Eugene Braunwald and the Rise of Modern Medicine by Thomas H. Lee (review)
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Eugene Braunwald and the Rise of Modern Medicine. By Thomas H. Lee. Cambridge, MA: Harvard University Press, 2013. 400 pages. Hardcover, $35.00.

This book is a meticulous biography of an extraordinary man, Dr. Eugene Braunwald, who was deeply involved in many of the advances to cardiac surgery in particular, and medical research more generally, in the twentieth century. The book's narrative begins in the middle of that century and continues almost to when the book was published in 2013, albeit at a much slower pace towards the end of the work, covering Braunwald's retirement years.

The book highlights an important facet of recent history that is not often visible to the general public: transformations within medical practice and theory over the course of roughly sixty years. Events are described largely through hundreds of quotes from Braunwald and dozens of people who worked closely with him, sometimes in the emergency room, sometimes at a patient's bedside, and sometimes in a research lab (and often all three for many of the narrators). Some interviewees were Braunwald's teachers, some his coworkers, and some his students. The author, Thomas Lee, first met Braunwald in 1979 during his medical training at Boston's Peter Bent Brigham Hospital, where Braunwald was chairman of the department of medicine. Thirty years later, Lee asked Braunwald to provide input for this book—a book that Lee characterizes as "a description of the evolution of medicine…as viewed through the lens of [Braunwald's] life and career" (xi).

Over the next several years, Lee and Braunwald met regularly, and those interviews, along with interviews of Braunwald's associates, form the basis of the book. Copious footnotes contain the dates of the author's interviews and references to many other sources, including papers Braunwald published, interviews that others conducted with Braunwald, and components of Dr. Allen B. Weisse's Heart to Heart: The Twentieth Century Battle against Cardiac Disease; An Oral History (New Brunswick, NJ: Rutgers University Press, 2002). Lee provides just enough personal biographical detail to put Braunwald and his work in context, but the main focus of the book is Braunwald's career and the surrounding medical milieu, including scientific innovations, advances in medical treatment, design and interpretation of clinical trials, and changes in medical training and hospital organization. [End Page 408]

Braunwald spent his early years in pre-Nazi Austria, but his family escaped to England before war broke out and then immigrated to Brooklyn with the help of relatives who had already come to America. (The description of their last days in Austria and their escape is chilling.) Always excited by learning, he managed to attend some of the finest schools in New York and was able to get into medical school, even though the number of Jewish applicants was severely limited because of prejudice. From the start of his career, Braunwald wanted to work closely with heart patients while also doing basic research; his dual desires soon brought him to the National Institutes of Health (NIH) and then to the University of California at San Diego (UCSD), where he was the first chairman of their new department of medicine. From there he went to Brigham and Women's Hospital in Boston, where he managed the work of hundreds of researchers and physicians. Braunwald was a prolific author or coauthor of peer-reviewed medical reports in all the major cardiology and medical publications—more than a thousand altogether over a period of more than sixty years—and continued to publish even after his retirement.

Beyond the trajectory of Braunwald's career and the parallel changes in medicine, Lee's book also details several controversies that involved fraud perpetrated by researchers working under Braunwald and the steps he took to prevent similar occurrences from happening in the future. Most notable is an incident known as the Darsee affair, in which one of Braunwald's colleagues had been fabricating research results for years, both on Braunwald's watch and at other institutions. This incident caused Braunwald to rethink how accusations of fraud should be handled, and so he and colleagues worked to establish new procedures for fraud investigations. Lee discusses...