by Mimi Swartz
He finished training school in the fall and headed for Saigon, armed with a copy of Marcus Aurelius’ Meditations, a paean to stoicism his aunt had given Bud just before he left home. He would need it.
His base camp was near Na Trang in the Central Highlands, the scene, along with the Mekong Delta, of some of the worst fighting in the war. Bud’s unit consisted of about three hundred men, mostly young—eighteen was the average age—mostly poor, and mostly of color, a microcosm of the US soldiers who fought in the war. Because Bud was all of twenty-eight, the boys called him Dad. He was one of two with a college education. The other was a fresh-faced graduate of UCLA who wanted to be a journalist, and thought a tour in Vietnam would be a great training ground.
There was a lot of downtime. Bud took in the stories of his fellow soldiers, and the uneasy relationship between the Korean and the Vietnamese troops. He tamed a pet lemur with orange slices, and learned to speak Vietnamese with a West Texas accent. He made beds for some kids in an orphanage, who continued to sleep on the floor. When Bud’s son Todd was born six months into his tour, he showed the pictures around and got plenty of props. “They say it’s very good fortune to have your first child as a boy,” he told Rachel in one of the tape-recorded letters they sent to each other. In the early days, Bud’s voice is soft and supple with humor and wonder, his descriptions sometimes set to the strings of Vietnamese café music or the sound of incoming helicopters.
That was the hint that the romance of war was fleeting. Bud’s job, among others, was to identify the men killed in his unit; the US Army didn’t want families missing death benefits because their loved ones were wrongly and indefinitely classified as MIAs. Soon enough, Bud was jumping on and off helicopters, riding to battle scenes, and helping to pull the dead and wounded off the field.
A helicopter in the middle of a battle is no place anyone wants to be. The wounded boys screamed to the thwamp thwamp thwamp of the rotor blades. The gunner returned fire from his assault rifle so close to the ground that the pings of enemy bullets blew tiny circles of light into the helicopter’s metal sides. The chopper pitched and bucked as the pilot tried to avoid being shot down, and the sharp, metallic smell of blood was everywhere.
In that chaos, Bud’s job was to stitch up the soldiers and start IVs as fast as he could. They were his friends: he’d dodged mortar rounds at camp with them, played cards and shared beers with them, heard about their mothers and fathers, wives and girlfriends, sons and daughters. Soon enough, he found himself wondering over morning coffee who wouldn’t come back at the end of the day.
Or who he would find with an arm or a leg blown off, or a hole in the head where an eye or an ear should have been. Blood spurted everywhere in the helicopters, cracked bones pushed through the skin—by the time Bud got back to base, he would be covered with crimson spatters and lost bits of muscle and flesh. Every mission was a mystery: Bud never knew what kind of damage he would find; he just jumped out of the chopper and grabbed whoever or whatever he could while the bullets flew. Sometimes it was too late—Bud would find the boy from New York or Indiana dead on a mountainside. All he could do was zip the soldier into a black body bag for his last ride home.
The dense, triple-canopy mountains had few good roads, and the North Vietnamese soldiers knew their way around much better than the GIs. Days were okay, but at night, no one left the compound because the Vietcong were always waiting just outside the perimeter. Sometimes Bud suspected his unit was dispatched just to flush out the enemy. The helicopters’ noisy clumsiness made them easy targets.
The American government kept secret its knowledge that the war was unwinnable as early as 1965, but it didn’t take Bud long to come to the same conclusion during his tour. The corruption required to fight the war was one indication—it seemed the South Vietnamese always required a payoff for anything Bud needed. He could see that the Vietnamese people didn’t really want the Americans there, and the more he treated the men in his unit for venereal diseases, the more he came to understand why. It reminded him of his days playing football for a neighboring West Texas high school team; all the local boys hated him for his arrogance, for taking their girls, for acting like a conqueror when he wasn’t any such thing.
Bud to this day describes his commander “as big a redneck as you will ever see.” It wasn’t surprising that he took an instant dislike to his college-boy doctor, either—he was sure Bud wasn’t owning up to being a Jew. Bud had been a good soldier to DeBakey back in Houston; DeBakey had been demanding, and maybe a little nuts, but he had never asked his troops to do anything stupid. Now Bud was being asked to report soldiers for smoking dope—“Of course they were,” Bud would say—and he refused. Soon after that, the commanding officer began sending him on ever more dangerous missions. Twice the VC shot out the engine of his helicopter, and the pilot had to land without power.
On another sweltering, sunny day, Bud was driving an ambulance back from a hospital near Cam Ranh Bay. Up ahead he spotted what looked like bodies on the dusty road, some moving, some not. As he drew closer, Bud realized they’d hit a land mine. The small group had been riding one of those oversized tricycles common in Vietnam, half a dozen or so men, women, and children hanging on to the handlebars and crammed into baskets. Now they were blown to bits.
Bud jumped out and started some IVs he had in the truck—people were bleeding and screaming all around him. In his haste, he left his .45 on the driver’s seat of the ambulance, and someone snatched it. Bud’s commander used the incident to start a court-martial, which, luckily, went nowhere. Around that time, his closest friend, the would-be journalist from California, was killed in the fighting. He was shot through the neck while riding home on the helicopter. In Bud’s tape-recorded account of his loss to Rachel, his voice is stilted and flat, like a robot’s. By then, he also had a notebook full of poems with titles like “The Body Bag” and “An American Boy,” a paean to a dead comrade.
It was a very long tour.
Bud returned to Rachel, finally met six-month-old Todd, and took his place back in DeBakey’s general surgery residency. He didn’t tell anyone what he was feeling, which was nothing. When Rachel asked him about Vietnam, all Bud would say was that he had seen so many lives wasted that he wanted to dedicate the rest of his to saving as many people as he could.
Bud’s father had gone to fight in World War II when Bud was three and had come back a stranger, never quite able to reconnect, never able to talk about what he’d seen. Now Bud understood. If he had always been solitary, now he was more so. When he wasn’t working, he spent his free time at a folk bar, Anderson Fair, listening to music, adrift. He did not always make it home. Rachel whispered to friends that the husband who had gone off to war was not the same man who had come back.
Bud had always been a voracious reader, but now he carried dog-eared, well-thumbed paperbacks—something classic or obscure, never a bestseller—in his lab coat pocket like a shield. He was often reading, or appearing to read, while shuffling through the hospital corridors in a way that kept others away. In staff meetings or during grand rounds, he sat in the back, sometimes with a book open, never quite present. And then he would rejoin the world with an incisive comment or offer an esoteric fact before going back to his book, rolling back into himself like some raggedy magic carpet.
“Be like a rocky promontory against which the restless surf continually pounds; it stands fast while the churning sea is lulled to sleep at its feet,” begins a passage from Marcus Aurelius that best describes Bud at that time. “I hear you say, ‘How unlucky that this should happen to me!’ Not at all! Say instead, ‘How lucky that I am not broken by what has happened and am not afraid of what is about to happen. The same blow might have struck anyone, but not many would have absorbed it without capitulation or complaint.’ ”
* * *
To be under DeBakey’s thumb was all-consuming—you just did what you were told and kept yo
ur head down. If you were assigned to the intensive care unit, you didn’t leave the hospital for three months. If your child was born during that time, too bad. If it was Christmas Eve, sorry: you celebrated alone, with fried pies and Fritos or whatever else you could scrounge from the cafeteria. As one doctor would later tell author Tommy Thompson in his chronicle of the Cooley-DeBakey feud Hearts, “I got a vitamin deficiency and my tongue turned fire red. I figured that what I went through was the supreme test of human endurance.”
Bud didn’t see it that way. The ICU was dark and quiet, except for the beeping of monitors and the occasional emergency, which he handled with ease. It was the perfect place for someone who did not want to think about where he had been or what he had seen. After all, he wasn’t under fire, and he wasn’t trying to stitch up a screaming teenager in a lurching, bucking helicopter. Still, when a pregnant Rachel brought Todd to visit during the off-hours, Bud was usually too tired to take much note; he could barely stay awake long enough to bounce his son on his knee.
The end of his term in the ICU didn’t offer much relief. The brutal Baylor call schedule still required thirty-six hours on duty and twelve hours off, which wasn’t much time to recover, even for a strong, stubborn thirty-year-old man. If DeBakey believed medical training should mimic the battlefield, Bud couldn’t argue: keeping himself in a world of trauma was, if not the safest place, then at least the most familiar. There was always someone begging to be saved.
But despite his own fog of war, Bud was still determined to be a heart surgeon, and he’d figured out that DeBakey wasn’t giving interns much action in his operating room. He had far too many good surgeons on his staff to let an amateur practice on his patients, even if they had been trained by Michael DeBakey, at Michael DeBakey’s medical school, and even if their combat experience trumped his. Bud found himself drawn to the neighboring Texas Heart Institute, which after only eight or so years in business was doing more heart surgery than any other place in the world. That was because it was run by Denton Cooley, who by the late 1960s was gaining on DeBakey for the title of world’s most famous heart surgeon.
In the highly competitive if still tiny world of heart surgery, Cooley was believed to have no equal. Watching him operate was like watching a master magician: even if you knew how a trick was done, you couldn’t possibly duplicate it. But Cooley had also gone to UT and distinguished himself as an athlete, like Bud. He was known to be a risk taker, someone who would try anything to save a patient, like Bud. As an added plus, Cooley had never, in Bud’s recollection, called anyone on his service a moron.
Bud figured that he could do his residency in cardiac surgery at Texas Heart and then go back to work for DeBakey. He was still committed to creating an artificial heart, and he knew Cooley didn’t have much interest in research.
It was a reasonable plan. There was just no way in hell it was going to work out, because Cooley and DeBakey were at war.
5
THE WAR AT HOME
If you were going to invent someone who was, in almost every way, the polar opposite of Michael DeBakey, it would be Denton Cooley. DeBakey was homely, cerebral, and hotheaded under pressure, which was virtually all of the time. He was a child of immigrants, with all the pressures that entailed. He wore lifts in his white English surgical boots. He was impatient and high-handed when he wasn’t charming the likes of Mary Lasker or Lyndon Baines Johnson.
Cooley, on the other hand, was from a prominent Houston family, best buddies with the sons and daughters of business and oil barons, the movers and shakers who made the city go. Tall and thin, with an athlete’s easy grace, he had eyes the pale blue of robin’s eggs and a toothy, rakish grin. Cooley was so handsome that even the starchiest operating room nurses could become giggling schoolgirls in his presence. He could make the wives of patients momentarily forget their husbands’ dire circumstances. His nickname was “Dr. Wonderful.” In the operating room, he did not throw instruments or tantrums; he was fast, dexterous, and inventive; he loved the unexpected disaster, which is all too common in heart surgery. He seemed to be, at least to the residents and interns on his service, always in control.
And Cooley had a real life outside of the hospital. DeBakey made it to his oldest son’s wedding in Peru only after his staff surreptitiously scheduled some lectures there. Cooley put in endless hours at the hospital, but photographs of his wife and five blond daughters decorated his office, and he took time off with the family at his ranch an hour or so from Houston. They called it Cool Acres.
The goals of DeBakey and Cooley were different too. DeBakey was a force of nature, a determined, relentless change agent. Cooley wanted to be the best surgeon who ever lived, period. During the early 1960s, when peace still reigned between them (more or less), the two Houston doctors were so famous that a popular television show called Ben Casey was based on their lives, and made their differences abundantly clear: Ben Casey was the darkly handsome and hip young surgeon, while his mentor, the peculiar and ethnic Dr. Zorba, was played by a much older, much shorter, much balder actor whose remaining hair had the texture of a beat-up Brillo pad. As time went on, the main difference between real life and television was that Zorba and Casey got along.
But for all his superficial ease and all his confounding gifts, Cooley was a complex man every bit as determined and competitive as his nemesis. In fact, he was expert at holding a grudge. Charmingly.
Cooley’s autobiography, 100,000 Hearts, offers an insight into his thinking. The title comes from the number of hearts Cooley operated on in his long career. Who’s counting? you might ask. He was. Despite a rich and successful career, Cooley was obsessive about keeping score.
That predilection had to have come from his 1920s Texas childhood. Cooley’s grandfather had made a fortune in real estate. Both his son Ralph and the East Texas beauty he married, Mary Fraley, were curious, cultured people—Mary especially loved to play the piano for company almost as much as she doted on her sons, Ralph Jr. and Denton, who was sixteen months younger than his brother. Ralph senior’s dental practice grew quickly because of the family’s prominence; he had intended to become a doctor, but an episode of hazing at the University of Texas put an end to his plans. For Denton, this may have been a good thing: when the senior Cooley wasn’t treating some of Houston’s most illustrious citizens, he retreated to his workshop, where he busied himself inventing dental instruments. Often he recruited Denton to help, and early on the boy showed a talent for fashioning tools and casting gold teeth.
Mostly, though, Cooley’s youth was unfettered in the way that so many Texans valued, and still value, above all else. He and his brother roamed the city at will. They rode their bikes across town to their grandparents’ turreted Victorian mansion in the Houston Heights, pedaling north from their modest brick bungalow in Montrose, dodging the streetcar on wide, magnolia-shaded Heights Boulevard. The brothers swam and fished in the bayous around town, and hunted birds and squirrels with their own shotguns. They plundered the orchard of one local oilman—“Our fig raids may have taught us a questionable lesson: stolen fruit is sweeter than store-bought,” Cooley later wrote—and borrowed golf clubs from neighborhood garages, playing for free on public golf courses. “Although the green fee was only fifty cents,” Cooley noted, “we were disinclined to pay it.”
They became experts at siphoning gas too—like most Texans of his time, Cooley got his driver’s license at thirteen, and saved money to buy his own Model T a few years later by delivering newspapers. (His dog Jack rode on the running board.) Cooley seemed to know instinctively how to keep the car running smoothly, his strong hands and long, deft fingers tightening the hoses and replacing belts with the confidence of an experienced mechanic. When Cooley couldn’t find a ready-made part, he made one himself.
Still, his life wasn’t trouble-free. Ralph Cooley Sr. was a drinker, and when he’d had too much he showed off a nasty temper. He beat his wife and tor
e into his sons. When the Cooley boys went off to college, their parents divorced, an uncommon practice in the 1930s. Cooley would note in his autobiography that in the aftermath neither parent “ever regained their rightful social standing.” Ralph’s professional life and health deteriorated as he drank more; Mary married unsuccessfully two more times, and finally changed her name back to Cooley.
The years of family strife left Denton with scars that were invisible but significant. He’d learned to keep his innermost thoughts and dreams to himself, the hallmarks of a man who decided early on that trust was negotiable and of dubious benefit. And that he was, mostly, on his own.
Cooley’s abundant gifts easily obscured whatever inner demons he harbored. While his brother became a life-of-the-party type at the University of Texas and later descended into alcoholism, Cooley slipped effortlessly into the role of golden boy: he played varsity basketball and, as a fraternity brother, extended his network of wealthy and accomplished friends, who would one day become the state’s lawyers, engineers, oilmen, and politicians as well as his patients. Cooley managed to be both a team player and a star on and off the court, a dashing ladies’ man who was revered by his fraternity brothers and who graduated with honors, seemingly without breaking a sweat. (“The lowest grades I made during my four years at UT were two B’s,” he was still noting, seventy or so years after he graduated.)
Cooley’s maternal grandfather had been a doctor, and there were his father’s frustrated medical ambitions to contend with. Cooley headed for medical school at the University of Texas Medical Branch in Galveston, but in 1942 transferred to Johns Hopkins in Baltimore, then considered the best and most enlightened medical school in the United States. Once there, he became a favorite of the chief of surgery, Alfred Blalock, one of the preeminent surgeons in the country. Among other things, he admired Cooley’s skill at ping-pong.