American Cardiology: The History of a Specialty and Its College by W. Bruce Fye

Abstract

974 Book Reviews TECHNOLOGY AND CULTURE Sylvia K. Kraemer’s overview of NASA’s culture mainly follows a well-beaten track with such themes as the tension between NASA’s ethos of in-house research and its practice of contracting research out. It is, however, an exceptionally well-informed reiteration. J. D. Hunley pushes beyond prior accounts of the birth of U.S. rocketry by dint ofmeticulous research and the productive device of compar­ ing the Peenemunde rocketeers’ use of academic and industry con­ sultants with the practices of the Jet Propulsion Laboratory. Rick W. Sturdevant’s article hews the most closely to the book’s title, laying out the air force’s organizational arrangements for space as they evolved over the course of five decades. In my opinion, how­ ever, the time is past for us to content ourselves with this kind of chronology or to limit our studies to a single organization as actor. Martin J. Collins recently exhorted us to view NASA’s program in the larger context of the combined military, intelligence, and civil­ ian efforts (Collins and Sylvia K. Kraemer, eds., Space: Discovery and Exploration, Southport, Conn.: Hugh Lauter Levin Associates for the Smithsonian Institution, National Air and Space Museum, 1994, p. 11). His injunction is equally appropriate for historians of military space. The final article, by Donald R. Baucom, is a clearly articulated account of the fight the Pentagon waged and won for control of the Strategic Defense Initiative against the High Frontier Panel, a group of influential private Republicans that was advising President Reagan. There are many excellent books and articles on the U.S. space program, but the glamour of the theme has also called forth scores of badly researched and hastily written ones. The field, therefore, has a particular need of work that upholds high standards. Except for the fact that it lacks an index—the reader is asked to purchase this separately—this collection amply meets academic levels of his­ torical scholarship. Thereby, it helps to elevate the whole specialty. Joan L. Bromberg Dr. Bromberg recently completed a manuscript, Partners in Space: NASA and the Aerospace Industry, for the NASA History Office. American Cardiology: The History of a Specialty and Its College. By W. Bruce Fye. Baltimore: Johns Hopkins University Press, 1996. Pp. xvi+489; illustrations, tables, notes, bibliography, index. $24.95 (cloth). When asked by the president of the American College of Cardiol­ ogy (ACC) to write a history of the organization, W. Bruce Fye pro­ posed situating the college’s history within the context of larger de- TECHNOLOGY AND CULTURE Book Reviews 975 velopments in the field of cardiology and 20th-century American medicine. With American Cardiology Fye has successfully realized his ambitious program. Drawing from government documents, organi­ zation minutes, correspondence, oral histories, and a wide range of secondary sources, he offers a nuanced study that traces cardiology from its turn-of-the-century beginnings through the formal organi­ zation of the field in the 1920s, the research and development sparked by post-World War II government spending, and the emer­ gence in 1949 ofcardiology’s professional society, the American Col­ lege of Cardiology (ACC), to present-day questions surrounding techniques ofbypass surgery, professional boundaries, and Medicare reimbursement. Using “representative biographies,” as he did in his earlier work on American physiology, Fye explores the educational opportunities and career paths open to early cardiologists. While physiological cardiologists concentrated on research, practitioner cardiologists fo­ cused on clinical care, academic cardiologists operated as clinicians in an institutional context, and public health cardiologists studied disease trends and stressed prevention. Throughout the text, Fye acknowledges the turf battles and tensions that accompanied the transfer of technology and cardiac care procedures from their aca­ demic and laboratory origins to the local physician’s office and the local hospital. Initially, researchers and public health cardiologists dominated the field; through the American Heart Association they set professional standards and secured government funds for re­ search and training specialists. In perhaps the most interesting chapter in the text, Fye uses ACC founder Franz Groedel’s career to demonstrate how clinical cardiologists, who consistently found themselves excluded from clinical opportunities and membership in the American HeartAssociation during...