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THE HOUSTON CHRONICLE
ATTENTION: NANCY BARNES, EDITOR, AND LISA FALKENBERG, VIEWPOINTS
This letter is in response to your May 24 article on Dr. Bud Frazier. I am Dr. Joe N. Kidd, a cardiovascular surgeon practicing in El Paso, Texas, for the past 40 years. I have known Dr. Frazier for over 50 years. We both attended Baylor Medical School, Baylor General Surgery residency under Dr. Michael DeBakey, and Texas Heart Institute for thoracic and cardiovascular surgery under Dr. Denton Cooley, and finished our training together in 1976. I began my cardiovascular practice in El Paso in 1976 and Dr. Frazier remained at Texas Heart to pursue his life-long dream of developing a total artificial heart.
I have never known a physician more dedicated, more conscientious, or more honest than Dr. Frazier. He has made a huge sacrifice in time that affected his family and his financial well-being. His main goal in life was to develop a total artificial heart and he has saved thousands of lives by doing so.
I would like to review the Houston Chronicle article and discuss the slanderous results you have come up with in your total hatchet- job of the finest, most honest, and most dedicated physician I know. Dr. Smart is not very smart. In your article you quote him as saying Dr. Frazier was inserting LVADs in patients that did not medically need them. In the next sentence Dr. Smart says Dr. Frazier’s mortality was too high. This makes no medical sense. The mortality rate would be very low if these patients didn’t need an assist device. All the patients Dr. Frazier performed surgery on were sent to him by cardiologists. The statement quoted by Dr. Smart that he had to hide patients from Dr. Frazier is absurd. Another statement the Chronicle printed quoting Dr. Smart that Dr. Frazier turned down heart donors for patients that already had working assist devices in order to show how well they were working is totally false. Can the Chronical prove what was written in this very slanderous report? Once the reputation of a great surgeon is ruined, the most precious thing he has will never be recovered.
The Chronicle report on Dr. Branislav Radovancevic is totally a hospital issue. The hospital should have removed him immediately if he didn’t have the correct credentials. Dr. Frazier was never censored or warned of any wrong-doing. These events occurred over 20 years ago and aren’t relevant at this time. The Chronicle’s attempt to make Dr. Frazier look as bad as it can in the public’s view is unfounded.
I offered a position in my practice in El Paso to Dr. Frazier in 1989 as a full partner. I have no idea how many other such opportunities he was offered and turned down. It would have been extremely
financially beneficial to him to go into private practice. He decided against joining my practice because he wanted to continue with his goal in life of developing a total artificial heart. He sacrificed a large financial gain, yet the Chronicle has falsely accused Dr. Frazier of being unethical in his financial dealings.
From the companies he was working with on the artificial heart and assist devices development, Dr. Frazier has not received one penny for his work and now over 50,000 LVAD devices are in use in patients all over the world. He was reimbursed for some of his travel expenses but not for all. Dr. Frazier has never been reprimanded by Medicare or Medicaid, FDA, or any other governmental agencies for the work he has done, yet the Chronicle is attacking the reputation of the most prolific heart transplant surgeon in the world, and the developer of the left ventricular assist device and artificial heart.
There is no way the Chronicle can ever repair the reputation of this great physician.
Joe N. Kidd, M. D.
I first met Dr. Frazier in 1987. My son Christopher was dying at Texas Children’s Hospital from heart disease. He had caught some mysterious virus in 1982 and had been ill several times with strep throat and pneumonia. Heart disease was finally diagnosed in 1985 and he was then followed by Texas Children’s Hospital. The pediatric heart transplant program was just beginning at TCH – they had clinicians but for the heart transplants TCH had an agreement with St. Luke’s for the surgeons. Christopher had maintained reasonable health until the spring of 1987 when he began to fail rapidly. He was admitted for an heart transplant evaluation in early May 1987 and within a week was in ICU. He was placed on a waiting list for a heart donor but there were no donors at that time. Around 7 AM on May 15 his heart stopped. The doctors at TCH did all they could but Christopher could not be revived. They told us that he had died and we were in the consolation room when we learned that Dr. Frazier has gotten Christopher going again. Dr. Frazier had rushed from another hospital’s surgery unit to try to save Christopher. We were told that his only chance was to be put on a left ventricular assist device. These devices at that time were very rudimentary. They were external units and were sized for adults, not a 9 year old boy. The doctors at TCH told us it would be a bad idea to pursue this avenue because they believed the chances of success were almost zero, but my wife and I thought that with the pump there might be some chance, however slim, so we asked the doctors to proceed. Christopher was placed on the LVAD and the next day a wonderful family somewhere decided to donate the heart of their child who had just died. The surgery was successful and Christopher became the first patient ever to survive by using an adult LVAD as bridge to transplant. Like many patients, he had bumps in the road but here we are, 31 years later, and still doing well because of this miracle and the dedication, determination, and skill of Dr. Bud Frazier.
We have gotten to know Dr. Frazier over these years and he is not only the best cardiac surgeon on the planet, but a warm and caring human being. He always spends time with the patients and the families, even staying at the hospital 24/7 when necessary. I know of no other doctor so dedicated. His sacrifices have come at the expense of spending much less time with his own family while caring for others. Unlike many other doctors who are primarily financially motivated, Dr. Frazier usually took a standard salary and was more concerned about patient’s health and doing the right thing that making money. He is personally responsible for saving many lives and adding many years of quality life to patients all around the world. He has traveled to many countries and shared the technology and devices to save other lives. The knowledge he has given other doctors has allowed them to share these life saving techniques with literally hundreds of thousands of people. The joy and happiness he has directly or indirectly brought these people and their families is immeasurable. Dr. Frazier is beyond the gold standard for excellence.
Grateful to heart surgeon
Regarding “Surgeon files defamation suit over news articles” (Page A3, Wednesday), count me among those who applaud Dr. Bud Frazier’s decision to sue the Chronicle. Your characterization of him is completely opposite to my experience. After Dr. Frazier operated on me in 2011, he was the first person I saw in the recovery room, and the fact that the attending nurses addressed him as “Buddy” and kidded him about his new glasses spoke volumes about how he regarded the staff and how they regarded him.
I was fortunate to have such an accomplished and dedicated man as my surgeon. Moreover, I never received a bill for his services.
Rather than being denigrated, Dr. Frazier should be honored for his life’s devotion to saving lives.
Ted Bruno, Houston
Dear Bud and Rachel,
The absurd point of view in this “investigation” is to find every misstep or controversy possible in the long and dedicated career of a man who saved thousands of lives and revolutionized the treatment of terminal heart disease, and then depict this as the story of that career. On each point the writer argues against his own logic, pointing out the patients who feel they owe Dr. Frazier their lives, that he was the main advocate for researching advanced heart devices that have saved 10s of thousands of lives the world over, and noting that Dr. Frazier indeed could have enriched himself but instead was only interested in treating his patients and advancing the science required to end their hopeless suffering. Dr. Frazier treated patients that came to him after being told to go home and die, nothing could be done. And yes, a number of them died. They all had a fatal disease. One he dedicated his life to alleviate.
Dr. Cooley, perhaps the greatest heart surgeon who ever lived, considered his founding the Texas Heart Institute, to research and advance the treatment of heart failure as his greatest achievement. But for Dr Bud Frazier, the advances in artificial heart devices which Dr. Cooley pioneered would have never become standard treatment for end-stage heart disease. It’s hard to imagine anyone with the determination to succeed in this quest, persisting for 50 years against huge odds, limited resources and road blocks from every conceivable direction. Yet, that is the legacy Dr. Frazier carried forward, full knowing and bearing the weight it brought and the price he would pay personally as well as professionally.
The author also points out that so much of this occurred against a backdrop of disruption from administrative turmoil, huge egos and politics. Yet Dr. Frazier persisted. As Dr. Willerson was known to often advise, Dr. Frazier ignored the politics and kept his focus on his patients and his research.
So, apparently the author thinks only the timid, meek and cautious physicians should be treating patients. They surely would never get in trouble or cause a fuss. Show me a physician researcher who never was called into question or sued for malpractice, and I’ll show you one who never advanced her field. In fact, it was these physicians who sent Dr. Frazier so many of his desperately ill patents. Second opinions are not surprising but second guessing like this is just cheap journalism.
Congratulations on your most recent lifetime achievement award Dr. Frazier. It’s sad that your achievements are smeared by this “investigation”. But it changes nothing you accomplished. The authors can pick any hospital or research facility that accomplished so much and they’ll discover that making cutting-edge work always brings controversy. But they won’t find another case where more lives have been saved by a single man, who once held the heart of a dying young man in his hand, and vowed to himself, we can, we must, do better than this.
Dr OH “Bud” Frazier: An American Legend
Recent articles published by ProPublica, a highly respected non profit newsroom that produces investigative journalism , detailed the failings of the Baylor St. Luke’s Medical Center heart transplant program that resulted in poor patient outcomes from the once top-rated program. This rightly focused on the individual patient and families that the Baylor St Luke’s heart transplant program failed in their advanced heart failure journeys.
Unfortunately, those heartbreaking stories of betrayal and disappointment by the patients and families are the result of a very complicated larger story.
In my opinion, the shocking story of the Baylor St Luke’s CHI transplant program is one of greed, careerism, corporate takeovers, appalling administrative oversight, failure of leadership, poor hiring practices, completely avoidable lawsuits, and the inevitable public distortions of their underlying mission, all of which have occurred as medicine has become perverted into “big business”.
In this era of corporate medicine patient care has been reduced to “patient volume” and “RVUs” (relative value units) . “Profit” is euphemistically called “margin” and the relentless focus on “margin” and patient volume , rather than on the individual patient and the development of patient centered programs has driven much of the poor decision-making that has resulted in the abysmal failures highlighted by the article.
Succession planning at St Luke’s has long been a problem; the question of how to replace surgeons with the stature of Drs Cooley and Frazier has been an open and lingering question. I personally brought candidates with national and international reputations to the hospital that would have been excellent choices to succeed these giants and to lead the Baylor St Luke’s program into a new era. They were not considered for reasons that remain a mystery. Dr “Bud” Frazier was not asked to participate as a member of the selection committee.
Moreover, there a dizzying and chaotic revolving door of chief administrators between 2008-2015; some temporary appointments, some permanent that did not last longer in the job than a blink of an eye. It was impossible in that environment to establish consistent leadership and build patient centered programs.
Make no mistake about it, the patients that present to a transplant program have very complicated health care problems and they are very sick. They are afflicted with a morbid and mortal disease that generally confers an inevitably downward spiral leading to a difficult and lingering death. Many of the patients have multiple diseases including malignancies, genetic diseases, pulmonary disease and renal failure that add to the complexity of their care. Transplant programs are the very last chance for these desperately ill patients. Transplant medicine is a team sport and good outcomes depend on a stable and well functioning team as well as well trained, competent and dedicated clinicians. The revolving door of clinician and staff departures and arrivals at the Baylor St Luke’s Medical Center during the years preceding the poor outcomes was completely unprecedented and made the goal of a stable and well- functioning team of trained, competent and dedicated clinicians impossible to achieve. The resulting poor outcomes in the heart transplant program in such a chaotic environment were inevitable.
Those of us that choose to work with, and dedicate our professional lives to this group of patients are familiar with death and defeat. To put it into perspective; heart failure is a disease that currently affects 5.7 million patients in the USA alone and we make a new diagnosis of heart failure in almost a million patients annually in this country alone. The mortality of this deadly disease still means that half of the newly diagnosed patients will die within 5 years. This is a condition that is just as fatal as advanced lung cancer. Those of us that have chosen this work accompany these patients on this medically and personally challenging journey, and we do what we can to cheat death, and to remain optimistic and hopeful even in the face of substantial loss.
“Bud” Frazier is the son of a schoolteacher and hails from a small town in Texas. He was a high school football hero and after his medical training he served as a combat surgeon in Viet Nam. He came back from his time in the military deeply moved and distressed about the wholesale death and destruction he witnessed as a young surgeon. He developed a deep love of history and philosophy and was never without a book stuffed in his pocket. I think this kept him sane.
I did not know Bud during his formative years as a surgeon when he worked with Dr Cooley, but I met him when he was clearly at the top of his game. I moved to Houston in the mid 2000’s and was trying to start an advanced heart failure program at the University of Texas. I did not have a surgeon on faculty that had an advanced heart failure skill set. He generously gave me his cell phone number and offered that I could contact him whenever I needed help. And, in fact, I did call him- many times. I called him when other surgeons had surgical complications that resulted in intractable cardiogenic shock. I called him when I had young patients with no options. I called him when a middle-aged ambulance driver ruined his heart with a late presentation of a huge heart attack. At that time Bud had a bad knee, but he, without hesitation, limped over- often in the middle of the night, reviewed the case with me, and never refused to help, or to accept the patient as a transfer to St Luke’s in an attempt to salvage the patient’s life. Bud has never ever walked away from the bedside of a patient who needed him. He has never given up hope. He hates death, and that may be a failing in some circumstances, but he simply does not stop trying.
Bud is a believer in the battle to triumph over this nasty, insidious disease. He was a pioneer of continuous flow circulatory therapy and his ground breaking work since the 1970’s in this area has led to the current therapy (the modern left ventricular assist devices) that have now been implanted in more that 24,386 (as of May 2018) patients in the USA alone. In the past no one thought continuous flow could work- after all, how on earth would a patient survive without a pulse ?, but he persisted to support this fledgling technology in his dogged fashion despite massive opposition and even occasional scorn from colleagues. His seminal work and seminal contribution to this field of medicine has saved tens of thousands of important lives and has provided hope, where there was little, to countless patients and families. Others have become very rich indeed as a result of this technology, Bud and his lovely wife Rachel, have not profited in this way. While other surgeons in the Medical Center drive Ferraris to work Bud drives a Volkswagen Beetle. His motivation is borne out of his selfless dedication to combating this terrible disease.
Bud is my kind of clinician and healer, all the way. He is kind, he is committed, he is scientifically and academically rigorous, he is egalitarian and he has a service heart. He doesn’t care if a patient is a pauper or a king. It is of no importance whatsoever to him. Never was. He is, at his core, a humble man that believed in finding solutions.
This man is a legend. He is responsible for saving lives of patients that have mattered very much irrespective of from whence they came or their station in life.
His career has spanned decades. I am at the age myself where I increasingly view perfection as the enemy of the good. Is Bud perfect? Probably not- if he were he might have foreseen the huge changes occurring in medicine around him, and within the very institution to which he dedicated his career. In all fairness, much of the mess that was described in the article was simply out of his control, as medicine has became a corporate endeavor, and our work as clinicians has became increasingly regulated and micro-managed by professionals that do not seem to grasp very much about what really goes on in patient care.
Bud Frazier has a legacy that should not be discounted. His legacy has encompassed the best of what medicine has been. His reach will extend into the future with the scientific and technological advances that he pioneered, and that should not be lost in the debacle at Baylor St Luke’s Hospital.
Deborah Meyers MD FRACP FACC
James T. Willerson, M.D.
June 7, 2018
Simply Put: I Believe in Dr. O.H. “Bud” Frazier
I have known Dr. O.H. “Bud” Frazier since 1963, meeting him in medical school and joining him professionally in 1989 at UT Medical School and the Texas Heart Institute. We have worked together to help patients with cardiovascular disease. I also consider him a close friend. I write this in support of Dr. Frazier,
It is illustrative, and certainly not hyperbolic, to point out that there are many facets to Dr. Frazier, and many ways that he has impacted medicine and people’s lives—as a great physician, a clinical scientist, a teacher of future surgeons and Sunday School children, a husband, a father, a friend. He has saved many lives, and given a better quality of life to countless numbers of people with cardiovascular disease. In this life, absolutely no one is perfect. But a few singular individuals have extraordinary gifts to share with us, and Dr. Frazier has been and continues to be one of those people.
Many who know Dr. Frazier well have described the principles that guide him and drive his pursuit to help others. As Dr. David Ott characterized him, Dr. Frazier has sought to be Theodore Roosevelt’s “The Man in the Arena”—a valiant, devoted “doer of deeds” who strives with the full knowledge that “there is no effort without error and shortcoming.” Contrary to what his recent critics may assert, there is no one who can claim he has not “[spent] himself in a worthy cause.” As Dr. Frazier has been inspired by Roosevelt, we draw inspiration from Dr. Frazier and his tireless commitment to helping people with cardiovascular disease.
I have some questions that I would like others to answer, especially those who have recently thrown stones at Dr. Frazier.
- Who among you has saved a human life?
- Who among you has ever held a human heart in your hands?
- Who among you has corrected a major heart defect in someone who is very seriously ill?
- Who among you will have a legacy of heroic efforts and full commitment—day and night—to help others and forever affect the lives of children and adults with cardiovascular disease?
Dr. Frazier’s contributions to human health will live forever and influence the care of thousands of patients worldwide. He has lived a life recommended by P.T. Barnum, “Whatever you do, do it with all your might. Work at it, early and late, in season and out of season, not leaving a stone unturned, and never deferring for a single hour that which can be done just as well now.”
Thank God for Dr. Frazier’s life and selfless commitment to others. I hope there will be others in the future who have his ability, passion, determination, and leadership in helping people. These will be very big boots to fill.
James T. Willerson, M.D.
Letters to the Editor – Houston Chronicle
Even though I’ve worked at a sister institution to St. Luke’s for the past 40 years (Houston Methodist Hospital) I have nothing but respect for the work done at St. Luke’s and the Texas Heart Institute by Dr. Bud Frazier. In my judgment there is not a more accomplished, caring and conscientious physician in the Texas Medical Center.
About 30 years ago, Dr. Denton Cooley did a coronary bypass on my mother-in-law (Nancy Pitzer) whom I dearly loved. Nancy was 5’2” tall and weighed about 80 pounds. After the surgery Dr. Cooley told us it was fortunate that he had done lots of pediatric hearts as Nancy’s heart was small and the vessels he had to suture were tiny. Nancy had a very rocky post op course and went into arrhythmias several times in the night after surgery when she was in the St. Luke’s ICU. Fortunately, Dr. Bud Frazier was there all night with Nancy and he kept her alive (she went on to live 8 more years).
I will “amen” everything Mack McIngvale said in his tribute to Dr. Frazier. Not certain who is funding ProPublica, but those two reporters did a terrible disservice to a great man.
Richard Stasney, MD, FACS
I was quite disappointed and indeed annoyed at the highly judgemental and one-sided article about your lifelong commitment to providing an implantable longterm assist device for patients with advanced heart failure that have little left to provide them with the reasonable extension of their life under some comfort. With heart transplant donors being in perpetually short supply, your passion to persist in developing a reliable continuous flow pump has never been allowed to falter in spite of numerous adversities and initial disappointments.
In my many years of knowing you, starting with your fellowship training rotation at the M D Anderson Hospital back in 1975, and on thru many years of mutual interaction in the operating room and outside in meetings and teaching events, I have been impressed by your outstanding surgical skills, and immense commitment to patient care throughout their hospital stay and beyond. I am not the least convinced by using the newspaper’s quotes of Medicare mortality figures as a reliable tool to compare surgical outcomes since they are NOT risk-adjusted. Furthermore, these numbers do not take account of how many patients have died while waiting for a heart transplant that never became available. Indeed a surgeon who selects the better risk patients would obviously have better survival at one year, than somebody like yourself who will accept the neediest and sickest patients, without concern about how the publicly available statistics would look down the road!. Again in my many years of knowing you here in the Texas Medical Center, and beyond, I have found you to be highly ethical and singularly committed to developing the mechanical heart assist devices without any emphasis on personal enrichment or egotistic satisfaction.
I am convinced that your patients and colleagues will know you for what you truly are; a world-class cardiac surgeon and a pioneering scientist in the field of Mechanical Heart Assist devices.
Kamal G. Khalil M
Adjunct Clinical Professor
Department of Cardiothoracic and Vascular Surgery
UTHealth / McGovern Medical School
To the editors of the Houston Chronicle…
I found your front page, featured article of May 28, 2018 maligning Dr. O Howard (Bud) Frazier unworthy of the premier newspaper of Houston readers. One thing I definitely agree with is the final statement that Dr. Frazier is a “living legend”.
I’ve known Dr. Frazier for many years. My one regret is that I have not had the chance to know him even better. The reason I say this is because I’ve been to so many events over the years where my wife Judye and I have enjoyed the company of Bud’s wife Rachel, but not Bud. The reason is because Bud was at the hospital caring for extremely ill patients. I don’t think I’ve ever met another doctor with such a single-minded dedication to the welfare of patients.
I also doubt that Dr. Frazier has ever sought to hide potential conflicts of interest. My impression is he gives very little thought to financial matters in general. His focus has been on saving lives.
I find it disturbing that impugning the reputation of one of the great physicians of our time is something the leadership of the Chronicle finds to be a worthy goal. The article makes some effort, for those with the patience to wade through all five pages, to provide a somewhat balanced perspective. The headline introducing it, however, seems to me to be a classic case of “mudslinging” and hardly worthy of the source to which so many Houstonians turn for local news and place a level of trust.
I’ll close by saying that I feel confident that the name of Dr. O Howard Frazier will be remembered and revered long after those of lead witness Dr. Frank Smart and the authors of this article, Mike Hixenbaugh and Charles Ornstein have been forgotten.
Respectfully submitted by,
In 1985 Our son Christopher Hilliard II was diagnosed with heart disease when he was only 7 years old and we were told that he would need a heart transplant to survive. He was followed by Texas Children’s Hospital who at that time did not have a transplant program.
He was managed with drug therapy for 2 years when suddenly he faced a rapid decline and was admitted to the pediatric ICU where he was hooked up to every conceivable life support machine to keep him alive. Suddenly, his father and I were told that we should be prepared to let him go and an hour later that Christopher was clinically dead.
Thank God that Dr. Frazier was courageous enough to intervene and placed Christopher on an LVAD whereby saving his life. By the grace of God and a wonderful donor family who in their darkest hour offered their child’s heart to Christopher, he survived. Dr. Fazier is the most brilliant caring individual that I have ever met. He is a giant presence with a gentle, quiet manner. He would try to ease my panic by speaking in football terms…”we are still in the game” and would quote Shakespeare. He radiates hope and faith.
He has dedicated his life to advancing heart research and has saved thousands of lives working around the clock while virtually living at the hospital to the detriment of his own family. He cares so deeply for all of his patients. He also has the devoted support of his wife Rachel who knows where is heart lies.
Unlike so many celebrated doctors he has never sought out the limelight. He travels to remote areas of the world to share his knowledge and superior surgical skills with others.
Christopher turned 40 last year and is enjoying life and is the beloved uncle to his nephew and niece because of Dr. Bud Frazier.
I thank God every day for this heroic doctor and world-class man.
May 28, 2018
CHI St. Luke’s Health/Baylor St. Luke’s Medical Center
I read the disheartening piece that was published in ProPublica earlier this week regarding Dr. Frazier. While I have not practiced medicine with Dr. Frazier or at the Texas Heart Institute, the accusations and innuendos included in that article are in distinct contradiction to the man and the physician that I know. Dr. Frazier has played a pivotal role in the development and dissemination of mechanical circulatory support, a therapy now acknowledged as standard of care in our most advanced heart failure patients. In fact, most would argue that he has been the most prominent figure in the development and scientific advancement of this technology. Left ventricular assist devices have saved the lives of tens of thousands of patients dying of heart failure without other therapeutic options. As a result of his work, these patients now have a treatment that extends life, improves quality, and enhances their functional abilities. It has allowed them to return to their families and serve their communities.
I have been an advanced heart failure cardiologist since 1995. I am confident that my colleagues and I have all benefited from the wisdom and clinical experience learned from Dr. Frazier. He has a remarkable way of cataloguing his successes and the inevitable failures that we all face in managing this challenging patient population. He has been and influential and effective teacher for our community. His seminal observations and vast experience have favorably changed the way we manage patients.
I have also served as a coinvestigator with Dr. Frazier on many national trials. I am unaware of the allegations of research misconduct or the practice of enrolling patients outside of clinical trial protocol.
Most disturbing, I find the treatment of Dr. Frazier in the ProPublica article to be appalling. It is always easy for the noncombatant to be critical of the decisions made in clinical medicine, particularly when the stakes are high and patients’ lives are at stake. I firmly believe that Dr. Frazier was acting in the best interests of his patients and was attempting to provide life-saving therapy to patients who had a predictably short lifespan without his skills.
I appreciate you allowing my catharsis. Dr. Frazier has been a friend and mentor to the most prominent members of our medical community and to his patients and their families. I am hopeful that through this process, he and his career will be vindicated.
Joseph G. Rogers, MD
Professor of Medicine
Division of Cardiology
Shafik and I both so appreciate and congratulate you on all the amazing work that you have done during your many years in Houston. We are appalled by the slanted and inaccurate account of your career that appeared in the Chronicle. We applaud your courage and persistence in doing good work. We are among so many Houstonians that respect and admire you and we are honored to consider you a friend.
Shelby Hodge & Shafik Rifaat
To the Chronicle Editors:
Dr. Bud Frazier has been my friend since 1963. For the last 50 years he has devoted his life to the medical profession. He began as a flight surgeon in Vietnam who provided medical care to patients in his Assault Helicopter Company as well as Vietnamese orphanages. He subsequently rose to the top of his field through his tireless work and dedication to improving the lives of those suffering from cardiac illness. I witnessed the compassion he showed his patients and the tremendous amount of time he spent providing their care and determining their treatment options. Bud’s patients have always been his priority. Even at the end of his career as a surgeon, he still grieved the loss of each and every patient. Bud is a man of faith, principle, exceptional intellect and character. He has dedicated his life to extending the lives of others through the medical advancements from his research and the sharing of his knowledge with doctors on a worldwide basis. I am heart sick by the Chronicle’s portrayal of him.
May 21, 2018
CHI St. Luke’s Health-Baylor St. Luke’s Medical Center
I very recently became aware of the adverse media attention that the Texas Heart Institute has received in regards to their heart transplant outcomes and how, as part of the media’s investigation, questions subsequently arose regarding Dr. Frazier and his involvement in the pivotal ventricular assist device clinical trials conducted approximately a decade ago. I am also in receipt of a summary of some of the reporter’s questions and the responses provided by Dr. Frazier and Mr. David Berg that were forwarded to me at my request by Ms. Libby Schwenke, the senior administrative assistant for the THI Cardiothoracic Transplantation and Circulatory Support Programs, and to whom I am Cc’ing this letter.
Although I am expressing my personal opinions as an individual involved in the transplant and mechanical circulatory support device fields for thirty years, by way of my current positions as the Co-Director of the USC Transplantation Institute in the Department of Surgery at the University of Southern California and the Chair of the Advisory Committee on Transplantation under the auspices of the Cabinet Secretary of the Department of Health and Human Services, in addition to having served as Chair of the UNOS Thoracic Transplantation Committee, as President of the International Society for Heart and Lung Transplantation (ISHLT), as Chair of the Thoracic Committee of the American Society of Transplant Surgeons (ASTS), and on the Board of Directors of the ISHLT, the ASTS, and the American Society of Transplantation, I am confident that my thoughts and opinions that follow below are extremely representative of the medical and surgical community as a whole.
Dr. Frazier has been for over four decades “THE” pioneer in the surgical treatment of severe heart failure and helped establish the Texas Heart Institute as one of the leading centers in the world. Starting in the 1970s he performed much of the animal work that lead to the first implants of ventricular assist devices in humans, and his clinical work has subsequently involved the use of virtually every generation of both pulsatile and continuous flow cardiac assist devices. In addition to both his laboratory and clinical surgical efforts, he has been front and center with the initial acceptance and subsequent research funding and regulatory approval of this very high profile field within the walls of the NIH, FDA and CMS.
I met Dr. Frazier almost thirty years ago when my Division Chief of Cardiothoracic Surgery at Columbia University in New York sent myself and one of my fellow residents down to Houston to “see what those cowboys in Texas were doing”. Dr. Frazier and his entire teams’ hospitality and willingness to share their experiences with both myself and countless other trainees both in the US and throughout the world has been characteristic of his commitment to teaching and furthering the field.
I carefully read the reporter’s questions and Dr. Frazier and Mr. Berg’s answers, including additional comments from Dr. (Billy) Cohn, and found them to be credible and in keeping with everything that I know about the conduct of those studies.
Dr. Frazier’s record of accomplishments in itself commands respect and even awe. But the truest measure of his career derives from his unique talent to inspire the continuation and extension of his own vision, creativity, energy and joy in life to his family, friends and colleagues. If Norman Shumway is the father of heart transplantation, and Tom Starzl is the father of liver transplantation, then surely Dr. Frazier is the father of mechanical cardiac replacement.
I am honored to be able to call him a mentor and a friend.
Mark L. Barr, M.D.
Co-Director, USC Transplantation Institute
Department of Surgery
University of Southern California Keck School of Medicine
Chair, Advisory Committee on Transplantation
U.S. Department of Health and Human Services
Deputy Editor, American Journal of Transplantation
“I have read the responses [meaning Dr. Frazier’s responses to the reporter’s questions pre article], and they are excellent—and completely consistent with what I know of Dr. Frazier. Not only is he a major pioneer in this field, he is also a compassionate and caring physician and person. Given the complexity of the field, the near death state of most patients who need this therapy, and the number of years that have elapsed since this trial [HeartMate II], I believe the reporter would be unfair and mean-spirited to proceed with an article without a prolonged, serious look at more data.
Let me know if I can provide further help.
James K. Kirklin
Professor of Surgery
Division of Cardiothoracic Surgery
Director, Kirklin Institute for Research in Surgical Outcomes (KIRSO)
Department of Surgery
University of Alabama at Birmingham (UAB)
May 17, 2018
To The Houston Chronicle,
I have known Dr. Frazier since 1999. I had the privilege and honor of working closely with Dr. Frazier at St. Luke’s from 2006-2011, when I served as the Medical Director of Heart Failure and Cardiac Transplant and again from 2014-2016, when I served as the Director of Outreach for Advanced Heart Failure. As a mechanical engineer and cardiologist, my career has focused on the care of the advanced heart failure patient who often requires mechanical circulatory support and/or heart transplantation.
Dr. Frazier is an international luminary whose passion, fortitude, and vision are primarily responsible for the advancement of heart transplantation and mechanical circulatory support. He was the originator of developments that have saved thousands of lives worldwide. I personally witnessed Dr. Frazier spend countless hours at the bedside of mortally ill patients and in the lab improving and perfecting device design. He was a charter member of key international societies, such as the International Society of Heart and Lung Transplantation (ISHLT) and the American Society of Artificial Internal Organs (ASAIO). The field of heart transplantation and mechanical circulatory support is not amenable to randomized clinical trials comparing a therapy to a placebo. The placebo is literally death. These are salvage therapies for patients facing imminent death. Hence there has never been a clinical trial to assess the utility of cardiac transplantation. The unfortunate reality is there are simply not enough donor hearts to treat all those patients who suffer from end stage heart failure. The option of a mechanical device to support the heart while awaiting a transplant or in lieu of a transplant allowed many more patients a chance to live a meaningful life. The early trial for left ventricular assist device (LVAD) therapy, REMATCH, showed the almost certain death for patients treated with medical therapy, leaving only 8% alive at 2 years. The engineering design to transition from a pulsatile left ventricular assist device to a continuous flow pump was born by Dr. Frazier and perfected with his consultation to a team of engineers. In all the years that I have known Dr. Frazier, I have never seen him motivated by financial gain. In fact, device companies made millions and billions of dollars from Dr. Frazier’s recommendations. To my knowledge, Dr. Frazier never received financial remuneration for his contributions. His payment was simply the gratification of seeing patients survive and even thrive. His passion stemmed solely from the vulnerable patient who struggled to breathe. With each patient death, I witnessed him retreat to his office for respite and strength to face the next patient. I often walked into his office to find him reading from his Bible.
Some of our early LVAD patients were not eligible for enrollment in a clinical trial because they developed cardiogenic shock requiring a temporary device to sustain life. In addition, a small continuous flow pump was not approved by the FDA and the older pulsatile pumps failed within 18 months. Dr. Frazier would appeal to Medicare for a Human Device Exemption for compassionate use of the continuous flow pump rather than allow the patient to expire. To the uninformed or uneducated observer, it may have appeared that he was inappropriately enrolling patients in clinical trials but these patients were not part of the clinical analysis. However, they were tracked by the FDA for outcomes. Many of these patients remain alive today and are contributing members of our community.
Heart transplantation is an art. There has never been a clinical trial comparing heart transplant to medical therapy. There is no set formula to determine the match between a donor heart and a recipient. There are simply lessons learned from thousands of transplants that were successful and thousands that were not. I spent five years taking donor call with Dr. Frazier. We received a call from our local organ bank with a donor heart for a potential recipient on our list. Each donor heart came from a patient who suffered a trauma, a stroke, a respiratory arrest, or even a suicide. Each donor required IV medications, machines, and sometimes devices to keep blood circulating to their organs. None of these hearts were perfect. We learned to match the heart to the patient’s blood type and body size (height and weight). We spent hours upon hours evaluating echocardiograms, hemodynamics, response to IV medications, and sometimes even requested a heart catheterization before making the ultimate decision to accept or reject the donor heart. All the while, we knew that the recipient may not survive until the next call. The decision was never straightforward but rather a judgement call. Dr. Frazier spent more than 10,000 hours making these decisions. As Malcolm Gladwell notes in his book, Blink, the brain develops a hardwiring with repetition that allows one to make a judgement call in the blink of an eye that a novice is unable to do after hours of careful study Dr. Frazier was simply a master at matching a donor heart to the appropriate recipient.
In the event of a death, we would respectfully request an autopsy from a patient’s family with hopes of acquiring some knowledge to help the next patient. Whenever Dr. Frazier was in town, he personally performed or assisted the pathologist with the LVAD removal and dissection of the heart or removal of a transplanted heart. It was his dedication to advancing the field that led to many engineering design changes and improvements in the durability of today’s left ventricular assist devices.
When faced with a clinically challenging scenario, he often called a number of his surgical colleagues to see if they had faced a similar situation. He and Dr. Brano Radovancevic hosted a Rodeo Meeting in Houston annually for many years, which brought together clinical cardiologists and surgeons from nationally recognized heart transplant programs. This conference fostered an open dialogue that led to many clinical practices and guidelines that directly improved the care of patients worldwide. One of the early Rodeo meetings highlighted the variability among pathologists on grading rejection in cardiac biopsies following heart transplantation. This finding led to an international grading system to standardize the grading of rejection in heart transplant patients. One of Dr. Frazier’s critics, Dr. Mandeep Mehra, attended a Rodeo meeting. He was highly critical of LVADs as a therapy. Dr. Mehra later debated Dr. Frazier at an ISHLT meeting. Dr. Mehra was the protagonist of heart transplant and Dr. Frazier was the protagonist of LVAD therapy. Dr. Mehra touted the benefits of heart transplants and disputed any benefit of LVAD therapy. It is interesting to note that the first author of the most recent MOMENTUM 3 trial, comparing the HeartMate 3 LVAD to the HeartMate II was Dr. Mandeep Mehra. It only took Dr. Mehra 10 years to see the benefit of LVAD therapy that Dr. Frazier realized long ago. Dr. Frazier was clearly ahead of his time!
Dr. Frazier was the first in our field to recognize the importance of an elevated mean arterial pressure in patients who had a continuous flow pump. He witnessed an increase in strokes and began closely monitoring the blood pressure using a Doppler. When Dr. Frasier shared his observations at national meetings, he was initially mocked and dismissed. However, the elevated mean arterial pressure was implicated in the Heartware Destination Therapy clinical trial as the etiology for their higher incidence of strokes. Dr. Frazier also clinically recognized the lack of aortic valve opening in the pathogenesis of strokes. He was the first to raise awareness of these issues at our international meetings and encourage close attention to both parameters. The newest LVAD, the HeartMate 3 is designed to vary the pump speed and promote aortic valve opening, based on the early observations, presentations, and articles by Dr. Frazier.
Dr. Frazier saw LVAD patients with me in clinic and orchestrated the ability to perform echocardiograms during the clinic visit. He would personally view the echocardiogram with me, measure the left ventricular size and measure the aortic valve opening time. We would adjust the pump speed to optimize the aortic valve opening to prevent clot formation and strokes. In addition, we would have patients sit in the waiting room after a pump speed adjustment for an hour or more. Dr. Frazier wanted to recheck their blood pressure and adjust their anti-hypertensive medications if necessary to keep their mean arterial pressure below 90 mmHg, thereby reducing their risk of stroke. Today, these practices are incorporated into our clinical guidelines for the care of left ventricular assist device patients.
Any individual who lacks appreciation of Dr. O. H. Frazier’s contributions and wishes to disparage his lifelong work needs to talk with the patients and families whom he touched, the colleagues who he enlightened, and the engineers who he inspired. As for me, I am grateful for the gift of working closely with Dr. Frazier. I am a better physician and person because of the time I spent with him. And as for our mutual patients, who have benefitted from his expertise and dedication, they are living life with a grateful heart. I would respectfully ask the Houston Chronicle to carefully consider their source before publishing anything negative about Dr. Frazier.
Roberta C. Bogaev, MD, FACC, FACP
Chief of Cardiology, Bon Secours Virginia
A response to the recent article the Houston Chronicle published about St. Lukes heart by Houstonian Jim “Mattress Mack” McIngvale
As a 38 year Houstonian I have been around the block a couple times. I have seen the good, the bad and the ugly…When by beloved brother George was laying unconscious in a coma and dying from congestive heart failure in the ICU unit at St. Luke’s hospital I would go visit him after I got off work. I work late. I would get there at 12am, sometimes 1am or 2am in the morning. Even though he was unconscious, he could feel my presence. He knew I was there. I knelt at his bedside and prayed offering my brother my support, love and prayers. As I would be kneeling there praying at George’s bedside in would walk the great Dr. Bud Frazier, world renowned heart surgeon who at that time was 68years old. He would check my brother’s charts, vital signs, doctor him and give me the support I needed in that time. Many times I would ask him, “Dr. Frazier why are you up here so late at night?” He would always reply: “My patients are my life.” Bud Frazier is a great man—he follows in the footsteps of DR. Michael Debakey and Dr. Denton Cooley- giants of the Texas Medical Center.
The heart devices Dr. Frazier has dedicated his life to through creating and designing them have saved thousands of lives for people all over the world. Dr. Frazier has never been afraid of taking on the worst cases with the least probability of success because above all to Bud Frazier, life matters. Your recent article discounted the hours and years of work that Dr. Frazier has dedicated to this field. It is a total affront for all of us who know him personally and are aware of his motives. Bud Frazier’s life is his patients and he brings life to his patients. I am lucky to know him, call him a friend and support all of his endeavors. He is one of my life mentors and I will always look up and admire Dr. Frazier’s intellect, work ethic, integrity and most of all concern for his patients. I only wish I had as much passion and concern for my customers as Bud Frazier does for his patients. When I have seen Dr. Frazier and the work he does at St. Luke’s I have not seen the good, the bad or the ugly- I have seen the GREAT and for that I am forever thankful. I have never learned so much from one individual or been more inspired. God chose this career path for him and he has certainly served our community and indeed the entire world very well.
My loving father and brother both died of congestive heart failure. I can only hope if I am laying on the operating table awaiting open heart surgery or a human or artificial heart transplant that the great Bud Frazier M.D. is the surgeon operating on me.
To whom it may concern
I hereby certify that I have known Doctor Howard Frazier since 25 years . I have been many times to Houston , especially to train in order to use the Heartmate I and the Jarvik later on . I was on the Board of the Heart and Lung Transplantation Society and have been involved in transplantation and LVAD since 1983.
Doctor Frazier is the most knowlegable person I ever met in this field . He has done more transplantations and implanted VADs than anybody in the world . He has advised ThermoCardioSystems for the Heartmate I and then II and III . I was thanks to his training among the fews in Europe using such univentricular pumps in Paris ( France ) as principal investigator . Then later I used the Jarvik 2000 pump always after having been trained by him . Later I have used this pump as a destination therapy . All this understanding and progress was greatly possible thanks to his input , his advices and understanding . He is a pioneer , a scientist and a great physician.
Doctor Frazier is an extremely human man , with a tremendous culture way above average . He is honest , reliable , and just a real gentleman .Throughout these years I always admired him , for this incredible work , for his constant devotion to patients and mankind . I can say that I am proud to have him as a friend . He is considered worldwide as a giant although always modest and with a great sense of humor . He can be considered as one of the few Cardiothoracic Surgeons in USA , who made the field progress and he is and will remain part of history.
As a man , as a surgeon , as a friend he is unique , and should be considered as such by everybody.
I wrote this testimony , which may be produced in front of a court and I am prepared to testify all these statements in person if needed.
Gilles DREYFUS MD, FRCS, FESC
Professorof Cardiothoracic Surgery
Medical Director of the Cardiothoracic Centre of Monaco
Response: Dr. O.H. Frazier and Houston Chronicle, Date: June 12, 2018
The life of a transplant surgeon is very stressful and disruptive. Most donors are encountered in the middle of the night, on weekends and holidays. Regular scheduled cases must be rescheduled. I remember my last visit to Houston. I had retired at age 75 and met Dr. Frazier, two years younger, who was still working. I had referred him a very difficult case. ”Bud” and I met in the hospital. He took me to see the patient, and sick as he was, still looked better than Dr. Frazier. As we left, I said, “’Bud’, are you alright? You look terrible.” He replied, “Yes, just tired. I finished a transplant at 3 AM this morning—still working,” It was 10AM. Then I inquired, ”Can’t you get some help?” No”, he replied in a dejected voice. “Nobody wants to work this hard in medicine anymore.”
Dr. Frazier is one of the most honorable, respected, brilliant, and talented surgeons that I have ever met. Over the years, I had frequently called “Bud” requesting advice about transplant patients and cardiac assist patients in my practice. Always helpful, he is a wealth of knowledge, having performed more than 1300 heart transplants, and 1000 cardiac assist devices, more than anyone else in the world. Recently the International Society of Heart and Lung Transplants, honored him with the Lifetime Achievement Award, bestowed by his peers, recognizing his contributions for improving the lives of thousands of patients with advanced heart disease.
It is hard to understand why anyone would attack this humble, productive humanitarian. Clearly they do not understand the difficulties and complexities of cardiac failure and it’s ramifications. “Bud” has sought answers to problems in the experimental laboratories, and then brought solutions to the clinical arena, cautiously testing results, helping desperately ill patients. Research activities have been overseen by federal agencies including the NIH and FDA. Corporate sponsors providing research funding have strict protocols and guidelines to test their inventions. Any improper activities could be stopped at any time by the government.
Conflicts of interest frequently arise in the field of medicine. Guidelines and regulations are usually settled in medical-surgical committees in open discussions. Sometimes there are poor outcomes. All surgeons have lost patients. Dr. Frazier has always been the last resort in situations where other surgeons have felt the risk is too high for them do the operation.
Dr. Frazier, by his own admission, has never billed a patient for his services. He is subsidized by the hospital. He only cares about the work and outcomes. The hospitals are responsible for billing Medicare and private insurance for patients in their hospitals.
Investigative journalism, trying to expose corrupt behaviors, have chosen one of the greatest and most respected pioneers in cardiac surgery, following in the molds of his mentors, Doctors DeBakey and Cooley, pushing back the limits of care of thousands of patients dying of heart failure, offering hope and survival, with numerous new technologies. Dr. Frazier may not have always conformed to guidelines of clinical trials; perhaps he was establishing new and better guidelines of care.
Dr. Charles Moore
May 18th, 2018
To Whom It May Concern:
Dr O Howard Frazier. That surgeon’s name immediately provokes a vision of a unique individual whom many surgeons Worldwide have had the pleasure of hearing of the history of the growth and development of the cardiovascular surgery program at Baylor and the Texas Heart Institute in Houston. His perspective on the lineage of research and development that formed the foundation of some of the greatest advances in Mechanical Circulatory Support is especially treasured as it comes from his unique perspective of personally knowing and walking shoulder to shoulder with innovators, surgeons and visionaries. As keen observer of the human condition, he absorbs and creates his own brand of problem solving. Solutions followed by many surgeons now have become mainstream in the field of cardiac transplantation and mechanical circulatory support due to his persistence in defining the limits of the therapy.
Dr Frazier graduated from The University of Texas at Austin with an English and history major in 1963. That year when he entered Medical School in Baylor the National Advisory Heart Council, set as a top priority the goal of building an artificial heart. When challenged to develop a research focus his research partner, Frank Pope, assigned him a project to work on the Artificial Heart and that experience with Domingo Liotta had him captivated. But in 1968 he was assigned as flight (Surgeon (Captain) to the U.S. Army 48th Assault Helicopter Company, Vietnam. Fulfilling a particularly hazardous role he came away with the Combat Flight Medal, the Vietnamese Navy Medal and the Vietnamese Distinguished Service Medal. Dr. Frazier’s interest in the field of cardiac support was prompted by his mentor, surgeon Dr. Michael E. DeBakey. At the Texas Heart Institute, founded by renowned cardiovascular surgeon, Dr. Denton A. Cooley Dr. Frazier set out to build a laboratory dedicated to the development and realization of his dream to build a functioning Mechanical alternative to the heart. Indeed many discoveries in his laboratory helped to refine and define the therapy.
I believe that the term translational research, the concept of taking an idea from laboratory experiments through clinical trials to point-of-care patient application, epitomizes Dr Frazier’s journey with many technologies we use today. With over 50 years of experimental and clinical work has resulted in his own personal achievement of performing or assisting at over 1200 LVAD device implantations and 1300 heart transplants.
Dr Frazier has spent many personal hours persistently improving circulatory assist pumps. In the age of pulsatile pumps, it was Bud who insisted that an implantable compliance chamber should be replaced with a vented driveline for the Thermo cardio systems LVAD. This of course led to the first Heartmate and the landmark REMATCH trial introducing the World to Destination Therapy. His insistence in championing rotary blood pumps through his association with Richard Wampler led to the successful clinical acceptance of the Heartmate II LVAD. And later he saw the potential for a centrifugal design that led to the development of the Heartware LVAD.
Dr Frazier is known for being a surgeon involved in many firsts: World’s first intra-abdominal left ventricular assist device, World’s first bridge to transplant with an LVAD, World’s first heart-kidney transplant, World’s first implantation of pneumatic TCI LVAD, First implantation of intra-corporeal continuous flow (pulseless) LVAD (Hemopump), Implantation of world’s first electrically powered LVAD, first patient to be discharged from hospital with LVAD, Implantation of first Jarvik pump as a bridge to transplant, Implantation of Abiocor artificial heart, Implantation of world’s first destination therapy continuous flow pump (Jarvik), first successful implantation of Heartmate II, first centrifugal support LVAD, now known as the Heartware, demonstration of feasibility of (experimental animal) of total heart replacement with continuous flow pump and the first implantation of total heart replacement with 2 continuous flow pumps in a patient.
Living legend, trailblazer, advocate, mentor, and of course pioneer, are ways we have all heard Dr Frazier described. His awards reflect his dedication to his vision. Living Legend Award from the World Society of Cardiothoracic Surgeons, Baylor College of Medicine Distinguished Alumnus Award, University of Texas Distinguished Alumnus Award, and the Gift to Mankind Award from the American Organ Transplant Association, the Distinguished Surgeon Award from the Houston Surgical Society. In 2014, Dr. Frazier was presented with the Lifetime Achievement & Distinguished Faculty Award from the Michael E. DeBakey Department of Surgery at Baylor College of Medicine. He has similar honors from the American Association for Thoracic Surgeons and this year from the International Society for Heart and Lung Transplantation for whom I was honored to serve as President in 2000.
I can comfortably state that there is not a Cardiothoracic Surgeon in the United States and indeed the world that would not rise to honor his intuitive approach in a field that carries considerable risk for the surgeons, their teams and indeed for patients and families given the critical nature of their illness.
Robert L Kormos M.D. FRCS(C), FACS, FAHA
Brack G Hattler Professor of Cardiothoracic Transplantation
Deputy Director for the McGowan Institute for Regenerative Medicine
Professor Cardiothoracic Surgery and Bioengineering
Department of Cardiothoracic Surgery
Heart and Vascular Institute
University of Pittsburgh Medical Center
“I have reviewed the responses prepared by Dr. Frazier and believe them to be an accurate assessment of the facts. I have know Dr. Frazier for over 25 years as a professional colleague. He is one of the pioneering physicians in the field of heart transplantation and mechanical circulatory support. Dr. Frazier is one of the most well-respected physicians in the field and he has consistently demonstrated compassion for his patients and the utmost integrity in terms of character and quality of his work, both on the clinical and research side of his career. I do not believe the report about Dr. Frazier’s activity in the HeartMate II trial to be accurate and is flawed by incomplete data and research into the issue.”
Francis D. Pagani, MD PhD
Otto Gago MD Endowed Professor of Cardiac Surgery
Department of Cardiac Surgery
University of Michigan
Dear Dr. Frazier, one of the reasons I moved my family to Houston seven years ago and joined the Baylor faculty was because of your reputation and extraordinary commitment to using medicine and science to better the world. Nothing has changed. I think you are amazing and am happy to say that on public record. I realize these might be challenging times, and I’m always happy to talk anytime.
Kind regards, Peter
Peter Hotez, MD, PhD, FASTMH, FAAP
Dean, National School of Tropical Medicine
Professor, Pediatrics and Molecular & Virology and Microbiology
Head, Section of Pediatric Tropical Medicine
Baylor College of Medicine
Texas Children’s Hospital Endowed Chair of Tropical Pediatrics
Director, Texas Children’s Hospital Center for Vaccine Development
Baker Institute Fellow in Disease and Poverty, Rice University
Co-Editor-in-Chief, PLoS Neglected Tropical Diseases
In 1974, my father was pronounced “dead” by the big shots at St Lukes Hospital … and a resident stood up and said “I don’t think he’s dead.” The big shots washed their hands of the case, and Dr. Frazier took over. As I read today’s paper, I remember the “unnecessary” care that Dr. Frazier gave my father … and saved his life. We can stay with leeches or we can advance humanity, and advances are always going to ruffle feathers of the less imaginative.
Gerger Khalil & Hennessy LLP
I have read the investigative report several times. My first read raised anger over the muckraking nature of the work, which relied primarily on the negatives expressed by physicians previously employed by THI. Bud has always been a courageous surgeon, cut from the granite of his mentors, Drs. Cooley and DeBakey. He has lived his life near exclusively at the bedside of patients dying of irreversible heart failure. His commitment to them and his efforts to improve their quality of life and longevity is far more evident in the thousands of patients he touched who survived than in the regrettably few less fortunate. His impact has helped to build the field of heart pumps. His positive view of the glass half-filled has made all the difference in the commercial development of pumps that now are available nearly worldwide to help physicians tame the inexorable suffering of patients sentenced to death from heart failure. His focus has most certainly been to advance the field by working with not only the physicians who have flocked to him to learn, but also to advise the inventors and vulnerable companies who committed to commercially develop and test the pumps. In their exposé, the reporters tell us that in over more than 40 years a few colleagues left THI who are now expressing “concern.” I would ask the reporters why they did not recognize the importance of Dr. Frazier’s work and why they did not find a way to help him diversify his view. The fact that the relatively recent, more explicit rules of disclosure or conflict of interest, which did not exist 30 years ago and were not closely followed by Bud, is regrettable, but was there personal gain or agenda? Hardly. I know that Bud’s brain simply does not see beyond his mission of compassion, and he disregarded any obstacles to his mission’s completion. He still seems incapable of sending an email or text.
As I reread the investigative piece, I evolved to a great sadness. Each of us is imperfect, and our flaws make us relatable. Dr. Frazier must now defend his life’s work to reporters and those influenced by them who I believe miss the point. They view their subject from an out-of-context and time agenda. They cannot possibly relate. Seemingly, they believe it is most important to emphasize iconoclastically the relatively innocent imperfections likely necessary for the gifted pioneer package. I believe that without those minor faults of Dr. Frazier and the giants who trained him, all of us would be in worse shape. Are any of the flaws uncovered fatal? Certainly not! Can they unfairly tarnish an aging icon? You bet.
Those fortunate enough to have a life’s calling to heal, care, hope and be compassionate to the sick are to be treasured. I remember when Denton Cooley spoke to my friend and me in the earlier days characterized by many losses of the “pain of the pioneer.” It was his way of encouraging us to persevere. There are many days when these words and a new sunrise got us back to the mission. We rationalize the deaths we could not avoid more so by selecting our memories to those more positive. Too bad those who choose to describe us might not follow a similar rule.
Bartley P. Griffith, M.D., FACS, FRCS
The Thomas E. and Alice Marie Hales
Distinguished Professor in Transplantation
Professor of Surgery
University of Maryland School of Medicine
May 30, 2018 Houston Chronicle
– REPLY TO QUESTIONNAIRE ON PAGE A1 OF HOUSTON CHRONICLE
– Date: May 23, 2018
– “A Heart Transplant, a Medical Mishap and a Drawn-out Death”
– Second in a Series by Mike Hixenbaugh and Charles Ornstein
If ever there was a “poster child for heart transplants,” I’m it. Everything about my heart transplant at the Texas Heart Institute (THI) / St. Luke’s Episcopal Hospital (St. Luke’s) was perfect. From my first visit to Dr. Reynolds Delgado to the day of my release with a new heart was 88 days. The heart I received on August 20, 2006, was strong and matched my body chemistry with no sign of rejection. Four days after returning home I attending church and taught my Bible study class standing up.
My tale began with a heart attack in September, 1988, thereafter, my cardiologist, Dr. John M. Passmore, progressed from medications only to using a bi-ventricular pacemaker/defibrillator and a triple by-bass to respond to my deteriorating heart functions. Eventually, with an ejection fraction of 33%, on February 13, 2006, Dr. Passmore gave me names of two doctors at Texas Heart Institute to contact about a heart transplant evaluation. I met with Dr. Reynolds Delgado on May 24, 2006, to discuss my suitability for a transplant. He checked me in at St. Luke’s on May 31, 2006, to begin the evaluation as I was weak due to congestive heart failure. Dr. Delgado had me attached to an Inner-Artery Blood Pump (IABP) to assure my kidneys functioned properly and would recover if they received an adequate blood supply. Once confirmed, he adjusted my medications and the evaluation sequence continued until July 18, 2006, when I was released with strong medications and to await my name being put on the National Heart Transplant Board’s (NHTB) List.
At home and office I resumed my daily activities but regained the 16 pounds I’d lose during the evaluation, indicating the congestive heart failure was returning. On August 8, 2006, I was admitted to the Cardiac Care Unit (CCU) and again put on an IABP. I was scheduled for a Left-Ventricular Assist Device (LVAD) implantation on Thursday, August 17, 2006. In the interim, my room became the Activity and Entertainment Center of the CCU. Most of my family live in Houston and visited me daily. We are a conversant lot and the nurses and interns found they might get trapped in a fire-storm of jokes and humor while attending my needs, yet maybe extending their stays longer than the Unit Supervisors and doctors on rounds wished they would. Several dropped in after their shift to resume the conversations that were terminated suddenly. Even the night shift found Room 8 to be a beehive of activity, especially when they arrived for the 2:00 AM sponge bath and linen change. With all that skill, talent and youth, I figured I should make the most of it and engaged the nurses and interns in discussions of anatomy, transplants and general hospital operations.
On Thursday morning, August 17th, Dr. Delgado arrived to inform me that, at the routine Wednesday night conference call which the NHTB has with all transplant surgeons, he had presented my case number, not name… and the NHTB had put me at the top of the list. “I would get the next heart when it became available.” On Saturday afternoon, August 19th, a nurse told me the extraction team had flow out to harvest my new heart and should be back the next day. On Sunday, August 20, 2006, at 4:00 PM, I met Doctors O. H. “Bud” Frazier, Delgado and others (my transplant team) in the OR and, after the pacemaker was de-activated, was put under. I wished I could have been in the gallery to watch the operation; but apparently “I didn’t go toward the light” so at 11:30 PM, I was wheeled into ICU and my wife’s comment was, “You are pink again. Your color changed from a greenish-yellow to a healthy pink in the OR.” By Monday morning, I was groggy, but aware enough to participate with my daughter who was joking with the nurses about our family’s crazy antics. I still had the IABP tube in my groin, but the next day, after they removed it, I was on my feet (with help) walking around the CCU with “Miss Therapist Nazi.” For several days, I was periodically returned to the biopsy lab where the rejection of the foreign heart by my body’s immune system was measured. On a scale of “0” to “4,” all of the biopsies were “0” except for one with a “1.” My body loves this strong, young heart and has shown no signs of rejecting it.
On August 23rd, I was moved from ICU to CCU in Cooley-Floor-8 and again was given the fantastic treatment by the nurses, interns and doctors for the next 3 days before I was transferred to the 25th recovery floor in St Luke’s. Once again, the nurses, interns and doctors were attentive, highly professional and encouraged me to get up and walk the circuit in the corridor at least one mile per day (11 loops around, but I usually walked 2 to 3 miles each day). The attention, care and friendly service my family and I got from the staff made me regret leaving the pampered life; however, on September 6 (Wednesday – 12 days later), they sent me home. I felt so well that on Sunday, September 10th, I went to church and stood to teach my Bible Study Class. As I said at the beginning, I am the poster child for heart transplants because there were only 88 days from when I had my first appointment with Dr. Delgado to when I received a perfect, not-rejecting heart that continues to do well these past 13.5 years. If I had to recommend a hospital for a family member or friend to receive a heart transplant, I would not hesitate to recommend THI/St. Luke’s.
SOME OF THE DIFFICULTIES FOR THE CHRONICLE TO GATHER HEART TRANSPLANT STATISTICS:
PERSONAL FACT FINDING: Because I was encouraged to walk the floors at St. Luke’s where patients were waiting for or had received heart transplants and also because I attended sessions of the Heart Exchange Support Group later, I met many of those who were candidates but were not ready for a transplant just yet. I learned many of the numerous reasons why a person might not be ready to receive a foreign heart or had received one that was being rejected by their own immune system. In walking those halls, I took it upon myself to visit with the patients and family members (heck, there was nothing else to do if you weren’t a fan of daytime TV shows). As we talked of their situations, I saw how delicate the decision to try for a transplant was yet how fearful a person might become as they wove their way through the strange new world of transplant technology, insurance policies and government regulations. My wife and I had done extensive research on the topic and knew that THI/St. Luke’s was one of the best institutes for transplanting hearts. They’d been at it a long time and their staff had developed many of the tools of the trade, plus my cardiologist had recommended them. Once decided, didn’t look back on my decision.
FAMILY IS PART OF A SUCCESSFUL TRANSPLANT: No small part of a successful transplant involves the family’s participation in aiding and supporting the recipient. St Luke’s did an excellent job educating my the family to their “total involvement” concept. Not only are the medical conditions of any patient’s total body (lungs, kidney, digestive track, muscle tone, etc.) evaluated, but the environment into which they will return is evaluated, their financial condition is evaluated, the social condition in which they live plays a part in the patients recovery, plus the patient’s willingness and ability to adhere to the medication regime and diet are confirmed. Success depends on things being perfect, both inside the patient as well as outside at home.
FOLLOW-UP AND ANNUAL CHECK-UP: In my follow-ups, Dr. Delgado has slowly reduced the dosages or eliminated some anti-rejection medications; and monitors the consequences as well as my heart’s performance annually with a nuclear stress test, X-rays and blood work. He no longer performs biopsy as my numbers don’t indicate any rejection. So far, everything is running smoothly and I am disappointed that some have judged the success rate of transplants at St. Luke’s to have fallen to an unacceptable level. One would never expect such a decrease from my case; but, after all, I AM the poster child for heart transplants. I wish all were the same.
THE SECOND ITEM ON THE HOUSTON CHRONICLE’S QUESTIONNAIRE LABELED
“ADDITIONAL AREAS TO LOOK INTO”:
COMPLETE DATA SET FOR EVALUATION: In all fields where new techniques are introduced periodically, there is a spectrum of outcomes that range from highly desirable to totally rejectable. Any publication of those outcomes is intended to influence the reader as to whether they want or should avail themselves of this new technology; however, that decision can only be made by evaluating the entire spectrum of outcomes and their applicability to themselves. To do this, any review article must include data of the numerical probabilities of success. The Chronicle article didn’t present the total number of transplants made at St. Luke’s in the past years and the number of those that were successful vs those that weren’t. All too often, the news media wants to excite their reader by presenting only the inflammatory cases and avoid the mundane, not-geared-to-sell-newspapers cases. Articles not including the latter cases are identifiable by their lack of objectivity, meaning their lack of the proper statistics from which a reader can calculate his own chance of surviving a particular procedure performed by a specific team. The writer may set as his goal an expectation that 95% of such cases should be successful, but the normal success rate of the industry might be far lower. From the above, my statistics are: a 100% success in 88 days having received a new heart that my body has never tried to reject and has lived a long and productive life for the past 13.5 years; plus, I expect to live at least another 20 years (or more). It would be valuable to know how many “me’s” there are in the St. Luke’s overall statistics. I think you should publish the number of heart transplants for each year back to when St Luke’s started transplanting hearts. Separate out the number of multi-organ transplants because the failure of a secondary organ (like a lung or liver) can materially affect the success rate of the simple heart transplant then publish the success rates of other hospitals in the USA so the patient can see where they stands in Houston.
THI’S REPUTATION FOR INNOVATION: In addition, because St Luke’s is attached to the Texas Heart Institute (THI) which has a reputation of being a leader in heart device research and transplanting, other doctors may refer their more difficult cases to THI as a way out of attempting a less-than-viable case. (I have a neighbor whose husband was determined to be “not viable” at St. Luke’s, but went elsewhere, received a heart and died as a result.) Because a remote doctor may know they do not have the facilities or talent to perform a difficult patient’s transplant, they opt out of doing it themselves and refer the patient to THI\St Luke’s. How many cases in your statistical volume were referrals by doctors who opted out of such cases?
BRINGING A PATIENT UP TO “VIABILITY:’ Another matter is that St Luke’s evaluates a patient for their suitability to receive a new heart, but will attempt to mend or solve any less viable patient’s ancillary maladies until such time as they are judged to be ready for the operation. While waiting, some marginally-viable patients may die from their weak, failing heart. Are those patients included in your statistics as “not successful?” While walking the hall of the floor where we patients were awaiting hearts, I became acquainted with many of those who could not accept my invitation to “come for a stroll with me around the elevator core” because they were too weak …or lacked motivation (another killer). The doctors had put them on a regime to build their strength, lose weight, have a colonoscopy, etc. which were characteristics that were judged to be detrimental to their successfully surviving the operation and recovery. One such patient had been on the floor for about two years while the doctors were trying to bring him up to the condition to receive a heart. I felt like I had broken in line ahead of him because I was walking and talking every day even though I had a 33% ejection fraction. There were days when the nurses played a game of seeing who could successfully measure my blood pressure, it was so low; but I still drove myself to walk the halls. I sometimes wonder if “attitude” was included in Dr. Delgado’s presentation to the NHTB the night he succeeded in getting me put at the top of the list?
NEW TECHNIQUE DEVELOPMENTS HAVE RISKS: Medical science is advancing faster than many other fields of research because it’s funding is justified when lives are at stake. Once a technique is demonstrated to save a certain percentage of lives, the technique becomes “standard practice.” When the field of medical science follows their usual course, some in research attempt to improve on the percentage of standard practice successes” by pushing that envelope. Then, that percentage falls because the research technology must undergo the same risk of failure that the standard practice did at its inception.
IMPLEMENTING NEW TECHNOLOGY: It’s not so difficult to gain funding for a project if it will result in the saving of lives. But to accurately delegate those funds to the best research study requires accurate decision statistics. Medical technology may progress faster than doctor training such that features of advanced instruments may be unused by all but the doctor’s team who developed it. A new technology may become “standard practice” but, in the hands of the unfamiliar, the technology may not be used fully or appropriately. For instance, a new drug may be prescribed at a low dose so a doctor can be sure his patient isn’t allergic to it before he raises the dose to a manufacturer’s recommended dose. An MRI may be capable of polarization but if the radiologist fails to use it appropriately, it is an expensive, but useless feature. Dr. Frazier is known for his innovation and creativity; but other thoracic surgeons, even in the same hospital, may not remember or be aware of all the subtleties involved in the advancements of the state-of-the-science involved. Pushing the boundaries of any technology is vital to progress but has risks. Those cases at THI/St Luke’s that materially lowered their transplant success rate need to be tagged if they centered around implementing new technology, so the prospective patient can evaluate whether he wants to opt for a more appropriate, but more innovative technique, even if it does have a higher risk factor.
The Texas Heart Institute and St. Luke’s Episcopal Hospital are leaders in heart research and the technologies and apparatuses that are used to prolong the life of we who have failing hearts. They served me remarkable well in my time of need and have given me many excellent reasons to recommend them to any patient who is in need of a new heart. I would return for another heart should this one begin to fail; however, by following Dr. Delgado’s recommendations as to life style, diet and medication, I expect this new heart will outlive other organs in my body … and my signing an “organ donor” card will pass it on to another lucky “poster child” someday.
Yours, with all my heart,
John W. (“Book”) Hathorn III
cc: Dr. Reynolds Delgado
To the editors of the Houston Chronicle:
The investigative reporters and the newspaper publishers obviously don’t know the heart and motivation of Dr. Bud Frazier or understand his God given compassion for his patients, his dedication to saving lives, his sleeping on the floor by the bedside to care for his critical patients, or his commitment to others needs rather than to his own.
We are writing this letter in support of Bud to the Chronicle. We hope it will be published to dispel the investigative “news” attack on one of the most caring, faithful medical doctors on this planet. Bud has cared for us and our family several times. We are blessed to know the genuine integrity and medical expertise of this humble servant.
I am a retired pastor in the United Methodist Church. Early in my ministry, I was fortunate to have Bud surgically correct an AV Fistula in my left neck, which had caused a noise that pulsed so loudly that persons sitting next to me could hear it. After the successful surgical procedure that Bud performed to close the abnormal blood vessel connection and reroute the blood flow. Dr. Frazier also found that the nerve to my tongue was wrapped around the vascular system involved. Had the nerve been clipped by a less observant surgeon, I would have been unable to speak.
Bud did by-pass surgery on my husband’s father’s heart adding 10 years to his life. He also surgically corrected a heart valve malfunction for our cousin. I know many people in our church and community who have contacted Bud to seek his helpful guidance in addressing health concerns. He is loved and respected around the world.
Those who have attempted to discredit him and his medical advances will have to answer to a higher power who knows Bud’s heart and his God given motivation to live the Hippocratic oath every day.
Respectfully submitted by
Rev. Isabell Mopsy Andrews and Gary W. Andrews
“how to think…not what to think”
May 31, 2018
John McKeon / President & Publisher
The Houston Chronicle
O.H. “Bud” Frazier is a physician in the line of the Immortal Imhotep, Hippocrates, Semmelweis, Osler …. O.H. “Bud” Frazier is a living Immortal. Immortality means to be loved by many anonymous people. The scandalous attempt to defame the reputation of this great physician, O.H. “Bud” Frazier, is unconscionable!
Richard J.V. Johnson was the quintessential publisher of what was once a major newspaper in our country, The Houston Chronicle. Your disgraceful publication of the article by Charles Ornstein, Mike Hixenbaugh, Matt Dempsey, Hannah Fresques, and Olga Pierce has destroyed the legacy of Richard J.V. Johnson.
Founder • Chairman • President / Wilhelm Scholê International
May 25, 2018
To whom it may concern:
Following reading the article attacking the accomplishments and character of Dr Bud Frazier, we believe a counterpoint to this biased smear attempt is due. It comes from the perspective of two academic and clinical colleagues who have worked with Dr. Frazier over 30 years. The authors of the article have dredged up questionable charges that date back over twenty years, were fully covered in the press, and resulted in refunds to the federal government that were less than $600000 for cases extending over several years’ time, with no finding of fault against the hospital or Dr. Frazier. It adds to this accusations of experimental procedures in patients suffering from heart failure who had mechanical pumps installed who did not fit into specific protocols. In the field of experimental drug studies, it is not uncommon to petition the sponsoring company for compassionate use of an experimental drug in a patient who does not fit a specific protocol. One submits a request to the company; if approved, a patient is offered the potential benefit of a treatment before a drug is approved. The accusation that Dr. Frazier indiscriminately subjected to placement of artificial devices is supported neither by a dispassionate review of the facts, the presence of medical review boards to clear candidates for cardiac support devices, or the FDA reviews of these experimental studies. Differences of opinion on optimum timing for surgical intervention may occur. Patients who are continued too long on medical therapy until they are hopelessly ill suffer from being denied a lifesaving intervention. Constituting reimbursement for travel to present scientific data or to serve on a discussion panel as a conflict of interest is inconsistent with current academic standards. All complications of devices are filed as Serious Adverse Events (SAE) with the FDA, whose records are publicly available. It is impossible to hide adverse outcomes.
The authors of this screed are apparently unaware of the rocky road of medical innovations. The first publication of cyclosporine’s use as an immunosuppressant had 10% of patients suffer lymphoma. 5 of 6 of Dr. Joe Murray’s first transplant patients treated with azathioprine died. Dr. Murray went on to receive the Nobel Prize for his pioneering work in transplantation. Dr. Frazier may not deserve the Nobel Prize; neither does he deserve this ill-informed and prejudiced attack.
Charles Van Buren, M.D.
Former Professor of Surgery at University of Texas Medical School Houston, Baylor College of Medicine
Whitson. B. Etheridge, M.D.
Medical Director Renal Transplantation Baylor CHI St. Luke’s Hospital
To Houston Chronicle,
Dr. O. H. Frazer has been a professional and personal colleague for many years (about 35). Methodist, St. Luke’s, Hermann, Memorial Hermann hospitals held me on their surgical staffs and on frequent occasion their operating facilities were used for complex team surgeries. During this tenure, Dr. Frazer had the highest of esteem and respect in the surgical community. His success in helping subject patients maintain an active and valued life was exceptional. Dr. Frazer’s work at innovating and perfecting artificial pumps is unparalleled and the medical/technical laboratory which he helped develop is very unique in the world. In my many years staffing hospitals in which Dr. Frazer conducted valuable research and performed skilled and lifesaving surgeries, there was NEVER an off color word heard about his professional capability or status.
That such an article as this could be written defaming his activities is without excuse and is shameful. But, in my experience it is too common to criticize and demean those toward the end of their professional career. Where was such information and negative comment when he was at the height of his medical/research/surgical career?
Although my information is that you have denied printing any counter statement, such a statement is justified and fully warranted. Denial only further adds to the disrepute of the Houston Chronicle.
With concern of your intent and integrity,
Ronald G. Presswood, DDS
Dear Dr. Frazier,
I am aware of recent asserts assailing your integrity and character . While I hold you in the highest esteem and suspect politics is afoot at the cause of this issue by men and women who haven’t the wit or moral fortitude you have . Your childhood with a father who was a results driven coach who inspired boys and young men by his career to attain feats athletically they previously thought beyond their attainment , caused you to push your limits daily . You are a venerated leader in cardiac surgery now and forever . You have reduced mortality of cardiovascular illness by your life’s commitment and exhibited considerable courage to dissolve the illusory boundaries of medical science . All the while maintaining your grace and christain charity .
My grandfather had multi vessel bypass surgery at THI in the summer 1971 . You were his physican and you commented in the H&P that he was very nice man from South Eastern Oklahoma with class 4 anginal symptoms for whom surgery was the only intervention to relieve his angina . The compassion you felt was evident to my father , aunts and uncles who read the document. It helped to bring closure , as my grandfather survived multivessel bypass surgery but three days postop had a stroke and died . You met my father during my time with you on the transplant service in 1992 and your kindly demeanor was endearing to him and me . To this day my father is grateful for your courage to attempt to save his father’s life for no other man was willing . You were a final option for him .
The ability to see in others the Devine plenipotentiary capacity of students , fellows and professional associates has been your driving force . You have affected my life and with time the depth and breadth of said affection broadens my appreciation . Your unfailing support and encouragement of me when the future was opaque and the support of colleagues often absent remains a touchstone for me of Christain charity and professionalism . Please allow me to be of assistance to you as a bullet in a cartridge belt any time you need my help . I have been the object of the false asserts of evil , selfish men and women and your support buttressed my position and resolve in moments of doubt. I have recalled our conversations and have found comfort and strength in the words always . I will be honored to assist in ANY MEANS should you need my help .
Regardless you are a poignant inspiration for good in my life and I am indebted to you as your effect is transcendental .
Knowing Mark would have your contact information, I am taking the liberty of emailing you from his phone. I do this because I know if he were alive, he would be doing the same thing for our friend Dr. Bud Frazier.
Bud was Mark’s Dad’s doctor, so we have known him for sometime, and just like Dr. Duke, Dr. Cooley and Dr. DeBakey, Dr. Frazier’s entire life was also devoted to improving and saving lives. Just like these doctors, he also gave up much of his personal life to achieve his goals. If you knew Bud, it was almost comical when the reporters insinuated that he was only interested in his financial growth. He didn’t pay attention to stocks, but if he was due some financial reward for his invention, he just said give it to my son because Bud was a simple guy who thought he had enough.
When the manufacturing company sold for millions of dollars, he didn’t get a dime. I remember him laughing about it during one of our conversations. The hospital was his life and he didn’t pay attention to the petty details ….. particularly petty hospital politics or anything else for that matter. He and Dr. Cooley were making history in the heyday of St. Luke’s and they certainly were not responsible for the fall of that hospital. If anything, they shored it up as much as they could. He was focused on his work and belief that he could make a difference. Thank goodness for doctors who do that research and have that desire which is one reason today that doctors have made so much progress in the treatment of many major diseases. There are always failures when you accept patients who are sick and dying and when you try to reverse that trend. It doesn’t always turn out the way you wanted. Did the reporters ever try to contact patients who owe their lives to Dr. Frazier. I have to wonder if they ever imagined holding a job that required 24/7 days on call in a life-saving environment? Would they be the perfect doctor under those conditions? A print deadline is one thing, but a deadline to save a life is another.
Today, I am sure the reporters are thinking that they have made headlines with a startling discovery in the Houston Medical Center, but what they have done is to take down a doctor who has devoted his life to patients and heart research by using fake news. Just like Trump, you can cut corners, interview those who have a bone to pick, leave out the good parts and tell the story. Of course doctors lose patients … and doctors hate that as much as families and I say that from recent experience! But what young doctor will be willing to step out of the box to announce new discoveries, new therapies and new techniques without the fear that it will not be 100% effective and a life might not be saved. Will they be graded on lives saved and not for trying to give some soul a few more years, days or weeks?
I know that I have been very emotional; but as a politician’s wife who experienced false reporting on more than one occasion, I know how devastating it can be in a family. Mark was a politician who expected bad reporting from time to time, and he was always my shield and protector when things got tough. His motto was if you accept the praise, you have to be ready to take the heat. Dr. Frazier is not a politician; his calling is one of the highest in our nation. At his peak, we rejoiced that he was a Houstonian. After this article, do we forget his years of service in Viero Nam. Do we forget his service as a successful doctor? Do we forget his work in trying to save lives? Have we reached the point in our society when readers only enjoy the spectacle of bringing down a person guilty of giving his life to medicine. Is this how far we have come in the Trump era of fake news? End of my story. Sorry it was long, but I think Bud Frazier deserves more than being on the front page of the newspaper in that manner.
Linda Gale White
At the age of 44 in 1975 with no prior sign of heart problems my husband Alfred Friedlander suffered a major heart attack.He was treated at St. Lukes Hospital and after 3 weeks returned home and led a normal life.This event was prior to stents and bypass surgery.We traveled extensively .. Alfred snow skied.. played tennis .. golf and he did well…along the way he had a angiogram thad was told he had an enlarged heart..A few years later stents were added ..In 1996 Dr. David Ott performed a triple bypass . Then in 2008 his heart failure returned with vengeance .Dr. James Willerson called for a leg pump on him and for 3 weeks he did so well that Dr. Willerson removed it and told us we could go home and he would keep a close watch on him .. Within an hour Alfred color turned gray and a leg pump was placed on his other leg.Dr. Roberta Bogaev and Peggy Orregard talked to us and encouraged us for Alfred to get an LVAD ..Dr. Willerson talked to me about the dangers involved but I knew he would not get out of the hospital without a try with the LVAD..At the time Alfred was 79 years old but did not have diabetes and had good kidneys.The surgery was performed in August 2009 by Dr. Bud Frazier .. The last 8 years Alfred has witnessed 2 of his grandchildren’s weddings and has been blessed with 5 great grandchildren with another in 2 months ..Dr. Frazier has been fantastic .Who is this source that claims that doctors hid their patients so Dr. Frazier could not operate on them ..Ridiculous and I don’t believe it. Once it was decided by Bogaev and the family Frazier met with us .. also you fail to mention why CHI was allowed to purchase St. Lukes when even Dr. Cooley said the day before the sale that Methodist was the popular choice.What happened to the Bishop that had the final say? CHI has always had a horrible reputation ..Obviously CHI made major mistakes after Frazier retired .. The only thing Dr. Frazier did was dedicate his life to saving 10’s of thousands of heart failure patients ..Shame on the Houston Chronicle for not telling a fair story …. Paula Friedlander
May 28, 2018
Regarding “ ‘Things….I just couldn’t imagine’ “ (Page A1, May 27), I was taken back by the way the paper portrayed Dr. Bud Frazier. As a Houston Chronicle subscriber for 50 years I am always concerned when Houston’s only paper skates close to “yellow journalism” which it did with this article.
I have know Dr. Frazier both personally and professionally for decades, and as a trustee of a local philanthropy that has supported Dr. Frazier and Texas Heart Institute’s research during these years.
As a businessman I learned about risk early in my career and as a research scientist and surgeon Bud has had to weigh the risk of using traditional medicine for a dying patient with the risk and opportunity of giving additional life to that person by using the latest mechanical procedures or heart transplants. These decisions require doctors who are the most experienced and most qualified. They require doctors like Dr. Frazier whose sole objective is what is in the best interest of the patient without regard to his own fame and fortune. For those that have known or have worked with Bud, to question his integrity is “beyond the pale”.
One of my favorite writers for the Chronicle is Lisa Falkenberg who recently wrote in her column that the “mission of journalism is to right wrongs, to be a voice for the voiceless, and to hold the powerful accountable.” A newspaper is one of the most powerful entities in the world. A newspaper can sway opinion one way or another. A single individual has little chance if the print media turns against them. Ms. Falkenberg has earned great success by her ability to study all sides of an issue and explain it to the rest of us in her column. I would hope Ms. Falkenberg would use her great talents to explain Dr. Frazier’s side of the controversy.
J. Dickson Rogers
Concerning Dr. Bud Frazier
Bud Frazier has been a personal friend of mine since we were teenagers at the University of Texas in Austin. Bud got his medical training working and learning from both Dr. Michael DeBakey and Dr. Denton Cooley. He served his country by saving lives and limbs as a surgeon in the jungle and on the battlefield of Viet Nam. He returned to the Texas Medical Center to complete his medical training, and when Dr. Cooley founded The Texas Heart Institute Bud was one of the first Doctors he ask to join him. Bud has literally devoted his life to patient care both in the OR and in the research facilities of THI. His focus has always been saving, extending and improving the patient’s life. The research that he and his team have done, and continue to do, at THI has resulted in extraordinary benefits to cardiovascular health care. Their current projects will be (in Bud’s words) world game changers.
To suggest that Bud Frazier would compromise his medical ethics or bend the rules is absurd. If he sees something that is not right he will be the first to ask questions. To suggest that he would do anything unethical for personal financial gain is a joke. Could he have used his position to become wealthy like many of his peers did? Yes. Did he? No. I have never known Bud to think in financial terms about anything. His total focus is on his patients and patient care. He just received the Lifetime Achievement Award presented by his peers in the field of transplantation. It is the world’s highest award in that field. Please note that it is presented by his peers and not by newspaper reporters.
People that know Bud Frazier, and those that matter, know that the Chronicle article was nothing but sensationalizing reporting – trying to dig up dirt where there is no dirt. Bud is a very strong person and this kind of slanderous news will not damage what he has accomplished or will accomplish. THI has lost some skilled Doctors over the last several years but is still one of the premier cardiovascular facilities in the world. It is led by Dr. James Willerson, a world renowned brilliant and distinguished cardiologist. The Chronicle owes not only Dr. Frazier, THI, Dr. Willerson and St Luke’s Hospital a sincere apology, but should also apologize to their readers for stooping to publish such a slanted tabloid style article.
To The Houston Chronicle:
This letter is a testimonial to Dr. O.H. (Bud) Frazier. Six years ago, my husband became a patient of Dr. Frazier. He could not have been a more caring and dedicated doctor. He was responsible for keeping my husband alive and hopeful beyond the time he was expected to live. His visits brought my husband pleasure, and Dr. Frazier was always available to family members.
Our family was also aware of his forward-thinking research and his surgical expertise. Dr. Frazier is a pioneer in his field, which requires taking risks to make progress. He was willing to take on patients other surgeons would not touch. Your articles regarding Dr. Frazier are disturbing, especially as we and so many others have had very positive experiences with him. There are always people wanting to take down those who have achieved greatness.
Dr. Frazier is to be commended for saving so many lives and putting his patients first. We shall forever be grateful to him for his kindness and being there when we needed him.
Carole Bratter and family