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The quest for a practical total artificial heart (TAH) stems from the large number of patients with advanced heart failure, and the limited number of donor hearts available for transplantation. In this Perspectives article, Cohn et al . give their expert insight into the development of TAHs over the past 50 years. They describe the evolution from positive-displacement, pulsatile pumps to continuous-flow devices, and give their opinion on the most promising avenues for future innovation. A practical artificial heart has been sought for >50 years. An increasing number of people succumb to heart disease each year, but the number of hearts available for transplantation remains small. Early total artificial hearts mimicked the pumping action of the native heart. These positive-displacement pumps could provide adequate haemodynamic support and maintain the human circulation for short periods, but large size and limited durability adversely affected recipients' quality of life. Subsequent research into left ventricular assist devices led to the use of continuous-flow blood pumps with rotating impellers. Researchers have attempted to integrate this technology into modern total artificial hearts with moderate clinical success. The importance of pulsatile circulation remains unclear. Future research is, therefore, needed into positive-displacement and rotary total artificial hearts.

Restoring hearing to people who are too deaf to benefit from hearing aids required an extraordinary, decades-long research endeavor. The 2013 Lasker–DeBakey Clinical Medical Research Award recognizes the contributions of three pioneers of cochlear implantation. The Lasker–DeBakey Clinical Medical Research Award, announced September 9, recognizes the contributions of three pioneers of cochlear implantation: Graeme Clark, Ingeborg Hochmair, and Blake Wilson. Their collective efforts have transformed the lives of hundreds of thousands of people who would otherwise be deaf. Deafness impairs quality of life by relentlessly dismantling the machinery of human communication. Ludwig van Beethoven, plagued by deafness, wrote in 1802, “For me there can be no relaxation in human society; no refined conversations, no mutual confidences. I must live quite alone and may creep into society only as often as sheer necessity demands. . . . Such . . .

Portrait of the President of the United States George Washington (1732–99), First President of the USA, painting by Gilbert Stuart (1755–1828) 1796/London National Portrait Gallery/Photo © Luisa Ricciarini/Bridgeman Images A century before Washington, a new group of practitioners—the genteel Parisian dentistes—had invented the idea that one should have one's teeth attended to for reasons other than the relief of pain, to improve one's looks, rank, or marriageability. Washington's uncomfortable expression on the dollar bill also highlights the continuing importance of artistic and cultural forces in determining the meaning of a smile. 18th-century attempts to represent and understand pain, in art and medicine, focused on the face and especially the mouth. Citizens of the Enlightenment established a voracious demand for devices and techniques to remedy the stained, rotten teeth resulting from overindulgence in tea, coffee, chocolate, sugar, tobacco, or Turkish delight, while 18th-century journals and newspapers were crammed with adverts for tooth powders, tooth whiteners, mouthwashes, breath sweeteners, toothpicks, tongue scrapers, and toothbrushes.

The 2007 Lasker Award for Clinical Medical Research was granted to Albert Starr and Alain Carpentier for their contributions to the development of the prosthetic heart valve. Dr. Elliot Chaikof discusses the evolution of heart-valve replacements. Albert Starr coinvented and implanted the first successful artificial heart valve in 1960. He is currently director of academic affairs and bioscience development at Providence Health System of Oregon. The 2007 Lasker Award for Clinical Medical Research, granted in mid-September to Albert Starr and Alain Carpentier, recognizes their extraordinary contributions to the development of the prosthetic heart valve, which represents a milestone in the journey toward the fabrication of synthetic living tissues and organ systems. The prosthetic heart valve was built on a foundation laid down during the first half of the 20th century with the introduction of cardiac catheterization by André Cournand and Dickinson Richards, the development of innovative surgical techniques by Alfred Blalock, the invention of the heart–lung machine by John Gibbon, and the discovery of heparin . . .