Harvey Cushing: A Life in Surgery (review)

Michael Bliss, the son of a physician and the brother of a medical researcher, is Canada's outstanding historian and Professor of History and the History of Medicine at the University of Toronto. He started in the medical field in 1981, with his book The Discovery of Insulin (Chicago: University of Chicago Press)—a moving and magisterial account of a supreme epoch in the history of medical science. He quickly followed with Banting, a Biography, in 1984 (Toronto: McClelland and Stuart), and in 1991, Plague: A Story of Smallpox in Montreal (Harper Collins Canada), in which the figure of William Osler played a major role. In 1999 came William Osler: A Life in Medicine (Oxford and New York: Oxford University Press), the book with which one starts in order to understand why Sir William Osler is revered throughout the medical world. Once into Osleriana, a life of Harvey Cushing, Osler's first biographer, would almost necessarily follow. Already in the field were two biographies, Harvey Cushing: A Biography (Springfield, Ill.: Thomas), produced in 1946 in the twilight of Cushing's career by the great Yale physiologist John F. Fulton, and Elizabeth Thomson's Harvey Cushing: Surgeon, Author, Artist (New York: Schuman, 1950), an even more readable account. Bliss's Harvey Cushing, however, is the one for which all students of medicine, surgery, history—and life—may have been waiting. For pre-medical or medical students, it shows what one individual can accomplish.

For the practicing physician or surgeon trying to balance the demands of profession, family, and community, this is a cautionary tale. Those in the groves of academe will see through a glass—clearly. From these pages emerges the portrait of an indifferent Yale undergraduate, toying with the idea of architecture, who finds his place in the sun in Russell Chittenden's biochemistry course—essentially the first pre-medical course in America—and in the work of Daniel Coit Gilman, before he went off to Berkeley and later Johns Hopkins, and at the last minute decides to go into medicine.

At Harvard Medical School, he starts his workaholic career and does well, although Elliott Joslin finishes first in their class. He then interns at the Massachusetts General Hospital and, after a near miss, becomes an assistant resident surgeon under William Henry Halsted. He works harder than several dogs, doing much of the professor's surgery and most of his teaching load without the knowledge that Halsted, in the course of investigating cocaine, had become incurably addicted.

At Johns Hopkins, his abrasive and compulsive personality is even more pronounced, and Osler cautions him about it. He sets up a surgical dog lab, christens it the Hunterian Lab, and goes on to establish the field of neurological surgery.

Cushing's appointment as Moseley Professor of Surgery at Harvard Medical School and surgeon-in-chief at the Peter Bent Brigham Hospital; his war years; the publication of his book, From a Surgeon's Journal; the writing of The Life of Sir William Osler; the 2000th verified brain tumor; and the final happy years in New Haven: all are here, with the added dividend, unavailable to Fulton or Thomson, of background from the journal of Madeline Stanton, Cushing's longtime secretary and later librarian in charge of Cushing's remarkable collection of historical books at Yale.

Michael Bliss has capped this phase of his career—he will achieve emeritus status this year—with a beautifully written, authoritative account that will have a wide appeal.

I was consistently amazed at his understanding and use of resource material and looked up every footnote, though I wished they had been included in the body of the text rather than relegated to the back of the book.

A Life in Surgery is published by Oxford Press in the United States and the University of Toronto Press in Canada. The Toronto Press uses better paper, provides a better reproduction of the illustrations, and has a more attractive dust jacket.

In the second...