Cooley in Bankruptcy : Heart King on the Road to Recovery

In the chill of the operating room, the King of Hearts leaned over the open chest cavity, working his magic. He was fast, a surgical sprinter, clamping and stitching the heart in a double bypass operation.

In less time than it would take to darn a sock, Denton A. Cooley was finished. He zapped the aorta with an electric shock and the thin line on the vital signs screen jumped into action.

“That was an easy one,” he said. “Now on to something a bit more challenging. This next one is going to be tough, and the one after it is going to be really tough.”

Patients Lined Up

Cooley peeled off his bloody surgical gloves and green paper gown and left them in a pile on the floor. Others would take care of closing up the chest. There was more work to do in the adjoining operating rooms--the patients were lined up and ready.

These antiseptic rooms are the center of Cooley’s private kingdom, the focal point of his life and the source of his fame. True enough, there are other signs of his success--the pillared mansion, the charity benefits, the opera and the society pages that are very much a part of Cooley’s world. But they are secondary to his Texas Heart Institute, where, in the course of his celebrated and controversial career, Cooley has performed 75,000 or so open heart surgeries, far more than any other man in history.

Denton Cooley is one of Houston’s elite. Until recently, and with the tragic exception of one daughter’s suicide in 1985, his life has been the good life, a storied existence.

In the world of medicine, few can claim to have worked harder or longer than Cooley in one of that field’s most demanding specialties. He was the first to implant an artificial heart and the first American to perform a heart transplant operation.

Enjoyed Making Money

He has also enjoyed making money. An article in a 1980 edition of Forbes magazine painted a glowing portrait of this surgeon-businessman whose net worth then was estimated at around $40 million and growing.

So it was deeply embarrassing to Cooley when the headline in a local paper last January read: “Pioneer heart surgeon files for Chapter 11.” Denton Cooley was bankrupt. Now, at the age of 67, when his thoughts should be turning toward retirement and a changing of the guard at the institute, Cooley must try to pay off millions in debts and at the same time protect his still-considerable income from creditors.

“I just got caught,” said Cooley, referring to Houston’s, and consequently his own, economic doldrums.

But humbled he is not.

“Smarter people than I have had to declare Chapter 11 or Chapter 7,” he said as he sat in his cluttered office at the heart institute. “Why should I feel disgraced because I, an amateur investor, have met with reverses?

“The important thing from my standpoint is that I still have my professional reputation, and, I believe, the respect of my colleagues,” he said. “I intend to carry on with my work as always.”

In fact, Cooley’s financial problems have done little to change his medical life, and he still maintains a schedule so precise that other doctors can set their watches by it. The money problems are simply an irritant--though a major and glaringly public one--when compared with his work.

Cooley drives here to the institute before sunup and leaves after darkness has fallen. When his children wanted to see him as they were growing up, they either stayed up late or got up earl2033066056in more than 30 years, on the theory that it is a waste of his time.

Doctors and patients alike hang on to Cooley’s every word, occasionally to the point of being perhaps too deferential. Yet he rules this place quietly, with a cool smile, cooler eyes and soft voice, for that is all that is needed.

Dubbed ‘Dr. Wonderful’

In the heady days of the late 1960s, when he was doing his first transplants, he was one of the most famous doctors on the planet, gracing the pages of Life magazine and being dubbed “Dr. Wonderful.”

“Cooley is an interesting phenomenon if you really think about it,” said Dr. O. Howard (Bud) Frazier, the director of cardiac transplants at the institute and a well-known heart surgeon in his own right. “What he did, more than anyone else, was make heart surgery safe.”

With that sort of reputation, it was not out of character for him to regard bankruptcy as a sin that only others committed. For a time, Cooley’s financial manager, Gerald Maley, was afraid to mention the word to him even as it was becoming inevitable.

“I had a lot of disdain for people who declared bankruptcy,” Cooley said. “It seemed like something dishonest was involved--admitting defeat and even wrongdoing.”

When Cooley did file, in early January, he owed almost $100 million. And while he listed assets roughly equivalent to that, half of the total was in Houston real estate, which is selling these days for a pittance of what it originally cost to develop. Cooley found himself paying about $9 million a year in interest alone, while his creditors would not take the land and buildings in lieu of the debt.

“We did not want to sell them at fire sale prices,” Maley said. “We did not want to sell with a very short fuse.”

Changes Business Thinking

Somehow, there is something wrong with the picture of Cooley investing his money in high-risk ventures. For years he had been bold in the operating room but a rock-ribbed conservative in financial matters. When Forbes interviewed him in 1980, he had advised following trends, not being a trend-setter. His style was to buy raw land at the city’s edge, then sell it for a profit when urban sprawl finally arrived at his acreage.

But then, as if his business philosophy had changed to that of the risk taker, he borrowed and spent millions on office buildings and apartment complexes in Houston during the oil boom years. This city is filled with hell-for-leather boomers, and for a while they could do no wrong. Until the rug was pulled out from under Houston and the rest of the oil patch economy, the sorriest of deals could turn a profit. One highflier who profited during those years was Costa Kaldis, Cooley’s son-in-law, now a Los Angeles real estate broker.

Cooley backed some of the riskier projects Kaldis brought to him, sometimes dismissing the misgivings of his own financial advisers. Kaldis is family and Cooley is very much a family man. He did, after all, buy mansions in the neighborhood for his daughters so they would be close by.

And when the deals started to go bad, it was Kaldis who went under first--from chauffeured investor to Chapter 7 bankrupt--two years ago. He moved to Los Angeles last year to start over. His wife, Louise, one of Cooley’s five daughters, carried on in Houston with her ophthalmology practice until last February, when she joined him in California. Kaldis admits that some of his own mistakes were whoppers, but he draws the line at sharing the burden of Cooley’s bankruptcy.

‘People Make Choices’

“I can’t take responsibility for his actions. All I can do is take responsibility for my actions,” he said. “People make choices. They can say yes and they can say no.”

But Louise candidly tells of the tension that built between the two men in the wake of such staggering losses and of the difficulties involved when the deal maker is kin and the deals are going bad.

“It’s a lot easier to be angry at someone who isn’t your son-in-law,” she said.

The plan Cooley has submitted to the court calls for the repayment of his debts over a five-year period. And he will keep his $1-million home and 489-acre Cool Acres ranch and probably his Galveston beach houses. If he wins in court, his income of some $9 million a year will be out of the grasp of creditors. There will still be meat on the table and good rubber on the Rolls-Royces.

Funny thing, though. Cooley said people think of him now as more of a real person, as if, by this failure, the great doctor is really only slightly larger than life.

“I think that happened,” Cooley said. “Here I was, perceived as not only a great surgeon, but also a financial genius, a huge success, an athlete, someone who does everything well. Now they can bring it into clearer perspective.

“I get the feeling they are warmer toward me,” he said. “People who maintained their distance before feel that I’m more human.”

Life has not snubbed Denton Cooley, either by birth or bodily design. His grandfather, a prominent Houstonian, was the developer of one of the city’s first planned neighborhoods. His father was a respected Houston dentist. Young Cooley was a 6-foot 4-inch basketball star in high school who went on to become a starter for the University of Texas Longhorns.

He had one other thing going for him as well--long, delicate fingers on hands so dexterous he used to tie surgical knots inside penny match boxes when he was in medical school. Cooley went off to Johns Hopkins University to study medicine, then did a stint in London, specializing in the heart in both places.

His first brush with medical history came in 1944, when he was a 24-year-old intern at Johns Hopkins. There, he administered fluids while Dr. Alfred Blalock of the medical school performed the first “blue baby” operation, which corrected a congenital heart defect.

Then, in 1951, Cooley returned to Houston. That in itself was unusual for a fast track young surgeon. Houston’s now vast medical center was not nearly so large then. And the Baylor University School of Medicine, which hired Cooley to practice and teach, was not of the first rank.

Teamed With DeBakey

But Baylor did have one major asset, a doctor named Michael E. DeBakey who was already making a name for himself in vascular surgery. Over time, the two great surgeons would both make medical history. But for years, the roles were of DeBakey the master and Cooley the apprentice.

And then the day came when DeBakey shook with rage at the upstart Cooley, who dared to implant an artificial heart without government approval, not to mention DeBakey’s. Further, it was an artificial heart similar to the one DeBakey had been working on for years.

The patient, Haskell Karp of Skokie, Ill., was kept alive for 65 hours while a donor heart was sought. Karp lived another 36 hours after the donor heart was implanted before dying of an infection. Cooley was famous; DeBakey was livid. The two men stopped speaking to each other, and the rivalry between the two giant egos turned bitter.

“He felt as though I had more or less defied him,” Cooley said. DeBakey’s view was that Cooley had stolen. Though they still work just across the street from each other, the two men have not exchanged words in some 20 years. Cooley said he once tried to call DeBakey and bury the hatchet, but his former mentor never telephoned back.

“I’ve never talked to him,” Cooley said. “I finally gave up on any reconciliation, and it is no longer of any importance to me.”

DeBakey did not respond to numerous calls regarding his relationship with Cooley.

With the break in his relationship with DeBakey came the move to St. Luke’s Hospital, where Cooley founded the heart institute.

Cooley doffed his surgical gear and sat down to lunch in his office at a spot where a place setting had been carved out of the mound of papers and books on his table. The meal is always the same--soup and frozen yogurt. This has been the daily ritual, year after year, for a man who had recently co-authored a cookbook that emphasizes healthy eating. Cooley shrugged off the apparent contradiction and dipped his spoon in the soup.

The room itself is a display of the most recent gifts that patients had sent to Cooley--Persian rugs and a sandalwood box, Japanese liquor and a carved Thai elephant, a peacock made of tiny pieces of mirror. There are surgical volumes and less weighty books like Vice President George Bush’s “Looking Forward.”

Cooley was being reflective on various subjects, from money to heart surgery to his family. He really did believe, he said, that the investments that did him in were good ones. It was all part of a game, really. You make a lot of money and you invest it.

And, no, he wouldn’t take back implanting the artificial heart, even though none of his patients survived their operations.

“It was a well thought-out move on my part, and I have no regrets,” Cooley said. “It stimulated a lot of activity in our center and contributed greatly to the knowledge of more advanced techniques.”

Pioneer in New Field

And, he said, it had been fun, being on the edge of a new field, feasting, as he put it, on each new breakthrough. He and DeBakey and others had built up almost a cult following, and that had allowed him to build his institute into what it was. The trick now was to make sure it survived.

Open heart surgery is not needed so often anymore; other new techniques can be used to clean out blocked arteries. The institute is doing fewer surgeries each year, Cooley said, partly because of the new methods and also because there are more heart surgeons. No longer do patients have to come to Houston for open heart surgery.

Cooley also talked about the family, about how his wife had shouldered much of the burden of raising their daughters. Louise had gone on to become a doctor and Susan a nurse. Mary and Helen were married to doctors. He spoke directly, if painfully, about Florence, the daughter who died of a self-inflicted gunshot wound in 1985 at the age of 28.

“I think she was like so many young people. For some reason she got depressed,” he said. “She was bright, an achiever. It was a great tragedy for my wife and me, but it’s something we have to live with.”

It was time to get back to work. Cooley donned his gear again and headed for the operating rooms. By the end of the day, he had performed five open heart surgeries and one to unclog a vein in the neck--a real light day, he said.

In late afternoon came another part of his ritual. Cooley breezed through post-op, checking on the day’s patients. On this day, all were doing well, news he brought to nervous relatives. He called each of their names and then huddled with them, talking gently about what he had done, what they could expect.

Making the Rounds

Then, finally, there was the last order of business--making the rounds of patients who would be operated on in the morning. His surgical team went with him and, again, it was Cooley of the gentle voice, allaying fears. One of the last people he saw was a woman who h1633951842transfusions. It makes for a more difficult operation, but Cooley does them regularly.

“Well, I guess we’d better get this thing fixed for you tomorrow,” Cooley said.

“I appreciate that,” the woman replied. “I’ve waited so long.”

As he was leaving, Cooley stopped by to look in on a small boy whose heart he had repaired the day before. He was doing well.

“Sometimes you operate on Big Ben,” he said. “And sometimes you operate on a pocket watch.”