On July 20, 1969, all eyes watched as Neil Armstrong set foot on the moon. Thirteen years later (and 4 months before my birth) the country was consumed once again by what many believed to be the medical moon landing equivalent. On that day in 1982, my father was listening to Ravel’s Boléro as he and Dr. William DeVries implanted the first total artificial heart (TAH) for destination therapy into a human being. I recall looking at old photos of my pregnant mother standing next to Barney Clark, the recipient of that heart, as he lived an extra 112 days thanks to the aluminum and polyurethane technological marvel powered by a 400-pound air compressor (see figure).

Figure. My 3 siblings sitting with Barney Clark following implantation of the Jarvik-7 total artificial heart.

In a country reckoning with social inequality, Apollo 11’s $28 billion price tag was not overlooked. Similarly, just 2 years after Clark’s death, Colorado Governor Richard Lamm joined the increasing swell of TAH critics proclaiming, “High-tech medicine is really the Faustian bargain, where for a few extra days of life, we have to pay the price that could bankrupt the country.” The cover of Time magazine read, “Medical Miracles, But How to Pay the Bill?” with a picture of DeVries holding the Jarvik-7.

Five years ago, I began my residency at Vanderbilt, a program that grew its reputation under the guidance of Dr. Joseph A. Smith. In Dr. Smith I saw many of the qualities I admired in my father: compassion, surgical expertise, a passion for teaching, a dedication to family, and a desire to explore the limits of medical technology. The example of his pioneering in laser and robotic surgery was a continual reminder to question the status quo and confront the fear of abandoning what’s comfortable in order to push the limits of what’s possible.

And yet again I saw critics push back against innovative initiative, pointing out that, despite providing no difference in long-term outcomes, more than 90% of radical prostatectomies are performed robotically today, contributing to a global market for surgical robotics that is projected to reach $17 billion by 2025.

Like any trainee about to enter the workforce, I felt the dissonance between the desire to innovate and the desire to reduce health care’s financial toxicity. Not long ago, as he performed his 7,000+ robotic prostatectomy, I listened as Dr. Smith shared with me the impact that Apollo 11 had on him. He explained how it guided and informed his circuitous path from astronaut training to making now legendary contributions to the field of urology.

The value of the ripple effect of inspiration cannot be quantified. Perhaps these (and future) costly monumental achievements will inspire others to innovatively reduce health care costs. Or perhaps they will “simply” recruit more physicians who emulate the admirable qualities of the mentors I’ve been so fortunate to learn from. As Gene Cernan, the last man to walk on the moon, said, “As I take these last steps from [the moon]… I’d just like to record that America’s challenge of today has forged man’s destiny of tomorrow.”