BRAINMAN

To physicians 40 years ago, the living brain was a jungle of tangled nerve fibres, a mass of corrugated grey tissue. A few brave men dared to perform brain operations, but most of their patients died. In 1905 young Surgeon Harvey Williams Cushing penetrated this wilderness, and in 28 years, almost singlehanded, he perfected the technique of brain and nerve operations. Today, thanks to Dr. Cushing, an operation for brain tumor is no more dangerous than a stomach operation.

Six years ago wiry, bright-eyed Dr. Cushing laid down his scalpel. But neither his patients nor his students have forgotten him. In 1932, a group of former students and associates formed the Harvey Cushing Society, for the exchange of information on neurology.* Last week, at Yale University, most of the 46 members of the Society, together with a large group of physicians from Vancouver to Boston, met to celebrate the 70th birthday of the world's greatest neurologist. For two and a half days the scientists presented brief reports on their latest accomplishments. On April 8, they capped the celebration by surprising Dr. Cushing with a birthday bibliography of all his writings. Said Dr. Cushing, overwhelmed: "I am deeply gratified and touched."

Baseball to Tumors. Dr. Cushing's extraordinary career is a record of one of the most single-minded men in the history of medicine. At Yale young Harvey Cushing played right field on the baseball team, and became a first-rate gymnast. Following family tradition (three generations), he decided to become a doctor, went through Harvard Medical School. Afterwards he went to Johns Hopkins Hospital and studied abroad. In Switzerland he was inspired by great Surgeon Theodor Kocher to enter the field of neurology. His inspiration burned with icy clarity.

One of Dr. Cushing's great contributions to surgery was his operation for removal of tumors rooted in the nerve of hearing. Turning down a flap of muscles at the back of the neck, the surgeon cuts out a piece of bone at the base of the skull, gently pushes aside the soft cerebellum in order to bare the acoustic nerve. After removing the tumor he resettles the cerebellum, tightly stitches down the tough flap of neck muscle. The bone is not replaced, for the muscle-patch is strong enough to protect the patient from injury. The entire operation is performed under a local anesthetic, which deadens only the scalp nerves. Strangely enough, gentle manipulation of a bare brain produces no pain at all.

Dr. Cushing, reticent and aloof, made few friends. He lived for medicine. But at the Hopkins he forged a lifelong bond with Hopkins Founders William Stewart Halsted and William Osier, both much older than he. After Sir William Osier's death, in 1919, Lady Osier persuaded Dr. Cushing to write her husband's biography. Dr. Cushing reluctantly set to work, appropriated an enormous laundry table from the cellar, piled it high with boxes full of notes, set about retrieving Dr. Osier's myriad postcards (he rarely wrote letters). Much to the surprise of Dr. Cushing and his family, who doubted his literary ability, the scholarly two-volume Life of Sir William Osier* won the Pulitzer Prize (1926).

Harvard Years. In 1912 Dr. Cushing became Professor of Surgery at Harvard, and head of the famous Peter Bent Brigham Hospital. His labors were phenomenal. He would rise shortly after seven, eat a light breakfast, work on his medical articles, then go to the hospital. One operation sometimes took him eight hours. He performed three or four such long operations each week.

Only a few lucky physicians would be invited to view each operation. Dr. Cushing always dressed in grey, made few remarks. Only sign when he struck an unexpected problem: he would lightly rub his hands together, or dip them quickly in the bowl of antiseptic solution which stood near the operating table.

After operating, Dr. Cushing would retire to the dressing room, dictate all his surgical notes, make his own sketches for hospital records. In his 20 years at Harvard, Dr. Cushing collected some 2,000 brain tumors, which he stored in bottles. Many of these are pituitary tumors, for Dr. Cushing has done pioneer work in diseases of this master gland. These specimens, with their corresponding case histories, form the most remarkable neurological collection in the world.

In his teaching also Dr. Cushing was hard, factual. He never spiced his lectures with humor, never unbent. During his entire career, he taught about 2,500 men from all over the world. To many of them he seemed a cold, reticent perfectionist.

The War. In the bloody operating rooms of France during the War, Dr. Cushing led a life of scientific asceticism. In spite of grueling works (he often performed as many as six operations in one day) he faithfully jotted down his scientific observations. He also found time to keep a detailed journal. As remarkable for its restraint as for its scientific and military detail, the journal tells in vivid doctor's language of Dr. Cushing's siege of Polyneuritis ambulatoria, a crippling inflammation of nerve trunks, which caused the muscles in his soles and palms to waste away. After the Armistice, Dr. Cushing regained control of his hands, but for many years he limped. He is now completely recovered.

Active Retirement: In 1933 Dr. Cushing returned to Yale, and in 1937 he retired. But retirement, to Harvey Cushing, did not mean rest. He hates vacations, spends his day at the New Haven Hospital. In the evenings he plays backgammon with kindly, sociable Mrs. Cushing. His greatest relaxation is playing with his two little granddaughters, Sarah Delano (age seven) and Kate (age three), the children of his charming, blue-eyed daughter Betsey (Mrs. James Roosevelt). Social affairs he has always detested. Mrs. Cushing tells a story of how she once tricked him into going to a coming-out party. As they drove up to the hotel, he saw what he was in for, marched into the revolving doors, marched around, marched out, drove back home to his work.

*Among Dr. Cushing's well-known students and proteges: Dr. Walter Edward Dandy of Johns Hopkins; Dr. Gilbert Horrax of Boston; Dr. Leo Max Davidoff of Brooklyn; Dr. Eliott Carr Cutler, of Peter Bent Brigham Hospital, Boston; Dr. William John German of New Haven; Dr. Howard Christian Naffziger of the University of California.

*Oxford University Press ($12.50)

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