This book describes the premier organization for the performance and funding of biomedical research in the United States. By articulating events that occurred at the National Institutes of Health from 1991-2008, this volume also examines the leadership of directors Bernadine Healy, Harold Varmus and Elias Zerhouni. To conduct his research, Dr. Kastor interviewed more than 200 people currently working at the NIH, those who have left and those funded by the institute. In an engaging and dynamic prose style, Dr. Kastor presents his findings on the operations, problems, controversies, financies, politics and structure of the NIH. The book begins by examining topics such as the NIH's evaluation of grant funding, the argument between those who favor support of basic biomedical science versus clinical research, the inclusion of HIV/AIDS in the National Institute of Allergy and Infectious Diseases, and the unique features of the Clinical Center, the hospital of the NIH. The volume concludes with a review of the recent conflict of interest controversy, the NIH's response to recent budget constrictions and the role of the institute in the Obama administration.