Michael E. DeBakey, MD: Introduction to the Molecular Surgeon Symposium

This is a very, I think, significant symposium that Chuck has put together and I think very timely. If one reviews the history of medicine and the history of science, one appreciates the importance of certain discoveries that sort of changes the course of events and has a tremendous impact upon society and the investigators in the field. One can look back and exemplify this by the discovery, for example, of the alphabet more than six or seven thousand years ago. I had occasion to be in Beirut at one time after they had found a sarcophagus in Byblos during the excavations. And there, on the sarcophagus, was the alphabet, which the Phoenicians had developed. First recorded evidence of an alphabet. Think of what that has done to society in general. What seems like a simple discovery, yet a profound one. Same is true, for example, of electricity.

In medical science one can also exemplify great discoveries that have had tremendous impact upon the progress and development of medicine, beginning, of course, with Vesalius in the 16th century. It's interesting to recall that there was no well-defined description of the human body before then even though there had been descriptions of various kinds. Galen, for example, described a number of aspects of anatomy but largely he used animals for his purpose, even though he observed certain anatomical findings in the gladiators that he treated. He knew, for example, that air was not in the arteries that actually red blood came out of the arteries when an arm was slashed by the gladiators. He also knew that blood was pumped out of the heart into the lungs. But he never put [it] together and of course it took William Harvey to do that sometime later. Even though several others had previously known something about the pulmonary circulation, like Servetus but Harvey's description of the circulation clearly established not only the concept but had a tremendous impact upon the subsequent events in terms of the physiology of the circulation and what was learned later in all aspects of it. And then too, this rather ordinary Dutchman who was fooling around with lenses discovered little animal-like things in water, van Leeuwenhoek, followed by the work of Koch and Pasteur in establishing bacteriology. A tremendous impact. And then, of course, the discovery of vaccination by Edward Jenner. You know the story there, I won't go into it. The discovery of anesthesia by Crawford Long. On one occasion Blalock had a meeting at Hopkins which I attended and he recalled the discovery of anesthesia by Crawford Long by saying that the first private application of anesthesia. As you recall, the first public evidence of anesthesia was done in Boston as known as so-called Etherdome. Well, coming to more recent periods, the discovery of x-ray by Roentgen in 1895. Think of what a tremendous change that has made in medicine and the impact it has had in the whole field of imaging that has subsequently occurred. Well, tissue culture, another good example, by Harrison, in terms of its impact upon medical science and then, of course, the discovery of antibiotics by Alexander Fleming. And then we come to the discovery of DNA and the work of [Wilkins and] Watson and Crick.

And that leads us to what we are talking about today, to some extent. This program is extremely important, I think, from a surgical as well as medical standpoint and I am delighted to see the way the program has been put together because it covers the field very nicely. The one thing that one must keep in mind in surgery is that surgery is in many ways the application of the principles of medicine in terms of physical use of various objects and various instruments and utensils for the purpose of restoring nature's work and nature's function. And that's why it's so important to understand how this may apply in surgery. And I'm sure that all of you will benefit from what's going to take place today. Another, I think, great development and another great impact in medicine. Thank you very much.

James C. Thompson, MD: Introduction to the Molecular Surgeon Symposium

I'm happy to be here. Actually, after three CABGs, a bilateral subdural, and a broken hip and five weeks in the surgical ICU, I'm happy to be anywhere. Certain things do accrue if you don't die. Actually that's the first rule for winning the Nobel prize. One of the great things that has happened to me is getting to know Mike DeBakey. I first learned about DeBakey when I was a third year medical student in Galveston. These rumors of these cataclysmic events that were occurring, this volcanic personality of "Black Mike" filtered down to the island and I listen to these stories in awe. I've met Dr. DeBakey now on about 50 occasions and each single time that awe has been reinforced. I'd like you just to reflect on what he just did. How many of you have had deans come at site visits to give some little blurb about what you're doing? How many of them, first of all, use good syntax? That cuts about half of them out. How many of them have spent ten minutes - five minutes - in preparing what they were going to say? We have had a brief discussion of the history of medicine and most of the major actors in that drama.

One time I went to the American Surgical at Boca Raton, on a now defunct airline, National Airlines, and I happened to be at the ticket counter when Dr. DeBakey walked up and we learned that the flight was go to be a couple of hours late. So he gathered Truman Blocker and me and we went up into one of those secret rooms where they took care of important people. When we got to Boca Raton, he had this big limousine and Truman and I got into it with him and Dr. DeBakey started dictating a letter to Richard Nixon. Great guns.

Shifting forward about 20 years later to another meeting of the American Surgical, I found myself in West Palm Beach and I needed to go the next day to Munich to give a talk and I got to the airport in Palm Beach and there's Dr. DeBakey and I say "Hello" and he says "Hello". We get off the plane at Dulles and I see that he and I are both in the international lounge and I allow as how I'm going to Munich and he says he's going - I don't know, Beirut maybe - but he's going on the same plane. And I said "God, I hope, I just hope I can hold together because I have to give a talk at seven o'clock tomorrow morning and jet lag just knocks me out." Dr. DeBakey says "Jim, you still get jet lag?" I though about that and I said "Yes, yes sir I do." He says "You haven't read my article." And I said "Where is it?" And he said "It's in the PanAmerican magazine." That's how long ago it was. PanAmerican had an airline and they had a magazine. And he said "I'll send you a reprint." I said, "Well okay, but right now I need to know the gist of it because I..." And he says "Well..." He was carrying on a little paper sack and he says there are several rules: "One of them is don't drink alcohol and don't drink anything that has caffeine or xanthenes." I'm never sure what xanthenes are, but don't do that. I said okay and then he said "And don't eat any airline food, because it's poisonous" and I said "Well yes, sir, that's probably right." And I said "Well, what do you eat?" And he says "You eat granola and bananas" And I said "I didn't bring..." and he reached in his sack and he handed me a banana and a granola bar. And then he said "The next thing is to be sure you go to sleep the same time the folks you're visiting go to sleep. I was writing this down, and I said "Okay". He said "You have a sleeping pill?" And I said "Yes, sir" and he said "Well, take it". So, lo and behold, we get on this great big plane and we take off and I go back and go to sleep and at the end of the movie everybody gets up, of course, and goes to the bathroom and I get up and am standing impatiently in line, and the stewardess says "Just go up there in first-class". So I went up there in first class. She had previously told us that the plane was sold out. I get up there and after I go to the bathroom, I come out, and there in first-class is Dr. DeBakey and he's asleep in two first-class seats. I said to the stewardess "I thought you said this plane was sold out?" She says, "Oh, it is. Dr. DeBakey always has two first-class seats." So then I knew the real secret.

I think the catholicity of Dr. DeBakey's interest, which we have seen a brief example of today, is absolutely astounding. He's written definitively on the pathophysiology and construct of gastric bezoars, sub-phrenic abscesses, the shearing forces of various kinds of blood pumps, the management of perforated duodenal ulcer, and he has opened the heart and great vessels for surgical repair. He has been for 40 years instrumental in public health policy in this country and has been advisers to every president probably since Andrew Jackson. He was personally responsible for the development of the NIH heart-cancer-stroke program that focused our health policy in America for about 20 years.

Today we are going to be participants in a banquet of molecular biologic observations devoted to this truly great man, put together by the holder of his chair, Chuck Brunicardi, in the department named for Dr. DeBakey. My own involvement in this field came about as sort of an epiphany one day when I had received a notice of approval of an NIH grant those (are always halcyon times) and I realized that this was probably the last grant that the NIH was ever going to give that was devoted to gross physiology. From that time on we were going to have to be involved in studying cellular mechanics and in signal transduction. I tried to learn how to go about doing this and with Courtney Townsend, we put together a redirection of our program to look into aspects of molecular biology. I'm inordinately proud that Dan Beauchamp and Mark Evers, two speakers today, were the earliest participants in that program of redirection. Tien Ko, another speaker, is a further example of the splendid talent with which we have been blessed. Their achievements are their own, but risking the charge of hubris, I'm endlessly proud of those accomplishments. I'm greatly proud to be here today with Dr. DeBakey and Dr. Brunicardi and their colleagues. We look forward to the great privilege of learning from the sparkling erudition of the speakers to come. Thank you.