Harvey Cushing in 1907 at his desk at Johns Hopkins, six years after he began his residency under the tutelage of surgeon William Stewart Halsted. While at Hopkins, Cushing rose to fame as a neurosurgeon and an expert in the pituitary gland.

An undated photo of a Cushing operating room. Cushing’s innovations in intracranial surgery reduced mortality rates from about 50 percent to 10 percent.

Throughout his career Cushing kept meticulous records of his cases, including photographs of his patients, such as this one showing a surgical incision. He also made detailed drawings of the brain. His collection of notes, microscopic slides, brain specimens and photographs are now known as the Cushing Brain Tumor Registry. The knowledge gleaned from the registry revolutionized the practice of neurosurgery.

Harvey Cushing: the man, the surgeon and the father

A new biography of the pioneering neurosurgeon explores different facets of the man who revolutionized brain surgery.

By Peter Farley

J. Michael Bliss, Ph.D., author of a new biography of Harvey W. Cushing, M.D., assumed the lectern at the Hope Auditorium last October to face what a Catskills comic might call a tough crowd: Cushing’s descendants and relatives, who had gathered to celebrate the renowned neurosurgeon’s life and to plan for a permanent home at Yale for Cushing’s rich collection of brain specimens, photographs, drawings and memorabilia.

But Bliss, a historian at the University of Toronto, proceeded without fear or favor as he discussed his book, Harvey Cushing: A Life in Surgery, and wasted no words in raising an issue of interest to those with a personal connection to the notoriously demanding Cushing. “There’s vigorous debate about Cushing’s professional motives and his professional personality, and this is the kind of thing we have to talk about so long after his death,” Bliss declared. “The question is whether or not he was an egotistical, hard-driving, selfish, mean son-of-a-bitch.”

Perhaps to smooth the way for that question, Bliss first emphasized that Cushing, an 1891 Yale College graduate and one of the most lauded figures in the history of medicine, truly was as great as his admirers would have it. In diligence, innovation and pure skill, Bliss said, Cushing—father of modern neurosurgery, artist, Pulitzer Prize-winning biographer of Sir William Osler and more—had no equal. Before Cushing, patients routinely bled to death during intracranial surgery, which had a mortality rate approaching 50 percent. Thanks to his introduction of rigid haemostasis, asepsis, electrocoagulation and other procedures, mortality rates plummeted to 10 percent.

In his professional life Cushing was a “tough hombre” who “reduced nurses to tears and residents to nervous breakdowns with withering scorn and sarcasm,” Bliss said. Cushing’s punishing schedule—including regular 98-hour weeks—exacted a toll on his wife and children, who “found it difficult to relate to their stern Victorian father, who disapproved of jazz, the movies, fashionable dress, telephone calls, boyfriends, women in medicine, women smoking—probably women at college—and young men who did not attend to their studies and the need to get on with qualifying for Yale.”

His patients, however, knew another Cushing. “His bedside manner was absolutely wonderful; his dedication to his patients absolutely boundless,” Bliss said.

Cushing’s reaction to his son Bill’s death poignantly captured his complex sense of duty. While Cushing was teaching surgery at Harvard Medical School and the Peter Bent Brigham Hospital in Boston, Bill died in an automobile accident after a night celebrating the end of his junior year at Yale. Cushing “called [his wife] Kate to tell her, then carried out a scheduled operation, which was a success, then told his team about the family tragedy and left for Connecticut to claim his son’s body.”

Though Cushing spent almost his entire professional life at Johns Hopkins and at Harvard, his undergraduate years at Yale College were so formative and important to him that he returned to Yale at the end of his surgical career to be Sterling Professor of Neurology and director of studies in the History of Medicine. There could be no more appropriate place than the School of Medicine to house the Cushing Collection, Bliss said.

“He was one of Yale’s most illustrious graduates, and the preservation of his work and legacy at Yale—his books, his papers, and now his wonderful collection of patient photographs and specimens—is a fitting aspect of the university’s service to generations past, present and future. Although Harvey Cushing learned a lot and did a lot at Johns Hopkins and at Peter Bent Brigham,” Bliss said, “Yale was his alpha and his omega.”

Peter Farley is a contributing editor of Yale Medicine and the managing editor of the medical school’s bimonthly newsletter, Medicine@Yale.