Epilogue

Healthcare Value: The Intersection of Clinical Expertise and Advanced Technology

On Thursday, July 22, 2009, President Barack Obama arrived for a visit at Cleveland Clinic. The event was significantly different from when his predecessor, George W. Bush, visited in 2005 because President Obama did not address any large crowds while on campus. Instead, he had a brief, focused conversation with Dr. Cosgrove, then–Ohio governor Ted Strickland, and me in a small, private classroom before heading up to the Heart and Vascular Institute’s fourth floor to see a demonstration of robotically assisted, minimally invasive mitral valve repair surgery. There was little fanfare associated with the presidential visit. The Secret Service did its very thorough Secret Service security sweeps, and a large tent was erected over the entrance that the president would use.

In preparation for the president’s arrival, a number of Cleveland Clinic media representatives were assigned places in the national press and media access center that had been set up on the roof of the Sydell and Arnold Miller Family Pavilion, the million-plus-square-foot building that houses the Heart and Vascular Institute. The roof features a very large, glass-enclosed observation space that affords a spectacular view of downtown Cleveland. But on that morning, something kind of odd happened.

Euclid Avenue, that long stretch of road that once housed so many of America’s titans of industry, runs all the way from downtown, past Cleveland Clinic to University Circle, Severance Hall (the home of the Cleveland Orchestra), the Cleveland Museum of Art, Case Western Reserve University, University Hospital, the Cleveland Museum of Natural History, and on into Euclid, Ohio, an inner-ring suburb of Cleveland that shares the grand old avenue’s name. Given its length and prominent placement as Cleveland’s main east-west artery, Euclid Avenue is normally quite busy, regardless of the time of day. But today, it was empty. Not a car was visible in either direction as far as the eye could see.

Then, way off in the distance, first one, and then two, and then a whole line of tiny black spots materialized, crawling in a long, slow line past the Terminal Tower east, approaching Cleveland Clinic’s old white hospital. It was a motorcade, a rolling phalanx of shiny black SUVs, probably a dozen in all, one after the other, with the lead and last blinking alternating flashes of red and blue from within their large front grilles. As they approached, three black military-style helicopters swept in from three different directions, aligning themselves in a perfect, rotating circle above the narrow length of green space in front of the J building where the president would soon disembark.

Another unusual feature of the president’s visit was, for us, perhaps even more memorable than the visit itself. It happened the day before the president arrived. In the days leading up to the visit, no matter who asked, the White House had refused to ...