Cardiac Cowboys, Episode 5: "A Man-Made Heart"

Podcast: Cardiac Cowboys (iHeartPodcasts)
Host: Chris Pine
Air Date: September 29, 2025

Overview

This riveting episode traces the high-stakes race to build and implant the world’s first artificial heart—focusing on the fierce rivalry between two surgical titans, Dr. Michael DeBakey and Dr. Denton Cooley. Against a backdrop of medical innovation, personal ambition, ethical controversy, and betrayal, the episode explores how these maverick doctors and their teams transformed the landscape of heart surgery, setting the stage for life-saving advances and bitter professional fallout.

Key Discussion Points & Insights

The Donor Heart Dilemma and the Birth of the Artificial Heart (00:35–03:37)

• Problem Statement: There simply aren’t enough donor hearts to save the hundreds of thousands dying from heart failure annually.
• Historical Context: With transplantation limited by donor shortages, Michael DeBakey and Domingo Liotta envision a future where a mechanical heart could take over—a vision fueled by both ambition and desperation.
• Notable Quote:

  "Counting on heart transplantation to cure the woes associated with heart failure is like counting on the lottery to cure poverty."
  —Lynn Warner Stevenson, cited by the narrator (01:25)

Shocking Betrayal: The First Artificial Heart Operation (03:38–06:12)

• Surprise Announcement: While DeBakey prepares to update federal officials, news breaks that Cooley (DeBakey’s protégé) and Liotta have implanted an artificial heart in a human patient—using a design DeBakey claims is his.
• DeBakey’s Perspective:

  "They weren’t even clever enough to make it look different."
  —Michael DeBakey, via Chris Pine (04:35)

• Ethical and Legal Questions: Immediate concern arises about misuse of government funds and lack of regulatory approval, risking reputations and institutional funding.

Roots of Rivalry: DeBakey vs. Cooley (06:12–11:09)

• Rival Surgeons: The personal and professional split between DeBakey and Cooley, cast as “a father-son complex,” becomes a defining feud.

  “We began to have some conflict…Mike and I began a bit of a rivalry. This was a typical father-son complex.”
  —Dr. Denton Cooley, archival (06:36–07:13)

• Cooley’s Ambition: Cooley establishes the Texas Heart Institute, raising vast funds and assembling a surgical “assembly line” to serve more patients, often recruiting from DeBakey’s own team.

Contrasting Leadership and Lives (11:09–15:25)

• Cooley’s Approach: Efficient, affable, and family-oriented, Cooley impresses colleagues and patients alike.

  “There’s not a surgeon today that could do 14 tough cases in a day. Cooley could do it.”
  —Dr. Bud Fraser (10:32)

• DeBakey’s Persona: The “Texas Tornado,” DeBakey is relentless, politically astute, but often absent from family, constantly advancing both his surgical and national policy agendas.

  “He was a notoriously fast driver…Debakey was in a race against time.”
  —Jamie Napoli (12:21–12:39)

The Inventor: Domingo Liotta and the Dream of Mechanized Hearts (15:09–18:31)

• Liotta’s Role: The brilliant, single-minded Argentine surgeon whose early work catalyzes progress toward an artificial heart, only to be overshadowed.

  “He was kind of Frankenstein, what he was doing…everybody thought he was crazy, but he was really ahead of his time.”
  —Patrick Liotta (16:27–16:30)

• The LVAD: As the total artificial heart proves elusive, focus shifts to the left ventricular assist device (LVAD), a temporary pumping solution that represents a major stepping stone.

Triumphs and Heartbreak: Early LVAD Trials (21:51–28:46)

• First Attempts: The first two patients to receive DeBakey/Liotta’s LVAD die soon after implantation, despite intense media attention and public scrutiny.

  "Dr. Debakey, the object of your heart booster implant was to prolong the patient's life...Why do you say that the operation was a success?"
  "The operation was a success on the basis of the fact that the pump did the job we wanted it to do. The patient's death was due to causes beyond our control."
  —DeBakey, Interview (25:38–26:04)

• Success at Last: Esperanza Del Valle Vazquez survives—marking the first successful LVAD implant. Yet Liotta remains unrecognized in public accounts.

The Ultimate Rift: Cooley, Liotta, and the Secret Artificial Heart Experiment (31:01–36:12)

• Liotta’s Frustration: Shut out by DeBakey, Liotta secretly begins a new partnership with Cooley, quietly moving forward on a total artificial heart.

  "The time had come to really give it a test. And the only real test would be to apply it to a dying patient."
  —Denton Cooley (31:38–31:48)

• Test Subject: Haskell Karp, terminally ill and out of options, consents to the radically experimental procedure.

  "It takes a strong person to try to help themselves."
  —Shirley Karp, Haskell’s wife (36:45)

The First Human Implantation of a Total Artificial Heart (37:12–44:16)

• Groundbreaking Surgery: On April 4, 1969, under intense pressure and with the world watching, Cooley and Liotta remove Karp's failing heart and implant the mechanical device. Karp survives long enough to receive a donor transplant, but ultimately dies from complications.

  “All of a sudden, into the room came a big device…here came in something new, and out came the heart.”
  —Dr. Kenneth Maddox, surgeon (38:42)

• Media Blitz: Cooley and Liotta become instant celebrities, while DeBakey is blindsided and enraged by the unauthorized use of his team’s research.

Fallout: Professional and Legal Consequences (44:16–54:46)

• Institutional Backlash: Cooley is censured by medical authorities for violating government research guidelines and resigns from Baylor.
• Personal Vendetta: DeBakey launches what Cooley calls a “personal attack,” and the feud polarizes the Houston surgical community.

  "It was a personal attack. It was an all out war…They both were playing a little bit dirty pool."
  —Dr. Don Wukash (49:00–49:07)

• Lawsuit: Shirley Karp sues Cooley and Liotta for lack of informed consent, with DeBakey called as a potential key witness. In a surprising turn, DeBakey refuses to testify against Cooley, effectively ending the case in Cooley’s favor.

Legacy and Aftermath (54:46–57:19)

• Enduring Impact: The dream of a true total artificial heart remains out of reach, but LVADs are now saving thousands of lives.

  “Today, the dream of a fully implanted, permanent, total artificial heart remains just beyond the horizon. The lvad, on the other hand, has become a common life saving measure for patients suffering from heart failure.”
  —Jamie Napoli (55:32)

• A Bitter Feud: Though only a few blocks apart, DeBakey and Cooley don’t speak for nearly 40 years, their split infamous in medical history.

Notable Quotes & Memorable Moments

• "Counting on heart transplantation to cure the woes associated with heart failure is like counting on the lottery to cure poverty."
  —Lynn Warner Stevenson (01:25)

• "They weren’t even clever enough to make it look different."
  —Michael DeBakey (via Life magazine, 04:35)

• “There’s not a surgeon today that could do 14 tough cases in a day. Cooley could do it.”
  —Dr. Bud Fraser (10:32)

• "He was kind of Frankenstein, what he was doing…everybody thought he was crazy, but he was really ahead of his time."
  —Patrick Liotta (16:27)

• "Well, in those days, I didn't feel like we needed permission...if I had sought permission...I probably would have been denied and we'd have lost a golden opportunity."
  —Denton Cooley, on taking the risk (35:56–36:12)

• "It was a personal attack. It was an all out war."
  —Dr. Don Wukash (49:00)

• "I believe that we as surgeons have an implied contract with our patients...if it means taking a risk with his reputation, I think that he would be neglectful of his duty if he withdrew from that risk."
  —Denton Cooley (52:55)

Structured Timeline of Key Segments

| Timestamp | Section/Event | |---------------|------------------| | 00:35–03:37 | Laying out the heart failure crisis and early artificial heart ambitions | | 03:38–06:12 | Cooley’s surprise announcement and DeBakey’s reaction | | 06:12–11:09 | Rivalry origins, founding of Texas Heart Institute, contrasting working styles | | 15:09–18:31 | Domingo Liotta’s backstory and early artificial heart prototyping | | 21:51–28:46 | Early LVAD implants, deaths, and first survivor | | 31:01–36:12 | Liotta’s partnership with Cooley and secret development of the total artificial heart | | 37:12–44:16 | The first artificial heart implantation in Haskell Karp | | 44:16–54:46 | Institutional censures, lawsuit, and DeBakey’s surprising restraint | | 54:46–57:19 | Aftermath, the rise of LVADs, and the lingering DeBakey-Cooley feud |

Conclusion

This episode distills a defining moment in medical history: a technological, ethical, and personal drama that shaped the future of cardiac care. Through vivid storytelling, archival recordings, and candid interviews, it documents the innovation and human cost behind making a "man-made heart"—and the legendary feud that nearly tore it all apart.

Next Episode Preview:
The series continues with the tailspin of Walt Lillehei and possible reconciliation efforts in Houston.

Useful For:
Anyone interested in medical innovation, the personalities who drive progress (and conflict), and the tangled web of ethics, ambition, and technology behind some of the most profound life-saving devices of the modern era.