When Houston heart surgeon Dr. Michael DeBakey is voted the Congressional Gold Medal, presumably today, he'll join a distinguished group that includes Jonas Salk, Mother Teresa and George Washington.

Of course, the group also includes pulp western writer Louis L'Amour and forgotten former Vice President Alben Barkley.

The eclectic list of recipients highlights the singular nature of an award one expert calls "part Nobel Peace Prize, part Madame Tussaud's Wax Museum." More than two centuries old and touted as one of America's two highest civilian honors, it's little known or understood outside of Congress and those who've won it.

"It doesn't have the sustaining power of a Nobel or even an Academy Award," said Donald Ritchie, a Senate historian. "A good way to think of it may be as our equivalent of knighting someone. The U.S. Constitution prohibits titles of nobility, but the Congressional Gold Medal similarly recognizes individuals' accomplishments that impact the nation."

To that end, the award is short on restrictions. Recipients can be American or foreign, living or dead, beloved or little known, apolitical or highly partisan. Congress can give as many as it wants or none at all. The medal can recognize a single outstanding deed or a lifetime of accomplishments.

Wide-ranging honor

Over the years, they have honored excellence in the arts, athletics, aviation, civil rights, diplomacy, entertainment, exploration, humanities, medicine, military affairs, politics, religion and science. Consider the last four medalists, all approved in 2006: Green Revolution father Norman Borlaug ; golfer Byron Nelson; current Dalai Lama Tenzin Gyatso ; and the Tuskegee Airmen , the all-black group of pilots who flew with distinction during World II.

The lack of restrictions has brought criticism.

"Awards often are criticized for their backstage politics, but in the case of the Congressional Gold Medal, it's just politics," said James English, a London-based University of Pennsylvania English professor and the author of The Economy of Prestige: Prizes, Awards and the Circulation of Cultural Value.

"There's no real criteria, no categories, no expert judges. That's why it doesn't have a lot of traction, a lot of currency in the world," English said.

In the United States, the medal is considered the congressional equivalent of the Presidential Medal of Freedom — and with a more distinguished history to boot. Whereas the Presidential Medal of Freedom originated with an assistant to President Kennedy suggesting he revive and convert a defunct World War II award into "the nation's highest civilian honor," the Congressional Gold Medal dates back to the American Revolution.

Since the late 19th century, the accent has been on humanitarian efforts, be it Roland Boucher's 1941 rescue of five children who broke through the ice on Lake Champlain, or Nelson Mandela's fight against apartheid. Some historians say the award's greatest meaning is when it is awarded to lesser-known people for deeds that might be forgotten, but the most attention has come when it's gone to celebrities, such as Bob Hope or Frank Sinatra.

DeBakey's gold medal has been in the works since 2003, when Houston U.S. Reps. John Culberson and Chris Bell introduced a bill honoring the pioneering doctor. It took until DeBakey's 99th birthday, 10 days ago, for the 2007 bill to amass the necessary signatures to bring it to final passage.

If it passes today, as expected, President Bush has 10 days to sign it.

The ceremony at which it's presented is another matter. Washington didn't get his until 1790, 14 years after Congress approved it. They're more timely now, but there was a wait of more than seven months for Borlaug's ceremony in the Capital Rotunda, eight for Nelson's and 11 for the Tuskee Airmen's. Congress is currently trying to schedule the Dalai Lama's for next month, 13 months after its passage.

Fast track

U.S. Sen. Kay Bailey Hutchison vows it'll be different for DeBakey.

"I intend to have Dr. DeBakey's ceremony before the end of the year," said Hutchison, who has sponsored the legislation in the Senate since 2004. "I'll start working to schedule it as soon as President Bush signs the bill into law."

The ceremony's date depends not just on scheduling, but also the design and casting of the medal, which is unique for each recipient. Sketches are made and reviewed, the selected design is sculpted, a die is made and the medal is struck at the Philadelphia Mint. The cost to the U.S. Treasury to issue each is about $30,000. Bronze replicas available to the general public defray costs.

It's already taken four years for DeBakey's backers to amass the necessary support — signatures from two-thirds of each legislative chamber — but that's hardly uncommon. The exception was Mother Teresa. In 1997, legislators needed only four days to gather the signatures.

Medal's history

Until the Civil War, the Congressional Gold Medal was awarded to military figures for conduct in battle and valor in action. But in 1865, the Congressional Medal of Honor was created for the latter purpose, and the gold medal began being conferred for a wider scope of reasons. Nearly a century and a half later, the two awards are often confused — since 1999, for instance, the New York Times has had to run corrections on five stories that referred to the Congressional Medal of Honor when they really meant the Congressional Gold Medal.

In the 1700s and 1800s, whole decades would go by without awarding the medal, but in recent years it has become more commonplace: There were five recipients in 2000, for instance. For that reason, a bill currently in Congress would limit the medal to two recipients a year.

For DeBakey, it will be the latest in a long line of awards, most notably the Lasker Award, the Presidential Medal of Science and the Presidential Medal of Freedom. Rep. Al Green, the bill's original sponsor in the House, said that when he called DeBakey on Sept. 7 to wish him happy birthday and tell him the bill had surpassed the 290 required co-sponsors in the House, the surgeon replied, "I'm so grateful that I'm a citizen of the United States."