| The Legacy of Harvey Cushing: Profiles of Patient Care, Aaron A. Cohen-Gadol, MD, and Dennis D. Spencer, MD, 2007, Thieme, New York, N.Y., and AANS, Rolling Meadows, Ill., 584 pp., $129.95 (AANS members, $117). |
This book is a recognition of the Cushing patients for their gift to neurosurgery. The emotional expressions on their faces more than words convey their suffering and senses of uncertainty. In this book, we witness suffering and renew our oath to care for our patients with passion and to honor their trust in our hands.
This is a book of photographs, photographs that have been painstakingly preserved at Yale Medical School, the home of the Cushing’s Brain Tumor Registry. These are photographs that allow us to see real patients with very real pathology.
The introduction is Michael Bliss’ essay presented to the 2006 Annual Meeting of the Congress of Neurological Surgeons-an essay that reviews Cushing’s life and puts things into proper perspective by closing with the quote by Stephen Paget with which Cushing famously concluded his commencement address to young doctors, “Consecratio Medici”: “…if a doctor’s life may not be a divine vocation, then no life is a vocation, and nothing is divine.”
After an explanation and history of the registry, the book is divided into seven divisions or chapters: pituitary tumors and other parasellar lesions (13 cases); gliomas and other malignant tumors (14 cases); meningiomas (13 cases); cerebral aneurysms and arteriovenous malformations (five cases); spinal tumors (10 cases); posterior fossa tumors and other pathologies (20 cases); and special illustrations, additional operative sketches, teaching slides, and operating room photographs. Each division has an introductory text written by experts in each respective subject. As in most multiauthored books, the quality and depth of subject is variable.
The case histories and operative notes are in Cushing’s own words and are obviously from an earlier era since their honesty and openness are no longer seen in today’s litigious world. Statements of greatest interest have been placed in boldface print by the editors. This makes many memorable words of Cushing impossible to miss. There are, however, many priceless comments which have not been given boldface emphasis.
What an amazing legacy Harvey Cushing gives to us all! He brings to us 2,000 brain tumor patients who all had pre- and postoperative photographs and meticulous medical records created and preserved. As the editors point out, each patient is of historical significance now because our discipline of neurological surgery evolved through his or her care. This book allows us a unique glimpse into a world of a century past. Wilder Penfield was right when he described Cushing as “an artist, a Leonardo da Vinci devoting his talents to surgery.”
Read this book. Do not miss the legacy that the father of American neurosurgery has left us.
Gary VanderArk, MD, is clinical professor of neurosurgery at the University of Colorado Health Sciences Center in Denver. He is the 2001 recipient of the AANS Humanitarian Award. The author reported no conflicts for disclosure.