A surgeon for the brain

Abstract

HARVEY CUSHING. A LIFE IN SURGERY By Michael Bliss 2005. New York: Oxford University Press Price $40.00/£23.99. ISBN: 0-19-516989-1 In the fall of 1901, Harvey Cushing (1869–1939) returned to Baltimore and joined the faculty of William Halsted's Department of Surgery at the Johns Hopkins Hospital and Medical School. Before his European sojourn of 1900–1901, Cushing had trained there in 1896–1900 (Fig. 1). Toward the end of his training, Cushing began to take an interest in neurological problems, and most of his laboratory time in Europe was spent on intracranial research. While he was still in Europe, Cushing apparently thought that he would take charge of the ‘brain cases’ upon his return. However, when Cushing got to Baltimore in September 1901, the senior staff at Hopkins had not yet reassembled after their usual exodus from the wretched summer weather. It was mid-October before the erratic Halsted agreed to Cushing's appointment on Cushing's terms. Those terms included taking charge of ‘the neurological side of the [surgical] Clinic,’ and the opportunity to ‘work in the neurological dispensary mornings with [the neurologist] Dr [Henry M.] Thomas and try to learn something in general about nerve cases’ (Fulton, 1946, p. 204). In other words, he needed to learn some clinical neurology, and he was eager to do it. Fig. 1 Harvey Cushing 1899. Courtesy of The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions. Halsted's reservations about Cushing's terms were actually well founded. In 1901, the outlook was dismal for the specialty that we now call neurosurgery. For starters, Halsted worried that Cushing would not be able to make a living on ‘head cases’—there had been very few and none successful at the Johns Hopkins Hospital in its 12 years of existence. More to the point, mortality rates for operations on brain tumour …