1981 Science Fiction Film fulfills Houston’s Artificial Heart Dream




Houston, Texas: world capital of space exploration, air conditioning, energy, petroleum exploration––and, since the 1960s––Heart Transplant Capital of the World. But another race--the medical equivalent of the space race--remains in the works: will Houston ever achieve the dream of developing a successful Total Artificial Heart?

Season 15 of the series “Movies Houstonians Love” kicked off on September 15th, 2019 at The Museum of Fine Arts, Houston with Dr. O. Howard “Bud” Frazier presenting the film Threshold (Richard Pearce, 1981). This annual film series invites notable Houstonians from different walks of life to present a favorite film. Threshold, starring Donald Sutherland and Jeff Goldblum, is a fictional account of both the development and implantation of the first successful ‘Continuous Flow Total Artificial Heart’. When implanted blood will flow continuously through the body, eliminating the pulse entirely. At the time it was written it was pure science fiction. Dr. Bud Frazier, a heart surgery pioneer with multiple faculty and association appointments, with multiple lifetime achievement awards, now 80 years old and described as a living legend, has an uncanny connection to the film: not only has he spent his entire career developing artificial hearts but for the last 15 years he’s specifically been focused on inventing a new continuous flow one exactly like the fictional character Dr. Thomas Vrain, portrayed by Sutherland in Threshold.

In the film, Dr. Vrain is a famed heart surgeon who brings medical biologist Aldo Gehring (Goldblum) onto his team to help develop the new device. When all else fails on prize patient Mare Winningham, Sutherland decides to defy the hospital board and use the experimental device. The controversial operation immediately generates media attention and while Sutherland waits out the consequences, Goldblum negotiates TV deals. Threshold brings to light the motivations behind artificial heart development and the role of the media in sustaining its ongoing allure - the seduction of technological progress.


The Museum of Fine Arts screening was packed to the gills with an audience eager to hear from the famous local surgeon. It's been 50 years since Houston first attempted to create a viable artificial heart and this million-dollar quest still mesmerizes the city. A whole elite culture has grown up around it; in country clubs, on golf courses, at a special viewing box at the Houston rodeo. The coterie of top surgeons who have made mainstream media headlines have left an indelible impression on the psyche of the city already known for its spirit of innovation. JFK gave his famous Rice University speech in 1962: “Despite the striking fact that most of the scientists that the world has ever known are alive and working today…the vast stretches of the unknown and the unanswered and the unfinished still far outstrip our collective comprehension…But this city of Houston, this State of Texas, this country of the United States was not built by those who waited and rested and wished to look behind them. This country was conquered by those who moved forward.” This mentality sparked the artificial heart program in Houston and subsequently led to a lineage of experimental heart surgeons, medical royalty of sorts, who have passed the baton to each other from the Kennedy era up till today, all in pursuit of this dream.

Though Threshold depicts the fictitious first instance of a ‘Continuous Flow Total Artificial Heart’ being implanted, other types of artificial hearts have indeed been implanted dating back to the 1950s. Dr. Frazier’s mentor, Congressional gold medal winner, and equally famed surgeon, Michael E. DeBakey, had led the research team at the Baylor College of Medicine. DeBakey successfully developed a ventricular assist device, or partial artificial heart, and worked on the Total Artificial Heart as well. However, it wasn’t until the late 1960’s, a few months before Houston’s NASA helped land man on the moon, that the first Total Artificial Heart was experimentally implanted. DeBakey’s rival surgeon, Dr. Denton Cooley, performed the operation at the Texas Heart Institute which caused much controversy. As the story goes, Dr. Cooley stole the Total Artificial Heart out of DeBakey’s laboratory at Baylor and implanted it without permission from the research team, the hospital board or the FDA. “Federal Agency Probes Use of Artificial Heart” (the patient died within 3 days of surgery) a news headline reads. In sheer horror, DeBakey stopped speaking to Cooley and for over 40 years the two leading surgeons did not communicate, maintaining perhaps the most famous feud in medicine while working across the street from one another as competitors.

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It would be a decade before the next Total Artificial Heart was implanted, yet again gracing the covers of magazines and newspapers around the world. This time the device was designed by Robert Jarvik who Jeff Goldblum’s character, Aldo Gehring, is said to be based on. According to Threshold producer Michael Burns, American novelist, James Salter (1932-2015) came to write the script in the mid 70’s. “He got an assignment by LIFE magazine to talk to the emerging superstars of heart surgery. Salter went across the country and interviewed many people including Dr. Denton Cooley and Dr. Robert Jarvik… and that’s the locus of the movie.” In fact, Robert Jarvik made the artificial heart prop for the film, bringing yet another layer of uncanny authenticity to Threshold. Before Production commenced, director Richard Pearce recalls visiting Houston with Donald Sutherland and following Dr. Cooley around for a day, they watched multiple surgeries up close in the operating room. “We were star struck by Cooley” he says. The awe Pearce and Sutherland felt clearly translates to the screen as we are expected to be wowed by the plastic and stainless steel heart as if it were gods gift. Dr. Vrain is infallible just as the fictional artificial heart is and, of course, the patient (Winningham) not only survives but manages to resume a lifestyle unlike any patient in the real world history of the technology.

Threshold premiered at the Toronto International Film Festival in 1980. The reviews were mixed. Stephen Zoller writes in Cinema Canada, “Director Richard Pearce and writer James Salter treat their subject matter with such complete reverence that the effect is, in the early going, very seductive”. 20th Century Fox picked up the film at the festival but sat on it for more than a year, uncertain of how it would fare at the box office. Then in 1982 with media attention on new star heart patient Barney Clark and the Jarvik 7 Artificial Heart, Fox decided it was time to release Threshold. According to the film’s producers, it was a big mistake as The New York Times review ended with, “Unless you're absolutely fascinated by heart surgery, ''Threshold'' may not be a film you'll want to drop everything to see.” Unfortunately not much more came of the film and it fell into obscurity till more recently. The films director, Richard Pearce, who attended the Houston screening, said in an interview in 2020, “The film found its audience 30 years after it was made that night in Houston - that was the audience the film was designed for.”


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Though Frazier claims to vaguely recall Sutherland coming to Texas to follow Dr. Cooley, he says he had not been familiar with the film and had never watched it until 2007 when Dr. William E. Cohn who was working on the new ‘Continuous Flow Total Artificial Heart’ with Frazier at the Texas Heart Institute, presented it to him. “They’re doing exactly what we’re trying to do now!” Dr. Cohn exclaimed to Frazier. The two became so enamored with the film that they recorded a fan video for Donald Sutherland and Jeff Goldblum. In it Frazier repeats one of his favorite mantras: “What man can conceive he can do and this conception in art has led to the reality in Science”. While Threshold provides a stranger-than-fiction mirror to Houston’s dream, endless failures performed on calves was the reality for Dr Frazier. “You do calf after calf after calf - it’s just a very high risk procedure” Frazier says. Today, millions of people remain at the mercy of a competitive heart transplant list and research continues to struggle to match nature’s complex design to provide the potentially life-saving Total Artificial Heart.

As a Houston Chronicle journalist wrote in 2019 “Fifty years later, the story of the first artificial heart’s implantation endures: science fiction made reality, cautionary tale, the event that launched one of medicine’s most famous feuds, a dream still being pursued. It is one of Houston’s signature stories but also a subject of continuing interest around the world.” While the mainstream media has always been the willing bedfellow to the dream of the artificial heart contingency, projecting success and courage over any signs of failure, investigative research can raise important questions about the culture and capital surrounding this quest. Artificial hearts are an imperfect technology, and its controversial history speaks to questions of expectations, limitations, and uncertainty in a high-tech medical world that plays out in the sensation driven media narratives that help maintain a hopeful audience. In 2008, after over forty years, Dr. Cooley and Dr. DeBakey managed to reconcile in the operating room as Dr. Frazier and Dr. Cohn tested their device, however, they unfortunately both passed away before seeing their life’s mission fully realized with a successful Total Artificial Heart. Will Dr Frazier achieve a world-changing advance on the frontiers of heart replacement within his own lifetime? We shall see. In the meantime, he has Threshold to fulfill the dream.