Ben Franklin and Open Heart Surgery

• In 1966, President Lyndon Johnson said: "Presidents. . .need to show more interest in what the specific results of research are in their lifetime, and in their administration. A great deal of basic research has been done. . ., but I think the time has come to zero in on the targets by trying to get our knowledge fully applied. . . . We must make sure that no life saving discovery is locked up in the laboratory (italics added)." President Johnson's words popularized a new set of terms: research in the service of man (implying that there are two types of biomedical research, one that is in the service of man and another that is not), strategy for the cure of disease, targeted research, mission-oriented research, programmatic research, commission-directed research, contract supported research, and payoff research. And the President's remarks have been summarized as "research is fine, but results are better" and "we know all we need to know; now all we must do is to apply what we already know." His philosophy led to a sharp upsurge in contract-supported research and commission-initiated research. Most scientists are convinced that basic, undirected research is essential to the prevention, diagnosis, and treatment of disease, and most scientists can support their convictions with dramatic examples. (1) When Roentgen discovered X rays, it was not to enable a cardiologist to visualize the coronary arteries of a patient suffering from angina pectoris; he was studying a basic problem in physics to determine the electrical nature of matter. (2) When Karl Landsteiner discovered blood