Welcome to the wild West of American medicine.

I'm Chris Pine in This is Cardiac Cowboys, the gripping true story behind the birth of open heart surgery and the Maverick surgeons who made it happen.

It's nineteen forty four.

Jim Crow looms large over Baltimore, Maryland.

Marriage between an interracial couple is punishable by up to ten years in prison.

Public schools are segregated by race, as our restaurants, hotels, and parks.

Johns Hopkins School of Medicine, located in a Victorian RedBrick hospital complex that looms over East Baltimore, won't admit its first black student for another eighteen years.

And yet a young black man working in a research laboratory at Johns Hopkins is about to pave the way for the future of cardiac surgery.

Vivian Thomas a very skillful surgeon and could carry out all of these procedures on assistant that night, take the normal surgeon two or three assistants to help them through.

Vivian Thomas ran the animal lab for Hopkins Surgical chief Alfred Blaylock.

Thomas was a master surgeon, but he never operated on a human patient.

He was paid little more than a janitor's wages.

To make ends meet, he'd moonlight as a bartender at Blaylock's parties, mixing drinks for the very same medical students he trained during the day.

Nearly a decade before Minnesota surgeons John Lewis and Walt Illa High operated on the living heart, Vivian Thomas and Alfred Blaylock pioneered a treatment for one of the most fatal heart defects.

We became almost overwhelmed with congenital heart cases of tetralogy I Fellow.

Tetrology of fullow is a complex of four different heart defectsves infants of oxygen, turning their skin bluish gray.

In most cases, it kills them.

It was one of the few female doctors at Johns Hopkins, a pediatric cardiologist named Helen Tausig, who had the groundbreaking idea to sidestep the defect.

What if you could create.

A shunt, a small pathway connecting two of a child's arteries to allow some blood to flow directly to the lungs without first passing through the defective heart.

It wasn't quite open heart surgery, and it wouldn't fix the defect for good, but it might just allow these kids to live long enough for someone else to invent a permanent cure.

Helen Tausig's idea wasn't taken seriously until she shared it with Alfred Blaylock, who assigned it to Vivian Thomas, and Thomas got to work.

For months, he toiled.

In the lab, perfecting the procedure that would come to be known as the Blaylock Tausig shunt, named for Alfred Blaylock and Helen Tausig.

As a black lab worker without a medical degree, Vivian Thomas was not credited for his contribution.

In the fall of nineteen forty four, a baby girl named Eileen Saxon was admitted to JOHNS Hopkins.

Eileen suffered from tetralogy filow.

She struggled to breathe even inside an oxygen tent.

Her skin and lips were blue, and at fifteen months old, she weighed just nine pounds.

Eileen was dying.

Her only shot at revival was the experimental Blaylock Tausig shunt, but there was a problem.

Neither Blaylock nor Tausig knew how to perform the procedure.

Only Vivian Thomas did.

Early on November twenty ninth, Eileen was rushed into an oar on the top floor of the hospital.

Vivian Thomas assumed he wouldn't be welcome in the room.

In nineteen forty four and for a long time to come, surgery was the exclusive domain of white men, but Alfred Blaylock couldn't operate without him.

Emerits and Vivian Thomas stood behind him, and doctor Blaylock would ask Vivian questions all the time over his shoulders.

If didn't shall do it this way, that's the why.

You know.

Thomas was given a stool so he could see over Blaylock's shoulder with an overhead view of the operating table.

He talked the chief of surgery step by step through the technique he developed.

When the operation was over and the clamps removed from Eileen's blood vessels, Blaylock and Thomas watched with amazement as the girl's sickly blue skin turned a healthy pink.

You did well in there, Vivian, Thank you.

He performed a next in surgery, doctor, Yes, I think I did.

In two thousand and four, HBO dramatized the Eileen Saxon surgery in the film Something the Lord Made, starring Yasin Bay and Alan Rickman.

This Blue Baby operation saved the lives of thousands of children and opened the door to all future cardiovascular procedures.

Vivian Thomas would be an old man before he was recognized for his achievement.

In the meantime, he trained a generation of surgeons.

His greatest pupil was a smooth talking, strikingly handsome Texan doctor Denton Cooley.

I felt so grateful that I was part of the team, but I was right in the middle of it, and that therefore I had an obligation to carry on that legacy.

Cooley was twenty four when he assisted in the first Blue Baby operation.

His surgical train under Thomas and Blaylock set him on a path to become the greatest technical surgeon the world had ever seen.

It also fueled his fierce competitive streak, which would send him headlong to the most famous feud in medical history.

Formoso's Studios, This is Cardiac Cowboys, a podcast about life, death and innovation.

In the American heartband episode two, Ready Fire Aim Here's writer and executive producer Jamie Napoli.

In nineteen fifty one, Detton Cooley could have written his own ticket to any hospital in the country.

He'd performed blue baby operations at Johns Hopkins, commanded an army hi hospital in Austria, and spent a year training under the eminent British surgeon Russell Brock.

So it might have seemed like a step backward when the thirty year old hotshot surgeon accepted a job at the long undistinguished Baylor College of Medicine in Houston, Texas.

But for Denton Cooley, Houston was home.

Not only that Baylor's surgical department was quickly making a name for itself on the national stage.

That was thanks to Cooley's new boss, a brilliant, ambitious, and uncompromising chief of surgery by the name of Michael de Bakey.

Denton Cooley rarely encountered anyone man or woman who didn't instantly fall under the spell of his genteel Texas charm.

Now he was putting that charm to good use.

To succeed at Baylor, he'd need to win over DeBakey.

He started by moving his wife, Louise and their young daughter Mary into a house down the street from the DeBakey family.

I always found him to be extremely charming.

That's doctor Debake's eldest son, Michael, who recalls Cooley's efforts to always keep his wits about him in the presence of his new boss.

Even in relaxed social settings.

My parents frequently gave small dinners or cocktail parties for the staff, and I always remember Denton would come in and he said, fix me a glass of club soda with ice, and then he said, point me a little bit of coke in there so that it looked like Scotch and soda, and then he would under around drinking that.

With Doctor Debake.

However, Cooley's charisma hit a brick wall.

Yeah, I've forgotten who it was.

It said that Dasha Debaki puts tabasco on everything, including his words, and that's probably true.

He was hell on wheels in the hospital.

He could look at you and melt you.

The Baky.

Biographer Craig Miller recounted the story of Denton Cooley's first day at Baylor.

As Cooley pulled into the hospital parking lot, the Baky spotted the golf clubs in the back of his car.

Get rid of those things, son.

The baky snapped in his Louisiana drawl, You're not going to need them while you're here.

Later that afternoon, as the Houston heat climbed into the nineties, Cooley followed the chief of surgery on patient rounds.

At six foot four, Cooley towered over the short stature of DeBakey, and yet he found it difficult to keep up with the man.

DeBakey was tireless, power walking from room to room and building to building, jogging upstairs rather than stopping to wait for an elevator.

He was perpetually in a race against the clock.

God helped the young doctor who got in his way.

There is an aspects of me that maybe he can be described as intolerant.

I'm intolerant of stupidity.

That's an archival recording of doctor DeBakey.

There's just absolutely no place for carelessness, and there's no plays for making mistakes, because even the smallest mistake can lead to a bigger mistake and bigger complication.

De Bakey's temper was legendary.

He would hammer his staff with insults for the slightest error, from blocking his light during an operation to hitting the wrong button on an elevator.

They tuned me out one time.

We were going to the eighth floor Methodist and I was tired of instead of punching ATA hit seven.

That's Houston cardiac surgeon, doctor Bud Fraser.

It was just a mistake that making.

He said, you're a mistake.

And here's a mistake.

For Denton Cooley, who had world famous surgeons practically lining up to mentor him, DeBakey's attitude was an unwelcome surprise.

Cooley followed behind as the entourage of doctors headed into the black section of the racially segregated Jefferson Davis Hospital, named for the president of the short lived Confederacy.

They arrived at the room of a forty six year old patient.

We had this African American guy named Joe Mitchel who had a luritic aneurysm in his essending a order.

The aorda is the largest of the blood vessels.

It's an artery that carries oxygen rich blood directly from the heart out to the rest of the body.

An aneurysm occurs when the aorda begins to bulge at a weak spot, its wall grows thin and frail.

Imagine an over inflated balloon.

If the balloon bursts, blood rushes out into the chest cavity, oftentimes killing the patient.

In nineteen fifty one, one of the only accepted treatments was to simply delay the aneurysm's eventual rupture by wrapping it in cellophane.

But this was not a permanent solution.

It was busy out through the chest and you see the pole sason.

Doctor de Bakey said, well, we have a new member here of our staff, doctor Cooobey.

What would you do to that aneurism?

And he expected me to say I'd put some wire and then try to cover it with sell a fan.

And I said, so, I think I would just exercise aneurism.

To excise or surgically remove the aneurysm, as Cooley suggested, was unheard of.

Cooley had improvised similar procedures during his residency at Johns Hopkins, but this was his first day at a new hospital.

He didn't have the team or the tools to execute what he just suggested.

The young hotshot surgeon was showing off and de Bakey called him on it.

He said, well you tomorrow morning he won.

Just like that.

The operation was scheduled for the following day.

Cooley was keenly aware of the fact that he'd just been handed the rope to hang himself, but he wasn't one to back down from a challenge.

At least until that moment, life had been pretty damn good to Denton Cooley.

He was born into Houston High society, the son of a wealthy dentist and the grandson of a developer nicknamed the father of Houston Heights.

At the University of Texas at Austin, Cooley walked onto the varsity basketball team and then led the Longhorns to win the Southwest Conference Basketball championships.

Buckwheat Cooley, as his teammates called in, was blessed with movie star looks and a confident charm.

He might have been taken for Kennedy if only he were a few inches shorter.

At Johns Hopkins Medical School, Cooley worked hard to shed the jock stereotype, graduated first in his class, and yet it was his jockside that opened the first of many doors for his career.

Here's Cooley's daughter, doctor Louise Cooley Davis.

There was a tennis court in the quadrangle of the hospital and Daddy decided to go out and play tennis instead of going on rounds with Blaylock.

In nineteen forty three, a year before the first Blue Baby operation, doctor Alfred Blaylock was already renowned for his innovative research into the circulatory condition of shock.

And outcomes.

Blaylock, with his entire entourage following behind him, and stop and watch my father play tennis.

And my father's first thought was I'm in deep trouble here.

He's going to know that I cut out of my rounds and I'm going to be kicked.

Back to Texas.

And instead Blaylock asked him if he knew how to play ping pong, because Blaylock had a lake house and really wanted someone to play ping pong with him.

So instead of it turning into a disaster, it turned into a really lucky introduction.

Cooley's friendship with Blaylock put his career on a fast track.

After the landmark Eileen Saxon operation, Blaylock began letting Cooley take the lead on some of his Blue Baby cases, and for good reason.

It turned out Cooley's dexterity on the basketball and tennis courts translated to the oar he.

Would tie knots inside of a matchbox with his fingers, and he had no wasted motion whatsoever.

That's trauma and cardiovascular surgeon doctor Kenneth Maddox so.

Smooth, fast, precise.

It was a symphony to watch.

With a potent mix of ambition, once in a generation, talent, and undeniable good luck.

Luck.

Cooley's rise was meteoric.

His mounting successes brought him, in nineteen fifty one, into the orbit of Michael de Bakey.

On the morning of July twelfth, DeBakey strode quickly toward the oars at Jefferson Davis Hospital.

It was now Cooley's second day at Baylor, and he'd already begun operating on forty six year old Joe Mitchell.

DeBakey knew the young surgeon was in over his head and would need a more experienced hand to take over.

The only question was how deep a hole Cooley had dug for himself.

It was entirely possible DeBakey was already too late.

De Bakey went straight for the scrub sink, and then he stopped.

There was no sign of panic in the or as de Bakey turned and stepped toward the operating table, he found the handsome, drawling young Texan with a big smile on his face.

What was the status of Missus Mitchell's aneurysm, DeBakey wanted to know.

Over there in the specimen basement.

The excised aneurysm lay in a bucket several feet away, and Cooley was already sewing up the patient's a order.

That was I think the first time that he really appreciates the fact that we could operate directly on the order.

For most of Michael de Bakey's life, he'd been the best at everything he pursued.

A genius academic and surgeon with an unparalleled work ethic, he struggled to maintain a staff that could measure up to his expectations.

But this was new, a young, overly confident surgeon showing DeBakey up on his second day of work.

Cooley was claiming this was the first anneurism repair of its kind anywhere in the world.

In that moment, DeBakey had to make a decision whether to treat Cooley as a peer or as a threat.

In stark contrast to Houston native Denton Cooley, the good old boy, the ultimate insider.

Michael Debake's life was largely defined by his outsider status.

Born to Lebanese immigrants in Lake Charles, Louisiana, he quickly picked up on the fact that his family didn't look or act like their neighbors.

Well, I do think that growing up dead, as well as his brother and his sisters all felt left out.

They were essentially immigrants into South Louisiana, and they certainly weren't part of the old Louisiana.

Rather than trying to fit in, DeBakey resolved to stand out.

He worked nearly twenty hours a day, seven days a week.

He was gone every morning from six am, and he was back at the house eight thirty or nine at night, sometimes later.

And when he was at home, he was locked in his study, working on papers or dictating.

And I know that my mother was very upset frequently, and I overheard her say, maybe your children would be better off his patients, because then they get more time with you.

When DeBakey was offered to head up surgical department at the Baylor College of Medicine in nineteen forty eight, he'd already cemented his reputation as an unstoppable force as a medical student at the prestigious Two Lane University, he invented a roller pump that would become an essential component of the heart lung bypass machines of the future.

During World War II, Debaki developed the Auxiliary Surgical Groups to improve medical treatment for soldiers on the front line, which would later evolve into the mass units that would play a key role in all army operations for the next sixty years.

And he co authored a series of papers on the correlation between smoking and lung cancer, a position that made him deeply unpopular within the tobacco growing South, But DeBakey had little interest in popularity.

The result of his fanatical work ethic was that by nineteen forty eight, De Bakey's future shown blinding bright, and he didn't imagine the swampy oil town of Houston, Texas would have any part of it.

Here's doctor DeBakey again.

But at that time Baylaw College of Medicine had no teaching hospital, no service, no n ice grants, and it was really living almost from day to day.

The first two times DeBakey was offered a position at Baylor, he turned it down.

I thought it was a pretty third grade school and I'd already turned down three jobs up in the East from good school.

De Bakey's mentor at TWU Lane urged him to reconsider.

Baylor may have been a medical backwater, but it was something else too, a blank canvas.

Like the crude oil being guzzled up from beneath the Houston dirt, Baylor was raw material waiting to be refined.

However, de Bakey saw fit in Houston.

DeBakey could build an empire and he would be its sole sovereign.

At that time, oil and gas and construction with the big moneymakers in Houston, there were people who were making money that they didn't know what to do with.

The first step in building an empire is raising the funds.

Dan had a bedside charm that he used to turn on.

He wouldn't send a bill to a very wealthy guy, and the guy would call up and say, doctor de baky, I haven't gotten your bill yet, and he would say, well, don't worry about it.

Well, no, I want you to send me a bill.

So he said, well, look, if you want to make a donation, fine, instead of you know, a bill for two thousand dollars, the guy ended up with a donation for twenty thirty thousand.

Thanks to his military contacts from the war, DeBakey began rapidly expanding his domain.

Long before his first day on the job.

The Veterans Administration was about to build a hospital right next door to the old Navy hospital.

So I spotlighted a complete waste of money, and I got a call from Director of the VA saying that can you organize puschannel to take it over?

I just moved in.

A few days after taking over the old Navy hospital, DeBakey convinced the Board of Trustees chairman to bring the local city county hospital under his authority as well.

So I had two teaching hospitals, by the way, That's what kept me in.

Rather than settling for the doctors Houston had to offer, Tobaki looked elsewhere.

He was openly elitist, a fact that didn't win him many friends within the local medical community.

He traveled the country, using money and charm to lure the best American surgeons to Houston.

Surgeons like Denton.

Over the next two decades, Debaki would come to see Cooley as a rival and as a threat to the empire he'd built at Baylor But on July twelfth, nineteen fifty one, as he watched the young surgeon swiftly and gracefully stitch up a patient's damaged aorta, saving his life, DeBakey saw something else in Cooley.

He'd found a workhorse, a man who could operate faster and better than any surgeon he'd ever met.

Together, DeBakey and Cooley began repairing aneurysms, which treated at any other hospital in the world would have proved fatal.

The following year, they took their technique one step further by patching damaged blood vessels with tissue taken from corpses called homographs.

Doctor debake was always looking at different approaches.

He would sometimes call a biomedical engineer into the room and say, this needs an upside down backwards approach, and so he might pause to look for a better way.

After treating scores of aneurysm cases using human tissue, DeBakey recognized that this, too, was not a permanent solution.

Houston had no shortage of corpses throughout the fifties.

It was known as the murder capital of the country, and yet maintaining a ready supply of differently sized homographs.

Proved difficult.

Once again, DeBakey needed to find a better way.

As soon became apparent that we really needed something that was sought of on the shelf, so we began doing experimental work on some substitute.

DeBakey liked to tell the story of his discovery of the ideal fabric for the first synthetic aortic graft.

He was shopping for nylon at a department store when he stumbled upon a new material called dacron.

I looked at the material, you know, and felt it, and it felt good.

I liked it, and I would take two sheets and cut them to the woods that I wanted and I saw leach is when you did that, if you go it too.

DeBakey brought his dacron tube back to the lab, where it would soon replace the need for human tissue, jump starting the field of reconstructive arterial surgery and saving countless lives.

At least that's the way de Bakey told the story.

His son Michael, has a different recollection.

That's not true that that's a story that was propagated by a lot of the people who worked with Dad.

I was upstairs in my parents' bedroom watching television and dad came in and he said, by the way, do you happen to have any wash and wear material.

At his father's urging, Mike retrieved a pair of boxer shorts he'd recently purchased at Brooks Brothers.

He said, this is dacron, and he literally pulled my mother's sewing machine out of the closet, took a pair of shears, and he cut two y shaped objects out of the shorts, and he sewed them together.

And they had it prepared for the following day to have it used in a dog And I never got those shorts replaced.

Boxer shorts are no Debaky's dacron graft was a game changer.

In the summer of nineteen fifty five, he and Cooley took their wives across the Atlantic for a lecture tour to share their groundbreaking techniques with some of the top surgical mines in Europe.

The two men were diametrically opposed in nearly every way, which meant that for a time, they complimented each other perfectly.

Cooley churned out operations with machine like speed and precision, while Debaky innovated, fundraised and promoted their work tirelessly.

As a result, by the mid nineteen fifties, Baylor's reputation was exploding.

Here's doctor Maddox again.

Prior to this era, we really didn't have any way to treat aneurysms in Suddenly we had some tools, we had some instruments, and there were a lot of backlog of people.

So it was an exciting time.

If you had a heart defect, you went to Minneapolis, and if you had a problem with your arteries, you came to Houston.

When Albert Einstein's aortic aneurysm began to rupture in nineteen fifty five, it was Michael DeBakey who got the call.

Working as a team, DeBakey and Cooley were rapidly transforming Baylor into the aneurysm repair center of the world.

Pine Bluff, Arkansas, nineteen fifty four, a thirteen year old old boy fell from an ice truck and was crushed underneath.

Miraculously, Calvin Richmond survived, but he was left with a rare traumatic heart defect.

The force of the truck tore three holes in the boy's heart, The largest of them was the size of a nickel.

If Calvin was to have any chance of reaching adulthood, he'd need to have these holes patched up, and there was only one doctor in the world who could help him.

At the University of Minnesota, doctor C.

W.

Lilla High, the surgeon who kept in the research team and actually performed the operation that spells hope at last for the children formerly so do.

In the years since the tragic case of Gregory Gliddon, Walt Lillehigh had performed thirty five more open heart operations using controlled cross circulation with about a seventy five percent access rate.

Once the object of derision and scorn for his radical ideas, Lilla High had become his department's golden boy.

Waldland was the only place that was doing okahat churgery at that time.

That's an archival recording of doctor Gilbert Campbell, who worked alongside Lilla High at the University of Minnesota.

In March of nineteen fifty five, thanks to a Little Rock fundraising campaign, Calvin and his mother, Mattie were flown to Minneapolis on an Arkansas Air National Guard plane.

This lady came up from Pine Bluff with Calvin Rick.

They were just a teenager, he was a knice looking kids and a night at person.

The Richmonds were African American.

Unlike Pine Bluff, Arkansas, Minneapolis was not legally segregated.

However, the city's population was over ninety eight percent white.

Calvin and Maddie suddenly found themselves in an extreme minority.

Their race would come to play an outsized but unstated role in Calvin's medical treatment.

I think she was just a little bit fearful of what might happen a lot of black people, and the certain that some white people too are not too anxious to undergo general anaesthasia and operations and so forth.

American medicine is stained by a horrific legacy of white doctors exploiting people of color, and so it's little surprise that Mattie Richmond, a mother of twelve and a widow, didn't trust the U of M doctors to risk her life for the sake of Calvin's operation.

Without Mattie, acting as her son's heart lung donor Lilla High turned to the Minneapolis prison population.

He'd convinced inmates to volunteer for operations in the past, but in the case of Calvin Richmond, he had no such luck.

With the boy's time running out, little High came to Maddie with a last resort, a procedure never before tested on a human patient.

Here's Minnesota heart surgeon doctor Sarah Shumway.

Gilbert Campbell had done a number of studies in animals, and they used a dog lung, and the dog lung acted as an oxygenator so they could see exactly where the holes were located.

It was a wild thing to try to do.

I'd never used it on a hamlet one during some other operate.

I tapped into a vein and returned it good to make sure it would work.

Don't expect to find them and inner debate in the wilderness.

You know we're flowing new ground.

Little High's personal motto was ready, fire, aim, In other words, act first, make adjustments later.

He began preparing to attempt Gilbert Campbell's dog lung techniqueeen year old Calvin.

On March twenty third, nineteen fifty five, Calvin Richmond was wheeled into ther his chest was cut open and his heart exposed.

Rather than using a human donor to oxygenate the boy's blood during surgery, Lilihigh connected Calvin's blood vessels to a dog's lung, which was suspended on a stand and heated to body temperature.

Lila High opted for a country dog because the lungs of city dogs were often coated in soot.

They ran his blood through it while they stopped the heart, opened it and fixed this traumatic defect, and then closed the heart.

That's cardiac surgeon, doctor Chip Bowman.

That would be very controversial now, I mean impossible.

But the boys alive because of it, you know, And that's all all cared about.

Trading a dog's life for a boys.

The procedure was grotesque by any standard, but it worked.

The day after the operation, Calvin was up and joking with the nursing staff.

Within a month, he was on his way back to Arkansas, his whole life ahead of him, and Walt Lillaheigh, having finally earned the trust of the U of M hospital administrators, was on a roll.

He was entering the most creative and wildly productive period, not just in his life, but in the life of any surgeon in history.

He couldn't be bothered by what other people thought.

Maybe to a fault, I guess genius of this type doesn't come in plain vanilla packages.

Lolahai made for an unlikely celebrity, though he was quietly intense and introverted.

The man had a flare for the dramatic.

He loved dressing for attention.

That's seeable.

She's a nurse who worked with doctor Lillihigh.

He was known for having flamboyant clothes.

He would wear a dinner jacket and everybody else would be in their sports jacket.

Five years had passed since Lila High's debilitating cancer operation, and something in him had changed.

Here's an archival recording of Lila High's protege, doctor Richard Duwall.

He developed an incredible capacity for alcohol.

He would drink enough to put four or five people under, but he never showed it.

He went through a well of a lot at that time, so I think this probably changed his mental attitude of live today.

Lillahi lived and operated at a breakneck pace.

He'd work in the o rs and the animal labs until late in the evenings and then often drove straight to a local jazz club.

He left little time for Ka and their young family.

In many ways, we were raised by my mother.

She was the one who was at the football games and all the events and such.

That's Walt and k Lilla High's son, doctor Craig Lilihigh.

There were resident parties or different parties and nightclubs that he'd been at, but there were times when he clearly wanted to be away up in his office.

I don't know when he slept.

He seemed to be up at all hours of the night in the study, and he'd walk in there and.

The lights would be on.

He was wide awake.

Now, with his sudden flash of stardom, the demands on Lili High's time were greater than ever before.

In nineteen fifty five, Lila High was asked to speak at a meeting of the American Thorassic Association in Houston.

The conference was held at the Shamrock Hilton, across the street from the Baylor College of Medicine.

Denton Cooley was in the audience that day.

He watched as this sharply dressed surgeon with an oddly tilted neck took the stage.

Walt was invited everywhere to give talks.

That's nurse cea ballman again.

I thought he was a wonderful speaker, but he would always just speak a little bit longer than you would hope he would.

Walt Lillehigh presented a film of his cross circulation technique.

Despite the procedure's success, its unseemliness still tended to provoke a mixed reaction, but Denton Cooley was captivated.

Here's doctor Alilihigh.

I had the honor of showing Denton the inside of the living human heart for the first time you ever saw it.

He said, it was like viewing through against heaven.

As he watched Lillihigh on stage, seemingly impervious to any and all criticism, Cooley saw something that he craved desperately for himself.

Here was a man living and working on the edge.

Lilahigh wasn't just breaking rules, he was writing his own rule book.

By the middle of nineteen fifty five, Cooley and DeBakey had performed two hundred and forty five aneurysm repairs between them, and Cooley was living up to his promise as an unflagging workhorse.

My father was.

We call him the ever ready battery Man because he truly was always always working.

That's doctor Louise Cooley Davis again.

I guess with you know, playing basketball and knowing how to run up and down the court, we have to be very disciplined.

But over the last year, Cooley's power dynamic with debake had started to grade on him.

Here's medical historian and plastic surgeon, doctor Gerald Imber.

No one manipulated the press as effectively as debaking And here is a guy named Cooley who's a far better surgeon, faster surgeon, more efficient surgeon, certainly an easier guy to get along with, and he wanted to be out of DeBakey's shadow.

Cooley always felt he was marked for greatness.

He saw himself as an innovator on par with his mentors, but he would never live up to that promise if he spent the rest of his career fixing aneurysms for doctor DeBakey.

Now he was ready to make his own seminal contribution to the field.

If debake wasn't going to support his ascension, Cooley would have to blaze his own trail.

In June, Cooley and his colleague doctor Dan McNamara flew to Minnesota to watch Walt Lillahi in action.

Ioha came to pick him up.

It was a customed then, as probably is still for the visitors to be treated the night before their visit.

That's doctor Dudd Frasier again.

So they were supposed to go out to some nice restaurant, which Coolly anticipated and everything.

Instead of going to a nice restaurant, they go to a road house outside of Minneapolis, you know, dancing girls and all of that.

Doctor McNamara took off early, leaving Cooley to party late into the night with the insatiable lillahih.

One of the things Cooley told me, he said, You've got to always remember, never never drink was Walt Lilaha.

You can never keep up with him.

Cooley woke up late the next morning, hungover and exhausted.

He and McNamara rushed to the University Hospital where Lilla High was scheduled to perform a VSD repair.

At nine point thirty, a half hour after the appointed time, Lila High finally turned up.

He went out to the scrubber sink and was splashing cold water in his face, and the nurse came out and broke an amal nitrate under his nose, the old boxer routine, and he go ahead, He did the case.

And killed his head.

Is a pretty surgery they were seeing, but it was.

What happened later that day that really left an impact on Cooley.

He and McNamara were treated to a tour of Lili High's lap, where they saw a prototype that would be laughed out of any medical conference.

This was what Lili High was truly excited about.

It looked like his cross circulation set up on steroids, a tangle of coiled hose, a Sigma motor pump, plastic tubes suspended on stands, and a blood reservoir.

The whole apparatus cost about thirty dollars.

To macnamara, it looked like the work of a madman.

To Koley, it felt like looking into the future.

This radical heart lung bypass machine represented everything Kooley had been waiting for.

If he could just replicate it back in Houston, it would grant him access to the new and wild frontier of open heart surgery and all of its endless possibilities for innovation and glory.

This was his chance to step out of Michael de Bakey's shadow, out of Alfred Blaylock's shadow, and onto the cutting edge.

Denton, Cooley, and the city of Houston were about to enter the heart race.

On our next episode, a devastating turn of events forces Walt the Laid to rethink open heart Surgery and in Houston, Denton Cooley's swift rise plunges him into a battle of egos with his boss and mentor Michael DeBakey, next time on Cardiac Cowboys.

Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios and Thirteenth Lake Media.

We're presented by Chris Pine and written and narrated by me Jamie Appley.

Our executive producers are Christina Everett for iHeart Podcasts, Dub Cornette and Jason Ross for OsO Studios.

Doctor Gerald Imber, author of Cardiac Cowboys, The Heroic Invention of Heart Surgery, Doctor Eric A.

Rose, John Mankowitz, Joshua Paul Johnson, and myself.

James A.

Smith is our supervising producer.

Editing and sound design by Joshua Paul Johnson.

Our composer is David Mansfield.

Our cover artwork is designed by Alexander Smith.

Archival materials courtesy of Special Collections, University of Rhode Island Library and g Wayne Miller, author of the Walt Lilla High biography King of Hearts, The True Story of the Maverick who pioneered open heart surgery.

For more information on the first cardiac surgeons, check out doctor Gerald Imber's book Cardiac Cowboys, The Heroic invention of heart surgery.