The distinguished service award medal for the Society of Vascular Surgery, 1999: Michael Ellis DeBakey, MD☆☆☆★★★
Article Outline
A life-sized bronze statue stands guard over the activities in the elegant lobby of The Methodist Hospital in Houston, Texas. The plaque affixed to the sculpture's base best explains the man depicted by this gift from King Leopold and Princess Lilian of Belgium: “Michael E. DeBakey, M.D., Surgeon, Educator, and Medical Statesman.”
The contributions made by Dr DeBakey (Fig 1) cannot be described fully here.
Fig. 1.
Dr Michael E. DeBakey.
Dr DeBakey himself traces his strengths to his roots in Lake Charles, La, and to his parents, Lebanese immigrants who met and married in the United States. From his parents, Dr DeBakey learned honesty, integrity, self-discipline, industry, and concern for his fellow man. His father, a pharmacist and businessman, and his mother both placed great emphasis on education. They encouraged him and his siblings to visit the local public library and to read a book from it each week. By the time he graduated from high school as valedictorian, Dr DeBakey had read the entire Encyclopedia Britannica . However, he did have other interests, including playing the saxophone in the school's band, participating in sports, and tending the family garden. Later, he learned to play the clarinet so that he could play in his college orchestra. Many times he has told young students that playing a musical instrument taught him dedication and manual dexterity, two qualities crucial for a successful surgeon.
As a 17-year-old high school graduate, he chose to attend Tulane University in New Orleans. He received a bachelor's of science degree, a medical degree, and a master's of science degree from that school. He was a member of Alpha Omega Alpha, the medical honor society. Equally important, he met the mentor who guided him during his early professional years. Dr Rudolph Matas, often called the “father of vascular surgery,” introduced Dr DeBakey to Dr Alton Ochsner, then Chairman of Tulane's Department of Surgery. The relationship between Drs DeBakey and Ochsner spanned several decades.
The Tulane years also guided Dr DeBakey's interests in the laboratory. While working to develop a pulse wave at the behest of one of his professors, he devised the concept of the roller pump (Fig 2).
Fig. 2.
The roller pump.
At the suggestion of Dr Ochsner, Dr DeBakey followed in the footsteps of other great US surgeons, going to Europe to study at the feet of masters there. He spent 2 years studying with Professor Rene Leriche in Strasbourg, France, and with Professor Martin Kirschner of the University of Heidelberg in Germany. Dr Leriche was a renowned vascular surgeon who was interested in sympathectomy for the treatment of vascular disease. Dr Kirschner was a pioneer who performed the first pulmonary embolectomy. While in Strasbourg, Dr DeBakey worked with Dr Cid dos Santos, who performed the first endarterectomy of the femoral artery in 1947 and with Dr Jean Kunlin, who described the first femoral-popliteal bypass graft in 1948.
On his return to New Orleans in 1937, Dr DeBakey continued his collaboration with Dr Ochsner. The pair published many now classic articles on scalenus anticus syndrome, hepatic abscess, venous thrombosis, transfusions, sympathectomy, peptic ulcer disease, and many others. Their article on lung resection for carcinoma was among the first to associate lung cancer and the smoking of tobacco.
When the United States entered World War II, Dr DeBakey volunteered for military service. He was named Director of Surgical Consultants in the Surgeon General's office from 1942 until 1946, eventually rising to the rank of colonel. While in the Army, he oversaw how the wounds of war were managed in the field and in the hospital. With Dr F. A. Simeone, he authored a report that described vascular injuries acquired during the fighting in World War II. He was instrumental in the development of the mobile military unit later called MASH. When he recommended the creation of the specialized medical centers in various areas of the United States to treat wounded veterans, he began the process that resulted in the establishment of the Veterans Affairs Medical Center System. He also urged establishment of the Commission on Veterans Medical Problems of the National Research Council and an extensive research program for the systematic medical follow-up of veterans. In honor of his work, he was awarded the Legion of Merit in 1945.
Although Dr DeBakey returned to New Orleans after the war, he was soon lured away by a struggling medical school in Houston, Texas. Arriving at what was then Baylor University Medical School at the end of 1948, he began working to improve the quality of education, research, and patient care almost immediately. His high profile medical career reflected well, not only on Baylor Medical School, but also on the emerging Texas Medical Center.
Dr DeBakey served as Baylor's Chairman of Surgery for 45 years, recruiting and training a number of master vascular surgeons to his staff. In 1969, shortly after the school became Baylor College of Medicine, an entity separate from Baylor University in Waco, Dr DeBakey became the school's first President. During his 10 years in that job, he oversaw major changes in the school's physical plant, the size of the medical school classes, and the caliber of research and training. In 1979, he became Chancellor of Baylor College of Medicine and now holds the post of Chancellor Emeritus. He was named a Distinguished Professor in 1968.
Even while burdened with administrative matters, Dr DeBakey continued his clinical research. Under his direction, Baylor College of Medicine and The Methodist Hospital became one of the most prestigious cardiovascular centers in the world. In part, this was the result of Dr DeBakey's surgical firsts. In 1953, he reported the first successful resection and graft replacement of an aneurysm of the descending thoracic aorta. Later in the same year, he performed the first carotid endarterectomy. In 1954, he made a bifurcation graft, using two pieces of Dacron on his wife's sewing machine (Fig 3).
Fig. 3.
Dr DeBakey made a bifurcation graft in 1954, using two pieces of Dacron and his wife's sewing machine.
In his laboratory, research into the best prosthetic material for a vascular graft continued. By 1948, he had settled on Dacron and convinced the Philadelphia College of Textiles and Science to manufacture the grafts on a special knitting machine. The resulting seamless grafts provided a major boost for the development of vascular surgery. Dr DeBakey also set up a machine shop at Baylor College of Medicine in which instruments suitable for vascular surgery could be manufactured. Many surgical instruments for vascular surgery now bear his name.
He has published over 1500 articles, chapters, and books during his professional life. In 1960, he published the first of a series of seminal essays that described the nature of atherosclerotic occlusive disease. Although atherosclerosis was diffuse, its distribution tended to be segmental. This observation established the principle of bypass surgery. A graft was sutured from a normal proximal artery to a normal distal artery, thus bypassing the diseased artery. He implanted the first successful left ventricular assist pump in 1966 (Fig 4).
Fig. 4.
The left ventricular assist pump was successfully implanted for the first time in 1966 by Dr DeBakey.
Fig. 5.
The axial flow ventricular-assist device developed in collaboration with NASA scientists.
Dr DeBakey was a founding member and the eighth President of the Society for Vascular Surgery (1954). Since 1951, eight renowned surgeons have been invited to deliver the John Homan Lecture. He gave the sixth lecture in 1982, “Dissecting Aortic Aneurysms—A 20-Year Follow-up.”
Dr DeBakey has served as president of many important organizations such as the International Society of Cardiovascular Society (1957-59), American Association for Thoracic Surgery (1960), International Society of Cardiovascular Surgeons, North American Chapter (1964), and the Southern Surgical Association (1990). He edited the Year Book of General Surgery for 15 years and was founding Editor-in-Chief for the Journal of Vascular Surgery in 1984. He has been Director of the National Heart and Blood Vessel Research and Demonstrations Center at Baylor College of Medicine.
Among the awards he has received are the Rudolph Matas Award in Vascular Surgery, the American Medical Association Hektoen Gold Medal Award, the American Medical Association Distinguished Service Award, the Albert Lasker Award for Clinical Research, the Presidential Medal of Freedom with Distinction (bestowed by President Lyndon B. Johnson), the President's National Medal of Science (bestowed by President Ronald Reagan), the American Heart Association Gold Heart Award, and many others. In addition, he has received more than 50 honorary degrees and medals from the international community. While serving on the Task Force for Medical Services with the Hoover Commission after World War II, he initiated the concept of a national medical library, paving the way for the establishment of the National Library of Medicine. He has served on its Board of Regents on three different occasions. He spearheaded the cooperative effort between Baylor College of Medicine and the Houston Independent School District that resulted in the creation of what is now the Michael E. DeBakey High School for Health Professions.
Perhaps the area in which his star has shone brightest to the public is in medical statesmanship. In the course of his travels to virtually every country of the world, he has advocated for good health care worldwide. During the Cold War, his trips to Russia and China formed a bridge between scientists and improved the lines of communication. Because Dr DeBakey viewed health care as a universal need, he pushed past many of the political barriers as an advocate for patients. His counsel and advice is sought by many foreign governments, hospitals, and medical schools. Recently, Russian surgeons consulted with him when their nation's president, Boris Yeltsin, developed heart problems. Because Dr DeBakey understands the difficulties presented by time and geography, he has pioneered the concept of telemedicine, which overcomes those obstacles that make dissemination of medical and scientific knowledge difficult.
Dr DeBakey has championed education and surgical training throughout his professional life. Over the years, hundreds of surgeons have had an opportunity to receive part of their surgical training in Houston under Dr DeBakey. In tribute, they organized the Michael E. DeBakey International Surgical Society in 1976 to honor his contributions to their training and to the field of medicine. Every other year, the 500-member society meets to discuss the latest in scientific achievements. Recently, the Baylor College of Medicine Board of Trustees named the school's Department of Surgery for him, the Michael E. DeBakey Department of Surgery.
A short and simple phrase exemplifies the teaching of Dr DeBakey: “attention to detail.” It is the way he has lived his life and practiced medicine. It is a principle he has never forgotten. It has guided him in his every endeavor and initiated the “pursuit of excellence” that has been his lifelong motto.
Perhaps, however, his greatest legacy is his example. Today, he continues to work and contribute as he has for 7 decades of his professional life. He continues to push the agenda of research, education, and medical care for all. Yet he finds time for people. Patients feel they have his full attention when he sits to talk to them. He makes special time for the students at the high school that bears his name. “I enjoy them. I get a kick out of those kids,” he said. “Sometimes they want to talk about their futures, and they are a little concerned about what they are going to do. They need to talk it out a little bit.” He makes time, he said, because “they are the future.”
That too is key to the man. Although historians reflect on what he has accomplished in the past, he is and has always been intent on building for the future.
☆ Competition of interest: nil.
☆☆ Reprint requests: Charles H. McCollum, MD, Baylor College of Medicine, Department of Surgery, One Baylor Plaza, Houston, TX 77030.
★ J Vasc Surg 2000;31:406-9.
★★ 0741-5214/2000/$12.00 + 0 24/1/103781
PII: S0741-5214(00)90171-X
doi:10.1016/S0741-5214(00)90171-X
© 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter. Published by Elsevier Inc. All rights reserved.
