By Craig Miller ~
Michael E DeBakey’s life and career are primarily associated in medical history and the public consciousness with his many years at the head of the Department of Surgery at Baylor College of Medicine in Houston, Texas. Prior to this, however, DeBakey spent the years from 1926 to 1948 (with the exception of two notable periods) in New Orleans, Louisiana, affiliated with Tulane University. These were years of personal and professional growth and maturation, but also of significant and lasting contributions on his part to clinical medicine and surgery.
Eighteen-year-old Michael DeBakey arrived at the campus of Tulane University in New Orleans in September, 1926. The valedictorian of his high school class, DeBakey enrolled in the university’s Premedical Course, a two-year undergraduate track designed to prepare students for the rigors of the Tulane Medical School. Accustomed to perfect marks, DeBakey was mortified when his first term report was studded with B’s. After some soul-searching he returned for the second session with a new determination to excel. From this point on, through the rest of his life, Michael took up his father Shaker DeBakey’s spartan example and worked exceptionally long days, seldom sleeping more than four or five hours a night.
This effort paid off in the classroom, where Michael earned high grades in his courses in zoology, mathematics, physics and most of the remainder of the curriculum. He especially excelled in the drawing and dissection aspects of the zoology course. The lowest grades he received were in French, despite the fact that his parents were fluent in that language.
Michael played intramural sports, including basketball, baseball, and handball. He also played saxophone in both the stage and marching bands.
The young pre-med student called Tulane’s Academic Dormitory home during his first two years in New Orleans. Annoyed by the constant intrusions into his studious privacy, though, Michael convinced his father to provide the necessary funds for his transition to a boarding house for medical school (he would live with a friend’s family in nearby Harvey, Louisiana for his second and third years of medical school, and then actually in Mercy and Charity Hospitals his final year).
During the spring of Michael’s second year of medical school, in 1930, he took an introductory class in Surgery taught by Tulane’s new Professor and Chief of the subject, mercurial young Alton Ochsner. He was bewitched by the South Dakota transplant’s obvious talents as a clinician and educator, and soon became convinced that his career path lay in the field of surgery.
Michael received his undergraduate degree in June, 1930. Two more years of clinical study in the medical school were characterized by continued excellence, and he finished in 1932 in the top 10% of his class. He chose to train in surgery with Ochsner.
In medical school Michael had observed the primitive methods of blood transfusion in existence at the time. In the days before blood banks, transfusion was, by necessity, a direct patient-to-patient affair. It was also a bloody and crude one, and Michael felt sure he could improve on it. Remembering the sleeve valves he had seen in the engine of an old automobile his father had given him, Michael applied the same concept to the design of a new transfusion apparatus. Along with a classmate, William Gillentine, he completed the sleeve valve transfusion syringe as a senior medical student, and put it to outstanding clinical use the next year as an intern. Ultimately it came to market under the aegis of the V. Mueller Company. Although the advent of effective blood banking obviated the usefulness of the apparatus in transfusion, DeBakey’s sleeve-valve syringe concept remains in use to the present day for efficiently drawing fluid from the pleural and peritoneal spaces.
As a senior medical student Michael also came under the influence of Rudolph Matas, the doyen of surgery in the South and Ochsner’s immediate predecessor at Tulane. Matas influenced DeBakey both in his interest in cardiovascular surgery (of which Matas was a pioneer) and his overarching Weltanschauung. Multilingual and possessed of enormous intellect and charm, Matas—along with Ochsner—completed the perfect set of surgical mentors for young DeBakey.
While working in the surgical laboratory DeBakey was faced with the problem of simulating a pulse wave experimentally. After failing to find any worthwhile material on pumps in the Tulane medical library he was directed to the Engineering stacks by his friend and former neighbor in the Academic Dormitory, Charles E. Schmidt. DeBakey became convinced by this reading that a roller pump was the best means of accomplishing his goal. When applying it to his experimental model, though, he was frustrated that the fluid-carrier tubing the rollers compressed migrated along the path of the rotating bearings. In a flash of inspiration DeBakey saw a simple solution: a flange attached to the tubing that could be clamped into place to prevent shifting. Almost immediately he recognized that this apparatus could be applied to the transfusion problem as well. Along with Schmidt and another associate he patented the device in 1935. Many years later this roller pump proved to be the final piece in the puzzle of a successful heart-lung machine, allowing open-heart surgery for the first time.
Impressed with their young charge’s intelligence and skill during his internship and first years of surgical training, Ochsner and Matas arranged for DeBakey to continue his education in two of the top surgical clinics in Europe. He spent the academic year of 1935-36 at the University of Strasbourg with the noted French surgeon Rene Leriche and the University of Heidelberg with the similarly-renowned Martin Kirschner. While there, DeBakey won over the Europeans with his transfusion device and honed his clinical and laboratory skills. He learned the latest surgical techniques and perioperative care (DeBakey first encountered recorded music in the operating theater at Kirschner’s clinic, as well as postoperative physical therapy). While in Germany the then-apolitical DeBakey also witnessed the growth of the Nazi movement, and was shocked and horrified by the court-ordered sterilization procedures that were performed.
DeBakey returned to Tulane in the summer of 1936. He continued as a trainee (his title was Instructor in Surgery) and, together with Ochsner, composed seminal papers on the treatment of subdiaphragmatic and hepatic abscesses and the connection of lung cancer and smoking. He was finally awarded a faculty position in October 1940, when he became Assistant Professor of Surgery.
DeBakey had barely settled into the life of a junior faculty academic surgeon when the United States entered World War Two. Emphatically patriotic, he wished to enlist at once. Ochsner initially indicated that DeBakey was essential to Tulane, but his protege’s entreaties ultimately won the day, and DeBakey joined the U.S. Army in September 1942.
He was briefly stationed at Gulfport, Mississippi but in January, 1943 was summoned to the Surgeon General’s Office in Washington where he joined the ranks of the Surgical Consultant’s Division. DeBakey served with distinction in this capacity through and even beyond the war, and returned to New Orleans in 1946.
In the summer of 1948 a fledgling medical school in Houston came calling. They were looking for a new Chief of Surgery.
Craig Miller, M.D., is Chief of Vascular Surgery at Pardee UNC Health and Adjunct Professor, University of North Carolina School of Medicine. He was a Michael E. DeBakey Fellow in the History of Medicine at the NLM in 2017 and is writing a biography of Dr. DeBakey, A Time for All Things: The Life of Michael E. DeBakey, M.D.