Machines in Our Hearts: The Cardiac Pacemaker, the Implantable Defibrillator, and American Health Care

Notes

NOTES INTRODUCTION 1. Elmer A. Braun, letter to Michael Halonen, 27 February 1990. 2. In the 1990s, a patient with left bundle branch block and episodes of dizziness or fainting would be a candidate for more extensive electrophysiological study to determine whether the heart had a tendency to go into sustained ventricular tachycardia (rapid heartbeat). Such a patient might end up with an implantable defibrillator rather than a pacemaker: S. Serge Barold and Douglas P. Zipes, ‘‘Cardiac Pacemakers and Antiarrhythmic Devices,’’ in Heart Disease: A Textbook of Cardiovascular Medicine, ed. Eugene Braunwald, 4th ed. (Philadelphia: Saunders, 1994), 729–30. 3. The pacemaker, a CyberLith IV manufactured by Intermedics, Inc., of Freeport, Texas, was one of the most sophisticated models then available. Although the physician could alter the pacing rate and other parameters through the use of an external programmer , Braun did not recall that anyone had ever reprogrammed it after its initial setup. 4. The second pacemaker was a Cosmos II from Intermedics. 5. Lewis Thomas, ‘‘The Technology of Medicine,’’ N Engl J Med 285 (9 December 1971): 1366–68. Thomas himself later became a pacemaker recipient: ‘‘My Magical Metronome,’’ Discover 4 ( January 1983): 58–59. 6. U.S. Congress, OTA, Policy Implications of the Computed Tomography (CT) Scanner, OTA-H-56 (November 1978); William W. Lowrance, ‘‘Summarizing Reflections,’’ in New Medical Devices: Invention, Development, and Use, ed. Karen B. Ekelman (Washington , D.C.: National Academy Press, 1988), 164. 7. Arthur Caplan, ‘‘The Concepts of Health, Illness, and Disease,’’ in Companion Encyclopedia of the History of Medicine, ed. Roy Porter and W. F. Bynum (London: Routledge , 1993), 1:233–48; Walsh McDermott, ‘‘Medicine: The Public Good and One’s Own,’’ Perspectives in Biology and Medicine 21 (winter 1978): 167–87; Walsh McDermott, ‘‘Social Ramifications of Control of Microbial Disease,’’ Johns Hopkins Medical Journal 151 (December 1982): 302–12; Stanley J. Reiser, ‘‘The Machine at the Bedside: Technological Transformations of Practices and Values,’’ in The Machine at the Bedside: Strategies for Using Technology in Patient Care, ed. Stanley J. Reiser and Michael Anbar (New York: Cambridge Univ. Press, 1984), 3–19. 8. Shoshana Zuboff, In the Age of the Smart Machine: The Future of Work and Power (New York: Basic Books, 1988). 9. Susan Bartlett Foote, Managing the Medical Arms Race (Berkeley: Univ. of California Press, 1992), 12. 10. Howard Bird, ‘‘An Affair of the Heart,’’ N Engl J Med 326 (13 February 1992): 300 NOTES TO PAGES 6–12 487–88; Mary Moore Free, ‘‘The Heart of the Matters of the Heart,’’ Am J Cardiol 78 (15 July 1996): 217–18. 11. Free, ‘‘Matters of the Heart’’; Lynn Payer, Medicine and Culture (New York: Holt, 1988), 74–75, 79–85. 12. I use the terms doctor and physician interchangeably to refer to persons holding the M.D. degree and licensed to practice medicine; thus surgeons are physicians. 13. John B. McKinlay, ‘‘From ‘Promising Report’ to ‘Standard Procedure’: Seven Stages in the Career of a Medical Innovation,’’ in Technology and the Future of Health Care, ed. John B. McKinlay (Cambridge: MIT Press, 1982), 233–70. 14. For an excellent introduction to the history of medical thinking about the heart and treatments for its maladies, see Joel D. Howell, ‘‘Concepts of Heart-Related Diseases ,’’ in Cambridge World History of Human Disease, ed. Kenneth F. Kiple (Cambridge: Cambridge Univ. Press, 1993), 91–102. 15. For a European’s analysis of the pacemaker/defibrillator industry, see Patrik Hidefjäll, ‘‘The Pace of Innovation: Patterns of Innovation in the Cardiac Pacemaker Industry,’’ Ph.D. diss., Linköping University, Sweden, 1997. 16. Susan E. Bell, ‘‘A New Model of Medical Technology Development: A Case Study of DES,’’ Research in the Sociology of Health Care 4 (1986): 1–32; Joel D. Howell, ‘‘Early Perceptions of the Electrocardiogram: From Arrhythmia to Infarction,’’ Bull Hist Med 58 (spring 1984): 83–98; Joel D. Howell, ‘‘Diagnostic Technologies: X-Rays, Electrocardiograms , and CAT Scans,’’ Southern California Law Review 65 (November 1991): 529–64. 17. Louis Galambos with Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme, and Mulford, 1895–1995 (Cambridge: Cambridge Univ. Press, 1995). Galambos does not formally define the phrase cycles of innovation and it does not appear in his index. 18. James M. Utterback and Fernando F. Suárez, ‘‘Innovation, Competition, and Industry Structure,’’ Research Policy 22 (1993): 1–21; Michael L. Tushman and Philip Anderson, ‘‘Technological Discontinuities and Organizational Environments,’’ Administrative Science Quarterly 31 (September 1986): 439–65; Hidefjäll...