Feuds

Feud: A bitter, prolonged hostility betweentwo families, individuals, or clans;vendetta; a quarrel.

—American Heritage Dictionaryof the English Language

Feuds of various types can occur between individuals, families, and nations. A number of notorious feuds have occurred throughout history. For instance, two early American politicians—Aaron Burr and Alexander Hamilton—had serious philosophical differences that eventually caused them to duel with pistols. Hamilton was wounded and died the next day. Burr, although victorious, forfeited his reputation and his political prospects.

In our nation's history, family feuds have also led to bloodshed. In 1878, a legendary feud erupted between the Hatfields and the McCoys, who were neighboring families in the Appalachian Mountains. The feud lasted until 1891 and claimed, all told, more than a dozen lives. Poems and songs were written to glorify the battles between these clans.

During the early 20th century, 2 surgeons in New Orleans disagreed about which one would operate on a patient who had a subclavian artery aneurysm. The contestants dueled, one armed with a hunting knife and the other with a pistol, and both inflicted wounds. The outcome of the patient's case was not reported.

In medical research, friction developed in the 1950s between Jonas Salk and Albert Sabin over the discovery of the poliomyelitis virus and the development of vaccines to combat it. Although control of the disease yielded innumerable benefits to society, the 2 scientists remained serious rivals. In the cardiovascular specialty, the rivalry between Dwight Harken and Charles Bailey—who, in 1948, performed the 1st successful closed repair of mitral stenosis almost simultaneously—was widely known. Amusing incidents occurred when both of these surgeons happened to appear at the same symposia. The rivalry remained unsettled, and they eventually died within days of each other. Harken's son, Alden, himself a highly reputable surgeon, commented that Bailey preceded his father on the obituary page of the New York Times by 2 days.

The rivalry, or feud, between Dr. Michael DeBakey and me deserves some brief reflection and an attempt at explanation. When, at Dr. DeBakey's invitation, I joined the faculty at Baylor College of Medicine in 1951 (Fig. 1), he was already well recognized as a surgeon, investigator, and educator. The first major operation that I performed in Houston took place at Jefferson Davis Hospital and involved the resection of an aneurysm of the aortic arch. This was possibly the first operation of its kind to be performed anywhere in the world. On the basis of its success, Dr. DeBakey and I began aggressive, curative treatment of aortic and other arterial aneurysms.

Fig. 1 Baylor house staff assigned to Jefferson Davis Hospital, 1951. Dr. Cooley (second row, far right) and Dr. DeBakey stand shoulder-to-shoulder as colleagues.

My own major interest was cardiac surgery, particularly open-heart surgery, which was an emerging field at that time. In 1956, my associates and I became the first surgeons in Houston to use a pump oxygenator. Because this breakthrough was accomplished without Dr. DeBakey's knowledge or participation, it marked the beginning of our rivalry.

To further the pursuit of my interest in cardiac lesions, I withdrew from Methodist Hospital in 1962 and moved my practice to the adjacent Texas Children's Hospital and St. Luke's Episcopal Hospital, where I could have an independent service. There, my team and I developed simplified techniques for cardiopulmonary bypass. We soon had a high-volume practice that produced numerous innovations and surgical “firsts.”

The first human cardiac transplants were reported in 1967 by Christiaan Barnard in South Africa and by Norman Shumway in California. The following year, Dr. DeBakey appointed a committee to consider whether Baylor should become involved in performing this procedure. Although I had become the most prolific cardiac surgeon in the world (and was still a member of the Baylor faculty), I was not invited to join the committee. Consequently, in my mind, I had been given an unintended opportunity to proceed independently. In May 1968, my team and I performed the first successful cardiac transplantation in the United States (Fig. 2). During the ensuing months, we performed a series of transplants, but our source of donors from local hospitals was then shut down by Dr. DeBakey, who had begun his own transplant program. Also, he recalled my team's perfusionists to Methodist Hospital; as Baylor employees, they had to comply with his wishes.

Fig. 2 Cover of Life Australia, regarding the 1st successful cardiac transplantation in the United States, performed by Dr. Cooley in 1968. Photo by Ronald L. McGlothlin; courtesy of St. Luke's Episcopal Hospital.

During this period, I became increasingly interested in developing a total artificial heart that could be used as a “bridge” to cardiac transplantation. Such a device would keep patients alive until a suitable donor organ could be found. Dr. Domingo Liotta, a surgical researcher at Baylor, was also eager to test this concept. Working quietly together, we designed a total artificial heart and tested it in animals. In April 1969, we performed the first clinical implantation of this device. This event led to my complete break with Dr. DeBakey (Figs. 3 and 4), who claimed that we had used his artificial heart. Upon advice, I resigned my faculty position at Baylor after 19 years of service. The news of our separation became widespread. Our hostility lasted for almost another 4 decades.

Fig. 3 Cover of Life regarding the feud, 1970. Photo courtesy of Getty Images.

Fig. 4 Cartoon by Oliphant in The Denver Post, 1969.

In late 2007, the time seemed appropriate for reconciliation. I had been reading the autobiographical book Last Man on the Moon, written by the retired astronaut Gene Cernan, who had been a patient at the Texas Heart Institute. This book depicted the end of the space race between the Soviet Union and the United States. During that race, the astronauts and cosmonauts had become personal rivals and had developed some mutual hostility. After the U.S. team's lunar landing, when the space race was over, the 2 programs began to collaborate. Cernan and his fellow astronauts discovered that the cosmonauts were “regular guys,” who differed from the Americans only in the degree of their vodka consumption.

Cernan's book inspired me to take the first step toward ending the “cardiac surgery race” between Dr. DeBakey and me. By that time, both of us had retired from surgical practice, so further developments in cardiovascular surgery were out of our hands. Moreover, Dr. DeBakey was 98 years old and was recovering from surgery for a dissection of the ascending aorta. I began to seek a means of settling the situation, which was increasingly on my mind. Our colleagues and staff members suggested a solution: on 27 October 2007, Dr. DeBakey was made an honorary member of the Denton A. Cooley Cardiovascular Surgical Society; the following spring, I was honored by his surgical society in a similar manner (Fig. 5).

Fig. 5 Reconciliation at the Michael E. DeBakey International Surgical Society meeting, 2008. Photo by Agapito Sanchez.

I believe that both of us were relieved and comforted that peace had finally been declared and that we could enjoy our remaining days without animosity toward each other.