American surgeons like McCarthy have brought a level of scientific professionalism to Batista's procedure. To be sure, the greatest benefit of U.S. hospitals is the state-of-the-art postoperative care. American doctors also offer a safety net for patients by placing them on a left-ventricular assist device that helps the heart pump blood into the body if the procedure fails. In addition, McCarthy has somewhat changed the procedure. Where Batista does his work on a beating heart, McCarthy stops the heart so he can make cleaner cuts (a common practice in open-heart surgery in the U.S.). Of greatest benefit is that American surgeons are keeping track of patients, so doctors can figure out the long-term benefits of the procedure.

Others have not been so quick to join Batista's backers. "It's a good idea," says Dr. Lawrence Kohn, a cardiac surgeon at Brigham and Women's Hospital in Boston, "but we're waiting to see the scientific proof." And lack of proof has certainly been a problem. Because many of Batista's patients do not have phones and come from all areas of Brazil, he has done little to track the long-term effects of his procedure. Surgeons in Brazil were no more eager than most American doctors to accept Batista's claims. "When I first heard of this procedure, I thought he was a crank, one of those mystic doctors who periodically appear in Brazil," says Roberto Franken, a SÅo Paulo cardiologist who has only recently accepted Batista's procedure. Critics do not bother Batista, though, because he believes so strongly in what he is doing. "Either I'm crazy or they are wrong," he says. "And I know I'm not crazy."