Life In Surgery Research Articles

In memoriam: Sir Roy Calne (1930-2024) - A life in surgery and impact on paediatric liver transplantation in Singapore.

In memoriam: Sir Roy Calne (1930-2024) - A life in surgery and impact on paediatric liver transplantation in Singapore.

Abstracts from Hydrocephalus 2015.

The 7th Annual Meeting of the International Society for hydrocephalus and Cerebrospinal Fluid Disorders (ISHCSF) is being held in Banff, Alberta, Canada September 19th-21st, 2015. There are three satellite symposia accompanying the main Congress. On September 17th, the 1st Calgary Hydrocephalus Symposium will be hosted by the Cumming School of Medicine to provide an intimate opportunity to explore state-of-the-art hydrocephalus care. On September 18th, the satellite Normal Pressure Hydrocephalus (NPH) Symposium will be held in Banff, providing an opportunity to share and learn from the experience of international experts regarding this challenging hydrocephalus disorder. We also welcome our colleagues and members of the International Hydrocephalus Imaging Working Group (IHIWG). IHIWG members include Neurologists, Neurosurgeons, Neuroradiologists and Physicists who will have their autumn meeting on September 18th in Banff. Hydrocephalus 2015 will cover the full range of CSF disorders affecting both children and adults. The focus of work done in our field is the patient and to this end, the theme of three special sessions of this Congress will be “The Patient”. These special sessions will examine: 1) Quality Improvement and Safety in Hydrocephalus Care; 2) Transition and Adult Hydrocephalus Care; and 3) Ethics and Patient Involvement in Clinical Research. These sessions will provide a foundation for the research that will be presented during Hydrocephalus 2015 which will include sessions dealing with pediatric hydrocephalus, adult hydrocephalus, advanced Neuro-imaging techniques in hydrocephalus, CSF shunt design and technology and intracranial pressure. We will also have special sessions devoted to young investigators and will recognize those with the best oral presentations and best posters. We have a great social program to span the conference. We start with the Welcoming Reception on September 18th, party at a bar-be-que buffet barn dance on September 19th and then celebrate at the Denim and Diamonds Gala Dinner on September 20th. Our very special guest speaker for the Gala Dinner is Dr. Michael Bliss, renowned historian and author of “Harvey Cushing. A Life in Surgery”.

Meditation on Mortality: Lessons From a Life in Surgery

Meditation on Mortality: Lessons From a Life in Surgery

A pioneer of urologic surgery from a small town in Ontario, Canada: A tribute to Abraham Groves (1847 - 1935)

Abraham Groves worked as a general practitioner and surgeon in the small town of Fergus, Ontario, Canada. Several priority claims have been attributed to Groves' life in surgery, including aseptic surgery (1874), appendectomy (1883) and the use of surgical gloves (1885). He was also an early practitioner of urological surgery. The purpose of this paper is to describe and objectively assess his contributions as a pioneer in urological surgery. A systematic search of contemporary journals was made for articles by or about Groves. These articles and his 1934 autobiography were reviewed. The information was assessed not only for priority, but also for the development of organized surgical principles and thought. Groves published frequently throughout his career; up to this point, 36 papers have been identified. Groves' claims are verifiable for aseptic surgery, which were the result of logical surgical thought and was practiced throughout his career. Contemporary publications support his early use of suprapubic lithotomy (1875), prostatotomy (1887), bladder repair (1892), urethral repair (1903), renal decapsulation (1905) and prostatectomy (1911). Despite his isolation, Abraham Groves independently developed a full range of surgical techniques and principles relevant to modern-day urology. His impact was reduced by the nature of the environment in which he worked and by the limited circulation of the journals in which he chose to publish.

Michael Bliss, Harvey Cushing: a life in surgery, New York, Oxford University Press, 2005, pp. xii, 591, illus., $40.00 (hardback 0-19-516989-1).

Anyone who has read John Fulton's biography of Harvey Cushing (1869–1939), or dug through the mountains of Cushing's surviving papers, will appreciate Michael Bliss's study, Harvey Cushing: a life in surgery. Bliss, with that characteristic verve and detailed finesse which distinguished his earlier biography of William Osler, has produced yet another fine portrait that will delight various audiences. Although historians of medicine will undoubtedly have more to add about Cushing's life and legacy, there can be no denying that this volume reveals much about the life of this American surgeon and scholar. Given the extent of the archival collections from Cushing's life, it is amazing how little historical attention has been paid to him as a figure, and to what his papers reveal about modern American medicine. Other than a few edited books, an excellent dissertation by Ock-Joo Kim, and several scholarly articles, the major secondary sources on Cushing have remained the 1946 “official biography” by Fulton and Elizabeth Thomson's 1950 study. Though each is useful, as Bliss notes, both suffer from limitations, including choices of literary style, lack of access to primary sources, and rather adulatory authorial voices. By contrast, Bliss, in what he describes as an attempt at “Fitzgeraldian sensibility”, uses wide-ranging sources to document an ambitious, perplexing, and often tumultuous, private and professional life (p. x). In concise vignettes, Bliss traces Cushing's life. Born in Cleveland, Ohio, Cushing was the tenth child of a medical dynasty—and thus, as one might expect, enjoyed numerous advantages from this privileged social background, including education at Yale, Harvard, and Johns Hopkins, where he was trained by many of American medicine's most important figures. Subsequent chapters portray Cushing's early medical career, the development of his surgical manner and prowess, deductive mind, and clinical research. From the “birth of neurosurgery” through the travails and even “inauspicious” brain-snatching involved in his pioneering research on The pituitary body and its disorders, Bliss illustrates moments in Cushing's professional life. Nonetheless, it is striking that Cushing always seems to have expected more. Bliss does not shy away from the consequences of such ambition: Cushing's relationship with his family suffered because of his workaholic lifestyle. Early on in the Great War, Cushing travelled to France with a Harvard medical team. His war diary, subsequently published to critical acclaim in 1936, is a fascinating and important account of a surgeon's experiences in France. Bliss builds upon that historical treasure further by revealing, surprisingly, that Cushing was initially unenthusiastic about this venture. In the remaining chapters, Bliss covers the last years of Cushing's life: from failed plans for a national institute of neurology, to book collecting, the marriages of his children, and the tragic death of one of his sons. It is an engrossing account. I enjoyed this book immensely and have had no trouble recommending it to others. Still, there is something dissatisfying about it as well. Before I started reading, it was obvious to me that Harvey Cushing was a “great man”. But could Bliss have said more? To be sure, his expository narrative style is elegant, but is there an argument in this book? His footnotes tell of diligent archival research, but there is little suggesting Bliss is troubled by his project's rather polemic nature. Despite the fact that there is now a considerably sophisticated secondary literature on the nature of biography and autobiography, there is no real indication here that Bliss possesses critical insight or theoretical knowledge of his chosen genre. Surprising this, since he is quick to denigrate Fulton's earlier biography, implying that it suffered because Fulton wrote it in an intoxicated stupor. However, for me, Fulton's biography reads like many other biographical works from that era and earlier, and I am not convinced that Bliss's book is altogether different. Indeed, one merit of Fulton's study is that it captures the social perception and reception of Cushing's ideas and techniques abroad in ways that Bliss's account does not. Though Bliss's research is remarkable, it is noteworthy that it is based mainly in North American archives (perhaps excusable since Cushing kept copies of much that he wrote). Still, there are archival sources elsewhere that would have subtly changed this representation of Cushing, and in consequence have produced an even broader perspective.

Harvey Cushing: A Life in Surgery (review)

Harvey Cushing: A Life in Surgery (review)

Harvey Cushing: A Life in Surgery (review)

Reviewed by: Harvey Cushing: A Life in Surgery Peter Keating (bio) Michael Bliss. Harvey Cushing: A Life in Surgery University of Toronto Press. xii, 591. $50.00 Trigeminal neuralgia or 'tic douleureux' results from pressure on the fifth cranial nerve and is expressed as intense in the anatomic sites irrigated by [End Page 499] that nerve, namely, the eyes, lips, nose, scalp, forehead, and jaw. The pain, described as electric-shock-like by sufferers, is so intense that early sufferers occasionally committed suicide. Although the pressure on the nerve may have a variety of common causes such as infection or tumour, the disease itself is relatively rare, affecting no more than five in a hundred thousand individuals per year. Even with that low rate of incidence, however, tic douloureux comprises 5 per cent of neurological disorders and the patient group attached to the disease in the United States, the Trigeminal Neuralgia Association, presently claims over twenty-five thousand members. The subject of Michael Bliss's most recent and scrupulous biography, Harvey Cushing (1869–1939), scored his first success as America's and indeed the world's most famous neurosurgeon of the first half of the twentieth century by inventing a method for surgically separating the cranial nerve from the brain where it enters the spinal cord. Patients have profited ever since. A student and soon-to-be colleague of William Halsted (1852–1922), inventor of the radical mastectomy for breast cancer and noted cocaine addict, at Johns Hopkins, Cushing's work on tic douleureux at the age of thirty solidified what was becoming an enviable reputation for careful yet daring brain surgery. Following postgraduate research in Berne where he made significant observations of the reaction of the brain to compression using dogs and monkeys, Cushing returned to Baltimore to become America's foremost neurosurgeon and to pursue parallel lines of research in brain physiology and brain pathology. There and later as Surgeon-in-Chief of the Peter Bent Brigham Hospital in Boston, he maintained a lifelong interest in the functioning of the endocrine system whose central organ he encountered through the window of the various pathologies of the pituitary gland. At the same time he amassed an enormous collection of tumours arising from the tissues that envelope the brain – meningiomas – that were issued in a monumental eight-hundred-page publication just before his death. Since surgery entails a great deal of craft knowledge, and many procedures can be learned only at the operating table, part of Cushing's formidable reputation is based on the fact that in addition to being an innovator, he was also an excellent and indefatigable operator; he retired only after having completed more than two thousand operations during the course of which he trained an entire generation of brain surgeons. Excluded from that extraordinary number of operations – and it is well to remember that, at the time, many procedures took eight to ten hours to perform – are those carried out during the First World War, where Cushing operated as a front-line surgeon, kept a diary that later become a book, and pioneered the use of electromagnets to extract metallic bodies from the brain. As Cushing's wife remarked while gazing at his sixteen volumes of collected papers: 'Such industry.' [End Page 500] As it turns out and as Bliss records in fine detail, Cushing's wife saw his papers about as often as she saw their author, which wasn't very often. An absent and somewhat distant father, and competitive to a fault, Cushing drove himself and others with an intensity that shocked and astonished his contemporaries. One of his students, Hugh Cairns (1896–1952), who would go on to become professor of surgery at Oxford University, once wrote to his wife complaining of Cushing that: 'He cursed me in front of everyone in the operating room the other day for doing something he had told me to do the previous, and when I protested hotly with, I imagine, blazing eyes, he lied promptly and with perfect technique.' As the Bliss biography makes abundantly clear, Cushing was also a world-class bully. Peter Keating Peter Keating, Department of History, L'université du Québec à Montr...

Michael Bliss. Harvey Cushing: A Life in Surgery. xii + 591 pp., figs., apps., bibl., index. Toronto: University of Toronto Press, 2005. $50 (cloth).

Previous articleNext article No AccessBook ReviewMichael Bliss. Harvey Cushing: A Life in Surgery. xii + 591 pp., figs., apps., bibl., index. Toronto: University of Toronto Press, 2005. $50 (cloth).Kim PelisKim Pelis Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Isis Volume 97, Number 4December 2006 Publication of the History of Science Society Article DOIhttps://doi.org/10.1086/512896 Views: 10Total views on this site PDF download Crossref reports no articles citing this article.

Harvey Cushing: A Life in Surgery

Harvey Cushing: A Life in Surgery

A surgeon for the brain

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 …

Harvey Cushing: A Life in Surgery

Harvey Cushing: A Life in Surgery

Harvey Cushing: A Life in Surgery

Opening: The Surgeon and the General 1. Western Reserve: The Cushings of Cleveland 2. Making a Yale Man 3. Making a Harvard Doctor 4. Making an American Surgeon 5. A Window on the Brain 6. Opening the Closed Box: The Birth of Neurosurgery 7. The Bottom of the Box: Interrogating the Pituitary 8. Adieu the Simple Life 9. Adieu America: Cushing Goes to War 10. An American Surgeon at Passchendaele 11. Fathers and Sons 12. Johnson and Boswells: Chief and Harem 13. Sprinting to the Tape 14. Regius Professor at Yale Closing: Inheritance and Memory

Harvey Cushing: A Life in Surgery by Michael Bliss (2005), Oxford University Press

Harvey Cushing: A Life in Surgery by Michael Bliss (2005), Oxford University Press

Assessment of quality of life in surgery.

The concept of patients' quality of life is assuming increasing importance in modern medicine and surgery. Interventions are increasingly being assessed in terms of their impact on such areas of functioning as mobility, mood, cognitive function, ability to fulfil occupational and social roles, and general life satisfaction. This paper discusses the theoretical underpinnings of the quality-of-life paradigm and its practical relevance for modern surgery.

Subject and Author Index

Subject and Author Index Volume 81 Complied by Carol Clausen Pagination according to issues: No. 1 (Spring): 1–334 No. 2 (Summer): 335–509 No. 3 (Fall): 510–698 No. 4 (Winter): 699–917 A Thin Blue Line: The History of the Pregnancy Test (media review): 439–40 Abel, Emily K., review by: 674–75 Acker, Caroline Jean, review by: 687–88 Ackerknecht, Erwin H.: social medicine and history of medicine (ROSENBERG): 511–32 Ackert, Lloyd, review by: 676–77 Advertising: childhood cancer in 20th c. America (KRUEGER): 70–93 African Americans: healthcare in the South (NELSON): 594–624 Agostoni, Claudia, review by: 891–92 Alesina, Gloria Actis, Dino Carpanetto, and Maurizio Ferro, eds. Il pregiudizio sconfitto: La vaccinazione in Piemonte nell'età francese, 1800–1814: 691–92 Algeria: Frantz Fanon, biography and history of colonial medicine (KELLER): 823–41 American Association for the History of Medicine: report of the 80th annual meeting (SAVITT): 625–646 American Cancer Society: and motion pictures, 1921–1969 (CANTOR): 39–69 Anatomy: "Body Worlds" phenomenon and its reinvention of anatomical spectacle: 848–65 Andrew, Donna T, review by: 667–68. Andrist, Linda C., Patrice K. Nicholas, and Karen A. Wolf. A History of Nursing Ideas: 671–72 Argentina: practice of eugenics in the treatment of Argentinian women in the 1930s (ERASO): 793–822 Armus, Diego, ed. Avatares de la medicalización en América latina 1870–1970: 892–94 Ashforth, Adam. Witchcraft, Violence, and Democracy in South Africa: 682–83 Azzolini, Monica, review by: 451–52 Bair, Barbara, review by: 437–39 Baldwin, Peter, review by: 490–91 Barnes, Linda L. Needles, Herbs, Gods, and Ghosts: China, Healing and the West to 1848: 449–50 Bello, Patrizia di, review by: 884–86 Berridge, Virginia, "Medicine and the Public: The 1962 Report of the Royal College of Physicians and the New Public Health": 286–311 Berridge, Virginia, ed. Making Health Policy: Networks in Research and Policy after 1945: 897–98 Bertomeu-Sánchez, José Ramón, and Agustí Nieto-Galan, eds. Chemistry, Medicine, and Crime: Mateu J. B. Orfila (1787–1853) and His Times: 870–71 Biography: Frantz Fanon, biography and history of colonial medicine (KELLER): 823–41 Biotypology: practice of eugenics in the treatment of Argentinian women in the 1930s (ERASO): 793–822 Birn, Anne-Emanuelle, review by: 442–44 Bivins, Roberta, "'The English Disease' or 'Asian Rickets'? Medical Responses to Postcolonial Immigration": 533–68 Blake, John B.: obituary (CLAUSEN): 844–46 Bliss, Michael. Harvey Cushing: A Life in Surgery: 469–70 Bourdelais, Patrice. Epidemics Laid Low: A History of What Happened in Rich Countries. Trans. by Holland, Bart K. Originally published as Les épidémies terrassées: Une histoire de pays riches: 490–91 Bowers, Kristy Wilson, "Balancing Individual and Communal Needs: Plague and Public Health in Early Modern Seville": 335–58 [End Page 918] Brieger, Gert H., reviews by: 458–60, 498, 689 Brimnes, Niels, "Vikings against Tuberculosis: The International Tuberculosis Campaign in India, 1948–1951": 407–30 Broberg, Gunnar and Nils Roll-Hansen, eds. Eugenics and the Welfare State: Sterilization Policy in Norway, Sweden, Denmark and Finland. 2d ed.: 894–95 Brockliss, Laurence, John Cardwell, and Michael Moss. Nelson's Surgeon: William Beatty, Naval Medicine, and the Battle of Trafalgar: 872–73 Bruenn, Howard G.: "definitive" account of Franklin D. Roosevelt's terminal illness (LERNER): 386–406 Burns, Chester R.: obituary (MORE): 433–34 Burns, Chester R., review by: 491–93 Cambrosio, Alberto, and Peter Keating, "Cancer Clincal Trials: The Emergence and Development of a New Style of Practice": 197–223 Cancer: prevention, detection, and treatment in the 20th c. (CANTOR): 1–38; public education about (CANTOR): 39–69; childhood cancer in 20th c. America (KRUEGER): 70–93; and popular film (LEDERER): 94–115; public eduction in 1950s Britain (TOON): 116–38; feminist surgeons and radiotherapy in early 20th c. Britain (MOSCUCCI): 139–63; treatments in 20th c. U.S. and U.K. (PICKSTONE): 164–96; cancer clinical trials (CAMBROSIO) & KEATING): 197–223; Rose Kushner, breast...

Lessons from a life in surgery I. Do you want the high figure or the low?

Lessons from a life in surgery I. Do you want the high figure or the low?

Lessons from a life in surgery I. Do you want the high figure or the low?

In my fourth year on the faculty at the University of California, Los Angeles–Harbor General Hospital and my first year as Chief, a young Latin-American man, a Jehovah's Witness, was admitted on December 20, 1967, with painless rectal bleeding of 1 day's duration. Our studies were nondiagnostic (fiberoptic endoscopy and selective angiography were not available then); rectal bleeding persisted. His hematocrit was 31% on admission and, after administration of dextran and electrolyte solution, fell to 22%.

A Psychological Support Concept and Quality of Life Research in a Liver Transplantation Program: An Interdisciplinary Multicenter Study

Considering the increasing number of liver transplantations with longer periods of transplant function, there is a growing need for quality of life research in the field. In addition to lethality, mortality and rehabilitation, parameters of 'quality of life' are to be evaluated: the patient's rating of his subjective physical symptoms, psychological condition (anxiety, depression and mental adjustment), social reintegration and life satisfaction. This paper describes our psychological support program that has been established at the Hamburg LTX center as well as the first results of the ongoing QoL research study. Using the methods developed by the Hamburg Study group on 'quality of life in surgery', 38 liver transplantation patients of the University of Chicago (cross-sectional study with control groups of patients with chronic liver disease as well as healthy individuals) and 29 patients of the University Clinic of Hamburg (longitudinal study with points of evaluation before and 2, 6, 12, 24 and 36 months after transplantation) have been evaluated. First results: (1) All successfully transplanted patients show a significant postoperative increase of their overall quality of life. (2) The psychological parameters of quality of life are only partly correlated with physical symptoms. (3) There is a high correlation between rejection crisis periods and the decrease of all quality of life parameters. (4) In both samples men have a lower quality of life than women, (5) Preoperative depression and lack of social support might be considered as being possible risk factors for long-term survival. (6) Long-term survivors rate their quality of life significantly higher than patients with chronic liver disease and--despite some persisting somatic restrictions--as high as healthy controls. (7) A psychotherapeutic support program increases the patient's compliance resulting a better adaption to the transplant procedure including rehabilitation.

Biologic frontiers in the control of healing

I never knew Thomas Grover Orr. The responsibility which the honor of giving the Orr Lecture before this distinguished society carries, however, has weighed heavily upon me. In looking over some of Dr Orr's contributions, it has been intere sting to find that much of his life in surgery is recorded in the Archives of the Southwestern Surgical Congress. There can be little doubt that our organization was important to Dr Orr and that the standard of his contributions played a prominent role in the success we have enjoyed on the national surgical scene. As I searched through Friesen's superb 1968 Orr Lecture [1] reviewing Dr Orr's contributions to surgery, I was struck by the relevance of Dr Orr's laboratory research to the needs the patients under his care must have presented. Clearly, Dr Orr did not go to the laboratory or send a student to the laboratory to fill a block of time, produce a paper, or fulfill a grant contract. I strongly suspect that Thomas Orr, if the whole truth were known, disliked the laboratory except for what it could do for a sick person under his care. He must have been, therefore, a real human biologist who recognized that the scientific method could not be applied to solve some problems in human beings, and so animal models were developed and adapted to provide data which would be useful to his patients. Invariably, however, there is the return to the patient and often there was a reward because self-descipline in the laboratory provided an answer which was otherwise unobtainable. This is a remarkable achievement which I have found extremely difficult to emulate.