Heart surgery, at least as we know it today, is a surprisingly modern field. For hundreds of years, all the way up til the middle of the twentieth century, doctors used to believe that “if you touch the heart, you kill the patient.” So they left well enough alone.
However, with the Baby Boom came an explosion of children with congenital heart defects. It became increasingly clear that surgeons were going to have to start traversing this unexplored territory. Cardiac Cowboys tells the story of the mid-century surgeons who were at the forefront of this era of rapid life-or-death innovation, working on the margins of their profession to make discoveries that would go on to save untold lives.
Although the marketing has really pushed actor Chris Pine’s (Ad Lucem) involvement in the series, on an episode-by-episode basis, his role in Cardiac Cowboys is fairly limited. He narrates the first five minutes or so, and then hands over to Jamie Napoli, who wrote the script.
Both men have similar sturdy, stoic voices; they could indeed pass for cowboys growling stories of great men at each other as they sit around a fire after a long day on a horse. The choice of a Western theme, however, makes for an odd juxtaposition with both the highly emotional material and the podcast’s jaunty backing music.
Neither narrator is unpleasant to listen to, but the almost total lack of expression in their voices can make a show that’s dense with technical and historical information feel rather dry, despite the enormous stakes. The decision to let the material speak for itself is an understandable one — you could well imagine a version of this show where they lean too far in the other direction, which would undoubtedly have been worse — yet just a little more inflection in the delivery would have gone down nicely.
Happily, this is a podcast with content so fascinating, it can readily survive underpowered narration. In fact, there was easily enough content here for twice as many episodes.
Perhaps the most noteworthy running theme is the horrifying but unavoidable toll of loss that littered the new medical frontier of cardiac surgery. This is not a Hollywood story — in Cardiac Cowboys, a successful operation can mean dying soon afterwards, but from something other than your original ailment. A happier outcome is living long enough with an artificial heart valve to receive a human heart transplant that your body goes on to reject. That lack of easy, obvious wins for the surgeons resulted in a tough time getting the funding for further research, and often put them at risk of being sued, and sometimes even jailed.
Most of the doctors we hear about are presented as empathetic people, more concerned with the patient’s emotional wellbeing than was typical at the time. For instance, after an operation went horribly wrong, one of the doctors encouraged the family of the injured party to sue, knowing that the man would need money to care for his newly brain-damaged wife. Nevertheless, there was also a rivalry between these ‘cowboys’ as to who would be the first to achieve the goals they were all aiming for, and who would get the credit for the procedures and research on which multiple people worked.
While that is in many ways the least interesting aspect of a supremely interesting podcast, Cardiac Cowboys makes it clear that this wasn’t just sheer glory hunting for ambitious surgeons (though there certainly was some of that). In an era when pioneering heart surgeons were regularly the stuff of front page news and guests on late night shows, the fame from being the first across the line could be parlayed into higher research funding, which in turn could lead to more saved lives. Knowing how to play the fame game was, in a very real sense, an important part of their job.
Still, Cardiac Cowboys never loses sight of the patients and families who helped the doctors make history: those who agreed to donate the hearts of their loved ones in the face of unfathomable grief, and those with terminal illness who agreed to operations they knew had little chance of succeeding, because they knew that research would yield life-saving results for others.
As Napoli says in the closing words of the series, “Their hearts would change the world.”
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Chloe Walker is a writer based in the UK. You can find her work at Culturefly, the BFI, Paste, and her Letterboxd.