First Annual Irvine H. Page Lecture

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For the past 5 to 6 years I have been spending much of my time looking backward to learn how great lifesaving advances in cardiovascular-pulmonary medicine and surgery of the past 30 years have come about. Did the cardiac surgeon of the late 1930s and early 1940s suddenly make a giant leap from sea level to the pinnacle (Fig. 1A)?1 Or did he walk up the back of the mountain (Fig. 1B)—up steps laboriously carved out by hundreds or thousands of scientists over many generations, scientists in many disciplines working in many countries?

I am not going to give a history lecture. Historians would not rate me as one of them—because I am not really involved in excavations that prove that the Yellow Emperor of China actually wrote on the circulation of the blood in 2600 BC (4200 years before William Harvey). My main interest is finding whether discoveries came quickly or slowly and, in each case, why. What accelerated discovery? What held it back? What was the importance of chance, of discovery in related fields, of undirected work (knowledge for the sake of knowledge), of authoritarian pronouncements, of mission-oriented work, of contracts for store-bought research, and of commissions, task forces, or presidential panels? How often did commissions advance knowledge, how often did they retard progress? How important was the character of individual scientists—for example, their persistence in the face of ridicule or indifference?

I am not going to give a lecture on hypertension, because it. . .



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