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The American Medical Association, which gave DeBakey its Distinguished Service Award in 1959, now finds itself in violent disagreement with almost everything he says. The report of the commission he headed (TIME, Dec. 18), recommending the establishment of intensive-care centers for heart disease, strokes and cancer, and community centers for diagnosis and emergency care, has jolted organized medicine to the soles of its surgical boots.
The report asserts that there is a wide gap between the quality of care available at major medical centers and that available in the smaller cities and rural areas; that there is a lethal lag between the development of new lifesaving techniques and their adoption by physicians in general. The A.M.A. denies the existence of such a gap or such a lag and plans to fight the proposals, which it sees as a plot to reorganize U.S. medicine under federal control. The DeBakey commission has on its side the President and such powerful congressional allies as Senator Lister Hill.
Even DeBakey's enthusiasm for an "artificial heart" and his confidence that it can be built stir debate among conservative colleagues. Critics scoff about science-fictioneering. But DeBakey is in good company: the Cleveland Clinic's Dr. Willem J. Kolff, who invented the artificial kidney, is one of the handful of other eminent researchers working on an artificial heart. DeBakey says emphatically that he believes it will ultimately be possible to replace an entire human heart with a self-powered and virtually indestructible plastic pump. But he adds with equal emphasis that the best surgeons are still far from ready to start replacing hearts.
Assistant Ventricles. What the medi cal and physical sciences can do today, says DeBakey, is to produce a replacement for part of the heart—its main pumping chamber, the left ventricle—and use it temporarily to support the failing natural heart, which thus can rest and regain its power. Five years after DeBakey put together a research team that now includes Dr. C. William Hall and Dr. Domingo Liotta, they not only produced a replacement for the left ventricle—or, more precisely, an assistant ventricle—but proved its practicality with actual tests in more than 100 laboratory dogs.
It was tried in a human for the first time on July 19, 1963. The man, a Negro, 42 years old, was almost dead from failing kidneys and a heart hopelessly damaged by a narrowed aortic valve. The assistant left ventricle implanted in him by DeBakey was about the size and shape of a banana. It looked like two Silastic sausage casings, one inside the other; it had a valve at each end of the inner sac and a 1-in. tubing leading from the outer balloon to an air pump. When it was installed, most of the patient's blood bypassed the natural left ventricle, leaving it free to take a rest. Pulsations of air in the outer sac supplied alternate suction and pressure to send blood coursing through the patient's body.
The doomed man improved markedly and lived almost four days on his artificial half-heart (TIME, Nov. 8, 1963). After that, it was no failure of the device that ended his life; it was old and irreversible damage to his liver, lungs and kidneys.