Cardiology 1985: 'Whither are we tending and what ought our aim to be?' Presidential address.

MUCH HAS HAPPENED in the field of cardiovascular medicine since the 1984 Scientific Sessions of the American Heart Association in Miami. For all the noteworthy advances that were made, certain events brought more notoriety than others. At times, the notoriety was unfortunate and ill focused, as in the abortive attempt at interspecies transplantation with "Baby Fae." At other times the attention was particularly delightful and richly deserved, as in the awarding of this year's Nobel prize for Medicine to Drs. Michael Brown and Joseph Goldstein. In a year of such extremes, it seems appropriate for the purposes of this annual address to ponder a question posed much earlier in this century by one of medicine's leading thinkers of the day: "Whither are we tending and what ought our aim to be?" Francis Weld Peabody, Professor of Medicine at Harvard Medical School and the first Director of the Thorndike Memorial Laboratory, wrote these words in his 1928 essay, "The Soul of the Clinic."' The point of his essay was that the physician-investigator was the "soul of the clinic" and his plea in those years was for more science in medicine. Considering that today's events are taking place a scant 14 years from the end of this century and just before the dawn of the third millenium A.D., some reflection on certain of the medical events that have occurred during the past 85 years would seem a timely way of formulating a contemporary response to Peabody's ageless question. Such reflection leads me to suggest there are two considerations that loom larger than all others in shaping an answer to the first part of the question, i.e., "Where are we heading?" The first is the incontrovertible fact that all the citizens of this