I've always felt that I did well as a student because I lacked confidence.

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.