Home Journal Issues Journal Index Blog Search Contact Us Help

Volume 2, Issue 4
Winter 2006:

Harvey Cushing: A Life in Surgery by Michael Bliss

Review by: E. Wayne Wilkins

Cell 2 Soul. 2006 Winter; 2(4):a1

Oxford University Press (2005); 610 pages; ISBN: 0195169891

Harvey Cushing: A Life in Surgery

Harvey Cushing is perhaps the most recognized name in all the history of American surgery. His career is known particularly for his role as the founder, and father, of neurosurgery. He was the founder because he brought the brain, in the final unconquered body cavity, into the stream of surgical therapy. He was the father because he trained many of the nation's leading neurosurgeons.

In addition to this, as author Michael Bliss' subtitle suggests, his was a career devoted to a life time in surgery. With access, as the publisher reports, to "new collections of intimate personal and family papers, diaries and patient records", Bliss (University Professor at the University of Toronto) has brought us an engaging account of his roles as scientist, innovator, teacher, scholar, family man and author.

One of the intriguing highlights of his career was his major role in educational changes at two of the prestigious medical centers of his country: The Johns Hopkins Medical School and Hospital and the Harvard Medical School and the newly founded Peter Bent Brigham Hospital. The Johns Hopkins Medical School was opened in 1893. As the medical historian F.H.Garrison1 recounts, "with it came the opportunity for teaching scientific medicine by modern methods." One of his mentors was Sir William Osler, the first Hopkins chairman of medicine. In his training and early years of surgery Cushing was literally in on the ground floor of these changes in medical teaching and the developing role of scientific research. His 1913 move to Harvard as the first full-time Chief of Surgery at the Brigham offered similar opportunities in Boston. He was a pioneer, in the true sense of the word, in two cities.

His approaches to the practice of neurosurgery, both in Baltimore and Boston, illustrate the differences from the doctor/patient relationship of today. The technical details of his early operations into the skull had to be, without prior experience, largely experimental. The mortality would not be acceptable today. The patient likely was not brought into the crucial discussion of the possibility of complication and death. His surgery had once been termed adventuresome. But again, he was a pioneer.

His literary masterpiece was his 1417-page The Life of Sir William
.2 This won him a Pulitzer Prize. His mentor and friend was by then the Regius Professor of Medicine at Oxford. On his several European travels Cushing visited the Osler family in Oxford and there, after Osler's death in 1919, he researched the Osler papers in preparation for the biography. Back in Boston he could find time to write this lengthy saga while continuing his active surgical schedule.

He played a major role in the development of trauma surgery during World War I. He served two tours of duty, at Ypres in 1915 with the volunteer American Ambulance and at Passchendaele in 1917 with the American Army. A poignant glimpse into Cushing's humanism is the account of his operating on twenty-one-year-old Edward Revere Osler, Sir William's son, wounded at the front by an artillery shell burst. The efforts of four distinguished American surgeons (including Cushing and George Crile) could not save him. He was buried early on the following morning "on a soggy Flanders field".

These are vignettes of events in the career of a neurosurgeon who had, at the same time, been able to operate on more than two thousand brain tumors and to do research resulting in the naming of Cushing's Syndrome and Cushing's Disease. His biography is recommended to any neophyte in the medical education world, whether student or resident. It demonstrates so vividly what a life devoted to the curing arts can accomplish. It clearly demonstrates the admonition that little is more fulfilling than a life in medicine. Yet with his devotion to surgery and teaching Cushing still had room for a rewarding family life.

There is irony today that it is the senior physician who has the time for reading and studying history. The student is said to be too busy. The late Lewis Thomas, erstwhile medical school dean and medical scientist, believed "History should be tested, with vigor". By that he meant
history, perhaps even more than science, should be the basic constituent in undergraduate preparation for medical school and a medical career.3 If one does not have the time for reading history in detail, one might pursue the story of a particular hero and that just could be Harvey Cushing.


1 Garrison FH. History of Medicine, 4th ed., p762. W.B.Saunders Company, Philadelphia, 1929.

2 Cushing H. The Life of Sir William Osler. (Complete in One Volume), Oxford University Press, London, 1940.

3 Wilkins EWJr. Why history is important for thoracic surgeons. Chest Surg Clinics of No America. 10: 1, Feb 2000.

Return To Top