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The man behind Yale’s brains

Harvey Cushing’s records include case histories, photos, and drawings. Harvey Cushing’s records include case histories, photos, and drawings. (Bill Regan for The Boston Globe)
By Jane Roy Brown
Globe Correspondent / September 4, 2011

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NEW HAVEN, Conn. - As Harvey Cushing saw it, every brain tells a story. In a serene, wood-paneled space two stories underground in the Cushing/Whitney Medical Library of Yale School of Medicine, more than 400 brains, all collected in autopsies by this pioneering neurosurgeon between 1902 and 1932, float like placid sea creatures in jars of amber liquid. Lining the walls on shelves suspended from the room’s low ceiling, the jars catch the light as if glowing from within.

These are not normal brains, but brains with tumors - an ugly word that most people have learned to dread, and for good reason. This is a scientific collection, displayed for study so that, in the best of all outcomes, the brain deformities exhibited here will yield to medical advances. Because of Cushing’s habit of fastidious documentation and his long-term relationships with many of his patients, non-scientist visitors will find the personal stories attached to each delicate organ preserved here as well. Nearly all are filled with suffering. Some, because of Cushing’s persistent care and study, ended in relief. Others were predictably tragic. But the people who are represented here (and/or their families) agreed to donate their brains for research.

Some of their stories unfold in annotated photographs displayed on a counter hugging the wall. Cushing’s patients stare without apparent self-consciousness at the camera: A round-faced child in a wide collar, her head shaved. A man whose bare scalp wrinkles in a network of furrows, as though revealing the underlying convolutions of the brain. A bare-chested man with a thick head of hair and a pendulous lower lip, his large right hand pressed to the left side of his chest. This hand-on-chest pose, which brings to mind a pledge or a sign of heartfelt commitment, adds an even more poignant note to many of the photos.

“Dr. Cushing was looking for particular deformities of the hands and fingers caused by certain kinds of tumors,’’ says Terry Dagradi, a photographer at the medical school and the de facto curator of the Cushing Center collection. “He believed in documenting his patients throughout the progress of their disease and recovery,’’ she adds.

This explains why Cushing accumulated thousands of images on glass plates and film negatives, plus histology slides - the small rectangles of glass used to view tissue with optical microscopes - and 50,000 pages of written records. A gifted draftsman, he also made detailed drawings of some of his surgical procedures. Dagradi is in the long process of exploring the abundant images. “It’s the journey of the brains,’’ she says. Two hundred remaining brains are in the process of being prepared to rejoin Cushing’s full collection of about 600.

Cushing’s own story is filled with contradictions. “When you think of a brain surgeon, the image fits Harvey Cushing,’’ says Dagradi. “He was very intense and demanding, a perfectionist.’’ The same personal qualities that equipped him for pioneering research also made this fourth-generation physician a distant father to his five children and an impatient colleague.

With his patients, though, Cushing was not only dedicated, but also kind and protective. “He said that his intent was to heal as many people as possible,’’ Dagradi continues. “He performed more than 2,000 operations, starting out with about a 20 percent survival rate. At the end of his career, nearly 90 percent of his patients survived.’’

The key to his success was that Cushing discovered, through tireless experimentation, how to control bleeding in the brain during surgery, which saved countless lives. He tried out every new surgical tool he could get his hands on and invented several more, which are displayed under glass in drawers below the counter. Visitors can pull out the drawers to inspect the tools of early brain surgery. He also used his formidable drawing skill to map the brain for those who followed him.

In the technological whirlwind that swept the 20th century, Cushing’s artifacts, his painstaking records, and the 600 brains were nearly lost to history. After his death in 1939, all of these things eventually wound up in various obscure basements at Yale School of Medicine. The brains in their jars were shelved in the sub-basement of a student dorm. Cushing would be pleased to know that it was students who rediscovered his work and recognized its importance. At some point, it became a ritual for first-year medical students to break into the locked storage room and commune with “Cushing’s brains,’’ as they dubbed the collection.

Finally, one student proposed that the neurosurgery department find a way to display the treasures more publicly and offered to help. After years of work that included washing the brains, changing the solution in which they were stored, and figuring out how to cart them between buildings, the medical school found space to display them - in the Cushing/Whitney Medical Library. During his life, Cushing had persuaded Yale to build a library to house his and related collections of rare medical books dating from the 11th through the 18th centuries. The 1,700-square-foot Cushing Center, designed by Turner Brooks Architects of New Haven, is as serenely modern as a museum for contemporary art.

Since it opened in June 2010, the unique museum has drawn medical experts and hosted seminars. Still, there is a palpable presence of the patients, photographed in their dignified quest to be freed from the torment of a defect.

Jane Roy Brown can be reached at janeroybrown@verizon.net.

If You Go

Cushing Center
Cushing/Whitney Medical Library
Yale University School of Medicine Building
333 Cedar St. , New Haven
203-737-4065
www.med.yale.edu/library/about/cc.html
The center offers free 1-hour tours on Thursday at 2 p.m. and Friday at 10 a.m. To schedule a tour at another time, e-mail lynn.sette@yale.edu with “Cushing Center Tour’’ in the subject line.