Cardiology: The Evolution of the Science and the Art By Richard Bing (review)

Abstract

named, was in curious impersonal contrast to the examples of his contributors, all of whom afforded their patients with names, or at least initials. In sum, the book is a worthwhile contribution to the medical literature and, read selectively, is both informative and satisfying. Susan Tuteur Address: 6 Glenn Forest LaDue, Missouri 63124 Cardiology: The Evolution ofthe Science and the Art. By Richard Bing. Philadelphia: Harwood Academic Publishers, 1992. Pp. 319. $16.00. Cardiology: The Evolution of the Science and the Art succeeds in giving the reader a thorough history of the major aspects of cardiology, from cardiac catheterization to pacemakers. Each author begins with basic information—so that even the non-cardiologist understands the material—and adds a personal reflection of the people and achievements that shape this medical field. The importance of each development is highlighted and its relationship to further work makes today's technology more clear. The reader realizes that work has been built on the ideas and trials of insightful doctors and scientists in the past who took great risks and faced great odds. As Bing and his coauthors say, "while the lineage of each of today's commonplace techniques can indeed be traced back to the innovations of our predecessors, we are frequently less cognizant of the blind alley-ways they tried and abandoned" (p. 25). Individuals often fought a system reluctant to change and to accept new techniques, and the authors portray the time of the technological advancements so that the achievements are even more incredible. Widely accepted religious beliefs, discriminatory practices, and educational institutions are often major factors in the science world, and Richard Ross quotes a 1934 lecture of Herricks to summarize this point: he would be rash indeed, who would venture to predict what will be the exact stages of medicine or the relation between physician and patient a century from now, yes even a decade ahead. Toppling thrones, scrapped constitutions, unsettled economic conditions, hostile industrial and social groups, angry nations brandishing loaded weapons, all these things not alone upset the world at present but threaten the stability and tranquility of the future, (p. 154) One walks away from this book with a clearer understanding of the development of cardiology and the people who made it all possible. Bing accomplishes what he set out to do: he produces a documentation of the evolution of the science and, more importantly, the art of cardiology. The doctors who made cardiology what it is today are given the chance to share their experiences; one excellent example is from Niels Stensen of Copenhagen in 1664, who makes a remarkable observation: "The heart has been considered the seat of natural warmth, as the throne of the soul and even as the soul itself. Some have greeted the heart even as the sun, others as the king: but if you examine it more closely, Perspectives in Biology and Medicine, 38, 1 ¦ Autumn 1994 | 147 one finds it to be nothing more than muscle" (p. 90). The authors tell the reader of the doctors' outside interests; that they have been poets, writers, travelers, and lovers of wine. And they relate that even Charles Lindbergh of aviation fame was a forerunner in the development of the cardiopulmonary bypass pump. In addition, the authors make it clear that they have a stake in this history, and the reader gains a sense of their feelings about the accomplishments they describe. In many ways, little has changed in medicine over the years: hospitals are still immersed in politics and funding, and fights continue to break out among competing colleagues. The authors acknowledge the accomplishments of the past in a way that connects them to the practices and research of the present. They comment thus on the changes: "Then we paid a price for our ignorance by inability to cure many diseases; today, we pay a price for the emphasis on science and technology, because we are less aware of the patient as a distinct personality, his social and economic concerns, and his personal response to disease" (p. 145). Cardiology: The Evolution ofthe Science and the Art tackles its subject in a comprehensive way that gives much needed recognition to everyone involved...