Happy 100th birthday to Dr. Richard John Bing
2009; Elsevier BV; Volume: 137; Issue: 2 Linguagem: Inglês
10.1016/j.ijcard.2009.07.008
ISSN1874-1754
Autores Tópico(s)Clinical practice guidelines implementation
ResumoDr. Richard John Bing (Fig. 1) will be 100 years old on October 12, 2009. There are very few physicians, to my knowledge, who remain very active and extraordinarily productive at 100 years of age. Witness the article Dr. Bing wrote on surgery of the young heart and about Drs. William Glenn and Francis Fontan (Fig. 2) that was published earlier this year [[1]Bing R.J. Past truth & present poetry. 40. Surgery of the young heart: William Glenn & Francis Fontan.News Bull Int Soc Heart Res. 2009; 17: 4-5Google Scholar]. There are even fewer physicians who are as multi-talented as Dr. Bing who is still productive at 100 years of age as a physician, scientist, musician, composer and author of medical and non-medical books, book chapters and articles. Indeed, Dr. Bing is a genius [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. I will discuss these attributes in more details later on. I do not intend to write a biography on him, because there have been quite a few excellent ones already published [2Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar, 3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar, 4Weisse A.B. Heart to Heart.in: The Twentieth-Century Battle Against Cardiac Disease. Ch 4. Richard J. Bing, M.D. (1909–) New Brunswick, New Jersey. Rutgers University Press, 2002: 57-71Google Scholar]. What I intend to do in the following few pages is to describe briefly Dr. Bing's achievements — listed in alphabetical order — from my personal knowledge, recollection and research over the years so that your readers may get a glimpse of what this “Renaissance man” [3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar, 4Weisse A.B. Heart to Heart.in: The Twentieth-Century Battle Against Cardiac Disease. Ch 4. Richard J. Bing, M.D. (1909–) New Brunswick, New Jersey. Rutgers University Press, 2002: 57-71Google Scholar] is really like.Fig. 2A 2009 publication of Dr. Richard John Bing.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Dr. Bing is a very productive author of over 545 peer-reviewed articles ranging in subjects from studies on myocardial metabolism in congestive heart failure [[5]Bing R.J. Studies on myocardial metabolism. VI. Myocardial metabolism in congestive failure.Am J Med. 1956; 20: 820-833Abstract Full Text PDF PubMed Scopus (60) Google Scholar] to echocardiographic study of the posterior left ventricular wall in experimental myocardial infarction [[6]Stefan G. Bing R.J. Echocardiographic findings in experimental myocardial infarction of the posterior left ventricular wall.Am J Cardiol. 1972; 30: 629-639Abstract Full Text PDF PubMed Scopus (20) Google Scholar]. In addition, he wrote books, not only medical books such as “Cardiology: The Evolution of the Science and the Art, Second Edition” (Fig. 3) [[7]Bing R.J. Cardiology.in: The Evolution of the Science and the Art. 2nd ed. Rutgers University Press, New Brunswick, NJ1999Google Scholar] but also non-medical books such as “The Bisquit Principle”, “Three Brothers and Other Stories”, “The Winds of Time and Other Stories”, “Fifteen Lives and a Cat's Story”, etc. The book “The Bisquit Principle” (Fig. 4) [[8]Bing R.J. The Bisquit Principle. Xlibris Corp, Bloomington, IN2007Google Scholar] published in 2007 is a delightful novel patterned after Don Quixote with all his involuntary wisdom. In “Three Brothers and Other Stories”, Dr. Bing strings together an impressive collection of short stories — five riveting, thought-provoking tales that have all mutated from his own life. Dr. Bing is truly an extremely imaginative and pensive storyteller, in the ranks of such bestseller authors as J.K. Rowling, James Patterson, Stephen King, John Grisham, Ian Fleming, Janet Evanovich and Agatha Christie. Dr. Alfred Blalock, Chairman of the Department of Surgery at Johns Hopkins Hospital, was responsible for bringing Dr. Bing to Hopkins in 1945 for the investigation and diagnosis of congenital heart disease by cardiac catheterization [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. “Not only was Alfred Blalock farsighted in realizing the need for investigations that would lend credence to his surgery for correction of circulatory anomalies but his choice of Richard Bing to carry out the mission could not have been more sensible. Bing, who possessed the genius, originality, and appropriate aggressiveness for this kind of pioneering endeavor…” [[9]Vandam L.D. Ferment in Baltimore in the forties.J Appl Cardiol. 1989; 4: 345-349Google Scholar]. While much of the credit for the pioneering work in the treatment of congenital heart disease went to Blalock and Taussig, Dr. Bing delineated in short succession the hemodynamic features of each of some 20 different types of congenital heart disease [[10]McNamara D.G. Contributions of Richard Bing to the field of congenital heart disease.J Appl Cardiol. 1989; 4: 351-356Google Scholar]. At Hopkins, Dr. Bing organized the world's first diagnostic cardiac catheterization laboratory [[11]Fye W.B. American Cardiology.in: The history of a specialty and its college. The Johns Hopkins University Press, Baltimore1996: 113Google Scholar]. His formulas, derived from the oxygen content of blood, for calculation of regional blood flow such as the effective pulmonary blood flow, 1A term that Bing coined to indicate the amount of mixed venous blood which is aerated in the lungs [[10]McNamara D.G. Contributions of Richard Bing to the field of congenital heart disease.J Appl Cardiol. 1989; 4: 351-356Google Scholar]. the direction and volume of the intracardiac shunt, and vascular resistance in the pulmonary and systemic circulations originally described in the late 1940s [12Bing R.J. Vandam L.D. Gray Jr, F.D. Physiological studies in congenital heart disease. I. Procedures.Bull Johns Hopkins Hosp. 1947; 80: 107-120PubMed Google Scholar, 13Bing R.J. Physiological methods in the diagnosis of congenital heart disease.Surg Gyn Obstet. 1949; 88: 399-401PubMed Google Scholar], are still being used today in every cardiac catheterization laboratory throughout the world. Dr. Bing is one of the pioneers in cardiac catheterization and probably should be the co-winner of the Nobel Prize awarded in 1956 to Forssmann, Cournand and Richards [[14]Cournand AF. Nobel lecture, December 11, 1956. In: Nobel Lectures, Physiology or Medicine 1942–1962. Amsterdam: Elsevier; 1964. pp. 529–42.Google Scholar]. His skill with the catheter left a deep impression on Lewis Dexter, another pioneer in cardiac catheterization [[15]Dexter L. Early days of cardiac catheterization.J Appl Cardiol. 1989; 4: 343-344Google Scholar]. Although Forssmann was the first person to perform cardiac catheterization in a human — himself — in 1929 [[16]Forssmann W. Experiments on Myself: Memoirs of a Surgeon in Germany. St. Martin's Press, New York1974Google Scholar], Dr. Bing in 1947 performed the first cardiac catheterization in Germany after Forssmann [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. Dr. Bing recalled “When I turned on the fluoroscope I could not believe my eyes; the catheter had entered the heart and in the right chamber it had made contact with a bullet acquired during the war!” [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. It might also be of interest at this point to recapitulate how Dr. Bing became the “Father of Cardiac Metabolism” [[9]Vandam L.D. Ferment in Baltimore in the forties.J Appl Cardiol. 1989; 4: 345-349Google Scholar]. To quote from his book, “The study of cardiac metabolism by catheterization was started in 1946, when I (RJB) found that the catheter slipped several times inadvertently into the region of the heart that under the X-ray looked like a portion of the right ventricle but actually was the coronary sinus; when the blood was withdrawn it was much blacker than that obtained from the right ventricle. Others had already observed that the coronary sinus could be catheterized. In 1941, as told by J.H. Comroe, in attempting to catheterize the right ventricle, Cournand obtained a sample of blood with lower oxygen content than the right atrial blood (23). Because the fluoroscopic picture showed that the catheter tip was misplaced and was possibly in the coronary sinus (by mere chance), Cournand was concerned with possible damage to the lining of the coronary sinus, and hastily withdrew the catheter (23). Gene Stead had trouble with three patients because the sample of blood from the right heart had a very low oxygen content; he concluded that the catheter must have slipped into the coronary sinus, and discarded the data (23). Sosman, a radiologist in Boston, listed among his “failures and errors” unexpected location of the catheter tip and published in one of his figures an X-ray film showing a catheter tip in the coronary venous sinus (23). In 1947 my (RJB) group at Johns Hopkins Hospital, originally organized to study congenital heart disease, wrote, ‘When the catheter is in the coronary sinus, it is seen curved upwards to the base of the heart. In the first cases, intubation of these vessels was fortuitous' (24). In the four remaining cases, intubation of these vessels was carried out deliberately. All our energy was now devoted to the new, rewarding field of coronary blood flow and cardiac metabolism.” [[7]Bing R.J. Cardiology.in: The Evolution of the Science and the Art. 2nd ed. Rutgers University Press, New Brunswick, NJ1999Google Scholar]. The rest is now all history! Very seldom does one possess double medical degrees. Dr. Bing is among these rare individuals. He obtained his first medical degree from the University of Munich in 1934. Then, because of some question about its recognition in the United States and the impending disaster in Europe following Hitler's appointment as chancellor of Germany, Dr. Bing matriculated at the University of Bern in Bern, Switzerland and obtained his second medical degree the following year [2Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar, 3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. There is another reason why Dr. Bing received his second medical degree. As he wrote, “my time in Switzerland was wonderful, because the beautiful mountains are close to Bern and I loved walking, climbing, and skiing. So, I received my second medical degree from the University of Bern, Switzerland” [[3]Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. Dr. Bing has often been called one of the “Founding Fathers of Experimental Cardiology”(Taegtmeyer, personal communication, June 3, 2009). At the age of 60 when most people would consider retirement, Dr. Bing went to Huntington Memorial Medical Institute, Pasadena, California to become the Director of Experimental Cardiology to continue his love. To quote from the editorial by Taegtmeyer and Ross in the festschrift celebrating Dr. Bing's 80th birthday published in 1989, “From accurate hemodynamic measurements to measurements of arterio-venous substrate changes across the myocardium, from measurements of protein synthesis to the biology of myocardial hypertrophy, and from such revolutionary ideas as the noninvasive measurement of coronary blood flow with radioisotopes to Bing's most recent work on the endothelium derived relaxing factor. There is hardly an area in cardiovascular physiology that has not been touched by Richard Bing. And one may add: He tackled each task with vigor and intellectual honesty….. Biochemists have chided him in the past as ‘too clinical’ for his unconventional approach to study substrate metabolism in the human heart. Clinicians have chided him to this day for being ‘too much of a basic scientist’. He simply does not fit into any mold.”[[17]Taegtmeyer H. Ross B.D. Richard Bing — life and adventures in cardiology.J Applied Cardiol. 1989; 4: 339-341Google Scholar]. So Dr. Bing combined both to form the perfect discipline of experimental cardiology. Frank of the Frank–Starling law of the heart was a mathematician and physicist and Starling was a distinguished professor of physiology at University College, London [[7]Bing R.J. Cardiology.in: The Evolution of the Science and the Art. 2nd ed. Rutgers University Press, New Brunswick, NJ1999Google Scholar]. Their heart–lung preparation represented a milestone in the development of our knowledge of cardiac metabolism. Dr. Bing heard Frank's lecture, although he was not a student of Frank [[4]Weisse A.B. Heart to Heart.in: The Twentieth-Century Battle Against Cardiac Disease. Ch 4. Richard J. Bing, M.D. (1909–) New Brunswick, New Jersey. Rutgers University Press, 2002: 57-71Google Scholar]. The work of Frank and Starling represented the basis for future work by Dr. Bing on metabolism of the human heart as carried out by coronary sinus catheterization and further gave impetus to other biochemical observations on the human heart [[18]Bing R.J. The metabolism of the heart.Harvey Lect. 1954–55; 50: 27-70PubMed Google Scholar]. Dr. Bing was born October 12, 1909 in Nürnberg, Bavaria [[3]Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar], which is now called Nuremberg, Germany. From 1933 to 1938, Nuremberg was the site of annual Nazi party congresses. After World War II, Nuremberg served as the venue for the Allied trials of war criminals in 1945–1946 [[19]The American Heritage Dictionary of the English Language. Fourth Edition. Houghton Mifflin Company, Boston2000: 1208Google Scholar]. Most of Dr. Bing's early clinical training took place in Munich [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. However, his happy days in Germany changed abruptly when Hitler became chancellor of Germany. From that moment on, Dr. Bing knew he had to get out of Germany and the German Nazism [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. Dr. Bing left Germany in 1934 [[4]Weisse A.B. Heart to Heart.in: The Twentieth-Century Battle Against Cardiac Disease. Ch 4. Richard J. Bing, M.D. (1909–) New Brunswick, New Jersey. Rutgers University Press, 2002: 57-71Google Scholar]. Of course, the rest is now all history. Dr. Bing is an outstanding historian in cardiology, as exemplified by his superb article, entitled “Evolution in Cardiology: Triumph and Defeat” published in 1990 [[20]Bing R.J. Evolution in cardiology: triumph and defeat.Perspect Biol Med. 1990; 34: 1-16PubMed Google Scholar]. Then came the excellent textbook, entitled “Cardiology: The Evolution of the Sciences and the Art”, the second edition of which (Fig. 3) [[7]Bing R.J. Cardiology.in: The Evolution of the Science and the Art. 2nd ed. Rutgers University Press, New Brunswick, NJ1999Google Scholar], was published in 1999 when he was 90 years old. He continues to write interesting historical essays with meticulous attention to details, which now appear in a bound volume, entitled “Past Truth & Present Poetry. A Search for the Origin of Medical Discovery” (Fig. 5). Among the topics covered are discovery of monoclonal antibodies by Köhler and Milstein, the development of statins by Bloch and Endo, the discovery of biomarkers by Kisch, performance of percutaneous transluminal coronary angioplasty by Andreas Grüntzig, transplantation of the heart and the discovery of cyclosporine in overcoming rejection, discovery of coronary angiography by Mason Sones, the exploration of Judah Folkman in finding new avenues for the treatment of cancer, and the advances in cardiac surgery in congenital heart disease by Glenn and Fontan (Fig. 2). The last one was published in 2009. It takes a man like Dr. Bing with his long years of experience, wisdom and humanism to become a perfect historian. To quote what he said in the Preface of his book “Cardiology: the Evolution of the Science and the Art, Second Edition”, “Science is a stream of discovery. From where we stand the present emerges and the past begins its descent. The past without the present is incomplete. Although younger readers may prefer today's knowledge to yesterday's history, age brings an appreciation of the lengthening shadows of the past. It is hoped that we have combined today's knowledge with the patina of the past.”[[[7]Bing R.J. Cardiology.in: The Evolution of the Science and the Art. 2nd ed. Rutgers University Press, New Brunswick, NJ1999Google Scholar], p. xiv]. On a more personal note, Dr. Bing was most helpful to me when I was preparing a biography of Dr. William Dock [[21]Cheng T.O. William Dock.Am J Cardiol. 1999; 84: 1215-1225PubMed Google Scholar]. Your readers might be interested in reading how Dock described Dr. Bing as one of “the men of measured mien” (Fig. 6) [[22]Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. Dr. Bing's spirit of internationalism is best exemplified by his many friends from all parts of the world. The high regards his friends from different countries held for him is best illustrated by a Happy 100th Birthday card (Fig. 7), signed by his colleagues from China (e.g., Chien and this author), Denmark (e.g., Falholt), France (e.g., the Manardis), Germany (e.g., the Mathes), United Kingdom (e.g., Gombrich), and the United States (e.g., Hurst, Taegtmeyer and Weisse), as well as his family members (e.g. his sons Bill and John and daughter Judy). Dr. Bing founded quite a few important journals in cardiology. In 1986 he founded the Journal of Applied Cardiology, as he felt an increasing need to bring basic research from the bench to the bedside [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. Dr. Bing also founded the International Society for Heart Research in 1965, together with the Society's journal, the Journal of Molecular and Cellular Cardiology. One area where Dr. Bing took an early interest upon arrival at New York City was renal physiology. He began work on the role of kidney in hypertension. He perfused ischemic kidneys with an amino acid, dihydroxyphenylalamine (dopa), which was converted by the kidney into a pressor substance, hydroxytyramine [3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar, 23Bing R.J. Zucker M.B. Renal hypertension produced by amino acid.J Exp Med. 1941; 74: 235-246Crossref PubMed Scopus (5) Google Scholar]. His papers caught the interest of Homer Smith, head of physiology at New York University College of Medicine. He spent 3 years with Homer Smith; his studies were concerned with the mechanism of the crush syndrome and with the effect of vitamin A on the kidney [[3]Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. Among other discoveries while working in Homer Smith's laboratory was Dr. Bing's demonstration that renal failure was a nonspecific response to a variety of interventions including hemorrhage and hypotension [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. Although everyone knows that Charles A. Lindbergh made the famous flight to Paris in 1929, few knew about Lindbergh's contribution to cardiology until Dr. Bing brought it to our attention in 1999 [22Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar, 24Bing R.J. The “lone eagle's” contribution to cardiology.Clin Cardiol. 1999; 22: 494-495Crossref PubMed Scopus (2) Google Scholar]. Because Lindbergh was also involved in biomedical (cardiovascular) research, this common interest was how Dr. Bing met Lindbergh [3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar, 22Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar, 24Bing R.J. The “lone eagle's” contribution to cardiology.Clin Cardiol. 1999; 22: 494-495Crossref PubMed Scopus (2) Google Scholar]. In 1936, at the age of 27, Dr. Bing was a young physician working at Carlsberg Biological Institute in Copenhagen, Denmark, to learn cell culture methods [[24]Bing R.J. The “lone eagle's” contribution to cardiology.Clin Cardiol. 1999; 22: 494-495Crossref PubMed Scopus (2) Google Scholar]. There he met both Lindbergh and Alexis Carrel, a renowned cardiovascular surgeon, who were attending an international congress of biological sciences to demonstrate their new perfusion system, which was supposed to maintain life of single organs outside the body. In setting up this apparatus, they needed someone who spoke both Danish and English. So Dr. Bing was assigned the job [[22]Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. Carrel and Lindbergh planned to establish their perfusion system in Denmark, and Dr. Bing was chosen to learn their method in New York and return to Copenhagen where the perfusion system was to be installed [[22]Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. It was Carrel who obtained a Rockefeller stipend for Dr. Bing. Receiving the Rockefeller stipend to go to New York City was a pivotal moment in Dr. Bing's life [3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar, 22Cheng T.O. Richard J. Bing, Charles A. Lindbergh, and cardiopulmonary bypass.Am J Cardiol. 2000; 86: 1290-1291Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. Carrel was also at Dr. Bing's wedding (Bing, personal communication, June 17, 2009). Music with a big M is Dr. Bing's other love beside medicine. Already during childhood his interest was music; he wrote his first composition when he was 7 or 8 years of age [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar] and has done so ever since (Fig. 8, Fig. 9). Dr. Bing plays piano and organ [[25]Lüderitz B. Richard J. Bing. J Interv Card Electrophysiol 2005; 13:167–8.Google Scholar]. In a recent article published in Leonardo in August 2008 [[26]Bing R.J. Composing music and the science of the heart: how to serve two masters.Leonardo (J Int Soc Arts Sci Technol). 2008; 41: 365-366Google Scholar], Dr. Bing chronicled his development as a musician — from his childhood fascination with improvising on the piano to his magnificent composition in 1990 of the “Missa” (Fig. 8). The Missa (Chanted Mass) for orchestra, organ, mixed chorus and soli was performed in the Cathedral of Saint Stefans in Vienna, Austria on October 30, 1993.Fig. 9A music score by Dr. Bing autographed to this author in 2008.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Dr. Bing finds that the common denominator in composing music and doing medical research is the creative impulse. In his life, music and medicine have never been in competition. Rather, when frustrated by difficulties in medical research, he found renewal in composing music (Fig. 10). As Dr. Bing wrote in Leonardo, “writing music is my hobby, being a physician and scientist is my profession. Both are challenges that make life an exciting adventure” [[26]Bing R.J. Composing music and the science of the heart: how to serve two masters.Leonardo (J Int Soc Arts Sci Technol). 2008; 41: 365-366Google Scholar]. Dr. Bing wrote more than 200 compositions of music for orchestra, chamber music, chorus and voice. He writes his music without access to an instrument (Bing, personal communication December 19, 2008). His works have been performed in Pasadena, California and New York City in the United States, in Bologna in Italy, in Vienna, Austria, and in Munich, Giessen and Nuremberg in Germany. Elucidation of the role of nitric oxide (NO) in medicine has been one of the great discoveries in recent years. Dr. Bing plays a major role in leading its investigation. He was the guest editor-in-chief of the Special Issue of the International Journal of Cardiology in 1995 on a symposium entitled “Nitric Oxide in Heart Muscle” [[27]Bing RJ, editor. Nitric oxide in heart muscle. Int J Cardiol 1995;50:203–96.Google Scholar]. I would like to quote from the concluding paragraph of his Introduction in the following: “This symposium contains a variety of approaches in the study of the effect of NO on the heart. In the first place, the endothelial form of NOS plays an important role in the cardiac contractility and blood supply of the normal heart. In pathological conditions, however, when immunologically inflammatory cells infiltrate the heart muscle, and when immune cells and cardiomyocytes are activated, iNOS becomes the dominant factor resulting in NO production during allograft rejection, cardiomyopathy, myocardial infarction and septic shock” [[28]Bing R.J. Introduction.Int J Cardiol. 1995; 50: 203-205Abstract Full Text PDF PubMed Scopus (3) Google Scholar]. Carl Orff (1895–1982) was a 20th century German composer most famous for his composition Carmina Burana (1935–6). It has appeared in hundreds of films and television commercials, one of which is the Old Spice after-shave commercial [[29]http://en.wikipedia.org/wiki/Carmina_Burana_(Orff). Accessed June 6, 2009.Google Scholar]. Despite Orff's controversial association with the Nazis [29http://en.wikipedia.org/wiki/Carmina_Burana_(Orff). Accessed June 6, 2009.Google Scholar, 30http://en.wikipedia.org/wiki/Carl_Orff. Accessed June 6, 2009.Google Scholar], Dr. Bing became a good friend of Orff and sent him the musical score of his music to the Latin Requiem Mass for orchestra and chorus [[26]Bing R.J. Composing music and the science of the heart: how to serve two masters.Leonardo (J Int Soc Arts Sci Technol). 2008; 41: 365-366Google Scholar]. Orff invited Dr. Bing to visit him in Bavaria [[26]Bing R.J. Composing music and the science of the heart: how to serve two masters.Leonardo (J Int Soc Arts Sci Technol). 2008; 41: 365-366Google Scholar]; it was one of several visits. Dr. Bing learned from him that music should have definite character and pattern [[26]Bing R.J. Composing music and the science of the heart: how to serve two masters.Leonardo (J Int Soc Arts Sci Technol). 2008; 41: 365-366Google Scholar]. Several years later, Dr. Bing wrote the “Missa”(Fig. 8), again for chorus and full orchestra, which he dedicated to Orff. Dr. Bing can rightfully lay claim to originating the technique of positron emission tomography (PET), which is widely used for the noninvasive assessment of regional myocardial blood flow and metabolism [[2]Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar]. He in 1964 had the idea of using positron emitters for the measurement of coronary blood flow and imaging of the heart. A cousin of Dr. Bing's wife Dr. George Clark was professor of physics at Massachusetts Institute of Technology and advised Dr. Bing to use positron emitters [2Taegtmeyer H. Richard J. Bing: Point and counterpoint in medicine and music.Clin Cardiol. 1990; 13: 745-749Crossref PubMed Scopus (3) Google Scholar, 3Hurst J.W. Richard John Bing, MD: A conversation with John Willis Hurst, MD.Am J Cardiol. 2000; 86: 72-79Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. Therefore, with the help of the Ford Motor Company's computer, Dr. Bing built an apparatus that made possible the determination of coronary blood flow in man [[3]Hurst J.W. Richard John Bing, MD: A conversation with John Wil
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