Photographs of the Earliest Brain Surgeries
Image: Cushing Whitney Medical Library/Yale University

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Photographs of the Earliest Brain Surgeries

The "father of modern neurosurgery" charted his patients' progress through photography.
June 10, 2015, 7:15pm

For decades, Dr Harvey Cushing's historical collection of brain tumour specimens and patient photography lay collecting dust in a basement underneath a Yale University dorm. A PhD thesis published on the collection in 1996 may have roused people's interests, yet it still took a further 15 years until enough funds were gathered to start restoring the collection.

"It's not that the brains were unknown, it's just that nobody cared," explained Terry Dagradi, the Cushing Centre coordinator, to me. The existence of 700 glass lead jars filled with historical brain-tumour specimens is no small matter. But what's cooler still is the accompanying set of 10,000 to 15,000 glass plate photographic negatives, which reveal the patients whose brains ended up pickled in those jars. This photographic collection, said Dagradi, only began to be digitized earlier this year.

Dr. Harvey Cushing Tumor Registry patient photos taken between 1900-1930s. Image: Cushing Whitney Medical Library/Yale University

"Cushing used photography to record the progress of a disease in a patient, and as a diagnostic tool," explained Dagradi. His extensive collection of photographs are expressive, revealing patients after their operations, or during different stages of their brain-related illnesses (Cushing had the same patients photographed over several years). Some are even abstract. Take, for example, a photograph of a bloody brain propped up on a wooden stool, which appears almost like a contemporary art piece instead of a clinical specimen.

Harvey Cushing began his career in the early 1900s; he was an American neurosurgeon who is considered today as the "father of modern neurosurgery." Back in the 20th century, brain surgery was being attempted in the US, Europe, and the UK, said Dennis Spencer, chair of the department of neurosurgery at Yale, in a YouTube video. However, success stories only really emerged once Cushing revamped the field.

Dr. Harvey Cushing Tumor Registry patient photos taken between 1900-1930s. Image: Cushing Whitney Medical Library/Yale University

Harvey brought techniques that would seem really simple and rational today into the operating room, and increased his patients' survival rates. His techniques included monitoring the patient's blood pressure and pulse, and using local anaesthesia rather than general anaesthesia.

Aside from his prowess as a surgeon, Cushing was also a prolific documentarian, who charted his operations in both writing, sketches and photography. In the years that he was active as a surgeon, the collection of brains, which was dubbed the Cushing Tumour Registry, acted as a valuable resource for aspiring surgeons.

Dr. Harvey Cushing Tumor Registry patient photos taken between 1900-1930s. Image: Cushing Whitney Medical Library/Yale University

"[The brains] were a valuable teaching tool, and a resource for other researchers," said Dagradi. "Cushing wanted to see the internal structure of the brain, and see what types of tumours had landed where." The idea, said Dagradi, was to allow students to study the brain and the symptoms, so that they could diagnose potential diseases earlier.

So far, the Cushing Centre have digitized around 3,000 photographs, and intend to compile a database. But the story doesn't end here for the pickled brains. "We didn't think that [the collection of brains] had anything new to share, but now there's a possibility for researchers to study the DNA of some of these tumours," said Dagradi.

Dr. Harvey Cushing Tumor Registry patient photos taken between 1900-1930s. Image: Cushing Whitney Medical Library/Yale University

The medical research team at Yale are currently in the process of identifying half a dozen brain-tumour specimens, so researchers can investigate them in order to gain a better understanding of acromegaly—a disease that causes a small gland in the brain to produce a growth hormone, which causes swelling.

"All of these older specimens could yield further scientific knowledge. In that case, Cushing would be so pleased to know that his collection has both continued to create curiosity, but also to inform people and yield influence," added Dagradi.

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