But less than a decade after graduating from Oberlin, Cohn had achieved star status of an entirely different sort. And by May of 2004, the national medical community was hailing him as the Thomas Edison of heart surgery.
A highest-order renaissance man, Cohn today not only performs cardiac surgery and sits on the boards of several medical technology companies, but he plays trombone in three bands. When not traveling for speeches or courses or professorships, he does fiendishly clever magic tricks. He also helps his five kids with math homework, science problems, and relationship issues, and, often in the workshop behind his home, invents things. Lots of things.
Cohn's smallish office in the Texas Heart Institute at St. Luke's Episcopal Hospital in Houston looks like a college dorm room on laundry day. It gives clutter a new meaning. Office assistant Sharon Williams says she used to try to tidy up, but finally gave up. "What's the use, he's always tinkering with things."
The walls are covered with mounted newspaper and magazine articles about Cohn from the New Yorker, Boston Globe, Popular Mechanics, Houston Chronicle, and Houston Press. Dotting the space are dramatic photos of masked men and women in blue scrubs crowding around an operating theater table. One photo is of world-renown cardiac surgeon and medical innovator Michael DeBakey, with "To my friend Billy C." above the signature.Two joined Dell flat screens sit on his desk. Two open laptops and two more computer screens, plus a video player and screen, rest on his bookcase. Three CPU towers vie for space under the desk amid a tangle of wires and cords. The CIA couldn't be more wired or complicated.
Crammed at an angle into a lower shelf on his bookcase are hardback copies of Atlas For Surgical Anatomy and Pumps and Pipes, which rest atop a commemorative edition of The Band's swan song concert and movie, The Last Waltz.
The bemused, slightly confused faces of U2 singer Bono and Houston mega-socialite Lynn Wyatt are locked on Cohn in an 8-by-10" frame; they're trying to spot his sleight of hand during a magic trick at a party. The photograph has a certain tension.
And then there are the official plaques recognizing Cohn's inventions: the biological fluid warmer; the catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a prechosen anatomic site in-vivo; the surgical retractor and method of use; the Cohn Cardiac Stabilizer that keeps the heart beating during a bypass operation, reducing the risk of neurological damage or death. Cohn holds or shares more than 60 patents.
There's also a plaque declaring the affable surgeon a "member in good standing" with the International Brotherhood of Magicians. And there's a doctoral degree from the Baylor College of Medicine dated May 23, 1986; a certificate declaring him an adjunct professor at Nanjing Medical University; and an honorary doctorate from Oberlin inscribed with "William E. Cohn, Class of '82: Celebrated cardiac surgeon, renowned researcher, musician, maverick, inventor of the Cohn Cardiac Stabilizer, inspired inventor of improved techniques for coronary bypass surgery."
A full day of surgery has made Cohn an hour and half late to our interview. He is obviously weary; he played a gig the night before with bluesman Little Joe Washington, performed heart surgery this morning, and oversaw the beginning of a critical FDA animal test of a new heart technology this afternoon. Nevertheless, Cohn grins and grabs some old spoons that lean against a wall near his desk. They've been sawed and cut and reshaped.
"They don't look like much but, yeah, these are what I'm famous for," he laughs. The spoons are the prototype of the Cohn Stabilizer that he invented in his workshop from a set of soup spoons he bought at Stop & Shop while a resident surgeon in Boston. These days, his ideas usually lead him to a plumbing or hardware store.
Piled on top of the inventor's kits, heart mock-ups, plastic tubes, magazines, computer program discs, and random ephemera on Cohn's desk are seven sheets of white paper with 15 items in 20-point bold print: tomorrow night's set list for his band, ChangoMan, at the Continental Club.
Billy Cohn didn't give college much thought until late in the game, eventually applying to Harvard, Princeton, and Yale. Princeton wait-listed him. Harvard and Yale said no.
His mom, an Ohioan, suggested he visit Oberlin. Cohn hadn't heard of the town nor the school, but thought, "why not?" "In high school, I was perceived as a bit screwy, someone who would try stuff other people would never think of doing. I was kind of an outlier," Cohn recalls. "But the second I got to Oberlin, I loved it. Everybody was an oddball doing their own thing. I knew I could go there and not stand out. And even better, they accepted me. I didn't have the highest GPA, but I had great SATs, and I think that's what they looked at.
"Oberlin also appealed to me because it has such a highly rated music conservatory, right there with Juilliard and Eastman, and I wanted to be a rock star, so Oberlin seemed perfect. What could go wrong?"
Looking back, Cohn admits, "I was only 17 and probably one of the least mature people in my freshman class.
"Coming from an environment like Memorial High School, I suddenly found myself surrounded by all of these individualists who were doing their own thing. I'd always been a creative person; I liked art, I liked music. I did all the art for the school newspaper and I worked part time at a T-shirt printing shop. I didn't exactly fit the Texas mold. Then suddenly I'm dropped in Ohio right in the middle of a whole bunch of people who are just as weird as I am. I loved it almost immediately.
"I quickly saw I didn't have to live up to anyone's expectations, that I didn't have to follow some already-in-place plan for my life. No one told you that; they were too busy doing their own thing. It was your job to figure out your thing. That was the big mental sea-change I experienced there: do what you really want to do."
So what happened at Oberlin to derail Cohn's dream of rock stardom?
"I arrived at Oberlin just as the whole punk rock thing from the U.K. hit the States, and it became huge overnight with people our age. So my freshman year I became this avid punk rocker, and I thought I was so bad.
"I was really bad about deadlines, so I started taking science courses, trying to avoid classes that were going to have huge live-or-die term papers with firm deadlines," Cohn confesses sheepishly. "By the time I had to declare my major in my junior year, I had all these hours in chemistry and biology and physics, so I took the science route."
Despite the fact that he was playing bass in several punk bands (and claims that his place was Party Central: "all my friends and their bands would come hang out and we'd play all weekend"), Cohn says he started to get serious about his future.
"My parents never pushed me in any direction," says Cohn, "but my mom would clip out these articles from the Houston Chronicle about medical stuff that was going on in Houston, the first transplant, open heart surgery, inventions, all that stuff, and she'd put them next to my cereal bowl. I guess some of it stuck."
He applied to medical school and was accepted at the prestigious Baylor College of Medicine in Houston. "My plan was to become a plastic surgeon," he says. "I was going to make all this money, but the work wasn't going to be all that serious; nobody was going to die. I was going to make people pretty and get paid well."
It didn't exactly turn out that way. One of only 35 students admitted to the program, Cohn found his plastic surgery courses rather dull. It was the heart surgery classes that grabbed his attention.
"They select 35 surgeons to come into the program. After three years, it winnows down to 10. A lot of people thought I was faking my interest in heart surgery just so Dr. DeBakey, who was partial to up-and-coming heart surgeons, wouldn't boot me out of the program."
By the fifth and final year, only seven of the original 35 students were left—Cohn among them. He had made his bones, at least on the first rung of the heart surgeon hierarchy.
But in spite of being in awe of the talent and names he was surrounded by, he recalls having innovative ideas after his first year of medical school.
"I would see a procedure, and I'd think, 'Why are we doing it that way?' Or I'd see some device that we used in a procedure and think, 'It would work better if it was like this.' But at first I kept that stuff to myself. I thought maybe I didn't know enough about why something was the way it was."
From 1986 through 1991, Cohn immersed himself in general surgical residency training at Baylor. He then became one of a handful of physicians chosen for heart surgery training directly under DeBakey. Aside from his surgical work, Cohn liked to tinker and think, and it wasn't long before his creative urges found an outlet. He filed for his first patent in September 1990, and in April 1992 was granted a U.S. patent for his biological fluid warmer. It was the first of many medical technology problems he would solve. He also became DeBakey's lead surgical resident.
After his training at Baylor, Cohn added another (non-required) year of training at Harvard before accepting a position on the Harvard faculty, which he held for a decade. There, he would go on to set the world of cardiac surgery abuzz and make his star. In 1998, Cohn revealed his biggest innovation yet, the Cohn Cardiac Stabilizer (made from the spoons in his office). The invention allowed surgeons to perform bypass surgery on a beating heart. When he was asked to join the Texas Heart Institute, despite having his parents and other family in Boston, it was an offer he couldn't resist.
"The 800-pound gorilla of medical innovation and invention was Michael DeBakey," Cohn says. "Just to be on his radar was an honor. To be asked to come work with him at the Texas Heart Institute is the chance of a lifetime that every innovative heart surgeon dreams of."
Cohn moved to Houston and fell into the realm of three of the world's most noted heart surgeons: DeBakey, Denton Cooley, and Bud Frazier, who has done more heart transplants than anyone in the world. And the rest is history — still in the making.
On March 23, 2011, Cohn, along with his boss/partner/mentor Bud Frazier and the Texas Heart Institute, were riding high on their latest, widely trumpeted scientific achievement: a fully mechanical heart. Implanted in a comatose, terminally ill patient with a life expectancy of three to four days, the device revived the patient. He came out of his terminal coma and lived four more months before dying from the rare incurable disease he had. The device and procedure were hailed as a monumental breakthrough in cardiac surgery. Yet, less than two years later, Cohn virtually dismisses it.
"Yes, it proved we could keep someone alive on a mechanical heart substitute. That's a breakthrough. But there were also problems with that generation of devices, and many of them have to do with quality of life. So, okay, you're alive, and you've got this machine inside that keeps you alive. But this machine requires a tube that comes out through your skin. It requires an external battery to keep it working, so you have an electrical wire that goes through your skin to the external power source and has to be with you 24/7. So there's all this baggage that went with that device. Frankly, the man we put the first one in asked us several times to let him die. It worked, but it was far from perfect."
Cohn has started clinical trials for a new, more compact, more elegant device he refers to as the Daniel Timms model (named after the Australian designer of the device, who, upon Cohn's counsel and urging, has now relocated from Brisbane to the Texas Heart Institute). An amazing conceptual idea and piece of technology and medical science, the new device has only one moving part. Its mechanics, physics, and performance are mind-boggling. Cohn and his team installed one of the devices in a young cow. Two days later, the animal was in the laboratory eating hay and walking on a treadmill. So far, so good.
"Here is the picture. There are about two million people in the country today who would benefit from a heart transplant," Cohn says. "But only 2,000 human hearts suitable for a transplant become available each year. If you need a heart transplant, waiting for a matching human heart to save you is equivalent to someone deeply in debt counting on winning the lottery to cure their financial problems. The odds are very, very long. The mechanical heart will be a game changer."
The mechanical heart is just one of six inventions and procedures on which Cohn is overseeing FDA trials as principal surgeon. "I can't go into the details yet, but we're working on a new heart assist pump that is going to revolutionize that technology," says Cohn, adding that such a pump is what is keeping former Vice President Dick Cheney alive.
But what excites Cohn the most has nothing to do with repairing hearts, per se. "We've known for a long time that one of the first things to look for in people who experience sudden rapid weight loss is a blocked celiac artery, which, simply put, serves most of the major digestive organs.
"It seems obvious now, but at some point we went, 'Voila! What if we could artificially restrict the celiac artery?' If we can perfect this technology and procedure, imagine what we can do for patients with morbid obesity, which is an epidemic in this country. I'm really excited about this. This will be relatively inexpensive, and it's going to help a lot of people."
Another way Cohn helps people is as a mentor, and he traces his willingness to serve in that function back to his own "outlier" status.
"Add to that I was part of the first class of punk rockers to come into the medical schools. I was the first medical student ever at Baylor with a two-tone hairdo. Well, somewhere along the way I've become a magnet for all these other outliers, these smart young people who want to do something outside the box, and I love that. They come to us, I let them spend time in my service, tell me their ideas, and I try to steer them in the direction they need to go."
Cohn strides backstage at the Continental Club at 9 p.m., trombone case in hand. He's dressed in jeans, a tail-out white dress shirt, and the same alligator boots he wore in the operating room the day before — the same alligator boots he wore two nights earlier when he played with Little Joe Washington at a club called Boondocks. He's ready to rock.
Sound check complete, Cohn and the other members of ChangoMan, all young Latino hipsters, tear into a wicked original tune with a Latin dance beat called "Devil's Cumbia." Cohn is the only horn player in ChangoMan, and he bleats aggressive fiery trombone into the hot mix. The dancers hit the floor, and it's on. The band burns through an hour and a half of mostly originals and some Latinized versions of Beatles songs. The crowd is loving it.
Afterwards, Cohn is greeting friends and well-wishers when a member of the club's management approaches. "Billy, Little Joe is in the office, and he looks real bad. He hasn't eaten in a couple of days. You want to take a look at him?" Cohn enters the office and closes the door. After five minutes, he comes out and says, "He says he feels really bad. I may call an ambulance and have him taken to Ben Taub [hospital]."
Cohn gets a glass of water from the bar, reenters the office, and evaluates the diminutive, frail blues man who has lived most of his chaotic adult life on the streets. The doctor, who has surgery scheduled for the next morning, finally coaxes the old man into his blue Audi and drives off into the night.
Destination? Kentucky Fried Chicken, Washington's favorite meal. And then Cohn drove him home into the Third Ward. How's that for a house call?
Just all in a day's work for a rock star and the Thomas Edison of heart surgery.