH: Well, one of the things that I felt like that I wanted to be was a cardiac surgeon because of my training at Johns Hopkins.
I had, actually, started a residency program at Hopkins when I was drafted for the Korean War as a doctor. It so happened
that when I got out of the Navy in 1954, I was looking for a place to work, and one of the persons that had been in medical
school and internship with me in Baltimore was here as a resident with Dr. DeBakey.
And, of course, being a fifth-generation Texan and having my friend, Dr. Ralph Dunn, suggest that Dr. DeBakey's star was
starting to rise (which, indeed, it was) that this might be a better place for me to be than staying on the East Coast where
I had opportunities to remain. So I decided to come home to Texas. When I got here in 1954, this was six years after Dr. DeBakey
arrived in Houston. Things were in a pretty formative stage at that time.
JG: Dr. DeBakey was born in September 1908 in Lake Charles, Louisiana?
JG: His father was a pharmacist. His parents were Lebanese. What do you know about his childhood? He was the oldest of five
children. Did he ever speak to you about his childhood or things of that sort?
WH: Well, he told me enough to realize that he, as a young person, was a very hard-working person. Matter of fact, I think
he even referred to the time when he used to dig ditches. Also, he was an avid reader. His father bought him an Encyclopedia
Britannica, and I believe that he is reported to have read the entire encyclopedia.
JG: His brothers and sisters did as well, I think.
WH: That's right. He was, of course, native-born, but his parents had immigrated, I think, from Lebanon. And there was
a strong affinity between Dr. DeBakey and the Lebanese community, and also for a lot of Middle Eastern people. They got along
well with Dr. DeBakey.
JG: You mentioned digging ditches. He dug ditches? What did you mean by that?
WH: Well, he worked as a common laborer. He was very physically strong. I think that is one of the things that I feel accounted
for his longevity, his ability to work and to overcome a lot of physical obstacles, which he did in the past.
JG: He had one brother and two sisters, and the brother also became a physician.
WH: Ernie DeBakey.
JG: Was there a push by his father for them to become physicians? Or was it just something that you think Dr. DeBakey decided
to do on his own?
WH: I am not sure of the motivation, but I know that Ernie DeBakey was an accomplished thoracic surgeon in Mobile, Alabama.
I became extremely good friends with him because one of my fellow interns at Hopkins ended up as his partner. It was a doctor
by the name of Larry McGee. When he went into the practice of thoracic surgery in Alabama, he joined Ernest DeBakey as an
associate. And as a matter of fact, when Ernest felt like, when I was working with Dr. DeBakey, he felt like Dr. DeBakey might
be too busy to handle certain things, didn't want him to handle maybe a smaller type case, he sent me the patient.
JG: What about Dr. DeBakey's mother? What kind of mother was she? What type of stories do you know about her?
WH: I am pretty ignorant of his mother and his parents. But his sisters have worked around Baylor and Methodist Hospital for
years, and are very renowned in the field of medical paper writing.
JG: Dr. DeBakey did his bachelor's, master's, and medical degrees at Tulane?
JG: Then he did his internship and residency in surgery at Charity Hospital in New Orleans?
WH: He worked with Dr. Alan Ochsner.
JG: Then he decides to do fellowships abroad. Talk a little bit, as much as you know, about his medical training at Tulane
University, and then his fellowships in France and then in Heidelberg.
WH: Well, I'm not too sure that I can contribute a great deal about his overseas work. But I knew Dr. Ochsner. As a matter
of fact, his son, John, was a year behind me in the residency program here. I know a little bit about Dr. DeBakey's time
in New Orleans. He was a very energetic researcher at that time. He did a lot of work with pulmonary disease and with gastric
disease. He and Dr. Ochsner were the two proponents associating smoking with lung cancer, and were among the early advocates
urging that not smoking would prevent most pulmonary cancers.
JG: Was that atypical in the 1930s? My thought would be that more surgeons would be interested in a clinical route rather
than doing research. DeBakey in the 1930s seemed to bridge both?
JG: What type of medical training do you think he received at Tulane?
WH: Well, I think he had a fair amount of operative experience. Of course, any charity hospital provides that amount of training
over some private-type institutions because the trainee is permitted, perhaps, to do more in a charity institution. He also
had a tremendous interest in venous problems. When he was in Europe, he, I'm sure, developed a strong idea for vascular
surgery because he was influenced when he was in Europe by his association with Rene Leriche, who is one of the pioneers of
JG: You mentioned that Dr. DeBakey observed the association between carcinoma of the lung and smoking. I think it was the
late 1930s - 1938 or 1939 - when he made that observation, published on that. What did he think about people that smoked in
the 1950s, 1960s, 1970s, 1980s and 1990s, having made that observation sixty years before?
WH: Well, I think that he certainly did not appreciate the fact that they were smoking because he felt like that that was
a disease that, in essence, could be prevented. One of the interesting things, I never ever saw him smoke.
JG: And some doctors would. Some physicians still smoke today. On the NIH campus you see doctors smoking today, and probably
more so back in the 1950s and 1960s.
WH: Right. There was a rumor that, occasionally, he would take a puff in his home, but we never saw him smoke around the office.
I would call him a non-smoker.
JG: While in medical school, he invented the roller pump?
WH: That's correct.
JG: And later, it became a component of the heart-lung machine?
WH: That's one of his greatest inventions.
JG: Speak a little bit about that.
WH: Well, the roller pump was originally designed to make it a convenient way to do a transfusion from one person to another,
to transfer the blood from a vein from someone that was, say, lying next to you having a little pump there that would actually
move the blood and put it into the other person. This was a pretty effective way. Now when they started working on heart-lung
machines, we needed a way to move the blood, and there were a number of devices to do it. Sometimes it was with air compression
around malleable tubes, and inside the tubes would be valves. Another way that was fairly popular was the SigmaMotor pump
which had fingers that sort of milked the tubing in a propelling way.
Dr. DeBakey's roller pump became, actually, the gold standard for heart-lung machines because it produced probably the
least trauma to the blood and was able to move the blood more efficiently than some of the other devices that were contemplated.
I would say that the invention of this roller pump, which is in use today on almost every heart-lung machine, was one of his
JG: How did he speak about that invention in the 1930s? Initially, it was not designed for the heart-lung machine. What brought
him to tinker with the pump?
WH: Well, I was doing some research in the surgery laboratory as the first heart-lung machines were being developed. We had
a machinist in our laboratories that could build anything. As soon as we began to work with moving blood and fluids, Dr. DeBakey
brought this concept in and we used it originally. One of the biggest problems at that time was devising a plastic tube which
could take the punishment and would be held in place while the roller pump was working. We actually worked out a tubing which
had a flange on it which, when it was placed in the jaws of the roller pump, would be held securely in place. Then the roller
pump could actually move without moving the tubing also.
JG: Between 1942 and 1946, Dr. DeBakey was a member of the Surgical Consultants Division of the Office of the Surgeon General
of the Army. He was a colonel in the Army Reserve. What do you know about his wartime experiences?
WH: Well, I do know that he has reviewed a lot of wartime injuries and written, I think, extensively on his military experience.
But his greatest contribution was the idea of the MASH unit, which is the Mobile Army Surgical Hospital. At the time when
I was drafted, I was placed on a surgical team in the Navy, which was designed to function in a MASH unit so that part of
my experience in the Navy was in a MASH unit setting, which was due to Dr. DeBakey.
JG: The concept of stationing doctors close to the front has become commonplace. Today in Afghanistan and Iraq surgeons are
on the frontline. What led Dr. DeBakey to that observation? Why was he able to see that need where others could not?
WH: Well, I am not sure exactly what brought the idea to his head, but I think in studying war wounds, he realized that the
quicker you can get skilled medical attention, the better the survival rate would be for the soldier. He then developed ideas
to have these mobile units. As a matter of fact, the Marine Corps, which I was associated with as a Navy surgeon, we had the
ability to go ashore and bring a hospital with us. Then we had the ability to move that hospital with operating capabilities
forward as the troops advanced to the interior.
JG: Just for the record, you were drafted for the Korean War?
JG: What years were your service?
WH: From 1952 to 1954. I was in Korea when the armistice was signed. That was in 1953.
JG: This is a strange question, but in my review of writings on Dr. DeBakey I haven't seen it asked, so I thought I would
be the first. What did he think of the television show, the MASH television show? I assume he would have thought something
of a TV show that explored his idea.
WH: Well, to my knowledge, when I was with him, he never mentioned the MASH show. He may have appreciated it. I do know that
in his later years, when he gave talks to certain community groups, that he would talk about his contributions, one of his
contributions, the MASH unit.
JG: Okay, let's turn for a few minutes to surgery in the 1950s and 1960s. DeBakey was there at the moment that cardiac
surgery really blossoms. What was the change point? What was the difference between cardiac surgery in the 1940s and then
in the 1950s? And what were the challenges?
WH: Well, actually, I came through at a time when cardiac surgery was developed. At Hopkins, of course, about 1944, Dr. [Alfred]
Blalock did his first tetralogy operation. If you followed Dr. Blalock around, and surely by the time I got to medical school,
every baby that you saw at Hopkins was blue. That was the beginning of cardiac surgery, but this blue-baby operation was what
we call a palliative operation. In other words, if a person was blue from Tetralogy of Fallot where there were four defects,
the blue baby operation added another defect, really.
But it improved the flow of blood to the lungs so that the baby then pinked up and could survive. Well, we realized that there
was a need to be able to operate inside the heart. Then people started developing ideas to get inside the heart. One of the
first approaches was what we call the finger fracture of the mitral valve in patients that had mitral stenosis. Without putting
them on the heart-lung machine, which was unavailable at that time, you simply were able to insert a finger into the left
atrium, one of the upper chambers of the heart, palpate the valve and, with the finger, actually expand the opening of the
valve that was narrowed.
Occasionally, there would even be a sharp knife that was put on the end of the finger in such a way that you could cut the
commissure if you needed to, or that area between the two leaflets of the mitral valve. That was one of the earliest invasive
ways. Then we began to do other things. Then it was Walt [C. Walton] Lillehei in Minneapolis who first figured out a way to
actually work on a heart by using a family member or compatible person as the oxygenator of blood. What he did was a procedure
called cross circulation. This permitted the advancement of heart surgery.
Then John Gibbon developed a machine in Philadelphia, I guess, around 1950 or so. When I was in Philadelphia, Dr. Gibbon asked
me to walk through his laboratory and he showed me the machine that he used as the first artificial heart where he did the
first few procedures using a machine which could pump the blood as well as oxygenate the blood. Then further improvements
in oxygenation came about, particularly at the Mayo Clinic where they developed what we call the Cadillac oxygenator, which
was a membrane-type oxygenator. Then, of course, in Minneapolis, they developed the Lillehei-DeWall oxygenator, which was
a bubble oxygenator, which was pretty practical.
I think it was in 1957, I believe, that here in Houston, Dr. [Denton] Cooley did our first open-heart operation, and I was
not scrubbed, but I was present in the operating room. What he did was to repair a perforation of the septum between the two
ventricles which had occurred in a man who had had a myocardial infarction. That was the first open-heart case ever done in
the Houston area. And, fortunately, the patient survived that operation, but the oxygenation of that patient was done with
a pretty primitive device, which we referred to as a coffee pot, which permitted the blood to bubble up and be oxygenated,
but when it came out, it was foamy. Then as it then traveled down a spiral where there was a defoaming agent, it became a
more liquid form, and then could be pumped back into the patient.
JG: You mentioned some of the early invasive procedures. Oxygenation is one problem. In the pumps, it can damage the blood
cells. What are some of the other challenges and what were the success rates of those early surgeries?
WH: Well, whenever a person survived, of course, in the early days, we thought it was pretty spectacular. There were a number
of cases done by surgeons in Philadelphia, for example, that we were aware of where the risk of the operation didn't seem
to justify the procedure. I think that is probably true when any new significant cardiac technique is developed because, as
the knowledge improves, the survival rate and benefit improves.
JG: You arrived in Baylor back in Texas in 1954?
WH: Yes, 1954.
JG: You are now a young surgeon. What is your first interaction with Dr. DeBakey? What is your role on his team at this time?
WH: Well, when I started a residency training program, of course, he was the professor. We worked primarily at the city-county
hospital. At that time, it was Jefferson Davis Hospital. This was before the present city-county hospital, Ben Taub General
Hospital, was built. We had a tremendous volume of patients. In those days, I might mention that in the South, our hospitals
were still separated. We had what we called a white surgery service and a colored surgery service.
JG: They were segregated.
WH: I might allude to that a little bit later, or I might just mention it now. Dr. DeBakey and I had an argument about who
put the first black patient in Methodist Hospital. I had always figured that I had done it, a patient who had a dissecting
aneurysm. He was a preacher from New Jersey. Dr. DeBakey convinced me that he was ahead of me by about a year in breaking
the color barrier at Methodist Hospital.
JG: What year is this?
WH: That was about 1959 or 1960.
JG: Was there a backlash to that?
WH: There did not seem to be a backlash. I think it was more of a natural evolution. People realized it was going to happen.
Particularly with my patient we, of course, had no black patients at Methodist at that time in the late 1950s. But with my
patient, it was just an accepted thing. We just worked under that normally. But now as a young resident, we had superiors.
The residency program was the pyramidal system. Dr. William Stewart Halsted at Baltimore developed the surgical residency
program. And Dr. DeBakey put it to use with magnification, so to speak.
We had a pyramidal residency program which most people were guaranteed to work, have at least three years' training. Then
if your work was not quite up to what he expected, you could not progress to a fourth or fifth year. By the end of the fifth
year in my day, we were training only three chief residents: one, at the Veterans Hospital; and, two, at the city-county hospital,
that completed their training and then were eligible to take the boards in surgery. That was the early experience. In those
days, we had Dr. DeBakey come to the city-county hospital frequently.
He did some of the earliest, most significant cases, particularly thoracic aneurysms that were performed at the city-county
hospital in the days even before we had the capability of using the heart lung machine because what we had was the technique
called sutured bypass. And just to illustrate this, let me just show you one of the papers that we wrote. This is a technique
of sutured bypass. If this is the aneurysm, first we would place a graft from the ascending aorta to the descending aorta,
and a graft to the carotid arteries. That would permit us to resect the entire transverse arch and replace it with a graft
without the use of a heart-lung machine.
JG: What is the title of this paper?
WH: The title of this paper is "Aneurysm of the Aortic Arch: Factors Influencing Operative Risk," Surgical Clinics
of North America, by DeBakey, Henly, Cooley, Crawford, Morris and Beall. This was an exciting period of time.
JG: Following on this, DeBakey recognized, I guess, the segmental nature of vascular disease. He realized that healthy artery
often adjoined diseased sections?
WH: That's right. In other words, the segmental nature of arterial sclerosis is what permits the surgeon to be effective.
JG: Because you can go in specifically to that section, take it out and -
WH: You can go from good tissue, and bypassing bad tissue, and go to fairly good distal tissue, which means that you can
either remove or bypass the obstructions. In the case of aneurysms, the dangerous part of the artery can be removed and replaced
with a graft.
JG: This was, I assume, a fundamental observation.
JG: How did he realize that?
WH: Well, some of the earliest approaches to aneurismal therapy was what they call an endoaneurysmorrhaphy, which means opening
the aneurysm and obliterating it just by suturing it shut. Depending on the case of an abdominal aneurysm, depending on collateral
circulation to keep the lower part of the body alive. This was done probably in his days in New Orleans in the early days
of vascular surgery. Dr. DeBakey actually was, I think, the first person to do an abdominal aortic aneurysm.
JG: In 1952?
WH: Let me look. I know it is here in my notes. Yes, I think that was the date that he first did the first abdominal aortic
aneurysm. He replaced that with a homograft. In those early days while I was still at Hopkins, we had done more aneurysms
even than Dr. Cooley and Dr. DeBakey in those days. The numbers were like eight or nine. Then by the time I got out of the
service, and was here, Dr. DeBakey was well entrenched by removing aneurysms of the abdominal aorta and other aneurysms and
replacing them with grafts, usually homografts.
Because they had a special arrangement where we would obtain permission from the medical examiner to take human tissue. One
reason Dr. DeBakey got ahead of many people, many surgeons in the United States, in doing aneurismal and aortic work, was
that he had a better availability of homograft tissues than other places.
JG: How so?
WH: Well, it was just the medical-legal system here, and the fact that most autopsies that were being done in those days
were done on patients that were not embalmed for medical-legal purposes because they wanted to determine the cause of death,
and it was more difficult to do that on embalmed people. So there was a greater availability of homografts here in Houston.
JG: Speak a moment, just in laymen's terms, about aneurysms. Almost from the beginning of times - Roman and Greek doctors
realized that aneurisms were a very dangerous medical condition if not treated. The thinness of the blood vessel can almost
be like a balloon. There was no way to treat it.
WH: That's correct. Until we began to actually operate on the arteries themselves, you're right. For example, people
like Einstein, he died of a ruptured abdominal aneurysm. Once that happened, there was nothing, in those days, that could
be done for those people. By the time I had finished my training in surgery, we were at the verge of starting to develop really
One of the things, of course, that Dr. DeBakey did was to develop a synthetic arterial graft. This was an example of how things
happen for the best sometimes. By accident we found out about penicillin, because an accident in a laboratory showed that
a certain mold could kill bacteria. It happened by chance. This was one of the things that happened in vascular surgery. Dr.
DeBakey realized that we needed something that we could take off the shelf instead of using homograft tissues.
What he did was he went down to the department store, and he was looking for some nylon or rayon, and they said, no, we are
out of all that material, but we have a new material called Dacron. And he said, "Well, let me have that." He took
that home, and on his wife Diane's sewing machine he sewed an aortic graft, a bifurcation graft. With that, of course,
along with that came studies in the laboratory that the body could tolerate that material without rejecting it. It became
suitable. Nowadays, most synthetic grafts are made of Dacron and are made with a much more sophisticated knitting and sewing
maneuver. So there is a great story that related to the development of the aortic grafts.
JG: This is an example of serendipity in science. If he would have gotten the nylon from Foley's Department Store, would
the body have rejected it?
WH: Well, I'm not sure, but I do know that there were a number of grafts that were made of different material that the
body did not tolerate too well. One of the grafts was, I believe, a Tapp-Edwards graft, which was a woven graft that tended
to sort of unravel after it was in place for a while. But the Dacron grafts were the ones that held up.
JG: In 1953, DeBakey performs carotid endarterectomy, thereby establishing the field of surgery for strokes. Describe the
significance of that surgery?
WH: In 1953, he was one of the first to perform a carotid endarterectomy. There was - matter of fact - he and I always had
sort of an argument about who did the first successful carotid endarterectomy. Dr. Eastcott, with his associates Pickering
and Rob in England, about the same time as Dr. DeBakey did his first carotid endarterectomy. Nevertheless, that procedure
has become a well-established procedure for the treatment of stroke. Dr. DeBakey realized that this was going to be a factor.
So he went ahead and performed the operation which you just suggested. This procedure, carotid endarterectomy, in today's
world, people are still trying to dilate and stint carotid arteries. The risk of this has still yet to approach the risk and
good results that can be obtained with open surgery, which is entitled carotid endarterectomy.
I might mention while we are talking about carotids, there are two techniques that are employed in that operation, which we
worked with and stressed in our surgical
laboratories. The one technique was the repair of the artery using a patch graft. The other technique is the use of a shunt
placed inside of the artery the minute the artery is open, the little plastic tube is placed inside the artery. It continues
to carry blood to the brain during the time of the cleaning out of the artery called endarterectomy. Both these techniques
are very helpful and have been proved through overall results of surgery, and they were worked with and established through
the help of our animal laboratories here at Baylor.
JG: In 1964, with Edward Garrett, he does an aortocoronary artery bypass. Talk a minute about the significance of that surgery.
It is now used throughout the world. You take a vein from someone's leg and use it as a bypass.
WH: Well, I might have to start out by saying that, in 1961, Dr. DeBakey and I wrote a paper on the surgical treatment of
angina pectoris. At that time, no one had successfully been able to operate on coronary arteries. A lot of experimental work
had been done, but the concept of bypass was out there, but the techniques were just being developed because we needed monofilament
sutures, and we needed an ability to get to the artery safely and so forth. So we, in the surgical laboratory, we used the
Dacron grafts that Dr. DeBakey brought, four millimeter diameter grafts, and we placed these in dogs, and the smaller grafts
functioned satisfactorily for about a month or two before they began to clot off.
At that time in the laboratory we were also using vein patches. Dr. Paul Ellis, one of the thoracic residents, was experimenting
using patches, I think - it is in that same paper - to open the artery and repair it with a patch. Dr. DeBakey told me that
it was our experimental work that gave him the courage to go ahead with doing the first bypass. This happened in 1964. Dr.
Garrett, at that time, when Dr. George Morris and I, about that time, had quit helping Dr. DeBakey in the operating room every
day, and so Dr. Garrett and Dr. Howell sort of took over for Dr. Morris and I. Dr. Garrett and Dr. DeBakey took this patient
to surgery, who had extensive disease, with the idea that they were going to do a coronary endarterectomy.
They found that the disease was too extensive. They felt that they could not do the endarterectomy and perhaps get the patient
out of the operating room. So they, with the experimental background that was going on in the laboratory, and the fact that
we had had some experience with using veins to bypass arteries in the leg, they used the vein to bypass the left anterior
descending coronary artery. The interesting thing about this is the patient survived, but the patient had a myocardial infarction
associated with the surgery. Dr. DeBakey and Dr. Garrett felt like, well, this may not have been a successful procedure.
Well, the patient was discharged. But seven years later, the patient came in with more trouble and had a cardiac catheterization,
which demonstrated that the vein graft that they had put in seven years previously was open and working. There is a picture
of it in his literature. I think I may have a picture of that. It is in a paper that Dr. DeBakey and I published just before
his death. There is a picture of this and this write-up here in the Methodist Journal. This is a picture seven years later
of the graft open.
JG: What is the title of this article that you are showing me?
WH: The title of this article is "Surgical Treatment of Angina Pectoris: A Fifty-Year Retrospective from Baylor/Methodist"
by Drs. DeBakey and Henly. This was published in the Journal of the Methodist DeBakey Heart and Vascular Center.
JG: This article that you write with Dr. DeBakey is still important and highly cited. What led to you working together with
Dr. DeBakey to write this article?
WH: Well, I had always been interested in coronary disease. Because, as a medical student listening to Dr. Blalock, I was
convinced that coronary obstruction was a mechanical situation that could be amenable to surgery, which goes along with this
segmental concept that you talked about Dr. DeBakey studying. So I was always interested.
When I joined the Department of Surgery, I had applied for and was awarded an
established investigatorship. That established investigatorship was based on a project to determine the myocardial blood flow.
Because I was concerned that, in those days, we had no way of evaluating what we were doing. There was a procedure called
a Vineberg Operation where Dr. Arthur Vineberg of Canada had developed this procedure which took the internal mammary artery
and just, with it bleeding, placed it in a tunnel in the left ventricle and relied upon chance to produce collateral circulation,
which would be helpful to the patient. Well, we had no way of evaluating. There were no arteriograms in those days.
JG: That is what that is, the images you are showing me, that is an arteriogram.
JG: So you were operating blind, so to speak?
WH: That's right. In those days, in 1959 and 1960, we had no way of evaluating how we were improving the circulation to
the heart. We wanted a procedure to do that. That is what started a lot of my thinking. Then it gradually worked into doing
experimental work on animals. First we were working with using what we call a Beck II operation, where Claude Beck in Cleveland
had introduced this procedure saying that it was helpful to patients with coronary artery disease, and what this did was to
put arterial blood flow into the venous system of the heart. We were working with that, and this helped us developed techniques
on working with small blood vessels.
But this is what caused us to write this article, pointing out the fact that in the future might be, I think, the use of the
bypass procedure. This paper is interesting because it was written way before anybody had even had the concept of doing coronary
The other thing that I wanted to mention was that the reason that Dr. DeBakey's report did not come out until later is
because they did not realize that they had done a successful procedure. And, actually, Dr. Favaloro and Dr. Dudley Johnson
were in two different institutions in the north part of the world. They published a series in 1968 and 1969 of their cases
using coronary vein bypasses. But then, by that time, it was, I think later, I am not sure when that other paper of Dr. DeBakey's
was published, but it was published later. Dr. DeBakey and Dr. Garrett must get the credit for doing the first one.
But then again, Dr. DeBakey said that this was almost a gift of God for him to be able to do that first one because Dr. David
Sabiston at Johns Hopkins, a year previous, had done a vein graft from the aorta to the right coronary artery, end to end.
Unfortunately, his patient did not survive. He died on the second day from a stroke, so that Dr. DeBakey had had the honor
of doing the first successful vein bypass.
JG: In May 1965, Time Magazine features Dr. DeBakey on the cover, and the article is about his pioneering work in cardiovascular
surgery. Was he excited to be on the cover of Time Magazine?
WH: I think he was, although he never spoke about it. I noticed that in those days, international recognition was quite
competitive because Dr. DeBakey realized, when you look around and see the Texas Medical Center, it is probably the largest
medical center like this in the world. Most of it is due, not all, but most of it is due to Dr. DeBakey's efforts, and
the efforts of others, of course. Dr. DeBakey really was the engine, so to speak, to make this whole medical center grow.
Having national recognition was part of that. Whenever they got national recognition, like a picture on Time Magazine, that
always helped bring patients in and helped them financially have the ability to grow.
JG: Let's talk about the growth of the Texas Medical Center for a few minutes. When Dr. DeBakey arrived in Houston in
1948, he was the only board certified surgeon?
WH: I think that is correct.
JG: People would hunt deer in the woods around the hospital.
WH: That's correct.
JG: He developed the residency program.
WH: There were only about two or three surgeons of note when Dr. DeBakey arrived: George Waldon, John Robert Phillips, and
JG: He became a great booster of Houston. He convinced community leaders in Houston that they needed a first-class medical
school. Talk about his relationship to the real estate developer Ben Taub. Who was Mr. Taub?
WH: Ben Taub was a very wealthy person who, basically, had, I think, a cigar store. He had many interests and was a great
benefactor to the Houston community. He used to come every Sunday to the city-county hospital and make rounds. Dr. DeBakey
would always meet him there. The two of them would go through the city-county hospital together. That was why (Ben Taub had
an interest in the indigent people of our community through a city-county hospital) the new city-county hospital felt like
he deserved to have this hospital named after him. Our present city-county hospital is the Ben Taub General Hospital. He was
a great benefactor and a very good friend of Dr. DeBakey's. When Ben Taub got sick, we just moved him into one of the
corner rooms here at Methodist and took care of him for, I think, at least two years that I recall.
JG: I read that when Dr. DeBakey became chairman in Department of Surgery, and then as he was promoted, he would only take
his teacher's salary, the fees from all his surgeries, which would later be in the millions, he gave back to the College
WH: That is correct. I am not aware of the specifics of this, but I do know that he developed a foundation which has been
very supportive of all the medical efforts. As an individual, I am familiar with some of his charges, and I will give you
this little anecdote. We were making rounds one day and a school teacher had been operated on. When we came into the room,
she said, "Dr. DeBakey, I'm very worried about how I can pay you." Dr. DeBakey said, "I don't charge school
teachers and nurses," and one other group, I think. But teachers were one of them, and she had a big smile afterwards.
One of the things that a lot of the younger doctors, particularly after Medicare came in, they would complain. Dr. DeBakey
never raised his fees much.
His charges were always reasonable. Not only that, he never turned a patient away, nor did I, nor did many others. Any time
a patient came to him that he felt like that the patient had no ability to pay, but that he could take care of this patient
better at Methodist than, say, send him to the VA or to Ben Taub, he never turned those patients down. He and I, and others,
would go to the hospital and say, "We're willing to do the work without recompense. Will you give this patient a break?"
The Methodist Hospital never refused us, never refused me one time when I had such a patient. This is one reason, I think,
that this institution is great is because they never lost sight of the need for charity for certain individuals in our community.
JG: Was that a reflection of the period that Dr. DeBakey went into medicine, in the 1930s and 1940s, where it was truly seen
as the noblest of professions?
WH: Well, one of the things. I told Dr. DeBakey, I said he and I practiced medicine at a great time. We didn't have to
worry about the business of medicine. In other words, we had plenty to do, our charges were reasonable, we never had to worry
about having our money to pay our staff, or pay our malpractice, and the usual overhead expenses because we were so busy doing
things. We never worried about the business aspect of medicine. If we wanted to give our services, that was fine. We still
do that. My partner and I, I am still operating, although I am eighty-three years old.
My partner and I, the other day we did a tremendous operation on a patient, double mammary coronary bypass, knowing full well
that we would never get any recompense for that, and we still do that. This is one thing that the government does not realize.
For example, when Medicare came in, the government really didn't realize the amount of charity work the doctors did. Because
we had thousands of dollars on the books that we would never collect from the elderly.
Then the government all the sudden says, "Well, we will pick up that tab." All of the sudden, they found that, "Well,
this is going to be more expensive than we thought." Because they did not count on the fact that doctors were doing the
work and taking care of people and not getting paid. Now we were taking care of older people and doing the work and getting
JG: That's fascinating. Another significant innovation was that Dr. DeBakey was the first to film surgeries. He set up
in the operating room a full-time photographer. Talk about that development and what it was like to actually have photographers
in the operating room.
WH: Well, I knew Gene Davis really well, who was our Methodist photographer. His name is Gene Davis. One of his helpers was
a fellow by the name of Bobby Dolby, The reason I know him well is because after he retired from doing pictures, he became
my ranch foreman. Gene Davis was a great professional. He devised techniques of making sixteen millimeter movies and developed
mechanical platforms where he could put himself in the proper position to film these cases.
I might mention a case that Dr. Morris and I did. Dr. DeBakey did scrub in on the case. This is a patient, a doctor that had
an acute dissecting aneurysm. This surgery was done about 1962. The paper was published in 1963. This doctor had collapsed
in Louisiana. He was a resident in surgery at the Mayo Clinic. But he was home visiting, and he collapsed in Louisiana, and
they brought him here, and Dr. Morris and I opened him up, and this was one of the early successful repairs of an extensive
aortic dissection. We had Gene Davis come in and set up the camera, and he photographed this.
Dr. Morris and I and Dr. DeBakey were recognized even in Britain for this particular movie, which was on repair of acute dissecting
aneurysm. And this, of course, has been published. This is just one of the reprints.
JG: The title of this article is "Correction of Acute Dissecting Aneurysm of Aorta with Valvular Insufficiency," and
this was in the Journal of the American Medical Association.
WH: Right. By that time, only a very few people, and there were only six people had ever done operations of that type.
JG: And the movies, eight millimeters or sixteen millimeters?
WH: Sixteen millimeters.
JG: They were then used for training for people all over?
WH: That's right. These were then given to the American College of Surgeons film library, and they were utilized. For
example, I made a movie on carotid endarterectomy. It was used for a number of years just to show surgeons all over the country
of our operative technique doing carotid endarterectomies. As I think about it, our techniques have changed very little since
I made that movie.
JG: Let's talk for a few minutes about research on the mechanical heart or the artificial heart. DeBakey searched for
the artificial heart, I guess, his entire career. Is it safe to say that?
WH: He did. He was one of the early proponents to realize the need. Of course, I think Charles Lindbergh first had an idea
of an artificial heart. But Dr. DeBakey got the first grant for working on developing an artificial heart. I was active in
the surgical laboratory during the time when a lot of this research work was being done on the artificial heart by Dr. Domingo
Liotta and Dr. Bill Hall, those two worked extensively. One advantage that we had at Baylor was that we had a mechanical technician
engineer by the name of Lou Feldman who could build anything. It would look like it had just come out from the most polished
manufacturer. Any idea we had need of a mechanical nature that we wanted built, he could build it.
JG: Was he a trained engineer or a machinist?
WH: I think he was more of a machinist. He certainly could turn out perfected work. He would work with Dr. Liotta and Dr.
Hall. They, of course, incorporated Dr. DeBakey's suggestions and finally ended up building a usable artificial heart,
which was being tested in laboratory animals. I think it had been used in seven or eight calves before the controversial episode
happened where one of Dr. DeBakey's associates took it and implanted it in a patient, producing a rather spectacular controversy.
JG: Just to move back a second, what are some of the technical and surgical challenges involved in developing an artificial
or mechanical heart? What was the challenge?
WH: The pumping of blood without thrombosis. In other words, you had to consider the fact that you wanted to move blood through
this machine for a long period of time. In order to move it, you had to have a pumping mechanism which usually employed valves.
Then you had to see that a thrombus did not occur because usually that was the thing that caused the whole procedure to fail.
JG: What is thrombosis?
WH: Clotting. Then in addition, of course, there is the problem of infection. So, ideally, you wanted to have an artificial
heart that could be implanted so that you did not have any connection with the outside world, because these connections from
the outside world that would go to the energy source, for example, might endanger infection and, ultimately, cause failure.
Then the actual energy source, of course, was a big thing because, ideally, you would want to be able to recharge the batteries,
so to speak, with a non-invasive technique. They were trying to work on a completely implantable artificial heart. Well, actually,
it has turned out now that these cardiac support devices which we have frequently are used not for long-term support, but
for temporary support until a heart transplant can occur.
JG: You mentioned that DeBakey was one of the first to testify before Congress and obtain federal support for the artificial
WH: That is right.
JG: What brought that about?
WH: Well, I think he realized first that he had a good influence with the politicians, with Presidents. He had a good relationship
with President Lyndon Johnson, and he had a good relationship with President Richard Nixon. I think that he felt like that
he could call on the government to be helpful in a project. This was one of the things that he did, was that he participated
in a rather statesmanlike way on many occasions.
JG: I read that there is a Hufnagel artificial heart valve.
JG: And that when the first Hufnagel valves were put into use, the main cause of death was suicide because the patients could
not stand the noise of the valve.
WH: It was a noisy valve. There have been a number of valves that have been designed, and Hufnagel was one of the first but
it was not a valve that could be put in place in the normal anatomical spot. It was so big, it had to be placed in the descending
thoracic aorta. It was noisy. You could hear the ball moving up and down, clicking, from maybe a block away almost. But other
valves have been produced that were a little noisy. I remember that when we were using ball valves, St. Jude had a ball valve
that they produced that I put in one fellow that he came back to see me a number of months later, and you could hear it by
just talking to him, you could hear the valve.
It was not too loud, but he said, "You know, doc," he said, ``I haven't been able to kill a deer since you operated
on me. I put myself seventy-five feet up in the air and the deer still hear me." That was one of the things that we learned
in the early days that we had to do, we had to make valves so that they were noiseless.
JG: DeBakey performed, one of his innovations was the left ventricular assist device.
WH: That's right.
JG: Talk a little bit about the use of this device, and then also in the 1970s, he hit a wall in what could be accomplished.
WH: I understand you are going to talk with Jimmy Howell. Jimmy and I were talking about this the other day. He, actually,
helped Dr. DeBakey to put in the first left ventricular assist device. I was under the impression that Dr. Crawford had done
it, but he said no, that he actually participated with Dr. DeBakey doing that, so you might ask him some of those extra details.
This was a device that, actually, was used successfully. When was it, 1964?
JG: In 1966, I think.
WH: Okay, 1966. We had had this device that had been worked out in the surgical laboratory where we could actually suture
the device to the atrium and use it to relieve heart failure, and take the strain off the left ventricle by pumping it from
the atrium to the aorta. This was first used and the patient did survive, and that is mainly my knowledge of that first episode.
JG: Let's talk a little bit about heart transplants. In an eighteen-month period, DeBakey did twelve heart transplants,
including a historic multiple-transplantation procedure, but he discontinued the program in 1970 because of organ rejection
problems. DeBakey's entry and exit from transplantation surgery, in fact, influenced other people operating on the national
stage, and I wonder what you might say on that.
WH: Well, I do know that we here at Houston were among the first to do transplants. Of course, Christiaan Barnard did the
first one in South Africa. But about the time that that was going on, we were actually, Dr. Beall and I were switching hearts
in dogs. That was only on an acute basis when we didn't expect the animals to survive. But the rejection process was the
main problem with early heart transplants until they found a better way to not only match the donor heart to the recipient,
but also to develop drugs to help stall the rejection process.
Even today, you know, I have never been a heart transplant surgeon as such, but even today, I think if you have a survivor
for ten years, you have done something really worthwhile because a lot of these patients develop not the usual type of coronary
artery disease, but they get a diffuse coronary thickening, which causes it to actually, ultimately, have failure of the transplanted
heart. Some of these people actually have a second heart transplant, which, of course, can be successful and can carry them
on. I feel like that this is a good procedure, but it needs to be reserved for really suitable candidates.
JG: DeBakey was quite proud, I guess, in the 1980s and 1990s, of the VAD. This was the size of a thumb, this ventricular assist
JG: It came out of work with NASA.
WH: Right. He and George Noon worked with this considerably. George, I think, has been a real proponent of this device, and
it makes a lot of sense because it can be placed using catheter techniques. A small device, and it can be placed in such a
way that it adds to the propelling of blood, and taking the strain off the left ventricle, without a lot of major surgery.
This is a device that is still under investigation and does carry some optimism.
JG: I found it interesting because this is a continuous flow pump as opposed to -
JG: So there is no pulse?
WH: There is no pulse.
JG: That must be startling. People did not think you would be able to do that.
WH: That's right.
JG: Let's spend a few minutes talking about Dr. DeBakey's personality. He described himself as a perfectionist. He
worked eighteen hours a day. In articles that were written about him, he was known as Iron Mike and the Texas Tornado. Others
have said that Dr. DeBakey had a very high energy level. He was a dynamo. I wonder what your impressions were, having to stand
next to him in surgery.
WH: Well, he was pretty much what you have outlined. He was a perfectionist. He insisted that everything be done just right
in the operating room. He had very little respect for someone of mediocre talent. Matter of fact, we have not talked about
this, but I think Dr. DeBakey's greatest contribution was in his ability to train surgeons, So that in the operating rooms,
this is one of the things that I can say, in my particular instance, it has been my observation that when a person finishes
his surgical training, he may meet all the paper qualifications, but is he at his maximum technical capability? Probably not.
Certainly Dr. DeBakey, working with him in the operating room every day for five years, developed me into a much better surgeon
than I ever thought I would ever be, particularly from the time I left my surgical training to the time I finished working
with Dr. DeBakey, I was a totally different kind of guy. And this is true for a number of doctors. I am just one of many that
Dr. DeBakey has trained. This educational training program is part of it, so that in his perfectionism, he used to say, "Why
does everybody have to make the same mistakes I make?" I feel like that he wanted everyone to do the work precisely, and
get the right kind of expected results. All of us fell into that line to make sure that we did not have technical errors.
One of the things, in working with him in the early 1960s, I call this the developmental time of cardiac surgery. In contrast,
people who came along later, like Gerald Lawrie and George Noon, were more in what I call the service time, because a lot
of the procedures had been developed. Some of them, of course, were changing and they were improving as the natural case,
but mainly in the 1950s and 1960s, we were developing a lot of these things. In the 1970s and 1980s, we were taking care of
people and applying the things that had been developed.
One of the things, too, is Dr. DeBakey was working hard. It is reported that he might just sleep about two hours a night,
not only was he working hard, but he expected everybody else to work hard. I have to tell you this story, which I have written
about. One Sunday I came in to Baylor. His primary office was still on the first floor at Baylor Medical School. I came in
on a Sunday morning, and Dr. DeBakey looked up from his desk. He was working on papers and shuffling things. He said, "Sam,
where is everybody?" I said, "Well, Dr. DeBakey, it is Sunday. I suppose they are in church." He said, "Well,
why aren't they here doing the Lord's work?"
That is just exactly the way he felt. He was married to medicine, and that was his calling. He did not appreciate anybody
not being there. I must admit that those of us who served with Dr. DeBakey, like Dr. Cooley, Crawford, Morris, myself, all
of us had families that suffered because he demanded that we put medicine first in our lives. That that was probably one of
the big pitfalls of being a close associate of Dr. DeBakey.
JG: He had four sons and a daughter. He was married, his first wife was a nurse.
JG: Diane. Then he was a widower for a time and he remarried and had another daughter. I read that he often would sleep in
his office. He worked eighteen-hour days. What did his first wife think about that? Did you ever talk to him about his family
WH: Well, Diane was very supportive. I knew her. She really took a shine to helping the residents and young associates of
Dr. DeBakey. She would make sure that we had plenty to eat and tried to help us out a little bit from time to time. I think
she was supportive and understanding of Michael. She always called him Michael. His second wife I have known a little bit.
I have been to a couple of meetings where she has been present, but I know nothing much of their personal life, although she
also seemed to be supportive and understanding, Their daughter has had medical interests, and is doing very well.
JG: His children from his first marriage, I do not think any of them became doctors?
WH: No, there is one that is a doctor. I think he is an OB/GYN doctor. But two of them are dead. I think Mike, and I am not
sure of the other name, are still alive. I think the doctor one is still alive. But Dr. DeBakey did talk to me about the death
of one of his sons that died of a gastric malignancy. This was a great concern and affected him deeply when he lost his son.
But, let's face it. When the children were little, they were raised by the mother because Dr. DeBakey was spending most
of his time in the hospital.
JG: How about for you during those five years? I assume you have children?
JG: How did your wife negotiate your relationship with Dr. DeBakey?
WH: Well, that was a difficult time. But, again, I had two boys and the wife raised the children. We tried to spend as much
time as we could at home, but it was difficult because we were working in the hospital, taking care of patients, and writing
papers, and doing research. And, again, we were all dedicated to medicine.
JG: Was Dr. DeBakey a mentor to his students?
WH: I think so, yes. As a matter of fact, there was a lot of complaining of the students because, frequently, when they were
on his service, they had to wait around for him to come and make rounds and do teaching rounds. Sometimes they would wait
an hour or more, and that sort of was upsetting to some. I think everyone really appreciated the fact that he made the effort.
As I said, his teaching and education program is one of his strong points. For example, he helped found a high school for
It is still functioning today for taking care of young people who are interested in medicine and medical things, and his efforts
started with the young people, and carried through with medical students, and carried through with his residents and his younger
staff. He was conscious of training throughout all of life. When I would talk to him, shortly before he died even, he would
tell me, "Sam," he said, "We need to think of what the future holds." He was always thinking about leadership,
the future, and improving medicine, and all of the aspects of medicine.
JG: What about his bedside manner?
WH: Well, he had a good bedside manner. He might not be completely versed on his patients, particularly when we were running
150 to 250 patients in the hospital, he may not have known all of the details, but he relied completely on his younger associates
to take care of the details. He would come in and he would talk to the patient in a very friendly way, just like I talk to
you about the teacher that could not pay the bill. Even though he would spend only a short period of time, when you are making
rounds on 150 people, you cannot spend too much time. But he was there with the proper comments for every patient, and they
listened to his every word.
JG: I read in Reader's Digest that he would see something like thirty-seven patients in thirty minutes?
JG: What about his relationship to the surgical staff in the operating room? He could be a little bit -
WH: [Laughter] Well, he could be tough on his younger people. I was fortunate. I did not seem to get criticized as much as
some. But he could be critical. I think he was critical because he expected more. He was not critical because you were not
doing a proper job, but it was because you were not doing a better job. You see what I mean?
JG: Always pushing people to improve themselves?
WH: Always pushing. Just like he said, "I don't want people to make the same mistakes that I make." This is one
of the things. For example, a lot of the residents got fired. He would take his big finger and push on the chest and say,
"But you did not do what I told you to do." Many of the residents, Dr. DeBakey would fire them, but they wouldn't
go away. They would just come back the next day, and he would have forgotten it and just continue on as if nothing had happened.
Others he sort of sent away because he knew that they were not the quality that he wanted to continue in the work.
I remember one guy that had been fired seven times, one of the residents that was on his service. The last time, he and Dr.
DeBakey both came out of the room in tears. They were both crying. But the next day, the resident who had been fired seven
times was back working, and it was life as usual. [Laughter]
JG: Was he a flawed character? Was his perfectionism a flaw?
WH: I never considered his personality to be flawed. First place, he was always one of the first to get down to see a patient.
He was always good about returning calls. He kept his doctors in line, and most of them were very happy with the service that
he rendered. I would not consider his perfectionism a flaw. He was just a pretty hard-working, well-rounded guy. He was well
educated. He could talk to you on almost any subject. Some people did not think he was a pleasure to be around, but he certainly
JG: His former students and residents founded the Michael E. DeBakey International Surgical Society. Talk about the work of
WH: Well it seems like nowadays, every important professor has to have a surgical society. It has been a good organization
to have the people come back to the institution where they trained. A lot of our people that he trained have been from foreign
countries, as well as from other parts of the United States. It is always good to have them come back. They present papers,
some of their original work, and Dr. DeBakey has always been supportive of that, and it has been good to see some of these
Now while we are visiting that, I might mention that there are a number of people that Dr. DeBakey has trained and participated
in their traineeship, as well as Dr. Cooley, that they have gone to the different parts of the world and been leaders in their
area. I can give you an example. Ted Dietrich, who left Dr. DeBakey, he worked closely with him for a few years, and then
he moved to Arizona, formed the Arizona Heart Institute. Ed Garrett, who worked with him for a little while, he moved to Memphis
and was very active and prominent in leadership capabilities in Memphis. Oscar Creech was one of the first to leave the Department
of Surgery. Oscar Creech became professor of surgery at Tulane University. And then, of course, Lars Svensson is now one of
the leading doctors at the Cleveland Clinic.
I will say this. A lot of what his trainees have done has been related to the time that they finished their training. For
example, when Dr. Blalock was training people, there were a lot of untrained people and a lot of professorships that were
just sort of waiting, you know, like Henry Bahnson went to Pittsburgh. Dave Sabiston went to Duke. Dwight McGoon went to the
Mayo Clinic. All of them went to prominent leadership posts. Dr. DeBakey did not train people that became professors everywhere
mainly because those professorships were just not available. He trained operating surgeons. He trained surgeons to take care
of people and to do what he was doing.
JG: He authored more than 1,600 articles, books, chapters. He was an extremely prolific writer?
WH: Yes, a lot of papers.
JG: In a personal essay he wrote in the 1980s, he spoke about the importance of self-discipline. He is quoted as saying, "Next
to intellectual curiosity, perhaps self-discipline is most important for continuing education." He would write early in
JG: What are some of your thoughts on his writing?
WH: Well, he had a lot of help with his sisters because, for example, they could do a lot of the minutia work. He could put
down his ideas, and they could pick up the references and put things together for him. But a lot of the papers that were written
were written by his younger people. For example, these papers I have shown you were ones that I picked of some of my papers
that were associated with him that I thought might be of interest. But, usually, the second author is probably the one that
wrote the paper.
Dr. Beall was a very capable surgeon, but he was also very much of an academician. He was two years behind me in the residency
program. Dr. Cooley remarked about him. He said, "Dr. Beall has made more trips to present papers than he has made incisions,"
which may or may not have been complimentary. But nevertheless, Dr. DeBakey's writings were prolific, and I must admit
that he participated vigorously. For example, in this last paper that he wrote that I participated in, I brought the idea
to him of us writing a paper, talking about fifty years of coronary surgery at Baylor and Methodist. He thought that was a
good idea. We started out two years before he died, and it was interrupted for about a year because of his dissecting aneurysm.
But after he recovered, he actually participated vigorously in helping to write the paper so that he was a participant in
paper writing, even though a lot of the basic work was done by a younger member of the staff.
JG: You mentioned his competition with other surgeons and his feud with Dr. Cooley. I think Dr. Cooley has written that the
feud benefited both men because, in some sense, competition is not all bad. I wonder what your thoughts on that are.
WH: Well, let me start by saying that there was competition, even within the department and with those that were without
the Department of Surgery, and as you say, competition is good. In my particular instance, let me start by saying this: In
1965, Dr. DeBakey came to me and said, "Sam, your practice is getting so big that I think you need to go into private
Mainly, I wasn't spending the time to help write papers and help with surgery. I didn't have the time because I was
taking care of my own patients. I said, "Well, Dr. DeBakey, can I use the heart-lung machine?" He said, "No, those
things belong to Baylor." Well, to make a long story short, Methodist felt that a private service to do cardiac surgery
was important because the people who we were training, the only place they could go to work was in another academic institution.
JG: Right. Because your research was so cutting edge.
WH: Right. So I formed a group, and we were the first group, one of the early groups to ever do heart surgery on a private
practice basis. But we remained working at Methodist. I felt like it was very important to have peer scrutiny. I started open
heart surgery at Hermann, St. Joseph, and the Memorial Baptist Hospital. I felt like it was important for us to have a service
at Methodist where the work of the private doctors could be under the scrutiny of what we considered the best cardiac surgeons
around. Getting to the competition idea, on the private service, we were using cardioplegia before the academic service.
And other things that we were doing, we were doing mammary artery implants before the academic service. One reason for that
was that, to take the mammary arteries down for grafts required a little more time. We did not have as many cases to do, so
we had a little more time. Dr. Morris, an academic surgeon, was very much against the use of mammaries, because he felt like
that it increased the operating time and caused more morbidity.
Eventually, some of this competition spilled over into the academic. We watched what they did, and they watched what we did.
For example, Dr. Cooley was, for example, using a different aortic valve about every two or three months. I said, "There
is no way I can do that." So I said, "We have got to watch somebody who is not changing so much." We were watching
each other all the time and competing a little bit. A good private service, I think, helped Dr. DeBakey and the academic side,
and certainly, it helped us. That was one of the things that the competition was there and good, and it probably gave this
whole medical center extra energy that it needed.
JG: I read an interview in which Dr. Noon said that Dr. DeBakey never felt displeased that his techniques became obsolete,
that he always appreciated that science progressed.
WH: Right. I think that is true. For example, the operations that I learned about in medical school were not being done when
I entered practice. In other words, if you don't learn and change, you will be outdated and actually be bypassed. The
surgeon's life and the doctor's life is one of continual learning. That's what the great institutions teach. You
just don't get educated and that's when your education stops. You continue learning your whole life.
JG: Donald McRae, in Every Second Counts: The Race to Transplant the First Human Heart, notes that the race to transplant
the first heart was almost as compelling as the race between Americans and the Russians to land on the moon. What were DeBakey's
views of Christiaan Barnard, Adrian Kantrowitz, Norman Shumway, and Richard Lower.
WH: Well, I am not sure I know of his private views. I don't know that he had any expressed view on that particular subject.
I never heard him talk about Christiaan Barnard. I think that he wanted to be competitive. For example, there was a lot of
competition between Dr. DeBakey and Dr. Cooley. Dr. DeBakey was not as good a cardiac surgeon as Dr. Cooley initially. But
Dr. DeBakey, with his determination and his help from some of the younger doctors to facilitate putting the patients on the
heart-lung machine and so forth, became a very capable cardiac surgeon.
In essence, even though there was a great disagreement, Dr. Cooley and Dr. DeBakey buried the hatchet a year or so ago, I
think always there has been mutual respect. We were all working to benefit Methodist, Texas Medical Center, and Baylor, when
Baylor and Methodist were together.
JG: DeBakey emerged on the international stage. One of the other roles that he played was that he saw people from all over
the world, he operated on the Shah of Iran, he operated or supervised surgery on Boris Yeltsin, he operated on the Duke of
Windsor. He served as consultant to Eastern Bloc countries and helped establish cardiovascular programs in Egypt, Saudi Arabia,
Yugoslavia. He operated on Jerry Lewis and Frank Sinatra. He was friends with George Bush, Sr. You mentioned his friendship
with LBJ, Henry Kissinger. Did he talk politics with his patients?
WH: Well, I'm not sure. He operated on Jeanette MacDonald, and he operated on Marlene Dietrich. It was not uncommon for
him. We operated on The Shadow, Lamont Cranston. I helped him do that case. We operated on Mr. Brown of Brown & Root.
So we were always operating on VIPs. Sometimes he would sit and talk with them a little bit about something besides medicine,
but to my knowledge, he never spoke extensively about politics to any of them.
JG: But he was also, in many ways, a politician. I am not sure if that is the right word, but he served on several government
commissions: the Hoover Commission, which reorganized the Executive Branch, and that was in 1949. He helped create the National
Library of Medicine. He was the chairman of the Board of Regents of the National Library of Medicine on two occasions. Lyndon
Johnson appointed him Chairman of the President's Commission on Heart Disease, Cancer and Stroke. He was, in many ways,
a medical statesman, I guess is the best phrase. What was that like?
WH: Well, I remember during the time I was with him, he made a lot of trips to Washington. I think he became, to some extent,
disillusioned. Because, first place, he wanted to establish a system of regional medical centers. Although his concept was
good, I think, he did not get the political support that he needed. I think that he had a feeling that many times, the politicians
were using him to accomplish their purposes.
Dr. DeBakey originally thought that he could influence the politicians more than he could. He found out, I think, that they
sort of used him to get their ideas across and their agenda going. He became a little bit disillusioned with national politics
towards the end.
JG: Dr. Noon was quoted in the New York Times saying that, over the years, there were many DeBakey's. "He was chancellor,
he was chairman of the Department of Surgery, he was a teacher, national and international leader." Which one of these
roles do you think Dr. DeBakey liked best?
WH: Being a doctor. When I thought about coming over here, I thought, you know, Dr. DeBakey has had many titles, but the
title he liked the best was just Dr. DeBakey.