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Cardiac Cowboys: The Heroic Invention of Heart Surgery
Cardiac Cowboys is the dramatic story of five deeply flawed geniuses who together—and in competition with each other—invented open-heart surgery against all conventional medical wisdom and saved millions of lives.
A decade after World War II, there was still no such thing as open-heart surgery, and yet half a million Americans were dying from heart disease every year. One in a hundred children would suffer and die from congenital heart disease as well, and doctors did little other than predict their deaths. After the first daring operation in 1954 and through the next three decades, five heroic surgeons braved the scorn of their peers, withstood fierce desperation, and faced possible death in order to devise procedures that would save overwhelming numbers of those doomed children and provide hope for a new life to all manner of heart-failing individuals. Devising and mastering heart transplants and bypass surgery, they invented artificial heart valves, the lifesaving pacemaker, and worked toward the holy grail of an artificial heart as their private and professional lives imploded. The story of the Cardiac Cowboys, their outsized personalities, and often self-destructive behavior is a saga more thrilling and exhilarating than fiction.
A decade after World War II, there was still no such thing as open-heart surgery, and yet half a million Americans were dying from heart disease every year. One in a hundred children would suffer and die from congenital heart disease as well, and doctors did little other than predict their deaths. After the first daring operation in 1954 and through the next three decades, five heroic surgeons braved the scorn of their peers, withstood fierce desperation, and faced possible death in order to devise procedures that would save overwhelming numbers of those doomed children and provide hope for a new life to all manner of heart-failing individuals. Devising and mastering heart transplants and bypass surgery, they invented artificial heart valves, the lifesaving pacemaker, and worked toward the holy grail of an artificial heart as their private and professional lives imploded. The story of the Cardiac Cowboys, their outsized personalities, and often self-destructive behavior is a saga more thrilling and exhilarating than fiction.
- GenresNonfiction
304 pages, Hardcover
Published February 20, 2024
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Displaying 1 - 5 of 5 reviews
October 28, 2025
Borrowed Hearts and Stolen Time: The Audacious Birth of Cardiac Surgery
Gerald Imber's Cardiac Cowboys reads like a thriller, which is appropriate because the history of heart surgery is one of the most audacious gambles in medical history. This is the story of surgeons who opened chests and touched beating hearts when the very idea was considered impossible, blasphemous, or both. Imber, himself a surgeon, writes with the authority of someone who understands the technical challenges and the narrative flair of someone who knows he's chronicling genuine adventure.
The book's central figures—Lillehei, Gibbon, Cooley, DeBakey—emerge as complex characters rather than marble statues. These were driven, competitive, sometimes ruthless men racing against mortality itself. Imber doesn't shy away from their egos or their errors; the early attempts at open-heart surgery resulted in horrifying failure rates that would end careers today. What makes the book compelling is how Imber contextualizes this: every failure taught a lesson written in blood, every death narrowed the path toward success.
The technical details are handled skillfully. Imber explains hypothermia, cross-circulation, and the heart-lung machine without drowning readers in jargon. You understand why each innovation mattered, what problems it solved, and how it opened new possibilities. The description of Gibbon's decades-long obsession with creating an artificial heart is particularly gripping—a man betting his career on a machine everyone told him was impossible.
Where the book occasionally stumbles is in its structure. The narrative jumps between storylines and time periods, sometimes losing momentum as we switch from one surgical pioneer to another. Some readers may also find Imber's admiration for his subjects tips into hagiography; these men were undoubtedly brilliant and brave, but the book could have dug deeper into the ethical complexities of their experimental surgeries.
Still, Cardiac Cowboys succeeds brilliantly at its core mission: making you appreciate that every heart surgery performed today rests on a foundation built by people willing to try the impossible and accept the consequences. It's a reminder that medical progress isn't a smooth arc but a jagged line drawn by individuals who refused to accept that some problems couldn't be solved.
For anyone interested in medical history, surgical innovation, or the peculiar courage required to cut into what should kill you, this is essential reading. Just be prepared for some genuinely difficult moments—Imber doesn't sanitize the failures, and he shouldn't.
Gerald Imber's Cardiac Cowboys reads like a thriller, which is appropriate because the history of heart surgery is one of the most audacious gambles in medical history. This is the story of surgeons who opened chests and touched beating hearts when the very idea was considered impossible, blasphemous, or both. Imber, himself a surgeon, writes with the authority of someone who understands the technical challenges and the narrative flair of someone who knows he's chronicling genuine adventure.
The book's central figures—Lillehei, Gibbon, Cooley, DeBakey—emerge as complex characters rather than marble statues. These were driven, competitive, sometimes ruthless men racing against mortality itself. Imber doesn't shy away from their egos or their errors; the early attempts at open-heart surgery resulted in horrifying failure rates that would end careers today. What makes the book compelling is how Imber contextualizes this: every failure taught a lesson written in blood, every death narrowed the path toward success.
The technical details are handled skillfully. Imber explains hypothermia, cross-circulation, and the heart-lung machine without drowning readers in jargon. You understand why each innovation mattered, what problems it solved, and how it opened new possibilities. The description of Gibbon's decades-long obsession with creating an artificial heart is particularly gripping—a man betting his career on a machine everyone told him was impossible.
Where the book occasionally stumbles is in its structure. The narrative jumps between storylines and time periods, sometimes losing momentum as we switch from one surgical pioneer to another. Some readers may also find Imber's admiration for his subjects tips into hagiography; these men were undoubtedly brilliant and brave, but the book could have dug deeper into the ethical complexities of their experimental surgeries.
Still, Cardiac Cowboys succeeds brilliantly at its core mission: making you appreciate that every heart surgery performed today rests on a foundation built by people willing to try the impossible and accept the consequences. It's a reminder that medical progress isn't a smooth arc but a jagged line drawn by individuals who refused to accept that some problems couldn't be solved.
For anyone interested in medical history, surgical innovation, or the peculiar courage required to cut into what should kill you, this is essential reading. Just be prepared for some genuinely difficult moments—Imber doesn't sanitize the failures, and he shouldn't.
May 31, 2025
This review is for the audiobook version of this book.
This is a very accessible history of the development of heart surgery. As someone who was born with a congenital heart defect in 1966 and who required open-heart surgery while an infant, I am incredibly grateful for being born at a time when cardiac surgery was developed enough to allow me to benefit from its life-saving practice. As I listened to this account, I realized that only 10 or 15 years earlier, the results of open-heart surgery were not encouraging at all.
This book focuses on the individuals who were behind the development of cardiac surgery, highlighting the often dramatic moments in the history of cardiac medicine, as well as the often eccentric lives of these pioneers. This book also records the tragic cases of lives lost when new procedures were tried. The reality is that, as tragic as these losses were, these deaths did lead to improvements in cardiac treatments, paving the way for the tremendous benefits cardiac surgery has provided for countless patients in the past half century or so.
For those interested in the story of how heart surgery began and the men who shaped its practice, this book is well worth the time to read or listen.
This is a very accessible history of the development of heart surgery. As someone who was born with a congenital heart defect in 1966 and who required open-heart surgery while an infant, I am incredibly grateful for being born at a time when cardiac surgery was developed enough to allow me to benefit from its life-saving practice. As I listened to this account, I realized that only 10 or 15 years earlier, the results of open-heart surgery were not encouraging at all.
This book focuses on the individuals who were behind the development of cardiac surgery, highlighting the often dramatic moments in the history of cardiac medicine, as well as the often eccentric lives of these pioneers. This book also records the tragic cases of lives lost when new procedures were tried. The reality is that, as tragic as these losses were, these deaths did lead to improvements in cardiac treatments, paving the way for the tremendous benefits cardiac surgery has provided for countless patients in the past half century or so.
For those interested in the story of how heart surgery began and the men who shaped its practice, this book is well worth the time to read or listen.
February 17, 2025
Imber is a physician and when doctors turn to writing, they usually make a good job of it. Imber is no exception. Once upon a time, surgery on the heart was off limit. This is the story of the development of cardiac surgery by the early medical pioneers whose renegade work has saved so many lives. All the big names are here: Michael DeBakey, Denton Cooley, and Walter Lillehei. John Gibbon's heart/lung machine made all the difference for these great surgeons. We learn not only about their extraordinary accomplishments, but their frailties as well. Altogether, Imber gives us a fascinating insight into the development of this life-saving surgery.
February 12, 2026
I loved this book! Will def need to purchase for my own collection to reread!!
February 6, 2026
Fascinating true story of the pioneering doctors in cardiac surgery.
Displaying 1 - 5 of 5 reviews