“Intentional Impact:” The Legacy of Michael E. DeBakey

Shelley McKellar, PhD and George P. Noon, MD, will give the inaugural Michael E. DeBakey Lecture on March 21, 2017 at 2:00 ET in the Lister Hill Auditorium at the National Library of Medicine. Today, Circulating Now presents an interview with Dr. McKellar. Shelley McKellar is the Jason A. Hannah Chair in the History of Medicine in the Schulich School of Medicine and Dentistry as well as an Associate Professor in the Department of History at Western University in London, Ontario, Canada. She studies the history of medicine and disease, with a special interest in the history of medical technology, instruments and devices, the history of surgery, and medical biography.

Circulating Now: Tell us a little about yourself. Where are you from? What do you do? What is your typical workday like?

Portrait of Shelley McKellar with books.Shelley McKellar: I was born and raised in southwestern Ontario, Canada and am delighted to be a tenured professor at Western University in London, Ontario.  Given my itch for travel and love of different places, my mother never imagined that I would return to southwestern Ontario to work and raise my own family!  At Western’s Schulich School of Medicine and Dentistry, I lead an active history of medicine program, where I am privileged to teach medical students on various medical history topics as well as run lecture events, facilitate a medical student history club, coordinate university-community activities, and more.  I love interacting with medical students; my goal is to get them to appreciate the historical and cultural contingency of medical practice—that is, time and place matter regarding what we think we know and how we practise medicine.  I am also jointly appointed in the Department of History at Western, where I teach undergraduate and graduate history courses in the history of medicine, disease and public health.  I enjoy introducing history students to the possibility of ‘disease’ as a historical lens through which to better understand individual and group response.  Sometimes intimidated by the ‘science’ of medicine, history students quickly grasp the political, economic and social factors that shape response to disease outbreaks and public health initiatives.  I also have great fun with medical objects and as curator of Western’s Medical Artifact Collection, I can often be found in the collections storage area either organizing a ‘History through Objects’ workshop or selecting artifacts for display in various cases located throughout campus. I am grateful to Associated Medical Services (AMS) for its pivotal support of medical history teaching and research in Canada, both in our medical schools and our broader community, which enables me to do these activities.

CN: How did you originally become interested in the history of medicine and the history of cardiac surgery and artificial heart technology in particular?

SM: I became interested in the history of medicine after attending an undergraduate lecture delivered by Dr. Charles Roland, who at that time was the Hannah Chair in the History of Medicine at McMaster University.  In particular, I became interested in the history of surgery, which seemed to me to be quite an invasive approach that attempts “to cure by cutting.”  For centuries, the heart was off limits to the scalpel.  In the 1880s, Theodor Billroth of Vienna, one of the world’s most prestigious surgeons, stated that, “Any surgeon who would attempt an operation on the heart should lose the respect of his colleagues.”  In 1896, Sir Stephen Paget of London declared, “The heart alone of all viscera has reached the limits set by nature to surgery.”  And yet the 20th century witnessed the dawn of open-heart surgery, cardiac transplantation, and artificial hearts!  I wrote a biography of Toronto surgeon D. W. Gordon Murray (1894–1976), who was Canada’s ‘blue baby doctor’ and performed many daring heart operations without using cardio-pulmonary bypass machines.

I became interested in artificial hearts through my involvement in Project Bionics, a documentary history project of the American Society of Artificial Internal Organs in collaboration with the Smithsonian’s National Museum of American History and the National Library of Medicine.  After meeting many of the historical participants—like Willem Kolff, Adrian Kantrowitz, Michael DeBakey, Denton Cooley and others—to proactively ensure the safeguarding of their artifacts and papers for posterity by depositing their prototypes and records in the NMAH and NLM collections, I was hooked!  I began researching the history of the development of artificial hearts as a case study of a controversial medical technology; questions of “could we” actually build a device to replicate the human heart also prompted questions of “should we”?  In development since the 1950s, the artificial heart, with its seemingly endless problems, seemed to suggest that there was a limit to what devices would be worth living with and paying for.   The promissory nature of artificial hearts was strong (and seductive), which fortified efforts to ensure its ongoing development throughout its rocky history.  My book, entitled Artificial Hearts:  The Allure and Ambivalence of a Controversial Medical Technology, is forthcoming from Johns Hopkins University Press in the fall of 2017.

CN: Later this month you’ll be at NLM to talk about ““Intentional Impact:” The Legacy of Michael E. DeBakey Beyond the Operating Room.” Will you tell us a little about Dr. DeBakey’s ‘intentional impact’?

SM: With ‘intentional impact,’ Dr. Michael DeBakey advocated on national and international levels for expanded medical services, research funding, medical education and training, cardiovascular disease awareness, and more.  His actions were intentional—that is, he prepared, planned, and executed with purpose.  He was a man who rarely seemed to sleep, demanded much of himself and those around him, and was driven to deliver the best care to his patients.

A group of people in medical clothing pose outdoors.

Michael DeBakey with Baylor University surgical staff, 1967
Profiles in Science
Courtesy of Katrin DeBakey

In the 1960s, Dr. DeBakey emerged as a top authority in the field of heart disease as a result of his busy and innovative surgical practice at Houston’s Methodist Hospital, his robust research program at Baylor College of Medicine, and his advocacy for a national heart disease research and treatment policy.  Dr. DeBakey was visible and active; he served on national committees that would influence medical research and public health policies.  Well-known celebrities and public figures, like Marlene Dietrich, the Duke of Windsor, the Shah of Iran, among others, traveled to Houston and Dr. DeBakey’s operating table for corrective surgery.  Dr. DeBakey was the presumptive leader in the field of bold, innovative cardiovascular procedures, repairing arteries with Dacron grafts or replacing damaged heart valves with plastic ones. The list of Dr. DeBakey’s surgical contributions is long—the first successful resection of an aortic aneurysm (1955), first patch-graft angioplasty (1958), the first successful coronary bypass (1963), the first successful use of a left ventricular bypass pump (1966), and more—which, by themselves, secured his place in medical history.

Dr. DeBakey was increasingly involved in securing federal support for heart disease research, capitalizing on President Lyndon Johnson’s expectation to do something about the problem of heart disease.   In March 1964, President Johnson asked Dr. DeBakey to chair The President’s Commission on Heart Disease, Cancer and Stroke.   President Johnson’s personal history of heart disease, dating back to his 1955 heart attack, intensified his commitment to increase funding for cardiovascular research and treatment.   Also in 1964, after much lobbying by Dr. DeBakey, the U.S. Congress announced the artificial heart as a development priority and established the U.S. Artificial Heart Program at the National Heart Institute.  Dr. DeBakey told Congress that mechanical pumps were “not a panacea” but “a definitely feasible program” with promising benefit to the pressing problem of heart failure.   For the development of artificial hearts, DeBakey’s engagement as a clinical researcher and statesman incited momentum, altered the research dynamics, and shaped the expectations of this technology.

President Johnson takes papers from DeBakey as they stand beside a podium.

DeBakey with President Lyndon B. Johnson, December 9, 1964
Profiles in Science
Courtesy of Katrin DeBakey

Under the Nixon administration, an intergovernmental agreement between the United States and the U.S.S.R., announced an official collaboration that was championed by Dr. DeBakey and Soviet artificial organ pioneer Valeriy I. Shumakov.  This stimulated joint conferences and visiting delegations between Houston and Moscow in the hopes of expediting the development of mechanical hearts.  Much of this collaboration was politics, of course.  In 1996, Dr. DeBakey was flown to Russia to supervise President Boris Yeltsin’s quintuple bypass surgery.

CN: In fact, we’re welcoming you back to NLM; you have done a lot of research here over the years, can you tell us a little about that work?

SM: I love doing research in the History of Medicine Division (HMD) Reading Room!  It started out as device background research and biographical profiles, then my research dug into the rich manuscript collections and Profiles in Science records and this morphed into a book-length project!  My book on the history of artificial hearts draws from the papers of Clarence Dennis, Adrian Kantrowitz, Michael DeBakey, William DeVries, John Watson as well as other HMD materials ranging from oral interviews to photographic material.

I also benefited from a NLM travel grant, back in 2005-6, to dig into the audiovisual and poster collections as part of a “Historical Material in the Curriculum” project.  I reviewed films like Man Alive (1952), This is TB (1946), Challenge: Science Against Cancer (1950), Private Snafu v Malaria Mike (1944), How Can Syphilis Be Prevented (1944), and others as well as long list of public health posters towards building several workshop modules for my undergraduate and graduate history of disease courses at Western University.  These workshops focused on working with film and posters as historical sources, through the topic of disease and public health, to enhance student methodological skills as well as content knowledge.  Students loved these workshops—it was quite a novelty as I created AV centers in the classroom to show old films and to lay out large, colour public health posters, using material from the HMD collections.  I still run the workshops, however, this material and more is now available online via the Digital Collections at NLM.

DeBakey in a lab coat poses in front of a wall covered with framed photgraphs and awards.

Michael DeBakey, in his office, with wall of awards and commendations behind him, ca. 1972
Profiles in Science
Courtesy of Katrin DeBakey

CN: What aspects of DeBakey’s career would you like to see fellows in the Michael E. DeBakey Fellowship in the History of Medicine explore in more detail?

SM: I think that there are so many aspects of Dr. DeBakey’s multifaceted career that could be explored. For example, what about his vision and impact regarding medical education?  To what extent did his vision for Baylor College of Medicine and Texas medical education produce the results that he wanted, and how transferable were his ideas beyond the state?  What about his role as medical statesman?  Many comment that Dr. DeBakey had the ear of Presidents and Congressmen; to what extent is that true, and to what effect?

The richness of the DeBakey papers will appeal to a broad range of scholars, who are able to ask different questions on a variety of topics.  As a result of the generosity of The DeBakey Medical Foundation, funds that promote access and use of the DeBakey papers will ensure that this collection will be mined for years to come by the history of medicine community.

Dr. Shelley McKellar’s presentation is part of our ongoing history of medicine lecture series, which promotes awareness and use of the National Library of Medicine and other historical collections for research, education, and public service in biomedicine, the social sciences, and the humanities. All lectures are live-streamed globally, and subsequently archived, by NIH VideoCasting. Stay informed about the lecture series on Twitter at #NLMHistTalk.