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Harvey Cushing: A life in surgery

2006; Elsevier BV; Volume: 55; Issue: 3 Linguagem: Inglês

10.1016/j.jaad.2006.05.036

1097-6787

Thomas G. Cropley,

Historical Psychiatry and Medical Practices

I was fortunate to serve a portion of my dermatology residency at Boston's Brigham and Women's Hospital. Once, I stood waiting to order lunch in the old Peter Bent Brigham building's tiny basement hamburger stand. In front of me in line was one of the most famous pathologists in the world. Just to strike up a conversation with His Eminence, I made an off-hand comment about the execrable quality of the food served in the little lunch room, which was exceeded in its mediocrity only by the even more atrocious atmosphere. The old man turned to me, his eyes twinkling, and said, “You know, Cushing used to keep his brain collection down here. They probably still have a few jars in the back room.” After that, I didn't much feel like eating there. Nonetheless, it was a bit thrilling to know that one of the giants of American medicine had once walked the same cracked linoleum floor where I queued up for my cheeseburger and fries.Another time, an elderly patient told me (possibly apocryphally) how, as youngsters growing up in the neighborhood of the Brigham, he and his friends would climb a certain tree at the corner of Francis Street and Huntington Avenue. From its branches, they could see through the gigantic windows of Dr Cushing's first-floor operating room and sometimes see the great man himself performing brain surgery. For me, Harvey Cushing (1869-1939) was and is still a presence, a fascinating, larger-than-life figure. He was: pioneer brain surgeon, father of neurosurgery, an almost accidental pioneer of endocrinology, Pulitzer Prize–winning biographer of William Osler, consummate clinical researcher and academician, and arguably the most famous American doctor of the 20th century.Michael Bliss, an eminence himself in the field of medical history, has written a wonderfully rich and readable biography of Harvey Cushing, the sequel to his 1999 book chronicling the life of William Osler (William Osler: A Life in Medicine. New York, 1999, Oxford University Press). It is the first Cushing biography to appear in over 50 years. Bliss masterfully interweaves the chronology of Cushing's life with the stories of the development of neurosurgery and American academic medicine. We see Cushing the brilliant operator and researcher, Cushing the mentor, Cushing the tireless medical writer and historian. We glimpse Johns Hopkins in the heyday of Osler and Halstead, and the early struggles—there were many—of the Peter Bent Brigham Hospital. Bliss also gives the reader a sometimes disturbing, but always fascinating, look at a workaholic doctor whose family suffered by his absence, a man who throughout his life held ugly, prejudiced views of race and ethnicity, a man who was in many respects the prototypical surgical prima donna. Cushing could be wonderfully kind and compassionate to patients, but sarcastic and mean to his colleagues and assistants. He was not lovable, and this is not a loving portrait of the man. But it is superbly entertaining.Despite its length (610 pages), the book moves along at a crisp pace. For the most part, it is Cushing's story alone, but Bliss devotes a good deal of attention to the key figures in Cushing's life. Cushing's wife Kate and their children, his mentors W. S. Halstead and William Osler, his troublesome protégé Walter E. Dandy (of Dandy-Walker malformation fame; portrayed in the book as an egotistical nutcase), and his longtime secretary and amanuensis Madeline Stanton are all deftly drawn in vivid prose. Now, brain surgery is not dermatology, and there is nothing of the history of our specialty in this book. But it is a vastly entertaining page-turner of a biography. And it is well-crafted history, a work which beautifully evokes the boisterous adolescence of American academic medicine. I was fortunate to serve a portion of my dermatology residency at Boston's Brigham and Women's Hospital. Once, I stood waiting to order lunch in the old Peter Bent Brigham building's tiny basement hamburger stand. In front of me in line was one of the most famous pathologists in the world. Just to strike up a conversation with His Eminence, I made an off-hand comment about the execrable quality of the food served in the little lunch room, which was exceeded in its mediocrity only by the even more atrocious atmosphere. The old man turned to me, his eyes twinkling, and said, “You know, Cushing used to keep his brain collection down here. They probably still have a few jars in the back room.” After that, I didn't much feel like eating there. Nonetheless, it was a bit thrilling to know that one of the giants of American medicine had once walked the same cracked linoleum floor where I queued up for my cheeseburger and fries. Another time, an elderly patient told me (possibly apocryphally) how, as youngsters growing up in the neighborhood of the Brigham, he and his friends would climb a certain tree at the corner of Francis Street and Huntington Avenue. From its branches, they could see through the gigantic windows of Dr Cushing's first-floor operating room and sometimes see the great man himself performing brain surgery. For me, Harvey Cushing (1869-1939) was and is still a presence, a fascinating, larger-than-life figure. He was: pioneer brain surgeon, father of neurosurgery, an almost accidental pioneer of endocrinology, Pulitzer Prize–winning biographer of William Osler, consummate clinical researcher and academician, and arguably the most famous American doctor of the 20th century. Michael Bliss, an eminence himself in the field of medical history, has written a wonderfully rich and readable biography of Harvey Cushing, the sequel to his 1999 book chronicling the life of William Osler (William Osler: A Life in Medicine. New York, 1999, Oxford University Press). It is the first Cushing biography to appear in over 50 years. Bliss masterfully interweaves the chronology of Cushing's life with the stories of the development of neurosurgery and American academic medicine. We see Cushing the brilliant operator and researcher, Cushing the mentor, Cushing the tireless medical writer and historian. We glimpse Johns Hopkins in the heyday of Osler and Halstead, and the early struggles—there were many—of the Peter Bent Brigham Hospital. Bliss also gives the reader a sometimes disturbing, but always fascinating, look at a workaholic doctor whose family suffered by his absence, a man who throughout his life held ugly, prejudiced views of race and ethnicity, a man who was in many respects the prototypical surgical prima donna. Cushing could be wonderfully kind and compassionate to patients, but sarcastic and mean to his colleagues and assistants. He was not lovable, and this is not a loving portrait of the man. But it is superbly entertaining. Despite its length (610 pages), the book moves along at a crisp pace. For the most part, it is Cushing's story alone, but Bliss devotes a good deal of attention to the key figures in Cushing's life. Cushing's wife Kate and their children, his mentors W. S. Halstead and William Osler, his troublesome protégé Walter E. Dandy (of Dandy-Walker malformation fame; portrayed in the book as an egotistical nutcase), and his longtime secretary and amanuensis Madeline Stanton are all deftly drawn in vivid prose. Now, brain surgery is not dermatology, and there is nothing of the history of our specialty in this book. But it is a vastly entertaining page-turner of a biography. And it is well-crafted history, a work which beautifully evokes the boisterous adolescence of American academic medicine.