These physicians include Cooley and his rival, Michael DeBakey, whose design Cooley supposedly stole. That artificial heart was an unwieldy honeydew melon-size piece of plastic that pumped blood using compressed air. Cooley’s protégé, Bud Frazier, continued the work of refining artificial hearts, eventually championing a design in which the device doesn’t pump so much as continually whir. A patient with such a device would have no pulse, but would nevertheless be alive.
If you come to “Ticker” expecting a story about the triumph of man over nature, though, you will be disappointed. The Food and Drug Administration has yet to approve a permanent artificial heart. Government funding agencies have become more interested in preventing heart disease than replacing diseased hearts with machines. St. Luke’s hospital and its affiliated Texas Heart Institute, where Cooley and Frazier did so much of their artificial heart research, have also lost their luster in recent years. A recent Houston Chronicle and ProPublica report (too recent for Swartz to address in her book) focused on Frazier’s role at St. Luke’s, accusing him of a tendency to put research before his patients’ interests. A former colleague even recalled “hiding patients” from Frazier.
Even without these newest revelations, Swartz does observe how the world has changed for her band of daring heart surgeons. Debacles like the Dalkon Shield brought F.D.A. scrutiny. Famous cases like Cooley’s rogue artificial heart implantation and Baby Fae (an infant who got a baboon heart) made the public wonder about doctors experimenting on patients for their own glory. Swartz mentions all this, but her narrow focus hampers any real exploration of the ethical limits of innovation. In casting Cooley, Frazier and other artificial heart evangelists as her protagonists, she has readers follow them beating long odds and proving naysayers wrong. They emerge as heroes, if slightly flawed ones.
The most riveting chapter in “Ticker” leaves Texas for Utah, the site of the first successful artificial heart in 1982 — “successful” being a relative word. The patient, Barney Clark, lived 112 days, during which time he suffered seizures, brain damage, renal failure, pneumonia, gout, swollen testicles and ulcer. At one point, he asked to be allowed to die.
Clark’s story momentarily flips the perspective from the doctor to the patient. Other patients come and go in “Ticker,” and I found myself wishing to know more about how they felt about their experimental surgeries. (The widow of the man who received Cooley’s stolen artificial heart, for example, later filed a medical malpractice suit — a fact Swartz glosses over in a paragraph.)