Heart to Heart: The Twentieth-Century Battle against Cardiac Disease: An Oral History (review)

This book contains a diligently researched set of interviews with sixteen individuals whose careers in cardiology, surgery, and related disciplines contributed significantly to what is aptly called "the twentieth-century battle against cardiac disease." The author, Allen B. Weisse, is a professor of medicine, a skilled oral historian, and an active participant in much of the history presented here from his vantage point of more than thirty years in academic cardiology.

Weisse's qualifications for this assignment are clearly shown in his concise, five-page introduction about the "epidemic" of cardiovascular disease that vied with cancer in displacing infectious diseases as the greatest killer in the modern industrial world. His mastery of evolving developments in the field is apparent also in the sharply focused interviews based on personal expertise and on thorough study of the subjects' publications. His book combines a lively narrative of the careers and achievements of these sixteen individuals with biographic snippets about Weisse himself, who elects to insert his own anecdotes and controversial interpretations as a challenging interlocutor.

Interviews conducted from 1970 through 2000 trace the progress of therapeutic developments from extracardiac to closed intracardiac procedures, going on to "open-heart" operations assisted by the heart-lung machine. Comparable physiologic and diagnostic advances worked reciprocally with surgical procedures to facilitate remarkable progress on multiple fronts. Each interview is preceded by a vignette outlining the role of the interviewee in the relevant historical period; this is elaborated in the subject's biographic account focusing on scientific achievements and on relations with other workers in the field. The latter observations are often unreservedly candid, providing unusual piquancy to the assessment of colleagues still on the scene. Interviews often end with a question about possible regrets over things that might have been done differently, leading to highly illuminating self-assessments. In addition to the major interviews and analyses there are seventeen pages of pithy chapter notes, a short bibliography, adequate indices by name and subject, and more than two hundred brief biographic sketches of individuals who had significant relationships with the interviewees and with general activities related to cardiac disease in the twentieth century.

Six of the sixteen subjects are surgeons: Charles P. Bailey, Michael E. DeBakey, Rene Favaloro, Adrian Kantrowitz, John W. Kirklin, and Albert Starr. Their stories highlight, respectively, early closed operations for valvotomy, vascular replacements for arteriosclerotic disease, coronary bypass procedures, devices for the support of failing hearts, correction of a host of congenital cardiac ailments, and the long saga of heart valve replacements. Kirklin's remarkable surgical achievements are captured in his laconic remarks on his early work with the modified Gibbon heart-lung machine, and his crisp appraisal of contemporary Minnesota surgeons in those heady pioneering days of open-heart surgery.

Of the cardiologists, William Dock leads the list with comments on his father, George Dock, a protégé of William Osler and himself the first full-time professor of medicine in the United States. Eugene Braunwald, J. Willis Hurst, and Jeremiah Stamler provide insights into the investigative, clinical, and epidemiologic aspects of cardiology for which they are well known. Work in cardiac catheterization is exemplified by André Cournand, one of three individuals who shared the Nobel Prize for studies in this area. Richard J. Bing, properly styled a Renaissance man for his creative work in cardiac physiology illuminated by catheterization and for his creativity in musical composition, was still active in research when interviewed in 1998 at the age of eighty-nine. His orbit touched a remarkable group of renowned workers, such as Alfred Blalock and Helen Taussig in congenital heart disease, as well as Mary Allen Engle, who tells the story of her own work with Taussig and others with admirably gracious modesty.

Willem Kolff...