Friday, October 2, 2020

Now Showing: The King of Hearts

The King of Hearts
Genre: Drama
Director: Bennett Miller
Writer: Chad Taylor
Cast: Tom Cruise, Tom Hanks, Holly Hunter, Kate Hudson, Gael Garcia Bernal, Billy Crudup, Linda Cardellini, Sean Harris, Bridget Regan

Plot: Based on a True Story - 1969

In a quiet room with white bare walls, Dr. Denton Cooley (Tom Cruise) nervously paces by himself. He is having a conversation with himself before finally stopping mid-pace. He looks down at his shaking hands. He puts one hand on the doorknob, ready to turn it and leave. But before he does, he takes a long, deep breath.

Seven Years Earlier - 1962; Houston, Texas

Dr. Michael DeBakey (Tom Hanks) is performing vascular surgery on a patient. He holds command over the room and all of the underlings who surround him, executing his demands with exquisite precision. He does encounter a brief mishap but deals with it with incredible calmness and the surgery is a success. We then follow Michael’s process after the surgery. He changes clothes and makes one last stop to his office. We can see the many awards that establish him as one of the world’s best surgeons.

At home, there are more awards and honors lining the mantle. He visits the kitchen and his wife Diana (Holly Hunter) briefly kisses him before continuing her cooking with the type of pressure her husband showed in the operating room. He eyes the clock and asks what time they are supposed to be there and she tells him in twenty minutes. He says he will get changed. Michael goes to his bedroom and changes into a more relaxed outfit before sitting down on his bed and looking down on his shaking hands. He lays back onto the bed and lets out a huge sigh of relief before briefly falling into a nap.

He suddenly wakes up when his visitors are at the door. It is Denton Cooley and his pregnant wife Louise (Kate Hudson), along with their three daughters. Helen and Louise exchange pleasantries while Michael and Denton talk shop (or the surgeries they performed today). The two men are wholly different in demeanor - Michael more stern while Denton exudes confidence - but they clearly share a rapport. The two families coalesce at the dinner table and catch up. Denton asks about Michael and Diana’s children, all of whom are in college at the moment. Meanwhile, Diana asks if they know the gender and Louise says they do: they’re having a fourth girl! Denton makes a crude joke about his genes.

After dinner, Denton says that he needs to talk to Michael in private in the parlor. Michael obliges and pours them some drinks. They talk a little bit about the surgeries they performed that day, as well as some murmurings in the medical community about the prospects of the “heart transplant”. They know would be a huge breakthrough but is still a ways off. Denton breaks from the conversation to say that he isn’t going to pussyfoot around why he pulled Michael into the parlor: he has raised enough money to start the Texas Heart Institute across town. Michael asks what this means and Denton says it means he is leaving Methodist Hospital (and thus his colleague Michael) behind. Michael is clearly bothered by this but tries not to show it. He asks if he will be staying on at the university and Denton confirms. Michael then asks if Denton is getting backed by his oil pals. Denton shrugs his shoulders and smiles, saying “I have no control over who wants to be my friends.” Michael chides Denton for telling this in his own home but Denton says that he wanted it to be face-to-face. He offers to shake Michael’s hand but is declined.

Eleven Years Earlier - 1951; Houston, Texas

Denton is sitting down in front of Michael’s desk for an interview for a faculty position at the Baylor University School of Medicine, where Michael is dean. He runs down Denton’s impressive education and resume, which makes him an obvious hire. Michael says there is something more important to him, however. He asks what is driving Denton to this profession. Money? A decent life? Something more? Denton delivers a monologue about the stakes of their profession: both in the lives of the individual patients they treat but, through research, the health and prosperity of the world as a whole. Making a change in this business means making a change in the world. Michael posits “so you’re driven to be the best?”. “You bet your bottom dollar, I am.” Michael smiles and offers a handshake, telling Denton that that is the most important criteria for being hired here. He only wants the best. Denton shakes his hand and says “well, you’ve got him”. He flashes his big trademark smile.

Back in 1962, both men talk to their wives later in the night. Denton and Louise are mainly stressing about the risk of this new venture, especially during a time where they need stability (being pregnant with a fourth child). He tells Louise that he needs her to be strong during this time but she rejects this and tells him that she needs him to be there for her. He says he will. Michael is mostly venting to Diana, talking about feeling betrayed. She asks what he expected when he hired an ambitious young surgeon all of those years before. She is able to talk some sense into him and he realizes that he should be happy for Denton. He just isn’t sure if he was ready for him to make the transition from protege to equal. She says that they are both going to do great things.

Michael conducts a series of interviews to find Denton’s replacement at the hospital. Following a similar line of questioning as he had 11 years earlier, he does not have much success. Until he interviews bright Argentine surgeon Domingo Lamotta (Gael Garcia Bernal). Lamotta answers the questions perfectly as Cooley had. Domingo shows Michael drawings of an artificial heart that he is working on, which could potentially be used as a substitute for a real heart in the case of an emergency. Michael is impressed by Domingo’s drive and hires him on the spot.

When Domingo starts work, however, Michael assigns him to assisting on a project of developing the world’s first ventricular assist device. Meanwhile, we see Denton performing surgery at his new institute. While Michael is like a technician in the O.R., Denton is like a wizard. Gifted with ambidextrous dexterity and lightning fast decision-making, he starts to gain a national profile as one of the world’s top surgeons.

Denton is at the hospital, as always, but in everyday attire. Louise is giving birth to their fourth daughter. He looks down to his shaking hands before he cradles the newborn for the first time, tears welling up in his eye.

Michael and Domingo experience a breakthrough on their Left Ventricular Assist Device and are publicly hailed for it. Domingo asks if they can shift their focus to the artificial heart but Michael dismisses this and tells him that they have found their lane. They should stick to it and thrive in it. At home, Michael is eager to watch the evening national news, who are doing a special on the world’s top doctors and interviewed him. However, the program talks about Michael a little bit before transitioning into a longer segment on Denton, which frustrates Michael. They have remained on friendly-ish terms, however, and Diana reminds him that Denton’s success is indicative of what a good teacher that her husband is.

Denton misses the program as he is at a fancy party on a ranch that is hosted by some of the who’s-who in the Texas oil industry. Despite being in a totally different profession, he fits right in as he shakes hands and takes names.

In December of 1967, Denton calls Michael and invites him over to his home for a drink. Michael hesitatingly accepts. He knows what this is about. They sit by the television and wait for a report before it finally comes in: Dr. Christiaan Barnard (Sean Harris) has performed the first successful human-to-human heart transplant in South Africa. Michael asks Denton if he is happy for him. Denton asks: the patient or Christiaan? They share a laugh over drinks as the game is definitely on. Clearly both are entranced by the advancement in their field but frustrated that it was not them leading the way.

A week later, at a gala for the world’s top surgeons, Denton runs into Christiaan and congratulates him on his big achievement (clearly a little upset that he is not the one being congratulated). While that was Christiaan’s first, Christiaan should start hearing about Denton’s first hundred soon, he says with his big trademark smile. After the conversation, Louise scolds him for his unearned cockiness.

But Denton commits to the promise he made Christiaan. As always, he puts his all into learning the ins and outs of this new direction: heart transplants. Louise again needs to reel him in and tell him he is pushing himself too hard. This work pays off as he successfully performs the first one in the United States, which he is lauded for. Building off of this success, he schedules around a dozen that year (although, as with Christiaan’s, these patients do not tend to live for very long after getting the implant as post-surgery medicine is not up to the standard yet).

Upon seeing this, Michael informs his team that they are changing the focus of research. They are also entering the heart transplant game. Domingo asks if they will be enlisting the help of his former colleague Denton Cooley, who is easily the most proficient transplant surgeon in the world to this point. Michael tells them they will not. After hearing Michael’s speech and realizing that he again did not mention the artificial heart, Domingo leaves early.

Louise and Diana share a tea at a Houston coffee shop as they are clearly on better terms than their husbands. They catch up on their personal lives while briefly touching on the simmering tension between their husbands.

Cooley, himself frustrated with the low success rate for his surgeries, vents to Louise. She comforts him in this rare moment of tenderness for him, knowing the toll that his high-pressure job is taking on his well-being. The doorbell rings and it is Domingo. He starts to introduce himself before Denton says that he obviously knows who he is. Domingo asks Denton if he is driven by a desire to be the best. After a beat, Denton smiles, knowing that question rings a bell. Domingo pulls out his briefcase and tells Denton that he has something to show him.

While continue performing heart transplants, Denton and Domingo begin working together on perfecting the artificial heart. After coming up with a model that they are comfortable with, they start to test the hearts on calves, with minor (if none at all) success. It is clearly still a work-in-progress. Denton asks if they should go to DeBakey about helping with the research but Domingo says no, he probably wouldn’t be interested.

Denton has a lengthy conversation with a potential patient named Haskell Karp (Billy Crudup). After hearing of the health scares and multiple failings of Haskell’s heart, Denton recommends he get a transplant. Haskell and his wife Margaret (Linda Cardellini) are against this as they know that the success rate has not been high. They instead want him to repair Haskell’s current heart. Denton says that he can try but that it is going to be a difficult surgery with a risk of death. He then says that if things go wrong, that he does have a back-up procedure in mind. He asks if Haskell would be willing to have an artificial heart put in him in the case of an emergency. Haskell nervously provides his verbal consent, saying that hopefully the surgery goes well to begin with.

At his home, Denton plays with his children while this looming surgery is clearly on his mind. Louise asks him if anything is up and he declines to talk about it. Louise says that Michael is taking Diana out to Hawaii for a week, maybe they should consider something similar. He doesn’t respond and continues to play house with the kids to put his mind off of things.

In a quiet room with white bare walls, Denton nervously paces by himself. He is having a conversation with himself before finally stopping mid-pace. He looks down at his shaking hands. He puts one hand on the doorknob, ready to turn it and leave. But before he does, he takes a long, deep breath.

Denton starts the surgery on Mr. Karp with his usual smoothness. However, as he is in the remodeling process, the heart collapsed and things turn dire. With his usual quick-trigger decision-making, Denton makes the call: they need to put in the artificial heart as it will be days before they would be able to get a real human heart to transplant. After putting it in, things start to stabilize and Haskell survives the surgery. He calls Domingo and tells him this joyous news. Domingo says that he is going to call Michael and let him know but Denton says not to bother - he is currently in Hawaii. Let him enjoy his vacation. Besides: he’ll be hearing about the news from the media soon enough.

In the days that follow, Denton is hailed as a hero and the Cooley-Lamotta artificial heart is seen as a technological/medical breakthrough. After having the artificial heart for three days, they get a real heart to transplant into Haskell. However, his body responds poorly to it and dies of pneumonia shortly after. Considering that it acted as a viable substitute, the artificial heart is still considered a success.

Michael, meanwhile, is furious. He goes on a publicity blitz upon returning home. He fires everyone from his lab, citing that they are all to blame for letting this theft occur. He accuses Denton of stealing the design from his lab (which Domingo was a member of). Denton responds that Michael did not give Domingo the light of day, which made Denton’s institute a natural contingency plan. However, Michael is very targeted in how he plans to destroy what he views as Denton’s mirage of a legacy. He points out the ethical flaws in Denton’s surgery, namely that this was never approved by a formal review and that Mr. Karp was essentially a human test subject.

Upon seeing each other at the grocery market, not even Louise and Diana can get themselves to talk to one another (which makes them both a bit sad).

All of the investigations that Michael launches towards Denton are fruitless. The device was obtained legally and mainly due to (although he may not like to admit it) his own hubris and blind spots. However, the ethical debates do muddy the true success of the endeavor.

A title card says that for the next 40 years, Denton and Michael never spoke to one another despite attending various events on the same night and living in the same city. They both continued to be known as the world’s two most famous heart surgeons.

In 2006, at his home, Michael (nearing 100 years of age) starts to feel piercing heart pain that spreads to his neck. He immediately recognizes this as an aortic dissection. This leads to an awkward conversation with his much younger doctor (Bridget Regan), who tells him he obviously knows about the procedure to treat this - he invented it in 1953! He insists that he does not want this, however.

He has a lengthy discussion with his family about this, who want him to have the surgery. He eventually decides to do it, although his doctor needs to get the approval of the ethic board given the patient’s advanced age and his initial refusal. Given the reverence attached to his name in the medical community, they approve.

After a grueling procedure, the surgery is a success and 97-year-old Michael begins his recovery. One day he is surprised by a visitor: Denton Cooley, himself in his 80s. They share a conversation about their lives and careers, lamenting the grudges that they held that were ultimately driven by their egos. They both apologize to each other and Denton points out how crazy it is that Michael saved his own life, in a way. Denton then reflects on how he still remembers the day that Michael interviewed him for the position at Baylor. “What drives you to be in this business?” or something like that. Michael smiles, “I still remember your answer: to be the best. Well?” Denton pauses for a beat. “Well, what?” “Were you the best?” A silence lingers as the trademark smile creeps up on Denton’s face.




No comments:

Post a Comment