That interest continued for decades. The two stayed in touch during Willerson's internship and residency, and Cooley eventually asked Willerson in 1989 to lead cardiology research at the Texas Heart Institute, Houston. And a little more than 50 years after their initial conversation in San Antonio, the two men had another memorable conversation when Cooley asked Willerson to succeed him in heading the institute.
“I don't think he had a peer in the world as a technical cardiovascular surgeon and making very wise decisions about what he did and how he did it,” says Willerson, now president and medical director of the Texas Heart Institute.
Dr. Joseph Caselli, chief of adult cardiac surgery at the institute, echoes Willerson's comments about both the professional and personal sides of Cooley. A Houston native, Caselli met Cooley when Caselli participated in a summer program at the institute during college, stocking shelves and working with the “pump team” in the cardiovascular operating room. He had planned on attending law school, but, after meeting Cooley, Caselli says he was “hooked by him and the work,” so he chose a career in cardiovascular surgery instead.
“His polished demeanor was ubiquitously present: in the OR, out of the OR, under pressure,” Caselli says. “He was calm, cool, collected, focused. You knew that when you were working with him, you were working with somebody who was a genius.”
Back then, in the early 1970s, it was not unusual for Cooley's team to perform 25 to 30 cardiovascular surgeries a day, according to Caselli, who says four to five procedures in a day for other teams would be considered impressive.
“This volume was of historic proportions,” he says of the team of associates and trainees that Cooley led. And as their leader, Cooley was what Caselli described as a “surgical athlete,” moving swiftly from room to room on several cases.
“To watch him operate was like watching a conductor of a symphony: smooth, no wasted motion, everything was purposeful,” Caselli says.
Reflecting on Cooley's many gifts, Caselli says it's the combination of skills as a surgeon in the operating room that he'd most like to emulate in his own career.
“The single most important aspect of the overall spectrum of taking care of patients is the precision and technical demands of conducting what you hope would be a perfect operation for that individual,” Caselli says. “If you're a surgeon, you want that for your patient. You always felt that's what Dr. Cooley embodied: the perfect technical procedure.”
By this time, the competitive Cooley knew the measure of his own talent and the far-reaching effects of his contributions to the medical profession. One story in particular captures this: In 1975, Cooley presented his notable credentials to a jury when the Houston surgeon served as a defendant in a Texas medical case. After he finished, an attorney asked Cooley if he considered himself to be the best heart surgeon in the world. Cooley answered yes, causing the attorney to ask him if he thought his assertion was immodest.
“Perhaps,” Cooley replied. “But remember, I'm under oath.”
Much like the smooth, clean, swift techniques he was known for in the operating room, the answer he gave in that Texas courtroom said—in very few words—what most people would find hard to dispute: that Cooley was one of the best heart surgeons in the world.
And to hear Cooley tell the story with a little laugh 38 years later, it didn't sound like boasting, but rather like truth-telling, Texas style: blunt and to the point.
Born in Houston in August 1922, Cooley later played varsity basketball and graduated with honors from the University of Texas at Austin in 1941 with a degree in zoology. He credits his experience playing basketball for helping him learn not only endurance, but how to behave on both a winning and losing team.
He went on to the University of Texas Medical Branch in Galveston for a year before transferring to the Johns Hopkins School of Medicine in Baltimore and graduating in 1944.
That was the same year Cooley was part of the Hopkins cardiovascular team—under the direction of Drs. Helen Taussig and Alfred Blalock—that performed the famous “Blue Baby” operation, which Cooley considers the dawn of modern heart surgery. The procedure is for babies who are cyanotic, or blue, because of a heart defect that prevents blood from being fully oxygenated.
Cooley continued his residency at Hopkins, and took a leave of absence from 1946 to 1948 to serve in Linz, Austria, as a captain and chief of surgical service in the Army Medical Corps. After completing his residency, he spent a year as a senior surgical registrar in thoracic surgery at the Brompton Hospital for Chest Diseases in London.
Dena Houchin, administrative director for cardiovascular surgery at the Texas Heart Institute who has worked with Cooley since 1974, likens that position to the role of chief resident in a U.S. facility. While in London, Cooley worked under the late Dr. Russell Brock, whom he considered a mentor. He also named heart surgery pioneers Drs. Dwight Harken and Charles Bailey as his other role models in the field.