Heart failure is the leading cause of death in the US, but modern medical advancements are working towards drastically reducing those rates for decades to come.

It’s 1982, and a man is having a heart attack. An ambulance rushes him to the emergency department, where he’s given a nitroglycerin tablet and a drug called nifedipine.

The treatment doesn’t seem to work, and the man’s heart sustains serious damage. An emergency physician delivers the news to the man’s family: “He might not survive the night. We’ll keep him comfortable, but there’s nothing else we can do.”

For years, this scene was a common one, played out again and again in emergency departments across the nation. Physicians did their best to care for heart attack patients—but their best too often wasn’t enough. That’s because nifedipine and other drugs used at the time simply weren’t effective.

Just a few decades ago, cardiac surgeons, engineers and scientists were working on new technology that would revolutionize open-heart surgery. Specifically, they were developing a device that would act as a patient’s heart and lungs, keeping the body’s blood supply circulating while the heart underwent complex repairs. At Barnes Hospital, now Barnes-Jewish, a solution to the problem arrived in 1956: the Gibbon-Mayo heart-lung pump.

Some call it the “therapeutic pipeline.” Others refer to it as “bench to bedside.” Both phrases refer to the scientific process that delivers new therapies, new medicines, to people who are sick. In the pipeline metaphor, an idea rushes along, like water in a hose, from the minds of researchers into the lab, through testing and approvals to the pharmacy or treatment room. In the bench metaphor, progress is similarly linear, advancing from the scientist’s bench in the lab to the patient’s bedside. But neither image paints an accurate picture.

The first baby conceived by in vitro fertilization, or IVF, was born in 1978 in Manchester, England. In 1985, a couple from Creve Coeur gave birth to Missouri’s first baby conceived by IVF at what was then called Jewish Hospital. The technology was controversial in its early days. The idea of “creating” a baby in a lab felt strange to some and raised ethical concerns in others.

When Barnes-Jewish Hospital and Washington University School of Medicine established the Alvin J. Siteman Cancer Center in 1999, the partnering institutions already shared a decades-long history of advancing cancer research and treatment.

Scientists and physicians experimented with organ transplantation using animals and humans as early as the 18th century. And though replacing a failing organ with a foreign organ has always been a significant surgical feat, it alone couldn’t save lives. Once the new organ was in place, the recipient’s body strenuously objected, mounting a deadly response. For decades, organ rejection was the stumbling block, the thing that drove researchers back to their labs, where they worked for decades looking for answers.

War is hell. This simple yet dramatic phrase, coined in the Civil War, also applies to World War I, which brought unprecedented carnage and destruction. If there is a silver lining to such events, perhaps it is found in the advances they bring to the practice of medicine. The ugliness of battle forces field surgeons to find better ways to care for wounded soldiers. And after the war ends, these advances benefit civilians at home.