Neurosurgery at Washington University: A Century of Excellence (review)

Imagine this scenario: One day, James S. McDonnell, Jr., founder of McDonnell-Douglas Corporation, offers your university financial support toward inquiries that will advance the scientific study of extrasensory perception (ESP), remote viewing, and other paranormal phenomena. What would you do? This situation, described at length in Robert L. Grubb's excellent history of neurosurgery at Washington University, actually occurred there in 1978 and involved William Maxwell Cowan and McDonnell.

Cowan, Head of the Department of Anatomy and Neurobiology, answered McDonnell's belief in extrasensory phenomenon by mildly suggesting that: "such phenomena as ESP and 'remote viewing' must ultimately be mediated by the brain," a hypothesis with which McDonnell apparently could not disagree. Cowan then offered: "Perhaps the problem lies in the fact that we do not know enough about how our brains work. We may be trying to understand the paranormal when we still know very little about the normal function of the brain. It is like trying to put a man into space or on the moon before Kitty Hawk has left the ground." McDonnell replied, "Now you are talking my language" (220). It was surely in moments like these that the modern-day neurosciences were made, and it is in moments like these that Grubb's history opens up questions about contexts far wider than the scope of his book.

Grubb is writing in a long tradition of medical men who have taken to writing biographical, institutional, and intellectual histories of medicine in their retirement. A former neurosurgeon, Grubb brings a great deal of insider knowledge about medicine, neurosurgery, and science to Washington University. His book, which relies upon hitherto unexplored archival sources, traces the history of the university and its relationship to medicine, and does so from the rather novel vantage of an institution at the center of North America. His narrative touches on such mainstays of the history of medical education such as the questions of full-time appointments, specialization, and attitudes toward training and therapy. He provides a compelling overview of the specialization of neurosurgery in the West, touching on such cornerstones of that story as Harvey Cushing's contributions, the legacy of Otfrid Foerster, and the impact of the World Wars.

Grubb's historical approach is dependent upon a prosopography of the institution (the details of which appear in footnotes and many appendices), a survey of its institutional history, and a genealogy of the impact of scientific and technological change in neurology, neurosurgery, and neuropsychiatry. His biographies of figures such as Ernest Sachs, Henry Schwartz, and Sidney Goldring are solid and subtle explorations of these individuals. Grubb's discussions of how computing came to be adopted at Washington University, of McDonnell's philanthropic contributions there, and his exposition of how these events led to the formation of a large interdisciplinary program of research in brain studies are extremely useful for framing the recent history of the neurosciences. Furthermore, his effort to provide an account of neurosurgery's interaction with other specialties (e.g., anesthesia, radiology, ophthalmology) or sub-specialties (radiation, neuropathology) usefully contributes to the sociology of medicine.

In sum, Grubb's institutional history, while traditional in its intellectual approach, sheds new light on the emergence of the brain and mind sciences at Washington University and thus in North America generally. Grubb's effort in producing this monograph will serve future generations of historians and scholars well. The serious historian of neuroscience, neurology, or psychiatry should not miss this book, for there is much in it that hints at untapped archival treasures awaiting further analysis.