Of the many 'firsts' with which I have been involved at the Texas Heart Institute —including the first successful human heart transplant in the United States and the first total artificial heart transplant in the world—the achievement that may have the greatest impact on health care did not occur in the operating room or in the research laboratory. It happened on a piece of paper... when we created the first-ever packaged pricing plan for cardiovascular surgical procedures.

I've always felt that maybe one of the reasons that I did well as a student and made such good grades was because I lacked confidence. Lacked self-confidence, and I never felt that I was prepared to take an examination, and I had to study a little bit extra. So that sort of lack of confidence helped me, I think, to make a good record when I was a student.

I still take failure very seriously, but I've found that the only way I could overcome the feeling is to keep on working, and trying to benefit from failures or disappointments. There are always some lessons to be learned. So I keep on working.

So much goes into doing a transplant operation. All the way from preparing the patient, to procuring the donor. It's like being an astronaut. The astronaut gets all the credit, he gets the trip to the moon, but he had nothing to do with the creation of the rocket, or navigating the ship. He's the privileged one who gets to drive to the moon. I feel that way in some of these more difficult operations, like the heart transplant.

I think work is a privilege. ... It keeps you alive, spiritually.

A successful surgeon should be a man who, when asked to name the three best surgeons in the world, would have difficulty deciding on the other two.

The spirit of Texas seems to pervade our everyday existence. Our desire is to be superlative, not only the largest, but also the best in the United States.