Good Fences Make Good Neighbors

Something there is that doesn’t love a wall,That sends the frozen-ground-swell under itAnd spills the upper boulders in the sun,And makes gaps even two can pass abreast.I let my neighbor know beyond the hill,And on a day we meet to walk the lineAnd set the wall between us as we go …He is all pine and I am apple orchard.My apple trees will never get acrossAnd eat the cones under his pines, I tell him …Before I built a wall I’d ask to knowWhat I was walling in or walling out,And to whom I was like to give offense.Something there is that doesn’t love a wall …He says again, “Good fences make good neighbors.”—Robert Frost“Mending Wall,” 1914Cardiovascular science and medicine have been friendly “neighbors” for decades. It was a beautiful day in the neighborhood—supportive neighborhood organizations (NHLBI) provided balanced funding of clinical and basic science projects, cardiology fellows were schooled in both clinical and scientific camps, and intimate family reunions (AHA) were designed to bring together citizens from both sides of the tracks. The “Boyz in the Hood” were Braunwald, Ross, Sobel, Willerson, Weisfeldt, Marcus, Abboud, Smith, and Haber; the icons for a generation of cardiovascular physician–scientists. It was the heyday of cardiovascular physiology, and this fundamental science was easily translated into major therapeutic advances that still form the mainstay of our current-day prognostic, diagnostic, and therapeutic approach to patients with heart disease. The experimental subject of choice was often patients themselves, or surrogate large-animal model systems that were easily manipulated by all the guys in the hood. …