by Mimi Swartz
One day, while Ally was still recovering in the hospital, Bud asked her to meet him in his conference room. She thought that her temper might have landed her in trouble again, maybe for snapping at a nurse.
Instead, Bud sat her down and began to tell her a story. It was about a young Italian boy he’d tried to save as an intern; he’d been fine, and then had gone into heart failure. Bud had squeezed his heart to keep it beating, but for nothing. He’d had to let him go. Just when Ally was beginning to wonder why Bud was telling her this particular story, she understood. Her heart had stopped beating too, and Bud had reached deep into her chest and squeezed and squeezed until he forced her back to life. Unlike the boy who haunted Bud’s dreams, Ally had made it.
Now here she was, with her mother, Krista, watching intently as Bud, Billy, Daniel, and a whole crew in sky-blue scrubs sewed a tiny mechanical heart inside a sacrificial calf so that maybe one day the same machine might save someone who was desperate for more time, no matter how short or how long, no matter the cost or the pain.
They wandered outside the operating room and into the Bivacor lair, where one of the techs showed them the glass case with all the artificial hearts that had led to this one. Krista gave her daughter a long look that was hopeful and helpless in equal parts. She hitched a thumb in the direction of the OR. “You’d better hurry up,” she said, “so that thing’s ready when Ally needs it.”
Bud didn’t hear her. He was still in surgery, cutting and stitching, still trying to make a heart that wouldn’t break.
ACKNOWLEDGMENTS
At about the same time I signed the contract for this book, my father came to spend the last years of his life with my husband, John, and me. I mention this because caring for him was not just a challenge for the two of us, but for all the people at Crown who went above and beyond in their care and concern for Ticker while I was often torn between two eerily linked tasks. Editor Roger Scholl’s patience, thoughtfulness, and unflagging enthusiasm for this book kept me going on days when I was racing from the emergency room to my desk and back again. The same is true of his editorial assistant Erin Little—her sunny, supportive presence is rivaled only by her velvet-gloved efficiency.
The entire Crown team’s enthusiasm for and loyalty to Ticker has just been overwhelming. Publisher Molly Stern and associate publisher Annsley Rosner had my back from the very beginning and never wavered, always providing crucial suggestions to make the book better. Publicist Liz Esman and marketer Becca Putman have been a font of creative ideas and unbridled energy, for which I will be eternally grateful. The brilliance of text designer Songhee Kim and jacket designer Chris Brand left me in awe—Chris designed not one, but two covers that took my breath away. And to Norman Watkins and Cindy Berman, production manager and senior production editor, respectively, I add a thousand apologies for what had to have been inconveniences that would have taxed the most serene of Buddhist monks.
The same is true of my longtime friend and agent David McCormick, whose encouragement and support provided just the right amount of jet fuel to get me started on what was another daunting project, one that turned out to be a lot harder than writing about Enron. Thanks too to Brian Sweany, Jake Silverstein, Tim Taliaferro, and Paul Hobby at Texas Monthly for what became a much longer leave of absence than I ever intended.
I was so lucky to have the most overqualified intern in the history of journalism—Emily Schaffer, graduate of Harvard law and budding novelist—who performed the tortures of microfiche and bibliographical research, among other torments, with grace, accuracy, and good humor. Sarah Hartzell was a lifesaver when it came to research in D.C. and taught me the value of Drop Box.
My husband, John, was not only a careful, thoughtful reader, but a constant source of love and the best title inventor on the planet. Dario Robleto not only showed me there was a book in the artificial heart, but spent countless hours in nerdy discussions on, yes, the meaning of it all. Doris Taylor, Emily Yoffe, Jan Jarboe Russell, Meg Boulware, Mary Teague, Andrew Gol, Frank Michel, Ken Hoge, Ruth Sorelle, Susan Cooley, Jane Grande Allen, Claudia Feldman, Richard Wampler, and Mike Friedman shared unique insights that shaped my thinking; a thousand thanks to Jill Jewett, Lisa Belkin, Bruce Gelb, Roberta Ness, and Kate Rodemann for the thankless task of reading a first draft and giving me their honest opinions about what needed to be done. Amy Hertz proved to be an incisive and thoughtful reader as well; it’s hard to know what was more valuable, her merciless line edits or her big-picture ideas.
In books, as in stories, there is always one person who ends up as the author’s go-to—the person who isn’t the subject of the book but who is so knowledgeable and so accomplished that he or she can answer any question from the dumbest to the most arcane. Marianne Mallia was that person for Ticker—a brilliant medical writer and editor whose patience as a former high school teacher prepared her for my constant assaults on her workday. This book could not have happened without her.
The same is true of the patients and relatives of patients, and to Robert Jarvik who urged me to talk with them in depth. Thanks a thousand times to Linda Lewis, Joel Karp, Ally Babineaux, Tara Templeton, and her extremely perceptive daughter, Shana. My deepest gratitude for your willingness to share such powerful memories, and my apologies for the pain this must have caused.
Billy Cohn, Mishaun Cohn, Daniel Timms, Mack and Linda McIngvale, and so many others at the Texas Heart Institute were dragged into this project unwittingly as it grew ever larger. Their patience with someone whose technical knowledge initially extended to The Heart/The Kid’s Question & Answer Book will never be forgotten, nor will my gratitude—thanks for allowing me to interrupt work that was always far more important than mine.
To Rachel, Todd, and Allison Frazier, thank you so much for sharing your husband and father with me, for digging into closets for nearly lost CDs, and for excavating your memories; ditto Libby Schwenke, who I wish could organize my life as well as she organizes her boss’s every day. To Bud Frazier, who must have never imagined I would actually finish: well, thanks for sharing a life of amazing riches and challenges, and for not once losing patience when I asked for the thousandth time to explain the compliance chamber. I know you signed on to this without a clue as to what you were getting into, and the kindness, doggedness, and graciousness you extended to me was the same as that you give to your patients, who love you for it still. You never gave up, and, I know, never will.
NOTES
PROLOGUE
The bulk of this chapter is drawn from personal interviews with Linda Lewis, Bud Frazier, and Frank Michel.
CHAPTER 1: THE WIZARD, 2015
The bulk of this chapter was drawn from personal interviews with Bud Frazier, Frank Michel, Betsy Parish, Denton Cooley, and others who recalled the boom days of the Texas Medical Center. Some of it is also drawn from personal recollection.
He had told his mother: Paul Harasim, “O. H. ‘Bud’ Frazier, M.D.,” Innovator, St. Luke’s Episcopal Hospital Magazine, Winter 2001/2002, 7.
a total replacement that could be implanted: Harold M. Schmeck Jr., “Artificial Heart Research Now Seeks a Portable and ‘Forgettable’ Device,” New York Times, December 6, 1982.
CHAPTER 2: HOW HARD COULD IT BE?
Personal interviews include Bud Frazier, Betsy Parish, Marianne Mallia, and others, including patients and friends with heart disease. The facts and figures on heart disease come mainly from the American Heart Association, https://www.heart.orgidc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_480086.pdf, and various other sources on heart disease. I read many books on the history of the heart, cardiology, and heart disease, which are listed in the bibliography. I did find this book to be one of the best: Stephen Amidon and Thomas Amidon, The Sublime Engine: A Biography of the Human Heart (Emmaus, PA: Rodale Books, 2012). On the availability of donor hearts, there are also many sources, but one is http://ww
w.syncardia.com/total-facts/donor-heart-facts.html. On the rise in heart failure and the decline of heart attacks, see, among other stories, Gina Kolata, “For Patients with Heart Failure, Little Guidance as Death Nears,” New York Times, November 6, 2017.
Many modern-day inventors: My interview with Richard Wampler was particularly helpful.
To explore the workings of the heart: Again, my description of heart function comes from a compilation of several books and websites. I confess to resorting to several from the Khan Academy, which were very helpful. See, for instance, Khan Academy, “Heart Disease and Heart Attacks,” https://www.youtube.com/watch?v=_wre2WRPiFI, and the information on Armando Hasundungan’s website, http://armandoh.org/subjects/cardiology.
As late as 1900: James E. Dalen et al., “The Epidemic of the 20th Century: Coronary Heart Disease,” American Journal of Medicine 127, no. 9 (September 2014): 807–12.
Then, on September 24, 1955: Clarence G. Lasby, Eisenhower’s Heart Attack: How Ike Beat Heart Disease and Held On to the Presidency (Lawrence: University Press of Kansas, 1997); Cody White, Heart Attack Strikes Ike, from the National Archives Text Message Blog, September 22, 2016, https://text-message.blogs.archives.gov/2016/09/22/heart-attack-strikes-ike-president-eisenhowers-1955-medical-emergency-in-colorado.
CHAPTER 3: THE MAKING OF A SURGEON
Personal interviews with Bud Frazier, Denton Cooley, Marian Mallia, William Butler, Stephen Igo, and Claudia Feldman, among others. Much of the history is compiled from multiple sources, as well as having grown up in Texas myself. Bud Frazier is the best source on his own history, but the story by Paul Harasim cited above, as well as a few mentioned below, was particularly helpful. As for the history of heart surgery, I used the Albion brothers’ book along with several others listed in the bibliography.
Despite that, Bryant ran: Jim Dent, The Junction Boys: How Ten Days in Hell with Bear Bryant Forged a Championship Team (New York; St. Martin’s Press, 2000).
Michael DeBakey had landed: For DeBakey’s beginnings in Houston, I relied on many sources, but among the best was William T. Butler and Diane L. Ware, Arming for Battle Against Disease Through Education, Research and Patient Care at Baylor College of Medicine (Houston, TX: Baylor College of Medicine, 2011). Much of the book was helpful, but in particular pages 37–42. I also drew on: Houston Hearts: A History of Cardiovascular Surgery and Medicine and the Methodist DeBakey Heart and Vascular Center (Elisha Freeman Publishing, Houston, 2014); Kenneth L. Mattox, The History of Surgery in Houston: Fifty-Year Anniversary of the Houston Surgical Society (Austin, TX: Eakin Press, 1998).
He was nothing if not focused: Mimi Swartz, “Till Death Do Us Part,” Texas Monthly, March 2005; NIH, US National Library of Medicine, The Michael E. DeBakey Papers, from Tulane School of Medicine to the US Army, 1928–1946; Thomas Thompson; “A Bitter Feud,” Life, April 10, 1970, 8; Winters, Houston Hearts, chs. 1, 3, 4. Also see the Michael DeBakey Papers, US National Library of Medicine, https://profiles.nim.nih.gov/ps/retrieve/Narrative/FJ/p-nid/322.
It was there that some of: John E. Salvaggio, New Orleans’ Charity Hospital: A Story of Physicians, Politics, and Poverty (Baton Rouge: Louisiana State University Press, 1992), 147.
Baylor, he wrote, was: Butler, Butler and Ware, Arming for Battle, 37–42.
That was never truer than: John F. Kennedy Moon Speech, https://er.jsc.nasa.gov/seh/ricetalk.htm.
Winning the Lasker Prize was not: Elizabeth Drew, “The Health Syndicate: Washington’s Noble Conspirators,” Atlantic Monthly, December 1967, 75–82.
DeBakey also found a way: There are many accounts of this story, but I trusted Butler’s account in Arming for Battle, as he was a close friend of DeBakey’s, as well as supporting documents from his own papers, https://profiles.nlm.nih.gov/ps/retrieve/Narrative/FJ/p-nid/322.
“We are on the brink”: Michael DeBakey, speech to Congress, US Congress, Senate Subcommittee of the Committee on Appropriations for 1963 Hearings on Department of Health, Education, and Welfare Appropriations (Washington, DC: GPO, 1963), 1402.
CHAPTER 4: A TOUR OF HELL
Even though Bud plays down his Vietnam service, I did make use of his video compilation and the recorded letters he sent home, as well as notebooks Bud kept at the time. I also interviewed several other combat veterans, most notably Michael Freedman, whose help was invaluable. For historical context, I drew particularly on Ken Burns’ ten-part series on the Vietnam War. Other interviewees for the section on DeBakey included his longtime associate George Noon. On Cooley’s skills, I interviewed Bud Frazier and many other medical associates.
Bud was drafted as part of the Berry Plan: Frank B. Berry, “The Story of the ‘Berry Plan,’ ” Bulletin of the New York Academy of Medicine 52, no. 3 (March–April 1976): 278–82.
One of his closest friends: Bill Bramer, “Salvation Worries? Prostate Trouble?,” Texas Monthly, March 1973.
The dense, triple-canopy mountains: James T. Gillam, Life and Death in the Central Highlands: An American Sergeant in the Vietnam War, 1968–1970, North Texas Military Biography and Memoir Series (Denton, TX: University of North Texas Press, 2010), 13, 79, 84, 115.
“Be like a rocky promontory”: Marcus Aurelius Antonius, Meditations, trans. George Long (Sioux Falls, SD: Nu Vision Publications, 2008), 32.
“I got a vitamin deficiency”: Tommy Thompson, Hearts (London: Pan Books, 1974), 244.
Bud found himself drawn to the neighboring Texas Heart Institute: Twenty-Five Years of Excellence: A History of the Texas Heart Institute (Houston: Texas Heart Institute Foundation, 1989), 10–19.
CHAPTER 5: THE WAR AT HOME
Interviews with Denton Cooley, Bud Frazier, Denis DeBakey, George Noon, and Ruth Sylvester, among others. Cooley’s history comes from personal interviews, as well as three books: Tommy Thompson’s Hearts; Harry Minetree’s Cooley: The Amazing Career of the World’s Greatest Surgeon (New York: Harper’s Magazine Press, 1973); and Denton Cooley’s autobiography, 100,000 Hearts: A Surgeon’s Memoir (Austin: Dolph Briscoe Center for American History, University of Texas, 2012).
That predilection had to have come: Ibid., chs. 2–3.
Still, his life wasn’t trouble-free: Ibid., 24–25.
Once there, he became a favorite: Ibid., ch. 5, for a summary of the Blalock years, including the “blue baby” surgery. Also see Minetree, Cooley, ch. 7.
Even for a native Houstonian: Jan de Hartog (New York: Atheneum, 1964).
The halls were crowded: J. R. Gonzales, “Busy Days, Busy Nights at Jefferson Davis Hospital,” Bayou City History blog, Houston Chronicle, March 14, 2012, http://blog.chron.com/bayoucityhistory/2012/03/busy-days-busy-nights-at-jefferson-davis-hospital.
On Cooley’s first day: Cooley, 100,000 Hearts, 90.
DeBakey published a paper: Minetree, Cooley, 127.
“I’m often obliged”: David Monagan with David O. Williams, Journey into the Heart: A Tale of Pioneering Doctors and Their Race to Transform Cardiovascular Medicine (New York: Gotham Books, 2007).
Heart surgery in its: The history of the heart-lung machine and Cooley’s use of it comes from multiple sources, including Cooley’s autobiography as well as several other histories, including Amidon and Amidon, The Sublime Engine, and G. Wayne Miller, King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery (New York: Times Books, 2000).
Yeager, however, was never prosecuted: G. Wayne Miller, King of Hearts, The True Story of the Maverick Who Pioneered Heart Surgery (New York: Crown Publishers, 2000), 227–240.
DeBakey had kept close tabs on Cooley’s progress: Cooley, 100,000 Hearts, 105.
Mary Lasker wrote of: Mary Lasker, Columbia University Libraries Oral History Research Office, Notable New Yorkers, Part 1, Session 36, 1110.
; He populated his formal office: Minetree, Cooley, 185.
The brilliant surgeon Adrian Kantrowitz: My account of the global race to transplant a heart comes from several books and news articles, including Cooley, 100,000 Hearts; Thompson, Hearts; and David K. C. Cooper, M.D., Open Heart: The Radical Surgeons Who Revolutionized Medicine (New York: Kaplan Publishing, 2010).
The dog, named Ruff: Adrian Kantrowitz Papers, https://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/GNBBKL.
On this point, Kantrowitz: NOVA: The Artificial Heart, PBS, aired October 18, 1983.
The legal and medical definition of death: Several sources were used in the brief account of brain death definition, including Calixto Machado et al., “The Concept of Brain Death Did Not Evolve to Benefit Organ Transplants,” Journal of Medical Ethics 33, no. 4 (April 2007): 197–200; as well as Michael A. De Georgia, “History of Brain Death as Death: 1968 to the Present,” Journal of Critical Care 29, no. 4 (August 2014): 673–78.
He distracted himself: Many sources were used in the account of the beginnings of the Texas Heart Institute, including Cooley’s autobiography and the Texas Heart Institute Foundation’s Twenty-Five Years of Excellence.