Twenty years trying to protect the brain: what do we know?

Thirty-five years ago at the Nixon Watergate hearings, a young attorney named Fred Thompson, current US presidential candidate, asked "What did the President know and when did he know it?" A couple of word changes and this question would be appropriate to ask any number of surgical specialties regarding negative neurologic outcomes. Even today, some specialties are in denial about impaired brain function after surgical intervention. Fortunately, the cardiac surgery community has been in the forefront in efforts to protect the brain.