BIG MEDICINE: WHOSE HEALTH ARE THEY PROTECTING? 323surgeons. In addition, Ess's own father was a distinguished physician
with a national reputation. But, as Ess remembers, despite being "health
experts," all four of these men were "ravaged by cardiovascular dis-
ease." His own father had a heart attack at age forty-two and Dr. Brook
had a heart attack at age fifty-two.
These were the men he looked up to, and when it came to cardiovas-
cular disease, all of them were helpless. Shaking his head, Ess said, "You
can't escape this disease. These people, who were giants in the prime of
their years, just withered." As he took a moment to remember his father,
he said, "It was the last year or two of my dad's life, and we were just
strolling along one day. He was saying, 'We are going to have to show
people how to lead healthier lives.' He was right on it. He was intensely
interested in preventive medicine, but he didn't have any information."
His father's interest has been a driving influence in Ess's life.
Following in these men's footsteps, Ess went on to amass an extraor-
dinarily impressive list of awards and credentials: an Olympic gold
medal in rowing; a Bronze Star for military service in Vietnam; President
of the Staff, member of the Board of Governors, chairman of the Breast
Cancer Task Force, and head of the Section of Thyroid and Parathyroid
Surgery at the Cleveland Clinic, one of the top-ranked medical institu-
tions in the world; president of the American Association of Endocrine
Surgeons; over 100 professional scientific articles; and inclusion on a
list in 1994-95 of the best doctors in America.^2 He remembers, "For
about a ten-to fifteen-year period I was the top earner in the depart-
ment of general surgery. As Dr. Crile's son-in-law, I was panicked about
not pulling my weight. I didn't get home until late at night, but I had
a position that was secure." When the then-president of the American
Medical Association needed thyroid surgery, he wanted Ess to be the
one to operate.
But despite the accolades, the titles and the awards, something was
not right. So often, Ess~ patients did not regain their health, even after his
best efforts. As Ess described it, he had "this haunting feeling that was
really beginning to bother me. I kept looking at how the patients were
doing after these operations." Slightly exasperated, he said, "What is
the survival rate for cancer of the colon? It's not so great!" He recounted
the operation for colon cancer on one of his best friends. During sur-
gery, they saw that the cancer had spread throughout the intestines. Ess
lowered his voice ever so slightly in remembering this, saying, "You get
there after the horse has left the barn." In thinking about all the breast