Wednesday 23 October 2019

Michael Bliss - Harvey Cushing: A life in Surgery - Review.

It is a strange mystery why a man of such accomplishments and medical innovation in the history of neurosurgery, the American pioneer in fact, is not more well known in popular culture.
Dr. Harvey Cushing has to be one of the most fascinating, complex and astounding medical personalities in the last century.
He became the first of American medical men to be an international leader in this special field. Harvey was part of a long line of medical men, his great grandfather, grandfather and father were all competent physicians.
A Yale graduate, later attending Harvard Medical and working at John Hopkins, he paved the way, as he called "The Northwest Passage", in the area of brain tumour surgery, his OR innovations, insistence on sterile working conditions, the use of clips to prevent excessive bleeding and the diagnosis of brain tumours, were all devised and applied by him, having operated on over 2000 patients with brain tumour related illnesses during his long career.
This man takes the term "workaholic" and takes it to an entirely new level. A tireless researcher, recorder, bibliophile, surgeon and prolific writer, his drive and obsession for work and life, set the precedent for future surgeons. A truly remarkable individual.
Michael Bliss, however, is a competent biographer, revealing Cushing's genius as well as his many faults. Cushing was an irascible perfectionist with zero tolerance for any incompetence in the OR. His arrogance and caustic tongue became the stuff of legend; interestingly, as Bliss implies, his personality has become almost a stereotype for the brilliant surgeon, egotistic, sarcastic with no patience for mistakes while in surgery. He was a difficult man to work with and for, however, his care for his patients took priority over all other actions.
Ambitious and single-minded with an insatiable appetite for knowledge, Cushing pioneered brain surgery, writing volumes of medical articles and essays, countless lectures, and even a Pulitzer Prize winning two-volume biography on his mentor and world renowned physician, William Osler.
There are numerous anecdotes in this fine biography, but the one that really stands out is Cushing's first experience with a patient who dies in front of his eyes.
A young student at Harvard, he managed to get invited to assist with `etherizing' patients for surgery. Weeks pass and everything is moving along fine until one evening he administers the ether to a young woman under-going an operation for a strangulated hernia, whose chances for survival are next to nil.
The patient dies before the operation commences minutes after Cushing etherizes her. This of course devastated the young medical student, who walked the streets of Boston deciding to quit the profession. When he returned and told his teacher of his intent, he berated the boy, calling him "a damned fool" and to "buck-up", for they had work to do. He continued on, of course, but remembered this incident over thirty years later.
As any good critical biography should be, it is written with erudition, (explaining medical terms and procedures for the laymen) as well as presenting as a riveting narrative- this is an entertaining and inspiring work of an astonishing individual in American medical history.

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