A Neurosurgeon's Identification: "Queer Breed" or "Happy Breed"?

A NEUROSURGEON'S IDENTIFICATION: "QUEER BREED" OR "HAPPY BREED"? BLAND W. CANNON, M.D.* "We neurosurgeons are a queer breed." This remark was made by Dr. Wilder Penfield while we were breakfasting in a Chicago hotel in 1956. Although Dr. Penfield presented a number of formal addresses during his stay in Chicago, it is this chance remark made at breakfast that has recurred in my memory patterns with that "lup-dup" monotony. Are we, in fact, a species apart, a group of physicians who outwardly seem to have those characteristics or qualities commonly attributed to physicians, but who are different intrinsically in some strange way from the usual physician? Did Dr. Penfield mean that the neurosurgeon of today is ofa special class ofhuman beings, or that he perhaps belongs to a class ofspecial human beings? I, for one, at times have felt remote from the mainstream ofmy profession. All ofus now and then are visited by the impression that neurosurgeons are regarded as different by their colleagues in other specialties. We can remember how occasionally we have been the targets ofjest over a cup ofcoffee, as our colleagues in medicine indulged in good-natured chaffing. In the days when neurosurgery was young and its practitioners numbered only a certain few renowned men, it might well have been that this small group ofdistinguished men in varying degrees embodied some of the characteristics which the word "neurosurgeon" seems to evoke in the mind ofthe public and even among our colleagues in other fields. These impressions traditionally have not concerned the arduous training of the neurosurgeon, but have centered upon his supposed stature, his emotional apparatus, his physical prowess, his stamina, his delicate touch. Probably we all have a model whose personal peculiarities come to rep- * 910 Madison Avenue, Memphis, Tennessee 38103. This presidential address was read at the meeting ofthe Memphis Neurological Society, May 29, 1965. I18 Bland W. Cannon · A Neurosurgeon's Identification Perspectives in Biology and Medicine · Autumn 1966 resent to us theideal characteristics which a member ofthe specialty should have. These may relate to his aggressive nature, his hobbies, or even his management of affairs within his family circle. Since I was trained by Dr. A. W. Adson, I suppose I could eulogize his traits as being most typical ofthose an ideal neurosurgeon ought to possess. But the fallacy ofsuch a course is obvious. The two-gun, deadeye knights ofthe saddle in the era before the West was won are not the typical cowboys oftoday, and the rollicking Rough Riders who charged up San Juan Hill in 1898 are not the coolly efficient American fighting men of our time. The specialty of neurosurgery has won its advance-guard skirmishes and is well established. That Dr. Penfield's remark referred only to our pioneer neurosurgeons as a distinct class seems unlikely. Surely his association with so many neurosurgeons over the years would stimulate a more comprehensive evaluation. Can we be sure that no special physical characteristics are required? Consider the surgeons of modest physical habitus, such as Cushing, Ray, Woodhall, Pilcher, Semmes, Buey, MacCarty, and many others. Is some compensatory force at work which produces, conversely, neurosurgeons ofthe physical size ofPoppen, Olivecrona, Monez, Svien, Uihlein, and Fincher? Small and large, heavy and slight, manually dextrous and intellectually inclined—all can be found among neurosurgeons. Admittedly, there may be more Napoleonic manifestations among neurosurgeons than among specialists in other fields of medicine, but surely we cannot accept the notion that neurosurgeons are different from other physicians, either physically or intellectually. We then turn to the question ofthe importance ofmotivation—whatever the force is that impels a man to be a neurosurgeon. Here, perhaps, we can come closer to the centrifugal force which acts to produce, ultimately , what we may call the "self-identification" of the neurosurgeon. For the motivation of a neurosurgeon is bound up in one inescapable challenge: the challenge to manage, to manipulate, and perhaps to exert influence over the master organ of the body. And as more and more secrets of the functions of the brain are unfolded for us, we cannot but stand in awe of the immense potentials of this relatively small structure. When both our...