Tribute - September 2008
Tex Med . 2008;104(9):9-10.
By Kenneth L. Mattox, MD, FACS
Since Dr. Michael E. DeBakey's death on July 11, very few superlatives have been spared when describing the remarkable career of this humanitarian, educator, researcher, statesman, builder, visionary, role model, and surgeon.
It is appropriate that Texas Medicine describe Dr. DeBakey as a Texan, Houstonian, and surgeon operating in the Texas Medical Center. Baylor College of Medicine and Dr. DeBakey are truly inseparable. Although he evaluated and operated on patients in many different hospitals in Houston and, indeed, around the world, Baylor College of Medicine in the Texas Medical Center is most closely identified with this great man.
For the first 40 years of Dr. DeBakey's life, he lived in Louisiana, except for his Army years during World War II, when he lived in Washington D.C. During his New Orleans years, he spent time visiting the leading surgeons of Europe: Dubost, Leriche, Kirschner, and many others.
For 60 years, Dr. DeBakey lived in Texas, on the same street, approximately one mile from the Texas Medical Center. He became chair of the Department of Surgery at the then-Baylor University College of Medicine and was one of the youngest chairs of surgery in history. He began to assemble young surgeons to be part of his remarkable vision - a direct surgical approach to treating atherosclerosis and other diseases of the heart and blood vessels. Previously, all treatments had been indirect.
Dr. DeBakey can correctly be described as a Texas wildcatter. Although not into oil and gas exploration, his exploratory and risk-taking personality led him to go where other surgeons had never been and to become good friends of those with like personalities. They were the famed Texans who drilled for oil, developed land, and reached for the moon.
In 2008, surgeons routinely enter the retroperitoneum for problems in the aorta, pancreas, vena cava, and others. Before 1954, no Western surgeon had entered the retroperitoneum to directly reconstruct this large blood-carrying structure - the abdominal aorta. Only one other, a Frenchman by the name of Dr. Charles Dubost, had ever performed such reconstruction. To continue his work on the aorta, Dr. DeBakey developed, in his research machine shop and on his wife's sewing machine, special instruments, operating room tables, and grafts. He devised special imaging techniques for surgeons to perform aortograms between operating room cases.
One of his many nicknames, the "Texas Tornado," described Dr. DeBakey's whirlwind schedule. He rarely slept more than three hours a night. Caricatures of the "Texas Tornado" depicted a "white knight" in constant movement.
A lasting memory among all trainees is Dr. DeBakey's remarkable ability to be an effective time manager and also the epitome of multitasking. I remember an entire entourage of staff, residents, visiting surgeons, and nurses following Dr. DeBakey up seven flights of stairs because the elevators were too slow. Rounds were made on the patients on every floor, taking the stairs down two steps at a time.
As a Texan, Dr. DeBakey wore boots. He had his own custom boot maker, and his boots were unique. As those of the original Texans, Dr. DeBakey's boots were designed to serve special functions and to be comfortable. I recall at least two different designs in boots and at least three different colors. For the last 30 years of his life, I recall that his boots were of only one design. I have never seen a similar boot design on any person, anywhere in the world. He did wear lighter color boots in the operating room and on rounds, but darker, usually black boots, when he was not wearing surgical scrubs. The boots were very stable and allowed for rapid movement during rounds, although they did not have the appearance of a sprinter's track shoes. They allowed for long hours of comfortable standing stationary in the operating rooms during long operations and long days. Even on airplanes, I do not recall ever seeing Dr. DeBakey remove his boots to ease tired feet as I have seen others do.
Dr. DeBakey was meticulous and had specific attention to detail in his clothing as he had in his patient care. He was an impeccable dresser. During the 1960s, one resident openly expressed that Dr. DeBakey had some wonderful "threads," in describing the quality of the cloth and the precisely tailored fit of his suits and shirts. His suits, shirts, ties, and the always-present pocket handkerchief were totally coordinated. In the operating room, his scrub suits were always of a different color from those of the hospital's usual distribution. His matching scrub caps and surgical masks were in a special container in the operating room and clearly labeled "Dr. DeBakey's Caps and Masks." Despite often performing surgery on vascular cases that could at times have "uncontrolled bleeding," I never recall seeing Dr. DeBakey with even a hint of blood on his scrub suits. His scrub shirts, as well as his white lab coat, were monogrammed with the ever-recognizable "MED" initials.
As a junior resident and faculty, I recall that Dr. DeBakey drove cars fast. I am not really sure he recognized that he was sometimes exceeding the posted speed limit; it was just that he did all he could do to reduce any loss of time between point A and point B.
The Methodist Hospital, during the late 1969s, developed an annex some two miles from the main building. It housed initial admissions and some pre-op and postoperative patients. Dr. DeBakey made rounds at this location, often taking residents in his car with him. I do not recall his ever running a red light, having an accident, or getting a traffic ticket, although it was not because he did not tempt fate. To my knowledge, he never had even a minor automobile accident. He told me that on one occasion he was driving quite fast on his way to Austin when he noticed a red light behind him. He glanced at the speedometer, noting a speed greater than 100 mph. When the officer asked Dr. DeBakey if he knew he had clocked him going more than 75 mph, Dr. DeBakey almost wanted to say that the officer needed to get his speed detector recalibrated.
Although he did not attend a majority of the meetings, Dr. DeBakey became a member of every Texas organized medicine society, association, and organization he was eligible to join. He was a member of the Harris County Medical Society and the Texas Medical Association from his first days in Houston. The Texas Surgical Association removed him from active membership when he missed three meetings in a row (they still meet twice a year). However, when they made him an honorary member, he didn't have specific attendance requirements.
Finally, Dr. DeBakey's trainees and his associates populate the many cities and towns across Texas. Even those who did not receive their training in Houston have benefited from the DeBakey culture of attention to detail and continuous pursuit of excellence. This Tall Texan continues to cast a long shadow and has left large boot prints for us to follow for many decades to come.
Dr. Mattox is professor of surgery in the Michael E. DeBakey Department of Surgery at Baylor College of Medicine and chief of staff/chief of surgery at Ben Taub General Hospital in Houston.
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