Medicine: 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).