Very few people within or outside the medical profession failed to follow the saga of the courageous and dedicated Barney B. Clark, DDS, the world's first recipient of a mechanical heart implantation. Dr Clark suffered from endstage congestive cardiomyopathy but, because of his age and overall medical condition, was ineligible for heart transplantation. The preoperative psychiatric evaluation of this patient and his family, along with a detailed description of Dr Clark's postoperative course ending with his death 112 days later, is provided in this issue of the Archives by Berenson and Grosser.¹ The heroic and noble efforts of Dr Clark and his family have been superbly detailed and many interesting questions about assessing the severely ill patient have been raised. Although the focus of their case report was to have been the process by which the patient was selected for this well-publicized experiment, it is their problems surrounding the