Dr. Cooley, were you a sort of budding scientist as a child? Were you very curious?
Denton Cooley: I think I was a curious child. I was interested in all of the biological sciences when I was a student in grade school. Eventually that curiosity developed into an interest in medicine.
Where did that curiosity come from?
Denton Cooley: My father was a dentist. His work interested me, and he was always willing to explain procedures and new devices. My older brother was sort of a naturalist, and together we pursued all sorts of activities that dealt with life itself.
So you liked being out in nature?
Denton Cooley: I really enjoyed nature. We did a lot of hunting and camping together, and it inspired me to major in the biological sciences when I entered the university.
Dr. Cooley, were you very extroverted as a child?
Denton Cooley: No, on the contrary. I think I was very introverted and shy. I didn’t participate in a lot of social activities in high school. I didn’t have any dates in school. It was always sort of a joke that I had only three dates during my entire high school career, and those were with the same girl for the Christmas dance sponsored by our high school social club. The rest of the time, I did not have dates. I was more interested in sports, and the outdoors, than I was in the usual social activities.
Were you a particularly good student early on? Were you very motivated?
Denton Cooley: I was determined to make good grades. I was a straight “A” student, both in high school and in college.
What other interests did you have as a kid? What sports or hobbies interested you?
Denton Cooley: I was a varsity basketball player for four years at the University of Texas. I was on the championship Southwest Conference Basketball team. I also enjoyed golf and tennis, and other sports. I divided my time mostly between athletics and my studies. It was not easy for me to make straight A’s in college and play varsity sports. But I was determined to do so, and I did. I graduated Phi Beta Kappa, with highest honors.
You probably didn’t sleep a whole lot.
Denton Cooley: I think I slept as much as some of my comrades. You do have to budget your time if you want to do these things in college. In my opinion, you should put your major emphasis upon your studies.
A surgeon needs tremendous self-confidence. Where do you think that confidence comes from? Did you always have this as a kid?
Denton Cooley: No, I didn’t. I think confidence is something you build gradually, with experience. I’ve always felt that maybe one of the reasons that I did well as a student and made such good grades was because I lacked confidence. Lacked self-confidence, and I never felt that I was prepared to take an examination, and I had to study a little bit extra. So that sort of lack of confidence helped me, I think, to make a good record when I was a student. But since I finished my medical training, and so on, at that level, I’ve gained self-confidence over a period of years. And had a great deal of experience in everyday surgery.
So even the shyness you described as a kid might have been a benefit in some ways, because it kept you working.
Denton Cooley: I think so. By being shy, I steered away from a lot of the activities that most young people get involved with. I studied harder. I wanted to play sports too, but my emphasis was always on excelling.
When you were growing up, were there any particular books that inspired you?
Denton Cooley: As a child, I mostly read boys’ magazines and books. I don’t recall any particular book that really inspired me. During college, I enjoyed reading biographies, or fictional works based on real experiences. One book that influenced my decision to apply to medical school was Miss Suzie Slagle’s by Augusta Tucker. That was a book about some young men living in a boarding house while they were going to Johns Hopkins medical school.
Did you decide you wanted to go there yourself?
Denton Cooley: Yes, I did. That book influenced me greatly to enter Johns Hopkins, and to live some of the experiences described in that book.
Dr. Cooley, were there any teachers who particularly inspired you while you were growing up?
Denton Cooley: Many teachers influenced me. I especially remember my English teacher, in the seventh and eighth grade, who was so intent upon learning grammar.
I think that one of the things that’s helped me so much in my life — I’ve done some writing, you know — but grammar has always come easy for me since I got that early grounding from a little, attractive teacher in the seventh and eighth grade named Miss Wineheimer. She taught us how to diagram sentences, and taught us the proper way to write. We never were forced to be real strong in composition, but in construction, it was always taught us that we should understand grammar. It disturbs me greatly nowadays when I hear people who are considered to be intelligent, or even intellectual, who can slaughter English grammar. You know, simple little things like using the pronoun “I” when you should be saying “me.” And people always think it sounds better to use the first person singular, “I” instead of “me” as the object of a preposition, and so on. All of those slights indicate to me an inadequate educational background.
That’s interesting, because we don’t think about surgeons needing to write. But obviously, you’ve written a tremendous amount of articles, and that is an important aspect of getting ahead in the field, isn’t it?
Denton Cooley: Oh yes. Writing is very important. And even in surgery, whether you’re an academician or a clinical practitioner, you have to “publish or perish.” I’ve participated in the writing of more than 1000 scientific articles. I’ve written several textbooks myself, and have contributed numerous chapters to other major textbooks. Writing has been a great asset to me throughout my life.
Do you enjoy writing?
Denton Cooley: I do and I don’t. Sometimes it’s a real chore. You have to discipline yourself. Sometimes I have something I want and need to write, but there are so many interruptions, the only time to I have to do it is them I’ve set aside for recreation. It takes discipline. Sometimes I have to write in the quiet hours between nine and midnight, or even later. That takes medicine.
Other than teachers, was there a particular person you emulated, or a particular doctor who inspired you?
Denton Cooley: The man who inspired me most, I think, was Dr. Alfred Blalock, who was professor of surgery at Johns Hopkins. He was a rather simple man with a burning curiosity. It was through his curiosity that he made many real contributions to medical science. I didn’t think he was an especially brilliant man, I just admired him for his curiosity, and for his perseverance. Dr. Blalock really inspired me more than any other person.
Was he a nice person to be with?
Denton Cooley: A very nice man. He was very humble and honest. In the operating room, he could be quite difficult. I never felt that he was entirely comfortable in the operating room. Outside of the operating room, however, he was entirely fair with his junior associates, and he inspired a spirit of harmony in the whole system. That’s something I’ve tried to emulate in my own program.
Dr. Cooley, obviously a surgeon needs highly developed motor skills. Were your skills apparent early on?
Denton Cooley: Perhaps so. I’ve always thought that my exposure to competitive sports helped me a great deal in the operating room. It teaches you endurance, and it teaches you how to cope with defeat, and with complications of all sort. I think I’m a well-coordinated person, more than average, and I think that came through my interest in sports, and athletics.
On the other hand, you can injure your hands playing basketball. Did that ever occur to you?
Denton Cooley: Yes, and I have injured my hands playing basketball. I’ve dislocated fingers, I suffered a severe fracture of my wrist playing tennis four or five years ago, but I’ve recovered from that, with some handicap. You can injure yourself, but those things don’t enter your mind when you are involved in athletics.
In basketball especially, you’re always thinking on your feet and adapting.
Denton Cooley: That’s true. You have to make decisions promptly, and that’s true in the operating room as well. You don’t have 12 or 24 hours to make up your mind to do something. In the operating room, you have to make a judgment, a decision, and act on it.
How old were you when you first decided to become a doctor, and what drew you to that profession?
Denton Cooley: I sort of got in by the side door. My father was anxious for me to become a dentist and take over his practice. When I went to the University of Texas, I planned to become a dentist. Then I had an experience which, I think, changed everything.
When I was a sophomore at the University of Texas. I was invited to visit a friend down in San Antonio, who was an intern at the time, working at a municipal hospital there. And he asked me to come over and join him on a Saturday night when he was working in the emergency room. And he had all of these patients there who were all beat up, cut up, or so on, in fights and so on. And he offered me the opportunity to sew up some wounds, which I had never done. And sure enough, I did that, and I enjoyed it, enjoyed the evening. It inspired me, and right then I decided that I would go on into medicine rather than into dentistry. So here I am.
Did you ever have a shaky stomach, having to deal with the sight of blood? Or were you always very cool about it?
Denton Cooley: The sight of blood never made me queasy. Before my first major operation I felt a little uneasy and insecure, but once I began the operation, I regained my self confidence. Since then I’ve been very poised in surgery, but even today I have concerns about some of the major, more difficult operative procedures. Sometimes I have a difficult time sleeping the night before, or sleeping the night after, if I think I may not have made the right decisions during the procedure. There is never a feeling of complete self-assurance in some of these difficult cases.
I can imagine. You’re world famous for being able to do operations that no one else can do. As you began to specialize in surgery, how did you hone your surgical skills? I read that you actually practiced in a matchbox. Can you tell us some of your secrets?
Denton Cooley: That is really an exaggeration, which shows how myths grow. I did, like most young surgeons, practice tying surgical knots. You know, you take some string to your room at night, and you practice tying knots with one hand, or your left hand, and doing that sort of thing. And just thinking about surgery. And, you know, practicing. Get a scalpel, and practice just, say, cutting a piece of meat or something like that. You sort of learn how you want to hold your fingers, and that sort of thing, and try to become graceful when you operate. Because it’s sort of that gracefulness and poise at the operating table that inspires others to think that you are an accomplished surgeon. I watched a number of surgeons in this country and abroad, and tried to see what it was about their technique that made them successful, and made them masters of the art.
Isn’t some of that innate talent?
Denton Cooley: I think it probably is, yes. It’s true in so many other aspects of life. Some people can just play a violin and others can do it well. The talent seems to be instinctive. It’s the same thing if you watch a real accomplished golfer. You know that he has a God-given talent. Perhaps I have some of that in my field. I hope so.
Even a great violinist has to practice a lot to really accomplish something, and I gather that you, too, have worked very hard.
Denton Cooley: Yes, I have. I don’t think many people have worked harder at being a surgeon than I have. Maybe there is something back there that qualifies me to do what I am doing today. I think that’s true of a great violinist, a great golfer, a great sportsman, and others who find a niche in life that suits them.
I think a lot of kids have the attitude that if you’ve got talent, you don’t really need the hard work. But there is a famous quote by Edison, that “genius is one percent inspiration and 99 percent perspiration.” Would you go along with that?
Denton Cooley: I think so. I really do. With your own effort, you can improve yourself, but people find they can’t improve beyond a certain point. I like to play golf, but I know that no matter how much I practice, I will never get above a certain level. I think that’s also true of surgery. Some people are born with the gifts and the mind for surgery, and they may go on to great heights. Others may try and try, only to reach a certain plateau. I’m very fortunate, I think, to have found a profession that seems suited, not only for my personality and level of intelligence, but also for my physical abilities.
As hard as the work is, I gather that for you, it’s also a pleasure.
Denton Cooley: There is a great deal of satisfaction in being a surgeon. You have instant evidence of success and accomplishment. In other medical specialties, you may not find such an instant reward.
On the other hand, you also have more dramatic failures.
Denton Cooley: Yes indeed, you do. The risk of failure is always there. But as I say, it’s an exhilarating feeling to walk away from a successful operation. You know you’ve done something great, and the patient is going to do extremely well. There’s a feeling of accomplishment that you may not get in other medical specialties.
You’re dealing with life and death situations on a daily basis.
Denton Cooley: Yes. There is something especially nice when you can do something with your hands to the patient. I’ve always told my residents this. This is why people go to osteopathic doctors and chiropractors. These practitioners may not use orthodox treatment methods, but they are doing something to the patient, and patients get a psychological boost from the fact that something is actually being done to them. I believe we should touch or manipulate patients in some way. We can learn from some of those specialties that make patients feel like something has been done for them.
We are taught in orthodox medicine not to have a great deal of respect for some of those manipulative types of physicians. Nevertheless, I think they are doing a lot of good for the patient, which sometimes we don’t have the opportunity to do as medical doctors. We might prescribe some pills to take care of a back spasm. But the chiropractor or the osteopathic doctor is the one that is going in to do some manipulation, and also give some pills, and the patients leave thinking that something special has been done for them.
Dr. Cooley, going back to the beginning of your career, how did your parents react to your choice of profession?
Denton Cooley: I think they were proud of it. Medicine is perhaps the noblest of all professions. My dad may have been a little disappointed because I didn’t join him in his dental practice, but at the same time, I’m sure my parents were very proud of my choice.
Did they live to see some of your great success?
Denton Cooley: Yes, they did. My mother only died 10 years ago. My father, unfortunately, died about 20 years ago. But he did have a chance to see some of the things that I was doing. I’m sure that he took a great deal of pride in my career.
You obviously have tremendous drive. Where does that come from? Did your parents instill that in you?
Denton Cooley: I don’t know. I think I was born with it. I had a brother who was a lot less driven. Somehow or another, I developed that drive. I always took a great deal of personal satisfaction in excelling. As I told you, I was a straight “A” student all through grade school, university and medical school. I don’t know how you explain drive, but I enjoy accomplishment, and I enjoy being at the top. I wasn’t brilliant. I studied hard in school. I budgeted my time, and tried to make a good record, and I benefited from that philosophy throughout my life. I would encourage any young person who has some goal in life to devote himself entirely to his own development and education. Unless you are very fortunate or lucky, you won’t get to the very top unless you apply yourself completely.
Another important prerequisite of pursuing a career in surgery, obviously, is confidence. I wonder if that was something that you always enjoyed: a sense of confidence about yourself.
Denton Cooley: I think I’ve had self-confidence ever since I got over the shyness of my teenage years. I’ve come to believe that maybe I am somewhat better than average. When new developments are made, I believe I’m the one who should be making them. I’ve had more experience as a heart surgeon than anyone else in the world. It was only appropriate that I do the first successful heart transplantation, put in the first artificial heart, et cetera. I think that it was not only my right, but my duty to do so. That’s what motivated me do new things.
Did you ever doubt your abilities along the way?
Denton Cooley: I never doubted my abilities as a surgeon. I may have doubted my ability as a thinker. I’ve had some misgiving. As I said before, I don’t consider myself a highly intellectual or brilliant person. I’ve always thought the really brilliant people go into sciences such as physics, electronics, and computer engineering. Many people who consider themselves average are accomplished contract bridge players. That’s an area where I can’t compete. Being an excellent bridge player requires a level of skill and intelligence that I don’t think I have. I think I can do well in my profession because I do have a certain amount of imagination, and the projects that I get involved with don’t take that type of intelligence. My work takes clear thinking and the ability to anticipate problems. This I can do well.
Dr. Cooley, was there someone in your early career who gave you a first important break?
Denton Cooley: That’s difficult to say. I can think of a few situations where I may have been given a break, even in my athletic career. Once, during a basketball game, the coach could see that we were losing the game. In desperation, he looked down at the end of the bench, and sent me into the game. Sure enough, at that one moment, I excelled. Had I not done well at that one opportunity, I probably would have never made the varsity team. Things like that stick in my mind.
My professor of surgery there at Johns Hopkins, Dr. Blalock, picked me out of the entire class and gave me some opportunities that I wouldn’t have had otherwise. I feel like I’ve had a rabbit’s foot in my pocket, because I had some lucky breaks along the way.
What do you think he saw in you that made him choose you?
Denton Cooley: I don’t know. He probably just saw me as someone who was a little different from the rest of the group. I may have been taller, or more athletic than most of my classmates, who were more of the studious type than I was at the time. He was a vigorous man, who liked an active life, and he may have thought that I just might have the abilities to be a good surgeon in the future. This must have been very premature, because I was still just a medical student.
So Blalock gave you an important break.
Denton Cooley: Yes. He gave me the opportunity, and he gave me the encouragement to go forward, and then he provided the inspiration. He was the type of man that I thought I might be too. As I said, he was not in my opinion a brilliant man, but he was a solid thinker, with a good, practical approach to problems, and he made a huge success of this career.
Dr. Cooley, what role has luck played in your career? You mentioned the rabbit’s foot.
Denton Cooley: I was able to participate in many new developments in heart surgery when they were not possible for others. I was able to start an open heart program long before any of the other major centers, except for the teams in Minnesota who developed extracorporene circulation and who were real pioneers. I had that opportunity in Houston, because I was the only one qualified to perform heart surgery in this area. I had access to several large hospitals where there were no space restrictions. When things like cardiac transplantation came along, we were ready and poised to do it.
We did the first successful transplant in the United States. Same thing with the artificial heart. I was fortunate to be in an institution where we were developing an artificial heart. The opportunity arose to do it, and I went ahead and did it. It was somewhat controversial at the time, but nonetheless, we did it and proved that people could live, not only with a heart transplant, but also with an artificial heart. What we needed to do from then on was to perfect the device.
As we talk, Dr. Cooley, it occurs to me that you couldn’t have been born at a more opportune time to be a heart surgeon.
Denton Cooley: The timing was absolutely perfect. It was ideal. I began my career as a heart surgeon in 1944 and now I’ve been in the field for almost 50 years. Everything important that’s happened in heart surgery, has happened in those four or five decades. I was right there to be a part of it, and I’m happy that I stayed with it.
Another good decision I made was that I’ve never departed from an academic atmosphere. I spent 18 years as a full-time faculty member in a surgical department, and then created our own academic program here at the Texas Heart Institute. I’ve stayed in an institutional environment, which I believe is necessary and ideal for a career in surgery.
What does teaching do for you? I have some idea what your teaching could do for others, but why have you kept teaching all these years, when you could fill up all your time with surgery?
Denton Cooley: I was a beneficiary of a good educational program, and it’s always been ingrained in me that I had an obligation to carry on that legacy. Most physicians in medical school are encouraged to teach, but not many do. I’ve always felt it was an obligation. It is also true that we learn by teaching. We have to organize our thinking so that we can transmit it to students. Every time I prepare a lecture, or write a paper on some scientific subject, I am learning something new. So, actually we learn by teaching. That’s one reason I believe we should continue teaching as long as we can.
Dr. Cooley, your speed as a surgeon is world-renowned. To what do you attribute that?
Denton Cooley: I think it’s having a game plan. I know what I want to do, and I try to think through the easiest, the best, the quickest way to get there. I try to do everything gracefully, and minimize the number of motions. What is the quickest way to get there? A straight line is the shortest distance between two points, and I try to use that concept in getting things done.
You also have a great reputation for keeping cool under pressure. How did you learn that, and was that something that you realized early on was important?
Denton Cooley: I don’t know how I learned that, but I figure it had something to do with my athletic experience. At the most critical point in crucial games, you have to be in total command of your faculties. I don’t like to see surgeons get frantic when something crucial comes up. I’ve found that I can solve such problems much better if I keep cool. When I’m cool, I can get my team to stay cool and confident. Then we get the best effort, even at those critical times.
Was there a time when you were a little hot-headed? Did you have to teach yourself to calm down, or were you always like that?
Denton Cooley: I’ve always been calm, I think. I’ve never been a temperamental type. I like to be a team player. I want to be captain of the team, and I think a good captain is someone who has everyone behind him and supporting him. There’s an old war story about second lieutenants who abuse their soldiers. When they go over the top, more of the new second lieutenants get shot in the back than get shot in the chest. I don’t want my team to think ill of me. And I want them to feel like I’m there to help them, and that I will stand behind them, even when they make a mistake.
You mentioned working as a team, and you have made an analogy between a surgical unit and a sports team. How are they similar?
Denton Cooley: A surgical unit is a team. When we do one of these operations, we may have three or more surgeons at the operating table. I try to be fair with everyone, and not overly critical. I realize many of my assistants are very learned. and if they were already accomplished surgeons, they probably would not be assisting at the operating table. I try to be a good teammate, and a good leader,
In a lot of ways, surgery is a team sport, isn’t it? You have to be able to work with people.
Denton Cooley: It is, yes. I have visited many operating rooms around the country, and seen many really celebrated surgeons in the operating room. The ones that I admire the most are those who maintain a sort of even pattern of behavior, who treat their assistants and nurses well, and don’t have flights of temperament or anger, and that sort of thing. To me, it just reflects their insecurity. I just don’t believe that that’s the way — the pattern — that I want to follow. I have five junior surgeons who are my associates, and none of them are temperamental. I selected them all because I liked their behavior in the operating room. In another institution, right here in our medical center, the surgeons are highly temperamental, and there are all sorts of histrionics going on in the operating room. You don’t see that at the Texas Heart Institute.
I’d rather come here for my heart surgery. It must take a very healthy ego to have the courage to open up another person’s heart. Is that the case, do you think?
Denton Cooley: Well, ego is a funny word. I think that might be part of it, but it’s still a matter of self-confidence. You develop that as you gain more and more experience.
I think surgeons are perhaps a little more egotistical than the average doctor. So much praise is heaped upon you, because of the dramatic aspects of surgical procedure, as opposed to overcoming other types of illness. The doctor may have accomplished just the same thing, but by a slower process.
Is that uncomfortable? All that adulation from patients and colleagues and students?
Denton Cooley: Sometimes it is, but it’s also a great feeling of reward for what you’ve done. I rather enjoy it.
How do you prepare for surgery? Is there a certain mindset?
Denton Cooley: I like to think through what we’re going to do, and try to anticipate what will be presented at the time of an operation. In anticipating things, I develop a game plan that helps me perform the operation in the simplest and most direct manner.
Do you prepare yourself psychologically for an operation? Do you have to brace yourself, or is it just routine?
Denton Cooley: It depends on the nature of the operation. If it’s a particularly risky one, I do try to prepare myself. For an operation like the first heart transplant we did here in 1968, I was determined that my part of the procedure was going to be done in the best possible manner. All through the operation, I was telling myself to do my best. Some operations are more or less routine, so you’re not under so much pressure.
So during the transplant, for example, you’re kind of coaching yourself as you go along.
Denton Cooley: That’s right. So much goes into doing a transplant operation. All the way from preparing the patient, to procuring the donor. It’s like being an astronaut. The astronaut gets all the credit, he gets the trip to the moon, but he had nothing to do with the creation of the rocket, or navigating the ship. He’s the privileged one who gets to drive to the moon. I feel that way in some of these more difficult operations, like the heart transplant. I got all the glory for doing the heart transplant, but actually, the technique of implanting the heart is not that difficult. People believe that anyone who can transplant a heart is some sort of magician, a special, gifted surgeon. Whereas now we know that any surgeon can do a heart transplant. Any of our resident surgeons who are in training can do the procedure. In the early years, I think transplant surgeons were glorified beyond reason.
Dr. Cooley, in an article, you were referred to as the Chuck Yeager of heart surgeons, and I think that’s quite apt. You enjoy pushing the envelope.
Denton Cooley: I think that’s true. And I like that designation for me, because I do believe that often people are hesitant to take that chance, to take that extra personal risk, in doing something.
You faced lawsuits after the artificial heart implant in 1969.
Denton Cooley: Yes, I did have a lawsuit waged against me, but it was not a very meritorious one, and it was thrown out of court.
In taking risks, one clearly risks alienating people. And even close colleagues. Have you had to develop a thick skin in this field?
Denton Cooley: Sometimes, but I’m not out to win a popularity contest. I want to do what I think is right and proper. Some people will always object, but I can’t be too concerned about that.
Dr. Cooley, was it painful for you when you and Dr. DeBakey had a rift?
Denton Cooley: In a way it was painful, yes. But I realized, even before we split up, that his personality and mine didn’t jibe. It was time for me to go my separate way, and it just happened at that particular time. I don’t think we could have spent our entire careers as associates.
Do you think you were both too competitive?
Denton Cooley: It may be. We were both leaders, and you don’t need two leaders on the same team. There was an opportunity elsewhere, so I created the Texas Heart Institute. I knew that the Heart Institute was going to be my future.
Dr. Cooley, tell us about the goals and the achievements of the Texas Heart Institute.
Denton Cooley: We set out to develop an institution that would be known not only for excellent clinical care, but also for education and research. The research aspect of our program has become increasingly important. We’re now the most prolific clinical center for treatment of heart disease in the world. But I think that we need to put even more emphasis on research and education. It may be a long time before we find a cure for heart disease, but we can teach people ways to help prevent it.
You’ve also made it possible for people to have discount heart surgery. Why did you try to do that?
Denton Cooley: I, like so many people, believe that the cost of medicine is going up at too rapid a rate. And I feel that if we are going to provide health care to society, that we have to keep the cost within certain bounds. I think that some surgeons and hospitals may abuse that sort of ability — or that opportunity — that they have to escalate the cost of everything, and be completely unconcerned about what things cost. I guess it’s because I was raised during the Great Depression that I have always been concerned about the cost of things. I don’t want to compromise a patient’s care because of the cost, but at the same time, I don’t want to abuse our privilege of providing excellent health care. Some people say the cost is of no concern, this is a human life, and you have to do everything possible. But I think there is a limit to that. And since we do have a high-volume practice, I want to turn some of that back to the individual, so that they can have a reasonable cost of their health care.
You once said that you consider the Texas Heart Institute your greatest achievement. Why so?
Denton Cooley: I’ve reviewed the history of physicians and surgeons who have gone before me, and so often it’s not so much what they did themselves, like Dr. Blalock’s “blue baby operation,” which may be replaced entirely by some new procedure, but the school of surgery and the institution that he developed. That’s something that will endure for generations to come. I believe the Texas Heart Institute will endure long after I’m gone. Many young people will get their education here, and that will be my major accomplishment.
What advice do you have for young people who want to become surgeons? What qualities do you think are the most important?
Denton Cooley: You have to be intelligent, and be able to cope with stress. It is a stressful life, both mentally and physically. Those are the qualities to succeed as a surgeon.
In general, what do you think are the most important elements of achievement in any field?
Denton Cooley: Application and dedication to duty, respect for yourself and others. I don’t lead by force, I lead by example. And if I can, set a good example. If I can set an example to my staff and my group, by being punctual, I come to work every morning, walk onto the hospital floor within two or three minutes of the same time every day, and they can depend upon it. I deplore these doctors who would show up, you know, an hour, a half hour late, because they were doing something else, or so on. If I say I’m going to be there, I am there every morning. And I am going to be there until I get my work done at night.
What’s a typical work day for you these days?
Denton Cooley: I get to the hospital shortly after six every morning. I get home about eight at night. That goes on every day.
Surely you don’t have to work that kind of schedule. You could have rested on your laurels a long time ago. Why do you keep going?
Denton Cooley: I enjoy it. I enjoy accomplishment. There are other things to do besides operating. I enjoy writing scientific papers. I’m writing a textbook right now, and have several papers on the way. When I get through by five o’clock, which is unusual, I spend two hours on those kinds of things.
So you don’t look toward retirement very soon?
Denton Cooley: No. I dread the thought, as a matter of fact. People say, “When are you going to retire?” And I say, “The only thing that would make me retire would be poor health.” As long as I’m healthy, and I enjoy what I’m doing, I’m going to continue doing it.
Dr. Cooley, working as hard as you do, there must have been sacrifices in terms of your personal life. Did your career ever get in the way of relationships?
Denton Cooley: That’s a possibility. I may not have gained as many close friendships as others would have done. People say, “You must neglect your family.” I don’t really believe that. They appreciate what I’m doing for them. I spend time with my family — my wife, my five daughters and 13 grandchildren — when I can. But I’m not lying around the house for hours at a time.
How do you refresh yourself away from work?
Denton Cooley: I enjoy a number of activities. I still enjoy sports. I play golf and tennis when I can. I have a ranch, and a beach house close by. I go to those places when I can. Just taking my wife to a movie is relaxation for me. I also enjoy reading. Sometimes I read novels, but historical fiction and biographies interest me most. I enjoy history. When I am traveling, even going to medical meetings, I love to take along several books. I enjoy reading, just to keep abreast of what’s going on in the world.
Are there any novels that you’ve enjoyed in recent years?
Denton Cooley: I thought The Bonfire of The Vanities was fun to read. Not very educational, but fun to read. I’d have to think of some others a little more meaningful than that. I enjoy reading biographies. I found Gore Vidal’s books about Aaron Burr and Abraham Lincoln very inspiring. I really enjoy Vidal’s books. Although they’re works of fiction, they’re based on solid fact and provide an enjoyable means of expanding our knowledge and giving us another look at historical figures.
Dr. Cooley, what do you think is the next great frontier in medicine? You have, as you said, been privileged to take part in so many of the great innovations in heart medicine. What’s coming up?
Denton Cooley: I think that we are getting closer to solving the problem of malignancies and cancer. And I think that we will probably see some real advances made in that direction in the next decade. I think that, as far as my specialty is concerned, most of the exciting things have been done. We have had so many procedures now to do to the heart, that now we may perfect what we are doing some, but no real exciting breakthroughs like transplantation, open heart surgery, or the artificial heart. I think that most of the publicity and excitement has gone. I think the real practical advances we can look forward to are better methods of diagnosis, enhanced of course, by computers. So computerization pretty soon will be a more standard thing, like x-rays and other things. And it will make the future much better in this field of diagnosis of disease.
If there was some mystery that you personally could solve in the future, what would that be?
Denton Cooley: I would like to understand more about the function of the heart muscle. Why is it the heart muscle sometimes just refuse to work? If we could understand how the muscle functions, we could restore the failing muscle, or at least we might be able to develop the medication that gets the most work from it. I would like to participate in the development of such a wonder drug.
I think you’re uniquely qualified to give advice on how to sustain a healthy heart — how to avoid getting on your operating table. What are the key factors?
Denton Cooley: You should avoid those things we know are harmful. Today, everyone seems to understand that tobacco is harmful in any form, and that alcohol can also be a poison if used to excess. At the same time, our lifestyles are often not healthful. As a society, we tend to overeat. I don’t believe obese people eat all high-fat foods, but I do believe they eat too much food. Obesity, in my opinion, is the scourge of our society. In addition, we don’t get enough exercise to keep our bodies toned. Much of what happens to us, unfortunately, is due to heredity. You can’t do a great deal about that. Fortunately, there are factors we can control. We have to begin educating our children at an early age about the effects of nutrition and exercise. on our health.
Do you ever eat bacon and eggs?
Denton Cooley: Yes. I must confess that I don’t watch my diet very strictly. However, I do watch how much I eat, and I’m the same body weight as when I was in college and played basketball, and I intend to keep it that way. It may take more self-discipline, but I believe appropriate body weight can be maintained.
You seem to have a lot of self-discipline. How much sleep do you get?
Denton Cooley: On average, about four and a half hours a night.
Denton Cooley: I’m probably sleepy a lot of times, but usually that’s enough. Now that I’ve gotten older, I take maybe 20 or 30 minutes on the couch in my office after having my soup and yogurt for lunch. That seems to be adequate for me.
Has your wife been an important support for you?
Denton Cooley: Yes, she has. She’s kept my family together, and she’s been very supportive of my life. She is the daughter of a surgeon, so she knew what she was getting into when we got married. We’ve been married for some 43 years now and we’re still together. I still enjoy a good family life, with my daughters and their children. I hope I can live long enough to see some of my great-grandchildren, which is a possibility. Unfortunately, I got married a little late, when I was 29 years old. People who were married when they were teenagers often get to see their great-grandchildren. I had a patient the other day who had several great-great-grandchildren!
Looking back, do you think there’s anything you would have done differently?
Denton Cooley: Nothing of great importance. I’ve had some financial reverses, and it’s always easy to second guess that. I was, perhaps, overly ambitious, and got involved in certain financial enterprises that met with disaster when we had a recession in this area. That was a mistake I wish I hadn’t made. I believed I knew what I was doing. I realize now that I was just as vulnerable as so many other people who got involved. But none of these problems were important to my professional career.
Does the work itself, or the results of your work, provide the greatest reward for you?
Denton Cooley: I think it’s about 50/50. I enjoy work. I think work is a privilege. I don’t understand people who say they have nothing to do. When I get up in the morning, I appreciate the fact that people are waiting for me to show up, and that I might be able to help someone. I think that is really a privilege. It keeps you alive, spiritually.
How many lives do you think have been saved by coronary artery bypass surgery?
Denton Cooley: It’s hard to say. In our own institution, we’ve done more than 40,000 coronary by-pass operations, and we continue to do about 100 a month.
Twenty years ago, many of these people would have died.
Denton Cooley: That’s right. They may have also been severely handicapped by chest pains, angina pectoris. After a bypass operation, most patients are relieved of that very disabling symptom, and can return to their normal activities.
How much satisfaction do you get from knowing that you’ve saved lives?
Denton Cooley: That’s the real reward for any heart surgeon, I think, knowing that you’ve saved someone’s life. Nothing can compare with that. That’s the richest reward anyone can have.
One last question. What advice would you give to people coming up in this field?
Denton Cooley: If you want to become a surgeon, you have to accept a life of dedication and of service. You must be prepared to make your work number one priority in everyday life, and apply yourself fully to the welfare of your patients.
Thank you for all your time. I know your work will be appreciated for many, many years to come.