Skilled Innovator

Michael Ellis DeBakey never lost the Southern drawl he acquired growing up in Lake Charles, La. He was born on Sept. 7, 1908, the oldest of five children of Lebanese-Christian immigrants who moved to the United States to escape religious intolerance in the Middle East. His parents chose Cajun country because French was spoken there, as it had been in Lebanon.

Dr. DeBakey credited much of his surgical success to his mother, Raheeja, for teaching him to sew, crochet and knit.

He was inspired to become a doctor from chats with local physicians while he worked at a pharmacy owned by his father, Shaker Morris DeBakey, who also owned rice farms.

As a medical student, he showed a gift for innovation when an instructor asked him to find a pump to study pulse waves in arteries. From library research, he fashioned older pumps and rubber tubing into one that served the instructor’s purpose, calling it a roller pump.

This was before the time of blood banks, so Dr. DeBakey used the pump to transfuse blood directly from a donor to a patient. The pump was later adapted for use in the heart-lung machine. .

After finishing his training at Charity Hospital in New Orleans in 1935, Dr. DeBakey started out as a general surgeon. At the time, few doctors specialized in heart and chest surgery. Young American doctors who aspired to academic careers typically sought further training in Europe.

Dr. DeBakey enrolled at the University of Strasbourg in France and then the University of Heidelberg in Germany.

In his first weeks at Baylor, in 1948, Dr. DeBakey found that a promised affiliation with a hospital in Houston had fallen through and that the hospital’s doctors would accordingly not let him operate on their patients. With nowhere to teach young doctors, Dr. DeBakey was about to resign from Baylor.

But then the Truman administration asked him to help transfer Houston’s Navy hospital to the Veterans Administration.

Seizing on the opportunity, he stayed on at Baylor to help make the veterans hospital Baylor’s first official hospital affiliate and build Houston’s first surgical residency program.

Dr. DeBakey had a knack for recruiting good surgeons who played key roles in many of his successes. One was Dr. Denton A. Cooley, who was Dr. DeBakey’s protégé until a rift left them bitter rivals.

In his public and professional lectures, Dr. DeBakey, an inveterate name-dropper, often showed photographs of his celebrated patients and spoke about their ailments.

Among these notables were the deposed shah of Iran, Mohammed Reza Pahlavi; the duke of Windsor, the former King Edward VIII of England; Marlene Dietrich; Joe Louis; Leo Durocher, the baseball manager; and Jerry Lewis.

His spacious office in Houston and the long corridors leading to it were lined with framed awards and pictures autographed by many of his patients.

Surgery Pioneer

The main focus of Dr. DeBakey’s surgical innovations was arteriosclerosis, a systemic disease in which fatty deposits can damage arteries feeding the heart and other tissues, leading to heart attacks, strokes and loss of limbs.

Dr. Allan D. Callow, a vascular surgeon and emeritus professor of surgery at Tufts University, said Dr. DeBakey had recognized that the damage from arteriosclerosis was often limited to critical areas in arteries and that these areas could be cut out or bypassed surgically.

In 1952, Dr. DeBakey successfully repaired an aortic aneurysm — a ballooning of an artery — by cutting out the damaged segment in the abdomen and replacing it with a graft from a cadaver. In 1953, he successfully repaired a blocked carotid artery in the neck. The blockage threatened to cause a stroke by choking off blood flow to part of the brain.

Luck played a big role in one of Dr. DeBakey’s major innovations.

Seeking to use synthetic instead of cadaver grafts, he went to a department store to buy some nylon. The store had run out of it, so a clerk suggested a new product, Dacron. Dr. DeBakey liked its feel, bought a yard and then used his wife’s sewing machine — he was married to the former Diana Cooper at time — to create his first artificial arterial patches and tubes.

He went on to collaborate with a textile engineer in Philadelphia to produce Dacron arterial grafts in large numbers.

Dacron turned out to last for decades as a surgical graft; nylon, by contrast, broke down after about a year.

Many doctors initially scoffed at Dr. DeBakey’s claim about Dacron, in part because he had a tendency, like a number of other surgeons, not to report failures.

But when the critics went to Houston, they found he was operating on many patients and was far ahead of them.

In 1964, President Johnson appointed Dr. DeBakey chairman of the President’s Commission on Heart Disease, Cancer and Stroke, which went on to raise standards of care for these diseases.

Dr. DeBakey was a pioneer in performing coronary bypass operations. In one of his last lectures, at the New York Academy of Medicine in Manhattan in November 2005, Dr. DeBakey said that his team had performed the first successful coronary bypass operation, in 1964, but that it did not report it until 1974.

Critics say Dr. DeBakey was eager to claim credit for innovations or exaggerate his role in making them, but since no biography of Dr. DeBakey or thorough analysis of his hundreds of scientific papers has been published, it will be left to medical historians to resolve such controversies.

Shortly after Dr. Christiaan N. Barnard performed the first human heart transplant in 1967, in Cape Town, South Africa, Dr. DeBakey followed, somewhat warily. His team was the first to transplant four organs (a heart, two kidneys and a lung) from one donor to different recipients.

Realizing that the demand for human heart transplants would outstrip the supply, Dr. DeBakey pursued the development of a total artificial heart as well as a partial one, known as a ventricular assist device, or VAD.

Dr. DeBakey is believed to have been the first to use a VAD successfully. Over 10 days in 1966, he weaned a woman from a heart-lung machine after heart surgery and then removed the device when her heart function improved. She died in an automobile accident several years later.

A number of such assisting devices, including a small one bearing Dr. DeBakey’s name, are now marketed or are being tested among patients with severe heart failure.

The use of the total artificial heart that Dr. DeBakey was developing with Dr. Domingo S. Liotta led to a widely publicized scandal in 1969. On walking into a meeting at the National Institutes of Health, which was paying for the research, Dr. DeBakey was shocked to learn that hours earlier Dr. Cooley, his former colleague, had implanted an artificial heart in a patient for the first time. The device was the one the DeBakey team had been testing on calves.

Dr. Cooley, who had moved to another nearby Baylor institution, St. Luke’s Hospital, had never tested the device on animals and said he had implanted it as a desperate measure to keep Mr. Karp alive until he could do a transplant. But others contended that Dr. Cooley had secretly been planning to use the device for several months.

The American College of Surgeons censured Dr. Cooley, who resigned from Baylor, and for almost 40 years the two master surgeons rarely spoke, maintaining perhaps the most famous feud in medicine. But it ended last year, in a surprise reconciliation, when the two men warmly shook hands at a ceremony at St. Luke’s in which Dr. DeBakey received a lifetime achievement award from the Denton A. Cooley Cardiovascular Surgical Society.

Medical Politician

Dr. DeBakey said his ties to the former Soviet Union began after he befriended a small group of Soviet doctors who sat by themselves at a surgical meeting in Mexico in the 1950s. Dr. DeBakey took them to lunch and invited them to watch him operate in Houston on their way home. Later, they invited Dr. DeBakey to speak in the Soviet Union.

In 1973, Dr. DeBakey went to Moscow to operate on Mstislav Keldysh, a nuclear scientist and president of the Soviet Academy of Science. A year later, the Academy of Medical Sciences of the U.S.S.R. elected Dr. DeBakey a foreign member.

For 30 years, from 1964 to 1994, Dr. DeBakey served as chairman of the Albert and Mary Lasker Foundation’s medical research awards jury. Contacts Dr. DeBakey made through the foundation led to referrals from around the world.

As a shrewd medical politician, Dr. DeBakey called on grateful patients and their families to influence national legislation creating the National Library of Medicine and then ensuring that it would be part of the National Institutes of Health in Bethesda, Md.

Dr. DeBakey never shied from controversy.

In the early 1960s, he attended a press conference at the White House with President John F. Kennedy to support the creation of the federal Medicare health insurance plan, bucking the American Medical Association, which had given him its Distinguished Service award in 1959. The Medicare legislation passed in 1965 under President Johnson.

In 1969, Johnson awarded Dr. DeBakey the Presidential Medal of Freedom, the highest honor given a United States citizen.

In 1987, President Ronald Reagan awarded him the National Medal of Science.

In April, he received the Congressional Gold Medal, Congress’s highest civilian honor, in a ceremony attended by President Bush.

Dr. DeBakey’s first wife, Diana, died in 1972. His survivors include his second wife, the former Katrin Fehlhaber, who had been a film actress in Germany; their daughter, Olga-Katarina; two sons from his first marriage, Michael and Dennis; two sisters; and a number of grandchildren.

Two sons, Ernest and Barry, died earlier. Dr. DeBakey was a perfectionist, intolerant of incompetence, sloppy thinking and laziness.

Before mellowing in his later years, he had a reputation for sometimes tyrannical behavior in firing assistants for making relatively minor errors like cutting a suture to the wrong length.

“If you were on the operating table,” Dr. DeBakey said, “would you want a perfectionist or somebody who cared little for detail?”

Dr. Jeremy R. Morton, a retired heart surgeon in Portland, Me., who trained under Dr. DeBakey, said: “He could be sweet as dripping honey when it came to patients and medical students, but could be brutal with surgical residents.

“I guess he was trying to make us tough.”