Some comments, too extensive to fit into the comment box:
(1) There is a fairly recent reworking of at least some parts of the proof in
the book "Heegner points and Rankin $L$-series", MSRI Publ. 49. (Brian Conrad
in particular has a paper in there reworking the deformation theory arguments.)
(2) The theorem is a computation: one computes the height of the Heegner point,
using Neron-Tate local heights, and relates the answer (a sum of contributions from
each place) to a corresponding expression for the derivative.
(3) It is Kolyvagin's work which shows that if the Heegner point is non-zero,
then it generates the Mordell-Weil group (up to finite index); so if you want
motivation for the truth of Gross--Zagier, you can think of it as being a consequence
of BSD + Kolyvagin. (This may be ahistorical, though.)
(4) Historically, Birch was the one who computed Heegner points on elliptic curves,
and found that they were generators of the Mordell--Weil group (up to finite index)
precisely when the rank was one. This was a big source of encouragement for Gross
(as he explained at one point when I was in grad school), because it meant that
there should be a relation between the derivative at 1 and the height of the
Heegner point, and one just had to find it.
(5) The arithmetico-geometric parts of Gross--Zagier are wonderful; I wouldn't at all
think of it as futile to study them. I've not studied the analytic parts, but no doubt they're equally wonderful.
(6) You might start with the Crelle paper of Gross--Zagier, which essentially treats the
case of level one. Since the modular curve of level one has genus 0, the height is necessarily zero, and so one gets a very nice formula relating the sum of the finite local heights to the archimedean local height. And one can prove the same formula another way,
using a special case of the analytic arguments that in the general setting compute the
derivative. The fact that the same formula is obtained these two different ways is a special case of the general Gross--Zagier formula; but it may be simpler to understand the two sides and the comparison between them in this level one setting.
(7) As far as I understand, Kato says nothing in the analytic rank one case.
For BSD in this case, one needs Gross--Zagier plus Kolyvagin.