I am a medical student/researcher with plans to become a cardiac surgeon or cardiologist. I enjoyed learning some of the history of the Cleveland Clinic and am personally involved in some of the new developments that the author mentioned in the last chapter. My only problem is that the book was not representative of american cardiology or cardiac surgery as a whole. It seems that the author did all of his research in Ohio and the Northeast, whereas significant advances have taken place in other parts of the country (U. of Alabama, Mayo, Texas Medical Center). Two of the most famous cardiac surgeons the world has known - Michael Debakey and Denton Cooley were only mentioned in a few short sentences. The reader gets the impression that some less important surgeons (that happen to work at the Cleveland Clinic) invented cardiac bypass surgery when it was actually the work of hundreds. In the last chapter, the author mentions a technique called OCT. Yes, this technique shows promise (I work with it) but it was only mentioned because someone at Harvard is working on it. I can think of 10 examples of techniques that show as much promise. I wish writers that wanted to tell the world about American medicine would search all of America before they sat down to write. In sum, it was readable but had some holes that made me feel incomplete after I read it.

Stephen Klaidman has provided us with a very interesting, easy reading book that I recommend to anyone who has a heart condition or is interested in the subject. The major portion of the book discloses chronologically how heart conditions were treated from its earliest practitioners to the present day. Biographical sketches of medical developers, practitioners, entrepreneurs, etc. provide human interest to the emerging history.

All major surgical developments, most of which occurred in the twentieth century, are explained in detail. The struggles of medical pioneers to gain acceptance of what at the time were radical innovations are amply explored. Among these innovations are angiography (imaging technology), heart-lung machine, coronary bypass surgery (with and without the heart-lung machine), angioplasty, and minimally invasive bypass surgery.

Hi-tech heart surgery-an extremely complex and difficult subject-is explained for the layman to understand. The benefits and problems of each of the current procedures are explained.

Klaidman explores hi-tech surgical instruments, a highly profitable multi-billion dollar business. His biographical profiles of some developers (doctor-engineer-inventors) and entrepreneurs disclose how the competitive race of developers to market first and the rivalry of entrepreneurs for market share may be detrimental to the best interests of patients.

None of the many present sophisticated treatments provide a cure! They just alleviate symptoms. The pioneers of today are searching for cures. Their approaches are described and are not only fascinating but also innovative.

The final chapter discusses the ethical questions raised by our current medical system: conflicts of interest between practitioners with financial stakes in various treatments; competition between advocates of various treatment options; competition between various surgical equipment manufacturers for market share; the pressure to reduce costs by HMOs; etc.

If there is one fault to the book, it is that the title "Saving the Heart: The Battle to Conquer Coronary Disease" led me to believe that it would be more comprehensive. The drugs-nitroglycerin, Coumadin, beta-blockers, calcium channel blockers, statins--were mentioned only as they pertained to a topic then being explored, not in the detail the surgical treatments were given. Not even mentioned are life style changes--diet, exercise and meditation--that Dean Ornish has proposed. A book on these topics written as well as this one would definitely be welcomed.

But for what this book does it does it so well a five star rating is most appropriate.