As Dr. Tom MacGillivray made an initial incision to open up a patient's chest earlier this month, Adele's voice echoed through his new operating room at Houston Methodist Hospital.

The sweetest devotion … hitting me like an explosion.

"Who picks the music?" MacGillivray said, repeating a question from a reporter who'd come to observe his first operation at the hospital. "Not me. I thought we'd be listening to George Strait or something."

He's joking now, but a year ago when MacGillivray was still at Harvard University and contemplating whether to take a job interview at Methodist, he'd imagined Houston was a city of cowboy hat-wearing, country music-loving Southerners.

After 19 years on staff at Harvard and Massachusetts General Hospital — having become regarded as one of the nation's top heart surgeons while practicing in his hometown — MacGillivray wasn't interested in moving to Texas. But an old friend, Texas Medical Center President Dr. Bobby Robbins, had called and asked him to at least make a visit.

"And out of respect to him, I said, 'Sure, I'll come take a look at it,' " MacGillivray said. "That's what I was saying. But what I was thinking was, 'There's not a chance I'm going to move to Houston. Why would I leave Mass General?' "

At the end of a two-day visit a year ago, while waiting to board his return flight to Boston, MacGillivray called his wife: "You know, Les, I could really see myself living here and working here," he remembers telling her. "In fact, I'd really be excited."

For a moment, there was silence on the other end.

And then: "OK. We can talk about it."

***

Robbins has seen it play out again and again as he's sought to recruit top physicians to the Medical Center since taking the job four years ago. At first, they're leery. Texas is far away, foreign. They've never been to Houston and have misguided assumptions about life here.

"But once you get them in the door and have them see how fantastic this place is, you can sign the deal," Robbins said, pointing out that, although most recruits are aware Houston has the world's largest medical complex, they don't fully appreciate the scope of clinical research being done here.

Robbins' official job description doesn't include recruiting, but he's become particularly obsessed with luring doctors from elite Ivy League institutions.

So when he learned Methodist was looking to hire a surgeon, Robbins — a cardiac surgeon himself — thought of MacGillivray, a man he's known for years. After calling to feel him out, Robbins got in touch with Dr. Alan Lumsden, the chair of cardiovascular surgery at Methodist, and told him "one of the best heart surgeons I've ever seen is potentially recruitable."

Lumsden called a mutual friend, another cardiac physician in Boston, who confirmed that MacGillivray was an expert surgeon. But he told Lumsden not to bother: MacGillivray would never leave New England. Lumsden decided to give it a try anyway.

"He's a big deal," he said of MacGillivray. "Bringing someone like Tom down here will generate interest and give us an avenue into even more recruitment. He's that kind of a talent."

Within a few hours of stepping off the plane at George Bush Intercontinental Airport last year, MacGillivray said he was "blown away."

Methodist had assembled a team of top heart surgeons that seemed to match its legacy as a pioneer in the field. He was particularly impressed with a program Dr. C. Huie Lin set up to treat adults with congenital heart disease, a new and developing field that MacGillivray specializes in.

More children than ever who were born with congenital heart defects are surviving late into adulthood, thanks in part to surgical techniques developed at Methodist more than 50 years ago by Dr. Denton Cooley and others.

"My suspicion is we have more adult congenital heart patients than anyone in the country," Lin said. "They exist here in Houston because Denton Cooley worked on them and saved their lives when they were children."

As a result, Methodist is now one of the nation's leaders in treating emerging health problems in those patients, Lin said. In Boston, MacGillivray had carved out a niche as one of only a handful of surgeons in the country who specialize in treating heart disease in those patients.

It was a perfect fit, Lin said.

"It's one thing to have someone who is a flawless and a phenomenal technical surgeon, but also to have someone who has the passion and vision to take care of this emerging population is pretty exciting," he said.

After a day with Lin and Lumsden, MacGillivray, 55, realized Methodist was likely the place where he could do the most good.

"The team here is involved in nearly every clinical trial that's pushing the field forward," MacGillivray said. "Boston was my home, and I was very comfortable there and had a thriving practice there. But to me it seemed like the future was here, and for me, that meant my future was here."

***

MacGillivray started at Methodist on Dec. 1. After assisting on several surgeries, the Jan. 3 operation was his first as lead surgeon.

The patient was a man in his 30s who'd survived a high-speed car accident several years earlier. A stent graft inserted in his aorta to improve blood flow following the crash had begun to fail, mimicking a condition that leads to high blood pressure that's common in adult congenital heart disease patients.

"This one's tailor-made for him," said Lumsden, who'd come to the operating room to see his high-profile hire in action.

As MacGillivray worked to open the man's chest and maneuver past one of his lungs, he noted that he was operating on hallowed ground - in the same operating room where legends of his field had worked. Cooley. Michael DeBakey. E. Stanley Crawford. Jimmy Howell.

"It's kinda like something you think about when you're a kid," MacGillivray said, an Adele track still playing in the background. "You get to work in the place where these men operated. It's a real honor."

That wasn't the only reason he agreed to come here.

Houston, he said, was not at all what he'd imagined. The food. The diversity. The arts. He's embarrassed to admit it now, he said, "but I had that parochial Northeasterner's view of the rest of the country. As I've come to learn, this is an amazingly cosmopolitan, metropolitan city, just like the few other huge cities around the world."

And despite her initial hesitation, it didn't take long for his wife, a dermatologist in Boston, to catch his enthusiasm, he said.

She'll be moving to Houston later this year.