Harvey Cushing Surgeon Author Artist

HARVEY GUSHING
Swgeon, Author, Artist

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HARVEY GUSHING

Surgeon, Author, Artist

BY ELIZABETH H. THOMSON

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HARVEY GUSHING

From a crayon portrait by Deane Keller in 1939
Courtesy of the Yale University Art Gallery

Harvey Gushing

Surgeon, Author, Artist

ELIZABETH H. THOMSON

Foreword by John F. Fulton

1950

Henry Schuman
New York

Copyright i$$o by Henry Schuman Inc.

Manufactured in the United States by H. Wolff
Designed by Marshall Lee

Publication No. 24

Historical Library

Yale University School of Medicine

This book is affectionately dedicated to

My Mother

Julia Bristol Thomson

And the Memory of my Father

Walter Ira Thomson

FOREWORD

FOLLOWING THE APPEARANCE OF HARVEY CUSH-

ing's detailed two-volume Life of Sir William Osier, there
were requests for a briefer account which would come more
within the purse and compass of the lay reader and the medi-
cal student. Mrs. Edith Gittings Reid, an old friend of Balti-
more days, responded with her well-known volume that
appeared in 1931 under the title, The Great Physician.

After the publication of my biography of Dr. Gushing, a
number of reviewers and many correspondents expressed the
same hopethat a shorter story might sometime be prepared
for the general reader and the young physician and surgeon
who might be put off by the size of my text. Having had mis-
givings about publishing so extended an account, I welcomed
Mr. Schuman's proposal that Miss Thomson, who had helped
me prepare my biography for press, undertake an account of
Gushing for The Life of Science Library to which she and
I had already contributed a life of Benjamin Silliman.

Inevitably when a new biography is written, fresh source
materials and new anecdotes come to light which give further
insight into the character of the subject. In the case of Dr.
Gushing these new materials have been of particular interest,
and Miss Thomson has utilized them freely* She has also re-
studied the sources that I used and in many instances found
sidelights that I had missed. Such is the wealth of material
that, except for official correspondence, the letters selected
for this volume are for the most part entirely different from

Wit FOREWORD

those which I included. The result is a completely new biog-
raphy, written with the general reader in mind. For this rea-
son, and because the story has been most skillfully woven, I
believe Miss Thomson's biography will have a wider appeal
than my earlier account.

A welcome feature of the book is that it gives a much
clearer picture of the large part that Mrs. Gushing played in
influencing Dr. Cushing's career and in directing the energies
of their children. During her lifetime I was unable adequately
to emphasize Mrs. Cushing's role, and I feel that Miss Thom-
son has told this aspect of the story with sympathy and keen
apperception.

The chapter on Dr. Cushing's relations with his patients
casts light, also welcome, on a phase of his life that a number
of reviewers felt I had not adequately brought out in my
biography.

Following Dr. Cushing's good example of keeping himself
out of the Osier biography, I attempted to do likewise in my
account of him. However, Miss Thomson has felt that her
readers might care to know something of our relationship, so
with some diffidence I have placed my files at her disposal
and although she has quoted rather more widely from my
letters than seems decent, I have not felt inclined to protest
because, having written one life of Dr. Gushing, I wanted in
no way to influence his next biographer. I can add that this
is entirely Miss Thomson's book and that it is written with
an insight which a man seldom, if ever, achieves.

John F. Fulton
Yale University
October,

A U T H O R'S PREFACE

TO WRITE ABIOGRAPHYOFAMANWHOSELIFEAND

work were as rich and varied as Harvey Cushing's is both a
privilege and a pleasure. My enjoyment of the task was in-
creased by the challenge created by the wealth of source
material. Many books could be written about the different
periods of his life, or about his different facets surgeon, au-
thor, artist. But for a volume in The Life of Science Library
the primary aim was to convey to the general reader, within
a brief compass, some idea of Dr. Cushing's scientific con-
tributions and his importance to this and succeeding genera-
tions.

By devoting his life to neurological surgery and its prob-
lems he made operations on the brain of little more hazard
than those involving the abdomen, and this of itself has as-
sured him a place for all time among the great contributors
to the science of medicine. To his achievement in developing
this specialty an ever-increasing number of people will owe
their lives, and the record of his accomplishments will always
be a source of inspiration to students and to those already es-
tablished in the profession. But Harvey Cushing's life has
meaning for a much deeper reason than this. By example he
taught that a physician is obligated to consider more than a
diseased organ, more even than the whole man he must view
man in his world. To do this, he must himself have breadth
and vision and courage. In living this philosophy, Gushing
joined the ranks of those humanist-physicians who have stood

ix

CONTENTS

Foreword vii

Author's Preface ix

i The Western Reserve of Connecticut 3

1 1 "As the Twig Is Bent" 1 1

in Son of Yale 18

i v Upperclassman 3 1

v Medical Student at Harvard 39

vi The Halfway Mark 54

vii "A Great Place to Grow Hair and Wear Out

Shoes" 66

vin The Johns Hopkins Hospital 70

ix Resident in Surgery 79

x A Young Provincial Abroad 94

xi The Closed Door 112

xn "For Books Are Not Absolutely Dead

Things" 123

xin The Discouraging Years 133

xiv The Doghouse 146

xv The Path Broadens 154

xvi Hopes Fulfilled 166

xiii

fc W CONTENTS

xvii Return to Boston 177

xvni "The Marrow of Tragedy" 185

xix Administrator 203

xx A Family of Individualists 216

xxi 'The Severe Ascent of High Parnassus" 228

xxii Teacher 240

xxin A Good Doctor 251

xxiv Founder of a "School" 260

xxv Adding Up the Score 272

xxvi Professor of Neurology at Yale 292

xxvii The Evening Years 3 1 3

xxviii "Be You but Brave and Diligent" 323

Bibliography And Sources 325

Acknowledgments 329

Index 331

ILLUSTRATIONS

Lambrequin-draped mantel of Harvey Cushings

room 21

H.C.'s drawing on place cards -for the Broivnie

Club dinner 55

The 'Rutland Arms and the accounting f$

Bicycle lesson 77

"We cheer up at the Frontenac" 7-2

Aver gnat-Romanesque church at IssoireEglise de

St. Paul 99

"There is more than one e way of stealing your O'wn

supper" 100

Le Puy from the north 101

Wild flowers near the ruins of the Chateau at

Allegre 102

"Flying through snowy space" on the Gee Whiz 103

From a letter to Mme. Jeanne Michaud of Berne 105

From facsimile of card to Dryderfs funeral 130

A page from Dr. dishing* s r war diary. En route to

France in March i$tf 188

PLATES

Harvey Gushing FRONTISPIECE

PLATE facing page

1. Henry Kirke Gushing 14
Betsey Maria Gushing

Gushing house at 786 Prospect Street, Cleveland

2. Sons of Eli 15
Baseball team of the Class of '^;

3. Microscopical anatomy 46

4. A human craniotomy 47

j. Katharine Croivell 142

Harvey Gushing
William. Osier

6. Dr. Gushing on the steps of the Ambulance

Americaine 143

7. Gushing children 174

8. Operating be-fore the Harvey Gushing Society, 1932 175
Writing the operative note after 2000th tumor

operation, 1931

$. Dr. Gushing and Dr. Otfrid Foerster in a moment

of perplexity, 1930 238

Surgical staff of Peter Bent Brigham Hospital,
xvii

XWll PLATES

70, Arnold Klebs, William Welch, Dr. Gushing, and

Sir Charles Sherrington, 1931 239

At Volendctm, i$29

H.C. and Gustave Roussy, Dean of the Faculty of
Medicine, Paris, 1933

n. Professor Chittenden, Dr. Gushing, and Governor

Wilbur Cross 270

On an ulcer diet

Watching a croquet game at 691 Whitney Avenue
Dr. Gushing and another guest of the Harvey
Gushing Society, May 1935

12. Studying Cattanfs copper engravings of the Ercole

Lelli -figures 271

HARVEY GUSHING
Surgeon, Author, Artist

"Rarely is it safe to prophesy any durability of recognition,
whatsoever the accomplishment. Fame that is contemporary,
fame that for a time endures, and fame that actually accumu-
lates, differ in quality as differ the flash of a meteor, the glow
of a comet, the permanence of a fixed star. Only when the
contemplation of both the man and his achievement truly
inspires and ennobles us will they remain indivisible to be
praised by the people for time everlasting."

Harvey Gushing, "Emancipators"

THE WESTERN RESERVE....
OF CONNECTICUT

Chapter I .

H

.ARVEY GUSHING, AN INTERN ON

the south side of the Massachusetts General Hospital in Boston,
entered one of the wards on an autumn morning in 1895
to do the routine surgical dressings. Among the patients who
watched his progress from bed to bed was Lucy Hogan, who
had come all the way from New Brunswick, Canada, for treat-
ment. Sometime before, Lucy had developed a persistent sore
on her foot, and having heard that there was a priest some
thirty miles from her home who worked miracles, she had
saved her money and made the journey to the town. She found
that the priest was itinerant, but the kindly wif e of the station
agent took her in until he should return. The priest must have
been a wise man, for he gave her some salve and told her that
if the sore did not heal, she should go down to the Massa-
chusetts General Hospital in Boston, and if they thought best
to cut off her foot, she must let them do it.

The sore did not heal, and now, two years later, Lucy Hogan
was in Boston. It was the first time she had ever been in a big
city, the first time she had seen a hospital. She was frightened,
and when the doctor and the nurse assisting him came to her
bedside and she saw the doctor reach for the scissors, she was
terrified lest her foot be cut off then and there. But the gentle-
ness with which he took off her bandage, the warmth in his
voice and smile, and the confident and interested manner in
which he examined her foot completely reassured her, and

3

4 HARVEY GUSHING

from then on she knew she was in sympathetic hands and was
no longer afraid.

This meeting was the beginning of a lifelong devotion to the
young intern on the part of Lucy Hogan, and she felt a per-
sonal pride when he subsequently became famous as a surgeon.
Years later, after his death, she wrote a letter to her friend,
Miss Ida M. Cannon, Chief of Social Service at the M.G.HL
Lucy was nearly blind then with an incurable eye condition
and she had returned many times to the hospital because the
Raynaud's disease, which had caused the sore on her foot, had
grown progressively worse and over the years eight partial
amputations had proved necessary. The letter went:

Dearest Miss Cannon, I am enclosing dear Doctor Harvey
Cushing's letter which you asked for. he is not dead he lives in
the hearts of his Pacients and friends if Doctors knew what they
give to their pacients that is not in bottles or pills, I am sure they
would find strength and joy to carry them over the very hard
places they are called upon to travel. . . . loveingley and greate-
fully yours, Lucy H. Hogan.

The story of Harvey Gushing did not begin with his birth on
April 8, 1869. The forces which shaped his destiny had been at
work long before that date perhaps as far back as a September
day in 1835 when Erastus Gushing, the young physician of
the town of Lanesboro in the Berkshire Hills of Massachusetts,
climbed into his carriage and turned his horses westward.
Among those wishing him Godspeed was his mother, Free-
love Gushing, who could not be persuaded to leave New Eng-
land, for it was here that her husband, David, Jr., the first
Gushing physician, was buried. But it was the very thought of
David and his early death from overwork and prolonged ex-
posure under the cold New England stars that caused Erastus
now to say farewell to all that was dear and familiar to him
and to make his way farther west where a milder climate and
new opportunities beckoned.

The Western Reserve, a portion of the grant made to Con-
necticut by Charles II in 1662, had been settled largely by mass
migrations from Connecticut and Massachusetts. This "larg-

THE WESTERN RESERVE OF CONNECTICUT J

est, strongest, and most characteristic single, compact colony
in the West, the last distinct footprint of Puritanism," became
part of Ohio when it achieved statehood in 1803.

When Erastus had gone to Cleveland earlier, on an inspec-
tion trip, the town had appealed to him strongly and he had
chosen it as the place in which to make a new start. As he now
set forth with his family, he took with him "the strength of the
hills," the cherished memory of his father, and his father's
books. These well-used and familiar volumes, so often a source
of comfort to David, gave Erastus a feeling of security as he
left the green hills and friendly valleys of his home and trav-
eled over the mountains into New York State by the trail
which still winds tortuously between mountain and rushing
brook. With his young, wife, Mary Platt Gushing, and their
three children (the oldest eight years, the youngest four
months), he eventually reached Troy, the first leg of the dif-
ficult journey behind him.

From Troy they had a week's travel across the state by canal
boat to Buffalo where they embarked on a sailing vessel for
Cleveland. Ordinarily this passage was short, but stormy
weather forced them to seek shelter along the Canadian shore
for two days, so that it was the i5th of October before they
climbed the bluff from the shore of Lake Erie and saw the
town of Cleveland stretched out before them. It was a beauti-
ful, clear autumn day; and to a family seeking relief from the
long, severe New England winters, it was gratifying to have
the pleasant weather continue until after the new yearan
auspicious beginning for their new life.

Warmhearted and friendly, Erastus soon made a place for
himself, and it was not long before he had a thriving medical
practice. He built a house and adjoining office on the lot he had
bought opposite the green in the center of town and having
established himself as a man of education and integrity, he be-
came a much loved and respected member of the community.

In the meantime, Henry Kirke, his eldest son, grew into a
tall, thin lad with a tendency to be shy and nervous. In the
autumn of 1845 he entered Union College at Schenectady,
New York, in the sophomore class and was graduated in 1848

6 HARVEY GUSHING

"with a fair stand in some things only." He then returned home
for three years to apprentice himself to his father and to attend
lectures at Cleveland Medical College.

During this period he was often a caller at the home of Wil-
liam Williams where his father, as family physician, was also
a familiar figure. Henry Kirke engaged one of the younger
Williams boys (at a sum which made him the envy of his
brothers) when he wished to make a study of the normal hu-
man heart, but he was more interested in the heart of the eldest
daughter, Betsey Maria a pretty, vivacious girl with large
dark eyes, and shining black braids wound around her head.
As time went on, his intentions became obvious.

Nevertheless, in 1850, Henry Kirke went off to Philadelphia
to complete his medical education at the Medical Department
of the University of Pennsylvania. Erastus wrote him fre-
quently, encouraging him to make his own decisions and
assuring him of support in whatever he thought it wise to
undertake. 1 He was pleased that his son was to room with a
divinity student instead of a medical student because it would
give him a broader outlook and, "if he is an intelligent, gentle-
manly man, and reasonably well acquainted with human nature,
as every clergyman ought to be, he will be both a pleasant and
profitable companion." His only advice was on a familiar sub-
ject "One thing I forgot to mention I deem of great moment
for you. It is this that you give yourself more time to sleep."

In December, 1850, when Henry Kirke, nearing the end of
his course, was offered the position of assistant physician in a
private retreat for mental patients, his father, after pointing out
the good and bad aspects of such an affiliation, wrote him thus:
"When you leave there, however, you will not find the world
or your patients all in strait jackets & as entirely under your
control as in such an institution but it's to be hoped that you
would acquire an ability in managing men that would be of

1 Erastus had had the best medical education then available (a two-year
apprenticeship to a local physician, a year at New York Hospital, and
a year at the Berkshire Medical School at Kttsfield, the Medical Depart-
ment of Williams College), and he was eager that Henry Kirke should
benefit from the advances in medical education since his time.

THE WESTERN RESERVE OF CONNECTICUT 7

use to you in managing the world generally after you leave
there." And when Henry Kirke did not get the position, he
wrote him sympathetically: "The turn things have taken rela-
tive to the expected appointment I would not let trouble you
it is undoubtedly a disappointment, but would not have been
if your expectations had not been previously raised, so you
have lost nothing. . . . It's only one of the minor mishaps
to which we are constantly subject thro life. If you had no
abiding place and were entirely afloat in the world, it would be
of more moment to you."

The decision as to his future was, however, taken out of his
hands, for Erastus became very ill and Henry Kirke went
home to fill the breach without having the desired year of
internship. Instead, he joined his father in the practice that was
becoming too large for Erastus to carry alone. In June, 1852,
he married Betsey Maria Williams, and soon the responsibilities
of a growing family left him little time for regrets.

Ten children were born to the Cushings, only seven of
whom reached maturity. 2 Because of the rapid growth of the
city and the encroaching business interests, they were forced
to move several times during the early years of their marriage,
finally settling at 786 Prospect Street (now No. 3112) near the
Erastus Gushing household on Euclid Avenue.

For the next forty years Dr. Kirke, as he was called, was
never absent from the demands of his large practice except
while on duty in the Civil War and when laid up for a year
with an injury to his knee after slipping on an icy step. He be-
came professor of midwifery, diseases of women, and medical
jurisprudence at the Cleveland Medical College and later
served for over ten years as a trustee of Western Reserve Uni-
versity. He played an active but inconspicuous part in medical
affairs in Cleveland. Although greatly respected, he had few
close friends, for the innate shyness and diffidence that had
kept him from making many friends in college had, in the busy

2 William Erastus (1853-1917); Alice Kirke (1859-1918); Henry Platt
(1860-1921); Edward Fitch (1862-1911); George Briggs (1864-1939);
Alleyne Maynard (1867-1903); and Harvey Williams (1869-1939).

HARVEY GUSHING

years of his maturity, taken the form of an austerity and reserve
difficult to penetrate.

Many people, and even his own children, would have been
surprised had they known that, when he closed his study door
on the rare evenings he had at home, the books he read were
tales of adventure in strange places of Lewis and Clark in
Oregon, Livingston in Africa, and Gordon in China. He read
much about the tribes of Africa and of the Indians in America,
of their customs and how they fought; he knew the history of
several of the British regiments their uniforms, their traditions,
their battles and campaigns. Had he been able to share these
interests with his children, much of the formality that existed
between them would have been dissolved, but it was not until
they were grown that they really came to know and under-
stand him. He did, however, teach them something of the stars,
which he had studied so that they would be company for him
on his long night rides, and he encouraged their interest in
natural history, especially in trees, of which he had extensive
knowledge.

One by one they came to realize that beneath his quiet, for-
bidding exterior was a lively curiosity that matched theirs.
William, his eldest son, later remembered his father's descrip-
tion of his first trip in an automobile. Dr. Kirke had carefully
watched the driver until he was convinced that had any-
thing happened to the man, he could have driven the machine
home although he had asked no questions about the "modus."
On another occasion the matter of whether or not elephants
were pacers engaged his interest. Failing to find the answer in
any book, he made a point of taking William to the next circus
that came to town. When the elephants went by, all pacing, he
nodded his head with satisfaction and turned around and went
home.

But this was much later. When the children were growing
up, it was Betsey Maria who filled most of their needs. It was
she who doctored their ills from her own medicine cabinet,
treated scraped knees and wounded feelings. It was she who
taught them their catechism and helped them with their
French, Latin, and Greeksubjects in which she had excelled

THE WESTERN RESERVE OF CONNECTICUT $

at the best classical school in Cleveland. She tried to create
for her children something of the atmosphere in which she
herself had been reared, for she had been one of ten children,
and their home had always been the lively center of a large
family clan. She inherited some of her energy, humor, and
warm friendliness from her father, William Williams an out-
going man of wholehearted enthusiasms and infinite good
nature. "Olympians in Homespun," 3 Lucien Price has called
these early settlers of the Western Reserve. Like the Cushings,
the Williams family had also come from New England and,
being thrifty and enterprising, had prospered in business. As
many as thirty or forty people of all ages were in the family
group that frequently gathered at William Williams' home on
Euclid Avenue. They created their own diversions reciting
original poems with gusto, singing (for all the Williamses were
musical), and presenting plays. On one occasion they even suc-
ceeded in persuading Dr. Kirke to take the part of Gruff
Tackleton in The Cricket on the Hearth.

Because of the early death of her mother and long invalid-
ism of her stepmother, responsibility for her brothers and sis-
ters fell to Betsey Maria while she was still very young. When
her own children arrived, she was already well versed in the
art of motherhood. During the winter evenings when Dr.
Kirke was off on a case, she could be found in a chair before
their open grate fire, holding one of her own babies in her
arms while she continued to help her brothers, first one and
then another, with their lessons. Or she would read with her
book propped up in a rack while she knitted endless socks and
mittens. When the children were old enough, she took them
with her to lectures and musicales.

Through the years, Betsey Maria thus offered her children
rich companionship, so that they did not gravely suffer from
their father's preoccupation with his profession. She rarely
lost her cheerfulness and serenity even when Henry Kirke
would withdraw into days and sometimes weeks of silence be-

3 In 1926 Lucien Price, who is 'IJncle Dudley" of the Boston Globe,
wrote this warmly appreciative essay, "Olympians in Homespun," about
his native Western Reserve for the Atlantic Monthly.

10 HARVEY GUSHING

cause of weariness or worry, for she was aware more than
anyone that his deep-hidden vein of humor and sentiment
underlined and supported her own spontaneity. The most in-
timate view of their relationship with each other is to be had
from an incident recounted by their youngest son. Henry
Kirke came home one day and told her solemnly that he had
just given all his money for a woman who had lost both her
arms and he had brought her home in his carriage. Betsey
Maria, as he had anticipated, was immediately full of sympathy
and concern and she hurried outside to find, on the front seat
of the carriage, a bronze reproduction of the Venus de Milo!

"AS THE TWIG IS BENT
Chapter II

H

.ARVEY WILLIAMS GUSHING, THE

tenth and last child of Betsey Maria and Henry Kirke, was born
on the 8th of April, 1869. He had a happy, secure childhood
with the companionship (and discipline) of a sister, brothers,
and innumerable cousins. Although their large, comfortable
house was on a city street, there was room enough in the back
yard for a barn where they kept a horse and where the boys
housed their pigeons, cats, and dogs room, too, for their
mother's garden, a chicken yard, a croquet set, fruit trees, and
a cemetery for departed pets.

Each season had its special pleasures spring brought the first
sapsuckers to the Norway birch in front of the house and the
first fragrant violets in the garden. It brought baseball and top
spinning and a new family of kittens in the barn. In summer
there were family picnics and excursions into the country,
swimming in Lake Erie after a dusty walk cross-lots, croquet,
and the excitement of poaching in the neighbors' cherry trees.
In autumn the Gushing boys flew homemade kites after school,
and in winter they skated (on rinks made by flooding some-
one's back yard), coasted, and had snowball fights. When it
rained, they were content for long hours in the attic with their
collections of postage stamps, coins, butterflies, and birds' eggs.

Yet the days were by no means entirely lazy and carefree.
They helped their mother plant her flowers and their father
with the spring chores. They mowed the lawn, swept the

77

12 HARVEY GUSHING

walks, shoveled snow, and helped with the semiannual upheaval
of house cleaning a task as distasteful as washing behind the
ears. They also had other responsibilities. Punctuality at meals,
at school, and at Sunday School was a strict requirement. De-
partures from grace were punished by spankings from either
mother or father, Dr. Kirke using a hairbrush across the open
palm when he didn't put the culprit across his knee. The last
such punishment that Harvey remembered was administered
by his mother when she caught him with a forbidden, and
therefore irresistible, ten-penny thriller about a Wild West
desperado who, despite his lawless exploits, was always the
soul of courtesy to ladies.

Harvey's earliest memories were of the stories that were read
to him at bedtime and of the poetry that his mother recited,
after he had said his prayers, until he fell asleep.

His particular companions were his brother Alleyne and his
cousin Perry Harvey, who was the nearest his age of all his
Crehore, Williams, Day, and Harvey cousins. Perry, more
often known as "Tot," was the oldest of four boys and always
gave Harvey healthy competition in their constant companion-
ship. Except for Alleyne, most of Harvey's own brothers were
far ahead of him when he was eight, Will had already finished
at Western Reserve and at Harvard Law School and had begun
practice in Cleveland; Harry was about to enter Cornell Uni-
versity; l and Ned, at fifteen, was almost ready for Cornell.
Harvey was the recipient of their "guidance" and their cast-
off clothes, but it was Alleyne, only two years his senior, with
whom he shared the joys and trials of brotherhood.

On Sundays, the Cushings attended Sunday School and serv-
ices at the Old Stone Church, arranged in the family pew from
William, next to the straight, unbending figure of Dr. Kirke,
down to Harvey, who sat by his mother. The sermons were
long and it was hard to sit still. Occasionally Mr. Parsons, a
sympathetic neighbor, would slip Harvey candies thereby,
he was later fond of saying, flavoring his Presbyterianism with

1 He later became an eminent geologist, occupying a chair at Western
Reserve University for many years.

peppermint. Their two-and-a-half-mile walk home always
stirred up a good appetite for Sunday dinner at which they
were joined by Grandfather Erastus, now a widower. In the
afternoon, someone, often Erastus, read aloud from Oliver
Wendell Holmes, the "Autocrat of the Breakfast Table," or
another popular author of the day, while Alice, Harvey, their
brothers, and perhaps a few cousins, sprawled about on the
floor or sat on the bumpy horsehair sofa in the front window
watching the Sunday strollers.

At six, Harvey began to attend the private school across the
street from his house. After two years there, he entered the
Sterling Grammar School, where he acquired a fondness for
baseball and the reputation for being the worst speller in the
school. His mother would often drive him back after lunch
in her carriage rehearsing him in his lesson, but, although seem-
ingly learned, it was soon forgotten, and there were certain
words he misspelled all his life. Many years later when he
wrote by hand to the president of Yale University in regard
to a chair at that institution, he was still writing "privaledge"
and "definate." 2

Harvey was a handsome child, with the quick grace that
characterized the movements both of his father and his grand-
father Erastus. This litheness made him adept at all kinds of
sports, and in the gymnasium they had rigged up in the barn
loft he excelled at the parallel and turning bars, at the rings,
and at tumbling. His skill at sports and his ready wit made him
popular with his classmates when he entered Central High
School in February, 1883. But despite the predominance of a
gay and mischievous spirit, he had early displayed signs of a
quick temper, which at home had earned him the nickname
"Pepper Pot." This tendency sometimes led him into difficulty.

On one occasion he quarreled with the Presbyterian min-
ister's son, Robert S. Carroll, during baseball practice with the
Sterling Grammar boys. Robert, although two years younger,

2 Other words he misspelled were exhonourate, fortolled, neybour,
swoolen, hammard, Sweed, church quire, characature, moskito, Turkish
bizarre, sacaraligious, exchecour, malitia, and mediocher. Throughout
this book his spellings have been left untouched.

24 HARVEY GUSHING

was several pounds heavier than Harvey, and while both had
had considerable gym training, what Harvey gained in ex-
perience, Robert made up in brawn. Neither knew exactly
what incited them to wrath, but Harvey shortly called Robert
a "freckle-faced freshy"; Robert retaliated with enthusiasm
by calling Harvey a "stuck-up snob." This was more than
either could stand, and for forty minutes the two boys wrestled,
breathless and perspiring. Finally, they became winded and
sitting down on the ground to rest, their faces grotesque with
sweat and dust, they grinned at each other sheepishly and
baseball practice continued.

Paralleling Harvey's enthusiasm for sports was a growing
interest in natural history. He collected aU sorts of bugs, cater-
pillars, butterflies, and leaves and discovered that his father was
a great help in their identification. He did not, however, show
his father the present someone made him of a brown and
white spaniel puppy, for after their last dog died, Dr. Kirke
had flady refused to let the children have another. Harvey
kept Jack well hidden in the barn and patiently taught him
tricks when his father was not about. Jack learned to carry
articles to people and, being a very talented dog, to play
the piano. Finally the inevitable happened, the dog was dis-
covered, and Harvey waited for the storm to break. But his
father remarked only that from his observation the dog might
better have been named Jill. Dr. Kirke thereafter ignored the
dog until one day he found Jack sitting proudly on the front
seat of his carriage which he had left at the front gate. From
then on he allowed the dog to accompany him on all his calls.

When Harvey was exercising one day at the Y.M.C.A. dur-
ing his second year at high school, he slipped from a turning
bar and broke his wrist. His father was immediately sum-
moned, and Harvey awaited his coming with considerable
anxiety, fearing more than the bonesetting the stern question-
ing he expected as to what he had been up to. To his surprise,
his father said nothing at all but set the bone and fixed the splint
with infinite care and gentleness. So fascinated was Harvey
by the whole operation that he scarcely felt the pain, and in
the days that followed, his interest in the mending process

HENRY KIRKE GUSHING

BETSEY MARIA GUSHING

GUSHING HOUSE AT 786 PROSPECT STREET, CLEVELAND

SONS OF ELI

left to right: Alfred M. Coats, Perry W. Harvey,
Harvey Gushing, G, Beekman Hoppin

BASEBALL TEAM OF THE CLASS OF

Harvey Gushing holding bat at lower left

AS THE TWIG IS BENT /J

considerably mitigated a boy's natural impatience with a tem-
porarily useless arm. This was the first time he had seen his
father in his role as physician, the first time he had come into
close contact with medicine.

It was also in this year that he came under the influence of a
remarkable young man, Newton M. Anderson, who taught
physics at Central High. Anderson, after graduation from the
University of Cincinnati, had installed the first telephone ex-
change at Liege, Belgium, for the Bell Telephone Company. In
addition to being a born teacher, he understood boys and
possessed the native talents which they admired. He was a
master of all sorts of tools himself, and, convinced that manual
dexterity was a valuable asset to any boy, he accordingly set
out to establish a manual training course. He rented a barn
back of Perry Harvey's house, bought the necessary tools, and
gathered in for instruction twelve boys, among them Harvey
and several of his cousins. The following year, through the
interest of a number of Cleveland citizens, he was able to build
and equip a three-story building which became known as the
Cleveland Manual Training School, a forerunner of the mod-
ern technical high school. Several years later, the courses he
gave there were incorporated into the public school system in
Cleveland. The boys were taught carpentry, bent-metal work
at a forge, mechanical drawing, wood turning, and the use of
machinery.

During the summer of 1884, Anderson took Harvey and his
cousins, Ed Williams and Perry and Al Harvey, on a fishing
trip up the Great Lakes. One of the boys wrote home: "I have
rowed so much and got so much muscle that I can turn you
city folks inside out. The insides of my hands are all calloused
and as hard as bricks." During the following winter, Anderson
bought an island in Lake Huron, not far from Sault Ste. Marie,
and there Harvey, his cousins, and other Cleveland boys spent
several happy summers.

The first year they left Cleveland on a lake steamer on the
night of July 3, 1885. A week later they arrived at the island
which they named Maskenoza the Indian word for pike
which it somewhat resembled in shape. It was beautifully

16 HARVEY CTJSHING

situated, one end facing the open lake, the other in a deep bay
where the water was calm even on the roughest day. Newton
Anderson liked nothing better than roughing it in unfamiliar
country, and during this and succeeding summers he and the
boys felled the spruce with which they built their cabin, ex-
plored, surveyed, and mapped the island, shot the game and
caught the fish which supplied their larder.

On the 24th of June, 1887, Harvey was graduated from high
school, the president of his class. With the help of his mother,
he had made a good showing in Latin and especially in mathe-
matics. His grades in Greek and English history were not so
high, but he stood eleventh among eighty-three, with an aver-
age of 89.34. He took no part in the Commencement activities
but he had a leading role in the class play and also gave a
tumbling exhibition with one of his classmates.

The summer following his graduation was his last at Mas-
kenoza. During the winter, Anderson had had a 42-foot
schooner-yacht built, and eight of the boys sailed the Susie to
camp. Harvey wrote home that the place seemed prettier every
year. He was very much a member of the group during these
summers and stood apart from the others only in his knowl-
edge of natural history. He told his father with offhand pride
that he was constantly interrupted by the boys yelling: "Oh,
Harve, what's this?" The boys cooked their meals in squads of
three, and Harvey reported that on one of his squad days their
menu consisted of stewed dried beef, corn patties, rice cro-
quettes, baked potatoes, and corn bread, "besides the usual
standbyes of hard tack and such things." Frequently, if their
luck had been good, they also had duck or woodcock all this
after a breakfast of twelve to fifteen pancakes along with ham
and bacon.

Many of the boys were seventeen and eighteen in the sum-
mer of 1887 and ready for college in the autumn. Harvey and
'Tot" had passed their entrance examinations for Yale, and
the happy days on Maskenoza were drawing to a close. Some
seven years later, when he was a second-year medical student,
Harvey was delighted to discover that one of the house officers
from Chicago named Cobb had "sailed the good and great

AS THE TWIG IS BENT /7

lakes even more thoroughly than the Maskenozeites. ... He
had actually been aboard a small craft by the name of Susie
which hailed from Cleveland 'run by a lot of boys and a school
teacher named Anderson.' The world seems small indeed."

Thus the mention of Maskenoza always stirred vivid mem*
ories of their high school days in the minds of the Cleveland
boys who had come under the influence of the "school teacher
named Anderson." One of his boys wrote of him many years
later: "He taught us a lot about being independent and made
us so by the duties he inflicted upon us during these summer
vacations. We were all undoubtedly better disciplined and bet-
ter prepared for life from the teachings of this man and from
association such as we had with him."

SON OF YALE
Chapter 111

r HEN HARVEY GUSHING AND PERRY

Harvey, who was to be his roommate, arrived in New Haven
on September 18, 1887, they went immediately to 166 York
Street (a lodginghouse still standing), where they had en-
gaged rooms. Harvey's excitement had been mounting steadily
since they had boarded the train in Cleveland. Of the large
group of boys who had come east together, many had already
had a year or more at Yale, for it was a natural choice for the
sons of Ohio families whose forebears had come from the Con-
necticut Valley.

Mysterious allusions as to what was in store for the fresh-
men, learned upperclassman talk of the forthcoming football
season, and what sounded like daringly frank comments on
various professors made a deep impression on the Yalensians-
to-be. When separated at the station from their more seasoned
companions, the two boys felt a little lost, and Harvey, who
all his life was to show distrust of new surroundings and an
impatience growing out of being unsure of himself in a strange
place, was definitely disappointed with his first glimpse of
Yale. Their rooms on the third floor, with only two small
windows and a slanting front wall on which nothing could be
hung, had just been calcimined, and the "smell was frightful."
Their landlady, Miss Prescott, was "knee high, old as the hills
(young hills), very fat and wrinkled, and exceedingly fawn-
ing." And the College itself, mixed up as it was with stores and
business blocks along narrow streets, was a sad contrast to

18

SON OF YALE Zp

Williams College, which he had visited on his way to Yale. And
at Williams the boys seemed to know one another; at Yale,
they said, you hardly got to know the members of your own
class.

The cost of Jiving also disturbed and alarmed him. In his first
letter home he complained that he had had to pay sixty-five
cents for a poor meal in a "tony" place and that breakfast had
cost him fifteen cents. Later, however, he and Perry made up
for these lavish expenditures by eating enough for both lunch
and dinner at Professor Ladd's where they had been invited
for "tea."

Professor Ladd, a cousin of Mrs. Cushing's, kept a watchful
eye on the Cleveland boys, especially Perry and Harvey, dur-
ing their years at Yale. Harvey found him in his official capacity
as Professor of Mental and Moral Philosophy very boring and
"a big bag of wind," and when he took his turn in chapel, as
did all the professors, Harvey attended with reluctance. He
was wholly in sympathy with one of the upperclassmen who
on a warm spring day gave an organ-grinder fifty cents to play
under Professor Ladd's window while he was lecturing on the
self-conscious ego. But as "Cousin George," Harvey found
him more tolerable, especially since invitations to his house
usually included food.

In 1 887 the College was under the presidency of the younger
Timothy Dwight, grandson of the Timothy Dwight who had
chosen for Yale's first chair of chemistry a young lawyer, the
twenty-two-year-old Benjamin Silliman. During the younger
Dwight's term of office, the process of changing Yale from a
college into a university was well begun. The elective system,
the honors system, the general examination, and other innova-
tions in method and curriculum were beginning to take shape.

It was a challenging time to be making a start in the world.
The role which science could play in the development of the
nation was now well recognized, thanks in large part to Silli-
man, whose voice had been raised in its interests from his ap-
pointment to the faculty in 1802 until his death in 1864, and
whose American Journal of Science had carried the scientific

20 HARVEYCUSHING

achievements of the new world to the old and vice versa. Of
the 305 students who entered Yale in the autumn of 1887, 100
enrolled in the Sheffield Scientific School which Silliman had
been instrumental in founding, and which in the forty short
years of its existence had developed from a small group of
graduate students and two professors (who served without
remuneration) into a thriving organization with a strong
faculty. The rapid growth of this school, the first in the
country to offer practical instruction in the sciences on a
graduate level, 1 was a clear indication of the trend of the time
toward utilitarian pursuits and of the need for trained scientists.
But when Harvey Gushing began his freshman year, the clas-
sical course offered by Yale College was still generally con-
sidered the only right road to education for a gentleman.

On his first Sunday in New Haven, Harvey began the cus-
tom, faithfully adhered to throughout his student years, of
writing every week both to his father and to his mother. Since
he often repeated news, he apparently took it for granted that
his parents would not share their letters. Occasionally he in-
cluded sketches which indicated considerable talent for draw-
ing. After his mother had sent him one of those typically
Victorian ornaments, a lambrequin, he drew for her their
mantel, appropriately draped.

When classes began, Harvey found that he had sixteen
recitations a week, one at eight-thirty, immediately following
the compulsory chapel at eight-ten; the others at twelve and
five every day except Saturday. His program included geom-
etry, Livy, Homer, Cicero, German, algebra, and Greek prose.
He liked all of his tutors except Mr. Moore, his geometry
teacher, who, he reported to his father with due apology for
using the term, was a stinker.

Although he was now walking familiarly in the classics, he
was still struggling with his youthful bete TZ0r spelling. But
it appeared to cause him more amusement than distress. Once,
after he had spelled pneumonia first "pheeunemia" and then

1 It was to Sheffield graduates that Yale was to offer the first PhJD.
degrees to be awarded in this country.

Lambrequin-draped mantel of Harvey Cushings room at 166 York
Street, New Haven, in 1887.

21

22 HARVEY GUSHING

had crossed that out and written "phneumonia," his mother
wrote him: "I'm sorry your friend is sick. . . . You had quite
a struggle with the word pneumonia, which ended in unneces-
sary generosity on your part in the way of letters of the
alphabet. It is well to have a lexicon at hand, if one gets be-
wildered in spelling as everyone does sometimes. Have you or
Perry one?"

A later comment brought this reply from Harvey: "I was
very much amused by your lecture on using Yale slang which
originated from my attempt to spell succumbed. I admit that
I am very poor at spelling but why you imagine that I am
swearing or using slang every time I spell a word wrong is
more than I can comprehend. Now what manner of slang did
you make out of a misspelled succumbed?"

He and Perry survived without a scratch the hazing and
rushes which were a vital part of college life in those days, but
the high cost of living continued to cause him considerable
anxiety. He was appalled at the ease with which money slipped
away for books, furniture, room rent, board, the newspapers
and college publications a man was obliged to subscribe to,
and such unexpected demands as the support of the crew and
the Junior Prom. That he feared his father would suspect him
of extravagant living was apparent in every appeal for funds
and these were frequent because he was never given a regular
allowance but had to write each time he needed money. In case
his father should demand an accounting, he preserved his
receipts Yale News, $4.00; Yale Record, $1.50; Yale Literary
Magazine, $3.00; and $10 for the Boat Club. "The News and
the 'Lit,' " he wrote, "are very good papers but I can't say
much for the Record."

As for the Junior Prom although he considered it foolish-
ness to buy tickets to an affair the freshmen were not allowed
to attend, he reluctantly took two, pointing out to his father
that his strength of character had exceeded Perry's, for Perry
had been induced to buy five and had furthermore been
"stuck" for $25 for the Boat Club. When the night of the
Prom came around, he looked in on it at the approximate time
for refreshments in an attempt to get some return on his invest-

SON OF YALE 23

ment. "I succeeded pretty well, too," he wrote his mother.

To offset these unproductive expenditures, he and Tot had
bought a second-hand lounge from Miss Prescott's church to
make up for their lack of comfortable chairs. This, he felt, was
a sound investment, though he wrote his mother somewhat
wistfully that he wished he had as much time to sit on it as
some of the other boys did.

The matter of rugs for their rooms was his next problem. In
one of his first letters to his mother he told her that Perry's
mother, Aunt Mary, had asked Perry for the dimensions of
their rooms and had said she would send them two rugs which
would be most acceptable in place of the matting that Miss
Prescott had provided. In about ten days, which, considering
the length of time it took for letters to make their way back
and forth, had given Aunt Mary less than a week for action,
he wrote his mother again: "I haven't heard anything of that
carpet which we were to have, have father and Aunt Mary
given it up?"

Since this brought no response, he touched on the subject
the following week: "By the way, what has become of those
rugs we were going to get? This matting is all coming up and
is so dusty everything gets coated with it." This time he waited
nearly three weeks but when the rugs still did not arrive, he
sent another, stronger plea this time to his father: "What has
become of that rug we heard of sometime ago? We have a ter-
rible time with the dust which rises off this matting. Every-
thing is just covered with it in the morning. My last bottle of
ink got so full of it I had to buy another which is rapidly
being spoiled. I have to stand up in a chair when I put on my
pants in the morning for if they touch the floor they get cov-
ered with matting dust."

This did the trick. Whether his father couldn't bear the
thought of the wanton waste of ink or the picture of his son
standing on a chair to put on his pants, we do not know, but on
the 1 3th of November Harvey was able to write his mother:
"This week has made a big improvement in our room. We
have got the rugs down and I wish you knew how much we
enjoy them. . . . We have great times with our rooms and

24 HARVEY GUSHING

the boys downstairs have taken a brace and have got their
room fixed up fine."

Harvey, being slower than Perry at grasping things, had to
spend more time studying but twice during the autumn he
managed to get to New York to attend football games. Such
opportunities did not come as often in a student's life as they
do now, and the Yale-Princeton game at the Polo Grounds
was not only Harvey's first visit to New York, but his first
big college football game. As he said, "a person would have
to see one of those big games to understand the excitement."
When word of his second excursion reached home, his father
interpreted it as evidence that Harvey was straying somewhat
from the path of duty and wrote him accordingly. The out-
raged and hurt amazement in his son's reaction must have
amused even the strict Dr. Kirke:

Dear Father: I was very sorry to have received such a letter
from you as I did last week. ... I don't know as you have any
reason to think that I have not been studying, and do not intend
to study faithfully, I am sure you know I always did at home and
I don't see why you should suspect I have not here. As for re-
penting that you sent me here I am very sorry if I have been the
cause but if you are afraid I won't study here I don't see why
you should suppose I would elsewhere. I went up to N.Y. to
spend Thanksgiving with [Tom] Young but did not go up ex-
pressly to see a football game although we did go to see the game,
and I am sure from the accounts of one of the boys who stayed
here that the excitement in New Haven was as great as at New
York, if not more so, with bonfires and so forth. I believe you
went to college once, and although one has to grind the greater
part of the time, there are times when one doesn't. I don't know
whether I will make the first division or not as there are a great
many remarkably bright men in our class but I have studied hard
for it. I hope I haven't said too much but I was surprised and
disappointed very much. . . .

Despite his father's disapproval, Harvey continued to be
deeply interested in all college sports; and the number of pro-
grams of track meets, football and baseball games pasted in
the two scrapbooks he kept during his four years testifies to
his frequent attendance. These scrapbooks were evidence that

SONOFYALE 2J

he had inherited in full measure the family tendency to save
all manner of things. Neatly cut newspaper clippings accom-
pany the programs, along with such mementoes as railroad
tickets from New Haven to Lake Saltonstall where the crew
races were held, a piece torn from the shirttail of some luck-
less spectator at a football game, and a photograph of the mus-
cular figure in shorts of Amos Alonzo Stagg (rear view),
Yale's famed varsity baseball pitcher.

There were evidences of other interests, but not many. Oc-
cupying second place were memorabilia about various socie-
tiesclippings, dinner programs, and mysterious summonses
to meetings. He always attended the concerts of the Glee and
Banjo Clubs and he was in the dress circle at the midyear Hy-
perion when the freshmen were successful in showing their
class numerals (despite the vigilance of the sophomores), first
by dropping a shower of cards from the balcony, then by
lowering a banner on the stage, and finally by loosing a flock
of pigeons with '91 flags tied to their legs. There was an ac-
count of a meeting of the Western Reserve Republicans, of
the sad decline of the moral and intellectual tone of Harvard
men, of how the city attorney in New Haven had retrieved
187 glass street signs from the rooms of Yale students, and,
finally, there was the mid-term examination schedule dated
December, 1887 and, sewed to it, the pen point with which
he wrote his answers.

Shortly after Harvey returned from Christmas in Cleve-
land, he had letters from his father and mother that were typi-
cal of each parent. His father congratulated him on attaining
the first division, told him to join a new eating club since he
was ready to meet all expenses that would contribute to his
comfort and advantage. "But," he added, "I must expect that
you deny yourself as much as possible superfluities of no last-
ing value and which I am told amount to a good deal in a term."
His mother cautioned him about taking proper exercise, ex-
pressed concern over his persistent cold, and then continued:
"I hope all is right between you and Perry. Here is a little
private word for my darling boy. May I say it without offense?

26 HARVEY GUSHING

You know that you have a propensity to scold. Watch against
it, my dear; remembering that your mother's anxious love
prompts the suggestion. 'A word to the wise is sufficient.' . . .
Goodbye my darling, I wish you could get rid of that cold.
Always your loving mother, Bessie M. Gushing."

His mother's letters continued to be placid and cheerful
although her strong-minded husband and her impetuous and
equally strong-minded youngest son were shortly engaged in
a battle of wills on two major issues that went on during most
of the spring term. Indeed, it was probably her influence and
sense of humor which prevented an open break between them.

After the excitement of the famous blizzard of 1888 (which
descended on New Haven on March 12) had subsided, spring
weather arrived and with it the questions of sophomore socie-
ties and baseball. When Harvey had set off to college he had
promised his father he would not smoke, drink, "be guilty of
any immoral conduct, or join a college ball club or boat
crew." In Cleveland this had seemed easy, but he had reck-
oned without the lure of competition when the freshmen went
out for baseball in the spring. He not only loved baseball but
he wanted the excitement of matching his prowess with the
others and of making the team. He began practice in February
but when he mentioned this fact in his letters home he assured
his father it was only because he needed exercise. He broached
the matter of joining a society first.

Here there was even more competition, for the two sopho-
more societies, and the junior and senior societies likewise,
would elect only fifteen men each out of their class of around
two hundred. In the spring, when elections were made, excite-
ment ran high. The Horoscope^ published annually at this
season "to give a just and impartial summary of the candi-
dates for the senior societies," had this to say about the perma-
nence of societies at Yale: "Deep rooted as they are in the
very foundations of our alma mater, it is simply absurd to
assert, as we occasionally hear, that they will or should be
abolished. Their objectionable features may be abolished, but
many a moon will wane ere the ruling spirits of the Univer-
sityCorporation and Faculty, so many of whom were society

SON OF YALE 2*J

men themselves will permit any radical change. Yale is pre-
eminently the home of secret societies."

Skull and Bones, founded in 1832 "so mysteriously that the
closest study of half a century has failed to lift the vail [sic]
surrounding its origin/* took in the "solid/* thoughtful men,
while Scroll and Key supposedly selected the "genial and the
popular." If, in addition to being an agreeable gentleman, a
Keys prospect was also "a scholar, a writer, and an energetic
worker," so much the better. What went on within their win-
dowless marble walls fascinated Harvey, as it had many a man
before him. The aura of exclusiveness and mystery surround-
ing all the activities of the various societies appealed strongly
to his sense of the dramatic, and since he very much desired to
join, he prefaced his letter with a statement calculated to put
his father in a receptive mood. He well knew that this was
one of the "superfluities" which he had been asked to avoid.
"I am very careful not to run in debt and I never get anything
charged and I don't know of anything that pays as well. It is
bad enough having a washing bill come in every now and then
but some of the boys are always dreading the end of the month
because of the bills which flock in." After this righteous be-
ginning, he got down to the point: "I want to talk to you
about a matter which I would like to have spoken about before
but could not very well for a good reason." (He hadn't yet
been asked to join!) Knowing that his father relied on the
judgment of Frank Herrick, an older Cleveland boy, Harvey
assured his father that Herrick had advised him that to get into
one of the sophomore societies (spelled "sophmore sociatys")
was a great honor. He finally admitted that having been of-
fered a pledge, he had accepted it "with your permission
that is."

Dr. Kirke countered with a long letter, concentrating more
on Harvey's opening paragraph than on what followed. He
even went so far as to endeavor to enlist his son's sympathy
with a rare mention of his own problems: "When this term
ends, I can say that the aggregate years of college life my
boys will have had will be twenty-three. In all that time their
monthly allowance has never failed. It has not always been

2% HARVEY CXTSHING

easy to do this, for the family at home has had to be kept going,
and taxes, repairs, and insurance kept up." He then continued:

Please buy a dictionary and consult it as you write. In almost
every letter I note misspelt words. In the last for instance you
omit the middle "o" in sophomore giving it thus "sophmore."

At the end of the letter he came to the important matter.

I do not know what to say about the Soph. Society, but am
glad that you consulted Frank Herrick. . . . Society influence
is either good or bad ... A man gets rated at his best rather
slowly, unless he is a very uncommon chap; but one inclined to
be fast gets his character very quickly. . . . Take all the time you
can have before deciding the Society matter, and whatever you
finally do I will acquiesce in.

Nothing more was said on the question until June, when
Harvey wrote:

You remember, Father, what I said to you sometime ago about
the Sophomore Society? Well, there was finally no question with
me which way you would want me to go and I would want to
go myself, and so last Friday I was taken in. The initiation fee
was $35 which I won't have to pay till the end of the term. . . .
The boys are all manly and studious and mighty nice boys in
every way. I was thinking this morning that there are 10 out of
the 1 6 in the first division while in the other society only 2, which
I think is illustrative of the two. I hope you will sanction my
choice.

Since Harvey was already initiated, there seemed littie else
his father could do, but he replied: "I trust you will critically
examine your Society relations and calmly judge if you do
not think the price asked for its blandishments is not large for
their worth. At any rate I am glad that you speak so well of
your classmen in your Society. You might mention its name."
Harvey closed the subject quite definitely in his next letter:
"I 'had critically examined my society friends as I promised
you before I entered the society, and the price charged for its
blandishments, as you term them, is smaller than I had ex-
pected."

Baseball was not disposed of so amicably. Dr. Kirke was
opposed to intercollegiate athletics on moral grounds. He de-

SON OF YALE 2j)

plored the emphasis placed on them, the excitement which
attended them, especially for the players, and the money
wasted on betting. Harvey, then, when he asked his father if
he had any "serious objections" to his playing shortstop on
the freshman nine, innocently gave the impression that it was
something which had come unsolicited, and laid more stress
on what an honor it was to try to win the Fence for his class
for the freshmen were not allowed to sit on the Yale Fence
(the original rail fence around the first building) until they
had beaten Harvard at baseball. The Fence had become an in-
stitution, a place where the classes gathered, separately, be-
tween recitations and after supper to talk and sing. "I suppose
it does more social work in the College than anything pos-
sibly could." It occupied such a vital part in the life and
memories of Yale men that alumni all over the country pro-
tested when it was to be torn down to make way for a new
recitation building.

Dr. Kirke, in reply to Harvey's letter, firmly reiterated his
position on college athletics but did not forbid him to play.
However, when he discovered that Harvey was going to Cam-
bridge with the nine, he gave way to restrained anger: "I will
try to reply to your letter calmly, though I do feel sore and
disturbed over the unhappy position you have brought us into.
... It looks to me as if in the glamour and excitement of
College sentiments and surroundings, you have reasoned your-
self into the feeling that if you only kept in the first division
it was none of my business what else you did. . . ." This was
indeed precisely how Harvey had reasoned and he had no in-
tention of withdrawing from the team since a Y was one of
the surer ways of being "tapped" for a senior society.

He told his father that there was general interest in this par-
ticular game throughout the College and that to withdraw
would place him in a most awkward position. Dr. Kirke re-
plied by pointing to a New York Tribune account of the Yale-
Princeton game when the seventy Princeton men left $1,000
(largely in bets), besides their expenses, at New Haven. "Col-
lege games seem to me to be rapidly taking their place side
by side with horse racing and professional ball playing. Can

$0 HARVEY GUSHING

you wonder that I feel concerned at seeing you inching to-
ward such a vortex?"

This made Harvey highly indignant: "I understand per-
fectly your full acquaintance with the evils of college life for
you have had enough boys in enough colleges to know, but I
do think that you place too much belief on some of the ac-
counts of college evils which come out in the papers, espe-
cially about Yale. . . . But I hope you, have enough confi-
dence in me not to suspect my doing anything of the sort
[betting] and if you have not, I don't know what I can do
about it." His father answered this letter coldly: "Yours of
the 1 3th rec'd. I cannot reply at this moment to your views
as therein set forth, but will send the money as it is needed,
while my advice and wishes do not seem to go for much."
So the battle continued.

In the meantime the Yale News was reviewing the possi-
bilities of a Yale victory and objectively estimating the abilities
of the team. "Gushing, ss., is a very good fielder, but often
throws wildly and loses his head." This must have caused Har-
vey some chagrin, but he had solace from another quarter. At
the spring indoor track meet it was reported that "the work on
the horizontal bar was unusually good and quite exciting.
Gushing '91 proved the best man."

The Yale freshmen lost the game in Cambridge, but when
Harvard invaded New Haven, Yale was victorious. The fresh-
men had won the Fence. His mother expressed her pleasure
and added philosophically: "I am glad you enjoy 'the fence.' If
it must go, perhaps some substitute may be found where the
boys may foregather, as they have done there. It may be the
fate of your class to discover such a place, which though it
may not have the charm of antiquity, may have that of nov-
elty. ... All things, great and small, must have a beginning.
Is there no other fence at Yale? At all events, the fence was
not always there." To this heresy Harvey did not reply. After
all, his mother could not be expected to understand these
things. He ended his freshman year with a telegram to his
father: "Please telegraph thirty dollars for secondhand furni-
ture."

UPPERCLASSMAN
Chapter TV

I

-N SEPTEMBER OF l888 HARVEY

was back in New Haven writing home with all the superiority
of one who is no longer a freshman: "Work has started in
earnest by this time and we have five new teachers. We have
Tracy Peck in Pliny and like him very much but the rest of
them I don't like very well. There are Mr. McLaughlin in
Rhetoric and English Lit., which is going to be hard for me,
Mr. Moore in Tacitus, Mr. Kitchell in Isocrates, and a new
German teacher, Mr. Strong, whom I have sized up to be a
regular chump, if I may be allowed to speak plainly."

This autumn the loss of the Fence was keenly felt. "Last
night four of us went and sat on the steps of the new building
[Bingham, still standing at the corner of Chapel and College
Streets] which run way around the corner and are quite high.
It just shows what a longing for the old fence there is for we
hadn't been up there more than a few minutes when there
were 10 or 15 fellows up there and we began to sing quietly
and before half an hour there must have been about 200 men
seated on the steps. It was pretty cold comfort sitting on the
dirty stones which don't fit as well as the old rails. The new
building is very imposing but one can't help wishing for the
fine old trees, the grass, and most of all for the fence."

There was less mention of his room this year; also less empha-
sis on food, but this did not mean he wasn't still interested. He
wrote his mother: "Tell Johanna she won't lack for someone

$2 HARVEY GUSHING

to eat when I get home. In one of the college papers the other
day there was a blessing for the eating clubs who are in the
clutches of the New Haven landladies which I think is very
appropriate. It goes:

Oh Lord be merciful
And keep us all alive,
There's ten of us at dinner
And grub for only five."

Social activities played a larger part in his life this year. His
well-filled prom card showed a wide diversity of interest,
with concentration in no one direction. "I never saw so many
pretty girls before in my life or met so many nice ones." At
these functions he frequently met girls from home because
several of the crowd he had grown up with Katharine Crow-
ell, Ray and Reba Williams, Melanie Harvey, Mary Good-
willie and her sister "Harry," and the Boardman girls, Jose-
phine and Nina attended the Farmington School or had
brothers at Yale and often came down for parties and football
games. Harvey liked to dance and was a graceful dancer, but
at Yale, as at the country club dances during Cleveland sum-
mers, he usually went with a group or joined the stag line.

In March he shared in the general indignation aroused in
the College when some who had stayed overlong in a local
tavern had unseated the statue of Benjamin Silliman on their
way home. In his scrapbook is pasted a cutting of the an-
nouncement that Mr. Carpenter, the night watchman, had been
dismissed because of laxness in his duties.

His father had laid down the condition that after the Yale-
Harvard game of the preceding June, he was not to play base-
ball again. This did not prevent Harvey from broaching the
subject the next year this time with even more determina-
tion, for he was now on the Varsity team. He wrote his father
a sincere and very appealing letter. Dr. Kirke tacitly admitted
defeat, and Harvey played throughout the remainder of his
college career. His "press notices" were now generally grati-
fyingas after a game in Philadelphia in which Yale had been
badly beaten when it was reported that the only redeeming

UPPERCLASSMAN 55

feature of the game was the playing of Gushing and Graves.
At the Brown game the following year he showed extraordi-
nary restraint for one of his quick temper when a Brown
player, whom he had brushed against in trying to make third
base on a fumble, had attacked him on third and struck him
sharply in the chest. The papers announced that "Cushing's
self-control tied his hands to his sides and kept him silent
before Sexton's exasperating jeers," and after the game the
entire Brown team apologized to him. He again made the
headlines in Cambridge when the score was 3-2 in favor of
Yale with Harvard at bat. With the bases full, the batter up
hit a long fly and the headline read: "An exciting game of
ball at Cambridge yesterday-Cushing's great sprinting for a
long fly starts 10,000 persons cheering."

Information of this sort did not find its way into his letters
home. With his father he continued to discuss the more serious
things of life the ever-present need for funds and occasion-
ally the political issues confronting the country. Being a
staunch Ohio Republican he expressed satisfaction that the
Republican Presidential candidate, Benjamin Harrison, de-
feated Grover Cleveland in the election of 1888.

His needs for clothes were also discussed with his father.
"I went down yesterday to see if I could find any trowsers
[always spelled with a w] that would do for me as my thin
ones belonging to my gray suit have about got on their last
legs, or rather upon my legs for about the last time." But if it
was underclothes he needed, he spoke to his mother, and in
very delicate terms shorts he described as "p. of d." (pair
of drawers) and undershirts he called "unmentionables."

In some of these letters home, Harvey complained that
there were so many boys in their rooms (he and Perry Harvey
had continued to room together) that he had difficulty writing.
His and Perry's popularity was also evident in the invitations
extended by classmates when vacations came around. "Sam
Colgate, the son of the big soap man, asked 'Tot' and me to
go down to their place in Orange, New Jersey, on Thanksgiv-
ing after Tom Young had asked me. He is a mighty nice f eUow
and has had three brothers down here." Later he wrote of a

$4 HARVEY GUSHING

visit to Shinnecock Hills, Long Island, where he was the guest
of another member of '91, Grosvenor Atterbury, who was to
become one of his lifelong friends.

From the Atterburys he went with another classmate, Star-
ling Childs, to visit the Robert Chapins in Lenox, Massachu-
setts. "The Chapins are in mourning for an uncle which has
prevented them from entertaining, which latter fact I don't
regret much for I prefer the drives and watching the tennis
tournament to the formality of these balls which begin about
the time when a Christian should go to bed and end about as
he should get up."

At the end of his sophomore year Harvey had been elected
to Delta Kappa Epsilon and at the Thanksgiving Jubilee of
the fraternity in November of 1889 he had opportunity to
display his histrionic ability. The program announced "The
Beautiful Melodrama, Pocohontas Powhatan," in which Har-
vey played the part of Pocohontas "that cute, coy coquette,
a Bar Harbor rosebud in her second season, and a terrible
example of the effect of Female Seminaries." He made his
entrance with a flourish of trumpets and a double back hand-
spring into the middle of the stagesuch a handspring, ap-
parently, as he was accustomed to doing off the gymnasium
steps with a lighted cigarette in his mouth.

Then came the greatest moment of his college career-Tap
Day. "Thursday were the senior society elections and they are
very exciting things to watch. First a Bones man comes from
their hall onto the campus and without saying a word to any-
one or without recognizing anyone he walks around till he
finds the junior he wants in the big crowd assembled there
and then slaps him on the back and tells him to go to his room
where he receives his election. Then a Scroll and Key man
comes and selects his man from the anxious crowd of juniors
and so on till the 15 are taken each way." Harvey, to his great
joy, was "tapped" for Scroll and Key as were Tot and Grove
Atterbury. "I won't attempt to tell you what fine things the
Senior Societies are acknowledged to be," he wrote his father,
"what a position they hold in the College World and what
good they do a man, for if you don't already know something

UPPERCLASSMAN $$

about it, it would make too long a story." Some twenty years
earlier, Dr. William Welch, who was to be his friend and col-
league, had written to his father of his election to Bones, "the
honor is more agreeable to me than any other in college could
have been."

In the fall of 1890 Harvey faced his final year with anticipa-
tion mingled with regret that his college days were so soon
to be over. In his first letter home he bemoaned the fact that
"one more week of this precious year has gone. I don't know
how or where. My time is so taken up from morn till night
that the days pass by like the ticks of a pendulum. We have
begun to feel at home by this time, you may imagine, as dig-
nified seniors. Dignified however is not a very appropriate
word, for I never saw men less so." He himself gave little sign
of it in the description of his rooms that his mother had
asked for.

B marks the place where our twin bureau stands
While S marks the place where we wash our hands,
In D we have dreams of far distant lands
While I at my desk do obey your commands.
T is the sofa on which Tot does snore,
While R are the rugs which lie on the floor.
C is the chimney down which the winds roar,
And on this same subject I'll write you no more.

He was happy about his courses, enjoying Marlowe in Eng-
lish and the study of the French Revolution in history. He
reported that he thought the latter course would be very inter-
esting "especially as the man himself, Prof. Wheeler, is very
much so. I wish I could say as much for Geo. Ladd," he con-
tinued. "It was all I could do to even translate the first 25
pages of his book. I have got to go down to the sloughter
house and get a calf's brain to explain to the class. Being the
only one in class whose name he knew, I suppose he spotted
me."

Harvey had taken chemistry, physics, and physiology the
previous year and this year was studying zoology and physi-
ological chemistry. These science courses fired his imagina-

36 HARVEY GUSHING

tion as Greek and Latin never could, and although he grum-
bled about the amount of time he had to spend in the laboratory
and at getting his assignments, he had at last found something
to get his teeth into, subjects on which he willingly spent
many extra hours of study. He was particularly keen about
his course in physiological chemistry with Professor Russell
Chittenden in "Sheff " the course which had the reputation
of being the hardest in college.

The matter of his future was beginning to concern him. In
his sophomore year he had written his father: "I will have a
talk with Prof. Ladd as soon as possible and see what he says,
more definately, about those chemical courses. There is no
doubt about it that if I am going to study medicine it is an
opportunity not to be lost as I can't take them next year."
However, he later wrote: "I don't know whether you have
any desires of what you want me to do after I leave college
or not. I have thought about it a good deal and can't come to
any determination at all." Now, in his senior year, he vaguely
had two thoughts in mind. His artistic propensities had given
him much in common with Grosvenor Atterbury, who
planned to study architecture, and he considered joining
Grove and later opening an office with him. The possibility
of . postgraduate study with Professor Chittenden also had
strong appeal. But on a visit to the Atterburys in New York,
he had met their family physician, Dr. Henry Stimson, who
had offered to take the boys on ward rounds with him the
next morning at New York Hospital. Grove turned pale when
a bad fracture case was being examined but Harvey was fas-
cinated by everything.

In the spring his senior society brought him the opportunity
to hear prominent members of various professions, among
them Dr. Bryson Delavan, of New York, who spoke on the
history of medicine and surgery, and to whom Harvey listened
"mighty interested" for an hour and a half, although he often
complained about the "forty-five minutes of wind" he was
compelled to endure in chapel from "Prexy," George Ladd,
or some outside speaker. These extracurricular contacts added
to the interest aroused by his course work. In addition to the

UPPERCLASSMAN 57

calf's brain which he had to explain to the class, he mentioned
dissecting the spinal and cranial nerves of a frog, and the dis-
section of a dog. Thus by the end of his senior year he seemed
headed for a career in medicine and the other plans began to
lose their substance.

A new interest was uncovered when, apparently for the
first time, he visited the library: "I went over to the library
to try to look up something for a composition . . . but got
so interested looking at other books and relics that I forgot
all about the composition till the librarian rang his bell for
closing." He mentioned the library a second time in connec-
tion with a visit of Katharine Crowell and her mother. "I was

luckily free for half an hour and we all went to the library

Mrs. Crowell seemed to enjoy it. I hope she did at any rate
for it is a part of the campus to which visitors don't often go,
as it probably never occurs to the men that they want to, but
I think it's the best place by far to take them and show them
it's not all play here. Besides, the reading room in the New
Library with the Tiffany window is a remarkably handsome
one." i

Finally, "the old man with the hour glass and scythe who
seems to hustle along with unprecidented speed" began to
catch up with him. On April 26 he wrote his mother: "The
time of year has come around for the prospective seniors and
juniors to pick out their courses and nothing has happened
which has seemed to shut us out in the cold as much as to
have no courses to pick out for ourselves for next year. All
we can do is to receive calls from and advise these illustrious
underclassmen as to what paths they should tread. I have per-
suaded some prospective physicians to follow the same studies
I have in 'Sheff' which courses and Prof. Chittenden I am
prepared to swear by."

Harvey did not make Phi Beta Kappa as his father had
hoped, but he finished in the first division (in the upper third
of his class). Clearly it was the social contacts of his college

1 He used a cut of this window as the frontispiece for the 1891 Pot-
Pourri, the Yale yearbook edited by Scroll and Key, for which he and
his friend G. Beekman ("Deacon") Hoppin were responsible that year.

$8 HARVEY GUSHING

years that most endeared Yale to him, and he kept in close
touch with many of his classmates throughout his lif e. During
his busy postgraduate years he wrote in rotation to a Keys
man every second week.

He was on the committee for the Senior Prom but some-
how did not manage to preserve a program and kept his dances
on a piece of cardboard. Elizabeth Le Bourgeois and Katha-
rine Crowell appeared twice each, and for one of the inter-
missions, Mrs. CrowelTs name was entered. But Ed Williams,
his cousin, took Kate to the class german. Harvey still showed
no inclination to lose his heart to any one girl, or indeed to lose
his heart at all even under the Commencement moon.

His father came on for the festivities but was able to stay
only a brief time. To his mother, who remained at home,
Harvey reported: "We went this morning to hear the Presi-
dent's Baccalaureate sermon in which he managed to tell us
in 60 minutes that the past was behind and the future before us
and not much more."

On June 24, 1891, Harvey Gushing received his degree from
Yale College, and it was a very sad boy indeed who, on the
last evening as he was packing to leave, heard the voices of
some of his classmates singing in harmony as they made their
way across the campus.

See the full moon, rising, weaves

Robes of light o'er tower and hall;
Thro* the slowly lifting leaves,

Silver lances flash and fall.
Louder yet the chorus raise,

Friendship lasts when youth must fail;
Jolly, jolly are the days,

'Neath the Elms of dear old Yale.

MEDICAL STUDENT AT
HARVARD

Chapter V

L

rfATE IN SEPTEMBER OF 1891,

Gushing started for Boston to enter the Harvard Medical
School, following in the footsteps of his brother Ned a de-
cision he apparently arrived at while with his family during
the summer. It had been an especially gay and carefree holiday
with his old crowd probably the last vacation they would all
be together. He had begun for the first time to devote his at-
tention to a particular girl Katharine Crowell, whose summer
home, Breezy Bluff, was a favorite meeting place for the young
people. Kate, as she was called, was a gay, high-spirited, popu-
lar girl, not only beautiful, but a good match for Harvey when
it came to things of the mind.

Gushing stopped off at New Haven with several of his class-
mates, among them Starling Childs who was on his way to
Harvard Law School. He saw Professor Chittenden and many
other friends, and the warmth of their welcome made his ar-
rival in Boston forlorn in contrast. He spent his first, rather
lonely night at the Tremont House and the next day set out to
find a room, but after "walking 10 miles and climbing a 1000
feet of stairs," he had only acquired a composite picture of a
landlady whose name was legion and whom he did not admire.
"It seems to me I never saw so many people before who were
all utter strangers and it's most depressing."

Then to his joy he ran into a "Keys" man on the street-
Henry Sage, of the Class of '89, who was at the Massachusetts

39

40 HARVEY CITSHING

Institute of Technology. With Sage's "invaluable" help he
settled in at 32 West Cedar Street, on Beacon Hill, and ac-
quired a lamp, a desk, a "washer-lady named Duffy," and a
map of Boston with which he soon learned to find his way like
a native.

And if he had been dismayed by the demands upon his
pocketbook at Yale, he was even more startled at the cost of
graduate education. "How medical books do cost! . . . They
are beautiful books though the Quain [anatomy] especially."
But he was lucky in the lot drawing for the last microscopes,
so did not have to buy one. He was also fortunate in securing
a seat in the classrooms, for there were not enough chairs to
accommodate the hundred members of his class (although this
was considered a small class), and late-comers had to stand.

It had been over a century since John Warren (younger
brother of Dr. Joseph Warren who fell at Bunker Hill) had
walked, when weather made the water-crossing precarious,
the seven circuitous miles from his home in Roxbury to give
his lectures to the Harvard seniors in Cambridge. It was with
his appointment to the chair of anatomy and surgery in 1783
that the Harvard Medical School had come into existence. He
was the first of many outstanding physicians and teachers
who brought honor and prestige to the Medical School. There
were his own descendants John Collins Warren, Jonathan
Mason, J. Collins; the James Jacksons, father and son; the Bige-
lows; the Bowditches Henry Ingersoll, Vincent Yardley, and
Henry Pickering; and Oliver Wendell Holmes.

Nearly all of these men had supplemented their education
with study abroad in the great clinics of Europe, and the Har-
vard Medical School had felt the influence first of the English
and Scottish schools of men such as John Hunter, Charles
Bell, and Asdey Cooper in London, James Syme and Robert
Liston in Edinburgh and then of the French, especially of the
founder of medical statistics, Pierre-C.-A. Louis of Paris. But
Charles W. Eliot, when he became president of Harvard in
1869, found that, despite the undeniable prestige of the fac-
ulty, many aspects of the medical curriculum were outmoded

MEDICAL STUDENT AT HARVARD 41

and he brought about far-reaching reforms and innovations.
J. Lothrop Motley, the historian, wrote: "Our new President,
Eliot, has turned the whole University over like a flapjack.
There never was such a bouleversement as that in our Medical
Faculty." The so-called "course" was adopted, the student
body divided into classes, and an experimental physiology
laboratory set up, where, for the first time in this country,
students could do their own experiments. Endowment funds
were increased, and in 1883 a new building was opened on the
corner of Boylston and Exeter Streets. This building, which
had seemed very spacious at the time, was in 1891 already
inadequate so great had been the increase in enrollment.

At 32 West Cedar Street, Gushing found a variety of in-
terests among his housemates. He was somewhat alarmed when
he discovered that the brother and sister who occupied the
two front rooms were musicians and that the sister was plan-
ning to give violin lessons. "They are very nice, however, and
if they must play I'm glad they play well. I get a good deal of
exercise out of it too as I unconsciously beat time with one
part or another of my anatomy, whichever is most convenient
foot, hand or head. This is difficult when the man above is
playing college songs on his banjo but it can be done."

He saw a good deal of Henry Sage during the autumn
they went together to football games, to visit their Yale friends
at the Law School, and occasionally to the Boston Symphony.
In a letter to his mother he described his first experience:
"Thanks to Sage I made my acquaintance with the Boston
Symphony last night. He is a regular attendant and having
procured an extra ticket next his, he presented it to me. . . .
I enjoyed it all hugely, especially the last number, the Heroic,
during which I wept and laughed alternately."

His courses kept him well occupied, but it was mid-Novem-
ber before he had an experience which stirred an intense in-
terest in medicine. It happened on the first day the class in
anatomy began dissections. He was assigned a table near the
window an advantage in the days of gas lights and his first
"part" was a right upper extremity. As he concentrated on his
work, the rest of the room retreated into the background. The

42 HARVEY GUSHING

perfection of the human body and the intricacy of its struc-
ture fascinated him. His facility in using a scalpel and handling
the delicate tissues seemed to be instinctive it was far greater
than might have been expected from his small experience at
Yale. So remarkable was his skill that soon his classmates and
his teachers began coming in groups of two or three to watch
him. This day not only set him apart from his fellows but
offered him a challenge from which he could never escape.
From this time forward medicine filled his life. He decided to
be, in his words, a "leper" to forego social activities and de-
vote all his attention to his work.

Already he had appraised his classmates and picked out those
who would offer the most competition. Elliott Joslin (Yale
'90) and C. L. Mix he thought would lead the class, while Edes,
White, and Painter he marked as "good men" something his
class abounded in, he told his father. But it was Joslin who set
the pace for him.

E. Amory Codman, who became a particular friend, re-
vealed in his letters, when he went abroad in the midst of their
course, that he knew of this silent competition. "Now, Harvey,
old man," he wrote from Berlin, "I really could not read a
part of your letter and if you really wish to get ahead of Joslin
you must brace up in that direction. Leave the girls alone or
you will be rising at ten in the morning as I do. May the
achievement of your ambition be the reward of your virtue."

But not even his growing absorption in medicine or his
competition with Joslin could keep Gushing from making the
most of every opportunity to revisit Yale. Even at this early
date he had only to step off the train in New Haven and his
concerns would drop away and his heart lighten and he would
be transported again to the idyllic atmosphere of his college
days. Late in November he attended the Yale-Harvard foot-
ball game with some of the Yale-Harvard Law group, Henry
Sage, and Dr. Charles Scudder (Yale graduate, friend of his
brother Ned, and demonstrator in anatomy).

Harvey now had lost his fear of approaching his father for
funds. Dr. Kirke, after his initial letter of caution and advice
(Harvey had designated it "a Chesterfield letter"), had begun

MEDICAL STUDENT AT HARVARD 43

to write him more as man to man. And he sent money more
freely and with little or no mention of the need for thrift. "I
am sorry you waited until you were penniless before calling
my attention to the propriety of a remittance. So many de-
mands gravitate my way all the time that I do not keep track
of the weeks and months as I might do."

Kate Crowell and Mary Goodwillie visited Boston in March.
In his letters home Harvey was very offhand about it, saying
he was so busy he found it difficult to change his clothes and
go to see the girls; but when Kate left, he took her to the sta-
tion and was so engrossed, he was nearly left on the train. He
admitted to his mother that if he had had the time and money,
he would not have minded at all!

In April he and Amory Codman, having already been
marked as promising students, were honored by election to
the Boylston Medical Society. The spring vacation he spent
in Boston doing extra dissecting, except for another brief visit
to New Haven "to renew his youth."

With the change in seasons his letters became Sled with his
pleasure in the flowers and trees of Boston. In every one he
described some aspect of the spring's awakening, and the Pub-
lic Garden, "a joy forever," was a favorite subject. His interest
in the Garden, which continued throughout his years in Bos-
ton, was shared by some of his classmates:

On pleasant evenings Painter, White and I usually take a small
stroll through the gardens for about a half hour as they are a
particularly pleasant spot at that time, being about deserted. We
usually spend our time betting on the names of trees, which are
of every imaginable variety. As I am extremely ignorant on such
subjects, I was o'ercome with glee to find that they did not know
the gentle Catalpa with which I had become acquainted, thanks
to Father. White knows all the foreign trees and Painter the New
England varieties. I hitch names onto the trees they don't know
and swear that they are indiginous to Ohio with whose vegeta-
tion I alone am familiar.

At the very beginning of the examination period in June he
slipped away to New Haven. "I had no idea of coming till
Saturday night but could not stay away and can only say it

44 HARVEY GUSHING

has been worth it a thousand times over. Would that Perry
could have been here! I go back tonight for the final grind."
On June 25 he wrote his father what came to be a familiar
letter he had a chance to do some extra work (substituting
at the Massachusetts General Hospital for a few days) and he
thought he had better accept it although it would delay his
home-coming,

SECOND YEAR 1892-93

In the autumn of 1 892 when Gushing returned for his second
year at medical school, he began his clinical work on the wards
of the hospital. Early in the nineteenth century it had become
apparent to several members of the faculty of the Harvard
Medical School that a hospital was needed both for the care
of patients and for the instruction of students. Accordingly,
the Massachusetts General Hospital, the first permanent hos-
pital in New England, had been built in 1821, largely through
the efforts of James Jackson and the first John C. Warren.
Charles Bulfinch, the Boston architect who did so much to in-
fluence American architecture, designed the building with the
simple Doric columns and the central dome characteristic of
his style.

In the amphitheater in the dome America's greatest con-
tribution to humanitypainless surgery was introduced to
the world in October, 1846, Warren himself performing the
operation while W. T. G. Morton, the Boston dentist who had
been experimenting with ether, administered the anesthetic.
Here had been introduced by the second John Collins Warren,
grandson of the first, the aseptic methods of Joseph Lister, in
whose surgery at Glasgow he had learned them in 1869. This
Warren, the fourth in his line to be actively identified with
the Medical School, was now teaching surgery to Gushing,
who often administered to Dr. Warren's patients the anesthetic
which the latter's grandfather had helped to introduce.

The close contact with patients, sickness, and death on the
wards of the hospital caused Harvey Gushing to approach his
work with increased seriousness and concentration. He had

MEDICAL STUDENT AT HARVARD 4jT

moved this year to 89 Charles Street, inhabited largely by men
from Technology. "My room is on the top floor and is much
more pleasant than last year's despite the fact that my outlook
is nothing but brick seen through a tangle of wires and the
front wall has a round-shouldered aspect, unmistakably attic."

His program included therapeutics, advanced anatomy,
pathological anatomy (which he hoped to like "have a splen-
did teacher, at any rate, in Councilman of the Hopkins"), and
theory and practice of medicine. (For this he had purchased
Osier's Textbook of Medicine, which he reckoned cost nearly
$5.00 a pound.) Partly through interest and partly because of
the security that extra knowledge gave him, he accepted an
opportunity to assist Dr. Charles Scudder in the out-patient
department, an assignment which, though exciting, was dis-
tracting because it conflicted with regular lectures and forced
him to copy notes from one of his classmates in order to keep
up with his work.

Because his days were so filled, he particularly enjoyed the
relaxation of occasional hours away from the hospital. A week
end in the open always afforded something special to enlarge
upon in his letters home and gave free rein to his powers of
description. In mid-September he visited Annisquam with
Henry Sage and gloried in the sail to Gloucester, the sunset
from Squam Rock after their arrival, and a tramp through
swamp woods bright with autumn color. He was chagrined
but amused by a joke Sage played on him when they got off
the Gloucester train:

Was nicely taken in by Sage last night. Being in a hurry we
left the car before the other people who were about fifteen in
number (though I am not sure now that there were less than a
hundred) all of whom were going in our direction towards An-
nisquam. We passed in a moment a fine old farm house garden
and Sage said "Did you ever see a Chinese plumb tree?" pointing
to a curious shrub near the house and on which was the most
curious white fruit. I was all interested in a minute and on ask-
ing if they cared if people looked at it, Sage said "No, we can go
in and I think the fruit is about ripe." We pushed open the gate
and not till we were at arms length from the tree did I discover

j6 HARVEY GUSHING

that the "fruit" consisted of a lot of nicely blown egg shells
placed about on the small twigs of a young pear tree. Sage
roared, as did the people following up the hill, for it seems that
the "egg tree" is a standing Annisquam joke. All I could do was
to acknowledge the corn and take off my hat to them. I shall not
forget that plumb tree till I have a chance to revenge myself on
somebody else.

This autumn his father had given him money for his own
microscope, which pleased him very much because he could
do extra work without fear of keeping the equipment from
another student. In addition to assisting Dr. Scudder, he wel-
comed the opportunity to perfect his skill in dissecting by
acting, with Amory Codman, as prosector for Dr. Maurice
Richardson who taught anatomy.

Although these extracurricular jobs added interest and ex-
perience, they took time, and he became concerned about his
marks. In November he sought out his physiology professor,
Henry P. Bowditch, to ask about his "Phisiology" mark.
"He seemed rather bored to be asked [and] was still more
bored when he found that they had made a clerical error and
that instead of being 77.5 it should have been 87.5%. I don't
know what impulse took me in there but am very glad that
I enquired."

He described his weeks as a rush in the middle and a gradual
slowing up toward Sunday, when there was a breathing spell
and a chance to think about something except pills, then a
rapid descent to the middle of the week, gaining momentum
with which to pass the next peak. Nevertheless, Sundays were
often used for reading papers, bandaging imaginary injuries,
and tying ligatures with Painter, Dolliver, Codman, or some of
his other friends. But at times he used these "breathing spells"
for something besides studying and once admitted: "I have
been under the spell of the majic pen of Nathaniel Hawthorn
all this afternoon and have just finished reading for the third
time The Scarlet Letter. After lunch I carelessly picked it up
from the table downstairs and opened it. That was enough
I finished the last ten pages at supper which was consumed
between the lines. Its a powerful book."

I
1

I!

\

J
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fcO

!

5 I

,*JtU UTUt-U

A HUMAN CRANIOTOMY

One of Dr. Cushing's own drawings showing a brain clot and
motor area (on which he has indicated the foci governing move-
ment in certain parts of the body). The inner covering of the
brain (dura mater) is held back by the two clamps.

MEDICAL STUDENT AT HARVARD 47

An early interest in books was stirred by being able to
browse in such places as the old Archway Bookstore, where he
once ran into a Yale friend, "Wint" Noyes, who "told me that
he got a Macauley's History of England which he wanted for
himself 5 volumes very nicely gotten up, good paper and type
for the magnificent sum of one dollar"

On November 24 he gently broke the news to his mother
that he might not be home for the holidays. "What do I want
for Christmas? A MINCE PIE packed in a box and sent to 89
Charles Street for I fear, Ma dear, that the present outlook
points to my Christmasing it here though this is not absolutely
final." On the same day he wrote his father that he had defi-
nitely settled his fate as far as the vacation was concerned and
had accepted an opportunity to work in the medical out-pa-
tient department for December. The following week he re-
ported on a little out-patient work of his own. "I have a patient
here at 89 Charles. One of the Technology boys who has hurt
his foot. I poulticed it and sent him to bed last night. Today
it's worse. It's a glorious profession all the same."

His first Christmas away from home was not too unhappy.
He got a box "as big as a piano" from home and there were
several people still at 89 Charles for company Gary N.
Calkins, "Professor of Low Life" at the Massachusetts Insti-
tute of Technology, better known as "Bacillus," two young
Technology boys, and Dr. Sears, who had his office in the
house.

On New Year's Day, his out-patient engagement over, he
confessed to his father that he didn't know what he had learned
except to ask people with more or less grace how their bowels
were. Anyway, it had made him feel a little more at home with
a stethoscope in his ears and less like a creature with a formi-
dable proboscis prodding innocent people here and there. He
hoped the experience would make materia medica, which he
despised, a little more interesting.

In a small diary which had been a Christmas gift, he began
to jot down the principal happenings of his days, and here,
rather than in his letters, was recorded his complete absorption
in his work here also were revealed moments of uncertainty

$ HARVEY GUSHING

and inadequacy that rarely found their way into the cheerful
notes he sent to his father and mother. "Still working over the
poisons. Contemplate taking some myself," and "HARD luck
again etherizing. . . . Dr. P. must think I'm a clumsy dunce."
On January 10 an incident occurred that plunged him into
deep despair; indeed, it was nearly the cause of his leaving
medical school.

He had been asked by one of his classmates to take his place
at the Massachusetts General Hospital for a week. One of his
duties was to administer ether to a woman who was being op-
erated on for a strangulated hernia. He had given ether only
a few times before and he was nervous because he had never
been adequately instructed in its use. In fact, there seemed to
be no formal instruction about anesthesia, the other men usu-
ally using enough of the volatile liquid to make the patient
insensible quickly and to keep him so a long time.

On this particular morning, Dr. Charles B. Porter, Professor
of Surgery, was operating and since he, like all the professors
in the Medical School, had a large practice by which he earned
his livelihood, he was in a hurry to get the operation over with.
When they began calling for the patient in the operating room,
Gushing hurriedly finished his job and wheeled the woman in.
Dr. Porter had no sooner opened the abdomen than the patient
died. Gushing was stunned. He was sure he had killed the
woman with too much ether. He left the operating room by
himself and wandered out of the hospital. All afternoon he
walked the streets of Boston, oblivious of the cold and the city
about him. A few short hours before there had been life in
another human being life he had snuffed out with his stupid
bungling. He must leave medical school and a profession where
life and death were so often in a doctor's hands, for where he
had failed once, he could so easily fail again.

In his anguish his thoughts turned to his brother. Had Ed,
when he was in medical school, known what it was to lose a
life that might have been saved? And his father had such
things happened to him? He seemed suddenly to feel closer to
his father, to see him in a new light his quiet ways, his uncom-
promising severity with himself and his children, his dedica-

MEDICAL STUDENT AT HARVARD 4$

tion to his profession and he longed for that solid anchor of
comfort and strength. He thought then of his grandfather
Erastus, who had had the courage to leave the home of his
forebears and start life anew so close to the wilderness that
wolves had often chased him as he returned from a night vigil.
And what of David, his great-grandfather? Had he known
doubt and fear and uncertainty as he drove long miles through
all kinds of weather to bring the comfort of a doctor's hands
to the scattered families of his New England practice? Must
he, Harvey, be the first to break the pattern that had been so
long in the making?

In the early evening he presented himself at Dr. Porter's
house and announced that he was going to leave medical school
and do what he could to assist the patient's family. To his sur-
prise, the surgeon told him that the woman was in such a con-
dition that she would have died anyway, that such occurrences
were not uncommon, and that he would advise him to get a
good night's rest and forget about the whole matter. After a
time this satisfied Gushing to the extent that he decided to go
on with medicine, but he dedicated himself more passionately
than ever to his work.

He and Amory Codman began to investigate a means of
safeguarding the patient by recording pulse and respiration
during operations. They started a competition to see who
could give the best anesthesia. The wager was a dinner, and the
test was the patient's behavior on the ward a perfect anes-
thesia being judged one in which the patient was sufficiendy
conscious to respond when left on the ward with the nurse
and did not subsequently vomit. With the help of a suggestion
from Dr. F. B. Harrington, they later devised some charts
which were put into use at the Massachusetts General Hospi-
tal. This was the first attempt to record the patient's condition
during an operation and was an important step forward in re-
ducing the number of deaths during and after surgery.

Gushing continued to administer ether for various members
of the staff, sometimes at the hospital, sometimes in their of-
fices. On Friday, January 13, he noted in his diary: "Encysted
hydrocele at 38 [Commonwealth Avenue] with Dr. Porter

JO HARVEY GUSHING

A. K. Stone assisted. Promised later to help in a bandaging
course with policemen." On the i4th: "Big operating day.
Etherized well but don't seem to hit it off with the house offi-
cers." On the 1 6th: "Etherized 3-4 times and pretty poorly.
Couldn't study in evening and went to bed early. I fear for the
Chemistry exam." And again in March, "Etherized this noon
for Dr. Porter who removed a dermoid cyst from a young
girl's neck* Beautiful operation. Assisted him till Alex came."
On the zad: "Shattuck told an old hypochondriac to remember
the Eleventh Commandment Tret not thy Gizzard' & forget
all the others if necessary." On the 3oth: "Walked out to park
with Codman. Saw first robin. . . . Bandaging class with po-
licemen."

Early in the year he spent a week end at Gloucester with
his friend Dolliver. "I was much interested in the fishing de-
partments," he wrote his father, "which in fact are the main-
stay of the place, as you know. We spent the whole morning
and afternoon gadding about in sail lofts, junk shops & on the
wharves and I still have a feeling as though my hair was full
of sea weed and my mouth of salt halibut, for they have a
custom in the smoke houses of offering the visitors appetising
pieces to chew which must be done with as much good grace
as possible. I consider the habit on a par with that of the good
German anatomist his name I forget now who is said to chew
connective tissue while dissecting. A disgusting thought but
it always amused me nevertheless."

Word pictures of such excursions revealed the maturing of
his artistic appreciation. For his drawing talent he was finding
a practical use in histology and microscopical anatomy, and
what he saw in the microscope was recorded with exquisite
detail and accuracy in his notebook. He also made use of it in
clinic by sketching patients to help him remember them. Even
in these small drawings, hastily executed, he was remarkably
apt in capturing the essence of a mood or condition the resig-
nation of a critically ill patient, the labored (Cheyne-Stokes)
breathing of a sailor in heart failure, the frightened bewilder-
ment of a foreigner ill in a strange country.

As he made greater use of his own gift, his appreciation

MEDICAL STUDENT AT HARVARD ?/

and interest in all forms of art increased. Art exhibits began to
attract him, and early in 1893 he attended one every three or
four weeks. In January he went to see the Massachusetts col-
lection which was to be exhibited at the World's Fair in Chi-
cago. Twice he visited art stores once to see an exhibition of
Hopkinson Smith water colors entitled "Summer days in
Venice," and again to see the La Farge pictures of Samoa and
Japan. In March, Painter and he attended a loan exhibition of
pictures at the St. Botolph Club. "I am afraid I am not educated
up to Millet but one of Meissonier and some of Corot and
Cazin are fine. The latter gentleman was new to me but he's
a dandy."

He was interested in everythingpaintings, etchings, water
colorseven modern art, for he asked his mother: "Have you
seen any of McKnight's impression pictures? I saw a lot of
them here last winter and they are of the most ultra sort. I ask
you because I just ran across this verse which amused me
greatly,

"If you were a sweet potato

And I were Dodge McKnight,
I'd paint you in colors prismatic,

So vivid & glowing and bright
That the world would exclaim, 'A Tomato!'

And damn it, they'd be right
If you were a sweet potato

And I were Dodge McKnight."

On April 7 his grandfather Erastus died suddenly of pneu-
monia. The letters from his mother and father touched him
deeply "What a legacy of an honored name he has left his
grandsons," his mother had written. Depressed by this loss
and overtired from his numerous activities, he decided to ac-
cept an urgent invitation from Grosvenor Atterbury, now a
"boy architect," to visit him in New York. He had two enjoy-
able days there, spending much of the time at hospitals. "The
new Syme operating theater [Sims at Roosevelt Hospital] is
a wonder, the gentle pyogenic germ is practically unknown
there I imagine," he wrote his father.

Kate Crowell came to Boston to visit Mary Goodwillie in

$2 HARVEY GUSHING

May. Although Harvey again wrote home that he had very
little time to see the girls, he recorded in his diary that he went
to Dedham with them ("Beautiful day dog tooth violets"),
on another occasion spent the evening with them reading "The
Dove Lady," and also that Kate had mended his black silk
umbrella for him. At the end of her visit, there is this diary
note: "Have just spent the afternoon with Kate. Too cold &
rainy to go to Riverside as expected. She's a fine girl but it's
best methinks for me not to see too much of her. Wood's lec-
ture tonight."

During this month he joined the Union Boat Club to get
some needed exercise rowing on the Charles River and often
after prolonged periods of hard study or before examinations
he would go there to cool off and relax. To the announcement
that he had joined and also that he had accepted an opportu-
nity to work at Children's Hospital during the early part of
the summer, his father replied:

"I can sympathize with you in your blistered hands from
unwonted rowing, for I have blisters and soreness which make
sitting a solemn business from unwonted devotion to the pig-
skin (you may or may not know that saddles are made of the
porker's integument)." Dr. Kirke expressed approval of the
extra clinic and other work, saying that even if his marks suf-
fered, compensation would come in other ways. He con-
cluded: "Jack [Harvey's dog] in spite of all care has had
some disgraceful liaisons of late, which have seriously shocked
the even tenor of family ways. This is the only piece of news
I think of which does not lie in your mother's department."

The month of hard work at Children's Hospital during July
was broken by a visit to Plymouth, a trip with Joslin to Welles-
ley ("which must be a very superior girls college *as such.' "),
and an afternoon (the first of several) with the famous Blaschka
collection of glass flowers in Cambridge, "the most perfect
things imaginable."

He left for Cleveland early in August, ready for a rest and
some relaxation, but his diary revealed that he assisted in an
appendix operation at a country farmhouse in Oberlin on the
24th of August and acted as anesthetist at operations at both

MEDICAL STUDENT AT HARVARD S3

Charity and Lakeside Hospitals in Cleveland on the zfth. Kate
CrowelPs name appeared frequently in connection with his
social activities "making a fool of myself about her" he ad-
mitted.

On September 13 he left for Chicago and a week with Ed
at the Columbian Exposition, the World's Fair. He was
enormously excited by the exhibits from all nations. A "Japa-
nese lady's boudoir" in the Woman's Building is mentioned
by name only, but the English nurses' exhibit he described in
minute detail. His diary was enlivened by many sketches of
things and people that caught his fancy and also by his careful
expense account where he listed every beer (sometimes spelled
"bier") and "orange cider" and such enigmatic expenses as
"crackers and hotbox" for thirteen cents, "M" for five cents,
and "W" for one cent. Buffalo Bill cost a dollar.

On the 26th he recorded his "last walk with Kate who had
come over to Lunch Club." Two days later he was back in
Boston "my routine of life has been resumed."

THE HALFWAY MARK
Chapter VI

THIRD YEARI 893-94

.T THE BEGINNING OF HIS THIRD

year, Gushing resolved not to take on so many extra assign-
ments and to attend lectures more faithfully. But he now had
more to do with actual patients in the hospital, and he found
that if he followed them as he wanted to and during the hours
he was allowed to see them, he again had to cut lectures. He
also could not refuse the opportunity to do extra work in pa-
thology with William T. Councilman. On the strength of the
high mark he later received in the course, Councilman offered
him a $250 scholarship. Gushing requested that it be given
instead to a classmate "who most certainly deserved it more
and, if you will excuse me," he wrote his father, "I think was
more in need of the money than I, thanks to your indulgence."
At 89 Charles this year were his close friend from Cleveland,
Abram Garfield, who was studying architecture at Technol-
ogy, and a classmate from Yale, George L. Amerman. Dur-
ing the autumn he spent a great deal of time helping Amerman
with his dissecting because he had fallen so far behind in his
work that he was threatened with dismissal. While he was
thus engaged, the weeks slipped away and suddenly it was
time for Amory Codman, who had been his closest companion
in medical school (Codman was a year ahead of him), to leave
for Europe for six months. An informal "quiz" club, known
as the Brownie Club, gave a farewell dinner for him, attended

54

THE HALFWAY MARK JJ

by Charles Painter, Elliott Joslin, Charles Russell Lowell Put-
nam, Henry Hewes, Frank Denny, George Dolliver, Nathaniel
Bowditch Potter, and H. T. Baldwin. Gushing brightened up
the occasion by bringing ridiculous presents for each one to
Elliott Joslin, already interested in diabetes, he brought a
wilted bunch of sweet peas. Later he drew a picture of Ye Dis-
consolate Brownie for Kate CrowelFs amusement.

H.C.'s drawing on place cards -for the dinner given by the Brownie
Club on the eve of Amory Codmaris departure -for Europe, 1893.

Harvey often chid Kate for not writing more often, al-
though his own communications were infrequent. Once he
sent a sheet of paper with nothing on it except a phrase cut
from one of her letters: ". . . I shall answer you promptly
a perfectly unheard of thing, but you'll see!" Although gkd
of her thought and attention, he was very guarded in express-
ing his own feelings. In his first letters after seeing her either
in Cleveland or in Boston, he usually slipped from his resolve
to keep everything on an impersonal basis, but after a month
or two he might begin a letter like this: "Sunday, Nov. 19 '93
11.45 P.M. Dear old Katy Guess its about time I wrote you
a letter. You see what time it is and I am going to stop at
twelve to get my beauty sleep, so that you mustn't expect
much. . . ."

He went on to describe a dance he had attended at Miss
Hersey's School where Mary Goodwillie was teaching. The
other gentlemen were in evening dress H.C. in a wool shirt
and tweed suit. "But that didn't cut any wood, for after the

$6 HARVEY GUSHING

piano started up, the old leper's heart beat fast and there was
no restraining his feet so Mary and he rushed up from the
office where they had been chatting and gaily plunged into
the merry dance." He also told her about an afternoon with
Mary Goodwillie visiting the glass flowers in Cambridge and
dining with Yale friends, then ended the epistle with "It's
twelve o'clock, Katy. Good night, Harvey."

In November he exercised his prerogative as a citizen for
the first time but he told his mother that "although I have
registered my name in a dirty book, in a dirtier room, around
the corner in this ninth ward of Boston, and on next Tuesday
shall cast my first vote, yet things political interest me little."

He went home for Christmas but stayed only nine days
because he wanted to be back by January 2 to start Amerman
on a new dissection and to begin some extra work in obstetrics.
He had been working so hard that he had lost weight and in
January he succumbed to a light attack of grippe. This was
followed late in February by a more serious bout lasting sev-
eral days. His father apparently became alarmed, for shortly
Ned appeared in Boston, and on March 2 they sailed to Havana
for a brief trip.

From New York, Gushing wrote to Kate Crowell (who
had been in Boston during February), revealing that her pres-
ence had betrayed him into saying more than he meant to.
This had been followed by an equally passionate denial, which
had hurt them both. He went off, lonely and apologetic, tell-
ing her that she meant a great deal to him, and at the same time,
that it must not be.

The change in surroundings soon brought him to a happier
mood. Strange places, so long as his stay was temporary, al-
ways delighted and stimulated him. On the trip down he wrote
in his diary:

. . . We have just now struck into the Gulf Stream and the
change in the color of the water is remarkable. . . . The wind
still holds northerly and against the current makes us roll a little.
. . . Ed went to bed with a "headache," and a cracker with some
lemon and apollonaris soon demonstrated the etiology of his ail-
ment, for he nearly filled our chamber with his gastric contents

THE HALFWAY MARK J7

and the remark "It's strange how much a little cracker will do." I
never could understand why seasickness should be so mirth pro-
voking. I had no sympathy for him but laughed roundly.

In Havana they visited hospitals, the prison, old Spanish
castles, the market. They ate strange and wonderful food, took
baths in "the ladies place the Gargon in holy horror at the
idea," and while Ned collected stamps, Harvey sketched. He
was fascinated by some beautiful women eating their ices, after
the opera, with their knives, he was disgusted at the bullfights
"a brutal event," and his artist's soul was saddened by the pass-
ing from beauty of "the old country palace of the Marques
de Almendares who 40 yrs ago came over from Spain with a
beautiful young wife . . . and there spent many gay years of
entertaining &c. . . . The desolate picture of decay of what
was but recently wealth & beauty was touching."

The rest and change did Harvey a great deal of good, and
he returned to the Medical School with enthusiasm. A letter
from Kate Crowell awaited him. "I couldn't forget," she wrote
him, "even if you wanted me to."

He was now faced with the decision of whether to take a
fourth year. The Medical School had required only three
years up to this time, but the requirement was being increased
to four. The program for the added year was in a formative
stage, and few from Harvey's class were going to stay on.
However, his father thought a fourth year would be wise,
and Harvey finally decided to take his advice. The race with
Joslin was over "Joslin will easily lead the class."

Planning to make good use of the summer, he accepted an
appointment in the women's medical out-patient department
at the Massachusetts General (as well as some work at Chil-
dren's Hospital) for July and he hoped for another out-patient
appointment during August; but his plans were changed.
Shortly after their return from Cuba, Ned had become very
ill with typhoid fever. Harvey's deep affection for his brother,
intensified by being so far away, overflowed in his letters
home. He implored his mother to write frequently, and his
relief was immeasurable when word finally came that Ned was

$8 HARVEY GUSHING

out of danger. When it was suddenly suggested in June that
an ocean trip would hasten Ned's recovery, he promptly
agreed to go to England with him. They sailed on June 30
with their aunt and uncle, Mr. and Mrs. Edward Williams.

From London, Harvey wrote his father and mother one of
the few letters he ever addressed to them both:

I have wished many times that you were along with us. How
you would rave over Westminster, the Kew gardens and every-
thing. So much to do and see that it's almost oppressive. . . .
Have been nowhere twice except to the National Art Gallery
and the Abbey whenever I pass by. We are right across from the
British Museum so the chances are we will never go in there, it's
so easy. I must see the Elgin marbles sometime however. Saw
the Duke of Cambridge review 2-3000 of the Horse Guards at
Hyde Park Saturday. It was very impressive to see the long lines
of red coats. . . .

The Williamses have decided to go over to Paris Saturday for
a few days. We remain here in rainy London. No one seems to
mind the wet, however, going about in their frock coats and "top-
pers" (in which I have not indulged though I should like to) as
though it were bright sunshine. ... It doesn't rain like a Chris-
tian sky, but as Ed expresses it, it seems as though there was a
sponge up aloft and every few minutes someone comes along and
gives it a squeeze.

His diary entries were telegraphic, but he remembered
everything he saw. "To Charter-House rich in associations of
Thackeray and others . . . saw the corner of the Yard
where Thackeray broke his nose. ... Ed chased a maid into
St. James Park which he was prevented from entering by the
gate being slambed in his face. Great embarissment followed
by mirth from H.W.C. . . ."

Ned, who had once spent six months in London, soon tired
of sight-seeing and they left for the "Peak Region." From the
Rutland Arms in Derbyshire they made daily tramping excur-
sions, and Harvey, who had departed from London reluc-
tantly, fell almost at once under the spell of the countryside,
which was "simply teeming with historic and romantic lore,
which has been gathering since long before the days when

e. TJO

f r ^ ;Vi

ttJMiuj.iHU.r'.'rrrml

"V

t* _

The Rutland Arms and the accoimting. From 1894 diary of trip

to England.

59

60 HARVEY CUSHING

William the Norman gave all this part of Derbyshire to Pev-
erel 'he of the Peak' . . ."

They left Derbyshire regretfully and returned to London.
After a delightful trip to the "tall spires of Oxford" in a
coach and four, they visited London hospitals, where both
found much to interest them. Finally the time came for them
to sail for home. Harvey wrote his father that the trip had
cost $4641300 for passage and clothes (two overcoats, a
dress suit, and some "trowsers"), and $164 for their twenty-
six days in England. He and Ned had had an "altercation" or
two, but they parted on the most friendly terms in New York
when the boat docked on August 10, and Gushing went imme-
diately to his clinic assignment in Boston.

FOURTH YEAR 1894-95

Cushing's fourth year was preceded by six weeks in the out-
patient department and a week's vacation in Cleveland. On a
typical day in the clinic he was busy from half past eight
until half past three setting fractures, dressing wounds, and
so forth. At four on this particular day, he met Elliott Joslin
(after lunching at the Great American Tea Company on a
cup of coffee with a raw egg in it) and accompanied him on
his rounds in a district near "little Italy." He was appalled at
the squalor in which the poor lived. "We saw ten or twelve
sick families fathers, mothers, poor meagre infants and what
not with various ills, urgent and otherwise. The ones we did
most for were least grateful and those for which we could do
nothing or perhaps could not recognize the trouble would
overwhelm us with 'God blessing' as is usually the case even
with more intelligent parties in a different grade of society."

Since the clinic was closed on Sunday and since he had no
studying to do, he was able to do some reading. He finished
John Fiske's Destiny of Man and prepared to start his The
Idea of God. He also became interested during this time in
the new Boston Public Library, not yet open to the public.
The sister of a classmate, Ned Williams, knew the librarian

THE HALFWAY MARK 6l

and had him taken on a tour. In gratitude for this opportu-
nity, Gushing took her paddling on the Charles but was glad
it was a cool night "as she weighed in the neighborhood of
fourteen stone."

During the autumn he acted as unofficial physician to his
cousin Mary Crehore, who had worn herself out getting a
master's degree at Cornell, and to her mother, his Aunt Lucy,
who was exercised over a date stone which was making itself
felt in various parts of her alimentary tract. He often took his
out-of-town visitors to the hospital, and their reactions caused
him to write home: "I am always a little surprised and shocked
to find people depressed by a hospital. I suppose familiarity
makes one callous but the Massachusetts General is essentially
a bright place."

Having taken on an sxtra assignment this time with Edward
Hickling Bradford, Professor of Orthopedics in addition to
his classes (he was taking clinical medicine, clinical surgery,
legal medicine, operative surgery, bacteriology, operative and
clinical obstetrics), he again overworked, and once more Ned
arrived to take him off on this occasion for two and a half
weeks in Bermuda. Cushing's diary (the habit was now firmly
entrenched) was vivid and enthusiastic and embellished with
unique spellings. There were a large number of young people
on the island, and the Gushing brothers were popular members
of first one party and then another. At one, H.C. sat next to a
U.S. Army captain and his "loquacious" wife who told them,
to Harvey's considerable amusement, that the "only way to
make a donkey go was to rattle nails in a tin can or to stick
a hot pin into him." Something of this sort must have happened
to Charlie, a donkey whose acquaintance they had made. "As
I write this Ed and Miss Morley have dashed by the Hamilton
at the rate of a mile a minute, Chas. with ears laid back, Ed. &
Miss M. looking very serious."

The equinoctial storms hampered their activities somewhat
but gave Gushing a subject for a bit of verse. "Miss Margarethe
Morley is a graphologist and has asked me for my writing.
Being morbid [about die weather] I gave her the following:

62 HARVEY GUSHING

"This land of lilly and rose
Is hard upon our starched clothes
As the clouds are such droppers
We are limp as the 'floppers'
And it's almost as bad when it blows."

One of the girls with whom he spent considerable time had
her hopes dashed at the end of the holiday when he told her
flatly that she needn't expect to see him in Boston because
his medical school work kept him fully occupied.

In New York on their return, Gushing was happy to find
at his hotel a letter from Abe Garfield saying notice had come
that he had passed the examination for his hospital appoint-
ment at the Massachusetts General. This meant four months
of "extern" service while he was finishing his course work
before he started his year's internship, which of course
required his living in the hospital. On April 2, when acting
as anesthetist for John Romans, he signed his first of the ether
charts for recording temperature and respiration during opera-
tions on which he and Amory Codman had worked together.
This was his initial contribution to general surgery.

During April, also, he witnessed, for the first time, a brain
operation on a patient with a compound fracture of the skull.
Gushing made no mention of the experience in his letters home,
but a keen interest was evident in his careful and detailed case
history and the fact that on his own initiative he followed
the patient after his discharge from the hospital until he left
the convalescent home. The "fearful" hemorrhage from the
dural sinuses which he mentioned in the operative note made
him aware of one of the most serious problems in any operation
on the brain the control of bleeding. This, he could see,
would have to be solved before cerebral operations could be
successful.

Abe Garfield persuaded him to take a break later in the
month and they went to Salem, whose architecture Garfield
had been studying with a class from Technology. Gushing
was immediately aware of its peculiar charm. "It certainly is
a fine old place, the more attractive because in its prosperity
it suddenly ceased to develope and grow but has ever since

THE HALFWAY MARK 6$

remained the same old Salem and though no longer the won-
derfully opulent center of Oriental trade, it has not degener-
ated but like a fine, neat old gentleman has simply retired
from business."

During his four years in Boston, Gushing attended church
spasmodically. Occasionally he went of his own accord, but
usually there was some special reason. When he first arrived
he was interested in Phillips Brooks (Dr. Brooks died in 1893)
and went to hear him with some of his classmates. The music
at Easter also drew him, but most frequently it was friends
from home who were responsible for his going. He once ac-
companied Kate Crowell and Mary Goodwillie "proudly,"
he said, but he left them before Communion. This spring he
escorted his aunt, Mrs. Edward Williams, and his cousins, Ray
and Reba, to King's Chapel.

Our pew was not only deep but big as a London "bus" with
seats all around it and I was very thankful that there were no
more than four of us as I should have had to ride backwards and
be stared out of countenance by the rear boxes full of stolid Bos-
ton respectability.

We heard a "most Unitarian" sermon of course, some fine mu-
sic, and after the service by a great effort I managed to reach
the lock on the door which was halfway to the floor and on the
outside and thus let my people out. In so doing I brushed all the
"nap" off Abe's silk hat which I had borrowed for the occasion.
Vanitas vanitatum.

At the beginning of May he began his extern service with
a few days at the convalescent home of the Massachusetts
General Hospital in near-by Waverley. He was back and forth
during the next four months between Waverley and the hos-
pital. In July he witnessed two more brain operations. When
Dr. J. W. Elliot had come back from England in 1889 after
meeting Victor Horsley, the London surgeon who had begun
to attempt brain operations, he had urged his colleagues to refer
to him any cases of brain tumor which they encountered, but
the opportunities had not been many.

However, on June 27, 1894 a thirty-one-year-old male, John
Maloney, entered the hospital with an obvious growth on the

64 HARVEY GUSHING

top of his skull. He had been struck on the head some three
years earlier, and after two years a tumor had begun to de-
velop at the site of the injury. Elliot operated on July 2, with
Gushing assisting. The growth proved to be spongy and deep
purple in color, indicating that it had an enormous blood sup-
ply. Elliot removed it, but the patient died a few hours later.
The tumor was of the type that Gushing was later to name a
meningioma, which grows from the meningeal covering of the
brain, occasionally as a result of injury, and usually invades
adjacent bone. Gushing did the autopsy report.

A second case appeared little more than a week later when
a man by the name of Jordan Hunter was admitted to the hos-
pital with severe headache and numbness of his right thumb
and forefinger. A diagnosis of tumor was made and Elliot op-
erated, with Gushing again assisting. In his carefully written
notes Gushing commented: "Elliot never had less bleeding in
opening [a] skull." Although the patient died because of the
malignant nature of the growth, there was cause for satisfac-
tion that the location of the tumor had been accurately diag-
nosed before operation.

During his assignment at Waverley, Gushing spent some time
at the McLean Hospital, the psychiatric division of the
M.G.H., located close to the convalescent home. It was here
that his interest in neurology was first sharpened. The work
was absorbing, and the days passed so quickly that he could
hardly believe it was time to pack his things. He was reluctant
to leave his room at 89 Charles "this little old top floor room
with its retreating frontal bone I have become most attached
to. ... All my belongings are boxed up and what a lot of
stuff one can accumulate in four years and the bare book-
shelves and walls with the litter of packing, a foot thick, make
the old place rather unprepossessing on this last night. I've al-
ways found it as hard to give up a room as an old shoe. They
are alike in certain ways." Amongst the "stuff" he had accu-
mulated were the course notebooks which in a way were an
index to his medical education. The careful and detailed notes,
written in the tight hand which many of his classmates had
cursed, and the exquisite drawings were an indication not only

THE HALFWAY MARK 6$

of his interest, but of his manner of working the pattern he
was to follow from this time forward.

Hospital duties kept him from attending Commencement,
but he received his degrees of M.D. and A.M. cum te^fe the
race with Joslin had not been in vain. He told his mother that
had he known what a struggle it was to be, he didn't suppose
he "should ever have had the sand to begin."

GREAT PLACE TO GROW
HAIR AND WEAR
OUT SHOES"

Chapter VII

c

BUSHING'S INTERNSHIP (OR A p -
pointment as house pupil, to use the M.G.H. term) began offi-
cially on the first of August. His assignment to the newly organ-
ized South side was initially a source of disappointment be-
cause Ned had been on the East side and both East and West
had been so long established as to have acquired traditions and
an impressive list of interns scratched on the lid of the senior's
desk. But the house staff of South which included a senior
and a junior house officer, an extern, and a "pup" was soon
bent on establishing traditions even more distinguished than
those of their older rivals. Of their superiors on the service,
Gushing wrote many years later: "I look back with an endur-
ing sense of obligation to our four chiefs to that resolute and
picturesque pioneer, John Romans, who twenty years before
had been privately advised not to do ovariotomies here, yet
persisted in so doing; to C. B. Porter, master of operative tech-
nique; to Jack Elliot with his brilliant gifts and uncanny sur-
gical instinct, and to the youngest of them, William Conant,
most generous and considerate of his hard-working juniors."
Cushing's new duties made his medical school days seem like
days of leisure. He rarely left the hospital it's a great place
to grow hair and wear out shoes, he told his father. But his
driving energy sometimes made him a hard person to work
with. When he became senior intern, his junior suffered se-
verely, claiming that although Gushing could be one of the
most charming people in the world when he cared to be, he

66

**A GREAT PLACE TO GROW HAIR*' 6j

wanted to be in the limelight and couldn't tolerate competi-
tion. Given a position of some authority, he was thus already
showing the strength of his ambition and the impatience he
felt when his efforts were nullified by co-workers whose
standards were not as high as his.

But it was usually the pleasant side that he showed to his
family: "Work prospers. I am ensconced in the out-patient
department mornings and do several interesting dressings and
a multitude of odd jobs during the rest of the day. It's a great
place here with a constant succession of curious and interest-
ing cases." And: "We have been having most wonderful
weather with days as balmy as those of May and nights lit up
most wonderfully by the Hunter's moon. It is the Hunter's
moon, is it not? At all events it makes the old gray pile of the
main building stand out like some castle of old if you are far
enough away to have the lights from the lower windows shut
off and can only see the Bulfinch flat dome with its cupola
surrounded by the array of sombre square chimneys. The hos-
pital yard by moonlight makes an impressive sight."

His father and mother paid him a visit in the autumn, and
the exchanges after their return to Cleveland indicated the
easy relationship that now existed between father and son.
Gushing wrote: "I was very pleased to learn of your safe
arrival home, for I had visions of fallen bridges, tracks washed
away, and other calamities. ... I wish Mr. J. Pluvious had
seen fit to delay or omit that storm. . . . Five inches fell in
those twenty-four hours according to the weather bureau's
bucket. . . . Father came to the M.G.H. the day of your de-
parture and left his umbrella as much as to say I shall never
need thee more: this must have been the last rain.* " To this
his father genially returned: "That umbrella you facetiously
allude to was no old one of mine but a brand new one, with
an orange wood handle of pleasant form, and with silk which
I hope will keep out a Boston rain." And H.C., with the same
light touch, replied: "I meant to cast no disparagements on that
umbrella even though I did not appreciate its newness. I
thought you had sacaraficed your own to your wayward son."

Late in November he managed to get home for a brief vaca-
tion and on his return he teased his mother, who had packed

68 HARVEY GUSHING

one of his trunks, about the number of drawers she had in-
cluded "great, long drawers too, 'a world too wide for his
shrunk shank,' and such a paucity of undershirts." Christmas,
however, brought a possible solution to the problem. It was
his responsibility to procure the hospital Christmas tree, trim-
mings, and a present for everyone. About four days before the
holiday, he had not yet had time to do anything about it, but
he assured his mother it would be doneeven if he had to
decorate the tree with iodoform gauze and "sacarafice a pair
of those drawers apiece. They will go around everybody, I
think, but Painter."

Early in the new year, news reached Boston of the new
X-rays that had been described on December 28 by William
Rontgen, professor of physics at the University of Wiirzburg.
Gushing was filled with excitement and enthusiasm. "Dr.
Rontgen may have discovered something with his cathode rays
which may revolutionize medical diagnosis," he wrote his
father. He was fascinated by the remarkable and uncanny pos-
sibilities of a ray by which one could see "through stone walls"
or through the chest to count the ribs and see the heart beat.
He contributed some money personally to procure an X-ray
machine for the hospital and spent many hours experimenting
with it, finding it most useful in locating needles and other
foreign bodies.

His letters became more brief than ever, but he occasionally
gave a hint of his activities in comments like these: "Things are
prospering with us. Elliot is giving us a good service. I think
he does the best abdominal work in the house." And again:
"Dined with Maurice Richardson the other night with two or
three of the house officers on some Egyptian quail Abbe sent
him from New York. Maurice is a corker."

An old patient of Ned's came to the hospital during the
spring. "He had a compound fracture of his big toe in Ward
28 under Ned's regime and an injured knee. The combined
efforts of the Gushing brothers have now given him a leg that
would pull a cork." "Sound as a twenty-dollar gold piece,"
was the way another patient described his leg. The senior
surgeons had said the leg must come off, but two young in-
terns had come along and looked at the leg and had sat down

"A GREAT PLACE TO GROW HAIR*' . <S>

on his bed to discuss it. They were Harvey Gushing and his
good friend, G Allen Porter, and they decided the leg could
be saved. Gushing persuaded his seniors to let him operate
with the result reported by the patient thirty-five years later.

In April, Gushing wrote to Kate Crowell to thank her for a
birthday present. "You were a good girl to remember me in
my senility few did [he was twenty-six on April 8]. ... lam
much pleased with the Amateur Emigrant. Hasn't he written
a sequel to it Across the Continent or something of the sort?
You introduced me to Robert Louis Stevenson. The Ebb Tide
was the first thing of his that I remember ever having read."

Throughout the year he had been thinking about the future
and had written to several of his friends studying in Europe to
ask about professors, courses, etc., in case he should accept his
father's offer of a year abroad. He also was considering the
Johns Hopkins Hospital. As early as July, 1895, Ned had
written him: "I have seen much of Robb in the past three
weeks and have been interested by what he has to say of
Halsted and the Johns Hopkins. He says that to his mind there
is no surgeon like him in the land, that his aseptic technique
is perfect, and that the scientific manner of his work, keeping
at it from the laboratory side simultaneously with his clinical
and operative work, is a revelation to a man. . . . He says
strongly that if a place is available after you finish your M.G.H.
service, take it by all means that a year there would be worth
five abroad &c &c. Think it over."

While Gushing was in Cleveland on vacation, he and Ned
had gone down to Baltimore to have a look at the hospital and
medical school. Although the Johns Hopkins Medical School
was still in its infancy, the eminence of its faculty and the fine
spirit which prevailed there were fast bringing it into a posi-
tion of prominence. Gushing liked the enthusiasm with which
everyone was working and he accordingly applied for a place
first with William Osier, the widely known professor of medi-
cine, then, when nothing developed, he approached William
S. Halsted, professor of surgery. After negotiations extending
over several months, he finally secured the appointment as
Halsted's assistant resident in surgery and for the time being
gave up his plans to go abroad.

THE JOHNS HOPKINS
HOSPITAL

Chapter VIII

D,

'URING THE FIRST DAYS AFTER

leaving Boston, Gushing was lost and desolate. The sudden ex-
change of the crowded, work-packed hours of his familiar
hospital existence for the idleness of vacation days left him
restless and ill at ease. However, his cousins, the Edward
Harveys and their daughter Melanie, and his brother Ned
were in a holiday mood and they had not been long on their
way toward Nova Scotia, Prince Edward Island, and Gasp6
before Gushing began to be more cheerful.

From Halifax they left for Baddeck where they made them-
selves at home in the Grand Narrows Hotel. There was much
merriment over Cousin Ed's soaking his "trowsers" while out
for a sail and over Ned's throwing a soda-water bottle at their
landlord when he innocently stuck his head in the room to
awaken them Ned mistaking him for Harvey who had
arisen early and taken all the blankets. As always, Gushing was
alive to the beauty of the natural scene. He reveled in colors
and tones "The sunset was gorgeous a fleecy mass of clouds
in the West in a great sworl like Elihu Vedder's with reds and
pure gold shifting in color constantly. The contrast of the
blue hills at the sides, and the dark green of those under the
dropping sun with the darkening water was wondrous."

From Nova Scotia they crossed to Prince Edward Island
with "its low shore, red soil, and garden-like appearance." The
beauty of the flowers, the antics of the curious-looking sand-

10

THE JOHNS HOPKINS HOSPITAL 7/

pipers, fat huckleberries and thick cream, and swimming on
a curving beach filled their days with contentment. Next they
visited the Gaspe Peninsula: "Early this a.iru we sail into the
majestic Gaspe Bay with veils of white mist encircling the
rugged tops of the high mounts of the Gaspe Peninsula
the end of the Appalachians." From here they traveled down
the St. Lawrence.

Bicycle lesson. Frottz Canada diary, 1896.

At Quebec they visited the Hotel Dieu where the surgical
rooms smelted of burnt-out candles and the chanting nuns at
the feast of the Annunciation of the Virgin brought tears to
Cushing's eyes and an unexplained sadness. After exploring the
city, they traveled overland to Lake St. John through miles
of bright goldenrod, tall pink spikes, bluebells, and white yar-

7^ HARVEY GUSHING

row. At the uncrowded hotel that night he and Melanie
danced alone in the deserted ballroom.

Two days later, on August 19, Ned and Harvey started from
Roberval to Chicoutimi by canoe with two guides. After nine
portages and a five-mile ride in a buckboard, they reached the
Shipshaw River at dark where a large group of lumbermen
made a picturesque scene around a roaring fire. Their guides

4n <&*-*wd -&cJSr**Y

"TTe Cieer p at the FT -ontenac." From Canada diary,

taught them old French songs-"Very old-clean French songs,
for there were such things oncepeculiar in their pathos and
with verses usually of four lines. . . Some had rollicking
choruses in which we joined vociferously, no one but Dame
Nature to be disturbed."

A few days later in Montreal he visited the Royal Victoria
Hospital, the Hotel Dieu, and the Montreal General-found

THE JOHNS HOPKINS HOSPITAL 75

that the latter compared favorably with the Massachusetts
General. Through Toronto and Niagara Falls they returned
to Cleveland. After a month at home, Gushing left for Balti-
more to begin the next phase of his career his residency with
the great surgeon William Halsted.

Baltimore in the nineties moved with the studied ease and
elegance of an age that was soon to pass. Her dedication to the
art of leisurely and gracious living indicated to an ambitious
Northerner a lack of initiative hard to understand. In the
market place, the contrast between the spineless lack of enter-
prise of the Southern shopkeeper and the bustling aggressive-
ness of his Yankee counterpart irritated Harvey Gushing. He
also looked askance upon the sumptuous dining habits of the
Baltimore epicures and told his mother indignantly that for
breakfast they ate griddle cakes and sausage together, and they
served their chicken fried! But his disapproval did not prevent
him from accepting any opportunity to escape from the hos-
pital meals.

And these were not his only complaints. The townspeople
were slow, the architecture uninspired row after row of
monotonous red brick fronts "as like as streptococci" always
with three white steps and the Hospital standards and staff
shockingly unsystematic. To complete the forlorn picture, he
was alone in a big, bare room with a few lonesome books in
his bookcase and no other adornments except a faded photo-
graph of Neddie. The future looked unpromising at best. One
wonders whether it was with amusement or exasperation that
his father took up his pen once more to suggest patience and
a reasonable trial before final judgment was made.

During the difficult days of adjustment Gushing ran across
Mr. Goodwillie, the father of his friends Mary and Barney,
who had moved from Cleveland to Baltimore. He told Kate:
"I should be very homesick here were it not for Mr. Good-
willie. Went to the theatre to see DeWolf Hopper and we are
to dine together tonight." Through Mr. Goodwillie he also
became acquainted with two of Baltimore's attractions
"Druidill" (Druid Hill) Park, where he was thrilled with the

74 HARVEY GUSHING

magnificence of the trees, and the great public market with
its fascinating array of produce, including "a hundred yards
of skinny-skinned rabbits, hanging on a rope with a row of
grinning darkies behind them." On his first visit there he found
an old friend, the Northern Spy apple, and returning that
night munching on one from the bagful he had bought, he
began to feel at home.

The Johns Hopkins Hospital had opened its doors in 1889,
sixteen years after the death of the eccentric and lonely
bachelor, Johns Hopkins, who had left seven million dollars
to found a university and a hospital. The university was com-
pleted in 1876, and Daniel Coit Oilman, one of the most for-
ward-looking educators of the time (he had been a professor
at Yale's Sheffield Scientific School and later librarian of the
University), served as president for twenty-five years. He
chose for his initial faculty six distinguished professors, 1 and
young though the University and Medical School were, both
soon took their places beside the best of the older institutions.

The hospital was twelve years in the building under the
direction of John Shaw Billings of the Surgeon General's Li-
brary who had had considerable experience in the construc-
tion of army hospitals following the Civil War. The plans
embodied sweeping reforms in hospital planning and construc-
tion, 2 but "the real hospital," he told the Trustees, "the moving
and animating soul of the institution, which is to do its work
and determine its character, consists of the brains to be put in
it." Accordingly, the building of a faculty was begun with the
appointment of William H. Welch to the chair of pathology.

1 Basil L. Gildersleeve, Newell S. Martin, George S. Morris, Ira Remsen,
Henry Augustus Rowland, and J. J. Sylvester.

2 There was an amusing provision in the plans which Billings described
thus: "If a female nurse is a properly organized and healthy woman, she
will certainly at times be subject to strong temptation under which occa-
sionally one will fall, and this occurs in all hospitals where women are
employed, without any exception whatever. Something may be done,
however, to remove opportunities and I believe the construction pro-
posed [elimination of large closets] effects this as far as it is worth while
to attempt it."

THE JOHNS HOPKINS HOSPITAL 75

This was the first full-time chair in pathology in an American
university, for pathology was a comparatively new branch of
the medical sciences. Welch brought to the Hopkins the tech-
niques and traditions of the great German laboratories, where
experimental science had been most highly developed. He had
spent two years studying under several of the most talented
pathologists and physiologists of the time, 3 and after his ap-
pointment to the Hopkins in 1884, he returned for a year of
further study while the hospital was being built.

The new professor of pathology a round-faced, jolly
young man, always immaculately dressed combined extraor-
dinary teaching ability with a boundless curiosity that was one
of his most winning qualities. In addition to his keen intellect
and attractive personality, he had a way of being able to rally
people to any cause, an ability that made him peculiarly well
suited for the task of organization now confronting him. After
his return from Europe, Welch went seriously to work on the
problem of a faculty for the Medical School. In the meantime
he opened a laboratory, and immediately a number of promis-
ing young medical students came to him Walter Reed, who
was to discover the cause of yellow fever, Simon Flexner, long
Director of the Rockefeller Institute, William S. Halsted,
who remained as professor of surgery, and William T. Council-
man, who became professor of pathology at Harvard.

Halsted, an outgoing, cheerful student at Yale (Class of '74),
had shown great promise as a teacher at the Bellevue Medical
College after graduation from the College of Physicians and
Surgeons. Now in uncertain health because of the fact, known
only to Welch, that he was fighting gallantly against cocaine
addiction, 4 he was reserved and withdrawn. He preferred to
spend most of his time in the laboratory, where he could lose
himself in thought and research, and there he made many

3 Ludwig, Waldeyer, Hoppe-Seyler, Kronecker, Koch, Cohnheim, Hei-
denhaim, and von Recldinghausen.

4 Halsted and three of his New York associates had experimented with
cocaine as a local anesthetic using themselves as subjects without knowl-
edge of its habit-forming tendency. Halsted alone was able to fight his
way back to a useful life.

HARVEY GUSHING

original and important contributions to surgery and medicine.
His surgery was a work of art, and the example he set for
careful study of each case, exquisite operative technique, and
close examination of tissues in the laboratory afterward was
to influence American surgery for many years. It was he who
introduced the use of rubber gloves because the delicate skin
of his operating nurse, who was later to be his wife, was con-
stantly irritated by the strong disinfectants used in "scrubbing
up."

A man of culture and sophistication, Halsted traveled in
Europe almost every year, sent his shirts to Paris to be laun-
dered, and was a gracious host or guest on his rare excursions
into society, but for the most part he lived the life of a recluse-
an enigma to his associates, and especially to his new assistant
resident. In the beginning the two men viewed one another
with respect but, on Cushing's side at least, with little warmth
or affection.

The next appointee to the staff of the Hopkins was the bril-
liant clinician and teacher, William Osier, professor of medi-
cine at the University of Pennsylvania. A person of medium
height, with dark, twinkling eyes and olive complexion, Osier
possessed great personal magnetism, for his irrepressible gaiety
of spirit and his deep human sympathy and understanding,
combined with a sometimes ribald enjoyment of life, drew to
him people of all ages. As soon as he entered the hospital each
morning, interns, residents, and nurses rallied round him. "Fall-
ing in step with his resident, he'd immediately start [with coat-
tails flying] around the great marble statue of Christ standing
in the rotunda and make for the long corridor leading to his
wards all others falling in line."

Of his tremendous energy and enthusiasm he gave gener-
ously. Osier represented the great English tradition of learning
at the bedside (as opposed to the German tradition of learning
in the laboratory) of which Thomas Sydenham (1624-89)
was the principal modern exponent after Hippocrates. It was
Osier who first and persistently advocated that students be
brought onto the wards to learn medicine while simultaneously
studying it in books. His ward rounds were memorable occa-

THE JOHNS HOPKINS HOSPITAL 77

sions, for between cheerful greetings and jokes with patients
and retinue, he carried on his teaching in a lucid, graphic way
that pinned facts securely in mind. His famous textbook, The
Principles and Practice of Medicine, begun during these
years, has been the bible of medical students for over half a
century (it is now in its eighty-fourth printing). But in the
last analysis his influence as a medical humanist and lover and
collector of books will probably outlive his contributions as a
physician.

The last of the four Hopkins doctors, immortalized by Sar-
gent in his well-known painting, was Howard A. Kelly, who
came in 1889, also from the University of Pennsylvania, to
fill the chair of gynecology and obstetrics. He was a sound
clinician and an excellent surgeon, far more interesting to
watch than his senior, Halsted. He was responsible for many
innovations in the operating room, was a man of enormous
energy and originality, with a sense of showmanship which
attracted students to him by the dozens. Although of a dif-
ferent character from either Welch or Osier, he too had a
most attractive personality. Despite his flair for the dramatic,
Kelly was a humble man, deeply religious, often calling to-
gether staff, nurses, and visitors, if any, for a brief word of
prayer before his operations.

With these four men as the leaders, the future held great
promise. They were all young when the hospital opened its
doors in 1889 Welch was thirty-eight, Osier forty, Halsted
thirty-seven, and Kelly thirty-one. The entrance requirements
to the Medical School, when it opened four years kter, had
been set higher than any in the country, 5 and the unique sys-
tem of residencies which enabled a man to work up to chief
resident and then to remain in his job, if he so desired, laid the
emphasis where Billings had wanted it. It meant that a few men
were trained very well as against many trained for only a brief
period, and the system, despite the criticisms of those who
were not chosen to reap its benefits, attracted ambitious stu-

5 For the first time in an American medical school, a college degree was
required for admission and, in addition, certain specified courses in the
sciences and a reading knowledge of French and German.

HARVEY CUSHING

dents of unusual ability and spirit and produced men of su-
perior stature.

The air was full of anticipation and opportunity it per-
vaded the hospital and extended even to Louie Hanselman's
bar where medical students, interns, and residents, and some-
times the chiefs, gathered to discuss the cosmic problems of
their hospital world over sandwiches and beer. The chiefs did
much to foster this atmosphere of enthusiasm and good will
by their deep admiration and respect for the special talents of
one another and their common desire to further research and
set new standards in medical education and medical care,
Harvey Gushing was aware of this spirit when he visited the
Hopkins as soon as he had "settled in" as assistant resident, it
began to take hold of him and to drive his ambitious mind in
many directions.

RESIDENT IN SURGERY
Chapter IX

a

F N NOVEMBER 6 GUSHING SAW HIS

first rase of spinal cord injury when the wife of a brawling
bartender was brought into the hospital with a bullet in her
neck. From the fact that she was paralyzed on one side and had
no feeling on the other he was reasonably certain that the
bullet was touching the spinal cord. He put to use an old static
machine and with the X-ray tube he had brought with him
from the M.G.H. (somewhat to the consternation of the staff
there) he ground out the first X-rays to be taken in the new
hospital. Sure enough, the bullet was lodged near the sixth
cervical vertebra, but since it had only half severed the cord,
there was nothing to be done and during the slow convales-
cence Gushing made a thorough study of the anesthetic areas
resulting from the pressure of the bullet. He made it the sub-
ject of his first medical report.

At Christmas time he and a newly made friend, Norman B.
Gwyn of Toronto, filled some of the big stockings used in the
operating room for the children on the ward. "I was surprised
that we could fill them so as to make them hang in the proper
bulging fashion of the preverbial Xmas stocking." He helped
a little girl empty hers and told his mother that -when he came
to Alice's Adventures in Wonderland at the heel he would
gladly have been transported back eighteen years.

The letter was written on New Year's Eve and he added
reflectively: "It has been rather an eventful year for me despite

79

SO HARVEY GUSHING

thz sequestered existence I have led. Ten months of hospital life
divided between two big institutions means a very narrow and
at the same time a very broad experience. Narrow as regards
acquaintance with people and things not medical broad in re-
spect to a little but wonderfully full hospital world. The City
bells are clanging away at this moment and I guess the old
gentleman is getting ready to slink away with his hourglass and
sythe. The noise of the bells is pouring in through my wide
open window, for it is quite springlike outdoors, and the twang
of a banjo is stringing in to meet it through the open door to
the tune of 'Sally in our Alley.' The approach of the New Year
is not a serious occasion to everyone."

The first important event of the new year was a visit from
Ned and Melanie Harvey who had just announced their en-
gagement. He shared the family's delight in the match but at
the same time was somewhat jealous, for he suddenly realized
that no longer would he be the principal object of Ned's affec-
tion. However, he showed none of this except in telling his
mother that he felt a little sad about it for it seemed as if he
had lost Ned.

This visit was followed by one from Kate Crowell. To tease
her, he had assured her shortly after his arrival in the autumn
that yes, the nurses were pretty a French girl by the name
of Miss Mahoney on his ward being especially nice. Perhaps
Kate came to see for herself at any rate she visited the Good-
willies in February. On one occasion Gushing had to break an
engagement with her and left a note saying, "You see what sort
of a person I promise to be not to be depended on even for
dog shows. We are going to operate at 4 on an emergency case.
Will tomorrow do?"

Although closer contact with Halsted had contributed little
toward an understanding of the "Professor," as he was called,
Gushing had come to respect his ability. At the Massachusetts
General where speed was considered important, the surgeons
had "operated by the clock," and Gushing was therefore much
disturbed when his first patient had not come down from
Halsted's operating room for more than four hours and he had
prepared a hypodermic of a powerful stimulant; but to his

RESIDENT IN SURGERY Si

amazement, the patient was in far better condition than the
patients whose operations had lasted twenty minutes at the
M.G.H. This was his introduction to the painstaking methods
of his chief the careful tying of each blood vessel, the meticu-
lous effort to keep the tissues from drying, the matching of
each wrinkle in the closure of the skin.

Despite his good foundation in operative technique, Gushing
found he still had much to learn, and he was therefore greatly
pleased to have Halsted, in April, suggest that he be advanced
to Resident in Surgery the following year. However, Joseph
Bloodgood, who then held the post, had not finished his re-
search and wanted to remain another year. Some uncertainty
resulted, and Gushing, unwilling to compromise, threatened to
resign. But the Professor went out of his way to make things
agreeable, offering to create a fellowship in surgery for Blood-
good if necessary and to do anything else that would make
the place attractive. Gushing finally calmed down and accepted
the divided responsibility without further ado.

Halsted, he had discovered, expected his house officers to
make their own bacteriological studies, and although he had
had a course at Harvard, he found his knowledge meager when
compared with that of his present contemporaries. During this
first year, therefore, he spent many an evening hunched over
a microscope on the second floor of the Pathology Building
with a German book in one hand. This extracurricular activity
added to his regular duties, plus the responsibility of the sur-
gical clinics during Halsted's frequent absences, left him in a
state of perpetual tiredness so tired that on visits to the dentist
he would fall asleep while being worked on "to the dentist's
amusement and my satisfaction," he wrote his mother.

His letters home consequently were infrequent and brief,
while his father's letters, on the other hand, from the leisure of
retirement, became longer, and were full of encouragement,
humor, and items of interest about books, medical affairs, and
such social gatherings as reached his notice. One from which
he could not escape was the marriage, on June 9, of Ned and
Melanie, and he wrote Harvey: "Please hurry up and get home
as soon as you can. The wet, and rather cold, Spring has de-

82 HARVEY GUSHING

veloped a rich green of grass and leaf rarely seen. I do not hear
all of the domestic talk [Dr. Kirke had become somewhat
deaf], but from what I do get, should presume that new dresses
and personal adornments were chief subjects. I think Ned is
rather sick of the fashionable prerequisites of marriage, and
will be glad to have it over, though he bears up bravely."

Gushing had a month's leave of absence during June. In addi-
tion to the wedding, he attended his sixth class reunion at Yale
where he played baseball with the graduate nine. He then went
on to Boston and the M.G.H. and wrote his father that it was
the most attractive place he knew of and professionally with-
out a peer. He was especially interested in their progress with
X-rays, since he was then doing all of the X-ray work at the
Hopkins.

During the summer his correspondence with Halsted, then
at his summer home in High Hampton, North Carolina, in-
dicated that they were on more easy terms. Gushing reported
on their various patients and suggested certain improvements-
better food and higher wages for the orderlies, a new plan for
handling ether convalescents, and more systematic methods on
the wards. Halsted thanked him for writing when he was so
busy and added: *1 am grateful to you for such suggestions &
hope that you will never hesitate to criticise freely what you
consider existing evils."

In September, Gushing himself became one of Halsted's
patients. Late in the month he developed an acute pain in his
abdomen which he diagnosed as appendicitis and he implored
Halsted to operate at once. Appendectomies were then only
ten years old and were undertaken with some reluctance. Gush-
ing had seen the operation in Boston (where appendicitis as a
pathological entity was first described by Dr. Reginald H. Fitz
in 1886) and had done an appendectomy himself just a few
weeks before, only to lose the patient later from peritonitis.
He therefore knew the dangers. However, the operation, per-
formed on September 28, was successful, and his convalescence
not unpleasant. He assured Kate Crowell that he was having a
beautiful time "am perfectly well, literally living in a bed of
Roses [sent to him by the children on the ward] . . . There

RESIDENT IN SURGERY 83

are great baskets of fruit outside each window, a lot of rare
old wine in the wardrobe and everything one could wish to
read on the table."

Halsted and Osier wired his father daily, and Ned came
down to see him immediately, but Dr. Kirke postponed his
coming until later. "Very glad to be informed that you can
step a little, and can wear, part of the day at least, something
besides bedding," he wrote. "... I hope to walk in upon you
Monday or Tuesday. . . . Probably I shall not have much
capacity for sightseeing, but will only want to get my boy and
bring him home."

One gathers that during this visit Gushing finally asked Kate
Crowell to marry him, although they said nothing to anyone.
Two days before Christmas he wrote her: "I have done no
Christmasing and will consequently feel very badly when peo-
ple send things to me because exchange of gifts is one of the
nice things about Christmas. So this letter and my love and
the picture, when it comes, is my little gift to Katy- Fm afraid
the second item is not a gift, however, as you've had it in your
possession so longlonger than I knew perhaps."

The year's end brought a warmly affectionate note (in grati-
tude for a Christmas present) from his good friend Max
Brodel, the artist whom Dr. Kelly had induced to forsake his
native Leipzig in 1894. To his associates at the Hopkins, Brodel
brought a wealth of creative talent, for he was both artist and
musician, and they in turn taught him anatomy and surgery
so that the medical drawings for which he became famous were
superb both in scientific accuracy and artistic beauty. With
this simple, jolly, friendly man Gushing had much in common.
They exchanged German and English lessons, and Gushing
studied drawing with him a fact which was to contribute
greatly to the perfection of Cushing's own medical drawings.

During his convalescence from appendicitis, Gushing had
become interested in having a bookplate for the library he was
0-radually acquiring as textbooks and birthday and Christmas
books accumulated. This year he had received a volume on
old Virginia from his mother, Dr. Holmes' life and letters, and

84 HARVEY CUSHIXG

a biography of the French surgeon, Ambroise Pare, from
brother Will. His pride in possessing books was growing, en-
couraged by visits to Dr. Osier's library. He tried his hand at
sketching a bookplate, which he sent to Dodd, Mead and
Company in late December. During the early months of 1 898
the well-known designer, Edwin Davis French, did a finished
drawing from the sketch and eventually the bookplate was
printed for the use of the whole family. It was a small rec-
tangle, employing in its simple design the Gushing crest, the
Gushing motto (virtute et numijie-by valor and divine aid), a
skull, and a variation of the caduceus of Mercury. It bore the
initials of all the Gushing doctors David, Erastus, Henry
Kirke, Ned, and Harvey, together with the dates of their
medical degrees and was so arranged that initials of any future
Gushing physician could be added.

Early in January, Gushing was invited to a dinner at the
Halsteds a rare occasion. The Professor was an epicure, and
infinite care went into each item of the menu consisting of
caviar on thin slices of toast, bouillon, roast oysters, a terrapin
stew, asparagus, quail in jelly with pate de f oie gras, an omelette
souffle, an ice, crackers and Camembert, fruit, candy, and
coffee which had been roasted that afternoon. All this was
accompanied by rare wines from the cellar of Mrs. Halsted's
grandfather, who had been a Southern aristocrat of wealth
and position.

This evening was in sharp contrast to an afternoon the fol-
lowing month when Gushing took Kate Crowell to call while
she was visiting the Goodwillies. On that occasion there were
only two grate fires to warm the magnificent stone house full
of rare old furniture, and Mrs. Halsted, who had been work-
ing with their dogs, met the young guests in a dirty butcher's
apron. "They are so peculiar, eccentric, so unlike other people
yet so interesting doubtless because of their oddities," Gushing
wrote his mother, "that one is inclined to shelve his thoughts
about them alongside of those of people from fiction Dickens
perhaps."

Kate CrowelTs visit to Baltimore was followed by a letter
from Gushing to her mother (her father was not living) saying

RESIDENT IN SURGERY $$

that he hoped she would give her consent to their marriage.
Mrs. Crowell's gracious approval, when it came, filled him
with deep happiness and something of this went into a letter
he wrote to Kate on March 15 a letter which opened wider
than usual the door to his mind and heart:

My Darling Girl

I have just come upstairs after the usual late lunch of pickings.
We have had two very hard days operations and operations.
Yesterday from ten in the morning till half past seven. One of
my very best operating room nurses cut her hand and divided
some of the tendons so that she, poor thing, had to take her turn
on the table and learn what anaesthesia means and all the rest.
She has been a good soldier and will look on it some day as I do
a good experience Fin quite sure. That kept us late yesterday.

Excuse this shop talk, Katy. I'm brim full of it. People don't
know what it means. Here I am, a youth, doing surgical work
that not one of my school confreres will hope to do for years.
It frightens me sometimes. The Chief rarely operates. Today I
did all his private cases. Everybody seems to do well, however.
I've been so fortunate lately that I hardly dare to speak of it lest
some day may come a fall.

I think it's all due to you. I'm so happy, I have so many new
thoughts and sensations it seems like a different world to me. I
never felt my strength so before never so confident of my abil-
ity to surmount obstacles. I've done more good work since I've
had you to help me than ever before. I hope you won't mind
these little confessions.

A week later he sent her a printed leaflet entitled "Special
Courses for Graduates" which showed that Dr. Gushing was
scheduled for the course in surgery at 8:30 a.m. on Mondays
and Wednesdays from May i to July i. These courses were
"refresher" courses for practising physicians, who often came
considerable distances to take them. "What will you say to this
schedule, Katy? I am afraid it [their wedding? ] cannot be till
July. I've got to get up very early in the morning from May
i to July i, 1 898. Perhaps no one will come to my course, how-
ever, and then I can come to yours. Think of my trotting old
greybeards about the wards and teaching them surgery."

Besides this graduate course in surgery, the spring brought

86 HARVEY GUSHING

several other events of importance to him. In March came the
news of a nephew, Edward H. Gushing, whom Ned and
Melanie decided to call "Pat" for short. April brought declara-
tion of the Spanish-American War, provoked by the blowing
up of the Maine, and many of Cushing's friends went off,
leaving him feeling somewhat restless, but he occupied himself
with a new interest the gall bladder doing his experimental
work on animals. He also wrote up the results of a study he had
begun the preceding autumn. Because of several deaths from
improper etherization, he had commenced to investigate the
possibility of local anesthesia by injecting cocaine into the
proper nerve trunks. The use of cocaine in this connection had,
of course, already been largely discovered by Halsted the dis-
covery for which he was paying so dearly but the published
account of his work was unknown to Gushing and he was a
little baffled and disappointed when Halsted was seemingly in-
different to his efforts. He first employed the drug in an ampu-
tation at the shoulder. Later he successfully extended his use
of cocaine to operations on the hip and for hernia the latter
being the basis of his paper. He presented it before the Johns
Hopkins Medical Society on May 8, 1898.

The Johns Hopkins Medical Society, together with the
Johns Hopkins Historical Club and the Johns Hopkins Hos-
pital Bulletin, were all started the first year the hospital was
opened. Welch and Osier were the moving spirits in their
establishment, with loyal support from Kelly and Halsted, and
their wisdom in thus providing an outlet and a means of en-
couragement for young men who were just starting was repaid
a thousandfold, for all three were powerful instruments in
promoting and spreading the vigorous spirit of the Hopkins.
Regularly on the first and third Mondays of each month a
large and enthusiastic crowd filed into the amphitheater for
the sessions of the Medical Society, the Historical Club
meeting once a month. These meetings served to make men in
different departments of the hospital acquainted with one an-
other and with the work going on within the hospital walls,
clinical as well as scientific. Interest ran high, the meetings often
exceeding the prescribed limits of 8:30 to 10 o'clock. The

RESIDENT IN SURGERY Sj

faithful attendance of the chiefs themselves in all kinds of
weather was a great inspiration, and often they invited men
from other medical centers and from foreign lands to read
papers and take part in the discussion, on these occasions
usually arranging a dinner at the Maryland Club beforehand.

During the spring the days for Gushing flowed into one
another, a new one beginning when he had barely closed his
eyes on the one before. He wrote Ijfs father that he needed a
change of scene a couple of deaths from streptococcus infec-
tion, although not among his own patients, had caused him to
lie awake seeing chains of "streptococcus devils" on all sides.
But it was hard to get away. "When people are sick I have to
live with them and when they get well I don't feel like pulling
out." However, an attack of bronchitis in April sent him off
alone to Old Point Comfort to recuperate, and he had a second
respite from his strenuous schedule when he and his good
friend Thomas McCrae, a Canadian who was resident in medi-
cine under Osier, went to Fredericksburg, Virginia, for a rest
and change.

From July 10 until August 8 he had a real vacation, going
first to Boston, where he spent most of his time "hospitaling,"
then on to Lenox in the Berkshires to visit his friends the
Chapins, next to New York to see Grosvenor Atterbury, and
finally on July 23 he started for Cleveland where the next day
he joined his mother, Ned, Melanie, and the baby Pat, and
Kate Crowell on a trip up the Great Lakes.

A week after his return to Baltimore his mother wrote him:
"I have learned but little of you from your brief communica-
tion to Dr. H. K. Gushing, and nothing at all from any letter to
Mrs. of the same name. I am sorry that you had to exchange
this delightful temperature, and these delicious days and cool
nights, for the heat of Baltimore so soon." She closed her letter
with this: "A lady who shall be nameless, told me last week
that she had heard that Harvey & Kate Crowell were engaged
or words to that effect. So you find that you need not be so
indignant with your Mother for her insinuations. *A word to
the wise is sufficient.' Your loving Mother, Bessie M. Gushing."

88 HARVEY GUSHING

Although Kate was very much a member of the family on the
Quting up the Great Lakes, Gushing still had not revealed the
true state of affairs between them. In fact, Kate Crowell had
several years to wait while he pursued his jealous mistress,
Medicine.

After the fall of Manila on August 13, and the end of hos-
tilities, the troops began to straggle home. Typhoid had been
a more disabling foe than the enemy, and Gushing was sent
late in August to Alabamajro assist in bringing back a trainload
of patients, making several trips for this purpose. Here he had
his first contact with typhoid perforation of the gut, and the
operations which he performed were the subject of two papers
which won for him considerable recognition, Reginald Harri-
son, a prominent British surgeon, wrote him: "Please accept
my best thanks for your reprints on TLaparotomy for intestinal
perforation.' It is a very admirable piece of surgical work &
one that is likely to be of great service to the profession. Your
first case is unique so far as my knowledge of the subject goes.
The whole essay is so well drawn up as to leave nothing to be
desired. It makes me almost regret that my field of work in
surgery lies almost entirely now in other directions."

His father also thanked him for a copy of the paper, which
he had read with great interest, and then went on to describe
his progress with the collection of portraits, photographs, etc.,
of Benjamin Franklin recently begun "Your mother smiles
primly, but it is as interesting to me as mat making seems to be
to her."

During the autumn there was admitted to the Hopkins a
thirty-three-year-old farmer from Fincasde, Virginia, who had
previously come to the hospital in March of that year and been
dismissed after observation. On October 26 a presumptive
diagnosis was made of bleeding peptic ulcer, and he was trans-
ferred to the surgical service for operation. The case came to
Gushing as the resident surgeon and he thought the man's
symptoms indicated splenic anemia, 1 about which he had been

1 This case got into medical literature as Banti's disease not once but
twice because of the second admission.

RESIDENT IN SURGERY 8$

reading in his recently purchased Allbutt's System of Surgery.
With some trepidation he went to Dr. Osier, told him what
he believed, and asked whether he might take out the man's
spleen if on operating he found no sign of pyloric ulcer. Osier
told him to go ahead and do what he thought best.

Gushing the next day made the primary incision on the right
side, found nothing, and then proceeded through a new in-
cision to take out the man's spleen the first splenectomy at
the Johns Hopkins Hospital. The patient recovered and two
years later wrote to Gushing as follows:

Dear Sir men of good business have advised me to write to the
Hospital as it is well known there can be no advertisement put
out that will represent the Hospital as well as the scars on my
body. I can readily see and know and have knowed for some time
that I can send many af&icted people there that never will come
until they see what had bin don for me. . . .

Since Gushing did not take advantage of this opportunity to
advertise his skill, two years later the man was peddling a
patent medicine and attributing his recovery to it!

Cushing's pioneer work on typhoid perforations had further
whetted his interest in bacteriology, an interest which was
encouraged by Welch and his pupils Simon Flexner, Nor-
man Gwyn, and Louis Livingood. Indeed, their influence
was all-pervasive, for on some notes of this period, Gushing
later wrote: "In the old days of the Hopkins everyone was en-
gaged in some sort of bacteriological work and had a pet or-
ganism which he was ardently cultivating. Young, I recall,
had a strange bug that one day was a bacillus, another day a
coccus, either in chains or pairs, and we called it the original
Adam bacillus." Gushing himself was interested in a bacillus
which he had found in a culture from a young Negro who
had been operated on for an abscess of the rib following a pro-
longed fever, possibly typhoid. He corresponded with such
authorities in the field as Theobald Smith and Walter Reed
and eventually named his bacillus "O." This work resulted
in a paper with a four-line tide and a flourishing friendship
with Simon Flexner who was called upon to criticize this and

HARVEY GUSHING

other papers on bacteriological subjects (he later published
two more).

In July he teased his mother about dating a letter a week
ahead said it was extraordinary of him to discover it because
he rarely looked at dates or knew what the day was.

... I am having a dogged hard but very profitable summer
privaledged to seek my own ends unembarrassed by students.
Morning rounds, operations daily, laboratory work in the after-
noon, littrary work when I can, German lesson every night with
Brodel, more rounds, reading and littrary work till midnight and
a chapter in Thackery before my light goes out combine to make
a busy day and let us hope no emergencies during the night.
Since the GVillies departed I have hardly been away from the
hospital. ... I have some very indefinite plans about going
abroad in the fall October or November or Sunday after next
i.e. some remote period.

AiFy, Harvey.

On September 2 Gushing did his first Gasserian ganglion re-
section. It had become clear that those who suffered from
acute attacks of excruciating pain on one side of the face
trigeminal neuralgia or tic douloureux were victims of irri-
tation of the nerve ganglia which supply the skin of the face.
The Philadelphia neurologist, W. G. SpiUer, had suggested that
relief might be obtained if the ganglion could be surgically
excised. Gushing was one of the first to act upon the sug-
gestion, and in his early cases the relief was so dramatic that
victims of the condition from many parts of the country were
referred to him indeed the operation proved a source of
bread and butter while he was developing less lucrative phases
of neurosurgery.

The new year brought a pleasant and flattering surprise
an offer of a post in the Department of Surgery at Western
Reserve University. While his mother and father would both
have been glad to have him at home, his father, after giving
him a suitable interval in which to make up his own mind,
finally told him that he believed him to be better off where he
was "it does not matter so much what your title is, or what
your relative rank is; the great thing is the opportunity to do

RESIDENT IN SURGERY

good work and to have it recognized." William Welch wrote
a warm letter of congratulation but made it very clear that,
although he did not know what they could offer in the way
of advancement at the Hopkins, he sincerely hoped that
Gushing would stay with them which he eventually decided
to do.

Details about his work went to Kate Crowell: "Kate, you
are the very best girl that ever lived. I have been very
much worretted of late over a man I'd give my right hand to
save but am losing him after all and I need you very much."
And again late in February: "I have been having a fearful
whirl for 48 hourswrote a long paper under pressure for the
Phila' Medical Journal. Had to get it off at 10 o'clock tonight.
Stenographer here all day and Tammas [McCrae] correcting
manuscript. I'll never be so foolish again even as a favor nor,
I hope, so sleepless."

This constant driving of himself, both to achieve recogni-
tion and to accomplish a little more than the next person,
often took him well beyond his wiry endurance. Taut nerves,
combined with the confidence acquired through his rare op-
portunity to do so much independent operating at an age
when most surgeons were still serving their apprenticeship,
resulted in self-assurance bordering on arrogance and impa-
tience, frequently ill-concealed, with his co-workers and even
with the Professor himself. Effie J. Taylor, Dean Emeritus of
the Yale University School of Nursing, who was a head nurse
at the Johns Hopkins during these years, remembers him as
difficult to please and not always popular with the nurses and
staff. But she also remembers vividly his absolute devotion to
his patients and his tender concern for their welfare whatever
the cost in time and effort on the part of the staff. Although
this did not endear him to his equals, it brought him the un-
qualified confidence and admiration of those entrusted to his
care.

In March he wrote Kate: "I shall certainly leave sometime
in June and burn my bridges. The Professor and I do not
quite gee. I think I embarass him. He had not been over for
ten days and its rather hard work with Mitchell sick and all

$2 HARVEY GUSHING

the rest. Hence my depression which I will shake off in-
stanter." During this series of bad days when Halsted was un-
able to come to the hospital, he sent notes to Gushing. On
many of these, all of which he saved carefully, Gushing wrote
comments, several revealing his impatience. The first note
read:

Dear Gushing, Dr. Fioney will hold my clinic for me this a.m.
I have caught cold again and think it more prudent to remain at
home. I hope our case of yesterday is not dead.

8:30 Friday

If any goitre cases turn up, please ask them to come again next
Friday. I will pay their expenses.

Across the top of the letter Gushing had written: "Professor
out at dinner Thursday night at Finney's." At the bottom he
added: "Friday morning, Mar. 16. I explained to the patients
and paid their expenses."

On Saturday Halsted wrote that he had a splitting headache
in addition to his cold and could not operate. "If my patients
for today do not care to wait until Monday, please operate
upon them & oblige. Yrs sincerely, W.S. Halsted." On this
note H.C. had written: "Mrs. Taylor did not choose to wait.
Femoral hernia with tuberculous peritonitis."

On Wednesday came yet another note from Halsted, warn-
ing Gushing of the arrival of another patient and giving direc-
tions for her reception. Across the top Gushing had penned:
"The Professor operated Monday on a 'wry neck.' Since the
Stomach case (15 March) this is his first operation. We have
averaged six a day since his absence and have almost caught
up." And again: "Dear Gushing, You may have the operating
room tomorrow, for I should like to watch the cases which
interest me at present for a day or two longer. P.S. I send over
some papers for the one-armed boy in D." This brought from
Gushing: "Characteristic note of the Professor not operated
for a week. One-armed boy left hospital a week ago."

During the spring, plans for a trip to Europe again began
to occupy him. Thomas McCrae, Simon Flexner, the Osiers,
another Hopkins friend, Henry Barton Jacobs, were all go-

RESIDENT IN SURGERY

ing abroad, and although he was not as enthusiastic about the
opportunity as he had been in medical school, the advice of
his father and Ned added to that of Osier and Welch con-
vinced him that it was time he went. He knew there was prob-
ably only one surgeon in Europe (Kocher in Switzerland)
who excelled HaJsted in operative technique, so he was not at
all certain he could learn more in Europe than he could right
at the Hopkins. Furthermore, he wanted to get on with work
that would add to the reputation he had begun to acquire
through his papers on typhoid perforation, splenectomy, bac-
teriology, and trigeminal neuralgia so that he could establish
himself and get married. But once again Medicine won out,
and Kate Crowell loyally went on waiting.

With some fine new trunks, supplied by his father along
with letters of credit, and a single letter of introduction from
Welch to Victor Horsley, one of the foremost surgeons in
London, Gushing sailed for England on June 23, 1900.

YOUNG PROVINCIAL
ABROAD

Chapter X

T

JLH

.HE MEDIOCRITY OF HUMAN KIND

when they have shifted their responsibilities to the sole duty
of holding down their respective steamer chairs is depressing."
With this misanthropic observation, Harvey Gushing began
his journey to Europe. The depression that came over him
each time he left familiar surroundings was not long in ap-
pearing: "I shall apparently be alone with a few books, some
tobacco, my thoughts, and some pretty keen regrets at throw-
ing up the J.H.H. . . . This relaxation from hospital strain
leaves one like a bicycle with a collapsed tire."

From the day he landed in Liverpool until his departure
over twelve months later, he kept a detailed diary, much of it
medical. The journal also records, however, his reactions to
people (often astute but often impatiently critical), his visits
to museums and to other places of note. But never is there
mention of politics or such things as the Boer War, the Boxer
Rebellion (which led to Russian occupation of Manchuria
and the Russo-Japanese War), the death of Queen Victoria
after a reign of sixty-four years, or the growing imperialism
of Germany.

On the third of July he reached London and settled him-
self at 69 Torrington Square in Bloomsbury, not far from
the British Museum, with Thomas McCrae. The next day he
breakfasted with Victor Horsley, Surgeon both at the Uni-
versity College Hospital and at die Hospital for the Paralysed

94

A YOUNG PROVINCIAL ABROAD pf

and Epileptic at Queen Square, the oldest and most cele-
brated hospital for patients suffering with disorders of the
nervous system. Horsley was the first surgeon in England to
devote himself largely to the nervous system.

Only twenty-four years earlier, in 1876, William Macewen
of Glasgow had diagnosed a brain tumor in one of his patients,
but permission to operate had come too late the diagnosis
was confirmed at autopsy. Eight years later, a brain operation
was successfully performed in London on a living patient by
Sir Rickman Godlee, nephew of Joseph Lister; the first in
America was carried out in 1887 by Dr. W, W. Keen of the
Jefferson Medical College of Philadelphia, where the tumor
he removed is still preserved in the medical museum. These
operations landmarks in the history of surgery would not
have been possible before the discovery of anesthesia (1846),
the introduction of aseptic methods by Lister (1867), and the
studies of Fritsch and Hitzig on the motor area (1870). These
studies, which indicated what part of the brain governed sen-
sation and movement of- various parts of the body, had been
carried forward by David Ferrier, Hughlings Jackson, Wil-
liam Gowers, and other neurologists, and it was on the basis
of the knowledge they had accumulated that Macewen was
able accurately to determine the location of the tumor in his
patient of 1876.

Victor Horsley had performed his first brain tumor opera-
tion on May 25, 1886, and the following year had success-
fully operated on the spinal cord. That same year he per-
formed an operation for the relief of symptoms where
removal of the tumor was inadvisable a measure Gushing was
later to call a "decompression." Despite discouraging results
in his early attempts, Horsley had persisted until by 1900 he
had performed a number of successful operations. It was there-
fore with considerable curiosity that Gushing made his way
to 25 Cavendish Square x on the morning of July 4. He found
Horsley a dynamic, energetic man of warm personality. Mrs.

1 Previously the temporary dwelling of another great student of the nerv-
ous system and predecessor of Horsley's at Queen Square the French
physiologist, Charles-Edouard Brown-Sequard.

$6 HARVEY GUSHING

Horsley and the children joined them at breakfast, and Hors-
ley divided his attention between them, his guest, and a male
secretary-somewhat to Cushing's discomfiture. At nine
o'clock he saw what he had come for an operation on the
brain, and was horrified by the fact that only ten minutes
were given to antiseptic preparation. He reported to his father
later: "I am a little disappointed in Victor Horsley. His place
is in the laboratory doubtless. I have seen him do some in-
teresting things, however neurological mostly. A spinal case
today causing paraplegia and a brain case a few days ago.
Monday he operates on the Gasserian ganglion which I will
watch with interest. The technique of all of these men is ex-
ecrable from our standpoint and they must have many septic
wounds."

Probably unaware that he fell short of the high standards
of HalstecTs apt pupil, Victor Horsley went out of his way
to be kind to Gushing and help him get established in London
and see the people and things that interested him. Osier also
saw to it that he met many of the men who were prominent
in British medicine among them Jonathan Hutchinson, Sir
William Broadbent, Sir William Gowers, and Sir James
Crichton-Browne. It was a rare opportunity for a young man,
and he was grateful for it "It's a treat to go about with Dr.
Osier," he wrote his father. "He gets at the meat of things
in an extraordinary way."

Sometimes alone and sometimes with his friend Henry Bar-
ton Jacobs, he visited the hospitals of London St. Bartholo-
mew's, founded in 1137; St. Thomas's (1215); Guy's Hos-
pital (1725). The spirit of "the great men of Guy's" hung
over the hospital Richard Bright, Thomas Addison, Thomas
Hodgkin, and James Parkinson, to mention a few, all of whom
described diseases still known by their names. "It's a fine place,
less old fogyism than in our comparatively young institutions
as the M.G.H. for instance."

It was at the Hunterian Museum, however, where the past
was most vividly evident. As he returned again and again to
the great museum with its more than 1 3,000 specimens of dif-
ferent species their variations in health and disease he felt

A YOUNG PROVINCIAL ABROAD 7

strongly the presence of John Hunter, the colorful Scot who
had elevated surgery to a branch of scientific medicine and
founded the science of experimental pathology.

Along with his professional activities Gushing began to seek
out a little of the flavor of old London. Around the corner
from Guy's was the George Tavern "a delightful old place
in which Sam Weller first makes his appearance in Pickwick
Papers. . . . This morning I passed 'Bleak House' and the
'Old Curiosity Shop' when coining away from the Royal Col-
lege of Surgeons which is in Lincoln's Inn Fields." He rode
on the top of a bus "through old London once fireswept in
the days of Mr. Pepys." And one night he dined alone in Ox-
ford Street for three shillings and was charged sixpence extra
for not drinking wine, which made him somewhat indignant.
He was not a little disturbed at the consumption of wine in
England said the question was always 'What wine?" not
"Shall there be wine?" However, he admitted that it seemed
to enliven a distinguished dinner party given by Jonathan
Hutchinson for Dr. Osier. Although he felt "rather out of
it," he nevertheless was flattered to have been asked.

After a week end with the Osiers at Swanage, in Dorset-
shire, a small village at the head of a bay lined with great
chalk-white cliffs looking toward the Isle of Wight, he re-
turned to London to be present at the centenary celebration
of the Royal College of Surgeons of England. Physicians came
from all over the world for the ceremonies, and Gushing at-
tended the gatherings and demonstrations with eager interest
and was overjoyed to see faces from home Drs. Warren and
Richardson from Boston, Dr. Keen, and Dr. Halsted. A few
days later he left for Paris, after saying good-bye to Halsted,
who had received an honorary degree at the celebrations, the
Osiers, and Humphry Rolleston, grandson of Sir Humphry
Davy, who had observed the anesthetic qualities of nitrous
oxide in 1800. "R's a daisy [his appellation of highest praise],"
wrote Gushing, "interesting talk and many fine old books."

At high noon on the first of August he kept an appointment
in the Eiffel Tower made six months previously with his Hop-
kins friend William MacCallum, and together, during the next

$8 HARVEY GUSHING

week, they attended the i3th International Medical Congress.
For the second time Gushing saw the pomp and color of a
great international gathering seventy-nine-year-old Virchow,
who had promoted the theory that all living matter is com-
posed of cells, was, with Lord Lister (seventy-three) the center
of attention. Another picturesque figure at the Congress,
Ernst von Bergmann, was of special interest to Gushing be-
cause he had achieved prominence for his work on head in-
juries and cerebral diseases. But the medical meetings in vari-
ous languages proved somewhat dull, and he escaped one day
with William J. Mayo and A. J. Ochsner, a well-known Chi-
cago surgeon, and, on a stone balustrade overlooking the
Seine, they planned a society of their own which eventually
came into being as the Society of Clinical Surgery.

The Congress over, Gushing moved to the other side of the
Seine and found a small room in the Latin Quarter where he
would hear more French, and from which he went daily for
six hours of "hospitaling" and some sight-seeing around Paris
which he loved. The hospitable French were much more like
Americans, he thought, than the English.

In the hospitals he was horrified at the careless operative
technique, the utter disregard for the feelings of patients-
women examined publicly, men bared promiscuously the
lack of histories, the poor, dirty, overcrowded wards, and the
indifferent attention to such things as anesthesia, asepsis, and
records. His diary became full of detailed notes about opera-
tions, equipment, drugs, etc. He noted that interns sometimes
held their jobs for four years and rotated, and that they
received 100 "franks" a month. Finally, at the Hopital de la
Pitie he saw Henri Hartmann operate. "First really good work
I have seen," he commented. He visited Hartmann's labora-
tory, admired his "scientific instincts," and came away from
dining at his home loaded with reprints, some of which he sent
immediately to Halsted.

On August 1 6, Grosvenor Atterbury arrived in Paris, and a
week later they went together to the "most picturesque place
in the world," Le Puy-en-Velay, a neat village of century-old
charm little visited by outsiders. Inspired by the beauty of

A YOUNG PROVINCIAL ABROAD

99

the countryside and the simplicity of the people, Cushing's
sketches on this trip were the most finished artistically of all
those which appear in his travel diaries. 2

After another month in Paris, Gushing left on October 1 1 for
Berne, Switzerland, in the hope of working with Theodor

'Hn^^uO

T3Sa<Fp^

Avergnat-Romanesque Church at IssoireEglise de St. fauL
From Le Tuy diary, 1900.

Kocher, the brilliant surgeon whom Hoisted so much ad-
mired. Along the way he visited in the clinics of the distin-
guished physicians of France and Switzerland Louis Dor, the
ophthalmologist, at Lyon; Auguste Reverdin, professor of
surgery at the University of Geneva; Cesar Roux of Lau-

2 This diary, A Visit to Le Puy-en-Velay, was published in a limited
edition (now exhausted) by The Rowfant Qub, Cleveland, in 1944.

too

HARVEY GUSHING

sanne, who came nearer to being the kind of man he was look-
ing for than anyone he had yet seen.

On October 31 he reached Berne, where he settled him-
self in a boarding house and began to explore the old walled
town with its seventeenth-century architecture, narrow ar-
caded streets, and curious gates. Kocher lived up to expecta-
tions. He was a slight, neat, rather short man, who was shy and
reserved and thus sometimes gave the impression of being
severe. For his work in clinic and operating room, Gushing

"There is more than one way of stealing your o*wn supper"
Front Le Puy diary, 2900.

had the greatest admiration. Here at last was what he had come
to Europe for "careful, painstaking work, elaborate tech-
nique, and all the rest which we have in Baltimore. A marked
contrast to Roux who was brilliant, showy, and rapid in his
work." And as for Albert Kocher, the son what operating!
"The J.H.H. outdone," Gushing wrote his father, "it's easily
seen why 'the Professor* thought so highly of their work."

But his high spirits waned as the days went by and Kocher
did not pose a problem which, he discovered, was a necessary
formality before he could work in the University laboratories.
Furthermore the weather, which was consistently rainy and
raw, with never a ray of sunshine, began to depress him. His

A YOUNG PROVINCIAL ABROAD

101

discouragement led him to the decision to leave Berne and go
to Heidelberg, but before he went he visited the physiological
institute, called the Hallerianum, 3 and was immediately at-
tracted by the friendliness of its director, Professor Hugo
Kronecker. "He is a kindly little man," Gushing wrote his
father, "a great friend of Dr. Bowditch [Cushing's physiology
professor at Harvard] a leader in his particular branch and
quite a favorite with American physiologists." Kronecker, on
his side, was taken with Gushing and evidently indicated to

Le Puy from the north. Drawn on a morning tramp to near-by
Polignac. From Le Puy diary , 1900.

Kocher that he would be glad to have him work at the institute.
The result was a formal invitation from Kronecker and prob-
lems from both him and Kocher. With work to do, Gushing
found the world a bright place again.

Kronecker not only made a place for him in his laboratory
but opened his home to him. Mrs. Kronecker and their daugh-
ter Charlotte were equally cordial, and their frequent invita-
tions were soon followed by invitations to the homes of other
professors in the University and of townspeople. Gushing
bought a sled which he named the "Gee Whizz" and in an-

3 Named in honor of the great Berne physiologist, Albrecht von Haller.

102

HARVEY GUSHING

other month was flying down the slopes outside the town
with an enthusiasm and gaiety which caused the heart of more
than one Bernese maiden to beat faster. But his own heart was

flowers near the ruins 0f the chateau at Allegre, 26
kilometers fro77i Le Puy. Fro?n Le Puy diary, /j?oo.

back in Cleveland, Ohio. To Kate Crowell he wrote on No-
vember 21:

My dear child, your letter troubles me a wee bit. When your
flag is not flying I always feel that I must chase home and marry
you instanter. It's wicked in me to have made you wait these long
years. If that moonlight night in Baltimore had never been, how

A YOUNG PROVINCIAL ABROAD 20$

different life might have been for you but oh! how empty and
forlorn mine would have been. There could have been no one
else and yet how selfish I am in my good fortune.

A month later he wrote again in this same vein:

I have no reason to suppose that there are any professional
plumbs [sic"] waiting for open mouths, or that mine would be

"Flying Through Snowy Space" on the Gee Whizz.
Berne, 1901.

selected were there any such. It certainly would not be should
I stop working and writing now. If after this year I should give
up the thought and hope of having a good teaching position
and should start in again on a new track, I know that you would
be my best help but I don't want you to be put in any such
position. I want you to move in with the house furnished and
the carpets down and a warm fire burning for you.

104 HARVEY GUSHING

Early in December, Professor Kronecker took Gushing and
J. Holmes Jackson, a Yale man who was also working in
Berne, on a mountain-climbing expedition to the summit of
the Niederhorn (6,445 feet). They spent the night in a small
inn at the base and, with a guide, started their climb the next
morning, carrying only some hard-boiled eggs and chocolate
in their pockets.The Jungfrau, the Wetterhorn, and the other
peaks were reflected in the lake at their feet, and Gushing
could not decide whether they were more beautiful by the
light of the full moon or when the morning sun first tipped
them with rose as the blue shadows receded. He sent his father
a glowing account, the letter continuing with comments on
his work and social life.

. . . It's very nice indeed to have the run of the physiological
laboratory and the Arbeit is a borderline one of surgery which
will profit me in the collateral reading necessary even if I suc-
ceed in accomplishing nothing of any import. The people are all
very kind in fact now that I have something serious to do it's
difficult to manage the social duties which seems to be expected
on all sides. . . .

Tomorrow night, for example, with Prof. Kocher to a Sam-
vnelreferat of the faculty (medical) at Prof. Zimmerman's; Tues-
day evening at the Kroneckers; Friday at the Rector's house
[president of the university] heavens! By day I am wildly irri-
gating frogs legs via the aorta with various kinds of transfusion
fluids and measuring muscle curves. I think tonight my own
would show marked evidence of fatigue, tested under similar con-
ditions,

But social functions, despite his mild complaints, contin-
ued to occupy much of his time. He and Jackson were joined
in January by another Yale man, John B. Solley, and the three
of them learned to wear their gloves until they reached the
dinner table, to dance a curious kind of German waltz with
their dinner partners after they had retired to the drawing
room when the meal was over, how to survive academic balls
lasting from eight in the evening until four in the morning,
with a large repast interlaced with speeches. "Eight mortal
hours think of it! I wish my frogs legs would twitch that

A YOUNG PROVINCIAL ABROAD 7OJ

long." But he felt at home in the friendly atmosphere of
Berne and entered into the spirit of things to the extent of
growing a professorial mustache. Despite his attempts to curl
it each morning, it had a tendency to droop after breakfast
and gave him the air of a villain in a rousing comedy.
To Kate Crowell he wrote of his progress: "We busy our-

From a letter to Mme. Jeanne Michaud of Berne to wish her good
luck in an examination at the University,

selves in the laboratory and try to make believe that we are
scientists which I for one am not and for that very reason
think it's good for me to work with those that really are so
that I can soak in some of their ways of doing and thinking."
To his father he reported that "Kocher seems pleased with
my results thus far, though it seems to me that I have hardly

106 HARVEY GUSHING

learned thus far the best methods or technique for carrying
on the research." His problem for Kocher involved finding
out what effect pressure in the brain had on circulation and
respiration. His experiments were carried out on monkeys,
and he conceived the ingenious idea of inserting a small win-
dow in the skull of an animal under deep anesthesia through
which he could observe the effect of increases in pressure
while recording respiration and blood pressure. He discov-
ered that if the pressure within the brain became elevated,
the systolic blood pressure rose correspondingly, but if at any
time intracranial pressure exceeded the blood pressure, the
flow of blood to the brain failed and the animal died.

"In addition to this," he wrote his father, "on off days I am
pegging away on a more strictly physiological research for
Kronecker with the most extraordinarily elaborate lot of ap-
paratusclocks and batteries and induction coils and trans-
fusion flasks for all sorts of fluids, all of which focus about a
miserable pair of frogs legs sometimes with green sometimes
with brown 'pants/ Prof. K. also seems pleased with results
though I don't know enough about the subject always to ap-
preciate them myself. In addition I am following Kocher's
clinics and the brain and stomach cases which he happens to
have also some other lectures during the week enough to
keep busy and get tired on as you may imagine."

In the back of his mind, as he went on with his work, was
the question of his future. In February, Thomas McCrae, to
whom he had apparently expressed some of his thoughts,
wrote him as follows: ". . . The Chief [Osier] asked me re-
cently what you were going to do. I said that I thought you
were uncertain and that you had no very clear idea of what
Dr. Halsted thought. ('No/ said the Chief, 'nor has anyone
else.') He spoke about your importance to the surgical side
as the man who had more c Geisf and go than anyone they
had. I hope you are not worrying over the future. Things will
shape themselves and you are sure of a good niche somewhere.
I wish that yours truly had one half the prospect."

From Baltimore came the impetus that prompted his first
attempt at historical writing. Osier suggested that he send

A YOUNG PROVINCIAL ABROAD 707

something about Berne for the Hopkins Bulletin, and this en-
couraged Gushing to write about Albrecht von Haller in
whom he had become interested during his first days in the
city. "Memories of Haller, the great Swiss physiologist and
poet, cling about Berne in many ways. . . . His best and
most enduring monuments are to be found on the shelves of
Kronecker's laboratory library 12 or so ponderous tomes in
Latin of his collected scientific works published in 1755+ and
much quoted today." So fascinated did he become with the
vast range of HaUer's mind and his tremendous energies
which brought him fame as physiologist, anatomist, botanist,
bibliographer, and writer of poetry and prose that the short
account suggested by Osier became a full-fledged essay en-
titled "Haller and His Native Town."

In March, Gushing decided to take advantage of a reduced
fare for the "Grand Tour" to visit northern Italy. On March
3 1 he set out for Turin, where he worked for a month in the
laboratory of Angelo Mosso, the colorful Italian physiologist.
Here he repeated his Berne experiments on dogs with great
success and the beaming approval of Mosso. He wrote Kate
Crowell: "I've made a lucky find in some experimental work
which won't make me famous but which will help me and
some other people understand a little better some things about
brain surgery."

A Catholic institution for 6,000 patients on the northern
edge of the town also interested him.

... I shall never forget those passages-pardy underground-
full of Sisters, of hobbling patients of chanting religious proces-
sionseveryone seemingly happy and content from doctor to
gibbering imbecile the great dormitory-like wards with sixty-
two beds in some of them the extraordinary kitchen with its
low arched ceiling, its brass pots and stirring blue skirted nuns.
. . . And most wonderful of all the procession of the idiots from
morning service a few hundred of them following a cross-bear-
ing priest and with grins and mocking laughs and gesticulations
they passed tinder the old gate, crossed the picturesque courtyard
and crowded about us while their comrades chattered and
mocked from the basement windows behind us. Awful, depress-

10$ HARVEY GUSHING

ing spectacle but picturesque to an extraordinary degree souls
condemned to live in the confinement of the motor and Sinnes
Sphare [motor and sensory spheres] with no association paths
along which they may wander no glimmer of remembrance, no
fear of a future, simple existence an enigma. . . .

Throughout his travels, Gushing recoiled from the dis-
plays of the pomp and power of the Church. Yet he could
not help being stirred by the beauty of the churches the
great columns of black marble, the tremendous silver orna-
ments and candelabra, the swelling organ, and the high, sweet
voices of the choirboys.

After a month in Turin, he moved on to Genoa where he
attended more clinics and hospitals. Then to Pisa "a glaring
treeless dead city under a cloudless Italian sky awaiting what?
But one corner within the old wall had any interest for me
and the Campanile and Battistero are too beautiful to be
seen in broad daylight." But Florence delighted him, particu-
larly the Spedale degli Innocenti with its della Robbia medal-
lions and its "modern fin de siecle babes," its cleanness and
modern equipment. The Spedale S. Maria Nuova with "real
operating room apparently beyond criticism," where 150 or
more students could be accommodated all able to see-
brought forth the commendation that it was "the best model
of an operating room for modern purposes" he had seen either
in Europe or at home. Here he heard Banti lecture on cir-
rhosis of the liver "a most interesting man who manages his
clinic like W.O. and teaches with the enthusiasm of the same.
Homely cadaverous with a marked cast in one of his blue
eyes and a nose which deserves a Cabot behind it."

Next he visited Bologna "from gay, glittering, beautiful
Florence to dull, homely Bologna what a change." He was
thrilled with the anatomical theater of the University"A
room finished simply in wood to which time has given the
richness of color that no learned artificial process can accom-
plisha room which, were it not from an artistic standpoint
beautiful and unusual, would still make us stand bareheaded
as though before a shrine, for here Vesalius reawakened the
study of anatomy which since Galen had had a long unques-

A YOUNG PROVINCIAL ABROAD /Op

tioned period of rest." He was also delighted with some
wooden figures supporting the speakers' desk, carved by Er-
cole Lelli, the professor of anatomy, in 1734. "It is hard to
tell," he wrote his father, "whether the artistic beauty of the
pose or the perfection of the anatomical details to the very
insertion of the tendons is the occasion of delight."

On May i he reached Padua, "a fine old walled town."
Here again the centuries lay richly on the university build-
ings which had been the end of a pilgrimage for scholars for
hundreds of years. Here Vesalius had also taught, and Fabri-
cius of Aquapendente had demonstrated the valves in the
veins by the fitful glare of torches to eager students, among
them one William Harvey who later discovered the circula-
tion of the blood.

Venice was a dream city where he thought of Kate and
home and became impatient to return to Berne and finish his
work. He delayed for a day at Pavk to secure a replica of the
apparatus which Riva-Rocci was using to record blood pres-
sure, then went on to Milan, and finally, on May 1 1, he was
back in Berne.

During the rest of the month he worked hard finishing
up his experiments and attending Kocher's clinics daily. On
Wednesday evening, June 5, he had what he termed "a
most extraordinary experience" with Professor Kronecker,
who wished to go over Cushing's Arbeit before his departure
for Glasgow. Cushing's independent spirit underwent baptism
by fire that night when Kronecker rolled up his sleeves and,
having brewed a big pot of coffee, proceeded to dictate the
results of his experiments. Gushing told him that in America
things were not done that way that if Kronecker wanted him
to publish the article, he would write it and Kronecker could
correct it as much as he liked. After some angry words, Kro-
necker conceded him the right to do his own paper recogniz-
ing that he had here something unusual in the way of a student.

Cushing's demonstration, on June 3, of his results with
Kocher's problem was greeted among the assemblage of pro-
fessors with unusual interest. The writing-up of the experi-
ments was completed at eleven o'clock on June 14, and so

UO HARVEY CUSHING

happy was he to be finished that he took the manuscript to
Kocher that very night. His friend Asher translated the paper
into German for him, and on June 27, after many farewell
parties, he left for Strasbourg. To Ned he admitted some-
thing that he did not tell either his mother or father: "I was
an idiot during my last three or four weeks in Berne and was
so anxious to see my work through before leaving that I had
little idea under what a tension I was living. I saw them [his
papers] through and soon after collapsed."

Strasbourg, Heidelberg, and Bonn passed in quick review.
He was fortunate in seeing the leading medical men wherever
he went but because of his tired condition he felt no impulse
to stay long anywhere. On July 4 he was back in London-
spending his first day visiting Guy's Hospital with Dr. George
Dock and William Francis, Osier's nephew.

He had written Victor Horsley asking if he might work
with him but was later advised to seek out Charles Scott Sher-
rington, professor of physiology at Liverpool, who was just
then beginning a series of experimental studies on the brains
of various primate forms chimpanzees, orang-outangs, and
gorillas. He accordingly went there on July 7 and spent the
first week somewhat impatiently trying to determine a
course of study, Sherrington not having any special sugges-
tions for him. Already eminent as a student of the nervous
system, Sherrington was a surprise to Gushing. He found him
younger than he expected, almost boyish, "wearing, when he
has not lost them, a pair of gold spectacles." He thought he
operated well for a physiologist but too often. In fact, he had
several criticisms to offer Sherrington wrote and published
too much, went at things too rapidly, and did not take enough
notes during his observations all in all, Gushing put him
down as "not quite as big a man" as he had expected. Further-
more, he was surprised to find that almost all physiological
observations were open to dispute or to various interpretations,
and that experimental neurology was in a most elementary
condition and offered vast problems.

It may have been the challenge of these problems, added to
the interest in the brain already aroused by his experiments

A YOUNG PROVINCIAL ABROAD ///

with Kocher and Mosso, that turned Gushing definitely to-
ward neurology and neurosurgery. At any rate, he was soon
deep in Sherrington's investigations and was tremendously
pleased when Sherrington, taking advantage of his surgical
skills, asked him to open the skull of a gorilla and an orang-
outang. In his diary he wrote: "It does not come within the
realm of everyday experience to be called upon to trephine
a gorilla. This happened to me yesterday the day before an
orang-outang and the day before that I saw Sherrington do
a chimpanzee. Experimentation on a large scale certainly
and expensive. Mr. Gorilla though ill and unacclimatized (hav-
ing been in Liverpool only 24 hours) cost 250 pounds."

Toward the end of the month Sherrington left for the Con-
tinent and Gushing wound up his work and went to Glasgow
to meet Thomas AlcCrae with whom he had planned to make
a brief tour of Scotland. He had come to admire Sherrington
and eventually they became close friends. Had he ever gone
back to the initial naive appraisal made during his first days,
he probably would have been as embarrassed as Sherrington
would have been amused.

The Hunterian Museum, left to Glasgow by William Hun-
ter, brother of John, whose museum in London had been such
a source of fascination for Gushing, was here also his chief
interest. After visiting the Firth of Lome, Edinburgh, the
Osiers at North Berwick, then Leeds, Manchester, and Liver-
pool, he sailed for home on August 15.

Gushing had approached the Old World with an apprais-
ing and somewhat arrogant eye, but he was to return again
and again for all it had to offer. From this visit he brought
back the definite desire to delve deeper into the mysteries of
the nervous system, and with a somewhat vague invitation from
Halsted which he had received in June, he planned to return
to Hopkins. A Yale classmate, John B. Townsend, meeting
William Osier at Old Point Comfort in Virginia that spring,
had asked him, "How is my friend Harvey Gushing getting
along?" Osier's reply was prophetic of the future: "Your
friend Gushing," he told him, "has opened the book of sur-
gery in a new place."

THE CLOSED DOOR

Chapter XI

T

JLH

.HE SUCCESS OF HIS YEAR ABROAD

and the joy expressed in Cleveland on his return gave Gush-
ing a feeling of security as he returned to Baltimore in mid-
September of 1901 full of enthusiasm for the future. But his
high spirits were soon dissipated, for upon arriving at the
hospital he found all the chiefs were still away and since he
had no real assignment only the promise of one he had to
mark time until they came back. And while there was much
to see and to talk over with his friends, his impatience to have
his status defined began to mount. Gradually the senior staff
began to return. Henry Hurd, the superintendent of the hos-
pital, threw off his customary reticence and gave him a warm
welcome. Welch and Osier were genuinely delighted to see him
again, Osier immediately inviting him to dinner to see his sum-
mer's haul of rare books.

But Halsted, on whom his future depended, was the last to
come back and even then it was several days before Gushing
was able to see him. He found the Professor cordial but, as
usual, reserved and somewhat vague and without any definite
plan for fitting him into the picture. Impatiently he poured
out his annoyance to Kate Crowell: * e lt isn't much fun, this
marking time and that's all it is; tho' everyone seems to think
I am part of the shooting match, I really am not. The surgical
side is in bad shape. I finally had a confab with the Prof, two
days ago and he made a proposition [that Gushing take up
orthopedics] and I told him I didn't want it and in fact got

112

THE CLOSED DOOR 7/5

rather mad. I came very near writing him a letter that night
telling him that he and his people could go to that I was
going to Cleveland. Then I thought of you . . . Tonight I
am going to the Kurds to dine. Wish I didn't have to pretend
that I'm chipper any longer."

He had come to the decision that he would like to con-
centrate on the surgery of the nervous system, despite the
fact that when in his first days in Baltimore he had looked up
some hospital statistics, he had discovered that in the decade
between 1889 and 1899 the diagnosis of tumor of the brain
had been made only 32 times in approximately 36,000 patients
admitted. Of the 32, but 13 had been transferred to surgery
and only 2 of these had been operated upon, both with fatal
results. These figures presented the challenge of a closed door.
He wanted to be the one to open it.

In all fairness to Dr. Halsted, it should be mentioned that he
may have been slow in encouraging Gushing in his determina-
tion because he saw no real future for him in the field he
wished to enter. He pointed out that in the hospital at that
time there were only two patients who might possibly have
need of neurosurgery. But Gushing gave him no credit for
consideration. Halsted's lack of enthusiasm only irked him.
Out of his deep pride he admitted: "I knew I could have ev-
erything I asked for. What I disliked was the asking. I wanted
offers."

Finally he was able to write his father that the die was cast
and he was to remain at the Hopkins. He and Halsted had
worked out an arrangement that gave him the neurological
side of the surgical clinic, work in the neurological dispensary
under Dr. H. M. Thomas, entry into the wards to see house
cases, one clinic a week with the fourth-year surgical group,
and the opportunity to operate once a week. In addition to
this, he gladly accepted an opportunity to teach a course in
surgical anatomy because he foresaw that if he began to spe-
cialize, he would get away from general surgery unless he at
least taught it. This course was to be followed in the spring
semester by an operative course in which he conceived the
idea of using animals as well as cadavers.

114 HARVEY GUSHING

With his work in the hospital settled upon, he accepted the
invitation of Henry Barton Jacobs and Thomas B. Futcher
to join them in bachelor quarters at 3 West Franklin Street,
next door to the Osiers at No. i. The three divided the re-
sponsibility of the housekeeping and with the help of a
houseman managed to maintain a comfortable establishment.
They each solved domestic problems in their own way:
Jacobs did his ordering from the grocery by telephone and
during his month the bills were high. "Futch" sent William
a-marketing, and William consequently fell behind in his
household tasks and neglected the brass on the front door and
on their name plates. Gushing, to balance things up, decided
to do his own marketing, and to Kate he wrote on December
3: "Began housekeeping today. Went to market and bo't
roast beef at ijc and chickens and a 'shin bone' for soup and
some green goods. It was really great sport and I think I'll go
right along, not telephone. It's very domestic and good prac-
tice for the days when life will really begin with you."

A later comment on food to his father set Dr. Kirke off on
some research. Gushing had said: "My marketing month. Do
you know what Chettelings are and corned pigs tails and
scrapple?" His father replied: "I have found what the Cen-
tury Dictionary says about chithelings (intestines of geese),
'corned pigs tails' I can reproduce in imagination, but 'scrap-
ple' is beyond research and imagination. Is it esteemed at No.
3 W. Franklin?"

The residents at this number soon discovered that the best
feature of their new arrangement was their proximity to the
Osiers. Mrs. Osier had given them all latch keys to No. i, thus
offering them free access to Osier's magnificent library and
the informal atmosphere of their home where there was al-
ways something interesting going on, centering either around
distinguished visitors or the many young friends whom the
Osiers like to have about.

It would have been impossible not to assimilate something of
Osier's enthusiasm, energetic way of life, intellectual curiosity,
and joy of living. Grace Revere Osier played a large part in ex-
tending this stimulating and friendly atmosphere. She was as

THE CLOSED DOOR //J

interested as Dr. Osier in his many students and young col-
leagues and followed them throughout their careers with
vivid letters full of news about mutual friends, forthright
comments on whatever was current, and amusing accounts
of what they were doing. She was always fully capable of
providing the practical requisites for Osier's generous hos-
pitalityas he once said of her, she was wasted on a house
and should have run a hotel.

When there was an overflow at No. i, the guests were sent
next door; during most of the year 1901-02 W. W. Francis,
a favorite nephew of Dr, Osier's who was living with him
while attending medical school, stayed with the "Latchkeyers"
and every night at u: 15 he and Gushing finished off the day
with a game of tiddlywinks.

During the autumn, Gushing began work on the prepara-
tion of the Mutter Lecture which he was to give in December
in Philadelphia. Dr. W. W. Keen, professor of surgery at the
Jefferson Medical College, had been responsible for his receiv-
ing the invitation. Although it was Cushing's disagreement
with Keen on certain aspects of intestinal perforation (ex-
pressed in his paper on the subject in 1898) that originally
brought him to Keen's attention, their common interest in
brain surgery was the basis for a continuing friendship. This
was Cushing's first public appearance outside the meetings of
the Hopkins Medical Society, and he wrote and rewrote his
paper several times. He had chosen to summarize the experi-
mental work he had done at Berne on the relation between
intracranial pressure and blood pressure. The published paper
contained a number of his own unusually well-executed draw-
ings, some in color, showing the blood vessels under both
normal and increased pressure as viewed through his impro-
vised window.

When the evening of December 3 arrived, he had worked
himself into such a state of exhaustion and apprehension that
he confessed to his father that he would have courted a rail-
road accident, a fire, or typhoid fever to escape the ordeal. A
major tragedy did occur he discovered when dressing that
his dress trousers had apparently been left home but this did

116 HARVEY GUSHING

not prevent his appearance. Dr. Kirke expressed concern as to
whether he blacked his legs or borrowed a pair of trousers, but
he did not say he only spoke of his disappointment that illness
in Harry's family prevented his father from coming to Phila-
delphia and said the lecture seemed to go off well.

By now Gushing had become impatient to get married. His
love for Katharine Crowell had deepened during his year
abroad and his need for her companionship grew stronger with
each day. With an eye to the responsibilities of marriage, he
accepted every opportunity which came to him to earn money.
He had received $200 for the Mutter Lecture and gradually,
from papers and occasional private patients, he was accumulat-
ing enough so that he began to feel he might be justified
financially in taking the step. On one occasion he told Kate:
"I stopped writing to you because I'm trying to earn that
guinea both with pen and scalpel. Writing a paper also hav-
ing some patients."

He decided to go home for Christmas and when his holiday
was over, he found leave-taking difficult, as is apparent from a
letter sent off immediately after he reached Baltimore: "I found
Pa waiting for me with everything packed and we went up to
the station and tramped up and down alone and I tried to be
cheerful, but don't remember saying much except 'Be good
to Kate for me,' and we both blew our red 'Gushing* noses and
talked about other things the Baltimore oyster I believe."

Letters thereafter went to Cleveland almost daily tender,
whimsical letters revealing his loneliness. It was now to Kate
that he told his thoughts and the minutiae of his days. "I was
very rude to the Professor yesterday. Sorry, but couldn't help
it. Some day I will tell him I don't like him and then pack up
my duds and go home. . . ." And again: "I have been at the
Chief's and dined with a lot of central nervous systems dressed
up in clothes. Today I've had a lecture and seen some patients
and now must correct proof. Had two fees this past week
f 1 60 and 50 sporadic but encouraging."

In February they announced their engagement and their in-
tention to be married in June on the roth, and as June ap-
proached, Gushing began counting the days. Once he wrote

THE CLOSED DOOR 7/7

Kate: "I'm so afraid we're going to be poorin money." And
"Please don't let people do any Svork' over our wedding
preparations. As long as it's fun, why all right. If it savors of
'Arbeit,' stop it. Don't let's have any 'glad it's over' feelings. I
want people to wish they could go to another like it every
week."

Dissatisfaction aroused by the lack of understanding be-
tween him and Halsted evidently prompted him to look into
the possibility of another post. He set his sights high and never
took his eye off the target. The only place he wanted to go
other than the Hopkins was the Harvard Medical School. On
February 22, 1902, he had an encouraging letter from W. T.
Councilman (to whom he had addressed his enquiry) suggest-
ing that he write President Eliot.

What Gushing wrote to Eliot, we do not know, but it
brought forth a cordial reply:

You left behind you at our Medical School and the Massachu-
setts General Hospital an excellent reputation, and your expe-
rience on the surgical staff of the Johns Hopkins Hospital has
doubtless added much to your value. There will probably be, as
you say, some reorganization of the clinical teaching staff of our
School within three years. If Dr. Burrell, Dr. Maurice Richard-
son, or Dr. J. Collins Warren knows you well, I should advise
you to state your desires to any one of the three, or to all three,
so that your name may be present in their minds whenever the
reorganization shall be attempted.

He followed up Eliot's suggestion, for there is a letter dated
March 15 from Herbert L. Burrell in which he says: "In
thinking and planning for the School you have been in my
mind for a long time. The work that you have done has deeply
impressed me and I admire your courageous effort in striving
for the highest and best in surgery."

There the matter stood. He must wait. But in June mention
of Harvard came from an unexpected source. The professor-
ship of surgery at the University of Maryland, offered first to
J. C. Bloodgood, an excellent general surgeon at the Hopkins,
was later offered to Gushing when Bloodgood declined. He

Il8 HARVEY GUSHING

apparently considered the offer seriously and wrote about it
to Halsted who was just leaving for Europe. Halsted asked
him to consider the obstacles that would be encountered in an
institution where lack of funds would mean drudgery and less
opportunity for experimental work. "Your position at present
seems to me so ideal that I really envy you. Your time is abso-
lutely your own and your opportunities all that can be found,
at least in America." However, if Gushing decided to make the
change, he promised the utmost in co-operation and assistance,
for, he said, "I have your interests very much at heart." He
closed the letter with "I wish you good luck in your choice
and great happiness in life. How can you fail to be happy with
such prospects &, may I say, such a wife."

It may have been this letter that influenced Cushing's deci-
sion, but it was more likely one he had two days later from
Bloodgood, which said in part: "I feel that you should know
this, which I have learned in confidence, indirectly. Your name
has been considered in Boston Harvard thinks much of you
in the rearrangement of its surgical teaching. If you did not
know this you should & should consider this possibility."

Whatever the deciding factor, Gushing elected to wait and
he therefore declined the Maryland offer and went on with
his work at the Hopkins. That it was creating interest was
evidenced by the fact that between March and June he was
asked to give six lectures one before the Johns Hopkins Hos-
pital Medical Society on his nine cases of Gasserian ganglion,
one at Buffalo, New York, where he stopped off after attend-
ing a bacteriological meeting in Cleveland, another before the
Medical-Chirurgical Faculty of Maryland, and two evening
lectures at Johns Hopkins University. The last and most im-
portant was the annual lecture in surgery given before the
State Medical Society at Milwaukee during its meeting held
June 4-6. He spoke on the avoidance of shock in amputations
by cocainization of large nerve trunks, with observations on
blood-pressure changes in surgical cases.

As soon as the meetings were over, he hurried back to Cleve-
land and, on June 10, 1902, he and Katharine Crowell were
married. Mrs. Osier in a letter to Henry Barton Jacobs, then in

THE CLOSED DOOR //p

Paris, said: "I hear that Dr. Cushing's wedding went off charm-
ingly. They were married in the country very quietly. Dr.
Barker was there and wrote it was quite ideal." By the first
of July they were settling themselves at 3 West Franklin
Street. In April Dr. Jacobs had married the widow of Robert
Garrett, the former president of the Baltimore and Ohio Rail-
road, but Thomas Futcher continued to live with the Cush-
ings until they moved to a larger house.

The summer brought a letter of congratulation on the paper
describing his work with Kocher from the above-mentioned
Lewellys F. Barker, a Hopkins friend now at Chicago: "The
Hirndruck etc. is magnificent. Hearty congratulations. You
are showing the world the kind of work that a real Professor
of Surgery ought to do. The coming profession in the clinical
branches must be an entirely new breed. We cannot put the
new wine into the old bottles."

In November, Gushing was flattered to be asked to go to
Philadelphia to discuss a paper on brain tumors although he
had had but two cases himself, neither successful. On this
occasion he met for the first time the eminent neurologist and
physician, S. Weir Mitchell, who invited him to visit his library
and fired his imagination in the direction of literature and
poetry.

With occasional invitations of this nature and with hospital
work, teaching, writing, and the increase in social activities
that came with marriage, the autumn and winter passed
quickly. In April, Kate Cushing wrote to Dr. Kirke: "This is
supposed to be vacation, that is there are no classes, but we
have several patients at different hospitals at different ends of
town, and some proof to read and articles to finish. . . . Dr.
Osier [who was attending a meeting in Cleveland] will give
you a good account of Harvey he is very well but there
are two questions I have been meaning to ask you how do
you make him take care of himself when he has a cold, and
how old is he? I put thirty-three candles on his birthday
cake, but he thought there should be more."

During the spring, Cushing had told his father that he might

120 HARVEY GUSHING

expect a fifth grandchild I at the end of July, and late in June
he urged him to come to see them before its arrival. "Don't
you suppose you could manage it for a week, before the
middle of the month, please? After the ioth or thereabouts
\ve prefer to be left alone. I wish you would, on the quiet,
hint to Mrs. Crowell that she had better come down after
'the Event.' Futcher is to be away on his vacation but a nurse
and an arrival and a mother-in-law in the house at the same
time, especially should it be hot, will make matters pretty
complicated with our new servants, as well as in other ways."

His father did not feel equal to making the trip to Baltimore,
nor was he more successful in postponing Mrs. CrowelPs visit,
but this may have been due to the fact that the baby did not
arrive until the fourth of August. It was a healthy eight-pound
boy whom they eventually christened William Harvey* The
happiness occasioned by the arrival of a son was, however,
somewhat overshadowed by the news from Cleveland that
his mother was ill. But since her symptoms did not seem indica-
tive of serious trouble, the family hoped that this illness, the
first in her lifetime, would soon clear up. Dr. Kirke's letter of
August 3 had been a little more encouraging. "Your mother is
spare, and weak, but not more so than would be expected, and
puts her best foot foremost mentally and bodily as usual.
Great thing if she would retire from business, after the manner
of H.K.G, but she will, I have no doubt, go down with her flag
at the main. Perhaps her way is best."

The birth of the baby brought a letter dated the loth from
his mother in her own hand. Gushing was relieved to see her
writing, even though it was somewhat shaky, but his heart was
twisted by her admission "I found myself one day enacting
the part of the child who cries for the moon I wanted so
much to see you. . . ."

This was the last letter he had from her. She was able to
gratify her wish to see the baby when Kate and William
Harvey went home at the end of August. Gushing joined
them early in September. After their return to Baltimore his

1 Harry had three children and Ned one.

THE CLOSED DOOR 121

mother failed rapidly and on October 21 she died. Gushing
went home immediately and wrote Kate from Cleveland:
"Just a big wreath of autumn leaves outside the door and
nothing black just like Mother. But oh! so still and cold. I
hardly realized it till I saw her. No one was there but Father.
I was glad because I behaved pretty badly. No one knows
but you and he and Mother how near the surface lie my emo-
tions. Father is always there perfectly calm and under control.
... I don't think he has slept any and looks thin and worn."
The next day he sent Kate another letter:

Everything is much the same here. Father is quiet and terribly
nice to everyone who comes and very communicative for him.
. . . Has a great deal to say of Mother, affectionate things, little
incidents of one sort or another. Keeps looking at her pictures
with red dry eyes, the old daguerreotype and the rest. ... I
stayed down here until about eleven to try and get him to lie
down, as Alice said he walked almost all the first night, and he
talked and talked. I wish you could have heard him. He spoke
of her hands how square they were for small hands, shaped like
his own and some of the rest of us how he had never seen them
for 50 years a moment idle or unoccupied; often doing unneces-
sary things to save others or holding needlessly heavy work like
those big carpet rugs she used to make but always doing some-
thing. . . .

I'm glad she saw and held our little boy before she died. I hope
that she passed on to him some of her absolute unselfishness and
rare qualities of other sorts which his father missed.

Betsey Maria Gushing was buried on the hilltop at Lakeview
on October 24, a beautiful autumn afternoon, and H.C. went
sadly back to Baltimore. Carolyn Gushing, Will's wife, later
wrote to Kate: "We all wished Harvey might have stayed on
a little. As Ned says, 'Harvey is the only one of us who can go
up and put his arm on Father's shoulder.' The others all min-
ister, and greatly to their father's evident pleasure, but Har-
vey's way is his own. ... I am so glad, dear Kate, that Aunt
Bessie had the happiness of having you in her closest circle,
and of knowing that Harvey was possessed of his heart's de-
sire. . . . Such force, such intelligence and judgment, such

122 HARVEY GUSHING

patience and courage, and so much love in her big heart the
combination was not a common one! "

Gushing wrote to his father as often as he could, and Dr.
Kirke's replies were cheerful but his loneliness evident* "I was
glad to get your letter and to have the latest news from you,
Kate and the young hopeful. Indeed, anything which breaks
in upon the enduring vacancy which fills the house is pleasant.
As with you, the weather is mild and pleasant. We pick some
flowers from her beds every day. Nasturtiums, dahlias, now
and then a rose, with chrysanthemums make up the variety."
But the thing that touched Gushing most deeply was his father
planting, under Ned's direction, some three hundred bulbs that
his mother had ordered. "What the result will be is a matter
of the hereafter, like so many others. Some were also put into
the grass of the cemetery plot." So under a blanket of crocuses
Betsey Maria Gushing rested on her hilltop while those who
loved her tried to fill the gap with memories.

FOR BOOKS ARE NOT
ABSOLUTELY DEAD
THINGS"

Chapter XII

a

THE ISLAND OF ZANTE, OFF

the coast of Greece, there died a physician in the year 1564,
whether from an uncommon disease or from exposure follow-
ing shipwreck, it is not known. But it is known that this lonely
figure, dying so far from his native Belgium, was Andreas
Vesalius, author of one of the greatest books ever written, the
first to picture the human body and skeleton as we know it
today.

The story of this man and his great masterpiece his preco-
cious youth, his impetuous twenties, the unfulfilled promise
of his middle age, and his death at fifty-fourwas to fascinate
Harvey Gushing until the end of his days. It was probably
Osier who introduced the two, or it might have been at a
meeting of the Johns Hopkins Hospital Historical Club that
Gushing first made the acquaintance of Vesalius. Anyway, he
was sufficiently interested in him in the spring of 1901 to seek
out the anatomical theater at Padua where Vesalius had per-
formed the public dissections pictured in the frontispiece of
his book, De humani corporis fabrica (On the Workings of
the Human Body), published in 1543 at Basel, Switzerland,
Vesalius having taken his drawings and manuscript from
Venice over the mountains on donkeyback.

Who was this Vesalius who was to lead him into bookstores,
libraries, and museums all over the continent of Europe for the
next forty years? Someone has called him "a man of wrath";

123

124 HARVEY GUSHING

impetuous he undoubtedly was, and strong-minded and coura-
geous. But such qualities were needed by a physician who was
to break with traditions that had governed the practice of
medicine for over fifteen hundred years. Impatient with pro-
fessors who sat on a platform reading medicine from a book
while the ignorant barber-surgeons dissected the cadavers for
the benefit of the students, Vesalius did his own dissections and
soon discovered that what he found and what the book said
were not in agreement. He further discovered that the dis-
crepancies were due to the fact that the anatomy which had
been taught for centuries was based on dissections of dogs and
pigs and not on the human body.

So at the age of twenty-eight he published his celebrated
Anatomy, and because he had the assistance of artists from
Titian's studio, perhaps even of Titian himself, his figures stood
forth from the pages as if they were alive. Even the dry bones
of his skeletons had life. Gone were the two-dimensional, flat
figures of his predecessors gone many of the old errors of
structure and function, and in their place something which
thrilled and shocked his contemporaries and which earned him
through the centuries the title of "Father of Modern Anat-
omy." His figures are still used as examples in schools of art,
and his contribution to the advancement of medical knowl-
edge never fails to stir the admiration of students and historians
of medicine.

Although the storm of criticism which greeted his revolu-
tionary work caused Vesalius in a fit of wrath to burn all his
manuscripts and retire from teaching to become a court physi-
cian for the rest of his life, this only seemed to highlight the
phenomenal activity of his earlier years. Many before Gush-
ing had found Vesalius a challenging and provocative figure
of great strength, imagination, and stubbornness, but few fol-
lowed his trail so long or so diligently.

Just how it all began is a matter of conjecture, but we do
know that on May 31, 1903 Gushing wrote his father: "Dr.
Osier has started me on a Vesalius essay. He has turned over
to me pro tempore a stunning copy of the T)e Corpera [Cor-
poris] Humanis [Humani] Fabrica' with the famous plates

BOOKS ARE NOT DEAD THINGS" 12 f

etc. I want very much to collect photographs of the various
portraits and as many engravings of V. himself as possible so
if you run across any of them in your perusal of catalogues or
see a notice of the sales of any of his books I wish you would
let me know."

But his ambition soon extended beyond photographs and
engravings, and we find William MacCallum writing him from
Paris during the summer; "As to Italy there was nothing un-
usual except that I got you a Vesalius like Dr. Osier's tho' not
in quite as good trim it is the Basel edition of 1543." Fuel was
added to the fire when Osier came home from Europe with
f our copies of the Fabrica}-

The paper on which Osier had started Gushing was given
the title "The Books of Vesalius" and presented before the
Book and Journal Club of the University of Maryland on
December 16, 1903. The day after this meeting, Dr. Kelly
left on Cushing's doorstep a handsome copy of the second
edition of the Fabrica.

Dr. Kirke's mention, sometime later, of his own copy of
the Fabrica caused Gushing to enquire immediately: "What
was the Vesalius which you were getting bound? If I make
some money this year I am going to try and purchase copies
of all of his writings to go with my Edns of the Fabrica."
Two years later came the opportunity to fulfill a part of this
desire: "A good doctor man on whom I recently operated for
epilepsy has sent me a check for $200 for books!" he told his
father. "I hope therewith to complete my Vesalius collection."
And other gifts came to him, for the Biblical phrase "to him
that hath shall be given" is true of no one so much as the book
collector: "Dr. Pilcher of Brooklyn came down to give us a
paper on Mundinus 2 at the Historical Socy he stayed with
us for a few days which meant dinners &c, but I feel well paid
for the time as he has sent me a Vesalius Fabrica, Edn 1568,
which helps fill out my collection of Vesal's works now reach-
ing some proportions."

1 Which he presented as gifts to individuals or medical school libraries.

2 An anatomist of Bologna who wrote a popular anatomical textbook
two centuries before Vesalius was born.

126 HARVEY CXJSHING

It was from these beginnings that the greatest existing
Vesalian collection was brought together. Although Gushing
rashly thought in 1906 that with 200 he might complete his
collection, he was still adding to it until the day he died. 3

Although the most engrossing, Vesalius was only one of
Cushing's interests. And Osier, although he gave much impetus
to Cushing's collecting by stirring up his enthusiasm, adding
to his knowledge of the men who had made medical history,
and by passing along book catalogues, was not the only one
who was responsible for his growing library. David Gushing,
it will be remembered, had collected a library which Erastus
had carried with him when he left New England. And such
small amounts as Dr. Kirke could keep for his own use during
the growing-years of his large family had been spent on books.
It was his father who offered him the earliest encouragement
by gradually transferring to him the books the Gushing doc-
tors had accumulated. Early in February of 1899 Gushing
wrote him that "the books came safely this morning and I am
delighted to possess them. My library groweth apace. I must
have some 250 volumes." A year later it was Dr. Kirke who
wrote: "Just as soon as I am able to do anything, I will send
off some of the old books we spoke about to you. How about
the five vols. of the International Surgery in the little case in
your mother's bedroom? You can have them if you would like,
or anything else that will help or comfort you."

And books 'were a comfort. What they meant to him, Milton
had eloquently expressed when he wrote "For books are not
absolutely dead things, but doe contain a potencie of life in
them to be as active as that soule whose progeny they are; nay
they do preserve as in a violl the purest efficacie and extraction
of that living intellect that bred them." And during Cush-
ing's year abroad, as he had walked the streets where Milton

3 Four years after his death another book was added the Bio-bibliogra-
phy of Vesalius which Gushing himself had partially completed and
which friends and his literary executor, John F. Fulton, finished so that
it might appear, as was Dr. Cushing's intention, on the four hundredth
anniversary of the publication of the Fabrica. It was published in a hand-
some edition by the firm of Henry Schuman of New York.

"BOOKS ARE NOT DEAD THINGS** 12J

walked, had seen the lifework of John and William Hunter
spread out before him in their museums, passed the site in
Leicester Square where "goodnatured Charlie Bell" had set
himself up in practice in a ramshackle house that proved "a
heavier burden than nine bastard children" as he had wan-
dered in these places of rich memory, the history of medicine
had beckoned to him and never let him go.

In Berne the ancient clock, around whose tower the mechan-
ical bears march solemnly every hour, had told the passage of
time to the great physiologist Haller as it did to him. At Padua
he had stood in the amphitheater where Fabricius of Aqua-
pendente had demonstrated by torchlight the valves in the
veins to William Harvey who was to return to England and
eventually discover how the blood circulates through the body
a riddle that had baffled the imagination of men since thou-
sands of years before Christ. 4 These men, and others like them,
who had labored and suffered through the centuries in their
search for truth came to life again as Gushing gathered together
their books and information about their friends and colleagues,
their predecessors and their followers. It was a game which
became an unending source of pleasure and relaxation during
the difficult years that lay ahead.

From a modest beginning (his book bills from December 31,
1902 to January i, 1907 amounted to $854.07), his collecting
grew to an expensive pastime. As long as his father lived, Gush-
ing continued to receive treasured volumes from the library
in Cleveland and gifts of books in which he had expressed an
interest. Rarely did a letter pass between them without some
reference to their mutual interest references such as the fol-
lowing:

FROM H.C. TO H.K.C., FEBRUARY 28, 1900
In spite of press of work I have had time to peek into the fine

* Gushing in 1907 had an opportunity to buy the memorable book in
which Harvey made known his discovery to the world in i62$Excrct-
tatio tmatondca de motu cordis et smguhiis in anhnalibusbvt he did not
have in ready cash the $200 purchase price. Since there are only forty-six
copies of the book known to exist, the next time he had a chance to se-
cure a copy, the price was $3,000.

128 HARVEY GUSHING

old volumes you sent on. The Chas. Bell 5 as a book is of course
far the most valuable but the associations with the others make
them doubly interesting to me. I found in one of D.C.'s [David
Gushing] the appraiser's mark. . . . The old Lancet is fine. This
volume is one of the most active of any in the crusade against the
"Hole and Corner" surgery of the day.

FROM H.C. TO H.K.C., OCTOBER 12, 1902

Many thanks for the Chas. Bell. I now have three of those thin
volumes and would like the other. I will give away no such books
for the present at all events. Kate and I are very proud of our
book shelves. Twenty fat volumes of Walpole letters, essays,
etc. came as a wedding present from Mrs. Tracy. Our "End of
the XVIIIth Cent." Collection is getting strong Mrs. Piozzi
your Johnsons "The Spectator" etc.

FROM H.K.C. TO H.C., MARCH 12, 1903

Last week there was a sale of part of the library of Harold
Price, of Philadelphia, a non-resident member of our Rowfant
Club. It was rich in Americana. I was fortunate in getting Dr.
John Morgan's "Discourse [upon] the Institution of Medical
Schools,'* Phil. 1765, with this inscription "For Dr Whytt Pro-
fessor of Medicine at Edinburgh from the Author." ... It bears
the imprint of Wm Bradford (By Dr Thomas Cadwallader Wm
Bradford the Second). At the Exhibition of the Grolier Club,
New York, Apr. 14, 1893, of Books printed by William Bradford
and other printers of the Middle Colonies there was no copy of
Morgan's Discourse. 6 ... I do not know as this sort of back
talk will interest a man busy daily with practical affairs of life,
and your paternal may seem a bit musty, or at least hard up for
materials for writing.

FROM H.C. TO H.K.C., JUNE 30, 1903

Kate and I are feasting ourselves on book catalogues of which
from the Osier supply we gain several a week. We have picked
up some interesting things in our present line of readingLord
Wharncliff J s "Lady Mary Wortiey Montague" e par example' from
the Shepard Book Co. of Salt Lake City, Utah. Strange place for

5 Bell was the leading British anatomist of the nineteenth century.

6 John Morgan's Discourse' led to the founding of the first medical
school in America (at the University of Pennsylvania in 1765). Dr.
Kirke was a graduate of this school.

BOOKS ARE NOT DEAD THINGS 12$

a large book (old) Emporium n'estce pas? Very (comparatively)
cheap books. . . .

We would like to have you come down if you can and care
to and we would like to have you bring your 'Kit-Cat Club'
book as we are continually having tantalising references to it
and its members. Lady Mary Wortley Montague was the young-
est 'toast' of the club. ... Do you remember, by the way, that
she brought back from Constantinople the inoculation against
smallpox scheme in 1717? Dr. O. mentions it in his text-book.

In January of 1904, Gushing wrote his father: "Much inter-
est was excited yesterday by the reception of an installment
of books which I had ordered sometime ago from Blackwell
in Oxford. They turned out to be from the library of Sir
Henry Acland with his bookplate etc. One of them was a
presentation copy of Gross's essay on 'John Hunter and his
Pupils' and in it was pasted Dr. Gross's note in which he refers
to a prospective visit to England of Dr. S. Gross and his 'sweet
and beautiful wife' the present Mrs. Grossler/ as Dr. O.
calls her. Curious that the note should have boomeranged back
so near to her after all these years."

Another association of interest was found in the gift of the
Statical Essays published in London in 1733 by the Perpetual
Curate of Teddington on the Thames, Stephen Hales. Hales
was a fascinating character, a contemporary of Isaac Newton's
at Cambridge, who not only performed his clerical duties most
zealously, but in addition contributed much to the scientific
progress of his time. He was the first to measure blood pressure
by an experiment on a mare in his parish yard, the first to
invent a ventilator and insist on its use in prisons, skve ships,
and hospitals. His books were read widely, and the copy which
came into Cushing's hands bears the bookplate of Patrick
Henry and was in the library at Red Hill, his plantation on the
Staunton River in Virginia, when he died. The book came
to Gushing through a descendant whose husband had been one
of his patients.

7 Mis. Osier had been married to Dr. Samuel W. Gross of Philadelphia,
the eminent son of an eminent father. Three years after his death in 1889
she had married William Osier.

750 HARVEY GUSHING

From collecting books it was easy, with Osier's example, to
drift into writing historical essays. His interest in the Kat-Kat
Club, for example, resulted in a paper which began: "In the
reign of Queen Anne, a pasty-cook, one Christopher, or Kit
for short, 'immortal made by his pyes,' kept a tavern near
Temple Bar at the Sign of the Cat and Fiddle. Here was wont

SIR,

|07 are dejiredtv Accompany the Corps
of Mr. John Dryden, from the
College of Phyjicians in Warwick-
Lane, to Weftminfter Abby ; on

Monday the i$tb of Ms Inftant May, 1 700.

at four of the Clock in, the Afternoon exaftly^

it being refohed to be moving by Five a Clock.

And be p leafed to bring this Ticket with you.

From facsimile of card to Dry den's funeral.

to gather a group of the most distinguished men of the time
. . . [among them] the subject of this sketch, the popular, the
generous, the companionable Garth."

Samuel Garth was a physician-poet whose rhymed history
(The Dispensary) of the attempt to have drugs dispensed by
physicians rather than apothecaries was enormously popular
in its time. It was Garth who saved his friend John Dryden
from ignominious burial, arranged for a proper ceremony, and
saw to it that he was buried in the Poets' Corner in West-
minster. Gushing searched for years for the invitation which
was issued on this occasion:

Sir, You are desired to Accompany the Corps of Mr. John
Dryden from the College of Physicians in Warwick-Lane to
Westminster Abby on Monday the T3th of this instant May,
1700. at Four of the Clock in the Afternoon exactly, it being
resolved to be moving by Five a dock. And be pleased to bring
this Ticket with you.

BOOKS ARE NOT DEAD THINGS** l$l

He finally had to be content with a reproduction of the only
copy he ever located. The original had been bought in a Lon-
don auction room by an American collector just a short time
before he began his search.

But such "misses" were more than balanced by the "finds'*
and added zest to the never-ending fascination of the game.
The word satiety does not appear in the lexicon of a true book
collector. The thrill of the hunt, the triumph of acquisition,
the joy of possession never diminish. For Gushing, the excite-
ment of his early years of collecting the books that made up
the history of his profession continued as long as he lived, even
when he became an experienced collector, branching out into
other fields of science. And when he shared it, as he did with
all who entered his library, there was no one who could with-
stand the contagion of his enthusiasm. "Books delight us, when
prosperity smiles upon us; they comfort us inseparably when
stormy fortune frowns on us. They lend ralidity to human
compacts, and no serious judgments are propounded without
their help." These words he had found in 1903 in the Philo-
biblon of Richard De Bury, who presided orer the See of
Durham in the fourteenth century, and, like the colorful,
book-collecting bishop, he enjoyed bringing others under
"the wondrous power of books" since "through them we sur-
vey the utmost bounds of the world and time, and contemplate
the things that are, as well as those that are not, as it were in
the mirror of eternity."

T H E DISCOURAGING YEARS
Chapter XIII

A

,LEXIS CARREL, THE FRENCH S C I -

cntist who is probably best known to the general public in this
country for his work with Charles A. Lindbergh on a mechan-
ical heart, 1 wrote a letter to Harvey Gushing from Chicago in
December of 1905. Although his English was good, the letter
contained an amusing misuse of a word. "Please tell me when
your new laboratory will be established," he said. "Then I will
go to Baltimore for a few days in order to admire it, and, if
possible, to see you performing some of your splendid nervous
operations."

It was an apt word to describe the early brain operations.
The story is told that when Gushing, in the midst of a long
procedure in which things were not going well, asked for the
blood pressure, he was surprised in a few moments to feel some-
one fumbling about his leg and to discover that the inex-
perienced student nurse was attempting to take his blood
pressure instead of the patient's!

The terrific tension under which the pioneer brain surgeons
labored brought Harvey Gushing to every procedure as keyed
up as a race horse. He allowed no conversation while he
scrubbed up, and insisted on absolute quiet in the operating
room. Each patient became his personal responsibility, and the
operation a fierce contest between him and the forces that

1 Dr. Carrel received a Nobel Prize for his work on intestinal anastomosis
and is also well known for his studies on tissue culture.

132

THE DISCOURAGING YEARS l$$

threatened life. Eric Oldberg once voiced the admiration of
Cushing's assistants for his tremendous courage in the operat-
ing room. "Although always meticulous and careful, he, like
all surgeons, was sometimes faced with catastrophic accidental
occurrences. He always rose to these occasions instantaneously
and magnificently, and to be associated with him in such a
battle was nothing short of emotionally moving."

It takes little imagination to guess what might happen to an
assistant or nurse who was slow in anticipating his needs in
such emergencies, or who handed the wrong instrument, or
who fidgeted or obviously showed signs of weariness even
though the operation might last from four to six hours. At
these times feelings were of no concern to Gushing, the only
thing that mattered to him was the exposed brain before him.
Such was his concentration that when the operation was over,
he himself never appeared to be at all weary. Sometimes he was
aware that he had been sharp and caustic and might hunt up a
student nurse who had gone out of the room in tears to say
that he was sorry. But he did not often make apologies and
some of his assistants smarted for a long time from tongue-
lashings they had received, deservedly or undeservedly, during
an operation.

Nor did he always confine his criticism to operations. Osier,
in 1902, felt constrained to write him a note in which he said
he had heard that Gushing did not get on well with his surgical
subordinates and colleagues. "The statement also is made that
you have criticized before the students the modes of dressings,
operations &c of members of the staff. This, I need scarcely
say, would be absolutely fatal to your success here. The ar-
rangement of the Hospital staff is so peculiar that loyalty to
each other, even in the minutest particulars, is an essential. I
know you will not mind this from me as I have your best
interests at heart." This brought from Gushing an offer to re-
sign, to which Osier replied cheerfully (and effectively): "Do
nothing of the kind! Who is free from faults-Be failings! It is
a simple matter 'Keep your mouth (as the Psalmist says) as
it were with a bridle/ Your prospects here are A.i. & we need
you."

/5-f HARVEY C0SHING

Although knowledge of the brain was slowly growing
through the persistent efforts of a few pioneers and the studies,
both physiological and pathological, coming out of experi-
mental laboratories, attempts at tumor removal still resulted in
a disheartening number of failures. Only five to ten per cent
of the different tumors were considered operable, and only
about five per cent of the operations were successful. The
studies of Charles Sherrington and his associates on the anthro-
poid brain had added extensively to the knowledge of cerebral
architecture already accumulated and had made possible more
accurate localization of tumors. Horsley and his associates,
particularly Charles Beevor and Edward Schafer, were con-
tinuing their work on the same problem. On the technical side,
the Gigli saw had been found to be more effective than a
trephine in opening the skull, and the German, W. Wagner,
had reported a new method for making bone flaps for the pur-
pose of cerebral exploration. All of those advances reduced the
hazards of entering the cranial cavity, but there were many
problems still unsolved the ever-present danger of hemor-
rhage, the control of increased intracranial pressure, the uneasy
question of how deeply the brain might be encroached upon
in the removal of an infiltrating growth; and there was the
constant threat of postoperative infection.

The story is told of Sir Victor Horsley by one of his gradu-
ate students, Dr. Ernest Sachs, that he walked into the wards
at the Queen Square Hospital one morning to see a patient at
the request of Dr. Charles Beevor. He decided that the patient
had a pituitary tumor and announced that he would operate
the following Tuesday. Beevor, knowing the usual result of
such attempts, protested, "But Victor, if you operate on that
man, he will die." "Of course he will die," returned Horsley,
"but if I don't operate on him, those who follow me won't
know how to perform these operations."

This had to be the underlying philosophy of all who at-
tempted surgery of the brain in the first discouraging years.
But Victor Horsley persisted courageously, success occurring
just often enough so that he felt justified in going on. His
efforts won him the distinction of being called the founder of

THE DISCOURAGING YEARS /5J

neurosurgery, although he was not the first nor the only one
in the field. .Macewen of Glasgow had had favorable results
with a long series of brain abscesses, but tumors presented more
difficult problems and it was tumors in which Horsley was
most interested. The work in France had been summarized by
the French surgeon, Chipault, in 1894, and von Bergmann in
Germany had published a monograph on cerebral surgery.

After the turn of the century it became apparent that the
neurological and pathological knowledge of brain tumors,
meager though it was in comparison with what is known to-
day, had surpassed the knowledge of the technical methods for
removing them, and it was here that Gushing made his great
contribution to neurosurgery. Although Horsley is said to
have founded the specialty", Gushing was the first surgeon to
devote his entire time to it. His interest was shared in America
by a small number of general surgeons and neurologists, nota-
bly Charles A. Elsberg of New York, who became the neuro-
surgeon of the Neurological Institute at Columbia and whose
particular concern was the surgery of the spine; Ai. Allen Starr
and Bernard Sachs, New York neurologists who were firm
believers in the surgical treatment of tumors, and the men who
did their surgery, Frank Hartley and Arpad G. Gerster; and a
group in Philadelphia (which S. Weir Mitchell had made
something of a neurological center). This group included W.
W. Keen, of course, Dr. Mitchell's son John, Charles K. Mills,
and William G. Spiller, neurologist, who worked with Charles
H. Frazier, surgeon. Together, Spiller and Frazier made im-
provements in the Gasserian ganglion operation for the relief
of trigeminal neuralgia, on which Gushing was also working,
and originated the operation of cordotomy severing the an-
terolateral tracts of the spinal cord for the relief of unbearable
pain.

From the beginning, Gushing pushed to the forefront of the
new field, although his early efforts were almost without ex-
ception unsuccessful despite careful study and infinite pains.
What motivation was behind his tremendous drive is a ques-
tion that his contemporaries asked many times. Personal am-
bition, of course, for he was by no means as disinterested in

l$6 HARVEY GUSHING

priority as was his chief, Halsted. His confidence that hard
work would accomplish almost any desired end was another
factor. But there can be no doubt that medicine itself aside
from the strong moral obligation of service to humanity, an
obligation he assumed seriously never ceased to fascinate him
from the moment he first began to dissect the human body. He
never failed to find excitement and challenge in its problems.
His curiosity about what lay behind the closed doors never
diminished.

It was well that this was so, for in the beginning there was
little beyond his own interest to encourage him in the way he
had chosen. The opportunities to learn through experience
were few and far between. Not only were patients reluctant
to submit to brain operations, but few physicians yet knew
enough about the symptoms to recognize them when they
were present. It was for this reason that Gushing made a habit
of publishing his results. When these were negative, he in-
cluded his appraisal of his mistakes and the results of the
autopsy if one was done. 2 In this way physicians began to be
aware of the conditions that might indicate disturbances of
the nervous system.

Because Cushing's first efforts so often ended in fatalities,
Halsted is rumored to have made the statement that he didn't
know whether to say *Toor Cushing's patients" or "Cushing's
poor patients." But defeat only acted as a spur. He continued
his work in a high fervor of determination and concentration.
His service was considered the most strenuous of any in the
hospital. First there was the detailed and time-consuming
neurological and physical examination. After the long pre-

2 Gushing, from the first, insisted upon autopsies because, although al-
ways important, they were particularly important in brain cases where
knowledge was in a rudimentary state. Some of the tales growing out of
his persistence on this point bear a close resemblance to the stories of
"body-snatching" in earlier centuries, when anatomists had to resort to
all manner of surreptitious methods to further their knowledge of the
human body. In one particularly baffling case, when autopsy was refused,
it was reported (with details left to the imagination) that Samuel J.
Crowe, his assistant at the time, secured the brain < under inauspicious
circumstances."

THE DISCOURAGING YEARS /J?

liminary study, the patient was prepared for the operation.
This again was a lengthy procedure likewise the operation
itself, which required an unusual number of instruments and
special techniques. Gushing liked to keep his patients absolutely
quiet after the operation, and sometimes they were not moved
from a small room adjoining the operating room for a day or
two. During the day he would slip in as often as possible to see
how the patient was coming along and to be sure that no
crisis was developing.

When the intern and the nurse finally took over, he would
call frequently from his house for a report on the patient's con-
dition, often at midnight and again later in the night, asking in
minute detail what had been done in the interim. Woe to the
intern or nurse who couldn't say which arm or leg the patient
had moved or in what direction the eyes were turned! When
they could not, they were often asked why, then, had they
taken up medicine if they were not sufficiently interested to
watch symptoms closely? It made no difference if the intern
had assisted in two or three long operations during the day-
Gushing drove him just as he drove himself. But because of the
quality of his own work and the standard he set for all who
worked with him, he was an excellent teacher of good medi-
cine. And it was the rare student who, even though smarting
under some of Cushing's strenuous methods, did not acknowl-
edge an indebtedness to his teaching.

In December of 1901 an undersized and sexually undevel-
oped girl of sixteen was admitted to the Hopkins complaining
of headaches and failing vision. After careful study, Gushing
attempted three exploratory operations (on February 21,
March 8, and March 17), but none disclosed a tumor, and the
patient died of pneumonia on May i with her symptoms unre-
lieved. Autopsy showed a tumor of the pituitary gland located
at the base of the brain, where it was then considered ex-
tremely inaccessible from a surgical standpoint. During this
same year Alfred Frohlich, the Viennese neurologist who had
been a fellow student in Sherrington's laboratory in July 1901,
wrote him of a case with similar symptoms. Frohlich had per-
suaded a surgical colleague to attempt operation, and the re-

l$$ HARVEY GUSHING

suits proved favorable. This success of another in a situation
where he himself had failed was a cause of chagrin to Gush-
ing and immediately fixed his attention on the pituitary gland.
But his knowledge grew slowly because he rarely encountered
such cases.

In the meantime he worked at perfecting the operation for
trigeminal neuralgia which had been his first venture into
neurosurgery. In May 1903 he wrote his father: "Received (or
will receive when the bill is paid) my first fee for a ganglion
operation this month my seventeenth case. Wish I had the

nerve of Dr. [a St. Louis surgeon who asked Gushing

to attest to the lawyers of his deceased patient's estate that
$3,500 was not exorbitant for a Gasserian ganglion operation].
I might in time make some money out of medicine."

He also concerned himself with similar problems cases of
facial paralysis, the virus infection called herpes zoster, and the
relation of the Gasserian ganglion to the taste buds of the
tongue. He worked, too, on devising technical instruments,
among them the cranial tourniquet for the control of bleeding
(no longer used, but at the time a distinct advance), and more
efficient burrs and saws for penetrating the bony structure of
the head.

While he was establishing himself in the field of neurosur-
gery, he made an important contribution to general medicine.
When he had been in Italy, he had made a special journey to
Pavia and the Ospidale di S. Matteo because he was interested
in the blood-pressure apparatus of Riva-Rocci. Here he was
given a model of the inflatable armlet which they used at the
bedside a much more practical means of taking blood pres-
sure than the instruments then available in the United States.

Upon his return he immediately had blood-pressure readings
added to the charts on which pulse and respiration were re-
corded. He made an initial report on his studies before the
Wisconsin State Medical Society in June of 1902. A year later
he and his friend George Crile of Cleveland were invited by
W. T. Councilman to report on their blood-pressure studies
in Boston. Cushing's paper was published a few months later
under the title of "On Routine Determinations of Arterial

THE DISCOURAGING YEARS l$$

Tension in Operating Room and Clinic." Because of the in-
terest aroused, a committee was formed at the Harvard Medical
School to consider the importance of blood-pressure deter-
minations in surgical diagnosis. After some deliberation, they
came to the conclusion that the skilled finger was more accu-
rate than any pneumatic instrument and dismissed the matter
as of no importance. Despite this conservative Boston judg-
ment, blood-pressure determinations became routine in medi-
cine and surgery throughout the United States, and Crile's
book on 'Blood-pressure in Surgery (1903) became widely
used. In it he acknowledged that most of the interest in this
country had been aroused by Dr. Harvey Gushing.

But although his work on blood pressure was important, it
was only a by-product of his main concernsurgery. In
November of 1903 he wrote his father: "I have been very-
busy all week. Have succeeded in getting my operative course
startedno doghouse yet but still hopeful. Also have operated
nearly every day, a baby with an occipital meningocele, re-
moval of a thyroid for exophthalmic goitre, a brain tumor,
etc." Later in the month there occurred a real event in his
surgical career. A case of spinal cord tumor was admitted to
the hospital and he not only diagnosed it correctly but made
an accurate localization of the tumor and was successful in
removing it. "It's the first case of the kind hereabouts," he
told his father, "and really only happens about once in an
operative lifetime."

Six months later, however, he had another spinal cord tumor.
When the report of the case appeared, Gushing received a let-
ter which pleased him so much that for years he kept it in his
desk. It was still there when he died. The letter was short "My
dear Dr. Gushing: Just a line to tell you that Charlie and I
have gone over your case in the Annals [of Surgery] for June
with great interest. The Cleveland case cerebral haematoma
in the child which Dr. Crile told us about is also great. It is
evident that painstaking work will produce results, and an
American Horsley has been found. Sincerely, W. J. Mayo."

The reference to cerebral haematoma was to a new opera-
tion that Cushing had been attempting. In making some in-

HARVEY GUSHING

vestigations on cerebrospinal fluid, the increased pressure of
which was such a hazard in brain operations, he had asked
Dr. Kelly, head of the department of obstetrics, if he might
perform autopsies on babies that were stillborn or had survived
only a few days. He found in many instances that the cause of
death had been an intracranial hemorrhage from birth injury
a cause, incidentally, of many of the spastic deformities in
children who survive such hemorrhage. This fact was known,
but many physicians thought an infant only a few days old
could never survive a brain operation. Gushing proved this
was not true. In 1905, at the annual meeting of the American
Neurological Association, he gave a paper entitled "Concern-
ing Surgical Intervention for the Intracranial Hemorrhages of
the New-born" in which he summarized his experience with
four cases.

In the autumn of 1904, Gushing wrote his father: "Very
busy here. Was out of town yesterday operating on a cracked
head football injury with hemorrhage. Tapped the clot very
luckily. Today a cerebellar tumor in a child. The successes are
so far between in cranial work that when they come life is
quite easy the failures are very depressing." The Puckish
sense of humor of a certain young reporter on the Baltimore
Sun did not help matters either. He was wont to insert notices
about people who had come long distances for operation, a
few days later recording their death without comment. The
fidelity of this reporter in following Dr. Cushing's efforts
finally brought a protest from the Hopkins authorities.

But the publicity at least had the effect of making him
known to the public as a brain surgeon. He stayed in Baltimore
during the spring holiday in 1904 in the hope of getting some
work, but none was forthcoming, and he told his father some-
what ruefully: "People have begun to think me a neurologist
and the ordinary run of simple money-making things doesn't
come my way. A lamentable condition which I am endeavor-
ing to face without chagrin."

Although it didn't provide him with much of an income, his
work was bringing him invitations to speak and calls to other
university posts. There had been the University of Maryland

THE DISCOURAGING YEARS 141

professorship in 1902, and in 1904 Dr, W. W. Keen invited
him to become his successor at Jefferson Medical College.
Gushing considered the matter for two yearshe was fond of
Dr. Keen and there was much interest in neurology in Phila-
delphiabut he finally declined in 1906, just a few weeks be-
fore he received a letter from President Arthur T. Hadley of
Yale asking him to come to New Haven to discuss a professor-
ship of surgery in the Medical School.

If it had been difficult to come to a decision about the chair
in Philadelphia, it was much more difficult to decline the post
at Yale. In doing so he set down his convictions about medical
education convictions that were little altered as time pro-
gressed: "So far as I could see during my brief visit, the one
pressing need of the School is a hospital with a continuous
service for those occupying the clinical Chairs. Without a hos-
pital in which they have clinical and teaching privileges the
year roundj clinical professors are as destitute of opportunities
for instruction and investigation as a chemist or a physicist
would be without a laboratory. And without such a hospital
a medical school can hardly expect to develop."

He further pointed out the advantage, in furthering the repu-
tation of a hospital, of the publications of a teaching staff. He
advocated higher entrance requirements to ensure more mature
students students who in their fourth year could safely be
given the freedom of the hospital wards. Until these conditions
were present at Yale, he did not feel justified in giving up the
opportunities offered at the Hopkins.

Although he elected to remain in Baltimore, such recognition
was gratifying, as were the invitations to present papers at
local and national meetings; they always meant hard work and
long hours of preparation but gave him a chance to arouse in-
terest in neurology and neurosurgery. He discussed the rela-
tion of the taste fibers to the trigeminal nerve before the
American Physiological Society in Washington in December
of 1902; reported on the surgical treatment of facial paralysis
by nerve anastomosis at a meeting of the Philadelphia Neu-
rological Society in February of 1903; spoke on "The Special
Field of Neurological Surgery" at the Academy of Medicine

1J2 HARVEY CTJSHING

at Cleveland; and was invited to address the Alontreal Medico-
Chirurgical Society in February of 1904. At this meeting he
reported on his results with his first twenty Gasserian ganglion
operations.

While in Montreal he was asked to operate on a cerebral
tumor. Although he never liked to operate away from his own
familiar surroundings, he reluctantly consented fortunately
with successful results. His return via Boston was hastened by
news of a devastating fire which destroyed much of Balti-
more's waterfront. Their own house was out of the path of
the flames, but at one point the danger was sufficient to
force Mrs. Gushing, who happened to be alone, to take young
William to the Goodwillies and return for their precious
Vesalius volumes.

In the autumn of 1903 there materialized the idea that had
originated on a balustrade overlooking the Seine during the
International Medical Congress in 1900, when William J.
Mayo, A. J. Ochsner, and Gushing had decided that it would
be profitable to form a small society of surgeons in the United
States, This became known as the Society of Clinical Surgery
and met twice yearly, "The Society is a sort of peripatetic one,
the towns visited being supposed to furnish the entire program
and to show the members what is being done in a teaching
way, in research, in the matter of records and new things in a
clinical and operative line. . - . They are all young and en-
thusiastic and I think we ought to make a good thing out of it."

Even though he now had a wife, a son, and a home, Cush-
ing's absorption in his work kept him occupied almost as much
of the time as it had before he assumed these responsibilities.
On June i r, 1904 he wrote to Mrs. Gushing, who was in Cleve-
land visiting her mother with young William: "Isn't it awful
to have forgotten that yesterday was our anniversary? Except
that every day is a sort of anniversary with you and none seem
particularly different. Still it would have been pleasant of me
to have sent you a message at least. Will you forgive your
thoughtless boy?" But it is probable that Kate Gushing, al-
though she did not always find it easy to accept, guessed before
they were married what pattern their life together would take.

KATHARINE CROWELL

Trom a daguerreotype 0f 2892

HARVEY GUSHING

His Christims cord in 1900

WILLIAM OSLER

Reproduced pom a snapshot in H.C.'s 1904 diary
under 'which he had 'written "The Spirit of research"

DR. GUSHING ON THE STEPS OF THE AMBULANCE AMERICAINE

Paris, 1915

THE DISCOURAGING YEARS 143

In July, Gushing and "Tammas" McCrae sailed for England
with Dr. Osier to attend the Congress of the British Medical
Association. The footworn steps at Oriel College in Oxford
where they were being put up for the meetings brought back
nostalgic memories of New Haven to Gushing. That evening
the president of the British Medical Association welcomed
them in the Sheldonian Theatre. It was a gorgeous spectacle,
the fine old hall making a perfect setting for the white dresses
and brilliant robes. Gushing and McCrae were surprised to
discover their friend William MacCallum among the colonial
delegates, and as the Association filed out, they "paralyzed
MacCallum by shouting in unison 'MacCallums Carriage' like
a lot of freshmen as they were calling the carriages of the dis-
tinguished guests."

The next day, again at the Sheldonian, degrees were con-
ferred on several distinguished physicians, among them Osier.
"I do not know when I have seen a more impressive ceremony,
one which was so associated with ancient formalities that seem
rightly to belong to a past generation of people." The candi-
dates all wore flamingo gowns with slate gray sleeves and all
received a great ovation but "nothing like that accorded Dr.
Osier who showed his emotion by a pair of bright red cheeks
as he took his seat."

Gushing attended two sessions of the Congress at which Vic-
tor Horsley spoke, for in the four years since his first en-
counter with Horsley he had come to appreciate something
beyond his operative technique. "Very interesting talks," he
recorded in his diary. "Horsley is a daisy." The rest of the
week he explored Oxford, "doing" fifteen of the colleges,
visiting bookstores and libraries. At the Radcliffe he told the
Librarian he could not leave without seeing the first edition of
William Harvey's De motu cordis (1628) and was promptly
shown ten editions! Later he visited the Merton Library,
ic where many books are still chained to the shelves and where
are old astrolabes and globes and beautiful carved oak shelves
'twould make in color and design and proportion an ideal
library for a modern bibliophile who like these books would
gladly remain chained to a shelf of such a room." His last com-

/-# HARVEY GUSHING

mentaiy on Oxford was: "It is a despair to see such a place and
ever to leave it; for it would take a life time, and more than
one, to comprehend and enjoy it satisfactorily."

Back in London, after a hurried trip through the iMidlands,
he visited a few hospitals and followed the trail of the "Kit-
Kat" poet, Dr. Garth, through bookstores, graveyards, and
the British Museum. On August 5 he sailed home with Dr.
Osier and McCrae. Although it had been a most stimulating
holiday, he and McCrae returned with heavy hearts, for Dr.
Osier had been offered the Regius Professorship of Medicine
at Oxford. The suspense they were in as to whether he would
accept was ended one day when Gushing picked up several
sheets of paper that had fallen from Osier's berth and read on
the first the scrap of a sentence: "The story of my acceptance
of the Chair at Oxford may be briefly told."

Cushing's research during the summer on Dr. Garth took
shape in December when he introduced the "Kit-Kat" poet to
the Johns Hopkins Hospital Historical Club. When the paper
(already described in Chapter XII) was published, it brought
him a letter from Worthington C. Ford, the historian: "Many
thanks for the copy of your essay on Dr. Garth as good in
substance as in dress, and with the flavor of a true critical
biographer. I congratulate you upon possessing this literary
taste and upon your use of it, for it means much fine essence
for sweetening the drudgery of a professional life."

Next door, the man who had given Gushing the inspiration
to do this kind of writing was preparing to withdraw his in-
fluence to a greater distance. Talk of books and medical his-
tory now had to be sandwiched in between patients (for
everybody in the country wanted to come to Osier before he
went), his sittings for a portrait, speech writing, and the many
functions given in his honor. The tempo of the Osier house-
hold, always brisk, became hectic. But Osier remained his
merry, cheerful self, and every time the Cushings slipped
through the fence for a few minutes when the coast was clear,
they went back carrying books and journals from Osier's
shelves gifts that would have delighted them were they not

THE DISCOURAGING YEARS 7#

reminders that the happy days of living next door to the Osiers
were numbered.

During the first months of 1905, Gushing spent from one to
two hours a day writing for contributions toward a suitable
tribute for Dr. Osier. He and Henry Barton Jacobs had taken
the lead in the project and had received some $30,000 in
pledges, but Dr. Osier's valedictory address, in which he made
joking reference to Anthony Trollope's suggestion (in The
Fixed Period) that those over sixty, having fulfilled their use-
fulness, should be chloroformed, was taken seriously by the
American press and given such publicity in the newspapers
that many of the pledges were subsequently withdrawn.

Furor, excitement, and sadness were thus mingled in Osier's
last months in America. He was deeply distressed by the re-
action he had unwittingly caused and in his last address, given
at a large farewell dinner at the Waldorf-Astoria in New
York, he said: "I have made mistakes but they have been mis-
takes of the head, not of the heart."

The Cushings bade the Osiers good-bye on May 16. The
next day a demolition crew arrived to take down the house,
and the hole in the fence was boarded up.

THE DOGHOUSE

Chapter XIV

A

.BOUT THE TURN OF THE CENTURY

a Baptist minister in Montclair, New Jersey, was introduced
to Osier's Principles and Practice of Medicine through a medi-
cal student who had formerly been in his congregation in Min-
neapolis, He was fascinated by the style and led on to read
the whole book in detail, but he was at the same time appalled
by Osier's frank admission that physicians could cure only
four or five diseases, that in many instances about all that
could be done for a patient was to give him good nursing care
and alleviate his suffering as much as possible. He began to
realize how neglected had been the scientific study of medi-
cine throughout the world, for places such as the Koch Insti-
tute in Berlin and the Pasteur Institute in Paris were very rare
and yet Pasteur's discoveries had saved a greater sum for the
French nation than that spent on the Franco-Prussian War*

This man was the Reverend Frederick T. Gates, philan-
thropic adviser to John D. Rockefeller. On the basis of his
reading of Osier's textbook he made recommendations to Mr.
Rockefeller out of which grew the Rockefeller Institute for
Medical Research and eventually the Rockefeller Foundation;
and the movement thus started in medicine led to the founding
in 1902 of the Carnegie Institution of Washington "which
Andrew Carnegie endowed with $10,000,000 for "the support
of biological and chemical investigation of great importance
to medical science."

THE DOGHOUSE

While these great philanthropic institutions to support
science were being set up, schools of medicine were facing the
fact that the laboratory sciences pathology, physiology, bac-
teriologyhad developed to such an extent that they were
now the strongest part of the curriculum. And the gap be-
tween the scientific discoveries of the laboratories and their
application on the hospital wards was rapidly widening. It
was clear that the clinical teachers must take the lead in bring-
ing about changes in the hospitals which would ensure that
the advances of the laboratory reached the sick patient
Lewellys Barker put it into words when he wrote Gushing:
"The coming profession in the clinical branches must be an
entirely new breed. We cannot put the new wine into the old
botdes."

Harvey Gushing, who, for all his firm belief in the value of
laboratory experimentation, never lost sight of the fact that
the primary concern of all medicine was the good of the pa-
tient, approached the problem in a most realistic way. In May
of 1902, very early in his teaching career, he addressed a
memorandum to the Committee on Schedules in which he set
forth his ideas for preparing a student to practise medicine by
integrating his theoretical and his clinical work. The most im-
portant of his several suggestions was that the course in opera-
tive surgery (application of bandages, dressings, etc.) be started
at the beginning of the third year to give the students prac-
tical work on animals and cadavers in preparation for their
work in minor surgery in the out-patient department and
operative clinic. He proposed that the course be given one
entire afternoon a week ("possibly Saturday") throughout
the year and that it be an elective. This memorandum brought
a reply straight from the desk of the president, Daniel C. Gil-
man, who wrote: "Your suggestions are entitled to great
weight," and asked that he stop in to discuss the matter with
him.

The important points in Cushing's plan were adopted, and
in October forty out of the forty-four men and women in the
third-year class elected Cushing's course in operative surgery.
Kate Gushing reported the general reaction to Dr. KLrke:

IjS HARVEY GUSHING

"Harvey has begun his clinic today with a new set of students.
People say the nicest things about that course he gives. They
all want to work in his laboratory." Gushing admitted to his
father that he was much pleased with the response but that a
smaller number would be easier.

The work involved in teaching a large group was well re-
paid at the end of the year when he received a letter from G.
Lane Taneyhill, Jr., W. R. Kellogg, and John B. Carr of the
third-year class, saying that they had been asked to convey
the class's appreciation of the value of the course for the origi-
nality in methods of teaching, the close personal attention, and
the clearness of presentation of the underlying principles of
operative surgery.

After struggling with the large group in inadequate quar-
ters, Gushing began to agitate more actively for a project he
had had in the back of his mind for some time. In June he
wrote his father: "I wish to the devil they would build an
animal house. A real good one such as we need would cost
about $10,000 but I am inclined to plea for a shanty pro tern-
pore which they could afford. We need a good animal hospital
where the animals necessary could be cared for like patients
and also where veterinary work could be done." His father
replied promptly: "Anent the Dog Shanty business, if a few
hundred dollars will avail in helping it on, why I think you
can safely talk to me about it." When in the autumn Gushing
reported: "Have succeeded in getting my operative course
startedno dog-house as yet but still hopeful," his father again
offered assistance: "On what are your 'hopeful' hopes as to
the dog house founded; if upon H. M. H[anna]., I hope his
brother Marcus has come out ahead in the Ohio voting today.
Remember I asked to be kept informed so that I could help a
litde perhaps as I am quite sure your Mother would have liked
to do it."

The following year he was "still hopeful" but still waiting.
"I have had another spinal cord tumor case since writing you
cases come in duplicate. Also a dog, a large grey greyhound
with a goitre which I removed Friday in the operative course.
Much pleased thereat as it is the beginning of the 'comparative

THE DOGHOUSE /-#

surgery' work I am anxious to inaugurate. Oh! for an animal
house. I have in small amounts raised $2400 and need $1200
more. Would this be a very inappropriate time to approach
Mr. Hanna again?"

The great fire in Baltimore which caused such extensive
financial losses to the University (because much of their in-
come came from real estate which was destroyed by the fire)
ended his hope for receiving any assistance from University
sources, but H. AL Hanna, Robert Brewster of New York,
and other interested friends finally subscribed $5,000, and with
this amount as a nucleus, the University in 1905 constructed
a laboratory at a cost of about $15,000 which would serve
Cushing's needs and also those of the pathology department.
After much thought and consideration the "doghouse" was
named the Hunterian Laboratory after John Hunter, whose
studies in comparative anatomy were unequaled.

In August the building was nearing completion. Gushing
and MacCallum had decided to put the radiators on the ceiling
to save floor space and because working next to them was
often uncomfortable, and he asked his father what he thought
of the idea. "It's an experiment of course, but then it is to be
an experimental laboratory!"

Dr. Kirke was finally given an opportunity to make good
his offer of financial assistance. They needed money for a
microscope * and pictures of John and William Hunter "to
hang in the hall and to be an example and stimulus." A check
for two hundred dollars arrived in the next mail from Cleve-
land. By December, Gushing was able to write him that
"everyone is showing great interest in the new laboratory and
I think we have started a new and original kind of place."

The name, Hunterian Laboratory, misled the public into
thinking it had something to do with hunting dogs, but this
was all to the good because it brought dogs to the Laboratory,
and the surgery done on the canine population of Baltimore

1 There is an amusing exchange in 1912 between H.C. and the superin-
tendent at the Hopkins, for Gushing took the microscope with him when
he left the hospital. He explained that since his father had given it, he had
always regarded it as more or less his own!

/j-0 HARVEY GUSHING

was no less expert than that which their owners might receive
in the hospital itself. The building was anything but beautiful
architecturally, it reeked of carbolic, and under the hot Balti-
more sun even less desirable odors became apparent, but the
building was kept neat and clean by a small, wiry man named
Jimmie who managed with equanimity to keep the various
departments of the school supplied with experimental animals
of the right size at the right moment. He managed the dogs
with the same effective complacency, thus preventing com-
plaints from people living near the laboratory. Cushing's word
was law to him and if he said no work was to be done on Sun-
day, Jimmie maintained the edict no matter how urgent the
requests.

Gushing now had the facilities to carry on the course as he
wished. Surgical experience on cadavers was quite a different
thing from experience on a living animal under anesthesia.
Even before he had the laboratory in which to expand, he had
begun to have the students write up histories, keep an ether
chart during operations, make operative and postoperative
notes and histological studies of tissues, and do a complete
post-mortem examination if the animal died. The whole pro-
cedure, therefore, was carried on as if the dog were a human
being. They usually began with a consultation of the "family
physicians," in which the history of the patient was discussed
and the diagnosis made. This was followed by the operation.
The students worked in groups of four, one acting as operator,
three others as first and second assistant and anesthetist.

Gushing followed the same plan in his course in operative
surgery for graduates, held in May and June of each year.
He often had in this class one or two of the local veterinarians
with whom he had established cordial relations. He limited
the number to sixteen and charged one hundred dollars for the
course. This gave him sufficient income so that he could offer
his university stipend of five hundred dollars to an assistant
who could take some of the routine of the laboratory off his
shoulders.

The first surgical assistant at the Hunterian was Philip K.
Gilman, a graduate of the Class of 1905. He was followed by

THE DOGHOUSE /J/

J. F. Ortschild, Lewis L. Reford, Samuel J. Crowe, Emil
Goetsch, Walter E. Dandy, and Conrad Jacobson. After a
year in the Laboratory, several of these men became Gush-
ing's assistant residents in surgery. Each year a report was
published under the title "Comparative Surgery" and the first
work of many of the men who were later outstanding in their
profession appeared in these reports. It was here that Lewis H,
Weed began his classic studies on cerebrospinal fluid, later
carried on at Harvard. Walter Dandy, who was to rival Gush-
ing as a neurosurgeon, did his first experimental work in the
Hunterian, as did Herbert M. Evans, the discoverer of vitamin
E. After 1908 almost everyone working there was engaged in
research on some phase of the pituitary gland in which Gush-
ing had become engrossed.

Interest in the work of the Hunterian spread. Dr. James G
Munro of Boston wrote Gushing: "I want to congratulate you
on the new pathway you have broken in your work on com-
parative surgery." The Sunday North American of Philadel-
phia (July 23, 1905) carried a full-page article with pictures
under the headline: Tet dogs replacing human bodies in sur-
gical demonstration: Some curious, humane experiments at
Johns Hopkins." The text announced:

No longer will the dead human body, or "cadaver," be the
main reliance in teaching operative surgery to medical students,
if experiments recently made with success at the Johns Hopkins
Hospital, Baltimore, are followed by other schools.

This departure is nothing less than the substitution of dogs or
other animals for human bodies in surgical instruction. By oper-
ating upon living instead of dead bodies the student is enabled to
observe the effect of his work upon normal tissues and nerves,
and to control hemorrhage from arteries filled with flowing
blood instead of coagulated masses. He is also impressed with
the absolute necessity of asepsis, or surgical cleanliness, which
otherwise he might fail to regard.

At first stray dogs were employed in the operations, but so
favorably known are they becoming in Baltimore that the own-
ers of valuable, though afflicted dogs, sometimes pets, are taking
them to the hospital.

l$2 HARVEY GUSHING

The reputation of the Hunterian for an interest in the treat-
ment of pets had both its comical and its tragic side. One day
one of the medical students returned to the Laboratory after
lunch to find a small boy with tears streaming down bis dirty
face clutching a badly wounded dog. The student, recogniz-
ing that the dog was almost dead, gently tried to take it from
him, but the small boy would not let him. He wanted Dr.
Harvey Gushinghe wouldn't trust his dog to anybody less.

Letters like this from Dr. Hurd also came to Gushing.

My friend Air. Kurtz (Jno. D. Lucas & Co.) has become very
anxious about his cat and asks me to inquire if you will not take
up her case. He seems to feel that while she may have but one
life to live now, she may have nine ex'entually if the surgical
operation is a success. I do not know what the trouble may be
but I hope in the light of experience it may be a phantom hair
ball. Please pardon me for my pernicious activity.

In Britain the work of the Hunterian Laboratory strength-
ened the hand of those fighting the antivivisectionists. Leonard
Hill, a prominent London physiologist, asked for information
on teaching operative surgery on animals to present to the
Vivisection Commission, which had a bill before Parliament
"the information will be of great value to our colleagues in
their up-hill fight." Victor Horsley, one of those who was
constantly working for animal experimentation in England,
also appealed to Gushing. "If you have another copy of your
paper on your Surgical Laboratory would you let me have it.
I want to refer to it at the Vivisection Commission." He later
wrote: "I thought of you the other day & your class. If you
want a cheerful exercise in the surgery of the cerebellum, I
recommend the common duck, on whom we are doing some
experiments at the present time, as calculated to break the
proudest spirit."

The example set by the Hunterian was followed by other
medical schools. The Surgical Laboratory at Harvard (ad-
ministered by the Arthur Tracy Cabot Fellow) was patterned
after it. In an account of the Hunterian Laboratory written
in 1920, Gushing paid tribute to Halsted: ". . , Dr. Halsted

THE DOGHOUSE 7J3

always had a problem on foot and came to the laboratory fre-
quently during its early days. His custom ... of giving his
juniors free swing with their own projects was what really
made the laboratory a possibility/ 7

Gushing felt that the most gratifying tribute to the work
of the Laboratory was the recommendation by Abraham
Flexner, President of the Rockefeller Foundation, that $100,-
ooo of the Rockefeller funds given to the Hopkins in 1912
be utilized for the enlargement of the Hunterian. That its
contributions were of inestimable value to the advancement
of medicine, there can be no doubt, and Gushing had a right
to be proud of the large part he played in its inception and the
early years of its growth to international recognition.

THE PATH BROADENS

Chapter XV

JLN DECEMBER OF IpOJ, DR. WELCH

had written to Gushing: "I dare say that I should have known
that Mrs. Gushing is not going out, but no one ever tells me
anything of real, vital, human interest. I am sorry that I must
lose the pleasure of Mrs. Cushing's company, but I am glad
that there are such prospects awaiting your family." The
"prospect" arrived on January 27, 1906, and was christened
Mary Benedict.

A month after her arrival, her father was offered a post at
the University of Virginia and six months later one at the New
York Hospital, but again he decided to remain at the Hopkins,
where the new Hunterian Laboratory offered ideal oppor-
tunities for teaching and research. And in the back of his mind
there was still the thought of Harvard. Each time an invitation
came and he looked over the possibilities, he compared the
opportunities in his mind's eye with those in Boston, and each
time held off in the hope that what he desired would eventually
be offered to him.

In January the Osiers returned for a visit which Gushing
described in a letter home:

The Osiers are here have been to luncheon in fact. It's very
good to see them again. They all look very well and even Dr. O
has a touch of English high color. He says it's port not health.
It was very interesting to hear their tales of Englishrather Ox-
ford life Rhodes Scholars, convocations, his rooms (John

THE PATH BROADENS Iff

Locke's) at Christ Church, the Ewelme Alms House and I know
not what all. They are very funny about it all Sunday service
at Christ Church, for example, where the most tardy of the dons
has to read the service. Dr. O consequently very prompt-
usually calls a carriage and hustles the family up scrabbles into
his cap and gown and marches in to sit with the Fellows on the
front bench, with a wink at Mrs. O as he passes by. She hopes
to make him late enough some day to have to officiate.

When life returned to normal after the Osiers' departure,
Gushing began work on two major papers which he had been
invited to give at the meetings of the American Neurological
Association and the Surgical Section of the American Medical
Association, both to be held in Boston in June. At the first he
discussed the causes of sexual infantilism and at the second,
cases of spontaneous intracranial hemorrhage associated with
birthmarks. In addition, W. T. Councilman had asked him to
prepare a special exhibit for the A.M.A. meeting on the work
of the Hunterian. These preparations, together with his con-
centrated operative course for graduates, a meeting of the
Society of Clinical Surgery in Baltimore and another of bac-
teriologists and pathologists with the attendant entertaining,
plus examinations, made almost everyone, he told his father,
come off with poor digestions and fretful tempers.

Meantime Mrs. Gushing was struggling with the problem of
getting two children, baby carriages, trunks, and servants
ready for an escape from sweltering Baltimore to Westerly,
Rhode Island, where she was to spend the summer. When the
Boston meetings were over, Gushing and William MacCallum
spent two days there sleeping, eating, and enjoying the coun-
try air before returning to their jobs.

Reunion in New Haven Cushing's fifteenth renewed
body and spirit and was more of a vacation than the month
he later spent at Westerly, for a manuscript on the surgery of
the head, which Dr. Keen had invited him to contribute to his
five-volume System of Surgery y was hanging over him and he
spent most of his days working. "The life of an editor, I pre-
sume, must be a troublous one," he wrote his father when he
had returned to Baltimore, "certainly that of an author is. Few

1$6 HARVEY GUSHING

do it so well and are so favored as Dr. Osier. I had a notice
from Appleton to the effect that they have sold two printings
(17,000 copies) of the present [Principles and Practice of
Medicine] the 6th Edition and are going to set up another
for the fall. Dr. Osier, too, had a good bargain with them a
dollar or moreperhaps two a copy. They must have sold
1 17,500 copies since the beginning. Pretty good for a text book
is it not? . . . There is little of news here. Futcher and I are
keeping house together. . . . One of our neighbors has
bought a talking machine (Edison) and another has married
one, which is worse as the machine runs down and she doesn't."
December brought another visit from the Osiersthey hav-
ing come over to celebrate W.O.'s mother's hundredth birth-
day. The Cushings gave a large reception and tea in their home.
Over four hundred guests were invited, including almost
everyone on the university, medical, and nursing staffs, as
well as local Baltimore friends and out-of-town guests such as
the Secretary of the Navy and his wife, Dr. Simon Flexner of
Philadelphia, Dr. George Crile from Cleveland, and Dr.
Charles Mayo of Rochester, Minnesota.

During the following year (1907), Gushing began imper-
ceptibly to take Osier's place in the Johns Hopkins Historical
dub. Welch was still a guiding spirit, always arranging din-
ners and taking a prominent part in the discussions, but he
was coming to be so much in demand outside the Hopkins,
particularly in his role as adviser to the Rockefeller Founda-
tion, that the leadership fell more and more to Futcher and
to Gushing, who served as president during 1907 and 1908.
Litde by little, too, they began sharing with the chiefs the
responsibility for entertaining, in the Baltimore tradition, the
distinguished guests who came to lecture at the University.
Early in January of 1908 the Cushings moved from 3 West
Franklin Street into a house of their own, at 107 East Chase
Street, which had electric lights "even in the cellar" (thus
making furnace tending less of a chore), a large, sunny nursery,
and the space they needed for their growing family. On May
1 8 a third child was born to them-a daughter, who was named
Betsey after her grandmother. When she was but a month old,

THE PATH BROADENS I SI

the family went on its annual pilgrimage northward. This was
the second of many summers the Cushings were to spend at
Little Boar's Head, situated on the short stretch of New
Hampshire which borders on the ocean.

During the month of August when Gushing joined the
family, he endeavored to sit still long enough for Edmund
Tarbell to paint his portrait. In March Dr. Kirke had written:
"I want a likeness of you, in oil, by the best artist in Baltimore,
Philadelphia, or Washington, and will pay cash for same on
demand. I will leave it to Kate after I am through with it." To
this Gushing replied: "Pm afraid it's an awfully expensive busi-
ness getting an oil portrait. Wouldn't a pastell satisfy you? I
am at such a nondescript age and so whiskerless that I cannot
imagine being portrayed even for your sake. If I was an infant
or had reached a dignified old age and could wear an academic
gown whose folds would be depicted, it would be different.
However, I promised Kate to submit and we shall see what can
be arranged."

The summer sittings were the result. Gushing told his father
that since he could not combine them with reading, the time
would have passed slowly had Tarbell not been amusing.
Tarbell, however, found Gushing difficult to paint. Between
sittings they played golf. Mrs. Gushing had interested him in
the sport, for she had been before her marriage an excellent
player, but although he enjoyed the game, he did not have a
great deal of time for it in Baltimore during the school year.
He reported to his father: "We are all brown and fat. Betsey
and I are racing in matters averdupois and I think she leads.
Furthermore, she is very good and cunning, which is more
than I can say for myself."

He worked during this vacation also on his section for Dr.
Keen's textbook (surgery of the head). On one occasion when
Keen had enquired as to when he might expect the manuscript,
he apparently had received a peppery reply, for we find him
writing a soothing letter in return: "I shall feel very badly if
I have been the cause of your being 'swearing mad.' I am sure
when you have written the chapter and see it in print, you will
be so proud of your baby that you will be 'swearing glad/ "

Zj$ HARVEY GUSHING

He went on to tell Gushing that his drawings were as good
as any he had ever seen and that he would be glad to have as
many as the article required.

When the manuscript was finally delivered, it was Keen's
turn to be disturbed, for instead of the 80 pages he had asked
for, Gushing had delivered 800 with 154 illustrations. After his
first concern, Keen was appeased by the excellence of the
manuscript. It was published in 1908 in a monograph of 273
pages. 1 The book stands as Cushing's first systematic treatise
on brain surgery and definitely established him as the leader
in the new specialty. Sir Victor Horsley congratulated him
"on presenting a succinct & yet thorough account of such a
complex subject. I hope and feel sure it will do a large amount
of good for it is extraordinary what lack of knowledge of
common methods still persists."

Cushing's growing reputation brought him both students
and an increasing number of patients. His surgical load had
now become so heavy that he was compelled to ask Halsted
for an assistant of his own in neurosurgery. He first ap-
proached Ernest Sachs, a promising young graduate of the
Hopkins who was interested in entering the field of neuro-
surgery, but he was in England at the time, studying with
Horsley, and felt he could not leave the work he was doing.
Finally Halsted let him have his own assistant resident, George
Heuer. Two students who sought him out at this tune were
John Romans, a young surgeon of unusual ability whom
Maurice Richardson had sent down from Harvard, and Robert
M. Yerkes, a psychologist, also from Harvard, 2 who was in-
terested in learning surgical and aseptic technique.

During this year two more chairs of surgery were offered
Gushing one at Rush Medical College in Chicago and the
other at the Bellevue Medical School in New York, but Gush-
ing declined both because he had begun some research in the

1 During the First World War the book was reprinted by the Surgeon
General and used as an Army handbook on traumatic surgery of the
head.

2 He later became the distinguished professor of psychobiology at Yale
whose primate laboratory at Orange Park, Florida, is well known.

THE PATH BROADENS

Hunterian Laboratory that was too engrossing to interrupt.
In April, Professor Edward Sharpey-Schaefer, the eminent
Scottish physiologist who had worked with Horsley on a num-
ber of experiments, was invited to Baltimore to give the Herter
Lectures. That he should have come into Cushing's orbit at this
juncture when Gushing was beginning to meet with some
success in his brain operations was of considerable significance
in his subsequent career. On four evenings Sharpey-Schaefer
spoke on different aspects of the pituitary gland, and Cushing's
interest in the gland, hitherto unexplored because of more
pressing problems, was intensely aroused. Indeed, he could
think of little else.

He began to delve into the literature on abnormalities of
growth to be interested in acromegaly and gigantism and in
dwarfs and the sexually undeveloped. Acromegaly, a disease
of the pituitary associated with enlargement of the bony struc-
ture of the hands and feet and with coarsening of the skin of
the face (as opposed to gigantism which is abnormal growth
in adolescence), was first described in 1884 by the German
pathologists, Fritsche and Edwin Klebs. Two years later Pierre
Marie, the French neurologist, named the condition acro-
megaly, and it was he who expressed the belief that it was
caused by a tumor of the pituitary gland.

Adiposity and sexual immaturity (called Frohlich's syn-
drome because of the case he had described in 1901) were also
thought due to an enlarged pituitary, since, at operation,
Frohlich's case proved to have a tumor of the gland. Gushing
immediately started research in the Hunterian. He set John
Homans and his surgical assistant of that year, Samuel J.
Crowe, to removing the pituitary gland from dogs. Most of
them died, but one day when Gushing was looking at a par-
ticularly fat, logy, sexless animal that had survived the opera-
tion, there flashed into his mind that here was Frohlich's asexual
adiposity caused by lack of secretion from the pituitary.
Acromegaly and gigantism, therefore, must be due to over-
secretion of the gland. This fact was beginning to be recog-
nized, but the asexual adiposity had been confusing because it

160 HARVEY GUSHING

likewise seemed due to enlargement of the hypophysis, or
pituitary.

Homans was with Gushing when he made this observation.
"It was Cushing's quickness and insight in connecting the
hypophysial adiposity of the dog with the Frohlich syndrome
which straightened out the confusion and made Gushing the
leader in this field. I remember well how quickly his imagina-
tion leaped from the hitherto overlooked fat, asexual dog to
the whole picture of the hypophysial disease." The door was
now open to a new understanding of pituitary disorders and
to the whole field of endocrinology. Gushing began to turn
his energies and ingenuity to devising a feasible surgical ap-
proach to the gland. On December 30 he gave an address be-
fore the American Physiological Society for which he chose
the challenging tide: "Is the Pituitary Gland Essential for
Life?"

Gushing was not the only member of the family who was
attracting public attention at this time. Late in November a
new laboratory of experimental medicine, made possible
through the generosity of Mr. Howard M. Hanna and Colonel
Oliver H. Payne, was dedicated at Western Reserve Uni-
versity. It was named the Henry Kirke Gushing Laboratory
of Research, Dr. Welch gave the principal address, and Gush-
ing attended as an official delegate of Johns Hopkins Uni-
versity. Kate Gushing wrote Dr. Kirke: "Harvey has just left.
Tomorrow will be a proud day for the Cushings! I wish I
might have gone with him on this great occasion nothing but
Betsey would prevent."

In January of 1909, Dr. Arthur Tracy Cabot of Boston
wrote Gushing about a personal friend on whom he had op-
erated four years previously and who was now having a
return of symptoms, Cabot wrote guardedly because his pa-
tient was the popular and prominent Major General Leonard
Wood, well known to the public for his outstanding service
during the Spanish-American War and his subsequent gov-
ernor-generalship of Cuba, during which he had virtually elim-
inated the scourge of yellow fever from the island.

In 1898 General Wood had struck his head on a low chan-

THE PATH BROADENS l6l

delier, and a few years later a tumor had begun to develop
at the site of his injury. The area of bone containing the tumor
had been removed by Dr. Cabot, and since the present symp-
toms were a weakness in the arm and leg of the opposite side,
Cabot was loath to believe that it indicated a return of the
tumor. Gushing, however, diagnosed it as such, but since it
appeared slow-growing, he decided to proceed cautiously and
recommended that operation be postponed.

Early in January W. T. Councilman sent him suggestions
for his paper before the Harvard Cancer Commission: "It is
veiy important that we should have represented here what the
intracranial tumor means; the gradually increasing pressure
within the brain; the variations in rapidity of growth; the
whole clinical phenomena. . . ."

The Oration in Surgery for the American Medical Associa-
tion to be delivered at Atlantic City in June on "The Hypoph-
ysis Cerebri" kept Gushing rushed during May. He vrrote
to Mrs. Gushing, who had by then taken "the caravan" to Lit-
tle Boar's Head, that "the Oration went off O.K., I think,
though I do not believe many of them knew what I was talking
about. There was a large crowd and they kept coming in and
I had to wait several times for quiet so that it was rather dis-
jointed. Still it was a good paper, wasn't it? And some day they
will find that e Sam' [Crowe] and 'John' [Homans] and I
helped straighten out the hypophysis question in the winter of
1908-09." To his father he said: "I think of little else than the
pituitary body nowadays a poor solace, however, for an
empty house."

But he found some solace in daily, or almost daily, letters to
Kate Gushing, a few of which follow:

June 24, 190$. My ganglion case went badly today 3 hours-
all tied up in the scars of die previous operation. Will have to try
again in a few days. Much exhausted and a German Geheimrath
Prof, looking over my shoulder all the time. . . . That washer-
woman! ! My shirts were simply eaten to pieces great holes. Says
she used the "gold dust" which you have always allowed Susie
to use. Found it in the laundry indeed! I gave her a good scare
and will buy some new shirts.

ifo HARVEY GUSHING

June 75, 1909. Hospitaling all day and a lady to tea. Fear not.
She's a suffragette-friend of Allie Porter's-M.D. Glasgow-over
here studying osteopathy!! Which she intends to practice. Rather
like Mrs. Porter and quite able to take care of herself. I sicked her
on to Miss Sabin only took one cup of tea.

I can't remember our anniversary nor when Betsey was born
but I know your birthday.

June 24, 1909. It's my turn to be depressed. I lost a little boy
today with a brain tumormost unexpectedly and his poor peo-
ple are terribly broken up. This is only one of many troubles. I
never had such a lot of bad cases at one time before. I guess it's
because my judgment is not very good just now. . . . Much love
from your most lonesome H.

Baltimore about the hottest in the country 90-94, but I stand
it well.

July 2, 1909. Hotter'n Tophet again. Glad you are having some
tennis and swims. You'll be feeling very sturdy good preparation
for our jaunt abroad.

It's a good thing you stirred up Tarbell. These artists are pro-
crastinators. Alice probably won't have it in the house. I know
she thinks it was a shocking expense and I hope the Pater has not
told her what it really cost.

What are you knitting? Good thing. You may have to teach
me some day. We will spend our evening years on the back
porch ruminating on the past knitting side by side.

July 6, 1909. I'm just hustling off to the dentist's teeth full of
cloth and all askew very cross. Age 40 and need repair much
porcelain. You can't drop me now or I'll break.

Still cool weather. The writing goes fairly well. Hope to have
the first draft ready by the end of the week then the going over
which takes much time.

July 24, 1909. A check from your Mother for "sidesteps"
abroad, I will deposit it in your acc't at the bank where it will
do most good, I judge. I'll pay for the sidesteps. . . ,

Gen'l Wood wants us to spend the night at Governors Island
will send us to the Lusitank in a gov't tug with a brass band.

Glad that his operation has been postponed; for everyone dies

THE PATH BROADENS l6$

that I touch. Have had a dreadful tumor mortality this month.
Another case todayagain tomorrow. Are you keeping your
fingers crossed?

In another letter, written in an injured, husbandly tone
(called forth because Mrs. Gushing had apparently overdrawn
her bank account), he revealed himself to be, beyond the
shadow of a doubt, his father's son.

You know how I hate this sort of thing. I don't see how you
could have mistaken your bank acc't to this extent. If there is one
thing in the world to be punctilious about it's the prompt! pay-
ment of debts. . . . Whenever you are behind you can come to
me and get funds as you know but this pushing off of settlements
until the last minute when there is no wherewithal to meet them
is paralyzing and destroys your and my credit with banks and
trades people. ... So you see it's poor economy as well as a
bad principle. It's one of the things I want firmly grounded in
the children's minds as they grow up.

On July 27 Dr. and Mrs. Gushing embarked on the Lusitanla
for Liverpool, after a gay send-off by Grosvenor Atterbury,
his father, and the Atterburys' guest, Mr. J, P. Morgan, which
included dining at Sherry's and attending the Follies of 1909.
This was their first trip abroad together, and they made a point
of visiting many of the places that Mrs. Gushing knew from
H.C.'s letters of 1900 and 1901.

Cushing's first duty was the William Banks Memorial Lec-
ture at Liverpool, for which he had chosen the tide "Recent
Observations on Tumours of the Brain and their Surgical Treat-
ment." He wrote his father that "the lecture went off well
enough and they ceremonially dined us and toasted us, to
Kate's embarrassment." This over, they hurried to Oxford.

At the Bodleian Library they studied the six anatomical
plates which Vesalius had issued before he completed his book,
the Fabrica. Only two original sets existed, and this copy,
which Osier had borrowed from Sir John Stirling-Maxwell,
was one of them. Both men were of course greatly excited,
and Gushing took two rolls of film of the various pages.

On August 1 1 the Cushings went up to London, and while

l6j HARVEY GUSHING

Mrs. Gushing went to art galleries, H.C. visited hospitals, the
Hunterian Museum, bookshops, and the tailor. At the Hun-
terian, Gushing was impressed anew at the extent of John
Hunter's collections "John's collossal industry is paralyzing
when one sees his things spread out." He was also much taken
with Sir Arthur Keith, the Curator: "The new Conservator,
Keith by name, is a daisya fit successor to those gone be-
fore." One evening before they left for the Continent they
dined with one of Britain's foremost neurologists, Henry
Head, and Gordon Holmes, who was on his way to similar
distinction.

On their way to Berne the Cushings traveled through Hol-
land and from The Hague H.C. wrote home: "We got here
this morning [August 15] at the unseemly hour of 7 having
been routed out of our steamer at the Hook at 5 A.M.! ! It was
a fine cold misty Dutch morning full of cows and dykes and
sabots and windmills." He spent an hour studying Rembrandt's
School of Anatomy:

Tulp's hands are the most wonderful part of it to me though
I dislike even more than in the familiar prints the way he is
holding and apparently crushing the muscle with a heavy pair
of forceps like modern clamps. The whole composition is of
course marvellous and it's curious how inconspicuous the cadaver
is in spite of its ghastly greyish blue color actually the lightest
part of the whole picture; more so against the black coats of the
graduate onlookers.

When they reached Berne, the Kroneckers, the Kochers,
the Michauds, and many others gave them a royal welcome,
and they spent several happy days there resting up for their
next objective the International Medical Congress in Buda-
pest at which Gushing was to give a paper. They went by
way of Munich, where they were met by Dr. MacCallum,
and thence to Vienna, where Alfred Frohlich entertained
them.

The opening session of the Congress on August 29 was a
"very gorgeous but piping hot affair" where there was too
much noise and too many people to hear and see very well.

THE PATH BROADENS l6f

But the pomp and ceremony, the color of elaborate uniforms
and academic gowns, and the distinction of the vast gathering
was fascinating. Here were collected the most eminent names
in medicine from every country in a half-professional, half-
holiday mood. Cushing's own paper was read on September 2
late and to a dwindling audience because he had been de-
tained by Sir William Alacewen, who insisted on eating a
leisurely lunch.

When the Congress was over, the Cushings went to Venice,
whose enchantments H.G had so longed to share on his first
visit there in the spring of 1901. They spent the first sunny,
cloudless day in and out of gondolas, ending with a swim at
the Lido and return by sunset. The next day, while Gushing
looked for Vesalian items, Mrs. Gushing went to find the Bel-
lini portrait that had reminded her husband of her when he
had first seen it. They then went on to Florence, where the Uf-
fizi, bookshops, Vesalius, Titian, the National Library, lunch on
spaghetti with chicken livers, chops, cheese, and Chianti left
them "worn but courageous." The next five days were spent
in Milan, the Italian lake country, Bellagio, Lausanne, and
finally Paris, whence they sailed for home. They parted in
New York, Mrs. Gushing returning to her family in Little
Boar's Head, and H.C. to Baltimore.

HOPES FULFILLED
Chapter XVI

E

/ARLY IN IpIO GUSHING WEKT TO

Cleveland to speak again on "The Special Field of Neurological
Surgery." Five years had passed since his first paper, and he had
encouraging progress to report. In all, he had had up to that
date 1 80 patients suffering with some type of brain tumor.
Of the last one hundred cases there had been eight operative
deaths in the first fifty, and only three in the second. This was
pardy due to the fact that patients were beginning to present
themselves before the outlook was completely hopeless, since
early signs of tumor were being recognized more readily. Pa-
tients less frequently arrived at the clinic already blind, be-
cause ophthalmologists had become aware of what conditions
indicated pressure on the optic nerves. Mortality statistics had
also been reduced through increased knowledge of the factors
important for surgical success:

They are ticklish performances, these operations for tumor,
and demand not only a rigorous regard for detail, such as the
patient's position on the table and the choice of the anaesthetic,
coupled with the highest skill in its administration, but also a
thorough knowledge of the diverse tricks of controlling haemor-
rhage from scalp, meninges and brain, with a full understanding
at the same time of the cerebrospinal fluid circulation under
states of tension; for this latter is really one of the keynotes of
success in these difficult problems.

While in Cleveland, Gushing received a telegram from Mr.
Abraham Flexner, then head of the Carnegie Foundation for

166

HOPES FULFILLED itif

the Advancement of Teaching, asking him to come to New
York. His object was to offer Gushing the chair of surgery at
the Washington University School of Medicine in St. Louis,
which was to receive an endowment of two million dollars
for reorganization on the Hopkins model It would be a chal-
lenging opportunity, offering free scope for his ideas and with
ample resources for implementing them. It was a real threat at
last to his long-held thought of Harvard.

While he was considering the matter, the problem of
whether or not he would operate on Major General Leonard
Wood again confronted him. The General's symptoms had
gradually grown more severe and it seemed as if the time had
come for surgery if he were to improve. He strongly urged
Gushing to operate, but the possibility of losing such a prom-
inent man and servant of the country filled Gushing with
apprehension. Nevertheless, he made up his mind to go ahead
and on February 5 made what proved to be a first attempt, for
the bleeding was so profuse that it was thought wise to replace
the bone flap and attack the tumor itself at another opera-
tion.

The second stage was scheduled for February 9. The day
before, Arthur T. Cabot, General Wood's close friend and
former surgeon, arrived in Baltimore at Cushing's suggestion
to be on hand for the procedure. This time by slow dissection
a large tumor was carefully tilted out. The patient stood the
four-hour session well, the wound healed without compli-
cation, and eleven days later General Wood was walking about
his room. Dr. Cabot was most favorably impressed. "He had
never seen an operation of the kind," Gushing wrote, "no
more had I." It was his first successful experience with a
meningeal tumor the most difficult to remove because they
are so vascular and his first complete (or so he thought)
removal of a tumor. Because General Wood's illness would
have caused national concern, his presence in the hospital was
kept as quiet as possible and he was able to leave shortly there-
after with only a brief mention in the newspapers of the fact
that he had been hospitalized for repair of an old wound.

l6S HARVEY GUSHING

Cushing's elation over the success of the operation was
dimmed immediately by word from Cleveland that his father
was ill. Dr. Kirke had felt poorly during the first days of
February and on the 8th was confined to bed with anginal
pain alternating with light cerebral attacks which caused tem-
porary loss of speech and paralysis of his right hand. On the
9th, the day of the second-stage operation, Harry Gushing
wrote H.C.: "I read father your letter half an hour ago. He
had another attack this noon, longer and more severe, it seems
to me, than the one yesterday, from which he has rallied how-
ever. He insists that I answer your note, telling you not to
come unless sent for, and giving you all his love, and I there-
fore do so, as instructed."

On the zoth there was a telegram from Ned: "Fair night.
Rather more comfortable. No return of anxious symptoms.
Demurs at your coming but I know will be very glad to see
you." Gushing arrived on the nth, barely in time, for his
father died that night shortly after midnight. His aff airs proved
to be in perfect order, as he had endeavored to keep them all
of his eighty-three years, and his children discovered that al-
though most of his suits were well worn, he had saved one to
be buried in.

The esteem with which Dr. Kirke was held in Cleveland
was expressed in unreserved terms that his own reticence
would have forbidden during his lifetime. The tribute of his
eldest son, William, in reminiscences written for the family,
would have pleased him, especially the statement that "he re-
mained, up to his brief final illness, in full command and con-
trol of himself and of his affairs." But the tribute that would
doubtless have moved him most deeply came from outside his
family. It was a memorial adopted by his fellow members in
the Rowfant Club.

... To us he was the cultured booldover, the collector of
portraits, and the lover of Cleveland's quaint and historic scenes.
... He had an affection for the last Indian, the old names, the
founders of our institutions; he remembered the Ohio City, the
bridges in the hollows, the boys' old trysting places on the fiats,

HOPES FULFILLED l6$

the trignale, the Ark, the early civic and social discouragements
and triumphs, in many of which he participated. . . .

We were the privileged ones. To us he was the charming
raconteur, to others, the austere and learned physician. While
others may have profited from the fruits of his labors, we had
the aroma of his life. He loved these rooms when empty and
when full. He enjoyed their charm alone or at the board. Even
when his eighty years weighed heavy on him and the grasshop-
per became a burden, and his ear dull, his erect form, draped in
his great gray cloak, sprinkled perchance with snowflakes, would
come in past the candle, and he would take a place amongst us,
be one of us, and grow young again. . . .

Toward the end of March, Gushing had a letter from Mr.
Lowell, President of Harvard. It was not an offer of the cov-
eted chair, but it announced the fact that it would be offered
to him. Arthur T. Cabot was a member of the Harvard Cor-
porationapparently his visit to Baltimore and news of the
developments in St. Louis had finally stirred Harvard to ac-
tion. In the meantime the people at Washington University
were bringing all possible pressure to bear. "Things moved
along pretty actively for a while," Gushing wrote some years
later, "But I wobbled a little owing to EdsalTs final withdrawal
[he had been offered the chair of medicine]; father's death
upset me greatly, and St. Louis seemed very far away."

In his moment of triumph, Gushing sorely missed his father's
counsel, and Ned took his place as confidant. On April 23 he
wrote: "I think your letter to the Brigham Hospital people
is good and ought to help them see the light, whatever the
outcome of your personal problem. I have gathered that they
are a pretty conservative group of folks and very positive in
their conceptions. ... I wish I could thrash over with you
all the pros and cons of the St. Louis-Boston propositions."

On April 12 Gushing received letters from A. Lawrence
Lowell and Alexander Cochrane, President of the Board of
Trustees of the Peter Bent Brigham Hospital, offering him the
position of Surgeon-in-Chief of the Hospital and a professor-
ship in the Harvard Medical School. He was to be appointed
to the senior chair in surgery, the Moseley Professorship, then

HARVEY GUSHING

occupied by his former teacher and long-time friend, Maurice
Richardson, upon Dr. Richardson's retirement.

The Harvard Medical School had never had a teaching hos-
pital under its control (as did the Johns Hopkins) until the
Peter Bent Brigham Hospital became affiliated with it. An in-
formal arrangement with the Massachusetts General Hospital
and the Boston City Hospital had filled this need. In 1872
Peter Bent Brigham, a merchant who had peddled fish on the
streets of Boston when he had first come from Bakersfield,
Vermont, left $1,300,000 to be held in trust for twenty-five
years and then used for founding a hospital for indigent per-
sons in the County of Suffolk. When the hospital was begun
in 1911, the estate had grown to $6,250,000, of which
$1,250,000 was to be used for the building, leaving the bal-
ance for endowment. The clinical material in its wards was
to be available to the students of the Harvard Medical School,
which was to have a voice in the control of the hospital
sometimes a larger voice than the Board of Trustees of the
Brigham deemed appropriate.

The land for the hospital had been bought in 1907 on Hunt-
ington Avenue near the Harvard Medical School, and John
Shaw Billings had been consulted about the plans for the build-
ing. Gushing himself at one time had met with Dr. Billings and
Dr. Welch at the Maryland Club to discuss the plans. However,
it was not expected that the hospital would be open to the
public until 1912, and Gushing in the meantime would remain
in Baltimore, carrying on by letter arrangements for the hos-
pital organization and the planning of the building with Henry
A. Christian, who was to be Physician-in-Chief and Professor
of Medicine. Christian was a Hopkins graduate of 1900 and
had had his later training under Osier. He and Gushing had
thus acquired many of the same traditions.

A flood of congratulatory messages poured in on Gushing
when his decision became known. Along with those on the
Harvard appointment, the Cushings also received congratula-
tions on the birth of a second son, on May 22, who was named
Henry Kirke Gushing. Because of young Henry, Mrs. Gush-
ing did not accompany her husband when he sailed for England

HOPES FULFILLED /7/

on June 22 with the Society of Clinical Surgery to visit hos-
pitals and clinics in Liverpool, London, Edinburgh, Newcastle,
and Leeds. They attended demonstrations arranged by Sir Vic-
tor Horsley, spent a day at Oxford with Oder, and dined
with the Royal College of Surgeons in Edinburgh.

September at Little Boar's Head was largely devoted to a
paper on controlling bleeding in cerebral operations by the
use of silver clips. This was the first description of the clip
Gushing had devised a valuable aid in brain operations which
is still used today. He also did some preliminary work on a
paper on disorders of the pituitary for the Harvey Lecture to
be given on December 10 his tenth paper during the year.

In March of 1911 Gushing had word from Cleveland that
Ned Gushing was seriously ill. It was discovered that nothing
could be done, for he had an inoperable carcinoma of the
bowel. While waiting helplessly for the end, H.C. wrote in
agony of spirit: 'In a short while I shall be the last of the
Gushing doctors. A little more than a year ago there were
three of us. Now Neddie is dying in a near room in a most
beautiful and ecstatic euthanasia." Death came on the 25th,
bringing deep grief not to his family alone, but to much of
Cleveland, for as professor of pediatrics at Western Reserve
and a practising physician he was widely known and greatly
loved. Cushing's only comfort was that his father had been
spared the knowledge of Ned's premature death.

A month later he was offered the chair of surgery at West-
ern Reserve, but even if his future had not been settled, he
would have found it difficult to return to a Cleveland that no
longer held his father and brother.

To take his mind off his loss, he buried himself in work.
In June he crossed the Mississippi for the first time to give a
paper on "Distortions of the Visual Field" at the annual meet-
ing of the American Medical Association in Los Angeles. He
stayed with Dr. W. Jarvis Barlow, the founder of the Barlow
Sanatorium there, who shared his interest in medical history.

His Harvey Lecture of the preceding year formed the basis
of a book for which he had been collecting material since he
first became interested in the pituitary. During the summer of

HARVEY GUSHING

1911 he commenced work in earnest, signing on August 31 a
contract with J. B. Lippincott for a book 300-350 pages in
length with 150-200 illustrations (the book when published
ran to 341 pages with 319 illustrations). He was to have the
completed manuscript in their hands by October 7. On Sep-
tember i he wrote to Mrs. Gushing at Little Boar's Head:
"Still at it. ... It's going to sell for $4.00 and if they sell
2,000 copies Fll be given 10% on all back ones. I'll give you
all my royalties! ! ! for being so patient. It's foolish to think I
can finish it before September 151*1 but I'm going to pretend
that I can. ... I get up at 7 (when I don't oversleep) and
work till eleven, then hospital till 4 and come home and work
till eleven. There are about 300 illustrations." These were
largely photographs of patients in various stages of pituitary
malfunction fat people, giants, pygmies, bearded ladies, etc.
He added, "There ain't nuthin' the hypoph can't do."

The book appeared in 1912 under the tide, The Pituitary
Body and Its Disorders. Clinical States Produced by Disorders
of the Hypophysis Cerebri, and was dedicated "In loving
memory of three physicians: Erastus Gushing (1802-1893)
Henry K. Gushing (1827-1910) Edward F. Gushing (1862-
191 1). 7 ' Based on a detailed study of fifty cases, the book was
not only an important contribution to endocrinology, but a
milestone in the history of American medicine.

Gushing had pointed out earlier that the "hypophysis and
the ductless glands in general so influence the function of every
organic process that they overlap into every individual spe-
cialty," The main contribution of the pituitary volume was
the elucidation of this influence, especially the effects of un-
dersecretion of the gland (hypopituitarism), oversecretion
(hyperpituitarism), and recognition of the clinical signs of
such malfunction. The numerous photographs were most ef-
fective in portraying the resultant changes which take place
in die body.

It was believed that the anterior lobe of the gland was essen-
tial to life and bore dose relationship to the disturbances of
growth (acromegaly, gigantism, and forms of infantilism).
The posterior lobe, on the other hand, was closely bound up

HOPES FULFILLED /73

with water metabolism. In his microscopical studies, Gushing
had discovered that the eosinophilic cells of the anterior lobe
(those that stained readily with a dye called eosin) secreted
the growth hormone, but the function of the other celk in
the lobe, the so-called basophilic cells, still baffled him. Twenty
years were to elapse before he knew the answer.

The monograph thus approached the pituitary gland from
every aspect anatomically, physiologically, pathoIogicaDy,
and, of course, surgically. Horsley and others had attempted a
few operations on the pituitary, but the results had not been
encouraging. After the publication of the pituitary mono-
graph, pituitary operations were undertaken with more con-
fidence and eventually came to be routine.

The book aroused much comment. Halsted wrote: "This
morning the book has arrived, and I am greatly pleased to
have it. It reminds me forcibly of my shortcomings, of which
I have been daily conscious for many years." Osier called it
"a ripper" which "opens several new chapters in cerebral
physiology, to say nothing of metabolism. The figures are
excellent. What a lot of work you must have put into it! It
is very nice to see the dedication to the three generations but
'tis very sad that poor Ned did not have a chance to live out
his days." J. Collins Warren, his professor of surgery at Har-
vard, wrote: "Please accept my thanks for remembering me
with a copy of your splendid monograph on the pituitary
body. ... I am taking the book to the country to learn the
new surgery so as not to get too far behind in the proces-
sion. With such progressive leaders as yourself, this is no easy
task." Harvey Gushing had indeed opened the book of surgery
to a new place.

At the end of the year Osier said to him: "I hope you are
going to take a good year 'off before you settle in Boston.
You certainly should do so, as you have had the topsails set
and a pretty stiff breeze behind you for a good while." But
for Gushing there was never any rest. He had become inter-
ested in a variety of subjects, for the pituitary had led him
into several byways. With Emil Goetsch, who had been sur-
gical assistant at the Hunterian in 1909-10, he had studied the

Ijf HARVEY GUSHING

phenomenon of hibernation, believing that the pituitary was
involved. With Conrad Jacobson, who followed Goetsch, he
had investigated the absorption of carbohydrates, having be-
come interested in the relation of the pituitary to sugar
metabolism because his acromegalic patients frequently had
diabetes. This brought him into touch with his former class-
mate, Elliott Joslin, now a world-renowned specialist in dia-
betes. His interests ranged over so wide an area that his friends
accused him of trying to relate every new clinical entity to
the pituitary.

In 1912-13 he had started his current assistant, Lewis Hill
Weed (Hopkins 1912), on experiments on the cerebrospinal
fluid. He had also engaged another graduate of the Class of
1912, Clifford B. Walker, to work with him on ophthalmo-
logical problems. Since tumors often pressed on the optic
nerve, causing visual disturbances, he had set up his own dark-
room for the study of the visual fields. Their collaboration
resulted in a number of papers which stand as classics in the
field of ophthalmology.

Some of Cushing's theories about the pituitary and its influ-
ence on bodily function were proved erroneous in the light
of later knowledge, but they served to set men to thinking
and working on the problem. His method of experiment was
for the most part based on inductive reasoning. Rather than
making deductions from an assemblage of facts, he was in-
clined to postulate a theory and then set out to prove it. There
would have been no quarrel with this method if, when proven
wrong, he had been willing to abandon his theories and start
on another bent. But Gushing, unfortunately, in pride and
stubbornness clung to his ideas and more than once wasted
the time of his assistants trying to prove the impossible.

In the meantime the walls of the Brigham Hospital were
slowly rising, and letters passed frequently between Gushing
and Christian, Alexander Cochrane, President of the Board of
Trustees, and John Reynolds, Chairman of the Building Com-
mittee. Many things cropped up to mar the serenity of their
days. Gushing found it difficult to concentrate on practical
details of the building because it was almost impossible for him

GUSHING CHILDREN

Betsey, Mary, Wittim holding Barbara, and Henry
Christinas, 191$

above

OPERATING BEFORE THE HARVEY GUSHING SOCIETY, 1932

below

WRITING THE OPERATIVE NOTE AFTER
2000TH TUMOR OPERATION, 1931

Courtesy of Richard U. Light

HOPES FULFILLED /7J

to visualize anything from plans he only knew (and that quite
definitely) whether or not he liked it when it was done. This
left much of the burden to Christian who, however, was in
Boston so that it was a little easier for him to make decisions.
When the work seemed to go along slowly, Gushing badgered
Mr. Cochrane, and again Henry Christian acted as go-between
explaining Gushing to Mr. Cochrane and vice versa.

But gradually the difficulties and problems were resolved.
The admission of private patients to a hospital intended for
the indigent sick was decided on the theory that the indigent
would greatly profit by the presence of paying patients. The
plan for organization which outlined personnel, salaries, re-
tirement age (sixty-three), and made special point of empha-
sizing the importance of autopsies to the success of the hospital,
was adopted by the Brigham Trustees virtually as Christian
and Gushing had drawn it up.

During the summer of 1912, while iMrs. Gushing and the
children were at Little Boar's Head, Gushing began to finish
off his work in Baltimore. From June to July he was in Europe,
again with the Society of Clinical Surgery, this time to visit
the German clinics. Gushing left the party long enough to
make a hurried trip to Berne for Professor Kocher's Jubileum
"it really was fine the music especially a great chorus of
male voices; and when they sang Mem Heimathnd it made
things run up and down your spine. ... A great crowd-
many notables. Kocher made a gift to the University of
$40,000 his Nobel Prize I guess for the establishment of a
research laboratory. Then there was a great banquet at which
I sat between Kronecker and von Monakow, the psychiatrist-
very amusing time. A lot of people I knew. ... It really was
bully and well worth the wear and tear of two long nights on
a German Schlafwagen"

Gushing bought a car during this summer which he spelled
variously "Cadilac," "Cadallac," and finally, "Cadillac." He
looked upon it with somewhat doubtful pleasure "I enjoy it,
but feel as though I had an elephant on my hands. Some day
it will step on me and squnch me." His reaction was akin to
that of his father when in 1899 he bought his first "electric"

1-6 HARVEY GUSHING

"Can say of it as Carlyle said of the Emersonian periodical,
the 'Dial 7 , 1 love vour Dial but it is with a kind of shudder.' "

7 .r

There were many problems buying a house in Boston, ar-
ranging for its redecoration, getting bank accounts transferred,
engaging additional house staff, and much else. On August j
he sent a clipping which announced that "Dr. Harvey Gushing
Buys in Brookline ... the old-fashioned residential property
at 305 Walnut Street. . . . The parcel comprises a handsome
colonial house, combination stable and garage, formal garden,
beautiful shrubs and trees, and about 121,457 sq. ft. of land."
To Mrs. Gushing he wrote: "We're getting altogether too
much notice. You'll have to wear a quieter hat, and I'll raise
some whiskers and hide myself behind 'em perhaps some spin-
ach from your garden will do. I suppose you think you're
going to drive around Brookline like Mrs. J. Gardner and have
a Vermeer on your w T all and Gustave up in front and Joseph
up behind and vote for vimmen, and lunch at the Chilblain.
Not much. I'm going to stay here and take the Preston Street
car and read the Journal on the way over."

On August 23 he announced: "I'm beginning to see the end
here. Have had about enough. Am winding up pro tern a lot
of papers on the J.H.U. material; am closing the lab'ty with
Lewis Weed who's about fagged out. Will begin to think of
packing next week. . . . Shall I bring the grass rugs in the
cellar?" Finally, on September 2, the night before their be-
longings left Baltimore, he wrote: ''Nothing left here but this
desk and it goes tomorrow, the last thing. All the reflexes of
5 years +. I look up at the clock reach for a watch turn for
a book nothing there. Very funny rather sad."

RETURN TO BOSTON
Chapter XVII

H,

JVRVEY GUSHING RETURNED TO

Boston in September of 191 2. With him was a group of young
house officers eager to begin work in the new hospital. But
when they arrived, they found the building still unfinished,
and except for Lewis H. Weed and Emil Goetsch, who im-
mediately began the organization of the experimental labora-
tory, all of them were forced to mark time. For Gushing this
was irritating not only because it interfered with his own
work, but because he hated to see anyone whose energies he
might command standing idle. What little operating they did
had to be done at the Corey Hill Hospital.

During the waiting time Gushing worked on several unfin-
ished papers and in December presented a report with Dr.
Weed and Conrad Jacobson (the resident) before the Ameri-
can Physiological Society in Cleveland. This paper, "Further
Studies on the Role of the Hypophysis in the Metabolism of
Carbohydrates," was an important contribution because it re-
vealed the extent to which metabolic functions were under
nervous control.

In the meantime Mrs. Gushing settled the family in the large,
comfortable house, painted yellow, with green blinds and a
white picket fence that they had bought in Brookline. "What
a bully house, what a nice yard & what a solid fence," wrote
William MacCallum on receiving their first Christmas card.
"I can just see the way in a few years the Boston Jeunesse
doree or cultivee will be sidling along that fence cussing the

HARVEY GUSHING

distance from the house & trying to catch a glimpse of 'the
Gushing girls.' " Those who entered the Gushing door were
immediately made to feel at homeeven the maids had assimi-
lated something of the friendly manner of the family they
served. The tea hour, in front of the open fire when the season
called for it, or by the tennis court in summer, was a daily
ritual, and many a medical student or house officer received a
warm welcome from Mrs. Gushing and all the family even
though their host, engrossed in a case or experiment, never
appeared.

Their grounds and garden were in the hands of Gus, the
man-of-all-work who also drove for Dr. Gushing after he was
involved in a traffic accident in which, though not through
his fault, a woman was killed. Gus was deeply devoted to Dr.
Gushing, but his unconventional ways were occasionally a
source of embarrassment to the family, and Dr. Gushing was
always fond of telling of the morning when, irritable from a
night emergency operation, he had pointed out to Gus all of
his shortcomings and Gus, quite unmoved, had announced:
*T)octor, you got egg on your chin."

The Cushings soon discovered that the social climate in
Boston was far more formal than that to which they were
accustomed in Cleveland and Baltimore a fact which doubt-
less meant more to Mrs. Gushing than to Dr. Gushing, for his
life revolved largely around his profession. Their frequent
guests were often his students, house officers, or distinguished
visitors but before the evening was far advanced he usually
managed to slip away to his study, and Dr. Weed, who was
often there, remembers many a time when he helped Mrs.
Gushing put the children to bed after his host had gone to
work.

Through the interest and friendship of a neighbor, James
Ford Rhodes, the historian, also from Cleveland, Gushing was
invited to join a number of select clubs in Boston. He became
a member of "The Club," the famous Saturday Club, and the
Tavern dub. The Wednesday Evening Club and the Win-
ters-night Club which met on Tuesdays he declined since he
was afraid they would interfere with meetings at the hospital.

RETURN TO BOSTON /70

The Saturday Club, which met the last Saturday of each
month for luncheon (an endowed feast which, as Mr. Rhodes
pointed out, was a unique feature of the Club), was founded
in 1857 and had had among its members James Russell Lowell,
Oliver Wendell Holmes, Ralph Waldo Emerson, John
Lothrop Motley, Richard Henry Dana, Jr., Louis Agassiz,
Henry Wadsworth Longfellow, and Nathaniel Hawthorne.
When Gushing joined, he found among the group his friend
W. T. Councilman; A. Lawrence Lowell; M. A. DeWolfe
Howe, then Editor of the Atlantic Monthly (which had been
founded by the Saturday Club); Bliss Perry, the eminent pro-
fessor of English at Harvard; and Harvard's former president,
Charles W. Eliot, who was one of his sponsors. But according
to Mr. Rhodes, who was Cushing's adviser in these matters,
the "Saturday Club is not 'in it' with The Club. Always
neglect the former for the latter but don't tell President Eliot
I said so."

Bliss Perry was in "The Club" also, and former members had
included Henry and William James and Mr. Justice Holmes.
Another member, who became a warm friend, was Major
Henry Lee Higginson, the financier who had sponsored the
Boston Symphony Orchestra. The Higginsons were especially
gracious to the Cushings and did much to make them feel
welcome in Boston. "The Club" met on Fridays for dinner
"Such good talk!" Cushing wrote, "even if the Civil War did
largely figure." The Club of Odd Volumes, of which he had
been a nonresident member since 1911, was another place
where there was always good conversation and associations
which Cushing enjoyed.

The Peter Bent Brigham Hospital finally opened its doors
in January. Amongst the medical profession in Boston there
was considerable opposition in the beginning to the resident
system that Cushing and Christian were inaugurating. The
interns in the other hospitals did not have sufficient training
to perform major operations, but the residents who had served
in the Hopkins system had had sufficient experience to qualify
them to carry out surgical procedures on ward patients who

ISO HARVEY GUSHING

did not have private physicians. To counteract this feeling,
Gushing selected men from other Boston hospitals for perma-
nent positions on the Brigham surgical staff, and John Homans
of the Massachusetts General Hospital (who had worked with
him in Baltimore in 1908-09) and David Cheever of the Boston
City Hospital carried the burden of the general surgical work
for the next twenty years.

Gushing had gone to the Brigham hoping to institute there
some of the good features of the Hopkins. He had three par-
ticular things in mind: a common instead of a departmental
source of animals for experimental purposes, a central library,
and a journal for the Medical School that would offer junior
men an outlet for their publications. The library was the only
one of these projects he ever came near to accomplishing.
But the sweep of the new broom touched so many hitherto
undisturbed corners that one of Cushing's colleagues on the
medical faculty, Dr. F. C. Shattuck, upon meeting a Hopkins
man, began quizzing him about Gushing in his Baltimore days
and said that at Harvard he was acting like a bull in a china
shop.

Early in his career at the Brigham, Gushing became involved
in a matter which was to bring him into opposition with the
authorities of the University. The question was whether or
not Harvard would adopt the so-called "full-time" plan, and
the decision was to have far-reaching effects. To understand
the issue at stake, one must know a little of the background of
American medical education. From the founding of the first
medical school (at Philadelphia in 1765), the teaching of the
clinical sciences medicine, surgery, obstetrics, pediatrics, and
so forth had been in the hands of busy practitioners whose
first concern had to be the private patients who were their
source of livelihood. When Gushing was appointed associate
professor of surgery at the Hopkins in 1902, at the age of
thirty-three, his salary was $500, which, even for that period
of considerably lower living costs, was obviously inadequate
for a married man looking forward to raising a family. An
outside source of income was essential. On the other hand,
chemistry, physiology, and the other preclinical sciences were
taught by men who held faculty appointments and whose

RETURN TO BOSTON l8l

salaries were adequate to allow them to give their entire time
to teaching.

Early in the twentieth century there was talk of giving
clinical teachers a salary sufficient to enable them also to give
full time to the medical school, the fees from private patients
reverting, under this arrangement, to the hospital. "Full-time"
men, trained in educational methods, whose entire energies
would be expended under the hospital roof, would, it was
believed, greatly improve the quality of medical education
and result in better medical care for the patient. The General
Education Board of the Rockefeller Foundation therefore of-
fered the Johns Hopkins in 1912 a million dollars to enable
that institution to embark on the full-time plan.

The preclinical and* laboratory men were in favor of the
change it was natural that they should want to see the clinical
teachers on an equal basis, for it was only human for them
occasionally to envy or resent the lucrative opportunities in a
successful private practice. Those clinical teachers who had
no desire to enter into the competition of a general practice
were also in favor of the change. But those to whom it meant
a much reduced standard of living, while they might approve
in principle, were reluctant to join in. Welch, however, was
able to put the plan across at the Hopkins despite opposition.

When the General Education Board offered Harvard a
million and a half to effect the same change, Gushing came
out firmly against it. He agreed that a clinical professor should
have his activities under one roof his teaching, his clinical
work, and his researchbut he did not think that he should
be deprived of the income from his private patients or the in-
centive which such a practice would offer. His stand was
dictated by principle and not by any personal reluctance to
give up the opportunity to make money from private prac-
tice, for he never coveted money for money's sake and,
although he spent liberally on foreign travel and his children's
education, he lived simply and turned much of his income
back into the clinic. Furthermore, he had private means, for
the real estate Erastus and his father had purchased in the
heart of Cleveland had through the years increased a hundred-
fold in value. He himself, therefore, could have managed well

l$2 HARVEY GUSHING

on a "full-time" salary, but he felt that the modified plan,
already in effect at the Brigham, was a sufficient departure
from the old system and that more radical plans should be
deferred until a fair trial had been made. Christian, with cer-
tain reservations, would have "gone along" with the adminis-
tration, but Gushing offered to withdraw if the authorities felt
the full-time plan was the best one and should be inaugurated
immediately. Harvard, with its eye on the badly needed million
and a half, countered with the suggestion, which did not
please Gushing, that a younger man might be secured for the
post of Surgeon-in-Chief while he stayed on as a consulting
neurosurgeon. In the end the Brigham Trustees voted to retain
Gushing as Surgeon-in-Chief and to reject the offer of the
General Education Board. Mr. Lowell accepted the decision
with grim grace and said nothing, but it was the beginning
of an aloofness between Gushing and the Harvard administra-
tion which was never dissolved.

During the first year of his incumbency, Gushing kept his
absences from duty at a minimum. He gave two papers, one
with Clifford Walker, at the meeting of the American Neuro-
logical Association, on the visual disturbances in cases of brain
tumor, and another before the Massachusetts Medical Society
on his studies on diabetes insipidus, which at that time, as has
been mentioned, he believed might be related to pituitary dys-
function. Percival Bailey and Frederic Bremer later proved
that diabetes could be induced by lesions of the base of the
brain which did not impinge upon the pituitary. But eventually
both were proved right, since the Bailey and Bremer lesions
had injured nerve cells controlling the secretory cells of the
posterior pituitary, and the ultimate effect was similar to a
pituitary lesion.

In April, Gushing planned an impromptu ceremony at the
Brigham so that Sir William Osier, who was in America to
give the Silliman Lectures at Yale University, might give his
blessing to the new hospital. The function took place on the
30th, although Gushing had received a somewhat indignant
note of protest from H. B. Howard, the superintendent of
the Hospital (prompted by H.C/s request for some potted

RETURN" TO BOSTON 1 9)

palms to grace the occasion), who said the Trustees had
wanted the hospital opening informal and informality would
be impossible with such a well-known man as Dr. Osier
present.

In June, Yale University conferred on Gushing an honorary
M.A. degree, and the summer brought other honors he was
elected to Honorary Fellowship in the Royal College of Sur-
geons in Engknd and was invited by Sir Thomas Barlow to
give one of the three principal addresses at the iyth Inter-
national Medical Congress held in London.

Like all international gatherings of this sort, the Congress
was especially brilliant on the social side. There were recep-
tions at the Savoy, at Windsor Castle, at all the London hos-
pitals, at Horace Walpole's Strawberry Hill. There were
excursions to Oxford and Cambridge and special services at
St. Paul's and Westminster. The most picturesque of all the
functions was an evening fete given by Lord Strathcona the
High Commissioner for Canada being then in his ninety-third
year at the Botanical Gardens in Regent's Park. The five
thousand guests wandered about by the light of Japanese
lanterns, entertained by the music of the Royal Artillery band
alternating with Scottish pipers and strolling singers.

Cushing's paper was entitled "Realignments in Greater
Medicine: Their Effect upon Surgery and the Influence of
Surgery upon Them." It was delivered to a session of the
entire Congress at the Albert Hall on August 7.* The address
was a frontal attack on the antivivisectionist obstruction to
medical research and on the British training in surgery (which
allowed a student to pass his examinations in surgery without
ever having seen an operation) and other weaknesses in British
medical education. It aroused several readers of The Times to
irate protest, with Sir William Osier and Sir Charles Ballance,

r, O. Hirsch, an otolaryngologist now of Boston, remembers this
occasion vividly. The following day, when Gushing came into the sec-
tion on otolaryngology, the whole audience rose and the chairman
acknowledged the honor extended by his presence. Young Hirsch was
not then connected with a university but was hoping to become a Dozent
(lecturer) at the University of Vienna. The fact that Gushing came to
the meeting to discuss his paper carried such weight that he received his
appointment the following spring.

l$4 HARVEY GUSHING

an eminent British neurosurgeon, entering the lists in support
of Gushing against his adversaries.

But there was also much favorable comment. James F.
Rhodes wrote: "I have read your brilliant essay and learned
from it much that I am glad to know. It is a triumph to
prepare so excellent a literary composition in the midst of a
busy and exacting life. I do not wonder that you had a large
audience eager to hear you in London." William Welch also
had warm praise for the address: "I am delighted that you
chose the subject you did, and the address was just the thing
for the occasion, the place, and the audience. You made a
good point in noting that animal experimentation in England
is no longer practised by physicians and surgeons, much to
the detriment of the science as well as the art, I am very proud
of you and the success you have had."

Welch himself did not attend the Congress, having gone to
Europe to take the cure at Carlsbad. "It seemed rather absurd,"
he said, "after crossing the ocean for a Cure, to break all the
traditions and take to rioting and feasting at once." From
Carlsbad he had gone to the Lido, whence he sent this startled
comment: "Unless you have seen it, you cannot imagine such
a spectacle as the bathing beach on the Lido in July and
August. It must be unparalleled. Men wear only swimming
tights, and women not much more, and all bathe together
from the beach."

Early in 1914 Gushing went to Philadelphia where he had
been invited to give the Weir Mitchell Lecture. In it he re-
ported the latest figures in regard to his patients with pituitary
disorders. He had described something over fifty operations
in his pituitary monograph in 1911 he now had performed
125 operations on 114 patients with only 10 fatalities, or a
mortality of approximately 8 per cent. These were exciting
figures, and the world began to look toward the Brigham as
a center for research and surgery of the nervous system. Then
war was declared in Europe in August of 1914, and Gushing
began to spend considerable time on plans for the organiza-
tion of a voluntary unit from Harvard to be sent to France
early in 1915.

"THE MARROW OF TRAGEDY"
Chapter XVIII

L

A NATIONWIDE BROADCAST ON

November 21, 1948, Edward A. Weeks, the distinguished
editor of the Atlantic Monthly, told the story behind a book
he had helped to publish early in his career. His comment on
some reminders of the war tin helmets pierced by bullets
and half of a pair of field glasseswhen in Dr. Cushing's office
at the Brigham in 1928 led to the discovery that Gushing had
kept a journal throughout his war duty. Weeks immediately
visualized an arresting story, but Dr. Gushing put him off,
saying it would have to wait until after his death. Regularly,
on the anniversary of this meeting, Weeks called to enquire
after his health, reminding Gushing cheerfully that he had
been promised a book. After several years of this, Gushing
was finally persuaded into selecting excerpts from the nine
fat typewritten volumes that were his war diary. The result
was a handsomely printed book of 534 pages with 35
illustrations.

"The marrow of the tragedy is concentrated in the hos-
pitals," Walt Whitman had written in the Civil War, and
Gushing used these words on one of the front leaves of the
book. In the pages that followed, one fact was abundantly
clear that the changes wrought in most men by the unnatural
tensions of war found little place in Harvey Gushing. Al-
though war changed the complexion of his days, it did little
to alter his habits. When the wounded came pouring in, he

l86 HARVEY GUSHING

would not allow himself to be stampeded into forsaking the
slow, painstaking methods which were the keystone of his
success in the surgery of the brain. Each time he operated it
was a personal matter between that patient and himself the
exigencies of war were to him no excuse for abandoning the
things he had fought for so consistently throughout his pro-
fessional career.

And when the end of the day came, even if this was in the
early hours of the morning, he set down, as was his habit when
aw r ay from home as faithfully as he wrote the operative note
after an operation what the day had brought forth. He often
wrote on a scrap of paper or the back of a temperature chart-
sometimes by lantern light in a tent or bumping along the
road in an ambulance. He augmented the written record with
newspaper maps and photographs taken with a forbidden
camera. Criticism and court martial threatened to penalize him
for this divine disregard for regimentation, but posterity has
a rare record of surgeon and soldiers facing up to the grim
business of war.

The first entry is dated March 18, 1915, when on a cold,
windy night Gushing and the other members of the volunteer
unit from Harvard began their journey to Paris. They were
headed for the Ambulance Am&icaine, the five- to six-hun-
dred-bed hospital in the Lycee Pasteur, a school which the
French Government had put at the disposal of a group of
Americans in Paris. Under the leadership of Ambassador
Robert Bacon and his successor, Myron T. Herrick, a military
hospital and ambulance service had been organized in con-
nection with the permanent American Hospital at Neuilly-
sur-Seine, Financed through voluntary subscriptions, with a
rotating professional staff largely recruited from the College
of Physicians in New York, the Ambulance had asked Ameri-
can universities to supply for periods of three months sufficient
professional personnel to staff certain wards of the hospital.
The first of these units, financed by patriotic American citi-
zens, had gone from Western Reserve University under the
leadership of Cushing's friend, Dr, George W. Crile. During
the early months of 1915 frequent letters were exchanged be-

"THE MARROW OF TRAGEDY" i8j

tvveen Crile and Gushing about matters of personnel and
equipment needed, with the result that the Harvard Unit,
when it sailed, consisted of six surgeons, seven house officers,
and four nurses.

On March 28 they landed in a heavy downpour at Algeciras
and from there traveled to Madrid, where Gushing, ever on
the trail of Vesalius, picked up "for a song 7 ' a copy of the rare
first edition of the Spanish surgeon Valverde's Anatomia, pub-
lished in Rome in 1 556, in which many of the Vesalian plates
were plagiarized. Passing through the Basque provinces on
the way to Paris, Gushing wrote: "Cold and rainy but early
spring betrayed by fruit trees in blossom. Rugged, semi-moun-
tainous country for we are in the foot-hills of the Cantabrian
range of the Pyrenees. From Vitoria, founded in 581 by the
King of the Visigoths, on to Irun-Hendaye."

Paris was not the gay city he remembered. Ominous-looking
armored cars with machine guns, officers speeding by in motor-
cars, ambulances gray except for their big red crosses, the
splash of red of the old French uniforms, and the citizenry in
black proclaimed a country at war. The Ambulance Ameri-
caine was a handsome building with its courtyard full of Ford
motor ambulances manned for the most part by uniformed
American youngsters. The 164 beds which Cushing's unit had
charge of were at the moment largely empty.

But they soon had patients. "It is difficult to say just what
are one's most vivid impressions," Gushing wrote, "the amazing
patience of the seriously wounded, some of them hanging on
for months; the dreadful deformities ... the tedious healing
of infected wounds . . . the risks under apparently favorable
circumstances of attempting clean operations. . . ." He was
not a little shocked at the fact that pressure was often brought
to bear by the wounded for the removal of a bullet or other
missile lodged in some harmless place so that they might ex-
hibit it to impressionable friends "souvenir surgery," Gushing
called it, which often led to serious and needless complications.

Cases of frostbite and influenza-like colds were numerous.
Many of the surgical cases involved buried missiles, "the
vagaries of the foreign bodies being many." "The actual sur-

A page from Dr. Cushings war diary, en route to France in
March,

288

"THE MARROW OF TRAGEDY" 189

gery itself, it would seem, is not very difficult," Gushing
observed, "but the judgment of knowing what and how much
to do, and the wheres and whens of intervention these are
the important things, only to be learned by experience. First,
or last, most of the missiles apparently must come out."

His greatest test of ingenuity came one day when a man
was referred to him with a shell fragment at the base of his
brain. With the use of a big magnet he tried with different
instruments and probes to extract the bit of steel, but with no
success. Finally Walter Boothby, one of the surgeons with
the unit, brought in a nail, the end of which he had rounded
off. The nail was slipped down, 3 J inches, to the base of the
brain, and the magnet swung into position. Slowly the nail
was withdrawn, but there was nothing on it. Three times they
tried it, carefully, slowly, but each time they failed to touch
the fragment. In the meantime, a crowd had gathered in the
corridors, and into the operating room itself had come Albert
Kocher with a friend from Berne. The excitement and tension
mounted, and Gushing was about ready to give up. He took
his gloves off and then decided to try once more. Again the
magnet was swung into position, and this time when the nail
was withdrawn, there was a small fragment of rough steel on
its tip.

When there was a lull between battles, Gushing took the
opportunity to visit other hospitals and installations. Alexis
Carrel, now back in France, invited him to visit his Hopital
Complementaire 2 1 and sent an official car to transport him to
Compiegne. Evidences of spring throughout the countryside
were a welcome contrast to the scenes in the hospital. "Noth-
ing could be more peaceful and lovely than a well-groomed
French forest in the early spring, its floor for miles on a stretch
carpeted with flowers lillies of the valley, anemones, and
low-growing narcissus, the latter in such profusion as to give
a yellow tone in among the trees as far as one could see-
magnificent stands of beeches intersected by paths and formal
allees of alluring kind. But our road lay tout: droit through
it all."

l$0 HARVEY GUSHING

He also visited the Second Army in the Amiens sector,
armed with his camera and two rolls of film. In his journal he
recorded the number of men fighting on the Western Front,
the kinds of guns, the number of beds in the Amiens Hospital
(4,000), and other facts which could have caused him con-
siderable embarrassment were it discovered that he had written
them down. But he knew that this was history in the making
and his interest in every aspect of the struggle made him
seemingly oblivious to the fact that from a security standpoint
he was treading on dangerous ground. He was close enough to
the firing line on this trip to see some disconcertingly recent
shell holes and to hear the frequent discharge of a cannon on
the other side of the road.

Toward the end of April he visited the distributing station
at La Chapelle a 250-foot-long freight shed where the
wounded were divided into three classes: those who could
walk, those in wheel chairs, and the badly wounded on
stretchers. Gushing described the scene thus:

The impressive thing about it is that it is all so quiet. People
talk in low voices; there is no hurry, no shouting, no gesticulat-
ing, no giving of directions nothing Latin about it whatsoever.
And the line of wounded tired, grimy, muddy, stolid, uncom-
plaining, bloody. It would make you weep. Through the opening
in the curtain, beyond which one of the cars of the train could
be seen, they slowly emerged one by one cast a dull look around
saw where they were to go and then doggedly went, one after
the other each hanging on to his little bundle of possessions. Those
with legs to walk on had heads or bodies or arms in bandages or
slings, in the hurried applying of which, day before yesterday,
uniforms and sleeves had been ruthlessly slit open.

The conditions in France among the wounded laid such a
hold on Cushing's emotions that he somewhat highhandedly
decided to leave the unit and return home to arouse people
to the need for preparedness so that when America became
involved in the conflict (and he looked on this as inevitable),
our soldiers would be more adequately cared for.

Through the influence of Osier, who was heavily involved
in war activities in London, he secured permission to visit

"THE MARROW OF TRAGEDY" /p/

R.A.M.C. hospitals in Flanders en route to Britain. He left the
Ambulance Ainericaine on May i. "Eight months have passed
since that eventful sunrise of the 6th of September when the
German tide was checked in this very region north of Meaux,
but it might almost have been yesterday. A battle leaves en-
during scars. The dead still lie in shallow graves where they
fell the fields and roadsides are dotted with crosses; and every
haymow of last autumn's harvest shows by the grim evidence
about it how its futile protection had been sought against the
scythe of another reaper."

He was soon closer to the front lines than he had yet been
and saw the batde of Ypres from the Scherpenberg Hill. He
visited No. 1 3 General Hospital at Boulogne, and a number of
casualty clearing stations where he saw some of the first vic-
tims of gas attacks "A terrible business one man, blue as a
sailor's serge . . . too busy fighting for air to bother much
about anything else a most horrible form of death for a
strong man."

On May 6 he was in London, but immediately headed for
Oxford where he got far from the war among Osier's books
after a quiet family dinner with Sir William, Lady Osier, and
her sister, Mrs. Henry Chapin of Boston.

In the morning there came news of the sinking of the
Lusittmia. At the Cunard office, when Gushing went to pick
up his own passage, an anxious crowd was waiting with hag-
gard, tearstained faces for more details. On the homeward
voyage two days later they passed for an hour through debris,
bodies, and overturned boats. The tragedy and the waste of it
caused Gushing to land on home soil more grimly determined
than ever to throw all his energies into preparing for America's
entrance into the war.

He was, however, at first amazed and then incensed to dis-
cover that although people along the eastern seaboard were
aroused over the sinking of the Lusitania, the United States for
the most part viewed the conflict on the other side of the
Atlantic with considerable indifference. General Leonard
Wood, now Chief of Staff of die Army, and a few others were
making herculean efforts to rouse the public to action, but

HARVEY GUSHING

many went along with President Wilson in believing that we
should remain neutral. Gushing, filled with patriotism, ac-
cepted every opportunity offered him to speak on prepared-
ness. In addition, he began actively to work for the Red Cross
and presented to Mayor Curley of Boston the possibility of
mobilizing three Red Cross hospitals on the Boston Common
to stimulate interest and to give needed experience to person-
nel. He also began the organization of a unit from the Brigham
large enough to man an entire base hospital.

But he ran into obstacles on every side: added to lack of
enthusiasm was the fact that disorganization in Washington
resulted in orders and counter orders that frequently discour-
aged those who were interested in the beginning. And as for
his plan for violating the sanctity of the Common! he found
even his good friends of the Saturday and Tavern Clubs unable
to follow him in this flight of fancy. Fond as he had been of
every corner of it in his medical school days, he saw no sacri-
lege in proposing that it now enter the service of the country.
But Harvey Gushing was a Middlewesterner. In the Battle of
Boston Common, as he called it, he fought a valiant fight, but
he was doomed to defeat from the beginning. Henry Lee
Higginson and his staunch friend, William T. Councilman
(who had once said he was almost willing to die to get out of
Back Bay), joined forces with him, but there were few others.

In the meantime, Dr. W. W. Keen, one of the senior advisers
in surgery to the newly formed National Research Council,
came to him for information that would help him write a
report to the Council on "The New Discoveries and Their
Application in the Treatment of Wounds in the Present War."
The Council had been formed under the auspices of the
National Academy of Sciences which had been granted a
national charter at the time of the Civil War when Abraham
Lincoln saw the necessity of enlisting the aid of the nation's
scientists in the war effort. The need was now felt for an
organization of younger men to organize the country's scien-
tific talent for national defense and to make "such other appli-
cations of science as will promote the national security and
welfare." It was the type of organization to which Gushing

THE MARROW OF TRAGEDY*' l$$

would give his fullest co-operation, and he promptly sent Dr.
Keen a long and thoughtful reply.

Along with these extracurricular activities, Gushing was
carrying a full schedule in his clinic. Miss Louise Eisenhardt,
who had come to him as secretary in 1915,* was assisting him
in the preparation of a book on Tumors of the Nervus Acusti-
cus and the Syndrome of the Cerebellopontile Angle. Like
the pituitary volume, it was to set a standard for the diagnosis
and operative handling of this type of intracranial growth
which affects one or both nerves from the ear, usually causing
deafness. For the first time hope could be held out to patients
suffering with these deep-lying tumors, so difficult to approach
surgically, for Gushing had devised a method which reduced
the operative mortality to approximately 10 per cent. Al-
though some of these tumors recurred, the majority of the
patients were relatively free of symptoms for considerable
periods and could often return to former occupations.

In this monograph Gushing, according to Geoffrey Jeffer-
son, the distinguished British neurosurgeon, "did for the first
time very clearly what he was to do more and more as his
experience grewhe came to recognize the fact that different
tumors have a predilection for certain situations, a fact which
general pathology tends too often to skim over. For it is a fact
that new growths have strong preferences for certain organs
and situations. ... So it has proved to be within the cranium
where different types, though theoretically they could appear
anywhere, do so but rarely."

In 1915 Gushing published a paper "Concerning the Results
of Operations for Brain Tumor" in which he reviewed the
operative mortality statistics of the leading surgeons dealing
with brain tumors. The mortality of Hermann Kuttner of
Breslau was 45 per cent; that of Fedor Krause of Berlin 50 per
cent; Anton von Eiselsberg of Vienna reported 38 per cent;

1 She later took her medical degree and worked with Dr. Gushing, until
his death, as his brain tumor pathologist. She developed a remarkable
facility for diagnosing tumors from fresh, unstained material while the
operation was in progress, a practice which has now become more or
less widely adopted.

HARVEY GUSHING

although Horsley did not publish his figures, it was estimated
that they were approximately the same (38 per cent) . Gushing
astounded his readers by submitting an average mortality of
84 per cent. It was higher with some types, lower with others.
Furthermore, in the Vienna series of patients, 10.5 per cent of
the patients were ultimately lost from meningitis occurring as
a result of postoperative infection. In London, 1 1.7 per cent of
Horsley's patients likewise succumbed from this cause. Gush-
ing reported that he had lost but one patient and attributed
the absence of sepsis to a careful method of closure of the
galea as well as the skin, thus preventing the wounds from
breaking down.

Cushing's family, now increased to five by the birth of
Barbara, on July 15, 1915, saw little of him during these years,
and on May n, 1917, he was again on his way to Europe.
The unit, which was to serve with the British Expeditionary
Force as Base Hospital No. 5, consisted of 26 officers, 185 en-
listed men, 81 nurses, 3 secretaries, and i dietitian. They landed
in England, where many of the group were immediately in-
vited by the Osiers to Oxford. "England in May! Some of us
never here before; few if any of us at this most wonderful
season. The roadsides abloom hawthorns, yellow-tasseled
laburnums, lilacs, red and white chestnuts rock gardens with
every imaginable flowering plant, iris, tulips, wallflowers, and
flowering vines of all kinds. It takes a gray wall to show off
wisteria properly."

On May 3 1 they were established at No. 1 1 General Hos-
pital at Camiers "a shockingly dirty, unkempt camp" and
received their first convoy of 200 wounded at i a.m. Gushing
fell heir to the tent of the pathologist of the group they sup-
planted and to some straggling Scotch marigolds.

For the next year, especially during the winter of 1917-18,
Gushing and his team operated sixteen and eighteen hours a
day. Night bombings, which meant the extinguishing of lights,
added to the hardships. Gushing also had to contend with
criticism of his refusal to rush cases through, for while he was
doing operations at his usual pace, some men died in his ante-

"THE MARROW OF TRAGEDY" 195

room. But he felt that one job well done was worth two men
only half alive.

By developing a careful technique for clearing away all the
injured brain substance, Gushing had actually reduced the
general mortality in serious wounds penetrating the brain from
50 to 28.8 per cent 2 in the series of cases he operated on in the
forward clearing stations. Thierry de Martd, a pioneer French
neurosurgeon, was the leading exponent of two other advances
in dealing with cranial wounds die use of novocain anesthesia
and the sitting position in brain operations to lessen venous
bleeding.

Bearing in mind the usefulness of records on the cases that
passed through his hands for the weapons of this war were
creating a different type of wound than had been seen before-
Gushing kept detailed histories of each patient. These excellent
case records served later as the basis for a monograph which
was one of his outstanding contributions resulting from the
war. In 1940, a year after another world war had begun, there
came to the Historical Library at Yale University an urgent
cable from the officer in charge of neurosurgery for the
RA.M.G Hugh Cairns (later Brigadier Cairns), who had
been Dr. Cushing's assistant at the Brigham Hospital in 1926-27
asking for the names of the 119 men whose brain injuries
Gushing had described. Since many of the records had been
lost on their way back to the States in 1918, it seemed doubtful
if the information could be supplied, but in Cushing's personal
copy of his paper there appeared in the neat hand of his secre-
tary, Miss Julia Shepley, who had been with the unit in France,
the name, regiment, and home address of every patient living.
These men were traced and examined for what they might
contribute to the solving of the problems of a new war.

On the night of August 30, 1917, when Gushing had just
turned in after a gruelling day, word was brought to him that
Osier's son, Revere, was severely injured. He rushed in an
ambulance to Casualty Clearing Station No. 47 where William

2 In World War II the use of suction for this purpose, supplemented
by the antibiotics, considerably lowered the mortality.

ig6 HARVEY GUSHING

Darrach of New York operated at midnight on the bare chance
of saving Revere's life. But there had been four shrapnel
wounds and it was a hopeless fight. Gushing saw him buried
the next morning beside a small oak grove where long rows
of simple wooden crosses marked the graves of other young
men, some who, like Revere, would have gone home a few
days later on leave. "Surely this will take me home," he had
said to Gushing when he had opened his eyes to find him at his
bedside. The great-great-grandson of Paul Revere was thus
laid to rest covered with the Union Jack, while six or eight
American Army medical officers stood with bowed heads
thinking of his father.

For Sir William and Lady Osier it was a cruel blow, their
only sokce in the loss of this beloved son being that Gushing
had been with him when he died. To Mrs. Gushing, Lady Osier
wrote: "Oh Kate, dear Kate, My darling fair baby has gone-
just laid in that wet, cold Belgium, but thank God for two
things your Harvey was with him and he has gone to a
peaceful spot. . . . My poor man is heartbroken. I feel very
anxious for him. He puts up a bluff in the daytime but the
nights three nights have been a torture and I am watching
near his door now in case he needs me."

In September, Base Hospital No. 5 was the target of a
bombing raid. A lieutenant and three privates were killed, a
nurse, three officers, and several enlisted personnel, and twenty-
two of the patients were wounded. Not long after this disaster,
Gushing heard of the death of John McCrae, the brother of
his close friend "Tammas." Never strong, this young Canadian
physician had burned himself out in the long second battle of
Ypres, during which he had written the unforgettable "In
Flanders' fields the poppies blow, Between the crosses, row
on row,"

February of 1918 found Gushing on a Paris leave to see
General Leonard Wood who had had a close call when a
Stokes mortar had blown up very near him, killing the French
officer with whom he was talking. But except for a bad flesh
wound, Wood showed no sign of having been through a
harassing experience. "A long drive with him in the after-

"THE MARROW OF TRAGEDY" /py

noon quite lovely. In an unfrequented part of the Bois we
passed a closed carriage out of which stepped a heavy, oldish-
looking man in a dark blue military cloak, who then tenderly
helped out a little old lady in black Madame Joffre and her
forgotten husband."

At the end of the month Gushing left for London to un-
burden himself of a collection of pathological specimens and
clinical histories for the Harvard Medical School. The next
day he dined at Brown's Hotel with his Yale professor, Russell
Chittenden, and Graham Lusk, the professor of physiology at
Yale (he having not yet secured his meat and bread card).
"I expected an 8-gram roll such as 'Chitty' is supposed to
live on, but instead had a very fine dinner with tongue, which
they said the British do not call meat, and a bottle of cider
which I strongly suspect was a bit fortified. They are over
here in the interests of nutrition, and when their influence
becomes felt I will see myself growing thin again. Lusk says
the Germans claim to be winning the war by using the Hin-
denburg offensive and Chittenden defensive."

As usual he hurried to Oxf ord "wintry cold, though things
are growing and Prunus blossoms are out. Even the wall
peaches in bud. The usual miscellaneous gathering at the 'Open
Arms.* . . . Tea and many appear, including the Robert
Chapins; then much over books in the library, where enter a
strange pair the enthusiastic Charles Singer, he of the Studies
in the History and Method of Science which begins with the
visions of St. Hildegarde and the other an aged and shriveled
university professor of Spanish with some rare medical in-
cunabula under his arm."

On March 10 Gushing was again in France, traveling by
back roads to Abbeville. "A wide expanse of fertile country
being ploughed and planted by people dressed in fragments of
old French uniforms this fact, with the two huge aerodromes
and anti-aircraft stations which we passed, alone indicating
war. Off the direct road at Marquise and through Guines near
which was the Field of the Cloth of Gold, though there's now
no trace of Henry VIII or Francis I unless the relic of the old

Ip8 HARVEY CUSHING

earthen fortifications can be such." And the Bowmen of
Agincourt had been supplanted by men with Luegers and
Enfields and by Big Berthas.

At Abbeville he found the whole region surrounded by re-
mains of Roman camps "Caesar's defenses against invasions
by the Belgians the great Roman road from Lyon to Boulogne
passed through the town, in whose local patois many Latin
words are still used. Then in the fifth century came the Hun
destroying as he went . . . and now in the whirligig of time
the Hun tries to repeat the process."

In the spring came the offensive which attempted to divide
the British and French armies and which carried the Germans
to within seventy-five miles of Paris. On March 3 Gushing
wrote: "This is the third day of what our local paper calls the
Gigcmtesque Eataille sur le Front Britannique. There is a
strange feeling of something critical impending. Yet it's a
lovely spring day warm a litde misty with no horizon.
Windows are open and the sun streams in ... We've had
practically no wounded, which is ominous. Word has been
sent to Wallace that Cutler and I will go up to Lillers imme-
diately if needed. Meanwhile there is nothing to do but sit in
the sun and stroll on the sands and wait. This is the hardest
thing to do."

Tense days of inactivity were punctuated by periods of
frantic operating when the wounded poured in. The Germans
were definitely gaining ground. Everyone was on edge and
impatient for the opportunity to do something when, on May
8, Gushing received orders to report at once to the Command-
ing General, Headquarters Service of Supply at Tours. He
thought he was possibly being summoned for examinations for
advanced rank and was deeply chagrined to discover that
something he had enclosed in a letter home had put him into
serious trouble. The paper, written by a colleague, had con-
tained rather harsh criticism of a British surgeon. As far as
Gushing was concerned, it was just part of his records he was
constantly sending Mrs. Gushing material that he asked her to
save to go with the diary. But since he had already been called
up once for quoting (which was strictly forbidden) an amus-

ing bit from a British Tommy's letter that he had read as
censor, this second offense brought the threat of court martial.
There are several versions as to what actually occurred during
the ten days while Gushing was kept in suspense. One is that
the petition of many of the doctors in France persuaded
Pershing to let him off. Another story claims that Gushing
himself went to J. M. T. Finney, Director of Surgical Services,
and although there had been no love lost between them at
Baltimore when they were colleagues at the Hopkins, Finney,
a fundamentally kind man, had interceded in Cushing's behalf,
and his case was dismissed. To one of his pride, the incident
was humiliating. He did not record the outcome in his diary
the only result appeared to be that he was transferred from
British to American Headquarters.

After the proceedings had been dropped, he secured leave
to go to Dublin, where he was made an Honorary Fellow of
the Royal College of Surgeons in Ireland, joining the company
of such bygone worthies as John Abernethy, John Hunter,
Joseph Lister, and Herman von Helmholtz. The next morning
his dinner partner of the night before, the Most Reverend Dr.
Bernard, Archbishop of Dublin, took him to St. Patrick's.

The Archbishop loves the old place and when Dean became
steeped in its lore. There was much to see in a short time. The huge
monument to Richard Boyle of black marble and alabaster, with R.
B. himself, Earl of Cork, in an upper berth, while some generations,
down to an infant, the great Robert, 3 kneel and pray below; the
interesting old brasses; the tombs with amusing inscriptions like
that of Dame Mary Sent Leger, who, after disposing of four hus-
bands, died in childbirth at 37 years of age, and "whose soule (noe
doubt) resteth in all joyfull blessedness in ye heavens." His Grace
dotes on the subtlety of the "noe doubt."

On June 17 he was transferred to the A.E.F., with medical
headquarters at Neuf chateau, and shortly thereafter raised to
the rank of lieutenant colonel, as Senior Consultant in Neuro-
surgery. When he wasn't operating with his own team in the

8 The Honourable Robert Boyle, one of the most prolific and colorful
scientists of the seventeenth century, carried on many experiments on
the air which led to the discovery of oxygen a century later.

200 HARVEY GUSHING

midst of battles, he was visiting other mobile units and casualty
clearing stations to inspect and to offer assistance and direction.
One of his duties was to attend monthly meetings in Paris of
the joint British and American Medical Research Committee,
where reports on present conditions and suggestions for future
action were discussed.

The next month was one of the most strenuous he had yet
lived through, although the Allies were at last beginning to
hold their lines and slow down the German offensive. He
moved about from one group to another frequently, often
without food or sleep. One night he and a fellow officer took
refuge in a boarded-up hotel during a six-hour bombardment,
where they waited in the wine cave with the innkeeper's wife
who wouldn't allow him to smoke for fear it would spoil the
wine! On the 22nd he wrote in his journal:

Times and dates are difficult to figure out. This must be Mon-
day. It's hot and quiet the birds chirping the hornets and flies
troublesome. There's a smell of hay about as I lie on the grass in
front of a square IL S. Army tent which is to be shared with Green-
woodtwo others were evidently here during the night shift.

We've been operating all night behind the and Division in this
newly pitched evacuation hospital which had never seen a battle
casualty till forty-eight hours ago and found itself equipped with
hospital supplies dating from before the Spanish War no X-ray
no Dakin's fluid no nurses, nor desire for any not a prepared
sterile dressing no sterilizer suitable for field work and little
compressed bundles of ancient gauze and tabloid finger bandages
with which to dress the stinking wounds of these poor lads.

On August 6 he reported that he had been in bed three days
with an attack of some undiagnosed malady which was like
flu or grippe. After two strenuous days around Chateau-
Thierry, where Mobile Hospitals i and 6 were joining forces,
he had returned to Neufchateau one night, cold, wet, and
supperless, so weak suddenly that he had to ask his driver to
help him upstairs. The fever had come over him after he had
stopped operating late one night on a case regarded as in-
operable, and Elliott Cutler, one of his Brigham staff, had put
him to bed in his cot. He was up on the yth but feeble. Advised

201

by Thayer to go to the Riviera for a rest, he got only as far
as Paris, where he spent five days in a hotel tossing with fever.
He returned to Neuf chateau on the i8th and managed to keep
going for the rest of the month. On September i he casually
mentioned that he had discovered the threatened blindness
which had rushed on him in the last ten days was an accom-
paniment of the muscular enf eeblement of the grippe.

Through the Saint-Mihiel and Argonne battles he stayed on
his feet, working steadily, but by October 8, when he went to
Paris for the Research Committee meetings, he admitted that
they had become so numb he could not feel the floor when he
got out of bed. His friend Richard Strong kept him at his
apartment for four days, after which, although his legs were
numb to the knees and he could scarcely stand, he returned to
his post. Three days later, when he had a bad time operating
because of his double vision, and when his numbness and un-
steadiness had increased, involving his hands, he finally gave
up and went with another friend, Sidney L Schwab, to the
hospital he directed at Priez-la-Fauche.

During these weeks of increasing disability, nobody knew
exactly what was wrong with him, least of all Gushing himself.
It was now clear that it was something far more serious than
grippe, but whether neuritis or what, nobody could definitely
say. As a matter of fact, he had begun to notice some weakness
in his legs as early as the preceding spring. He had been walk-
ing one Sunday with Gilbert Horrax, his devoted operative
assistant (a Hopkins graduate who had been the Arthur Tracy
Cabot Fellow in the Surgical Laboratory at Harvard in 1913-
14), and when they were about four miles from camp, he said
"Gil, I have to go back." Horrax, in surprise, asked why.
"Something seems to be the matter with my legs. I am too
tired to go on." No more was said. Both of them put it down
to fatigue from the long hours of operating. Although Dr.
Horrax remembered this incident later, it did not seem to
help toward a diagnosis.

The necessity for hospitalization must have caused Gushing
deep concern, but nothing of his discouragement was set down
in his diary, and his increasingly alarming symptoms were

202 HARVEY GUSHING

noted briefly with the objectiveness of any medical report.
He occupied himself with his fellow patients, with following
the progress of the fighting, or with such things as cutting out
clippings about birds that he thought might interest his son
Bill. To Mrs. Gushing he wrote: "Please don't bother Popsy or
any other MD.'s about me. It's not the thing to be ill in the
Army, and Fm keeping very low about my transient malady
lest I have to go before a Board and get canned as a decrepit.
Give me a week or two and I'll be quite fit again."

As the Allied armies pressed forward on an ever-shortening
front; there was encouraging news of victories. Gushing had
been following the receding German line on an official map
with pins and a ball of yarn, but he was no longer able to
hold and stick in the pins. However, he wrote cheerfully to
Mrs. Gushing: "Your October jth letter has just come with
one from Mary, the dear . . . I'm glad you've got a fur coat
for the Puss Cat [his pet name for Mrs. Gushing]. Hairy side
out? or skinny side? May get one myself of the sheepskin
kind just like Bryan O'Lynn's . . . Miss Shepley is here to-
day doing some business for me I still am keeping a little hold
on my office affairs pour passer le temps. She's been a perfect
trump all through please tell her mother so for me."

By November 5 he was getting slightly restless: "Isn't it
rotten luck to be laid up at this time. Miss Shepley tells me
the offices are deserted everyone 'up front.' An interesting
time-the period of getting into redeemed villages and seeing
the joyous population what are left of them." Six days later,
when people all over the world were celebrating the Armi-
stice, Gushing, wrapped in a blue-gray dressing gown, watched
die autumn leaves hurrying past his hospital window and
imagined that even they were expressing joy in their zooming
and whirling. By November 16 he was weU enough to return
to headquarters at Neuf chateau. Here he found his colleagues
c *too squalid, and uncomfortable to talk to one another, we
scarcely need to do so while familiar shibboleths resound in
our ears that this was to be a war to end all wars, and that
the world from now on will be made safe for democracy. We
wonder. We shall at least see what democracy can make of it."

ADMINISTRATOR

Chapter XIX

c

PUSHING RETURNED FROM FRANCE

in February of 1919 full of enthusiasm for the establishment
of a national institute of neurology for study of the vast
amount of neurological material resulting from the war not
only for the purpose of helping those suffering from war
neuroses, but for the advancement of medicine. During the
spring he spent a great deal of energy and time stirring up
interest both among individuals and among the foundations
the Carnegie Foundation for the Advancement of Teaching
and the General Education Board of the Rockefeller Foun-
dation. But his efforts came to nothing. The foundations felt
unable to provide the ten-million endowment needed for the
project, and although the Surgeon General attempted to carry
it forward in Washington, some of his superiors in the War
Department, and the determined economy of a reactionary
Congress, presented insurmountable difficulties. The wealth
of material was lost in the files of the Veterans Bureau, and
there was little follow-up on the cases from which so much
might have been learned toward returning men to a useful
existence and toward saving lives in the next war. To Gushing
it was more than a personal disappointment, it was a public
tragedy.

In June, two honorary degrees a Doctor of Laws from
Western Reserve and a Doctor of Science from Yale were
added to the recognition of Cushing's war service already
taken by the British government when it conferred on him

203

204 HARVEY GUSHING

the order of the Companion of the Bath, and by General
Pershing, who had cited him "For exceptionally meritorious
and conspicuous services as Director of Base Hospital No. 5."

September brought the disquieting news that Sir William
Osier had one of his heavy colds-brought on from a trip in
an open motor, necessitated by a railway strike in Britain.
The cold progressed into a fever and finally into pneumonia.
He told Mrs. Osier on October 13 how it would end, but he
continued to fill each day as full as they would let him with
reading, writing, and sending cheerful notes to the wide circle
of those whom his affection had wanned and cheered for so
many years. "I make pleasant excursions from one side of the
bed to the other & am enjoying life immensely," he told one
friend. His last letter to Gushing in his own hand was dated
November 14. A physician to the last, Sir William made notes
on the progress of his illness. The end came on the afternoon
of December 29. Although he had a definite physical ailment,
he really died of a broken heart. The loss of Revere had been
more than he could bear.

Osier's death touched Gushing deeply. He had lived close
within the circle of Sir William's influence for more than
twenty years, and no one had been so near to the inner reaches
of his mind and heart. In the early days Osier had not hesitated
to speak a good-natured word of caution when it seemed indi-
cated, and his pride in Cushing's successes was a father's pride.
Osier in every way had offered Gushing an ideal in his keen-
ness as a physician, his popularity as a teacher, his integrity
as a scholar; in his abundant enthusiasms, his vitality and hearty
enjoyment of life, his amazing productivity, his fascinating
and endless knowledge of the historical backgrounds of medi-
cine, his daily acts of thoughtf ulness and generosity.

To give vent to his emotion, Gushing immediately set down
an appreciation. Although he stated at the beginning that "in
the first shock of grief at the news of Sir William Osier's
death, it is difficult for anyone who felt close to him to say
what is in his heart," nevertheless, in the warmth and sim-
plicity of the brief story of Osier's life which followed, he
revealed more than he knew. He chose some lines from Isaiah

ADMINISTRATOR 20$

as the final expression of what Osier had been to those who
loved him:

And a man shall be as an hiding place from the wind, and a
covert from the tempest; as rivers of water in a dry place, as the
shadow of a great rock in a weary land.

This tribute, entitled "William Osier, the Man," was pub-
lished anonymously in the Boston Evening Transcript of Jan-
uary 3. Immediately Lady Osier had read it she asked Gushing
(she had first thought of William Thayer) to write the official
biography of Sir William "I am convinced that there is no
one else who understands as you do." Although he had many
misgivings as to his capabilities, Gushing told her that what-
ever she wanted or thought Sir William would have liked, he
would try to do.

He spent a month in Oxford that summer collecting mate-
rial and daily questioning Lady Osier about details until she
sometimes protested good-naturedly. The year he had esti-
mated for the task lengthened into five he spent much of the
first two in a painstaking search for material, since Osier had
saved little in the way of letters. Miss Madeline E. Stanton, a
young Smith graduate, was added to the staff so that Miss
Shepley might spend her entire time on the biography.

The loss of Osier, following upon his own illness and dis-
appointment as a result of his failure to implement the idea
of the National Institute of Neurology, made Cushing's read-
justment to the routine of the clinic difficult. During the war,
David Cheever had managed the surgical service * with the
assistance of Conrad Jacobson as resident, but Jacobson left
shortly after Cushing's return, and Elliott Cutler took his
place. In order to make a place for Gilbert Horrax, who had
been with him all during the war, Gushing appointed him to
the staff as Associate in Surgery. From April 1919 until just
before Gushing retired, Horrax shared the operative burden,
later handling all the trigeminal neuralgia cases and doing

i Although John Romans did not go over with the group from the Brig-
ham, he eventually was sent overseas. William C. Quinby, urological
surgeon, joined the staff in 1916.

206 HARVEY GUSHING

many of the time-consuming openings and closures so that
Gushing would not have to be so long on his feet Although
Dr. Gushing had at first feared that the clumsiness of his hands
and feet resulting from his illness would cut short his operative
career, his dexterity soon returned, but he now wore glasses
to operate and began to sit whenever possible during the
longer procedures.

After his conversation with Horrax in France, the subject
of his legs was never mentioned between them, but in a quiet,
unobtrusive way Dr. Horrax did what he could to save him.
He brought loyalty and understanding in an unusual degree to
his selfless devotion to his Chief, and it is widely stated that he
mastered Cushing's meticulous surgical technique more thor-
oughly than did any of his other men. "If you have seen Gil
operate, you won't want to see me," Gushing would say. But
his fondness for Horrax guaranteed no immunity from his
brusque criticism. Although a saint in disposition and as slow
to anger as his Chief was quick, Horrax sometimes resented
this treatment momentarily, but he would remind himself that
this was Cushing's method of teaching medicine and would
hold his peace.

Percival Bailey, a brilliant young graduate of the Medical
School at Northwestern University, came to the Brigham at
this time as Arthur Tracy Cabot Fellow for 1920-21. After a
subsequent year abroad, he returned to begin a histological
study of the brain tumor material Gushing had amassed. He re-
mained with Gushing nearly ten years, "He was not an easy
man to work with," Bailey said. c We disagreed often, some-
times vigorously. When the tension became too great I went
away for a while. But I always came back. My debt to him was
incalculable."

During 1920, the first of a series of voluntary graduate as-
sistants, largely from foreign countries, were attracted to the
Brigham. Charles P. Symonds of London and Frederic
Bremer of Brussels were the initial incumbents. Patients also
were coming from long distances, referred by physicians all
over the country. Sometimes they 6ame unheralded, as once
did a member of the Chamber of Deputies of Peru who ar-
rived with many official attendants, far too ill himself to explain

ADMINISTRATOR 201

that he was there because a Peruvian physician knew of Dr.
Cushing's reputation and felt his only hope was to go to Boston
for an operation.

With the increasing burden of work, Cushing's office staff
was busy from eight-thirty in the morning, when he arrived,
until after normal closing hours. His daily routine varied little-
breakfast before eight, then off with the children Gus leaving
him at the hospital before taking the children to school. Un-
less he had been called back during the night, he invariably
looked fresh and full of energy upon arrival. His hair had
begun to show gray during the war, but he was still thin and
wiry, always impeccably dressed, and conservatively except
for his neckties, which once prompted a former resident to
perpetrate a parody entitled "The Tie that Blinds." His hat
was set at a slight angle and, like the twinkle that appeared in
his eye at unexpected times, always gave him an air of youth-
ful jauntiness.

He started with the morning mail and an hour or more of
dictation. Operations were usually scheduled for ten o'clock
and might last from four to six hours, after which he dictated a
detailed operative note, sometimes drawing a sketch to accom-
pany it. While dictating, he was accustomed to having toast
and tea it might then be three or even four o'clock and he
would not have eaten since breakfast. In fact, about the only
time he ever ate lunch was on those days when he joined the
Saturday Club.

There followed dressings and visits to patients awaiting op-
eration, and when he finally returned to his office, both
patients and secretaries greeted his coming with relief. In be-
tween he might have had conferences with his house staff,
looked in at the Surgical Laboratory in the Medical School, or,
more often, stopped at his own hospital laboratory to look over
brain specimens and indicate what sections he wanted prepared
for microscopical study. His day rarely ended before seven.

During his years at the Brigham, Gushing was able to spend
less time than formerly in the laboratory. However, he kept
closely in touch with what was going on there suggesting
problems, advising, and, when the experiments were com-
pleted, going over the written results with great care. He some-

208 HARVEY GUSHING

rimes resembled Kronecker in trying to impose his own unique
style and was as surprised as Kronecker had been to meet with
resistance, but he was finally convinced that his assistants liked
to write up their results in their own way.

As an administrator, Gushing was conscientious but he pre-
ferred other aspects of his work. The controversy over the
full-time plan and the interruptions of the war had prevented
until now the full expression of his capacities. He had long
since discovered that the free spirit of the Hopkins did not exist
at Harvard, and, face to face with the solid structure of long-
standing university policy at Harvard, he missed the elasticity
of attitude to which he was accustomed. Whenever he enthusi-
astically put forth ideas for change or reform, he invariably ran
into a paralyzing and disheartening lack of interest and co-
operation in the places from which such changes had to em-
anate. This, of course, aroused in him a brisk irritation that he
often took no pains to conceal a fact which doubtless nullified
his efforts on occasion.

Where the lines of administration crossed those of medical
education, Gushing was consistently practical, periodically
asking the question, Is the student being adequately prepared
to give good medical care to the patient? This might result in a
letter to the Dean suggesting a re-evaluation of the third- and
fourth-year curriculum, or a shake-up in the out-patient teach-
ing because he felt the students were giving more service to the
hospital than they were getting out of it in the way of educa-
tion.

He tried also to prevent his service from becoming static by
refusing to set up rules and regulations. Although his own
habits and idiosyncrasies might impose just as rigid a discipline
as written regulations, nevertheless he encouraged his men in
original thinking and supported them wholeheartedly in their
projects. Regimentation in any form annoyed him, and since
the Dean often seemed the personification of all retarding and
exasperating influences, they had many brushes. One of his
early battles was to get the Arthur Tracy Cabot Fellow re-
lieved of responsibility for supervision of the animal farm
that supplied the laboratory with experimental material, and
he brought the subject to the attention of the Dean with the

ADMINISTRATOR 20?

same persistence with which he had written his father about
rugs for his room at Yale.

Another thing that was a source of continuing annoyance
was the Dean's method of calling faculty meetings. He in-
variably sent out the notices so that they were received the
day before the meeting. This resulted in poor attendance be-
cause of previous engagements, and the administration was
able to pass measures which might not have been passed had
a larger group been present. Gushing was regular in his pro-
tests.

The thing for which Gushing agitated the longest was
better salaries for his surgical staff. Every year one or more
letters went to the Dean, but despite persistent efforts, he
never succeeded in materially improving the situation. The
attitude that stood in his way seemed part and parcel of the
narrow policy which prompted the Dean to question the neces-
sity for the Laboratory for Surgical Research in the Medical
School when there was a similar laboratory in the Hospital. In
Cushing's reply, which ran to three pages, he said that a hos-
pital was not a suitable place for experimentation with large
animals; and he then set forth in a calm and objective manner
his ideas about the importance of research, both in securing
positions and in growing professionally thereafter. Under-
lining this forceful statement of his philosophy was something
of his disappointment that the prize so long coveted, a pro-
fessorship at Harvard, fell short of his expectations. But he
possessed an indomitable optimism he always hoped that if
things didn't improve, perhaps he could do something to im-
prove them.

By 1919 the number of neurosurgeons in the country had
grown to the point where it was felt the formation of a society
would be valuable for the discussion of mutual problems. This
group of eighteen men 2 became known as the Society of Neu-

2 Alfred W. Adson (Rochester, Minn.), Edward Archibald (Montreal),
Charles Bagley (Baltimore), Claude C Coleman (Richmond), Harvey
Gushing (Boston), Charles E. Dowman (Atlanta), Charles A. Elsberg
(New York), Charles H. Frazier (Philadelphia), Samuel C. Harvey
(New Haven), George J. Heuer (Cincinnati), Gilbert Horrax (Boston),
Allen B. Kanavel (Chicago), W. Jason Mixter (Boston), Howard C.

210 HARVEY GUSHING

rological Surgeons. Dr. Gushing was elected president, and the
first official meeting was held in the autumn of 1 920 at the Brig-
ham Hospital. The early meetings were largely occupied with
discussion of technical problems, many of which have long
since been solved. At the 1921 meeting in Philadelphia, there
was much talk, pro and con, of the then new procedure of ven-
triculography, 3 which Dr. Horrax has called one of the most
epoch-making contributions to intracranial surgery ever an-
nounced. Writing in 1942, Horrax said: "The importance of
this diagnostic method, not only for the localization of hereto-
fore uiJocalized brain tumors, but also for the more accurate
localization of many growths whose situation could not be
ascertained with absolute exactness, can hardly be over-
emphasized. It brought immediately into the operable field at
least one third more brain tumors than could be diagnosed and
localized previously by the most refined neurological meth-
ods." In 1921, however, it appeared to be a radical procedure
and some of the older surgeons adopted it slowly.

It might have been expected that Gushing, although he was
conservative, would have at once visualized the possibilities of
this new diagnostic aid. But it had been introduced by his old
assistant at the Hunterian, Walter E. Dandy, and there were
reasons beneath the surface which probably explain some of
Cushing's reluctance to adopt ventriculography immediately.
During their association at the Hopkins, Dandy and Gushing
had not seen eye to eye on some research Dandy was carrying
on in the Laboratory. From this time on, each seemed to bring
to the forefront the combative nature of the other, and when
Gushing was picking men to go with him to the Brigham, he
did not invite Dandy to join the group. Dr. Dandy remained at
the Hopkins and became known for his daring in attempting
far more radical surgery than Gushing advocated. So dis-
tinguished an authority as Geoffrey Jefferson felt that he even-
tually surpassed his preceptor in technical steps and innovations

Nafiziger (San Francisco), Ernest Sachs (St. Louis), Alfred W. Taylor
(New York). Walter E. Dandy of Baltimore was asked to join but
refused the invitation.

3 Injection of air into the cerebral ventricles. If the X-ray shows displace-
ment of the ventricles, operative intervention is indicated.

ADMINISTRATOR 211

in surgical procedure. Be that as it may, although Gushing was
sincere in his distrust of the new method (since accidents had
occurred in injecting the air and since he felt it might lead
surgeons away from doing careful neurological examinations),
it is possible that the events of the past may have colored his
opinion without his being aware of it. It was some time before
he adopted ventriculography as a routine measure in his own
cases.

One of the 1923 meetings of the Society of Neurological
Surgeons (there were usually two a year) was held in Boston.
Before the annual dinner on the first evening, Dr. Jason Mixter
gave a cocktail party which was such a success that they were
late arriving at the Harvard Club. When they were barely
finished with the soup, Dr. Gushing jumped up and said: "It's
time to go now. I have arranged a clinic for you at eight
o'clock, and the patients are all lined up." This filled everyone
with consternation. Nobody wanted to stop at the beginning
of a good dinner and attend a clinic arranged without their
knowledge. Dr. Ernest Sachs as secretary took Gushing aside
and remonstrated with him. "All right," said Gushing angrily,
"if you're going to make this an eating club, I'm going to get
out." Some of the men reluctantly attended the clinic, but most
did not. The next day, when the group convened at the Brig-
ham, Gushing was serenely affable as if he had done nothing
to spoil a pleasant dinner for his associates the evening before.

Gushing firmly believed in the value of medical gatherings
for the interchange of ideas and for keeping abreast of the work
in other centers. He therefore attended the meetings of all the
local and national organizations of which he was a member.
From his experience at the Hopkins, he also knew the value of
a local medical society, and his enthusiasm was a large factor in
making the Harvard Medical Society a vital influence in the
School. He made free use of his many contacts outside Boston
and outside medicine to arrange meetings of interest to stu-
dents. And he encouraged young physicians interested in the
history of medicine, as is evident from the following letter
from Chauncey Leake, then at the University of Wisconsin
(now Dean of the Medical School at the University of Texas
atGalveston):

212 HARVEY GUSHING

I thought when you were kind enough in your last letter to
me to suggest that I come to Boston to talk to you about Per-
cival's Code of Ethics that you were just making a nice gesture
to a youngster out in the sticks. I find, however, to my great
delight, that you are one of those rare persons who means
exactly what he says.

Gushing also asked men from other hospitals to participate
when out-of-town guests were to speak on subjects in their
field, and often sent the next day a thoughtful letter such as
this to Dr. Francis Benedict, Director of the Carnegie Nutrition
Laboratory in Boston:

Dear Benedict: Just a line in the cool of the morning to ex-
press again my appreciation for all the trouble you took to give
that demonstration here last evening. I know that those things
are not done without preparation even by such as you. It was
a friendly and neighborly act, and I only regret that the entire
student body had not been there, ten deep, to hear you. Medi-
cine, alas, now-a-days is a circus of many rings and the students
may be captured by a trapeze act while something really impor-
tant is going on in another tent.

Not only did he write innumerable letters to speakers and
students, but he also paid the bills, as one secretary discovered
to his surprise when he submitted an account for printing and
stenographic services during the year. He promptly received
reimbursement for $85.40. "I am sending you a check to cover
your expenses as has long been my custom," Gushing wrote
him.

Gushing never lost his interest in sports. Despite the fact that
he suffered frequently from the poor circulation in his legs, he
played a devastating game of tennis, as anyone who had the
temerity to oppose him soon discovered. Baseball and football
took him regularly to Yale, and there was much reminiscing
about "the good old days" when Walter Camp, long the foot-
ball coach at Yale, stayed with the Cushings while in Boston in
December attending a dinner in his honor.

Medical school affairs also called him to New Haven on
occasion. In April, 1921, he was invited to arrange a program

ADMINISTRATOR 21$

and act as toastmaster at a farewell dinner in honor of Joseph
Marshall Flint, the retiring professor of surgery. Dr. James
Rowland Angell had taken President Hadley's place at the helm
of the University, and Milton C. Winternitz, who several years
earlier had come up from the Hopkins full of vigor and new
ideas, had been appointed dean. Francis G. Blake, of the Rocke-
feller Institute, and Samuel C. Harvey had been secured for the
chairs of medicine and surgery, and the plans Gushing had long
cherished for the Yale University School of Medicine seemed
about to materialize. He planned the dinner with great care, in-
viting Dr. Welch, Simon Flexner, Ross G. Harrison, William
H. Carmalt, and others to attend.

In May, H. C. had joined with his friends Malcolm Storer
and Edward C. Streeter (who had just been appointed lecturer
in the history of medicine at Harvard) in calling a meeting of
physicians in New England who were interested in the "his-
torical and cultural aspects of medicine." The enthusiasm
which launched this, the Boston Medical History Club, has
been rekindled through the years, and the Club is still in exist-
ence.

In the autumn of 1921, on the occasion of the seventy-fifth
anniversary of the introduction of ether anesthesia at the Massa-
chusetts General Hospital, Gushing was asked to give a twenty-
minute address. He did not choose to discuss the discovery of
ether or to pay customary tribute to the illustrious names asso-
ciated with the hospital since its inception. Instead he spoke for
forty-five minutes (instead of the allotted twenty) on "The
Personality of a Hospital," extolling the virtues of those faith-
ful employees night orderlies, apothecary clerks, waitresses,
laundresses who in giving a lifetime of loyal service were no
less responsible than the surgeons for the "particular flavor,
tone, and color of the hospital."

Many letters of congratulation came to him as a result of this
address, one from Dr. Halsted pleasing him as much as any of
them.

Dear Gushing: I am so pleased to receive a copy of your
Ether Day Address, which I had missed. . . . Can it be a sign
of "progeria" that I enjoy so gready reminiscences, particularly

HARVEY GUSHING

of those who can see, interpret and appraise? The M.G.H., born
aristocrat, has been the breeder of fine Brahmans and I can well
understand the pull it has on the cockles of the "p u P s> "

I happened to be in London when Bigelow described his
lithotrite and evacuator. Samuel D. Gross also I saw only once
and this was at a lecture by Sir James Paget on plant pathology.
It was on this occasion that old Darling, asleep in the front row
of the gallery, dropped his cotton umbrella on the head of a
spectator below, much to the amusement of everyone except
Paget. I regret so much having missed the opportunity to see
Oliver Wendell Holmes. I loved John Homans, as everyone did,
and Arthur Cabot. For Jack Elliot I have always had a very high
and warm regard, and wish that you would remember me to
him. Graves told me the other day that Elliot is still riding to
hounds. . . .

To return to "The Personality of a Hospital" such a happy
theme I read it twice and shall read it again some day.

Heuer departed yesterday for Cincinnati. . . . Weed is doing
finely; you judged him aright.

I am promising myself the pleasure of seeing you and Mrs,
Gushing and the children before all are married. With love to
the family, I am, Ever yours, W. S. Halsted.

In June of 1922 Gushing sailed for Europe, accompanied by
Mrs. Gushing. He had several responsibilities, the first a lecture
at the III e Reunion Neurologique Internationale. He chose to
speak on the diseases of the pituitary, and the lecture was trans-
lated into French for him by Paul Martin, a young Belgian neu-
rosurgeon who had been working in the clinic as a Rockefeller
Fellow. Percival Bailey, who had been studying that year with
the French neurologist Pierre Marie, read the paper for him at
the meeting, after which there was a large banquet that brought
together an impressive number of the world's greatest students
of the nervous system.

A few days later, in London, Gushing was made a "Perpetual
Student*' of St. Bartholomew's Hospital as he took over the
surgical service for two weeks. The Lancet commented: "Al-
though recognized as the leading neurological surgeon in the
world, Professor Gushing did not operate while he was in this
country but spent his time in observing methods of instruction,

ADMINISTRATOR -27J

talking to students, and teaching in the outpatient and casualty
departments of the hospital."

On June j he gave a second paper, this time the Cavendish
Lecture at the West London Medico-Chirurgical Society, after
a dinner in his honor. At the suggestion of Lady Osier, with
whom he and Mrs. Gushing were staying, they were accompa-
nied to London by a young Rhodes Scholar from Minnesota,
John Fulton, who was studying with Sir Charles Sherrington.
Gushing discovered that this young man, thirty years his junior,
was as enthusiastic about Osier's books as Osier himself had
been and already possessed a wide knowledge of them it was
natural that they would find much of common interest. For
Fulton it was a momentous occasion, and his deep devotion to
Dr. Gushing dated from this memorable evening.

The lecture, Cushing's first formal presentation on the
tumors he had named meningiomas, was superbly prepared
down to the last slide, and the large audience, unusually re-
sponsive to the force of his personality, cheered him heartily at
its conclusion. After a few more days at Oxford, he and Mrs.
Gushing returned to Boston, where he spent the rest of the sum-
mer on the Osier biography. In August there was a pleasant
interruption when the French government honored him by
making him a Chevalier of the Legion d'Honneur. President
Lowell presided at the brief ceremony, and General Gouraud
presented the award, pinning the ribbon on his coat with a
safety pin procured at the last moment from an aide who,
having taken it from a vital place, had in turn to ask Mrs. Gush-
ing for one to replace it a situation which afforded Gushing
considerable amusement.

During these years when he was occupied with the book and
could go less frequently to Little Boar's Head, he occasionally
had the care of the children, particularly Bill, who was now old
enough to have a summer job or affairs of his own that kept
him in Brookline. This closer contact gave Gushing a new view
of his children. It was brought home to him forcibly that they
were growing up and developing individualities of their own,
and, in approaching adulthood, they made demands on him as
a parent which he could no longer ignore.

A FAMILY OF
INDIVIDUALISTS

Chapter XX

.ARVEY GUSHING WAS ADORED BY

his children but, having dedicated himself to medicine, he
often sacrificed his family to his profession. He was almost a
guest in his house a delightful and familiar guest who enjoyed
and contributed much to its hospitality, who could exercise
the privilege of an intimate of the household by chiding or
disciplining its members but, after stirring things up, could
make a graceful exit and return to the main business of his life.

It was Katharine Gushing who, like Betsey Maria Gushing
before her, carried the real burden of parenthood and under-
stood its heartaches and its satisfactions. Until the children
reached their 'teens, she arranged for their schooling, had their
full care during the summer from June to September, and
was ever their counsellor and confidante. In their home she
displayed her feeling for color and love of antiques, and the
combination of her appreciation of fine materials with a nice
sense of utility and function always resulted in an attractive
and gracious setting. In every room there were photographs
and objects of art and sentiment which expressed the per-
sonality of the occupants and made the house look hospitable
and 'lived in."

But Kate Gushing did more for her family than provide
pleasant surroundings and "creature comforts." She worked
hard and untiringly to create a spiritual atmosphere in which
her brilliant husband and her more-than-usually gifted chil-

216

A FAMILY OF INDIVIDUALISTS 21*?

dren might grow and develop- Harvey Gushing was no or-
dinary parent, and often the children, when small, did not
understand his preoccupation with other things. Unques-
tionably she herself would have been happy to claim more
of his attention for their personal interests, but outwardly she
gave no sign. Only intimates of the household, such as Lewis
Weed, when helping her put the children to bed, or Gilbert
Horrax, walking with her on a summer's evening in Little
Boar's Head when Dr. Gushing had stayed in Boston, guessed
what was in her heart.

The atmosphere of the Gushing household was not always
placid, for Mrs. Gushing had a strong nature and a quick
temper that matched her husband's, but this perhaps was the
salvation of their marriage this and a love for one another
that was long-standing and deep-running and strong enough
to withstand the impact of two highly motivated individuals
working out a life together. An understanding commentary
on their relationship has been made by Mrs. Albert Bigelow,
a warm friend and close neighbor in Brookline:

It is not possible to write about Harvey and not write of
Kate also. She not only forestalled all his needs, but was in every
way the perfect companion for him, for not only did she have
a mind and character but she carried herself well and had a
beauty of face and expression that well matched his distinguished
appearance when they went about together. . . .

I think another way in which Kate helped Harvey was by being
just as decided as he was. I don't believe she put up with irri-
table moods and probably discouraged them by not being over
sympathetic, but helped instead all she could by providing cheer
and comforts. I suppose it was a fault that he was so absorbed by
his work, that although he loved his children he had little time to
take responsibility for them, and I believe he leant on Kate far more
than she did on him. This is all speculation, yet in painting a
portrait, it is what the artist has to go by to bring out the char-
acter of his subject. ... It is probably far from easy to live
with a tense, sensitive, brilliant being such as Harvey was, but I
know Kate superbly achieved her role in guarding his strength
to enrich the world and in helping him to fulfill his destiny.

21$ HARVEY CUSHING

Because Gushing like any father had high hopes, perhaps
undefined, for his first-born, he seemed to be particularly
critical of all that William did. Bill was a most attractive and
popular lad with a beguiling smile, and in a happy mood was
charming and lovable. But his nature was very like his father's,
and the battle of wills that was sometimes waged between
them was the counterpart of that between Gushing and his
father many years before. Bill was fond of people and action
and sports, to the detriment of his studies, and this was a con-
stant worry to his father. From France during the war Gush-
ing had written: "We must not expect our children to be
phenomena. Bill will get really interested in something one of
these days and find himself. I'm sorry for his lack of ambition
and application, but then it's not so rare at his time." In 1920
it was Mrs. Gushing who was taking Bill's part. Writing from
the HF Bar Ranch in Buffalo, Wyoming, where she had
taken Bill and Mary, she said: "He is liked and admired by
young and old. He never loafs or hangs around, is full of
business riding, fishing, rounding up cattle if he would only
work as hard at his studies as he works at this life! But he's
full of promise if we only handle him right. Mary is just
the way you would know she would be so dear and thought-
ful of me rides like a trooper and is happy all the time. She
has her happiness safe inside."

The discord between father and son went deeper than
the matter of application to schoolbooks it seemed as if the
more Gushing loved the boy, the more determined he be-
came to bend him to his will. William, on the other hand, to
whose inner self his father was a stranger his father having
been too busy to fish with him, to take him on trips, to grow
up with him bitterly resented such highhanded interference
with his affairs. Something of this can be glimpsed in the
letters Dr. Gushing wrote to Mrs. Gushing during the sum-
mers he and Bill spent together in BrooHine:

Bill blew in last night an hour late for dinner with that defiant
look of his. I told him in some heat what I thought of it, and
subsequently apologized, but he is still sulking this morning and
got up an hour late. . .

A FAMILY OF INDIVIDUALISTS 21$

This is the 2nd blow up in two weeks perhaps not so bad
after all, and we may grow to understand each other* He has
engaged to play ball Saturdays and Sundays so we'll not be com-
ing down. For I think I'd better stay here if he does.

The baseball team Bill joined was the Brookline All Stars.
When they played the "House of David Bearded Giants,"
whom Gus called Mormons, Gushing and Gus attended. "Bill
says they are nice fellows polite on the bases despite their
whiskers." Bill's late hours and a girl who called three or four
times a day and tied up the telephone for long stretches goaded
his father to another expression of irritation: "I just told Bill
if he didn't take his lasso and sombrero off my table they Ve
been here since Wednesday I'd hang myself with it. O House
of David!! Oh, Osier's Biography!! The cat's the only thing
around here in a family way. Damned if I am anyhow. Hope
you are enjoying your summer. We probably won't be down
Sunday. Play the Mormons again and Gus wouldn't miss it."

Then came a letter which said "Bill and I are making
progress."

Quite an extraordinary episode last night. We were going to
dine at 7:30 with Mr. Sargent. We had been playing tennis till
seven and came in to dress. At seven thirty I began to howl for
Bill no sign of him. Suddenly he blew in hot, sweating, in his
baseball clothesl He had stepped off for half an hour to play
ball. My, I was mad. Can't you imagine? Well, I went alone-
somewhat late wondering what would happen when I got home.
What do you suppose? Instead of a sullen boy or no boy here
was Bill studying! Very contrite very apologetic. I could have
cried. He's in here now reading me an extract from the Spectator
your old copy and giving me tips about Addison and Steele.

All this may have something to do with the fact that he is
going somewhere to spend the week end with a girl from St.
Louis, I believe.

Remembering the letters that went back and forth between
Gushing and his father about "sophomore," junior, and senior
societies, it is amusing to find a similar exchange in the next
generation. Bill was writing from Andover, where he was
preparing for Yale, having transferred from Milton Academy

220 HARVEY GUSHING

because his father thought it would be good for him to be
among boys who might later be his companions in college.

Dear Va, You know that I got into that Frat a few weeks ago.
I didn't know that I had to pay anything outside of what I spent
on the week that I was running. I went down to the house the
other day and saw that I had some other fees. Golly, at first I
didn't believe that it was right, but I found out that I owed the
Frat $88.30. . . . That seems pretty steep to me but perhaps I
don't know much about that kind of thing. I ran up a couple of
bills last month and I'm pretty low just now when it comes to
raking up a sum like that so I wonder if you could help me out.

Cushing replied:

It is quite a sum, as you say, and I think that perhaps they should
have warned you beforehand. Perhaps some day when you be-
come a pundit yourself in the Society, you may be able to hint
to the others that it is a good thing to warn candidates for
membership about the expenses, so that they can ask their parents.

However, I am glad you made the election, and I hope you are
going to find they are a fine lot of fellows in the Society, and
that you will get some satisfaction out of it.

There were other letters from father to son:

How are things going? I wrote you a sassy note about your
marks which were shocking. I hope you will buck up on them
this month. . . .

I wish that I might run up to see the game Saturday, but I
have promised to go down to New Haven to preside at a dinner
for Flint who is leaving the Medical School and to whom we are
trying to give a proper send-off. I hope you will take a fall out
of the Exeter people; but winning the game is not the whole
thing. ... It is a great art to be a good loser, and shows perhaps
more sportsmanship than to be a good winner. . . .

I am so glad to have had your note and your itemized account.
It's quite all right for you to set up the other boys for an occasional
treat, but to take thirty-six at a time is quite an item. I don't want
you to be stingy with the other boys, and I am sure you will never
be. At the same time, I want you to'get in the habit of reasonably
conserving your resources and of coming to me without any hesi-
tation when you are hard up.

A FAMILY OF INDIVIDUALISTS 221

The memory of his own reluctance to approach his father
for money prompted Gushing to give Bill, and later Henry,
a generous allowance when they were at Yale.

I think it will be more satisfactory for you to have a definite
sum each month, so that you will know where you stand. But you
had better let me see your month's expenses, or perhaps we can
go over the matter together when we come down for the Prince-
ton game.

I am delighted to hear of your good marks. *It*s dogged as does
it.' I am sure you are liking the mathematics and hope that the his-
tory and English will not come too hard.

You will be amused to hear that Hen was arrested by a police-
man Hallowe'en night in what I take to be the annual performance
of ringing the church bell. Poor lamb, he must have been scared
out of his wits; and it never occurred to him to run away.

By the end of his first year at Yale, Bill and his father were
on easier terms. "Well, Va," Bill wrote him, "the year is al-
most over. I know I didn't by any means cover myself with
glory as far as the Freshman year was concerned, but I hope
to do better next year. The next thing to think of is this sum-
mer. I think it might be a good plan for me to write to Mr.
Bursch of the General Electric and ask him what kind of a
job he would give me or could give me if I came up for a
couple of months this summer. [Bill had worked for General
Electric before, getting up at four in the morning to get to
Lynn on time for his job.] I would sort of like to go out west
and have a good time but somehow it doesn't appeal to me as
much as it might have a few summers ago. I think I would
rather stay in Brookline or go up to Little Boars Head with
the family than go out there."

In another letter Bill came to his father for advice as to
whether he should continue in the academic course or transfer
to Sheffield, as some of his friends were doing. In this letter
there was a paragraph that again had a familiar ring: "Yester-
day was tap day. One of the most moving sights that I ever
saw or hope to see in connection with college. Barney and
Johnny Bordley went Elihu and Hank Baldwin went Wolfs
Head. Two fellows fainted during the half hour. One when

222 HARVEY GUSHING

he was tapped and another when the boy next to him was
tapped." His father's reply was a long one-it revealed the new
relationship between father and son and much of Harvey
Gushing himself:

May 17, 1924

Dear Bill:

Thanks for your letter. I don't really believe I can advise you. I
sympathize with you a lot, however, in the matter, for I know how
hard it is to make decisions in life. However, you'll have to begin
to make them for yourself. The important thing is, having made
a decision, stick to it without misgivings. I really have no choice
to express. All that you say about a liberal education is true, but
as you know, many a man gets an education without ever going
to college at all. It depends a lot more upon the man than it does
upon the institution. Between 'Sheff' and academic, therefore,
there need be no choice if a man goes at his work hard and gets
the most out of his friends and his tasks before him. Your Uncle
Ben was a 'Sheff ' man for example.

On the other hand, I have always thought the academic men
were a little more stable and got more out of college and college
life than the men in the Scientific School, but here my impressions
are coloured by the impressions in my own time, when the 'Sheflf
men were only in New Haven for three years and when, I think,
the society system was at its worst. Things may be different now,
but I suppose something of the old order must continue.

It's foolish for a parent to expect his son to follow in his own
footsteps. Much better to let him map out his own career.

Of course it would please me some day to pat you on the back
in the hall on College Street; but then, after all, if you should make
good and your friends were going the other way, you might
choose Bones, or Wolf's Head, or, for the matter of that, might
not make a senior society at alL . . . The primary motive of the
societies is partly a reward of apparent merit, and in addition to
the good-fellowship the societies foster a source of inspiration.

I say "a reward of apparent merit" because many a good man,
as you of course realize, never makes a senior society, and there
are many heart-burnings over it; but it was true of my class, as of
many others, that time shows the best men have been overlooked
and some of the poorer ones chosen. As a matter of fact this you
will find happens through life. . . .

A FAMILY OF INDIVIDUALISTS 22$

This letter brought the following response from Bill on
May 19, 1924:

Dear Va, Thanks for your letter, Va, I have something more
that I want to say to you. I think that I am just beginning to realize
just how weak and selfish I have always been. You have often told
me that I was selfish and didn't think of anything but my own
personal pleasure. I always meekly agreed and then went upstairs
and stormed around bemoaning my fate in having a parent who
wasn't so lenient as some others. I am just beginning to realize that
you have always done the right thing. I only wish you had taken
me across your knee and spanked me. I don't know what started
me thinking. Perhaps I have come to the turning point. . . .

There was another letter from Bill:

It was awfully nice to see you. Pm glad that you could get away
and have supper with us last night. It does us both a world of good.
I can't quite explain what I mean except to say that it makes me
feel toward you more as friend to friend than father to son. Per-
haps it ought not to make any difference but somehow it does.

Two years later, on June 12, Bill was killed in an early
morning motor crash near Guilford, Connecticut. The word
came to Gushing just as he was leaving to perform an opera-
tion on a woman who had gone blind the day before. He shut
his study door for a time, made some calls, and then went
through with the operation, not one of his team knowing
until afterward what a strain he was under. Bill's death was
a blow from which he did not recover for a long time. He was
filled with remorse for not having given the boy more com-
panionship and attention, and the only thing that brought him
comfort was the fact that he and Bill had come to an under-
standing.

Cushdng's relationship with his other children was some-
what less tempestuous, although he was equally strict. He and
Henry had periods of not seeing eye to eye and sometimes
they were as much at odds as he and Bill had been, but he often
took Henry's side. One summer, as Henry was setting off to
camp, he wrote Mrs. Gushing at Little Boar's Head: "Hen is
quite justified in wanting to change his bathing suit: it's neither

224 HARVEY GUSHING

male nor female and buttons on the shoulder! Impossible!!"
As with Bill, there eventually came the time when father and
son began to understand one another.

The girls aroused his fatherly (and his Victorian) instincts
when they grew up to the point of wanting to smoke or to
entertain in the drawing room beyond ten o'clock, which was
about the time he was well settled down to writing in the ad-
joining study. He felt that any self-respecting young man
should go home at that hour a belief dictated perhaps more
by his own convenience than by other considerations. Cock-
tails, as well as cigarettes, they were forced to consume sub
rosa, he not becoming reconciled to the family partaking pub-
licly until after they had left Boston.

With Mary, his second child, he had much in common she
had his keenness of mind, his sense of humor. After attending
Miss May's School in Boston, she went to Westover at Middle-
bury, Connecticut, whence he had this letter from her:

Dearest Va I loved your letter. I wish I could write such origi-
nal ones as you.

I am so proud of you that you are made a Chevalier of the
Legion d'Honneur. I know it's a great honor and you deserve it.

This is Sunday afternoon. One of my roommates is reading, and
the other, in whose head genius is burning, is writing a story for
the school magazine "The Lantern."

This morning we all went to church in a couple of dreadfully
seasicky trolley cars, and in our civilized clothes. After trying
awfully hard to sit up straight, I only got "fair" in posture, and
after running around the hockey field to get long winded, they
put me in as goal guard. I am feeling rather squelched; "but "If at
first you don't succeed, etc." and I shall keep right on trying. Loads
of love Sis Cow.

Much later, when one summer the whole family, with the
exception of Dr. Gushing, went to Europe together, she wrote
him from the Samaria:

Beloved Phad So clear and beauteous is the day so uncompli-
cated the existence of even such a "family of individualists," as
Mum calls us, on board this pleasant boat, that I think you would

A FAMILY OF INDIVIDUALISTS 22$

thoroughly enjoy us. It's nearly perfect, but the utter complete-
ness of all of us being together is lacking without you.

Hen is trying to be extremely nonchalant as though he had fre-
quently sailed the shining seas but he was up very early this morn-
ing and doesn't want to miss a trick. . . .

Barbara is wildly excited and everywhere at once. She seems
to grow more beautiful every day.

Later

All is well except that Babe succumbed to the rough weather
and has spent the last two days in the cabin. The rest of us go gaily
on. I'm a winner at deck tennis if I do say it. What do you say
we get a net and tie it up between two trees in our back yard it's
a slick game . . .

Dearest love we all miss you like the devil and keep wishing
you were here Sis Cow.

A neighbor who saw a great deal of the Gushing children
in Brookline (again Mrs. Bigelow) described Betsey as being
more like her father than any of them: "Although fair like
Kate, her sensitive, eager features and her affectionate way of
coming forward to greet me wherever and whenever we meet
reminds me of him. She also goes straight for anything she
-wants to do and nothing can stand in her way once she has
made up her mind. She is most understanding and wants always
to help others."

Mrs. Bigelow also described a jaunt on which she and her
daughter Gwladys joined forces with Dr. Gushing, Betsey,
and Henry for a trip south she to Summerville, the Cushings
to Thomasville, Georgia, to visit Perry Harvey. Upon arriv-
ing in New York, the children wanted more than anything
to have tea at the Waldorf, and although Gushing was eager
to take a look at the first proofs of the Osier biography which
were at the Oxford Press, he did not disappoint them. On the
way, when he stopped to ask a question of a policeman in the
middle of the street, the man became so interested that he left
his post and followed along for half a block talking with him.
At tea, Gushing ordered all the toast, jam, and cakes the chil-
dren could eat and they then went to the station to board a
southbound train. Betsey's every thought was for her father,

226 HARVEY GUSHING

and she asked the porter for an extra blanket (since he was
just getting over the grippe) and hoped he would sleep late
because she knew he would read his book (Arrowmiith) far
into the night. After a visit to the Azalea Gardens at Charles-
ton (which Gushing was all for omitting when he discovered
it cost two dollars each), the party went their separate ways.
When Betsey had returned to school (she was now at West-
over), she wrote:

Dearest Fa-I meant to write to you as soon as I got back here.
I've never had such fun in my life as we had in Thomasville and
it was sweet of you to take me. I really feel so well, because I had
such a lot of exercise etc. and I hope that you feel all well, too,
now. Didn't we have fun in New York? I wish we had had more
rime to look at the picture in the Grand Central. . . . Please write
me soon, Faddie dear, All my love, Bet.

On another occasion when he had temporary charge of
Betsey and Henry, H. C. wrote Mrs. Gushing:

I let Bet and Hen go to the carnival at the C. C. for skating un-
der the promise they would come home at 9:30 prompt and be in
bed at 10. They were but they skated an hour in the rain which
began at 8:30 and came home sopping. Can you beat 'em? But
they seem all right today and Bet has gone in to spend the p.m.
with her beloved and Hen is now making a date with the Grays.
Does this have a familiar sound? I'm glad you are away from it
for a while, as yours is quite a job.

Gushing set aside the established custom that a surgeon never
operates on a member of his own family and did appendec-
tomies on both Betsey and Henry. In 1930 he performed a
much more serious and extremely delicate operation on Bar-
bara when he removed a growth from her neck lying danger-
ously near the jugular vein, facial nerves, and much else. The
operation was successful and the incision healed without a
scar. Many wondered how Gushing could undertake an opera-
tion of such delicacy on his own child, but he did so not only
because he thought he had as steady a hand as most, but be-
cause he was very reluctant to put the heavy burden on any
of his colleagues.

A FAMILY OF INDIVIDUALISTS 22~[

Eventually Barbara, too, reached Westover. This time it
seems to have been her father's side of the correspondence
that was preserved. Although sometimes containing fatherly
advice, his letters usually were lighthearted and whimsical-
such as this which began: 'The beautiful darling! Such a
summer and I scarcely saw her except when she was mumpish
or dentiferous. Now that you've lost all your four wisdoms,
I suppose your whole character will have changed for better
or for worse, in the words of the wedding ceremony. ... I
hope you are getting broken to harness. Good fun when you
do finally all get the color of your uniforms and settle down
to get some fun and some work out of each day. I expect you'll
be president of your class or whatever it is you most want.
With your grace and smile (which I suppose constitutes
charm) and your good mind, you can beat them all."

This "family of individualists" was thus bound together
with unusually strong bonds of affection. Although the chil-
dren realized their father could never belong entirely to them,
they sometimes had a wistful feeling which was perhaps best
expressed by Barbara when at about the age of eight she wrote
him in a round, childish hand:

Dear papa stay home with me. and Dont go earning money.
We'll just do Something funny. I'll give you my Pennies, and I'll
give you my shiny Buckle. I'll arrange all for you.

"THE SEVERE ASCENT OF
HIGH PARNASSUS"

Chapter XXI

L

IATE IN AUGUST OF 1922 THERE
came news from Baltimore that Halsted was seriously ill he
died on September 7. In the appreciation which Gushing im-
mediately wrote for Science, the warm friendship that had
developed between Halsted and his former resident was clearly
reflected. Gushing carefully recorded all of Halsted's many
important contributions to medicine and surgery and con-
cluded his tribute with an admission of his own tardiness in
recognizing him for what he was.

His loss to the Johns Hopkins Hospital which he served so faith-
fully and long, and to which he bequeathed his property, will be
irreparable. It will be equally so to his many and devoted pupils.
One of his long series of resident-surgeons who, as others have
done, came to know him better after leaving his service, just as
many sons learn to know their fathers not until after they have
grown up has in all respect and affection written this inadequate
note of appreciation: "Who knows whether the best of men be
known, or whether there be not more remarkable persons forgot,
than any that stand remembered in the known account of time?"

Late in October, at the meetings of the American College of
Surgeons, Gushing had the responsibility both of a presidential
address and of a technical paper; also he had the pleasure of
presenting the Bigelow Medal to his old friend, Dr. W. W.

228

ASCENT OF HIGH PARNASSUS 22$

Keen (now in his eighty-fifth year), on behalf of the Boston
Surgical Society. The medal (established by the son of Henry
J. Bigelow), designed to honor outstanding surgeons, had been
given for the first time the preceding year to William J.
Mayo. 1

Although devoting all of his "spare" time to the Osier biog-
raphy, Gushing did not neglect local affairs. He planned a
special meeting of the Harvard Medical Society in January to
celebrate the centenary of the birth of Louis Pasteur which
had fallen on December 27, 1922. He also saw to it that the
students had opportunities to meet informally the distin-
guished surgeons who came each year to act as Surgeon-in-
Chief pro tern for a period of approximately two weeks. Dr.
Christian had begun this custom on the medical service, and
Gushing took it up with enthusiasm. Although some of the
surgeons were from this country, many came from abroad and
offered the students a refreshing insight into the medical ac-
tivities of other nations. This year the visitor 2 was Sir Harold
Stiles of Edinburgh, who occupied the chair once held by
Lister. The influence which Edinburgh had exerted through
the early fathers of the Harvard Medical School was thus once
again felt in Boston.

1 Subsequent recipients: Rudolph Matas of New Orleans (1926) ; Cheva-
lier Jackson, Philadelphia (1928); George Grey Turner of England
(1931); J. M. T. Finney, Baltimore (1932); and Gushing (1933).

2 Others were Dr. Dean D. Lewis, Rush Medical College, Chicago, 1920;
Mr. G. E. Gask, St. Bartholomew's Hospital, London, 1921; Sir Cuthbert
Walkce, St. Thomas's Hospital, London, 1923; Dr. Charles F. Hoover,
Lakeside Hospital, Cleveland, 1924; Sir D'Arcy Power, St. Bartholomew's
Hospital, 1924; Dr. Evarts A. Graham, Barnes Hospital, St. Louis, 1925;
Dr. Clarence L. Starr, Toronto General Hospital, 1926; Dr. Emmet RIx-
ford, Stanford University, California, 1927; Sir Charles Ballance, St.
Thomas's Hospital, 1928; Prof. Rene Leriche, University of Lyons,
France, June, 1929; Prof. D. P. D. Wilkie, Royal Infirmary, Edinburgh,
October, 1929; Prof. Gunnar Nystrom, University of Upsala, Sweden,
May, 1930; Prof. Otfrid Foerster, University of Breslau, Germany,
October, 1930; Prof. Vittorio Pura, University of Bologna, Italy, 1932;
Dr. George J. Heuer, New York Hospital, July, 1932.

HARVEY GUSHING

In May, Gushing addressed the American Neurological As-
sociation on the subject of "Neurological Surgeons: With the
Report of One Case." He was not unconscious of the changed
order of things which permitted him, a neurosurgeon, to be-
come president of an association long devoted exclusively to
neurology. "That surgeons should have been admitted into
this intimate guild now nearing its half-century of existence
speaks well for the open-mindedness of its members. . . . The
fusion will be of benefit if for no other reason than that the
balance sheets of surgery should periodically be audited by
those not actually engaged in its practice."

A third invitation to accept the chair of surgery at Western
Reserve came during the summer when it became known that
Dr. George W. Crile was relinquishing the post. But he de-
clined for the same reason given the preceding year to Dr.
Weed, Director of the Johns Hopkins Medical School, when
Weed pressed him to become Halsted's successor at fifty-
four he was set in his ways and didn't believe he could stand
another transplantation.

When the Distinguished Service Cross was presented to him
somewhat belatedly in 1923 (the award is actually dated 1926),
he had a prompt letter from General Leonard Wood, then
Governor General of the Philippines: "Sincere congratula-
tions on the award of the D.S.M. I have not heard of any award
for some time which pleased me more than this." In 1920,
when Wood was being proposed as the Republican nominee
for President (for the second time; he had been defeated by
Charles Evans Hughes in 1916), Gushing had taken as active
a part as he ever did in anything political. Among other things,
he signed, with several other Boston physicians, a letter in the
'Boston Transcript: "On Why the Medical Profession Wants
General Wood," reprints of which were used as campaign
material. But their efforts were in vain. Although public
opinion was strongly in favor of General Wood, whose work
during the war had increased his popularity, the Republican
convention nominated Warren G. Harding.

In June of 1924, at a meeting of the American Neurological
Association, Gushing and Percival Bailey presented a paper

ASCENT OF HIGH PARNASSUS" 2jl

describing a type of cerebellar tumor which they had named
"medulloblastoma." Through Bailey's microscopic studies of
the tumors in Cushing's collection, he had discovered that this
type of tumor was pathologically different from the type that
formed slow-growing cysts. The medulloblastomas are prone
to occur in children and to recur, sometimes many times,
and Gushing, although he knew the outlook was un-
favorable, would operate again and again on the same child in
an attempt to give it a few more months or years of life. There
was always the hope, too, that some day he might find a way
safely to remove that part of the brain where the cells origi-
nated.

The Osier biography, on which he had spent evenings, Sun-
days, and every summer since 1920, had grown far beyond
his expectations both in length and in time required for com-
pletion. However, by May of 1924, he was able to send the
manuscript, via Miss Shepley, to Oxford where the University
Press was to print the volume. He too went to Oxford at the
end of June to make final arrangements and to read the early
galleys as they came from the press. In his first letter to Mrs.
Gushing, written from the Scythia, he told her of his send-off
at the boat: "Elliott and Carol [Cutler] came down and a flock
of about 15 house officers in their white suits led by the genial
Sosman. I was overcome." From Oxford he wrote again (on
Wednesday, July 2):

I am on what they call an up train viz. not one going down to
London. [He had it reversed.] . . . Have seen the Press and made
promises regarding the amount of MS. they were to get each day
which has meant working till 2 a.m. the last two nights. . . .

Chapman at the Press wants me to cut out another 500 pages.
Golly! It would mean another six months. Meanwhile Bill
[Francis] has been the greatest help he's read the Canadian Period
picking out innumerable small errors and points I would never
have seen. You can have no idea how complicated it is. You mustn't
say "next fall'* but autumn. "Headmaster" means a master of heads
not a school master which should be Head Master with capitals
whereas head-prefect is with capitals and hyphenated, &c. . . .
Julia [Shepley], thank Heaven, has become already saturated with

2$2 HARVEY GUSHING

all this and calls on Bill when in doubt so I'm pretty safe. Lady O.
very nice about it though she insists on my taking her out of the
tub in the plumber's shop and such descriptions.

Dr. Francis was engaged in the monumental task of com-
pleting the catalogue of Sir William's library, barely begun at
the time of his death although he had written an introduction
and done annotations for many of the books in his own original
way. When Dr. Francis had completed the volume (he had
the assistance of Archibald Malloch, whose father had been a
close friend of Osier's in Canada, and of Reginald H. Hill of
the Bodleian Library), the books, according to Sir William's
will, were to go to McGill University, his alma mater. The
catalogue, like the biography, was more of a task than was
estimated, 3 so Gushing well understood Dr. Francis' prob-
lems. "Poor Bill. My sympathies go out to him. A gentle,
learned, modest, hardworking, lovable cus. He leads a hard
life with his job."

No. 13 Norham Gardens was thus a beehive with the biog-
raphy and the catalogue going on at the same time. In addi-
tion, the house was constantly full of friends who sought out
Lady Osier as eagerly and faithfully as they had always come
when Sir William was alive. "Popsy and a Dr. and Mrs.
Freeman (he of Hopkins Med. 1905) here all day. . . . [Also]
Prof. Sherrington in A.M., Mrs. Chapman, wife of Secy to
Press in P.M. At 4.30 Myra Tutt with 2 young, very sweet,
soon a Noah's ark disgorging Barkers a herd of them, then
several local people Carr and Margaret Sherrington who have
left Cornell for a fine post in London, John Fulton and his
Lucia for tennis. 4 That's all I can recall at the moment, but
it was a lot, especially the Barkers."

As to the progress of the book, it seemed to him that it went

8 When published in 1929, the Bibliotheca Qsleriana contained 7,785
entries and ran to 785 pages.

4 John Fulton was still at Oxford and was in and out of the Osier library
practically every day, occasionally helping Dr. Francis. Several letters
had passed between him and Dr. Gushing in the two years intervening
since their first meetingin 1923, just before Dr. Fulton's marriage to
Lucia Pickering Wheadand of Topsfield, Massachusetts, Dr. Gushing

ASCENT OF HIGH PARNASSUS 2$$

slowly. "Apparently it's a question of metal, as they say, at
least 'Scroogs the Mono' says so. Scroogs the Mono! Did you
ever hear the beat? Mr. Scroogs runs the monotype machine.
These people are the greatest for abbreviations. Our American
slang is nothing to it." Although the book was far from com-
plete, he felt he could not stay longer and had taken return
passage for August 9. "Julia will have to stay and finish Vol.
II and do the index. She's quite capable of it and by that time
it ought to be smooth running." At the end of the letter he
added, "Sorry about the bronchitis but glad to know Hen
went to camp o.k. He'll be the better for it in the fall. Gracious,
I mustn't say f all: autumn!

"There was a young person named Ball
Who fell in the spring in the fall
Love to all, Va."

During his final week he worked feverishly, hardly leaving
the house except to play tennis occasionally with Bill Francis
or John Fulton. It was discouraging that everyone who read
proof discovered more errors he constantly found his punc-
tuation changed and all his "forebears" turned into "ancestors."
And then there was the Bishop of Ripon! The Bishop was a
'^Delegate" of the Press, a distinguished authority who often
read manuscripts for them. He had discovered on Galley 7
that Cushing's description of the Parker Society contained a
grievous error for the Society dealt merely with the Ref-
ormation and not with the Early Fathers as he had stated!
"How in thunder was I to know?" he demanded in a letter
home. '1 never heard of the Parker Society and never met our
Early Fathers. And it's now in pageproof. But the Bishop is
one of the delegates and something must be done. It's too
funny."

The outgoing secretary of the Medical Research Council,

had written: "Such exciting news about you. A first in physiology; a
first in matrimony; first in the hearts of his countrymen. But I am sure
from what I know and have seen of you, that you are still keeping your
feet on the ground. What are your plans, and when are you coming home
to take a Chair in Physiology?"

234 HARVEY GUSHING

Sir Walter Motley Fletcher, who had been close to Osier, ar-
rived for the week end, and Gushing immediately set him to
helping with the proofs. Sir Walter, however, lured him away
from duty to call on his friend John Masefield in the hope
that together they could persuade Masefield to write a poem
on science and surgery. 5

The Life of Sir William Osier was finally published in two
volumes in 1925. It began thus:

William Osier, the youngest son in a family of nine, was born
July 12, 1849, in a parsonage at Bond Head, Tecumseth County,
near the edge of the wilderness in what was Upper Canada. How
this came about, as to place, rime, and circumstance, needs telling
from the very beginning.

It ended with the oft-quoted and beautiful passage:

So they the living left him overnight; alone in the Lady
Chapel beside the famous Vatching-chamber' which overlooks the
shrine of the Saint, and with the quaint effigy of his beloved Robert
Burton near by lying in the scarlet gown of Oxford, his bier
covered with a plain velvet pall on which lay a single sheaf of lilies
and his favourite copy of the 'Religio,' comes inae vitaeque.

And perhaps that New Year night saw, led by Revere, another
procession pass by the Vatching-chamber' the spirits of many,
old and young of former and modern times of Linacre, Harvey,
and Sydenham; of John Locke, Gesner, and Louis, of Bardett,
Beaumont, and Bassett; of Johnson, Bovell, and Howard; of
Mitchell, Leidy, and Stille; of Oilman, Billings, and Trudeau; of
Hutchinson, Horsley, and Payne; of the younger men his pupils
who had gone before Jack Hewetson, MacCaUum, and McCrae;
and in still greater number those youths bearing scars of wounds
who more recently had known and felt the affection and warmth
of the 'Open Arms' doubly dead in that they died so young.

Between these two passages there is unfolded the crowded
life of a man whose activities and friends covered two conti-
nents. It was a straightforward day-by-day account, told in
minute detail and with warm admiration and affection.

5 Masefield later, when visiting in the United States, came to -watch
Dr. Gushing do a brain operation.

ASCENT OF HIGH PARNASSUS 2$$

Through the inclusion of much of Osier's own writing both
formal and informal his physical radiance and zest for life
stand out from the pages alongside his accomplishments. There
was little attempt at critical evaluation, reflective pondering on
Osier's inner life and motivations, or assessment of his impact
on his century. These were left for the reader to infer from the
wealth of material presented. Absent, too, were all indications
of the long and close relationship between the biographer and
his subject a relationship which could not have failed to leave
its mark on the older man as it had on the younger. But in the
style of the book and its arrangement, in the finished quality of
its prose, and especially in its omissions, the discerning will find
the biographer clearly revealed.

The Life received immediate and wide recognition and was
handsomely praised not only by friends, but in the public press
as the greatest medical biography that had ever been written.
Gushing was particularly pleased with the many letters from
physicians and students who had not known Osier personally.
He was also proud of a letter from a literary critic Stuart P.
Sherman of die New York Herald Tribune, who had praised
the book enthusiastically in his columns:

Dear Dr. Gushing: I am very fond of valorous people who do
difficult things; far more than is possible; and I rate the writing of
that "Life," even in four vacations, as among these things. It is a
pleasure to hear that you thought it not nnintelligently reviewed;
but that pleasure was nothing to the satisfaction I had in reading
the book, and so in feeling the encouragement of those two strenu-
ous souls, Osier and his biographer.

The following year (1926) the biography was accorded the
Pulitzer Prize in Letters by Columbia University. William
Osier, who had always brought out the best in Harvey Gushing,
had once again called forth the full measure of his talents and
devotion. As Dr. Francis has said: **No one but Osier himself
has done so much for Osier's immortality."

For Gushing, writing had now become the medium of ex-
pression for his artistic talents as sketching had been in his

HARVEY GUSHING

youth. From the first he had had the knack of presenting his
clinical papers in a fresh, vigorous style, and his skill increased
with experience. There were some who thought he over-
dramatized in his technical papers, thus threatening the impar-
tiality expected of a scientist, but there is no doubt that they
made interesting reading. Even his Annual Reports had a re-
freshing vitality rarely found in this traditionally dull type of
writing.

But it was in his essays that he displayed his greatest skill as a
writer. These fall into three categories: his writings on medical
education and the medical ideal, his biographical appreciations
of his contemporaries, and his historical essays. Among the first
are such titles as "The Physician and the Surgeon," "The Clini-
cal Teacher and the Medical Curriculum," "Experimentum
periculosum; Judicium difficile," "Realignments in Greater
Medicine," "The Medical Career," and "Medicine at the Cross-
roads."

In many of his biographical pieces there was a serene, affec-
tionate tone that make them documents of great warmth and
understanding. In his tribute to his cousin Perry Harvey, the
inseparable friend of his childhood and college days, he out-
lined the happy hours of youth and the more tenuous, but none
the less loyal, relationship of later years. His tribute to "The
Mayo Brothers and Their Clinic," although less personal, was
no less warm.

There was nothing mysterious or supernatural about this twen-
tieth-century Lourdes at whose doors incredible numbers of the
lame, halt, and blind have for years been daily delivered from the
ends of the earth. Nothing supernatural unless possibly the flaw-
less, lifelong devotion of two brothers for one another be so re-
garded. . . . Their father, the senior Dr. Mayo, pioneer and
Indian fighter, was still alive when I first came to know the clinic
in its early simplicity. There were then but two operating tables,
at one of which **Dr. Will" officiated, at the other in an adjoining
room "Dr. Charlie." They were thus affectionately differentiated
by everyone staff, patients, employees, and fellow townspeople
not to mention the countless visiting doctors who even then were
wearing a path to their door.

ASCENT OF HIGH PARNASSUS" 2tf

To quote more would be to detract from the pleasure of
reading the whole, 6 a pleasure that may be repeated in "The
Doctors Welch of Norfolk," "William Beaumont's Rendez-
vous with Fame," and in his appreciations of Halsted, James
Ford Rhodes, William T. Councilman, and others.

Something of the same intimate, informal style lends great
charm to his historical essays. The problems of the day fell
away from him when he entered his study after supper, and he
was soon in imagination walking the streets of pastoral Glouces-
tershire with a country doctor named Edward Jenner who, a
century and a half before, had noticed that although almost
every other person was badly pock-marked, the dairymaids
seemed immune to the scarring disease. With Jenner he shared
the thrill of discovery that the cowpox which they frequently
caught had made them immune to smallpox.

Or he was in Vermont when Nathan Smith, the founder of
the Dartmouth School of Medicine and later the bright star of
the first faculty of the Yale School of Medicine, was introduced
to the healing art.

A hundred and fifty years ago a young Harvard undergraduate
named Josiah Goodhue because of a swollen knee was obliged to
leave college, and in due course became the pupil-apprentice of
the doctor in whose care he had recovered and in whose activities
he became interested. He started practice in Putney, Vermont,
became the pioneer surgeon of these parts, and ere long was sum-
moned to Chester to amputate the leg of a man who had been
severely injured. He had never before performed a major amputa-
tion, and, needing help, asked the bystanders if someone would
volunteer to hold the leg. A farmer boy who happened to be teach-
ing in the district school at Chester stepped forward and accepted
the trying task without flinching.

Or, on a journey entitled c From Tallow Dip to Television,"
Gushing was in Boston in the days when its population con-
sisted of but 12,000 persons and the dwellers of Beacon Hill
were legally entitled to "pasture and exercise multiples of two

6 The sketches here mentioned, together with several essays on medicine,
were published after Dr. Cushing's death by Little, Brown and Company
(1940) in a volume entitled The Medical Career.

2$S HARVEY GUSHING

legs on Boston Common: two legs, a goose-four legs, a cow-
six legs, a cow or a pig and a goose." He brought old Dr. Ed-
ward Holyoke from his Salem home where he had trained
thirty-five apprentices to ask some embarrassing questions of
the present-day scientists and educators at Harvard, and sent
him back again in his one-horse gig, "scorning that modern
impediment to progress, the red light," as he disappeared in the
direction of Salem.

Despite the fact that the stimulation and diversion offered by
these wanderings in the past seemed to make his essays write
themselves, Gushing worked many hours over them, writing
and rewriting. Wide reading, of course, preceded the stage of
pen and yellow pad. Stories of his own Western Reserve per-
haps came easiest to him and "The Western Reserve and its
Medical Traditions" and "The Doctor and His Books" (the
latter given at the opening of the Allen Memorial Medical
Library in Cleveland) are among his best essays. Early in the
first one we find a passage on traditions that gives us the key to
several of his own inner doors:

Tradition, indeed, is the most powerful binding influence the
world knows. It lies deep in most of us, and pride in tradition sup-
plies the glue which holds people and groups of people in cohesion.
Pride in family and friends, in Alma Mater and profession, in race
and birthplace, in state and nation. The controlling subconscious-
ness of one's stock and upbringing is something from which time
and distance can never wholly wean us.

A year or so after he wrote this essay, Mrs. Gushing drew his
attention to an Atlantic Monthly article in the same vein
"Olympians in Homespun" by Lucien Price. The spell of the
Western Reserve was on this native son also, and in his vivid
description of the vigorous environment created by the early
settlers, Gushing recognized a kindred spirit. "Hardscrabble
Hellas," the story of the boys' school that antedated the West-
ern Reserve Academy, later the University, was also a source
of delight to Gushing, and he and Lucien Price became warm
friends.

Cushing's writing brought him other friends outside his pro-

DR. GUSHING AND DR. OTFRID FOERSTER IX A MOMENT OF PERPLEXITY, 1930

SURGICAL STAFF OF PETER BENT BRKHAM HOSPITAL, 1919

front row: Richard U, Light, Donald E. Dial, Richard W. Farnsworth, Thomas

L Hoen, Louise Eisenhardt, WilVuxm deG. Mahoney, John E. Scarff
middle: Harlan F. Newton, Gilbert Horrax, John Ho?wms, Gunnar Nystrom
(Surgeon-in-chief pro tern), H.C., David Cheever, Francis C. Newton, John H

Powers

top: Kenneth W. Thompson, two students, John H. Lawrence, Arthur T. Her-
tig, Bronson S. Ray, William T. Green, Eric Oldberg, George Armhage, Wil-
liam R. Henderson, Richard H. Meagher, Edward B. Castle.
Courtesy of Waiter W. Boyd

ARNOLD KLEBS, WILLIAM WELCH, DR. GUSHING, AND SIR CHARLES SHERRINGTON

BERNE, 1932

AT VOLENDAM EN ROUTE TO INTER-
NATIONAL OPHTHALMOLOGICAL
CONGRESS, 1929

Photograph by Dr. Klebs

H.C. AND GUSTAVE ROUSSY, DEAN OF
THE FACULTY OF MEDICINE, PARIS,

1933

ASCENT OF HIGH PARXASSUS" 2$$

fession, for the time and painstaking effort he expended on it
resulted in craftsmanship of such quality that he was widely
read outside of medical circles. His pen thus became a powerful
adjunct to his scalpel in spreading the broad concepts of medi-
cine to which he had dedicated himself. "Few indeed have been
the disciples of Aesculapius who have climbed 'the severe
ascent of high Parnassus' and at the same time been successful
in their vocation. For the laity has ever been shy of the phy-
sician who allows his mind to soar above the level of most
practical and mundane things; and a genius so inclined has, in
reciprocation, not uncommonly failed in his profession from an
equal shyness of the public. 7 * Such a fate was not meted out to
Dr. Samuel Garth, Gushing pointed out in "The Kit-Kat Poet."
No more was it meted out to Gushing himself, and Gay's lines
about Garth might likewise have been penned about him (if
"prose" be substituted for "poetry"):

Whenever Garth shall raise his sprightly song,
Sense flows in easie numbers from his tongue;
Great Phoebus in his learned son we see
Alike in Physic as in Poetry.

TEACHER
Chapter XXII

c

fUSHING AND BAILEY, FOLLOWING

their paper on medulloblastomas in ipz4, continued their work
on the classification of the different types of tumor by publish-
ing jointly a volume on tumors of the glioma group in 1926.
There were three principal categories of brain tumors: those
growing from the brain covering (meningiomas) ; those arising
from glands within the head (pituitary and pineal); and those
of the glial cells found in the brain and spinal cord. The glioma
group of tumors formed approximately 40 per cent of all intra-
cranial new growths, and their appearance under the micro-
scope differed "widely; but Bailey after careful study came to
the conclusion that all of these tumors had a common cellular
ancestor and he made up a family tree showing their origin and
interrelationship.

As the authors pointed out, this could have been done only
with a large series of cases available, and then only if these cases
had been followed throughout their span of life. Gushing had
the detailed records and an unrivaled collection of brain
tumors, and Bailey had gone to Madrid to learn the methods
for their study devised by Ram6n y Cajal, del Rio Hortega,
and the other members of CajaPs school. The result, entitled A
Classification of the Tumors of the Glioma Group on a Histo-
genetic Basis with a Correlated Study of Prognosis, was re-
ceived with enthusiasm all over the world. It was dedicated to
"Professor S. Ram6n y Cajal and to the disciples of his dis-
tinguished school of Spanish neurohistologists."

240

TEACHER 241

The study had been largely financed by the Philip EL Gray
Fund, established in 1923 by the widow of a patient who had
died of a malignant glioma. It gave Gushing $10,000 a year for
ten years for study of tumors of the glioma type. Mr. Chester
C. Bolton of Cleveland supplemented this fund several years
later in gratitude for Cushing's care of his son Charles after
injury from a diving accident. Such generosity helped mate-
rially toward accumulation of the approximately $30,000 that
Dr. Gushing had to provide each year to pay the running ex-
penses of the laboratory, the salaries of Dr. Bailey, Dr. Eisen-
hardt, a photographer, artist, technician, and so forth. Addi-
tional income came occasionally from large fees charged
wealthy patients with the understanding that these would be
turned over immediately to the laboratory. The balance Gush-
ing made up out of his own pocket. 1

During the summer of 1925, Gushing was engaged in a last
editing of the glioma monograph and in the preparation of the
Cameron Lectures which he was scheduled to give in Edin-
burgh in October. This lectureship, established by Dr. Andrew
R. Cameron of New South Wales in 1878, had previously been
graced by such distinguished physicians as Pasteur, Lister, Fer-
rier, Horsley, and Macewen, the only American having been
Simon Flexner. Three lectures were required (honorarium
200), and Gushing chose as the tide for the first lecture, "The
Third Circulation and its Channels." He summarized the
papers published by him and his pupils since 1901, most notably
those on the origin of the cerebrospinal fluid which Lewis H.
Weed had begun at the Hunterian in 191 2. The second was on
"The Pituitary Gland as Now Known"; again he summarized
the work of his laboratories ever since his interest had been
stimulated by Edward Sharpey-Schaefer in 1908; including de-
velopments in the field since the publication of his monograph
in 1912.

The third lecture, on "Intracranial Tumors and the Sur-

1 Dr. Gushing also provided supplementary support for the Surgical Lab-
oratory in the Medical School to augment an inadequate budget. Out of
the $5,000 which was his salary during his entire service at Harvard, he
also had to pay his secretary.

342 HARVEY GUSHING

geon," covered the historical background of the subject, tumor
classification, and gave data on his own cases, which now num-
bered 1,146. The three lectures were subsequently published
under the title, Studies in Intracranial Physiology and Surgery.
His audiences had come to expect something superior from
Gushing and they were not disappointed. "His distinction is
and it is a distinction which places him for all time in the front
rank of scientific investigators . . . that he has regarded and
studied his specialty from every conceivable angle."

Early the following year (1926) Gushing went to Baltimore
to be present at the unveiling ceremony of a portrait of Revere
Osier in the new Tudor and Stuart Club where Revere's books,
given by the Osiers to Johns Hopkins University (together
with a gift of money), were to be placed. At the same time
Gushing attended a dinner to honor Dr. Dean Lewis of Chi-
cago, who was to take Halsted's chair of surgery.

It was not long before Cushing's attention again turned to
the Hopkins when Dr. Weed consulted him about a library
that they were planning in honor of Dr. Welch. After the archi-
tect had come to Boston to show him the preliminary plans, he
wrote Dr. Weed most enthusiastically. 'What a monument to
Popsy this library will be! It ought to become the most impor-
tant in the country next to the Surgeon General's." He had
only two suggestions for improvements on the plansone in re-
spect to the stacks and the other on a point he considered basic
in a library, that it be on the ground floor without a single step
which might act as a deterrent to students using it.

In June he gave the Commencement address at the Jefferson
Medical College in Philadelphia, where Thomas McCrae occu-
pied the chair of medicine. During the exercises he received an
honorary Litt. D. His address, "Consecratio Medici," offered
him an opportunity to expound a favorite theme the doctor-
patient relationship. This theme was part and parcel of his deep-
rooted convictions about medical education. A clinical teacher
himself, he was inclined to believe that a student learned more
medicine at the bedside than during his preclinical indoctrina-
tion in the "pure" sciences. He had elaborated upon this in a

TEACHER 243

paper entitled "Experimentum periculosum; Judicium diffi-
cile," presented at New Haven (1925) when he and Dr. Welch
were invited to help dedicate the new Sterling Hall of Medi-
cine.

Even when the relation [of preclinical subjects to ultimate goal]
is obvious, it would seem to be a needlessly long and uninteresting
process. The anatomist describes the form and situation of the
pancreas; the embryologist shows how it buds off from the gut;
the histologist in turn points out the acini and the islets; the physi-
ologist presents the accepted theories of the manifold functions of
the normal organ; the biochemist discloses the complicated ways
of detecting and of quantitating the various sugars; the pharma-
cologist perhaps demonstrates the action of the newly discovered
insulin and -explains how it is prepared; the pathologist, getting
down to more solid ground, shows in turn the diseased organ; and
finally, after two years of this, the student first sees a patient with
symptomatic evidences of pancreatic disease, possibly brought to
light by a carbuncle or a gangrenous toe.

How much simpler to have shown the patient first, to have
briefly explained how diabetes came to be recognized and what
its complications may be, how step by step the mysteries of car-
bohydrate metabolism have partly been unraveled and the princi-
ples of our present-day treatment establishedin short, the solid
facts of the matter in the order in which they were discovered.
Is not this the logical method of presenting our increasingly com-
plex subject? . . . Could science be prevailed upon to concede to
the clinic from the beginning of the course a single hour a day,
if necessary from eight to nine in the morning . . . the average
run of students would certainly face their subsequent laboratory
hours not only with greater interest but with a clearer appreciation
of why it is necessary to get the best possible scientific grounding
for their future career.

It was a challenging theme for an address at the opening of a
building to house preclinical laboratories. And his stand, of
course, brought him into conflict with his preclinical col-
leagues, for they believed that the student was unprepared to
appreciate the disease conditions encountered in the clinic be-
fore he had had a broad background in the biological sciences.
Undoubtedly many resented the fact that Gushing thought a

244 HARVEY GUSHING

busy practitioner could better teach students the basic scientific
principles of medicine than physiologists, anatomists, and
pathologists whose main concern was teaching and research.
But this did not keep him silent. He even went so far as to say
that "there is much that a present-day medical student might
envy in the opportunities offered to a young man of a century
ago, apprenticed to such a person, let us say, as Nathan Smith,
with the chance to get at the outset an intimate knowledge of
people and of people's maladies; to discuss the problems of the
sick room with the master while driving him in his gig as he
went on his distant house-to-house rounds; to have his col-
lateral reading directed; and subsequently to take a short course
somewhere in the so-called fundamentals and get his degree."
And again: "I do not believe that students can begin to think in
terms of the patient too early in their course, nor too early be-
gin to interpret and record what they can see, hear, and touch-
perhaps even smell and taste at the bedside."

This gospel of observation and deduction grew up alongside
another tenet that had its roots in the same soil. "No one can be
a good physician who has no idea of surgical operations, and a
surgeon is nothing if ignorant of medicine." This was a theme
on which Gushing ruminated throughout his professional life
and he practised it- 2 At a time when the tendency to specialize
was growing, he preached vigorously the principles of "the
good old days" when the family doctor was physician, surgeon,
technician, psychiatrist, and physiotherapist all in one. He be-
lieved that the modern physician in relying on all the aids which
science had placed at his hand to assist in diagnosis and treat-
mentX-rays, laboratory tests of all kinds, etc. tended to lose
sight of the value of examination, observation, and common
sense. "It would be an admirable thing," he thought, "if every
student, before his graduation, be required, under the control
and supervision of his teachers or the district physician of the
community, to engage in an actual house-to-house practice,

2 In 1939 Dr - Gushing was made an Honorary Fellow of the Royal Col-
lege of Physicians of London. He was the only surgeon ever to receive
this honor, and in the two centuries and half of its existence, the Col-
lege had appointed only six Honorary Fellows.

TEACHER

armed perhaps with nothing more than a clinical thermometer,
a stethoscope, his fingers, and wits, supplemented perhaps by a
microscope and a few simple dyes. In this way he might learn
something at least of the living conditions which modify the
health of the people he now only meets in the dispensary, sur-
rounded by all of the paraphernalia and instruments of pre-
cision supposed to be necessary for a diagnosis."

This was oversimplification of course, but it made his point
that specialists can become too specialized and it emphasized
a .fact of growing importance, namely, that to consider the
mind and body of a patient is not enough, a knowledge of his
environment is essential in order to remove the causes which
brought him to illness.

When it came to teaching, Cushing's ideas were equally
"practical." Because he was not an easy lecturer, he had, from
the first days at the Hopkins, done most of his teaching in the
operating room or by clinical demonstrations rather than in
the formal lecture. He believed even more firmly that students
learn by doing and was supported in this conviction by the
popularity and success of his operative course on dogs at the
Hopkins, described in a lecture to the Yale Medical Alumni
Association back in 1906. "It will make of the students better
and more trustworthy assistants when, later in the curriculum,
they are privileged to take part in the more responsible opera-
tions on man occasions when slips in technique must not
occur." He had concluded with this statement a belief that
was not modified or shaken by the years-

Emphasis is laid . . . upon the fact that the operation is not the
beginning and end of surgery, but a therapeutic measure alone;
and that those employing this manner of treatment must have the
same knowledge of disease, the same ability to make examinations,
the same instincts to follow pathological material to the laboratory
and to investigate there the causes and symptoms of disease, as
should characterize any other well-trained members of the body
medical.

Mr. Geoffrey Jefferson has called this paper one of the most
fascinating in surgical literature, "since it illustrates an ap-
proach to surgery bearing the hall-mark of what one might

246 HARVEY GUSHING

call the University mind at its highest level applied to hu-
manitarian purposes."

In Boston, Gushing offered an elective clinic on Saturday-
mornings for first- and second-year students. In addition he
had a regular Wednesday noon clinic for third-year men, in
preparing for which he spent the entire morning each week,
much as if the subject to be considered were completely new
to him. Despite this careful preliminary planning, the clinics
were always informal, and on one occasion an opinionated
student remarked that he wished Dr. Gushing would some-
time prepare for his clinics!

Gushing also had staunch convictions about the value of
postgraduate study and research, especially abroad. The
memory of his year in Europe was always close to him and
he appreciated the broadening influence of an opportunity to
observe and work in foreign hospitals and clinics. It led him
in 1925 to write to Dr. Weed that he and Mrs. Gushing wished
to make $25,000 available for a graduate fellowship at the
Hunterian Laboratory. Dr. Weed not only expressed grati-
tude to Gushing, but thoughtfully wrote to Mrs. Gushing
also: "All I can say is that this gift of yours and Dr. Cushing's
is just like you both. Both of you have always been so won-
derfully good to the young people around you: you have so
markedly broadened the viewpoint, the horizon of so many
of us. And now this personal influence is going to be continued
permanently."

A similar fellowship was established (by outright gift of
$25,000) in the Department of Surgery at Yale named in
memory of their son William. And at the Brigham, Gushing
began in 192 1 to turn over to the Trustees a portion of his fees
from patients for the establishment of a "Surgeon-in-Chief
Fund" created to send men from his staff abroad for study (or,
if deemed wise, to some American institution). On his retire-
ment, in 1932, the Trustees designated the fund, then grown
to nearly $35,000, the Harvey Gushing Fellowship Fund. The
Treasurer of the Trustees, Mr. E. D. Codman, called the fund
a representation of "the finest spirit of loyalty to the Hospital,

TEACHER 247

the staff and its future beyond any gift the Hospital has
received."

It was this June (1926) that William had been killed. After
a brief time at Little Boar's Head with the family, Gushing
returned to Boston and endeavored to bury his grief in hard
work. His legs had grown increasingly worse. The incessant
smoking he had done while writing the Osier biography had
aggravated his circulatory difficulties, for the arteries in both
legs were already permanently affected by an ascending throm-
bosis. He made no mention of his discomfort, however, but
his staff were not unaware of the reason why he would stop
two or three times while going down a long corridor on the
pretext of discussing a case or to make comment on what
might be going on outside a window. Nevertheless, he did little
to slacken his general pace, in fact he seemed to increase it
occasionally scheduling two operations a day instead of one.
And he would appear completely oblivious to the annoyance
he caused everyone when he so often scheduled these "double-
headers" on Saturdays.

Several improvements had come about in the control of
hemorrhage since the days when Gushing had invented his
tourniquet. This had long since been replaced by injecting
the skin with the blood-constrictor, adrenalin, and by the use
of the silver clips he had devised in 1910. Blood transfusion was
now used during operations, but blood coagulants had not yet
been developed. The problem continued to be a serious one,
and there were many types of tumor still unapproachable be-
cause of their profuse bleeding.

In the autumn of 1926, Gushing used for the first time an
electric cautery apparatus in a brain operation. In general
surgery and in genito-urinary surgery, high-frequency cur-
rents had been used for some time in dealing with both benign
and malignant growths, but it was Gushing who established
their value in neurological surgery. With the co-operation of
Dr. W. T. Bovie, a physicist with the Harvard Cancer Com-
mission who had previously developed apparatus for dealing
with cancerous growths, he experimented with currents and

2$ HARVEY GUSHING

equipment until they had one current that would cut tissue
without attendant bleeding and another that would coagulate
a vessel which might have to be cut during the course of an
operative procedure.

The first occasion was not without its drama. The New
England Surgical Association was having a meeting in Boston
and many members attended, and a member of the visiting
staff brought five French guests to witness the event. The
homemade apparatus was wheeled down the street from the
Huntington Hospital, where Dr. Bovie had his laboratory,
and had to be carefully adjusted after the rough journey. Such
was the excitement and confusion in the operating room and
the suspense as to whether the apparatus would work that the
student who was to act as blood donor, should one be needed,
fainted and fell off his chair. And the first assistant, a resident
who had arrived from England about three days previously,
found the whole procedure more than he could cope with
and Dr. Horrax had to be found and called in. But the result
was most gratifying, and Gushing was so encouraged that he
immediately began to call back all the patients on whom he
had not dared to operate before he had this electrosurgical
device. The Liebel Flarsheim Company became interested in
the project and later Mr. Liebel presented Dr. Gushing with
the first unit constructed commercially.

Cushing's mortality figures began to climb somewhat be-
cause he was attempting to remove what had been considered
inoperable tumors. Nevertheless, his success on the whole was
phenomenal. Writing and almost everything else were for-
saken while he spent more and more time in the operating
room. Had Dr. Horrax not assumed a large portion of the bur-
den, Cushing's health would doubtless have suffered. The
new assistant resident, Mr. Hugh Cairns, said the Battle of the
Marne was nothing compared to the stress and strain of being
Dr. 1 Cushing's assistant that year.

Recognition of the work of his clinic came from several
different directions during the following year. He sailed for
England on June 4, accompanied by Betsey (now eighteen)
with Miss Stanton as her companion and incidentally a useful

TEACHER

helper in connection with his three papers, yet unfinished.

His first responsibility was a lecture on acromegaly from a
surgical standpoint before the Medical Society of London. He
was amazed and delighted to have that great student of the
nervous system, Sir David Ferrier, now eighty-four, come
from virtual retirement to hear the lecture. His subsequent
travels resembled a triumphal tour at Glasgow he inaugurated
a lectureship to honor Sir William Macewen, who had died
in 1924, and received an LL.D. from the University. His paper
was a milestone in neurosurgical history since it described for
the first time the use of electrocautery in the removal of brain
tumors. He next attended a meeting of the Society of British
Neurological Surgeons at Manchester, where he visited the
John Rylands Library and had opportunity to meet again his
warm friends, Mr. and Mrs. Geoffrey Jefferson.

In Dublin on June 28 Gushing received, in an elaborate and
colorful ceremony, the degree of Honorary Master of Chi-
rurgery from Trinity College. He was also made an Honorary
Fellow of the Royal Academy of Medicine of Ireland. After a
week in Paris he went to Edinburgh to give an address at the
Lister Centenary celebration. The inspiration for his paper had
come to him the preceding spring when standing in front of
the Lincoln Memorial in Washington. Stirred almost to tears
by its beauty, it came to him that this man who had freed men
from slavery could be compared to the man who had freed
mankind from sepsis, and his address, "Emancipators," is one of
the most moving of all his essays. A third honorary degree, an
LL.D. from Edinburgh, was later followed by election to
honorary fellowship in the Royal Society of Medicine and
honorary membership in the Society of British Neurological
Surgeons.

But his pleasure in these honors was soon overshadowed. He
returned home immediately his lectures were over because he
was faced with another operation on General Leonard Wood.
He found General Wood eager to have the ordeal over, and
although reluctant to undertake so important a procedure after
being absent from the operating room for over a month, he
acceded to the General's wish. He found a massive recurrence

250 HARVEY CUSHING

of the meningioma which presented problems taxing all his skill
and ingenuity. Four transfusions were necessary during the
seven-hour operation, and when at last the General was resting
quietly in his room, untoward symptoms appeared which ne-
cessitated re-elevating the flap. Once again he hoped that all
was well, but General Wood's condition became rapidly worse
and he died in the early evening. The loss of any of his patients
always had a profound effect on Gushing, but this courageous
man who had been a valued friend for so many years was a
double loss. In severe self-criticism and unconsolable dejection,
Gushing wrote: "He was a great man. I've never lost a patient
after operation that so upset me. It was so near success. ... If
I had used better judgment he would certainly have been
saved."

A GOOD DOCTOR

Chapter XXIII
nrl

IH

.HERE IS NOTHING MORE SINCERE

nor more heart-stirring than the gratitude of a sick person to
the physician who has helped him regain the precious gift of
health. Harvey Cushing's files are crowded with letters from his
patients and letters to his patients, because he followed for
years the lives of those his skill had helped. He followed them
for two reasons, his own personal interest in their welfare and
for what a record of their subsequent history would contribute
to the progress of medicine.

Although he was a specialist in a large medical center, Cush-
ing's relationship with his patients was much like that of a coun-
try doctor; indeed the country doctor was the prototype of
what he thought a physician should be what he aspired to
when he said that he wanted above all to be "a good doctor." In
reading the letters he encouraged his patients to write each year
on the anniversary of their operation one fact will be apparent
over and over againthat while few of his patients were un-
aware that in the eyes of the world he was a great man, the feel-
ing that he was their friend was uppermost in the minds of all
of them. They sent him birthday and Christmas cards and re-
membrances, told him of their marriages, babies, and other
events important in their lives, and asked his advice about many
things. And his replies assured them of his interest in all their
concerns.

Of the thousands who loved and admired him, a few, chosen

251

2$2 HARVEY GUSHING

at random, will illustrate the warm friendliness and interest that
existed on both sides. Just as Gushing made each operation a
personal issue between him and the forces threatening his pa-
tients' lives, so throughout their days he stood between them
and any recurrence of the same misfortune. For many, of
course, one operation sufficed, but there were others who, be-
cause of the nature of their tumors, had to return again and
again.

Dr. Fulton wrote during the year he was one of Cushing's
neurological assistants: 1

In going over the histories one is continually impressed with
the Chief's perseverance in dealing with the more malignant group
[of cerebellar tumors in children] the medulloblastomas. Though
these children return time after time, often after a period of six
or seven months, with recurrence of symptoms, the Chief always
goes in again with the hope that this time he may be able to remove
the tumor in its entirety. He fights for the life of these unfortunate
children with the ardor of a religious missionary and seems never
willing to admit that it is a losing game. His attitude is much that
of Dr. Joslin in his struggle with diabetic children. Dr. Gushing
had one patient with a medulloblastoma who had lived four years
(the usual survival period being about fourteen months after the
onset of symptoms). He was so elated over the fact that he re-
ported the case, and then had his hopes shattered six months later
when the child returned with an enormous recurrence and died
several months later. Now that the new electrosurgical technique
has been developed, he attempts radical extirpation of the tumors
with renewed hope that now at last he has found something which
will enable him to deal with the cases effectively, but alas! one of
the cases done only last November came back a few days ago.
The Chief's only comment was, "I didn't do it as well as I should
have."

But no matter what the nature of his patients' illness, Dr.
Gushing kept in touch with their subsequent progress with in-

1 Gushing persuaded John Fulton that he should have a medical degree
in addition to his doctorate in physiology. He accordingly entered the
Harvard Medical School and received his M.D. in 1927,

A GOOD DOCTOR 2$$

terest and sympathy. There was twelve-year-old John D., a
very bright, lively boy who, because of pituitary malfunction,
was undersize for a boy of his age. In 1922 Dr. Gushing re-
moved a supracellar cyst. After the operation he kept in close
touch with John's progress and after three years suggested
that he return to the hospital to try some injections of pituitary
extract in the hope that his growth would be stimulated. John's
father wrote in March of 1925, "John is overjoyed at the pros-
pect of entering the Hospital and seeing you again." Two
weeks later Gushing reported:

This is just a line to let you know that John has been behaving
splendidly, making friends with everyone, "taking his medicine"
like a little man, and with no complaints. Inasmuch as it means
pricking him with a needle and making him a little sick to his
stomach once every forty-eight hours, it shows how co-operative
he is. He is the pet of the hospital and is allowed many privileges.
So I think you may feel at ease.

Eut the experiment was unsuccessful and Gushing reluctantly
admitted defeat, writing John's father on May 15:

I think you are quite right about John. We do not seem to be
making any great progress just now and I think the hospkalization
may have been carried on as long as justifiable. I may say, however,
that he is just as cheerful and loveable as he can be. I brought my
small boy down here the other night with a broken arm and went
into the ward to dress him. It was nine o'clock and the ward was
dark and they should all have been asleep, but John was entertain-
ing the patients with a bed-time story over which they were in a
gale of laughter. We shall miss him greatly when he leaves.

While the family were in Little Boar's Head in the summer
of 1929, Gushing once again called in some of his patients
suffering from pituitary dwarfism, taking a few of them into
his house to save them the expense of the long hospkalization.
But the growth hormones which Tracy Putnam had found
effective in animals in his experiments at the Surgical Labora-
tory did not accomplish the results in humans that Gushing
had hoped and again he had to send John home without the

254 HARVEY GUSHING

desired gain. "He's been a perfect angel patience on a monu-
ment."

There was a prominent naval captain who came to Dr. Gush-
ing with a meningioma like General Leonard Wood's which
threatened to cut short a brilliant career. He was descended
from a long line of naval men, his father having been an admiral,
and a great uncle a former Secretary of the Navy who founded
the United States Naval Academy at Annapolis in 1 845.

In less than two months after the first operation, a second was
made necessary by postoperative complications, but after that,
the patient made a good recovery, received a promotion to
Rear Admiral in due course, and returned to duty. In 1937 he
wrote Dr. Gushing: "Beside yourself, Cairns, and some of the
hospital staff, few can know of the great battle you fought to
save my life, and how unsparingly you gave of your time and
unequalled skill and knowledge to pull me through and restore
me to useful service. ... I am able to run this Naval District
. . . without undue strain or f atigue."

There was Milton W. Ferguson, who first came to Gushing
at the Hopkins in 1907 when he was eight, almost blind from a
cerebellar tumor. The last of five operations was done in 1925,
and when Milton sent his annual report in 1936, Dr. Gushing
wrote him:

Dear Milton: Thanks for your letter with its Easter greetings.
I am always so happy to hear from you, particularly when, as now,
you say that your head is feeling better and that you feel like a
new person.

You say that it was April nth, 1925 that I last operated on you,
but it must have been nearly twenty-five years since a small boy
in knickerbockers who was unsteady in his gait turned up at the
Johns Hopkins Hospital and was subjected to an operation, then
supposed to be very dangerous and which amounted to nothing
more than opening a cyst/ If we could only have known in those
days that there was a little nodule of tumor in the wall of the cyst
which could be removed, you would not have had all this trouble
from loss of vision. But there is no use crying over spilt milk, and
you fortunately were a born optimist. So that's that, and I am sure

A GOOD DOCTOR 2$$

you have got more out of life than a lot of people do who have a
good pair of eyes.

Please give my regards to your father, and believe me, Always
affectionately yours.

Milton Ferguson wrote many letters to Gushing over the
years, and Dr. Gushing never failed to answer. They discussed
Braille, George Gershwin, laxatives, Dr. Cushing's having met
his sister at a Grenf ell lecture, or Milton's having seen a picture
of the three Gushing girls in the Boston Post "I think my sight
is improving," he wrote. Their last exchange was after Dr.
Cushing's seventieth birthday: "First of all may I send you my
heartiest congratulations upon your birthday anniversary. The
news came over the radio tonight and was I thrilled!"

Six months later another letter came from Milton Ferguson,
written in the simple dignity of deep grief:

My dear Mrs. Gushing and family: It was a great shock to me
this morning when I heard over the radio that Dr. Gushing had
passed away. I hardly know what to say.

My associations with Dr. Gushing were perhaps unique as he
saved my life five times. ... I looked forward every year to
April 1 1 to make my report to him on my condition and always
got a prompt and cheery reply. It is like losing a very dear friend,
as you must realize that a blind person has few friends to whom
he can go for advice when in trouble. . . .

... I will close by saying I share with you the very great loss
to us all in his passing.

But although Milton Ferguson had to have five operations,
there were others for whom Dr. Gushing had to fight even
harder, aware often, as with the recurrent medulloblastomas,
that it was a losing battle. He knew, for example, that Timothy
Donovan, who inherited the charm but notthe luck of the Irish,
could live only a few years at best. He removed four tumors in
seven years, and the difficulty he had with the fourth caused
him to say: "After this desperate procedure the unanimous feel-
ing was 'never again. 7 But Tim was not so easily discouraged.
To the surprise of all he walked into the hospital eight months
later, January 20, 1927, with a gleam in his eye as much as to say
4 I told you so.' "

HARVEY CUSHING

A year later he was back again for the sixth rime, and on this
occasion a junior staff member wrote on his record that another
operation seemed hopeless. "Euthanasia appears to me the only-
indication." Gushing, in writing up Timothy Donovan's case in
his monograph on the meningiomas several years later, was led
by this comment to write:

Both patient and surgeon may philosophically decide that life
is no longer worth living; yet each will instinctively rebel at bring-
ing it to a close, though this would be so painless and easy during
an operation by exsanguination or an overdose of the anaesthetic.

No fine distinction can be drawn between courage and coward-
liness. All of us know plenty of people, leading useful lives, who
once went under an anaesthetic in the hope of not waking up,
leaving the surgeon, whatever his misgivings, to go about the legiti-
mate business of doing that for which he was trained. His hardi-
hood depends greatly on the state of his digestion, the soundness
of his sleep, and freedom from extraneous worries. He may shrink
today from an operation that he approaches with confidence to-
morrow. So, when after a few days, poor Tim aroused sufficiently
from his stupor to indicate that he was ready, that was enough.

Even this was not the end. *Tim Donovan returned twice more,
but died six months after the last operation mercifully, since
with each recurrence the period of mental deterioration grew
longer.

But there was a case more heart-stirring than this because
it did not at first appear so hopeless and because the patient
was able to live a normal and extraordinarily rich life in be-
tween the recurrences of her tumor. This patient was Dorothy
May Russell of Salem, Massachusetts a talented pianist who
came from a family of musicians. In 1919, shortly after leav-
ing the Graduate School of Fine Arts at Syracuse University,
she was admitted to the Brigham Hospital with a suspected
tumor since for six months she had been gradually losing the
use of her right arm. Her convalescence was slow after the re-
moval of the growth, but when she returned home, she seemed
happily on the mend. She wrote Dr. Gushing immediately:

A GOOD DOCTOR Z$7

My dear Dr. Gushing: It seems strange not to be able to see yon
any more. I used to watch for you in the afternoon and was always
so glad when you came. Now I cannot watch for you but I think
of you. . . .

For the past five years I have gone to Syracuse University this
month [September] and it seems strange not to be going back
now. ... I have made all sorts of plans for the future, that glori-
ous time when I shall have two good arms, hands and fingers.
Then you can pity the neighbors when I practice again. My hand
is gaining all the time which gives me all kinds of courage.
. . . Most gratefully and respectfully, Dorothy Russell.

Within three months she was back, and again in four, and
during the next four years had to return about twice every
twelve months. Realizing that a concert career was now im-
possible, she began to give music lessons (at twenty-five cents
a lesson) and to study the violin. Once she wrote: "I have
thought of you many times . . . and hoped to write you that
I was feeling 'bully' and had entered the Conservatory as a
violin major. Now I cannot tell you either. ... I am sorry I
have to write about my losing consciousness, but I am not
complaining. You must think I am one of your Vorstest' pa-
tients and I would desire to be one of your c bestest.' However,
I have some good news to tell you. I can practice three hours
a day on the violin and my arm is growing stronger all the
time."

In 1923 Gushing wrote her family physician: "Dorothy Rus-
sell has been back again with, I am glad to say, only a small
nodule of tumor in the scalp. So far as I can make out there
is no intracranial recurrence. She is a good girl and has been
very cooperative and I shall stick to her, if necessary, to the
end, but hope that this may prove to be the end." But it was
far from that. On her tenth admission, Dr. William Van Wag-
enen's comment in the case record was: "A thin, undernour-
ished young woman with one of the most unusual personali-
ties I have ever had occasion to meet. It was astonishing to find
any human being who could maintain mental equilibrium so
well, and have a sense of values so completely undisturbed as
has this woman after her long siege of difficulties."

2$8 HARVEY GUSHING

At one point her mother wrote Dr. Gushing: "Dorothy is
so distressed that we have been unable to pay you for your
many operations, and great kindness. Yesterday she sent for
me to come to the hospital. She said 'Mother, I just can't lie
here and take Dr. Cushing's time and owe him so much. Won't
you put me in the open ward and pay him the difference?'
I think our great obligation to you, and our inability to meet it
has been one cause of her anxiety to succeed." 2 To this Gush-
ing replied: "If I were not interested in Dorothy and her trou-
ble and not eager to see her make a perfect recovery from her
baffling malady, I would have sent her to the public ward and
turned her over to someone else long before this. ... If she
gets well, as I am sure she is going to do, that will be quite
sufficient payment for me."

After three years of struggle with the violin, Dorothy Rus-
sell had to give it up too. Her mother described to Dr. Gushing
the day she finally admitted defeat:

One day after trying to practice she put the violin in the case
and put the case away and also the music saying, "It is hopeless,
no need to try longer," with such a look of despair on her face,
but turning to me and adding "Don't mind so much, Mother, see

1 am not crying." I could not keep the tears back, but she met it
bravely. She never touched the violin to play after that.

With splendid courage she next turned to harmony and was
successful in selling a few of her songs. She was then partially
supporting her family with her music lessons, but these were
interrupted periodically by her visits, now yearly, to the hos-
pital. In 1927 Dr. Gushing wrote to the Boston Music Company
without her knowledge, telling something of her story. This
resulted in their buying two of her manuscripts, for her work
had real merit. One, for the organ, she asked for permission

2 Dr. Gushing always made a point of inquiring about a patient's financial
status when the history was being taken. His charges were always mod-
erate (his usual fee for a craniotomy being $250 to $500), but if he dis-
covered that the patient had limited means, he sent no bill at all or a
very small one. If the patient came from a distance, he never thought-
lessly asked him to return to the hospital for a routine check-up, but
made arrangements if possible for him to see someone near at hand.

A GOOD DOCTOR

to dedicate to Dr. Gushing: "The Twilight Reverie' is an
unpretentious bit. I would wish it better than anything Bee-
thoven has ever done to dedicate it to you, but it is the best I
have done up to the present time. While the composition is
small, the spirit and affection that accompanies my wishing to
dedicate it to you is very big. I hope you will understand."
His reply was: "Do as you lie, but not having any music in
my soul, to my everlasting regret, I am afraid that to dedicate
a piece of music to me would be enough to spoil it."

After each operation there came the joyful feeling of well-
being, and the ability to accomplish more work. "I am going
to try so hard to make good, to be of some use in the world so
that you may not feel that your skill and kindness have been
wasted." This indomitable spirit kept her at her teaching until
ten days before what proved to be her last hospital admission,
in December of 1932. Many of her pupils won scholarships
and other honors in music. "Every pupil seemed to feel a
greater incentive to be something and do better work by being
with her," her mother wrote.

During 1932 she had had two operations, the second bring-
ing the total to seventeen. When she returned to the hospital
on December 17 (her twenty-first hospital admission) she was
in a state of semi-stupor. If she heard the carolers in the ward
on Christmas morning, she gave no sign. There was nothing
more Dr. Gushing could do, and she died in the late afternoon.

Her brain was set aside at autopsy for further study. Ten
years passed before he had the courage to examine it. In his
meningioma monograph, he wrote: "In the postmortem proto-
col it is stated that no description [of the brain] had been
received and the opinion is expressed that one might never be.
But even a pathologist surely might make allowances should
a surgeon fail to show great enthusiasm over a lifeless brain he
has handled a dozen or more times when pulsating and alive;
learning meanwhile, both at and between sessions, things about
its quondam possessor no microscope could ever disclose. One
does not get the whole story from the autopsy."

FOUNDER OF A "SCHOOL"
Chapter XXIV

! THE SPECIAL TECHNIQUES WHICH

had made possible the development of brain surgery came into
wide use through the men Gushing had trained, he began to
be called the founder of a "school." And because he taught
not only techniques but a broad approach to .medicine, he will
stand in history as a leader of men long after his technical
contributions have been replaced by new advances.

Men were attracted to Gushing not alone because he was
known as the world's most eminent neurosurgeon but be-
cause of his compelling personal magnetism. Through it he
inspired a rare degree of loyalty in those who worked with
him although many of them ruefully admit that he could
make them more angry than anyone they had ever encoun-
tered. But although he did not always have the warmth, Gush-
ing possessed something of the physical radiance that was
Osier's and he could quickly win again those he had antag-
onized. It was to this charm that he owed his many loyal
friends in college and medical school and when he made use
of it, it was difficult to resist him.

The atmosphere of his clinic was largely created by his
colorful personality. His own energy, his ranging enthusiasms,
his high standards of performance kept things moving at a
rapid tempo. Because many of his patients came with desper-
ate or out-of-the-ordinary conditions, there was an unusual
air of suspense surrounding his activities, intensified by the

260

FOUNDER OF A "SCHOOL" 26l

fact that he had a way of investing any situation with drama.
The distinguished visitors from foreign shores, and the honors
from home and abroad that were constantly coming to Dr.
Gushing, also added interest. But work was carried on under
military discipline, and Gushing as commander-in-chief was
unpredictable. He might spend hours helping a junior assistant
with a paper but have no patience at all if the man left some-
thing undone in the clinic. On such occasions he had a way
of correcting that was hard to forget. Dr. Carl W. Rand of
Los Angeles remembers one such occasion vividly.

At lunch one day Gushing told Rand that he would like
that afternoon to do a dressing on a certain patient who had
been operated on the previous week for a cerebellar tumor.
Preceding Dr. Gushing in order to have everything in readi-
ness, Dr. Rand split the tremendous crinoline dressing that
extended from the top of the head to the waistline in the form
of a cast so that it could be more easily removed. "Never was
Cain more severely castigated for his misdoing!" Rand wrote
later. "I do not recall exactly what was said after his first look
of astonishment, and toss of the head, but I can never forget
that succeeding hour. I was given a lesson in the technique of
dressing a wound which was indelibly impressed on my mem-
ory, and then left in gloomy silence to ponder on it for the
next several days." Thereafter he seemed unable to do any-
thing right and when he had almost reached the point of des-
peration, Dr, Gushing asked him to come to Sunday dinner
the following day. Dinner, however, was a matter of embar-
rassment to Rand despite the efforts of Mrs. Gushing, who
did her best as an understanding and gracious hostess. The rest
of the evening is best described in his own words:

Doubtless he too was aware of my uneasiness, and after coffee
had been served he excused us from the family circle and led the
way into his library. ... As I sat and watched he began to look
over his stacks of books until his hand fell upon a large thin folio,
which showed signs of age although it had evidently been rebound.
He drew up beside me and laid it open upon the table. It proved
to be a first edition of Sir Charles Bell's "Illustrations of the Capital
Operations of Surgery," Part I, Trephine, published in 1820. He

262 HARVEY GUSHING

went over it carefully, as only a book lover can, paying especial
attention to the part that dealt with "dressing after trepanning."
... To my utter surprise when I left he handed the book to me
as a gift. To make it even more precious, I discovered upon later
examination, that it had been given to him by William Osier.
Surely a coup de grace in wound dressing never to be forgotten.

This experience could probably be duplicated with varia-
tions by almost any man who ever worked under Gushing.
But despite uncomfortable incidents (some of which were
not resolved as agreeably as this one), the general atmosphere
in the clinic was a healthy one of give and take, enthusiasm
and co-operation. It was well described in an entry in the
diary of John Fulton at the time of the fif teenth anniversary
celebration at the Brigham in April of 1928:

He talked to us as though he were speaking to members of his
own family, and one somehow carried away the feeling of being
in a happy family group. This, I think, is the secret of the delight-
ful spirit of co-operation which pervades all departments of the
Brigham Hospital, and I somehow feel that when the Chief's ac-
complishments come eventually to be enumerated, the spirit of
co-operation and friendship which he has inculcated in the Brigham
group will be looked upon as one of his great achievements.

His assistants saw many sides of him and each was attracted
by a different aspect of his complex character. J. Paterson
Ross, who was a junior associate for six months during 1923,
has a vivid recollection of a visit to the Ugly Lady in the circus
who had come to Dr. Cushing's attention because of her acro-
megalic headaches. Cushing's work on the pituitary had made
him particularly aware and sympathetic with the abnormal
conditions which so often found their way to the circus, and
he had a lifelong interest in the problems of these people. At
one time he wrote indignantly to Time magazine about a
woman whose picture they had published under the caption
of "Uglies." He explained that, previously a vigorous and
good-looking woman, she had become the victim of the disease
acromegaly and had accepted the offer of Mr. Ringling's agents
to pose as "the ugliest woman in the world" in order to support
her four fatherless children, but "she suffers from intolerable

FOUNDER OF A "SCHOOL" 263

headaches, has become nearly blind, and permits herself to be
laughed at and heckled by an unfeeling people. . . . Beauty
is but skin deep. Being a physician, I do not like to feel that
Time can be frivolous over the tragedies of disease."

Dr. Leo Davidoff, a well-known neurosurgeon in New
York, remembers that one time in 1924, when he was assistant
resident, Dr. Gushing had been in a particularly disagreeable
mood, finding fault with everyone and especially with him.
"As you know," Davidoff said, "it was never his policy to
apologize for this kind of behavior. The next morning, how-
ever, he felt better again, greeted me most cordially, and we
started on rounds. The first room we entered on the private
pavilion was that of a new female patient. He asked her what
she complained of and she declared a change in her disposition
had occurred which made her disagreeable to all her friends.
The Chief looked at me with a twinkle in his eye and said
'That's no sign of a brain tumor, is it, Davidoff?' "

Dr. Cushing's rare skill in drawing people out reminded
Dr. William K. Livingston, professor of neurosurgery at the
University of Oregon, of an incident which occurred during
his medical school days. During an informal conversation with
Dr. Gushing, Livingston ventured to ask him to what he
ascribed his eminent position. Gushing immediately seized
upon a slang word which Livingston had just used. "By being
cagey," he told him with a twinkle. He went on to explain
that during his early years he was constantly aware that his
co-workers often had a wider grasp of certain subjects than
did he. In such cases, he made a habit of drawing them out,
learning directly all he could of the subject. He would then
supplement this information with reading until he felt he knew
as much if not more than the man he had been drawing out.
As a result, he frequently had something in reserve some
special bit of knowledgethat singled him out from his fel-
lows. "Sometimes," he told Livingston smiling, "that differ-
ence was very, very slight, but it gave me the reputation for
being cagey, and I've always tried to maintain that reputation."

Nearly all of his men were struck by his constant desire to
check on himself by keeping some kind of tally or score. He

264 HARVEY GUSHING

made a habit of reviewing his material constantly and often
used the term "batting average" in the evaluation of his work.
It was an example in avoiding complacency that many of his
men found worth while to follow.

Dr. Thomas A. C. Rennie of the New York Hospital had
an experience that revealed yet a different facet of Dr. Cush-
ing's character. One evening, when Rennie was an intern in
medicine, he was sitting in the residents' quarters about 11:30
p.m. playing the piano. He was tired and, completely absorbed
in the music, did not turn around to see who had entered the
room. He knew only that someone stood behind him with his
hand on his shoulder and after some five or ten minutes moved
away. As the person left the room, Rennie looked up and
realized that it was Dr. Gushing realized, too, that he must
have climbed the long flight of stairs, since the elevator did
not run so late at night. He felt chagrined and remiss in
courtesy.

Several days passed, but though he saw Dr. Gushing several
times in the hospital corridor, there was no opportunity to
speak to him. One afternoon, however, when he was working
in the laboratory, a nurse came in in some excitement and
said Dr. Gushing wanted to speak with him.

He was phoning [Rennie writes] to ask my advice about his
maid, Nellie, who was sick at home with a sore throat, and to know
whether I would come out in consultation that evening to see her.
He said he wanted a consultation with a good medical diagnosti-
cian, and phrased his request in so gracious a manner that I, a mere
pup on the service, could hardly fail to be flattered. I agreed to
meet him in his office within a half hour and drive home to dinner
with him. I stuffed my pockets with swabs, test tubes, and media,
and joined him promptly.

With more diligence than skill I examined Nellie, and took
innumerable throat cultures. After dinner Dr. Gushing asked me
if I would be good enough to play for him. I did my best with
what limited Brahms and Beethoven I knew, and he listened
quietly for almost an hour. He then asked me if I would play for
him his favorite piece of music. My heart sank, for I was sure he
was going to ask for Stravinsky or Shostakovitch. At least I would
find out what a great man liked in music. My anxiety was unneces-

FOUNDER OF A "SCHOOL" 26$

sary, for I could play his favorite piece. It was "Old Man River."
The next morning he left at the front desk with a note John
Hunter's A Treatise on the Blood, InfLwimiation and Gun-shot
Wounds.

One summer Dr. Gushing returned from a trip abroad to
discover that in his absence the library had been moved up-
stairs in the Medical School and its former quarters taken over
by the Dean for administrative offices. This was too much.
Not only did the men have to climb stairs to get to the library,
but it was for the convenience of, of all persons the Dean!
Dr. Reginald Fitz, Associate Professor of Medicine at the
Medical School and Chairman of the Committee on the Li-
brary, received an immediate call from Gushing and the full
blast of his wrath. After he had delivered himself forcibly of
his sentiments about libraries, about deans (that they should
all be in the cellar and the more prisonlike the quarters, the
better), and several other things, he stamped out, leaving Dr.
Fitz feeling as if he had been at the center of a cyclone. The
next day two notes of apology to him with roses for Mrs. Fitz
arrived at his house.

Despite the fact that Dr. Gushing could loose a verbal bar-
rage without much warning, he almost never was heard to
swear. Paul Martin of Brussels, the first man from abroad to
serve as his resident, remembers one rare occasion when he
and Dr. Gushing were walking down the corridor and Gush-
ing suddenly threw open a door and stepped into the room.
He discovered to his chagrin that painters were in the process
of painting the floor and with his foot squarely in the wet
paint, Dr. Gushing said "Dam" and then added somewhat
shamefacedly "nation."

In the autumn of 1927 Sir Charles and Lady Sherrington
arrived in Boston to spend a week with the Cushings while
Sir Charles gave the Dunham Lectures. Their visit was fol-
lowed by one from the eminent French brain surgeon, Thierry
de Martel, and the equally distinguished neurologist, Clovis
Vincent. Their purpose was not only to observe in Dr. Gush-
ing's clinic but to make him an Officier of the Legion d'Hon-

266 HARVEY GUSHING

neur, 1 the highest honor France bestows on a foreign civilian.
The decoration was bestowed on him at tea time at 305 Wal-
nut Street, with Dr. Gushing standing under a picture of the
Rheims Cathedral and with those friends present who hap-
pened to drop in on that afternoon.

Mr. M. A. DeWolfe Howe, then Editor of the Atlantic
Monthly and one of his Saturday Club friends, persuaded
Gushing during this year to let the Atlantic Monthly Press
publish a volume of his essays. He accordingly collected four-
teen of them under the tide Consecratio Medici. He also com-
mitted to press another technical monograph on tumors this
time on tumors of the blood vessels. In addition, he published
eighteen papers, among them an essay on "The Medical Ca-
reer" which received warm praise when he gave it at Dart-
mouth College in November; also a technical paper on visual
disturbances resulting from meningiomatous tumors at the base
of the brain (presented to the American Medical Association),
which won him the award of the Herman Knapp Prize in
Ophthalmology the following year. A provocative essay on
"Who Put the Fox in Foxglove?" was read to the Club of Odd
Volumes but never published.

While he was at Little Boar's Head with the family during
the summer, the sad news came of the death of Lady Osier.
. When he wrote a few days later to Edith Gittings Reid, a
close friend of the Osiers whom he had known well in the
Baltimore days, he said, "Let us imagine the three of them
happily reunited Muz, Dad and Isaac 2 in as good a world
as they helped this one to be. Heaven could hardly be better."

Affectionate whimsy of this sort was his refuge when he
had to speak of things that touched his heart. Earlier in the
year when Mr. Goodwillie died, he had written Mrs. Good-
willie: "When it comes my time to go to a better place, he
will be one of the first people I shall look for. We will kick
our right legs in the air [their special gesture of greeting]
and be happy to be together again."

1 He had been made Chevalier in 1922.

2 Revere, because of his fondness for fishing, had been nicknamed Isaac
Walton.

FOUNDER OF A "SCHOOL" 267

Harvey Gushing was not a conventionally religious man,
although in his life of service to his fellow men can be found
the very essence of Christian teaching. He lived so vitally in the
present that the question of the hereafter seemed something
very remote. He rarely spoke of death, although he once wrote
his good friend Alan Gregg of a mutual acquaintance: "I am
glad he went off suddenly and without a lingering illness. It's
die way doctors would like to go and ought to be privileged
to go." In a letter he wrote near the end of his life to his old
colleague Howard A. Kelly is to be found a rare mention of
religion: "No, I don't think anyone would talk religion to
George. I do not pretend to understand the psychology of it;
but a good many of us, I imagine, had a peculiar kind of Cal-
vinism drilled into us in our youth that has left us inarticulate
and quite unable to talk simply and sensibly about the 'supreme
question.' Nor do we necessarily regard it as the supreme ques-
tion, believing that to lead clean and useful lives while we are
here is more important than cogitating over the hereafter."

On April 8, 1929, Gushing reached his sixtieth birthday.
Two years earlier, Elliott Cutler, who had gone with him to
France and had- been at the Brigham until he went to the
Western Reserve, had asked all of Cushing's older pupils to
contribute papers to a birthday volume. It was published as a
special issue of the Archives of Surgery (of the American
Medical Association) through the interest and co-operation
of Morris Fishbein. The birthday party at which the volume
was presented to Gushing was held on Saturday afternoon,
April <5, with nearly a hundred present, including the Gushing
family. When Gushing began his speech of gratitude he was
almost incoherent with emotion, but he gradually found
words to express himself." Comic relief followed in the presen-
tation of a flamboyant necktie and the reading of the poem
once before mentioned, called "The Tie That Blinds," by
Kenneth McKenzie, a former assistant resident who had come
down from Toronto for the party. Within a week thereafter
Gushing wrote by hand to all of the eighty-two contributors
to the birthday volume.

268 HARVEY GUSHING

Later in April, Betsey's engagement to James Roosevelt was
announced at a tea at the Gushing house. Governor and Mrs.
Roosevelt, Franklin, Jr., and John came over from Albany,
New York, for the occasion and were photographed with the
Gushing family and their close friend, Jonas Lie, the artist,
and his daughter. But Dr. Gushing managed to escape when
he saw photographers approaching, so he is conspicuously
absent from the picture.

On May 29, Gushing, as representative of the Osier Club
of London, attended the dedication of the Osier Library at
McGill. A room had been especially constructed in the Medi-
cal School building to receive the books, and Gushing com-
mented that while the alcoves, oak wainscoting, rugs, etc.,
were most attractive, the books themselves <c would furnish
any, even a poor room." Osier's former assistant, William
Thayer, gave the principal address. "Thayer was simply in-
spiredthe best thing I have ever heard him give. It included
a perfect tribute to Bill Francis which was timely and what I
particularly went up to hear."

Late in the summer Gushing was heavily involved in the
1 3th International Physiological Congress, which brought to
Boston physiologists from all over the world. Dr. and Mrs.
Edwin Cohn, assisted by an able committee, had arranged the
affair with such thought that it proved to be a marvelous suc-
cess. Gushing had as his guests Sir Walter Morley Fletcher,
Professor and Mrs. Leon Asher from Berne, Professor Bottazzi
from Naples, and a former assistant, Dr. Frederic Bremer from
Brussels. Dr. Asher, when going through the customs upon his
arrival in Boston, was surprised to have the official ask him
his destination and even more surprised to have him, when he
found he was to visit Dr. Gushing, wave him on without in-
vestigating his luggage. Later, at a formal tea given by one of
the leaders of Boston society, the hostess tried to draw Dr.
Asher out about what sort of man Dr. Gushing had been when
he was studying in Berne. Asher, with a twinkle in his eye,
admitted that he was a "lady killer," and was startled when
his questioner responded quickly: "He still is!"

One of the leading figures at the Congress was, of course,

FOUNDER OF A "SCHOOL*' 26$

the great physiologist, Professor I. P. Pavlov of Russia, who
was within a month of his eightieth birthday. He was eager
to watch Dr. Gushing operate, and Gushing accordingly sched-
uled an operation which went off very successfully despite
the fact that Pavlov in his intense interest repeatedly came
dangerously near the operative field with his whiskers.

After the Congress, Gushing sailed for Sweden, where he
was to give a lecture on cerebellar medulloblastomas on Sep-
tember 4. The invitation had come through a young patholo-
gist, Arvid Lindau who two years previously had described
a new disease which Gushing had called "Lindau's disease" a
condition involving tumors of the blood vessels of the retina
and central nervous system and sometimes causing degenera-
tion of internal organs such as pancreas and kidney. This trip
to Sweden brought him the opportunity to visit Dr. Erik
Waller, a scholar-physician who possessed one of the finest
private collections of early medical books in all of Europe.
With Dr. Waller, a busy country surgeon, Gushing found
much in common, and this visit was the beginning of an enthu-
siastic friendship.

Gushing was also entertained by the well-known Swedish
explorer, Sven Hedin, who had visited his clinic as a patient
the year before with his sister Alma. As a token of gratitude
and admiration, Hedin presented Dr. Gushing with a beauti-
fully illuminated parchment scroll, seventeen feet long, copied
from an important early surgical manuscript of the fourteenth-
century surgeon, John of Arderne. Gushing had been particu-
larly interested in the manuscript when in the Royal Library
in Stockholm, and the copy became one of his most choice
possessions.

He made his presentation to the King of Sweden the subject
of a delightful fantasy for the entertainment of his children
when he returned home. Shortly after this state occasion, he
bade farewell to his hospitable Swedish hosts and flew to
Amsterdam, where he was met by Ignaz Oljenick, who had
shortly before completed two years as a voluntary graduate
assistant at the Brigham, and by his friend Arnold Klebs. He
had first met Dr. Klebs in Baltimore when Klebs was practis-

2JO HARVEY GUSHING

ing in this country, and despite the fact that the two men
were completely opposite in personality and tastes, a warm
friendship had developed between them. Klebs was a man of
great erudition and sophistication, with a hedonistic philoso-
phy of life that recognized none of the Puritan restraints which
had been Cushing's heritage, yet in their love of books and
the history of medicine they had a strong bond in common.
After Lady Osier's death, it was to Les Terrasses, Klebs' villa
at Nyon overlooking Lake Geneva (to which he had retired
in 1912), that Gushing went instead of to Oxford.

On this occasion they proceeded from Amsterdam to
Scheveningen to the 13$! International Ophthalmological
Congress where Gushing was to read a paper on blindness
caused by brain tumors impinging on the optic nerve. His
official responsibilities over, they motored to Nyon to rest
for a day before starting for Milan to attend a book auction
where Gushing acquired some particularly fine early works,
several of which were incunabula. At Bologna they visited an-
other avid collector, Vittorio Putti, the eminent orthopedic
surgeon who lived at San Michele where Gushing had found
so much to interest him when he first visited there in 1901.
Stopping at Zurich to have luncheon with Felix R. Nager, the
Swiss otolaryngologist, Gushing acquired an inclinable the
Hartmann Schedel copy of Pietro d'Abano's Conciliator
printed at Mantua in 1472 which became the oldest and one
of the most treasured items in his now extensive library.

On his return Gushing had the happy duty of giving the
principal address at the dedication of the Welch Library. The
gathering was reminiscent of the lively meetings of the Johns
Hopkins Hospital Historical Club, and "Popsy's" boyish pleas-
ure and enthusiasm seemed no less at seventy-nine than in the
days when Gushing had sat with him on the front row and
discovered those truths which he now expressed so cogently.

But there is a spirit world of books, and the ideas they contain
wander forth to haunt and torment those whose grasp they can
elude, to solace or stimulate those who have learned the secret of
their capture. . . . From the spirit that hovers over some obscure
volume, of parentage and birthplace unknown, times forgotten

i i

upper left PROFESSOR CHITTENDEN, DR. GUSHING, AND GOVERNOR WILBUR CROSS

A <taftt(0R of Betnnnont Mound Highway, w

upper right ON AN ULCER DIET

MAY 1935

H. Crowell, Jr. (upper right) vd KO*d U. Light

STUDYING CATTANl's COPPER ENGRAVINGS OF THE ERCOLE LELLI FIGURES

The insert (a copy of which Dr. Gushing holds in his hand) shows the ecorches

in the anatomical theater at Bologna

Photograph by Dr. Klebs

FOUNDER OF A

may be reconstructed, the sequence of discovery unraveled, the
tendencies of thought traced, the relation of yesterday and tomor-
row better understood.

This, then, is the true function of the library, to quicken the
dormant book so that it may speak again; and with those who treat
it lovingly and compassionately its spirit enters eagerly into com-
munion. To these a library becomes a laboratory for the crystal-
lization of ideas perhaps long expressed, out of which process new
ideas have their birth.

Books and men it was on these that Gushing depended for
the furtherance of those traditions to which he had dedicated
his own energies and genius for what was now many years.
During the preceding summer, Arnold Klebs, who was an
excellent photographer, had caught Gushing in an unusual
pose, leaning on a stone parapet of the Axenstrasse overlook-
ing Lake Lucerne. He was resting on his elbows, his square
hands clasped loosely before him, the familiar cigarette be-
tween his fingers. In his eyes was a reflective, far-away look,
as if he were "hearing oftentimes the still, sad music of human-
ity." It might have been the likeness of an ascetic or a philoso-
pher. Harvey Gushing had always worn his years lightly, but
this picture, snapped when he was unaware, recorded unde-
niably the fact that he was no longer young.

ADDING UP THE SCORE

Chapter XXV

I

.N 1930, AT THE AGE OF SIXTY-ONE,

Gushing reluctantly faced the thought that he and Henry
Christian had placed the retiring age at the Brigham at sixty-
three. That the time was uncomfortably close was brought
home to him by the fact that he was already being offered
other chairs Dr. Welch was trying to persuade him to return
to the Hopkins and take his place as professor of the history
of medicine, and President Angell and Dean Winternitz of
Yale had invited him there (where the retiring age in the
Medical School is sixty-seven). Although in the full swing
of his busy clinic he found it difficult to think of retirement,
his friends were not discouraged. Dr. Welch broached the
matter a second time when he arrived in Boston in February
of 1930 to stay with Gushing and to speak at a fund-raising
meeting of the Boston Medical Library. In April, Gushing
went to Washington to join in the gala functions arranged
to honor Dr. Welch on his eightieth birthday. A luncheon
sponsored by President Hoover was followed by a dinner in
the evening, and at this, to Cushing's embarrassment, Dr.
Welch announced that he was to be his successor.

Accounts of such occasions went regularly to John Fulton,
who had returned to Oxford as a Fellow at Magdalen College
and was teaching physiology. Gushing kept in touch with all
of his former assistants, but Fulton was singled out for special
attention because of his enthusiastic interest in books "I have

272

ADDING UP THE SCORE 2^$

been doing but little with books lately, though it is an evil
day if something doesn't turn up. However, I ordered some
Leonardos the other day from Berlin and I am horrified to see
that they take up more room than the Murray's Oxford Dic-
tionary. Luckily Kate is in the South fattening up Barbara
and Betsey. I think I shall have to build a cupboard under the
dining room table where they won't especially be noticed
and where we can pull them out at dull dinners. No, I have
no copy of Raynaud's original thesis * and would be delighted
to have one."

Fulton in turn kept Gushing in touch with events in Eng-
land in which he had a particular interest. Dr. Gushing occa-
sionally gave him bookish commissions and in one instance
he asked that he take a copy of Robert Bridges' poems to him
at Boar's Hill and enquire "if he will do me the supreme favour
of writing his name in it. You may tell him that I collect poetry
written by doctors, even if they happen to be poet laureates."
The Poet Laureate died before Dr. Fulton was able to see him,
but the commission had stirred him to do some research on
Bridges, the result of which he sent to Dr. Gushing. In thank-
ing him, Gushing enclosed a letter "from my friend, Lefty
Lewis. ... I wanted you to read his characterization of
Streeter and his sad and gentle enthusiasm about you. This
will be enough to let you know that Lefty is a man of humor
and one after your own heart." This was Fulton's introduction
to the man who was to exert a considerable influence in future
affairs of concern both to Dr. Gushing and to him. He replied:
"I have just had your letter of May 2yth in which you enclose
the amusing communication from your friend 'Lefty' Lewis.
I assume from his name that he must at some time have occu-
pied with distinction the centre of a baseball diamond. ... I
am returning Mr. Lewis's letter with this; I suppose he is
'Mr.' for you do not mention that he is a physician in fact,
I am just a little vague as to what he does do, but I can assure

1 Maurice Raynaud was a nineteenth-century neurologist whose paper
on symmetrical gangrene, published in 1862, has become a classic. The
condition he described is known as Raynaud's disease.

214 HARVEY GUSHING

you that I am eager to make the acquaintance of anyone who
writes such a letter."

Dr. Gushing enjoyed this sort of lighthearted exchange,
and when writing to someone of whom he was especially
fond, he slipped even more easily into a whimsical vein as
in this letter to Mrs. Fulton, written in May of 1930, which
gave hint of approaching events:

Dear Lucia: I am simply delighted to have your letter written
in John's absence. I wish he would go away oftener and leave you
home so I could hear from you directly. . * . Of course I shall
expect to spend 99.5% of my visit next July with you. And you
can reserve a seat for me in your car, thank you.

Jimmy and Betsey will also be browsing around England at the
same time on their honeymoon, and they will probably be using
John's car. If he is good, therefore, we can take him with us in
the nimble. If D'Irsay and Winternitz and H. M. Evans and Sud-
hoff have not already gotten ahead of me by booking their rooms
for the summer, you will please tell them that everything's let for

July.

Betsey and James Roosevelt were married on June 4, 1930,
at St. Paul's Episcopal Church in Brookline, and although
Gushing had complained of prematrimonial neurasthenia,
"nowadays purely a parental disease," and had told Betsey
that Gus would probably have to give her away, he neverthe-
less was on hand in correct morning attire with topper, morn-
ing coat, and spats despite the 90 heat. He reported to Klebs:
"Our front yard looks like a circus and I feel like Mr. Ringling
the wedding ringling."

When the excitement caused by the wedding had died away,
H.C. began working on the Lister Memorial Lecture which
would take him to Engknd in July. For the first time in twenty
years he had become convinced that disturbances in which
the pituitary were involved were due not entirely to dysfunc-
tion of the gland but to impairment of nerve centers adjacent
to it. He had paid little attention to the work of Bailey and
Bremer in his laboratory, but when John Beattie (then teach-
ing anatomy at Montreal) spoke before a meeting of the Har-
vard Medical Society on the excitability of the hypothalamic

ADDING UP THE SCORE 2*1$

area at the base of the brain and the work he had been doing
with G. R. Brow and C. N. H. Long, Gushing became inter-
ested. He commenced studies which confirmed in human be-
ings what Beattie, Brow, and Long had discovered in animals,
namely, that centers in the hypothalamus control visceral proc-
esses such as sweat glands, activity of the stomach and intes-
tines, and so forth. Since these reactions can also be brought
about in moments of extreme emotion, it explained why tumors
impinging on the hypothalamic area had resulted in emotional
disturbances in his patients. It was these observations which
formed the basis for his Lister Lecture in London on "Neuro-
hypophysial Mechanisms from a Clinical Standpoint." In the
huge and enthusiastic audience were Arnold Klebs, Jean
Morelle, who had traveled from Louvain, Ignaz Oljenick from
Amsterdam, and other former assistants from all parts of
Britain.

Lord Moynihan, as president of the College of Surgeons,
then presented Gushing with the Lister Medal "for distin-
guished contributions to surgical science." In the evening he
was the guest of honor at a dinner in the House of Lords given
by Lord Moynihan for the Council of the College. This state
occasion was followed the next evening by a simple dinner
which gave him equal pleasure because it was attended by a
large number of former members of the Brigham group and
such good friends as Klebs and Geoffrey Jefferson. Jefferson,
in proposing a toast, pointed to his devoted following of pupils
and acclaimed him as the founder of a school.

The promised visit to the Fultons in Oxford afforded op-
portunity to rest up for his Oslerian Orationalso for spending
his lecture honorarium on books and for pursuing Vesalius
in the Bodleian Library. The meeting of the Osier Club on
July 12 (Osier's birthday) was held at the house of Alfred
W. Franklin, one of the group of student members who of-
fered a contrast in years to Sir D'Arcy Power, then seventy-
five. Young and old enjoyed Cushing's informal talk about
the preparation of the Osier biography, for he included many
incidents he had omitted from the book.

He saw many old friends on this visit Sir Charles Sher-

yf6 HARVEY GUSHING

rington, Sir Henry and Lady Head, Sir Arthur Keith, and
Mr. G. Buckston Browne with whom he visited Down, Dar-
win's birthplace (which Mr. Browne had purchased and
presented to the nation), Sir Walter Morley Fletcher, and
Geoffrey Keynes, about whom he had earlier written to John
Fulton: "Gracious, how delighted I would have been to have
heard Keynes talk to the Osier Qub! He is a most energetic
fellow, as you say, and though he is a good surgeon, he is
becoming so distinguished a bibliographer that this is likely
to overshadow his vocational contributions which have always
been good."

Shortly after Cushing's return home in August, he wel-
comed Otfrid Foerster from Breslau, one of the leading neu-
rologists in Europe, as the Surgeon-in-Chief pro tern. The
whole staff soon discovered that the energy of their Chief,
home from a European vacation, was as nothing compared to
that of Foerster, who kept them up talking until three in the
morning and then was in the operating room ready for a brisk
day's work at seven.

During Foerster's visit Gushing gave the Arthur Dean Bevan
Lecture in Chicago and there met Dr. Welch, who was full
of enthusiasm for the Huntington Library which he had just
visited, early Spanish medical publications, and Gushing be-
coming his successor to which he continually made public
allusions, much to H.C.'s embarrassment. He saw Dr. Welch
again in Cleveland late in December at the meetings of the
American Association for the Advancement of Science and
described something of what went on to John Fulton, who
was now the professor of physiology at Yale. "I am just back
from Cleveland. We had a thrilling time I clung to the trail
of Popsy and Klebs, though it nearly finished me. Klebs and I
left Cleveland Wednesday night with our tongues hanging
out. Popsy was just preparing to see the New Year in with a
group of young folks under Pat's [Ned's son, Edward Gush-
ing] leadership. I am sure he was the liveliest one of the party."

The year 1931 was a high point in Cushing's career he
reached the two thousandth verified tumor and he found an

ADDING UP THE SCORE J?77

answer to a disease condition that had been baffling him for
over twenty years. But before the year was far advanced he
was laid low by the circulatory difficulties in his legs and feet.
The pain and discomfort from which he was rarely free had
increased to the point that he was irritable and short of pa-
tience and was less able to stand long hours at the operating
table. On February 16 he went into the hospital with gangrene
threatening both extremities. Six weeks without tobacco and
a course of physiotherapy healed the gangrenous patches and
reduced the pain, and the strict regime enforced by one of
his devoted junior house officers, Richard Meagher, whose
Irish wit made him more than a match for his Chief, helped
him back on his feet.

During his uneasy convalescence, he and John Fulton car-
ried on an entertaining correspondence about the religious
preferences of chimpanzees which Dr. Gushing -concluded
would probably be Congregationalism. H.C. started it by a
reference to some chimps he had heard of on his visit to Cleve-
land; it was furthered by Fulton's receiving an unexpected
shipment of eighty-five monkeys from a friend on the Gold
Coast. "I have one running around without its left hemisphere
who absorbs pituitrin like a sponge!" he told Dr. Gushing.
To this Gushing replied:

Dear John As W. O. used to say about books it's a sad day
when something from you doesn't come in. Bartels redivivus! For
thirty, perhaps forty, years Bartels, who was an old diener of
Ludwig's, was actually in charge of the Physiological Laboratory
in Bern though Professor Kronecker was unaware of it. Even in
those days he was good at monkeys. I haven't heard from him for
years. But I am glad that you and he have gone into business to-
gether and that you have representatives on the Gold Coast. Why
don't you enter the eighty-five in the next freshman class? I judge
from what you say that they are just as good without their left
hemispheres as with them, and that this is true also of many coon-
skin-wearing freshmen.

But in the midst of this light banter, he couldn't help asking:
'TBut where do you put the pituitrin in the ape without a
hemisphere? The ventricle, of course, must be open and the

27$ HARVEY GUSHING

space formerly occupied by the brain full of fluid. Perhaps
that accounts for the absence of reaction, just as in our hydro-
cephalic cases."

Gushing took advantage of his confinement to prepare the
Balf our Lecture which he was scheduled to give in Toronto
on April 8. In it he pursued further the subject which had
formed the background of his Lister Lecture the relation of
the hypothalamus to visceral function. He turned to his rec-
ords and studied instances in which acute gastric complica-
tions had followed cerebral operations. It was disclosed that
only those in which the base of the brain had been encroached
upon were followed by gastric complications. Cushing's con-
tributions as a "pure" scientist have sometimes been challenged
and some of the bold deductions that a surgeon is frequently
called upon to make Gushing stubbornly held to, but in this
instance his conclusions were later vindicated in the experi-
mental laboratory.

Shortly after his return from Toronto, a special ceremony
was arranged at the Brigham. Dr. Eisenhardt, who had care-
fully kept Dr. Cushing's operative statistics, had previously
warned him that he was approaching his two thousandth case
of verified brain tumor, and on April 15 he had sufficiently
recovered from his illness to be able to perform the operation
assisted by Dr. Horrax. His assistant, Richard U. Light, and
Walter W. Boyd, house officer in surgery both amateur pho-
tographers of professional skill recorded the occasion for
posterity. While Dr. Gushing was still in his operating gown,
the staff gathered to hear Dr. Eisenhardt review some of the
figures and to hear Dr. Romans' presentation of their gift, a
silver cigarette box. It was a "family" gathering but it marked
an event of importance to medicine as a whole, for the care-
ful and complete records of this unique tumor series offered
a gathering of clinical data of inestimable value not only to
contemporary surgeons of the brain, but to future surgeons
interested in the life history of brain tumors.

Ten days after this occasion Gushing wrote to Dr. Fulton:
"I am just back from attending Popsy's belated 8ist birthday
dinner at the Maryland Club in Baltimore a pleasant and

ADDING UP THE SCORE 2J$

amusing occasion. Baltimore is much changed during these
past twenty years, but the Maryland Club goes on unaltered,
the same paper on the walls, the same old father terrapin in
the cellar, the same old Baltimoreans wearing imperials stand-
ing in the window. It is just like a visit to Madame Tussaud V

At the end of April, Gushing gave the William H. Welch
Lecture at the Mount Sinai Hospital in New York, but after
that he canceled speaking engagements outside Boston and
tried to follow an easier schedule, for he had ahead of him a
strenuous trip to Europe, where he was to speak at the first
International Neurological Congress at Berne in September.
In June, however, he attended three commencements, one at
the University of Rochester, where he received a D.Sc., the
Harvard Commencement, at which he also received a D.Sc.
(he referred to it as his "honorary P.D.Q."), and the Yale
commencement where, at his fortieth reunion, he and Perry
Harvey roomed together and "renewed their youth."

When Gushing sailed for Europe late in August he was ac-
companied by John Fulton and as soon as they reached Cher-
bourg they were joined by Hugh Cairns and later by Georges
Schaltenbrand. Arnold Klebs awaited them in Berne, where
he had arranged for a large suite at the Hotel Bellevue over-
looking the Bernese Oberland. The Congress opened on Mon-
day, August 31, in the Municipal Casino with the greatest
students of the nervous system in attendance Sherrington,
Pavlov, de Martel, Foerster, and Gushing and with eighty-
one-year-old Dr. Welch presiding benignly over all. For Gush-
ing the occasion had special meaning. It was here in Berne that
he had received his strongest impetus to embark on a career
in neurosurgery and now after thirty years he had returned to
give an account of himself. At the first session he and Sher-
rington were given honorary degrees. That they were to be
awarded was a complete secret, and Dr. Fulton, charged with
the responsibility of seeing that the recipients attended the
session, had not a little difficulty. Sir Charles, when called
early, meekly agreed to be on hand, but Dr. Gushing, who
wanted to spend the morning on his paper, was not pleased
to be awakened and could not see why he should go. He

2&0 HARVEY GUSHING

grumbled further at being urged to sit down front, but the
reason for it all was soon apparent, and both Sir Charles and
Dr. Gushing were so moved that it was fortunate they did not
have to reply to the extravagant words of praise of Professor
Asher, Cushing's old friend, who was now rector of the
University,

Cushing's own paper was presented in the afternoon. More
of his pupils had arrived from various parts of Europe until
there were twenty-five in the audience when he began, some-
what haltingly, to give a resume of his lifework. There was
complete silence in the hall as he spoke of his early experiences
in Berne and then began to outline the factors which, in the
years that followed, had enabled him to achieve his spectacular
reduction in mortality rate in cerebral operations. "Younger
men picking up where I leave off can reduce the mortality still
further," he said. He paused a minute and then added: "Gentle-
men, this will be the last report on the statistical results of brain
tumors as a whole that I shall ever publish." Stunned silence
greeted this statement before the applause burst forth. Dr. Ful-
ton wrote: "His paper was brilliant but there was a tragic air
of finality about it, which everyone felt even though unex-
pressed. Old animosities were put aside and he was hailed by
everyone as the supreme master of a great specialty."

Arnold Klebs gave a brilliant dinner for forty that evening
in honor of Dr. Gushing and Dr. Welch, and the following
night Gushing invited his pupils to meet his masters. Seated
around the table were Sir Charles Sherrington, Dr. Welch,
and Dr. Klebs, Wilder Penfield of Montreal, Otfrid Foerster of
Breslau, Geoffrey Jefferson of Manchester, Gaston de Coppet
of Berne, George Armitage of Leeds, Ignaz Oljenick of Ain-
sterdam, Hugh Cairns of London, Herbert Olivecrona of
Stockholm, Dimitri Bagdazar of Bucharest, Thierry de Martel
of Paris, Paul Martin of Brussels, Daniel Petit-DutaUlis of Paris,
Jean Morelle of Louvain, Norman Dott of Edinburgh, Fred-
eric Bremer of Brussels, Frederic Schreiber of Detroit, Percival
Bailey of Chicago, John Fulton of New Haven, and Franc
Ingraham, Richard Light, Tracy Putnam, Richard Meagher,
and Frank Fremont-Smith of Boston.

ADDING UP THE SCORE 2$2

In a letter to Mrs. Gushing, H.G described some of the
details:

. . . Popsy and Klebs have been wonderful. Their rooms are
just below ours and command a marvellous view of the Alpen
Ketten. They gave me and Sherrington a surprise doctorate of
Berne at the opening session Mondaynice but embarrassing.

I enclose the seating for a dinner given Tuesday for the Brig-
hamites who are here. Imagine my surprise when Meagher and
Light turned up!!

This noon the same crowd are going out to put wreaths on
Kocher's and Kronecker's graves and on that of Klebs' father as
well for he was Prof, of Pathology 2 here.

Gushing next wrote from Les Terrasses at Nyon:

We motored here from Berne on Saturday John, Popsy, A.K.
and I. Stopped at Fribourg for lunch at the Aigle Noir and filled
ourselves full of two or three kinds of Welch "Rabbit" after a
course of blue trout and reached here in rime for tea. Sunday
Sherrington and Graham Brown joined us also Franc Ingraham
and the Oljenicks. It's a lively place. Yesterday we had luncheon
at an old patrician chateau belonging to the de Saussures since
circa 1600. . . . Popsy leaves Thursday and I will join him for a
few days in Paris before he sails.

Everyone asks for you. I often wish you and Sis one or both-
were here. The Klebs constantly lament your absence. They are
very nice and simply perfect hosts. As much like the Open Arms
as anything could possibly be.

During the days in Paris, Dr. Welch persuaded Gushing to
take his place as an official delegate at the centenary celebra-
tion for Michael Farraday, which was to be held at the Royal
Institution in London. Immediately after he sailed for home.
He found that Welch had arrived and already arranged a
luncheon in New York so that he and several others might
meet Dr. Henry E. Sigerist, a distinguished European scholar
who was Director of the Institute of Medical History at Leip-
zig and who was to give lectures on the history of medicine in
Baltimore. These lectures aroused such enthusiasm that a few

2 It was he who first described acromegaly and with Ldffler the diph-
theria bacillus.

282 HARVEY GUSHING

days before Dr. Sigerist came to Boston in the autumn to speak
at the Brigham, Dr. Gushing formally declined the chair at
Baltimore and urged Welch to make an effort to secure Siger-
ist. He would have been proud to occupy the professorship,
he said, but until they had chosen his successor he could not
concentrate on his own plans for the future.

After Sigerist's visit he wrote more urgently, saying that
Sigerist had captivated everyone by his learning, enthusiasm,
and personal charm. "I cannot imagine a more suitable person
for the post or one more certain to develop it in the way you
would desire." Sigerist was offered the chair several weeks later
and ultimately accepted. 3

Early in January the matter of Cushing's successor was set-
tled, and President Lowell notified him that it would be the
man of his own choice, Elliott C Cutler. Mr. Lowell added
that there was some awkwardness in announcing the appoint-
ment since Dr. Gushing had not yet resigned. This Gushing
immediately did with the blunt explanation that since his term
of service automatically ended that year, it had not occurred
to him that it was necessary to resign from a position he was
not entitled to hold. It was not until after this that President
Lowell offered Gushing a professorship in the history of medi-
cine. Only those who knew him well guessed that he was
deeply hurt because Harvard was the last to offer him a place.

A few months later, President Robert E. Vinson of the West-
ern Reserve asked him to become Cutler's successor at the
Lakeside Hospital. This fourth call to the Western Reserve
strongly tempted him and the idea of changing places with
one of his pupils was somewhat intriguing. He thought of tak-
ing his Brigham staff "they were a fine group, Meagher, Glenn,
Ray, Bishop, Mahoney, and Kendall, and would have made
things easy for me" but in the end he decided that to take

3 During the sixteen years from this time until the spring of 1947 when
Dr. Sigerist resigned to devote his full energies to the preparation of an
eight-volume history of medicine, he more than fulfilled Dr. Cushing's
prophecy. His place has been taken by Dr. Richard H. Shryock, formerly
Chairman of the Department of History at the University of Pennsyl-
vania, who assumed his duties on October i, 1949.

ADDING UP THE' SCORE 2$$

over an active service in a new setting at his time of life was
foolish.

In the meantime there was a steady barrage of letters from
New Haven. Dr. Fulton had written the previous year: "There
is nothing in Baltimore like this here we have youth, enthu-
siasm and above all co-operation qualities which you have al-
ways engendered and could stimulate further. The proposal
made last December stands and we all want you to think about
it." This was shortly followed by a handwritten note from
Mr. Angell who said that although not unmindful of their
promise not to annoy him, his flexible conscience nevertheless
allowed him to say that they often thought of him. After a
visit to New Haven in November, H.G had written (also by
hand): "We had a delightful time in New Haven and enjoyed
particularly the privaledge of staying with you." As to the
proffered chair "This is largely a matter of legs mine and the
chair's. I'm much better than I was a year ago but I still tire
with disconcerting ease and I consequently hesitate to inflict
myself on anyone who may expect more of me than I can
give." A reference to his grandfather brought from Mr. An-
gell: "With every respect for your excellent grandfather, I
trust you will not feel that you must adopt at sixty . . . the
regimen he found appropriate at ninety." Then in a more seri-
ous vein: "You have made the most brilliant contributions to
your profession and to mankind. . . . You have many years
of fine work before you and all we ask is a chance to furnish
the conditions in which you can carry on to your own satis-
faction."

Dr. Fulton also tried to lure him with lively descriptions of
the activities of the Beaumont Club, the Elizabethan Club, and
other groups in which he knew Dr. Gushing would be inter-
ested. "I saw Herbert Thorns last night at the meeting of the
Beaumont Club, and he was immensely pleased by your letter
about his excellent etching of Pare. I believe he is sending you
a copy of his engraving of Beaumont's birthplace. Mr. Hen-
drickson, the Professor of Classics, read a remarkably interest-
ing and erudite paper on Fracastoro's poem [Syphilis]. He is
translating it and has unearthed all manner of interesting in-

284 HARVEY GUSHING

formation concerning the derivation of the word syphilis."
And again: "John Donley is coming down from Providence
today to talk to our medical history group on Greek medicine*
He is a very learned and charming fellow." But although
Gushing in his replies revealed his interest in all of these things,
he still could not bring himself to a decision.

Early in the year he had given a paper at the New York
Neurological Society in which for the first time he put forth
his conviction that certain baffling symptoms, long classified
under the vague term of "polyglandular syndrome," were in
fact due to an increase in the basophilic cells of the pituitary.
He gave the name pituitary basophilism to this syndrome
which subsequently became known as "Cushing's disease." He
had first become curious about these symptoms when an un-
married Russian girl, referred to him by a New York physi-
cian, had been admitted to the Hopkins suffering from painful
adiposity of the face, neck, and trunk. Although many of her
complaints were similar to those caused by tumor, her sight
was not affected and an operation therefore did not seem indi-
cated. Three years later she appeared at the Brigham Hospital
in Boston, but again, after two months' observation, no answer
was found to explain or relieve her condition. Dr. Gushing be-
gan to watch the literature for reports of other cases and over
a period of twenty years carefully studied six examples of
similar disorders which came to the Brigham. But although
these patients were extremely uncomfortable, they rarely suc-
cumbed to their disease; and when autopsies were occasionally
reported on such patients, it was usually stated that the
pituitary body showed no apparent abnormality. However, in
two or three of the later cases, a small tumor was recognized
although the pituitary was scarcely enlarged.

In preparing for his Lister Lecture, Dr. Gushing came across
an autopsy report of a case of this nature by Dr. William Raab
of Prague. Although a basophil adenoma was disclosed, neither
Dr. Raab, nor Professor K J, Kraus who later studied the
postmortem findings, related its presence to the clinical mani-
festations of the polyglandular syndrome. But the patient's
symptoms and appearance were so like those of a patient Gush-

ADDING UP THE SCORE 2$$

ing had under observation that he jumped immediately to the
conclusion that his patient, too, had a basophilic adenoma. He
was then determined to secure autopsy reports on any patients
who succumbed, and when Dr. Harold Teel, one of his junior
co-workers, discovered an unmistakable basophilic adenoma in
a case of polyglandular syndrome, he felt sufficiently sure of
his conclusions to announce them. The recognition of this new
disease entity stands as one of Cushing's most original contri-
butions to clinical medicine. Imagination had never been lack-
ing in his investigations, but his major achievements had more
often been accomplished through hard work than through sud-
den flashes of genius. This disclosure proved that although he
might have reached the age of retirement, there were still
closed doors that he could open.

On May 6, 1932, some thirty-five enthusiastic young neuro-
surgeons and neurologists met at the Peter Bent Brigham to
form an association to be known as the Harvey Gushing So-
ciety, and William Van Wagenen and Glen Spurling, the chief
organizers, were elected the first president and vice-president.
After watching the operation scheduled for the occasion, one
of his former assistants commented: "I have never seen the
Chief operate with greater ease and sureness. It seems to me
that his technique has progressed even during the last year,"
Cushing's pleasure in this honor was expressed to Tracy Put-
nam, Secretary of the Society, to whom he wrote when the
meetings were over: "I am very proud of you all and that I
should have been immortalized by having you use my name is
a source of pride and gratification."

Shortly after this, John Fulton (with A. D. Keller) pub-
lished a neurological monograph entitled The Sign of Babinski
which was dedicated to Dr. Gushing. Cushing's reply con-
tained a sketch of a monkey perched on a tavern sign on which
he had drawn the typical "upgoing" toe and called it the
"Sign of Babinski." He said: "A great book multum in parvol
I shall expect to put up at the above whenever I come to town.
The very expectation of it gives me up-going toes which in-
dicates, I take it, the loss of my cortical dominance, long
appreciated. Best love to you both. Affy, H.C."

2 86 HARVEY GUSHING

In July the Boston Evening American carried a paragraph
headed in large type "Dr. Gushing Should Stay." It continued:

When Dr. Harvey Gushing reached the terrible old age of 63
years last April, announcement was made that he must retire as
surgeon-in-chief of the Peter Bent Brigham Hospital this fall be-
cause of the age limit. The Boston Evening American then said
and now repeats that this silly requirement should be abandoned
in favor of this eminent brain surgeon and specialist. . . . Harvey
Gushing is at the pinnacle of his career. He is still a young man and
will be a young man for many years to come, we hope and expect.
The world . . . recognizes his extraordinary ability and we of
Boston should insist that he be retained in the position where his
talents will be of the widest value.

But public opinion did not change the rules. He carried on a
heavy schedule of operating throughout the summer, and on
August 17, the day before he sailed for Rome and the Inter-
national Physiological Congress, he performed his last opera-
tion. The rush of departure robbed the occasion of its finality
and not until he returned did he realize that he was no longer
head of the hospital, that his connections with Harvard and
the Peter Bent Brigham were officially ended.

When Gushing arrived in Europe, Arnold Klebs was await-
ing him, and his extensive knowledge of Italian history, litera-
ture, and art added much to the trip as they journeyed toward
Rome accompanied by Henry Viets and John Fulton. The
plenary session in the Campidoglio on the Capitoline was
opened with a speech of welcome by Mussolini, and Gushing,
seated beside Pavlov, was highly amused when Pavlov re-
marked audibly as II Duce gave the Fascist salute: "A condi-
tioned reflex." Cushing's own paper, given on the last day of
the Congress, summarized his evidence for the existence of
special centers in the human hypothalamus for the regulation
of visceral processes. As soon as it was finished, Klebs and his
party left Rome by the Flaminian Way, whose tempestuous
history seemed exceedingly remote on that quiet September
afternoon. The old walled towns on the route fascinated H.C.,
and they stopped in several for a hurried glimpse of their

ADDING UP THE SCORE 28j

particular treasures in art or architecture. In Venice they vis-
ited the library of San Marco in order to examine its rare copy
of Vesalius* six anatomical tables published prior to the Fabrica.
In Munich they again sought Vesalius and had the exciting
experience of examining the original wood blocks used for the
Fabrica which had recently been discovered in the basement
of the University library. 4

After several days' rest at Les Terrasses, Gushing flew to
Paris and then, with Henry Viets, to London. He had only a
day before the Berengaria sailed but he managed to visit the
Sherringtons, the Geoffrey Keynes, Hugh Cairns, William
Wright, the Vesalian scholar, and several other friends.

His return to the Brigham was something of a shock to him.
Only when he found Elliott Cutler fully established in the
offices he had occupied for so many years and discovered that
he had no further part in the hospital activities did he fully
realize what retirement meant. Not to enter the operating
room, not to have an eager group of assistants and patients
awaiting him was hard to get used to. Somehow he had ex-
pected to be a kind of senior adviser to both Cuder and the
junior staff, but this was not to be. Dr. Gushing concealed his
hurt and disappointment from all except those who knew him
best and settled himself in the Surgical Laboratory, where a
place had been made temporarily for him to continue his work,

On the boat coming back from Europe, Gushing had re-
newed acquaintance with R. Scott Stevenson, a well-known
London surgeon whom he had met in France. When he dis-
covered that Scott Stevenson was to be in Boston, he invited
him to spend a week end at his house. After taking him to the
Boston Public Library, where Stevenson wanted to see the Sar-
gent murals, Gushing then wanted to show him his favorite
painter, so they drove to the Isabella Stewart Gardner Mu-
seum on the Fenway to see "one of the most beautiful

4 These wood blocks were used to print a handsome edition (price $105)
sponsored by the New York Academy of Medicine in 1935. The book
was published by Mr. Willy Wiegand of the Bremer Presse and the
blocks remained in Munich where they were destroyed in the bombing
attacks of World War II.

2$8 HARVEY GUSHING

Vermeers in the world." En route Gushing quizzed Scott Ste-
venson about Vermeer: "Don't you know that he died young
and in debt, and that there are only thirty-seven authentic
Vermeers known a dozen of them in America and that his
friend, van Leeuwenhoek, the inventor of the microscope, was
his executor?" They studied the picture "The Concert" for a
long time and Stevenson later commented: "I could certainly
understand the appeal of Vermeer to Gushing: the perfection
of craftsmanship, the essentially architectural construction of
the painting, the serene air of fastidiousness, the superb skill
in detail, the refined delicacy and perfect harmony." After
they left the museum, Gushing showed him around the wards
at the Brigham and even a stranger sensed his nostalgia that
they were no longer his.

During the autumn, Gushing followed the Presidential cam-
paign with considerable interest. Although still an Ohio Re-
publican, violently opposed to the so-called "New Deal," he
had come to appreciate many of Mr. Roosevelt's virtues and he
wrote a warmhearted letter congratulating him on his over-
whelming victory over Mr. Hoover. At the same time he
greatly admired Mr. Hoover and wrote to John Fulton that
Mr. Hoover would be a splendid candidate for an honorary
degree at Yale. Dr. Fulton replied: "Your suggestion about
Mr. Hoover's degree is first-rate. I shall forward it to the Hon-
orary Degrees Committee and I am still optimistic enough to
hope for your personal support in February. You don't know
how exciting it is to back candidates before the Corporation.
It has the Derby backed off the board!"

The reference to personal support followed an earlier prod-
ding: "I cannot bear the idea of your toasting your toes all
winter in Brookline. A decision will be just as difficult in June
as in January, but I am not going to write you any further
about it because you know where my heart lies. I shall be pop-
ping up to Boston very soon to see you. You mustn't fear
bargaining with University Boards, because that is the one
thing that keeps us all young; it's rather fun, you know."

Despite this and other urging to come to a decision, Gushing
continued to procrastinate. He resumed work with Dr. Eisen-

ADDING UP THE SCORE 2&$

hardt on a book begun many years previously on the menin-
giomas, since the clinical material was all in the Brigham
records that would soon be unavailable to him if he decided to
go to New Haven. He also worked on five lectures, one of
them the Harvey Lecture in New York a particular honor,
as he was giving it the second time. Since in the first he had
reported his initial work on the pituitary, he chose as a tide,
"Dyspituitarism Twenty Years Later," and summarized the
progress made in the twenty intervening years, culminating
with the most recent disclosure in the field pituitary ba-
sophilism.

In December word came that Dr. Welch had had a slight
illness. In February he entered the Hopkins for a kidney op-
eration. Gushing stopped to see him twice during the spring
on his way to meetings, the second time, in May, he found
Welch, despite three operations, sitting up reading a book,
cheerful, and full of interesting talk. Although he was not
again to leave the hospital, he so far recovered as to live on for
nearly a year. It was William T. Councilman, Cushing's loyal
friend for even longer than he had known Welch, who slipped
away during this month. The appreciation Gushing wrote, one
of his best, revealed how deep had been his admiration and
affection for this forthright teacher and colleague. He con-
cluded it with a moving description of Councilman's fight,
during the later years of his retirement, to preserve the trailing
arbutus of which Gushing himself was so fond.

During the twentieth anniversary celebrations of the Brig-
ham, also in May, the Boston Surgical Society conferred on
Gushing the Bigelow Medal. His devoted colleague, David
Cheever, made a particularly gracious presentation speech
which closed with: "But this medal is a symbol not of a trade,
but of a splendid profession; its exquisite workmanship typifies
the consummate perfection of your handicraft, and the metal
of which it is composed, which does not tarnish or corrode
with age, symbolizes the changelessness of scientific truth, for
which you have striven. And we dare to believe that among
your honors it will not rank least, because it will always remind
you of our admiration and affection."

2$0 HARVEY GUSHING

There was another tribute during the reunion when an oil
painting, executed by Mrs. Calvin G. Page of Boston, was
presented by Gilbert Horrax to the Hospital on behalf
of Cushing's students. At the same time, Dr. Francis Blake of
New Haven presented a painting of Dr. Christian on behalf of
his students. On the heels of these honors came the announce-
ment that Gushing had been elected to foreign membership in
the Royal Society of London, the first surgeon among the
thirty-four American scientists who had been elected to this
distinguished society over a period of one hundred and fifty
years.

Always behind these various activities lay the undecided
matter of his future. In March he had written Dr. Fulton:
"The newspapers here say I am going, or have gone, to New
Haven to live in one of the new colleges to inspire the under-
graduate. For my own part, I have about come to the con-
clusion (i) that my surgical days are over; (2) that in these
troublous and uncertain times it's inadvisable, both for me
and for the University, to take on any new obligations; and
that consequently (3) the latter had better postpone action
at their April meeting, at least until June, so that everyone can
find out where they are at." 5 Two weeks later: "Though I
often have yearnings to get back into surgery, I am beginning
to feel that it would be foolish for me to do so, even if I limited
myself wholly to cases of pituitary disorder. And the Sterling
Professor of the Pituitary Body would hardly go, I am afraid."

Finally it was John Fulton, in a tactful and understanding
letter, affectionate but firm, who forced him to take definite
action. Gushing consequently wrote Mr. Angell that he might
announce the appointment at Commencement, and Mr. Angell
reported on June 23: "Even your modesty would have been
flattered by the tempestuous applause when I announced to the
great gathering of our alumni Wednesday the fact that you

5 The collapse of the Boston banking firm which had handled his local
business affairs for years added to his uncertainty, for he was not sure
what arrangements he would have to make to reassure the financial
security of his family.

ADDING UP THE SCORE 2)1

were coining back to your first love and that the new Sterling
Chair was at your disposal."

Early in October, Gushing had the satisfaction of attending
the 1 5oth anniversary of the founding of the Medical School
and of hearing the forceful speech of James Bryant Conant,
Harvard's new president, which gave him new hope for the
future of the school in whose interests he had himself striven
untiringly for twenty years.

On October 12 the day given over to honoring the dis-
covery of a new world Harvey Gushing left Boston. He took
formal leave of President Conant and made a final visit to the
hospital, escaping unnoticed through a side door. On the drive
to New Haven the tensions and strain of the years seemed to
slip away, and with the same eagerness that had drawn him
back to Yale again and again he looked forward to his new life.

PROFESSOR OF NEUROLOGY
AT YALE

Chapter XXVI

T

JLH

.HE YALE TO WHICH HARVEY CUSH-

ing returned in 1933 was a far cry from the college he had
known as an undergraduate, and yet he had kept so closely in
touch with its growth that he did not feel nostalgia for the old
days as strongly as did some alumni returning after long years
away. The chimes in the Branf ord Tower at twilight and at
curfew were as sentimentally regarded by present sons of Yale
as the old Fence and other landmarks of treasured memory.
The beautiful new Sterling Library had supplanted the old
Chittenden Annex with its much-admired Tiffany window.
These and other manifestations of growth and development
had come gradually. He was familiar with them and applauded
them. And there still remained enough of the old and tradi-
tional to make him feel at home. There were still Senior So-
cieties and Tap Day and harmonizing songsters, although they
now gathered at the "tables down at Mory's" instead of on the
Fence. And there was a warmth and wholeheartedness about
the welcome he received on all sides that he had never felt
at Harvard.

While the house the Cushings had rented at 691 Whitney
Avenue (a large frame house not unlike 305 Walnut Street)
was being settled, he sailed for Europe, where he was to in-
augurate a new lectureship at the invitation of the Medical
Research Society of University College, London, and also to
receive an honorary degree from the University of Paris. The

292

PROFESSOR OF NEUROLOGY AT YALE 2$$

faithful Klebs met him in London and accompanied him to
Paris when his lecture was over. One among those who wel-
comed him was Professor Henri Hartmann recalling to mind
a welcome over thirty years earlier when he was a stranger
in Paris. In addition to the degree ceremony, he attended the
state funeral at Notre Dame of the great French bacteriologist,
femile Roux, and gave an impromptu speech at the Salpetriere
in the old lecture room of another great French scientist,
Charcot, the neurologist. He found these activities strenuous
and when he reached New York on his return trip on Novem-
ber 1 8, he looked worn and weary, but he recovered enough
strength to join in the welcome to Professor Arturo Castigli-
oni, the eminent Italian medical historian, who had come to
New Haven to speak before the Yale Medical Society. Dr.
Castiglioni was followed by Henry Sigerist, who had been
invited by the Beaumont Club to talk on William Beaumont,
it being the hundredth anniversary of the publication of his
classic book on the gastric juice.

These functions over, Dr. Gushing succumbed to the gastric
ulcer that had been causing him pain for nearly a year and
entered the New Haven Hospital. Much of his indecision about
the future had stemmed from the fact that he had been feeling
miserable, but it was not until September that he had admitted
the gastric pain and had submitted to an examination and
X-rays. He had tried to keep it in check with rest and diet,
but the trip abroad and the invitations that were showered
upon him when he returned were his undoing. The gastric pain
was accompanied by increased pain in his feet, and he slept
poorly and had little appetite. But although at times acutely de-
pressed and bored by his Sippy diet and hospital confinement,
he managed to be cheerful on occasion. To Mrs. LeRoy Crum-
mer, who with her husband was a book collector, he wrote on
December 14: "As before, I haven't allowed them to separate
me from my trousers which are in the second bureau drawer
at least they told me they were. There is nothing so humiliat-
ing, not to say terrifying, for a man as to be separated from
his pants."

2$4 HARVEY .GUSHING

To Mrs. Ruth Mitchell, a patient who had come to him in
1922 after seventeen years of suffering with Raynaud's disease,
he wrote early in the new year:

Dear Mrs. Mitchell: How nice of you to have sent me this
Christmas lett'er which has found me still laid up in bed here in
New Haven, incidentally losing the end of one of my toes. It
quite serves me right for not having done better by you and your
fingers and toes. Dr. Fulton will be so happy to have your message
and to know that you still remember him. He drops in to see me
every day. . . .

It's perfectly beastly that you should be having these bad fingers
on your right hand. ... I wish that I could show as much courage
and fortitude about my present malady as you for so many years
have shown toward yours. In fact, you always did more to help
other people by your cheerfulness than any of us ever succeeded
in doing to help you.

And to Barbara at Westover he wrote in the light vein he al-
ways assumed for her benefit:

Dearest Babe: What do you mean by lying in bed on a Thursday
morning looking out a window on the world. I think it is a form
of plagiarism. I have been lying in bed here looking out of the
window viewing the works of creation so far as I could see them
from a small window for some two or three months; but I little
wot that you were going to be a copy-cat.

... I am glad you noticed my stylish pyjamas. Just now I am
in silk, kind of greenish blue; but up to now pretty much all day
I have been, as you might say, in the pink, having things done to
me.

I wish that you might have been here today to have seen the
flow of people who came in, beginning with Lucia about an hour
ago and ending with John who has just gone flippity-flop down
the hall. I don't know just what it is, but I think he must have
springs in his tendo Achillis which makes it impossible for him to
let the soles of his shoes come down quietly after his heels have
once struck the ground. Then there came a skinny man named
Day and a medical student named Ehrlich, and then Francis Blake,
my doctor; and then Mother, and then Auntie Mame.

PROFESSOR OF NEUROLOGY AT YALE 2$$

It was early in March before he was able to take up his work
again in his hospital office x and he turned once more to the
meningioma monograph. In May he laid it aside to write an
appreciation of Dr. Welch, who had died on April 30. He
called it "The Doctors Welch of Norfolk" and its warmth
was token of his deep fondness for the man so many had loved.

There is a touch of sadness and melancholy about Autumn
which would seem the more natural time of year for an old man
to die. But so far as anyone could ever tell, sadness and melancholy
were moods of which he was incapable and it was as though he
whose youthful spirit and reactions so belied his years had delib-
erately waited for Spring. ... It was wholly consistent and
typical of him that he should choose to rest where to the future
passer-by he would be just another of the many Doctors Welch
of Norfolk. . . .

During May, Gushing was also engaged in preparing a major
address for the centenary celebration in June of the College
of Medicine at Syracuse, founded at Geneva, New York, in
1834. ^ e chose as a theme, "The Pioneer Medical Schools of
Central New York," and the necessary delving into their his-
tory was a task much to his liking. He received an honorary
LL.D. at the close of the ceremonies and returned to New
Haven just in time to be present when Yale bestowed the same
degree on Mr. Roosevelt, President Conant of Harvard, and
Yale's popular professor of English, William Lyon Phelps.
Gushing wrote a classmate: "The Alumni luncheon, too, was
excellent, and Conant and Mr. Roosevelt both made a great
hit. They certainly do stage these things well here, in the tradi-
tion of Anson Stokes well carried on by the present Secretary,
Carl Lohmann."

His work on the meningioma volume, pursued spasmodi-
cally during the summer, received welcome impetus when
Louise Eisenhardt arrived in September to help him, bringing
with her all of the specimens of his brain tiimors. This unique

1 Gushing continued his interest in experimental work during his years
at Yale and directed several investigations suggested by his studies on
pituitary basophilism. He brought Kenneth W. Thompson from the
Brigham to be his research assistant.

2$6 HARVEY GUSHING

collection had been the subject of debate for over a year.
Since the pathological specimens were of little use without
the clinical histories, Gushing had expected to give the collec-
tion to Harvard to be housed in the Warren Museum of the
Medical School across the street from the Brigham, but se-
curing funds for its maintenance had presented difficulties.
While Harvard was dallying with the problem, Dr. William
Van Wagenen, the president of the Harvey Gushing Society,
suggested that the collection be made the basis of a brain
tumor registry to which neurosurgeons might send obscure
specimens for diagnosis. Since Harvard had displayed little
real enthusiasm for the project from the beginning, Gushing
eventually decided to obtain authorization from Mr. Conant
to move the collection to New Haven where such a registry 2
could be established. This accomplished, he then had to have
the clinical histories photographed, and Frederic Ludwig of
the University Library staff began the extensive process.

In September, Gushing gave an address at the opening of a
new Neurological Institute in Montreal an institute con-
ceived along lines similar to the national institute of neurol-
ogy for which he had striven so enthusiastically in 1919. "We
may well expect," he said, "that under the widely trained
and many-sided director [Wilder Penfield] of this new insti-
tute, neurology will receive a new impetus, making of this
place still another mecca for workers in the great subject in
which we all feel so vitally interested. We may rest assured
that here not only will the story of neurology's great past be
cherished but that a new and significant chapter will be added
to it." He was delighted with the inscription in the foyer
(which Dr. W. W. Francis, who had been Librarian of the
Osier Library since its arrival at McGill, had found in the

2 The Brain Tumor Registry, under the directorship of Dr. Eisenhardt,
was financed at first from the Bolton Fund with generous grants from
the Childs Fund (a fund established by Dr. Cushing's classmate, Starling
W. Childs, and his sister) until it was endowed at the time of Dr. Cush-
ing's death by Mr. Howard M. Hanna of Cleveland. A number of gradu-
ate physicians come each year to work under Dr. Eisenhardt in the
Registry, which is now in the Department of Physiology.

PROFESSOR OF NEUROLOGY AT YALE 2$J

works of the great Greek physician, Galen): "I have seen a
badly wounded brain heal." But he was starded to find his
own name on the foyer wall along with Sherrington, Cajal,
Pavlov, and many others.

This visit to Montreal was to have far-reaching results, be-
cause while there he of course visited the Osier Library and
seeing the books, which he knew so well, arranged in the
friendly room in the midst of the Medical School, gave him,
during a disturbed ride home on the sleeper, an idea for his
own collection. After discussing the matter with Mrs, Gush-
ing and pondering on it for several days, he wrote Arnold
Klebs that, although he had always intended to have his books
dispersed at auction after his death so that others might have
the fun of collecting them, he was now thinking of leaving
them to Yale as the basis of a medical-historical collection. "I
waked up in the middle of the night with the thought why
not a Klebs-Fulton-Cushing Collection so that the three could
go down to bibliographic posterity hand in hand? Just imagine
some young fellow long hence stumbling on our diaries and
papers and correspondence about books. I envy him to think
what fun he would have, for I think in a certain way our three
collections have a more personal and intimate provenance than
has W.O.'s library."

Klebs was somewhat startled at this suggested disposition of
his library, but after considering its many angles he gave
wholehearted approval to the idea: "I am heart and soul with
your plan if you can insure to it, as well as is in one's power,
the continuity of personal interest and influence. If you can
give ten more years to it, perhaps with a litde help from me
and a great deal from John, something lasting might be
started." Dr. Fulton claims to have first heard of the idea from
Switzerland, but he, too, was enthusiastic and all three began
to limit their collecting to specific fields so as to avoid dupli-
cation and achieve greater unity and coverage when the li-
braries were brought together.

The problem of a suitable building next concerned Gushing
and he turned his attention to a consideration of the most de-
sirable type of building and the means of achieving it. He had

2$8 HARVEY GUSHING

long had a good friend in Mr. Andrew Keogh, the Librarian
of the University Library, and he promptly consulted him.
Air. Keogh thought space would be available in the University
Library, but it was nearly a mile from the Medical School, and
Gushing throughout his entire career had held tenaciously
to the idea that since medical students and interns had so little
leisure at their disposal, any library for their use should be
immediately at hand. He therefore insisted that the books
should be housed near the Hospital. Dean Winternitz and
President Angell gave him ready support, and the Corporation
shortly appropriated money for architectural plans. The "part-
nership" he had once contemplated with Grosvenor Atterbury
was at last a reality when Mr. Atterbury was engaged to draw
the plans for "the special library."

During the autumn of 1934, Gushing was able to enter more
actively into the life of the University and the community.
He had become a member of The Club an organization similar
to The Club in Boston which enjoyed the fast-disappearing
art of conversation and he began to attend their meetings.
The programs of the Beaumont Medical Club had always in-
terested him and he also thoroughly enjoyed dropping in at
the Elizabethan Club 3 because it gave him a chance to meet
undergraduates. He also made a point of dining on Thursday
nights at Trumbull College, of which he had been an Associate
Fellow since 1932. Trumbull was presided over by Dr. and
Mrs. Stanhope Bayne- Jones, who became close friends of the
Cushings and who made his visits there particularly enjoyable.
But here again he was interested especially in the students, for
through them he seemed to live again the happy days of his
own college years.

With the impetus provided by the new plans for his library,
Gushing began to collect in earnest and also to put his books
in order. He lovingly mended backs and tears, inserted his

8 The Elizabethan Club is a literary organization founded by Alexander
Smith Cochran of the Class of 1896. Cochran had become a collector of
Elizabethan drama and especially Shakespearian quartos and he endowed
the Club that professors and students might meet informally with the
stimulus of some of the classics in English literature at hand.

PROFESSOR OF NEUROLOGY AT YALE 2$$

bookplates, and gathered together correspondence and mem-
orabilia for binding. His correspondence with Dr. Welch
filled four volumes, that with Arnold Klebs also four because
hardly a week went by that letters didn't pass between them,
full of bookish gossip and information.

In the midst of this pleasant existence there came a letter
calling him back to professional responsibilities. It was an
invitation from Miss Frances Perkins, Secretary of Labor, to
serve on a Medical Advisory Committee to the Committee
on Economic Security 4 appointed by President Roosevelt in
June of 1934- The function of the Advisory Committee was
"to study practicable measures for bringing about the better
distribution of medical care in the lower income groups of
the population and more satisfactory compensation of phy-
sicians and others who render medical services to individuals
in these groups." Gushing in accepting the invitation wrote:
"I am glad the Committee has thought of establishing such
an advisory group, particularly since most of the agitation
regarding the high cost of medical care has been voiced by
public health officials and members of foundations most of
whom do not have a medical degree, much less any actual
first-hand experience with what the practice of medicine and
the relation of doctor to patient mean."

As with all responsibilities of this nature, Gushing took the
assignment seriously and sought advice from his colleagues
on the Medical School faculty and from others he knew to
be well informed on the matter of health insurance. From
William J. Mayo he received this reply:

I do not know that the burdens in the medical profession are
any greater than in any other line of work, but I quite agree with
you that to put an office holder, probably a politician, between
the doctor and the patient will not do either of them any good.
Personally, I do not know of any poor person who is not able to

4 Its members were Frances Perkins, Secretary of Labor; Homer S. Cum-
mings, Attorney General; Henry Morgenthau, Jr., Secretary of the
Treasury; Henry Wallace, Secretary of Agriculture; Harry L. Hopkins,
Federal Relief Administrator, and Edwin E. Witte, the Administrative
Director.

00 HARVEY GUSHING

get good medical attention, without regard to money. And espe-
cially do I believe that this is a poor rime, when the Aimee Mc-
Phersons are running the heavens, the Upton Sinclairs the earth,
and the Townsends taking care of the aged, for the medical pro-
fession to permit itself to be drawn into the whirlwind of unin-
formed opinion,

Cushing's particular contribution to the work of the com-
mittee was that of balance-wheel. On the one hand he coun-
seled those favoring drastic health insurance measures to
proceed slowly, and on the other he urged Drs. Olin West
and Morris Fishbein of the American Medical Association to
take the initiative, since some kind of sickness insurance was
inevitable, in offering their own solution to the problem. To
Fishbein he wrote: "You have it in your hands more than
anyone else to make things run smoothly and to get the pro-
fession adjusted to the possibility of some sort of sickness legis-
lation. I am sure that if we bury the hatchet about the C.C.M.C.
report [Committee on the Costs of Medical Care of the Mil-
bank Fund] and make a fresh start, we may be able to get
somewhere and preserve the things which most of us regard
as precious to our age-long profession."

The Committee, after several months of correspondence
and deliberation, recommended in May 1935 that additional
Federal funds be appropriated for more adequate public health
service and for extension of public medical service, but in re-
gard to the program for social insurance against illness they
voted: "We . . . recommend that any Federal or State legis-
lative action be deferred until these various experiences under
different conditions in diverse localities can be suitably ana-
lysed and made available for the ultimate drawing up of a
satisfactory plan adaptable to the needs of our people and ac-
ceptable both to them and to the medical profession."

Out of Cushing's thinking on this problem came a sugges-
tion which he forwarded directly to Mr. Roosevelt. He asked
why, since there was on foot a movement for establishing
national sickness insurance, "would it not be a good move just
at this time to take into consideration the establishment if not

PROFESSOR OF NEUROLOGY AT YALE 07

of a governmental department at least of a super-bureau of
public health to coordinate a number of welfare agencies?
Such a department would naturally include such scattered in-
terests as infant welfare and the Children's Bureau, old age
insurance, possibly the matter of the veterans' hospitals and
health compensation, vital statistics, the administration of the
Food and Drugs Act, and the existent public health and marine
hospital service."

He went on to say: "I know that such a fusion would be
difficult owing partly to inter-departmental jealousies . . .
but I am sure that opposition could be overcome and it cer-
tainly would mean a great saving of energy, prevent much
duplication of work, and lead to a proper concentration of au-
thority on subjects that have to do with public health." Gush-
ing felt that if such a department or bureau could be formed,
the matter of sickness insurance might better be postponed
until there was a department that could permanently and
properly administer it. President Roosevelt's reply indicated
agreement with Gushing on the soundness of the idea, but he
felt that the time was not ripe for such a move.

There was also mention of health insurance in a less formal
exchange, Gushing writing on January 6, 1935:

Dear Franklin: Herewith a few messages:

(1) Thanks much for the Christmas box of preserved fruit all
too rapidly disappearing,

(2) The children had a grand time at the White House parties.
Barbara says you accused me of being "high hat" and worse than
that. But I wasn't feeling so in the least I had to address some
scientists a la Henry Wallace on their duties to the Government,
etc.

(3) Your message to Congress was A++. I hope my repeated
cheers over the radio did not interrupt you. I'm glad you did not
stress immediate sickness insurance though friend Witte seems to
be doing so. We need more time, and more local experiments with
the various plans proposed if the backing of the profession is to be
secured. This will be necessary to the success of any plan, though
public officials backed by the Milbank Fund don't seem quite to
realize this.

02 HARVEY GUSHING

(4) Herbert Putnam and Senator Fuess have some new ideas
about what might be done with the Surgeon General's Library:
viz to install it on one floor of the new Annex to the Congressional
Library. It might be the best solution of the problem.

(5) I enclose something I came across last night which I thought
might interest you. 5 Cicero's maxim I take it is yours also; that
the well being of the people is the most important thing. Salus
appears to mean that as well as Security and I suppose they go
together.

More power to your elbow and love to you all. H.C.

To this President Roosevelt replied:

Dear Harvey: I am delighted to know of that new suggestion in
regard to the Medical Library. We might even add another story
to the new annex, and architect it to look like a pill-box.

What a grand quotation that is from Mackail! You are right
about that word "salus." We have no exact equivalent, though
"well-being" is the nearest.

I hope the Supreme Court will remember that when they decide

5 The quotation, from J. W. MackaiTs Classical Studies, is interesting in
the light of subsequent events: "No more than other communities was
Rome free from the selfishness of privileged and the discontent of un-
privileged classes, from wrecking demagogues and obstinate reaction-
aries. But no other city or nation has so splendid and continuous a record
of citizens who subordinated everything: wealth, power, office, the inter-
est of their own class, lif e itself, and what was dearer still, the life of
their children, to the service of the Republic, to the national ideal. Patri-
otism was with them less a passion than a law. It is put with the incom-
parable Roman brevity in the maxim laid down by Cicero as the central
rule to be observed by all those who for their term of office were in-
vested with the imperium, the delegated sovereignty of the Roman
people, Salus populi suprema lex esto. In that maxim they rose to the
conception of a law beyond law; and they carried it out in practice.
Their fundamental principle of the sovereignty of the people did not
make them hesitate in creating, and using when need arose, the device of
dictatorship, supreme power, military and civil, over the whole magis-
tracy and the whole commonwealth conferred on a single citizen for a
fixed period and for a prescribed purpose. It is the most striking testi-
mony to the patriotism both of the Roman people and of individual
citizens, that no abuse was ever made of this absolute power; that the
dictator always laid down his office as soon as he had finished the special
task assigned to him,"

PROFESSOR OF NEUROLOGY AT YALE $0$

the Gold case. Also I hope they will remember one of the earliest
recorded law cases where the question of the terms of the con-
tract were being considered from the point of view of "well-
being." You can read all about it in a funny old play called "The
Merchant of Venice."

Early in 1935 Dr. Gushing had a letter from Edward Weeks
of the Atlantic Monthly Press, whose persistent efforts to
persuade him to publish portions of his war diary were finally
bearing fruit. This was followed by a letter from Ellery Sedg-
wick, Editor of the Atlantic Monthly. Encouraged by their
enthusiasm and by the letters which were pouring in follow-
ing publication, during the preceding autumn, of four excerpts
from the diaries in the Atlantic, Gushing decided to go ahead
with the project. The instalment entitled "The Battle of Bos-
ton Common" brought him letters which indicated that the
issue was by no means dead, even after twenty years. He also
drew fire from another quarter from his friend Henry D.
Dakin for reference to him in connection with his widely
known bactericidal solution for the irrigation of wounds.

Dear Gushing, How could you have done such a thing! "The
Incomparable Dakin." My wife titters every time she looks at me
my acquaintances point at me behind my back and guffaw. Dale
who has been staying here says that your phrase ranks with "The
Admirable Crichton," "The Venerable Bede" and "The Unspeak-
able Turk." In despair I sought solitude on horseback when a
wretched banker mounted on a fast Irish hunter galloped up to
me and began "Did you read this month's Atlantic?" I saw a cruel
grin on his face & bolted, almost breaking my neck as well as my
horse's.

I am thinking of seeking refuge in our cess-pool.

Do, for God's sake, send me a sworn, witnessed affidavit that the
word you intended to use was "incompetent" & that a printer's
error was responsible for the outrage.

In spite of it all, my wife and I send you and Mrs. C. our love.

Gushing attacked the task of editing his journal much as he
went about the Osier biography, sparing no pains to ensure
that his facts were correct. He wrote letters such as this to

304 HARVEY GUSHING

Mrs. Reginald Fitz: "Dear Phoebe: Do you possibly recall two
very nice people who were, I suppose, associated with the Red
Cross in Boulogne and whose job was to get in contact with
the relatives of patients on the D.I.L. who came over from
England? In my journal I called them Captain and Mrs. Lang-
ridge, but whether I spelled the name correctly, I am not
quite sure." Or this one to his good friend Richard P. Strong:
"Dear Dick: I am in train to get out some more sections of
my war diary and am having a bad time with names of people
that I never knew how to spell. At the moment, it concerns
the two possible candidates we had for louse experts: namely,
Bacot (?) of the Lister Institute and as an alternative if we
failed to get Bacot, Bruer (?) from the U.S. A. Do let me know
if I have spelled these names correctly."

In the meantime he continued a lively correspondence with
Edward Weeks, who wrote in July: "The Boston newspapers
tell me you are going to Russia. I welcome the idea as the
source of new journals and thus the makings of a new book.
But not, pray Heaven, before August ist, by which time, if
the wind continues in the right quarter, we shall have com-
pleted the assembling of your magnum opus" To this Gushing
returned: "I decided to go to Russia after reading the blurb
[which advertised the book] in Little & Brown's Summer and
Autumn catalogue. But I don't know how the news got in the
Boston newspapers. . . . Moral: 'Whenever you see some-
thing in the newspapers [or in book catalogues] that you had
supposed was true, begin to doubt it at once. (W. Osier)' "

When the book was entirely set up in galley proof, Dr.
Gushing suddenly suggested a format similar to that of the
Atlantic, which brought a vigorous protest from Weeks: "I
must go on record as being firmly, sternly and impetuously
against any idea of a double column type page. . . . That's a
Welsh rarebit idea. If it occurs to you again, take some soda."
As a matter of record, the book was entirely reset in a style
more to Dr. Cushing's liking, although not in a double column
page. When it was published, the reviews were most favorable,
as well as the reactions of friends and unknown readers. Weeks
reported: "Incidentally, there were a hundred re-orders [from

PROFESSOR OF NEUROLOGY AT YALE $05

booksellers] for the Surgeon's Journal on this very day. What
are you going to do with all that money-bury it in the cellar? "
Dr. Gushing replied that if any royalties were forthcoming,
Weeks had better deposit them in his bank in Boston quickly
because his book bills the preceding month had shocked him.
One reference to the book in the public press annoyed Gush-
ing, and he sputtered to Weeks:

That awful thing that appeared in a smarty journal called Time,
picking out the items of my clinical history and asking the world
what was the diagnosis has resulted in my getting many letters
from people to say that Grandpa had exactly the same symptoms
and what could be done about it. ...

He also complained to Arnold Klebs, who consoled him but
chid him at the same time:

I know this Time article must annoy you in some ways for it is
so d d personal, but truly since they took it from the book that
you yourself allowed to go out, there is no indiscretion and cer-
tainly a great deal of warm interest in yourself and gratitude for
your achievements to say nothing of a very respectful admiration.
"That medically significant author's own activities" was written
by a man I should like to know and I agree in his complaint that
you did not give more of them, for what in the world is a better
lesson for suffering man and those that tend him than to hear one
who feels and knows tell us just what he went through in one of
those trials . . . ?

The work of getting out the Surgeon's Journal had occu-
pied a large portion of Cushing's time for a year, but he inter-
rupted it on many occasions to turn his attention to other
things. In April of 1935 he persuaded Richard Light, who had
returned a few months earlier from a flight around the world,
to fly him to Washington so that he might attend a meeting
of the National Academy of Sciences in whose affairs he had
always been keenly interested. Dr. Light's own plane was
away for repairs and he was reluctant to fly the only plane
available at the New Haven airport, but Dr. Gushing was not
to be denied. He felt unable to make the journey on the train

$06 HARVEY CTJSHING

and he was particularly anxious to stop on the way at Philadel-
phia to see Thomas McCrae, who was seriously HI.

The trip proved all that Light had feared, with a heavy rain-
storm on the way down and more rain on the return trip,
which had been delayed until after dark because Dr. Gushing
had insisted on conducting him on a tour of the Folger Library.
But Light, being an experienced pilot, was able to land his
precious cargo safely despite the failure of battery and light-
ing system, and finally the engine itself over the New Haven
airport. Dr. Gushing was not alarmed rather he seemed
amused at the predicament he had brought them into, but
thereafter (with one exception) he was content to have a sec-
ond-hand report of the National Academy proceedings. Dr.
Walter R. Miles, professor of psychology, a fellow member,
was always particularly thoughtful to drop in and bring him
news of these and other meetings in which he knew Dr. Gush-
ing would be interested.

In May the Harvey Gushing Society met in New Haven and
was entertained at a buffet supper by Dr, and Mrs. Gushing.
During the two-day meeting Dr. Gushing presented an ac-
count of pituitary basophilism and Dr. Eisenhardt introduced
the members to the newly established Brain Tumor Registry.
A week later Gushing received the gold medal of the National
Institute of Social Sciences in recognition of his "distinguished
contributions to modern medicine and ... to science and
literature."

The three hundredth anniversary of the settling of Con-
necticut coincided with the i5oth anniversary of the birth of
William Beaumont, and during the spring Governor Wilbur
Cross, as a part of the tercentenary celebrations, dedicated a
state highway through Lebanon (Beaumont's birthplace) as
the Beaumont Memorial Highway. Russell Chittenden, now
nearing eighty, presided at the ceremony in the church on the
Lebanon Green, and Gushing delivered the principal address,
entitled "William Beaumont's Rendezvous with Fame."

Autumn brought a recurrence of his gastric symptoms, with
an attendant increase in the pain in his feet. At the end of
November Dr* James White was called from Boston to con-

PROFESSOR OF NEUROLOGY AT YALE ^OJ

sider an interruption of the sympathetic nerve supply to his
legs. Drs. Horrax and Romans also came down to consult with
Dr. Ashley Oughterson, who was the surgeon in charge, as to
whether his left foot or the toes should be amputated. Early in
December, Dr. Oughterson and Dr. Samuel Harvey operated
on Cushing's gangrenous left middle toe, with Dr. Gushing
supporting himself on his elbows to watch while they tried
with difficulty to sever the tiny nerve roots. This operation
helped, but it did not save his toe which was amputated on
January 8. Despite the poor circulation in his entire leg, the
wound healed nicely and his other toes were soon improved.
For the second operation Dr. Oughterson made certain that
Dr. Gushing had a general anesthetic!

The birth of a second daughter to Betsey and James Roose-
velt shortly after Gushing returned home in February was an
excuse for an amusing exchange with Mr. Roosevelt who had
talked with him for ten minutes from the White House on
New Year's Day to wish him cheer.

Dear Franklin: One of my "fat cat" [Mr. Roosevelt had previ-
ously used this designation for certain Wall Street Republicans]
friends in Boston having seen the announcement of your new
grandchild in the same paper which announced the Supreme
Court's T.V.A. decision suggests that the child should be called
Tennessee. I thought you might be interested. Much water-power
to your elbow, Always affy, H.C.

P.S. You might tell son Franklin that the next time he takes
Barbara to a night club, whether or not he allows photographs of
the fact to be taken, all will be over between us.

To which the President replied:

Dear Harvey: I think Tennessee would be a splendid name for
our new grandchild, provided her fond parents give her "Author-
ity" for her middle name. That is only fair to her future husband!
Notwithstanding, I prefer Kate and so do you.

When will you ever become old enough to realize that the new
generation goes to a Night Club instead of Sunday School and that
being photographed there is the modern parallel of the pretty col-
ored card you and I used to get for good behavior and perfect
attendance?

$08 HARVEY GUSHING

I am so glad to hear that you are really feeling so fit again. I do
hope that you will come to Washington sometime this spring.
Be sure to stay at the White House this time.

Home after his two-month sojourn in the hospital, Gushing
began the compilation of a bibliography of the works of
Galvani, the colorful Italian physiologist whose work on ani-
mal electricity had led Volta to discover the electric battery.
He also wrote a tribute to his Yale classmate, Lafayette Mendel,
whose work on nutrition and vitamins had brought fame to
himself and great prestige to Yale.

During these years of comparative inactivity, Dr. Gushing
continued to keep in touch with scientists from other countries
and he saw or entertained many who came to New Haven. It
was now mostly a matter of people coining to him, for he did
not feel able to go very far from home base. He was disap-
pointed not to be present at his son Henry's marriage in June
of 1936 to Marjorie Estabrook of Marion, Massachusetts. Nor
was he able to attend Harvard's tercentenary in September, but
he relayed to Klebs how the heavens had opened in the midst
of the impressive ceremonies and had given Mr. Angell a
chance to get off his now-famous jest that this must be Har-
vard's method of soaking the rich.

Gushing was keenly interested in the centenary of the Army
Medical Library in November. In August he had pointed out
to Mr. Roosevelt that it would be an ideal time to announce
the allocation of funds for the new building so urgently
needed. Mr. Roosevelt replied: "I wish I were the dictator you
assume me to be!" and went on to explain that the matter of
housing for the Surgeon General's Library would require an
act of Congress, and he hoped that the next Congress would
authorize it, but this would not be in time for the centenary
celebrations.

H.C. did not reopen the subject the next time he saw Presi-
dent Roosevelt, for the occasion was in the midst of the 1936
election campaign when he came to New Haven to give a
speech on October 22. Mr. Roosevelt arrived for luncheon over
an hour late with a large retinue, and although Mrs. Gushing

PROFESSOR OF NEUROLOGY AT YALE 30$>

had calmly played solitaire in the drawing room, Dr. Gushing
had become somewhat disturbed, as had the crowd on the
Green impatiently awaiting his appearance. It was clearly not
a proper time for conversation about personal interests.

During 1936 two books appeared which for Gushing had
special interest We Northmen by his friend Lucien Price, and
Trail Blazers of Science by the physician-writer, Martin Gum-
pert. The latter was significant in that a contemporary pictured
Gushing as typical of the scientist of the future. "In order to
avoid any hypothetical survey of human greatness and scien-
tific genius, we will close with the description of a life-work
that fixes the standard of inspired research past, present and
future as the organic unity of daring and knowledge" There
followed a vivid presentation of Cushing's contribution to
medicine a personal tribute to Gushing but a tribute as well
to the unselfish ideal toward which all physicians strive, each
in his own capacity.

Price's book was dedicated to Gushing with a quotation from
Balzac's Pierrette:

To
Dr. Harvey Gushing

. . . There now took place between the doctor and the disease
one of those struggles which physicians alone comprehend, the re-
ward of which, in case of success, is never found in the venal pay
nor in the patients themselves, but in the gentle satisfactions of
conscience, in the invisible ideal palm gathered by true artists from
the contentment which fills their soul after accomplishing a noble
work. The physician strains toward good as the artist toward
beauty, each impelled by that grand sentiment which we call virtue.

The book contained a stirring account of Mr. Price's meeting
with the great Finnish composer, Jean Sibelius, as well as
chapters on Wagner and Bach, and prompted Dr. Gushing to
write Edward Weeks, who had had a hand in its publishing:

Dear Ted: ... I have just finished reading Lucien Price's book
last night with a great thrill. I haven't seen any reviews of it yet and
hope he gets some good ones. It certainly deserves them. Being
entirely unmusical myself, even though I went to hear the Whif-
fen-Poofs sing last night, I can only sentimentally understand his

5/0 HARVEY GUSHING

great enthusiasm for music and realize that something valuable is
missing in my make-up. Nevertheless I am sure I would have en-
joyed his talks with Sibelius and it's all so vivid that I almost feel
as though I had been there myself.

With the coming of the new year, Gushing faced his second
retirement, for he would be sixty-eight in April and the retir-
ing age was sixty-seven. Again he viewed the prospect with
no eagerness and was not satisfied with any of the titles sug-
gested for his approaching "Emeritus'* state. Finally, in view
of his hopes for his library, the designation of Director of
Studies in the History of ^Medicine was decided upon as being
acceptable to all.

Meanwhile, he "pegged along," as he called it, at the
meningioma monograph. "But it's slow business," he wrote
Klebs, "for I find composition increasingly difficult, my sex-
agenarian loss of orientation, which grows worse rather than
better, proving a great handicap, for I can never find my place
in the MS. and can't remember overnight what I have written."
However, he felt well enough in April to attend a dinner
meeting of the Yale University Library Associates in New
York arranged by Frank Altschul (President of the Asso-
ciates), and then to go to Washington to the meetings of the
National Academy, where he saw many Hopkins friends. He
reported that everybody looked surprised, having supposed
he was long since dead and buried, and he sent Klebs an amus-
ing account of the sessions, which, he said, were dominated by
astrophysicists who wrote complicate formulae on blackboards
that he could not understand.

But this trip was a rare occasion he now spent most of his
days writing or working on his books. The frequent letters
that passed between him and Klebs discussed not only their
purchases, but the progress of plans for the library. Late in
April Klebs suggested that they use as an emblem the clover
leaf or "the more acid one of oxatis ... the green of oxalis is
a lovely green and the inversely heart-shaped leaves 'obcordate'
are quite appropriate." Later he wrote: "Your idea of making
choice collecting as the center of efforts is perhaps after all the
most promising. The notice in the Report of the President of

PROFESSOR OF NEUROLOGY AT YALE J77

Yale for 1936/7 about the Director of Studies in the History
of Medicine, just received, also the approval of Grosvenor
Atterbury's plans, are pleasant reading. . . . The day per-
haps will come when we can learn something for today from
the lessons of the yesterdays. With John in the offing, you
have at Yale a sort of insurance for continuity. 6 I only wish
I could be of more help, but I am afraid my 'positive useless-
ness' is increasing to an alarming degree."

Shortly after receiving this letter, Dr. Gushing reported
that their plans were attracting other donors or so he hoped:

Your welcome dossier arrived yesterday a day that I wish you
had been here to share, for John and I had a most enjoyable after-
noon and evening with E. C. Streeter and George Smith of our
local faculty who is a bibliophile after your own heart. I don't
remember whether you met him when you were here, but he col-
lects fish and has a superb ichthyological library with all the early
books on the subject. He is much interested in our trifoliate project
and I have no doubt plans to turn his things in with ours when the
library plans are consummated. . . . Incidentally, Ned Streeter
got quite enthused and I think will, with a little cajoling, let us have
his books on weights and measures in which he has been specializ-
ing these past several years.

After this first meeting, Dr. Smith made a habit of drop-
ping in frequently and, having so many common interests, he
and Gushing became warm friends. Since he was confined,
Dr. Gushing particularly appreciated the visits of those who
sought him out. During the spring he enjoyed a spirited con-
versation with Sinclair Lewis, whom his good friend,
Chauncey B. Tinker, Professor of English, had brought to
tea, and he was delighted to welcome the Geoffrey Jeffer-
sons of Manchester, who had come over for the Philadelphia
meeting of the Harvey Gushing Society which he could not
attend. And he was always glad to see Carl P. Rollins, Printer
to Yale University, not only because he admired his talents
as a designer of beautiful books, but because Rollins viewed
printing much as he did medicine they both had the same

6 Dr. Gushing named Dr. Fulton his literary executor with final author-
ity over the disposition of his library.

312 HARVEY GUSHING

love of craftsmanship, the same practical approach to their
arts, the one aspiring to be above all a good printer, the
other a good doctor.

In June, Gushing "retired with the Angells," as he called
it. His speech at the alumni luncheon afforded a welcome
opportunity to pay affectionate tribute to "Sunny Jim"
Angell, who had been responsible for much of the recent
growth and development of the University. "Those of you
who yearn for 'the good old days/ and, in a changing world,
regret that you can't send your sons to an unchanged Yale,
would feel quite otherwise could you have shared with me in
the great privilege of coming back to enjoy this extraordinary
new Yale that has emerged during the wise and courageous
administration now drawing to a close." It was on this buoyant
note that Gushing entered upon his retirement.

THE EVENING YEARS
Chapter XXVII

L-/EVERED NOW FROM EVEN THE

slight responsibilities that had been his as Professor of Neurol-
ogy, Gushing could at last fulfill the promise made to Mrs.
Gushing in 1909: "We will spend our evening years on the
back porch, ruminating on the past, knitting side by side."
They were particularly happy years, for he was surrounded
by friends and books and could choose those activities which
gave him the most pleasure. In the autumn of 1937 ^ e had been
elected president of the Elizabethan Club and he made a habit
of dropping in almost every afternoon at the house on College
Street. There was often a group of students around him, for
with his wide knowledge of the library's books and their in-
teresting provenance, he easily attracted an audience. He
enjoyed arranging meetings and often planned dinners before-
hand, as he had done at the Hopkins and at Harvard, for the
distinguished scholars and writers who came to address the
Club.

These stimulating sessions were described to John Fulton,
then on sabbatical leave and hunting Tarsius monkeys in the
Pacific Islands. He also reported on the progress of the com-
mittee to choose a successor for Mr. Keogh, University Librar-
ian, of which he was a member. "We are now on the trail of a
man named Knollenberg, a New York lawyer of scholarly in-
stincts who at odd times is writing a history of the Revolution.
The members of his firm, all of whom are Yale men, don't want

HARVEY GUSHING

to see him as the Sterling librarian because he is their tax expert.
Just what this means I am not sure though I assume his task is
to instruct people into ways of reducing their taxes by manipu-
lating their returns. Some of us might be able to use him should
he come down here." Later that month, Bernhard Knollenberg
was appointed Librarian and was to hold that post until he was
called to fill an important position in Washington during
World War II.

Tea hour at the Cushings attracted many from all parts of
the university, for Dr. Cushing's lively interest in everything
that was going on was a source of inspiration to old friends and
new. In the summer tea was served out of doors, as had been
their custom in Boston, croquet having replaced tennis as the
attraction. Dr. Gushing was no less devastating at this game
than he had been at tennis, but he rarely lacked opponents
among those accustomed to dropping in Dr. Clements C. Fry,
a fellow collector particularly interested in Weir Mitchell;
Mr. Donald Wing of the University Library and Mrs. Wing;
Mr. and Mrs. Burton Paradise; Miss Mary Nettleton and her
fiance, Gordon Haight; the Bayne-Joneses; Mr. James T. Babb,
a young man interested in books who was to succeed Mr.
Knollenberg as University Librarian; and many others. Deane
Keller, of the Yale School of Fine Arts, with whom Dr. Gush-
ing shared an interest in art and baseball, tried to sketch him on
various occasions but, as had so many others, found it most dif-
ficult to catch on paper the warmth that was his particular
charm. He made several charcoal drawings, and although he
was never at all satisfied with any of them, others have thought
he succeeded better than his predecessors.

In February of 1938 the meningioma monograph at last went
to press. Dr. Gushing reported to John Fulton, who was still
away: "I have no local news for you except that we are sitting
here waiting for proof; and Charles C (without a period)
Thomas says it will be a book of 750 pages with an illustration
on every page at least. We knew there were a great many so
we clustered them, giving them a single number, sometimes as
many as six or eight to a cluster, hoping he wouldn't notice it."

Early in March, Gushing went to Philadelphia to attend a

THE EVENING YEARS //

dinner for his old friend, Max Brodel, given by Lawrence
Saunders, President of the W. B. Saunders Company. "It was
a delightful affair," he wrote Klebs, "with a great turn-out of
some two hundred people to pay tribute to the man whose
name, I suppose, will outlive most of his Hopkins contem-
poraries owing to the uniqueness of his contribution to medi-
cine." It was the first time in years that Gushing had seen so
many of his Hopkins friends together, but he greatly missed
Thomas Futcher, who had died suddenly during ward rounds
one morning in February.

Although he had grave doubts as to the wisdom of it, Dr.
Gushing decided during the spring to go to England in July
to receive the D.Sc. which Oxford was to confer upon him. He
was accompanied by his nephew, Dr. Edward H. (Pat) Gush-
ing, and Klebs, although he also had been in uncertain health,
was in London to greet him. In the Lancet for July 23, under
the heading of "Dr. Gushing at Oxford," there was the follow-
ing notice:

On Saturday last the honorary degree of doctor of science was
conferred by the University of Oxford on Dr. Harvey Gushing,
professor emeritus of neurology at Harvard [sic"]. The event was
more than academic, for in receiving this new degree, Dr. Gushing
also received expressions of respect and affection that few men
could command. It was also more than English, for colleagues and
old pupils from many parts of Europe had gathered to do him
honour.

There was then a long list of those who attended a luncheon in
his honor, and besides friends such as Sir Almroth Wright, Sir
Richard Livingstone, Sir D'Arcy Power, Sir Cuthbert Wal-
lace, Mr. R. T. Gunther, and Professor George Gask, there
were Dr. George Riddoch, Mr. Geoffrey Jefferson, and Pro-
fessor Raffaele Bastianelli, who had come from Rome for the
occasion, as had Dr. Thierry de Martel and Dr. Clovis Vincent
from Paris. As always, there was also a group of his pupils-
Georges Schaltenbrand, Paul Martin, Jean Morelle, Ignaz
Oljenick, Norman Dott, George Armitage, W. R. Henderson,
A. R. D. Pattison, Hugh Cairns, and J. Paterson Ross. Klebs
called it "a great gathering around a beloved master such as the

$l6 HARVEY CXJSHING

world has rarely produced." Before leaving Oxford, H.C. held
a clinic at the RadclifFe Infirmary on pituitary basophilism.

Gushing now had degrees from many of the great universities
of Europe Cambridge, Lwow, Dublin, Glasgow, Edinburgh,
Strasbourg, Brussels, Budapest, Berne, Amsterdam, Paris,
Leeds, and Oxford. In America he had been honored by Wash-
ington University, Western Reserve, Yale, Jefferson Medical
College, Dartmouth, Harvard, Rochester, and Syracuse. Hon-
orary membership in one form or another had been conferred
on him by the most distinguished scientific and medical bodies
on both sides of the Atlantic. England had made him a Com-
panion of the Bath, France an Officier of the Legion d'Hon-
neur, and Peru had given him the order of El Sol del Peru. It was
a list to savor in die evening years, but although each had
brought him deep gratification, he did not linger on them.

In September Reinhold Gehner, the talented book designer
of the George Banta Publishing Company which had printed
the meningioma volume for Mr. Thomas, brought the first
copy to New Haven. It represented some twenty-five years
of work and it has been said that "It is the embodiment of all
the things he [Gushing] has stood for during his career as a
clinician: his painstaking case records and photographs, his un-
usual artistic ability evident in his own numerous operative
sketches, and his extraordinary knowledge of the day-to-day
life of his patients." With this volume (which has come to be
regarded as his greatest clinical monograph) he had now com-
pleted studies of the more important types of brain tumor
those impinging on the pituitary body, tumors of the nervus
acusticus, the gliomas (with Percival Bailey), tumors of the
blood vessels (also with Bailey), and the meningiomas. A re-
viewer wrote: "If the art falls into disrepute because of present
practices, it will be from neglect of the main lesson which he
[Gushing] attempted to teach."

For over a year, Dr. Gushing had been concerned over the
growing tenseness in Europe caused by Hitler's activities. He
became addicted to the radio, and he frequently mentioned to
Klebs the appealing letters he was constantly receiving from
friends in Europe who were having to flee for their lives. After

THE EVENING YEARS 5/7

a visit in March from L. L. Woodruff, Chairman of the Zoology
Department, he wrote Klebs:

This botany [Sir John Hill's British Herbal] is an amazing book,
and it led us to look at some other botanies, and then he asked if
I had a copy of Valerius Cordus, of whom I knew nothing but
he said he thought he was the most important of all German bota-
nists. So I made a note of it and in a few days I had an offer of a copy
of the Annotationes of 1561 which by chance had been bound for
Maximilian II, King of Bohemia and much else. I wonder what he
would have had to say could he have been in Prague yesterday and
have witnessed Hitler's triumphant entry at the head of his highly
mechanized troops.

I wonder, too, about other things: How would Switzerland re-
act should he decide to lop off the German-speaking cantons on
the grounds that they were being imposed upon by the Republic
and really belonged, like all other good Germans, in the Reich? I
had always supposed that Bohemians and Czechs had a very high
national spirit of their own, and I wonder if they won't make very
uncomfortable subjects for the Reich to handle.

The Harvey Gushing Society had planned their meeting in
1939 to coincide with Cushing's seventieth birthday. On April
5 he wrote Klebs that "Cairns and Geoffrey Jefferson who
were planning to come over for my birthday party are being
kept at home by the present political uncertainties whereas
Putti, who had also planned to come, is in bed with the yaller
janders." As it happened, Klebs was already on the high seas on
his way to the birthday party, unknown to Dr. Gushing, who
was completely astonished and more than delighted to see him.
The dinner on the evening of April 8, climaxing the usual two
days of papers and clinics, was a gala and happy affair, with Dr.
Eisenhardt, President of the Society, presiding over the large
gathering of pupils and old friends. Mr. Arnold Muirhead, who
had been a "latch-keyer" at the "Open Arms" in Oxford,
brought messages from the Osier Club in London, and his old
friend W. W. Francis was one of the speakers. Dr. Francis
reminisced about the "latch-keyer" days in Baltimore when he
was living with Osier: "I wonder if two adjacent houses, with
a couple of boards knocked out of the intervening backyard

$1$ HARVEY GUSHING

fence . . . can ever, before or since, have sheltered such a pair
of congenial geniuses, so useful, hard-working, stimulating,
informative, Vesaliolatrous, and withal so exuberant, cheery,
witty and playful. . . ."

Olof Sjoqvist of Stockholm, a Rockefeller Fellow at Yale,
presented a birthday volume of papers from Dr. Cushing's
friends in Sweden, and a few of the cables received from friends
and colleagues throughout the United States and Europe were
read. 1 Even Cushing's faithful operating orderly, Adolph
Watzka, who had adjusted his surgical headlight and mopped
his brow during operations for many years, was present. 2 A
bibliography of Cushing's writings twelve books and 330
papers (as well as 328 additional papers from his laboratory)
which had been prepared without his knowledge was pre-
sented by Dr. Eisenhardt. Dr. Cushing's happily chosen words,
addressed to "My fellow co-workers, guests and friends; neu-
rologists, neurosurgeons, ophthalmologists, printers, publishers,
and others unclassified and unexpected including an interloper,
Dr. Arnold Klebs, also Dr. William Francis and Adolph," con-
cluded seriously with a verse from the Talmud:

"The day is short and work is great. The reward is also great
and the Master praises. It is not incumbent on thee to complete
the work but thou must not therefore cease from it."

When life had again returned to normal, Gushing resumed
work on his biobibliography of Vesalius. During the preceding
autumn he had decided to do something about his long interest
in Vesalius and his works, but when he announced his intention
to Klebs, the latter thought he was assuming a task more pre-
tentious than he realized: "And now you ganz allein tackle the

1 The Yale Journal of Biology and Medicine (under the editorship of one
of his colleagues, Dr. George H. Smith, Professor of Immunology)
devoted its May issue to commemorating his anniversary.

2 In order to distinguish Adolph from interns at the Brigham, Dr. Gush-
ing had told him to wear special trousers of blue and white stripes. One
day Frederic Schreiber and Adolph were walking down the hospital
corridor when Dr. Homans came along and teased Adolph about his
pants. Adolph turned to Schreiber and said with great scorn, "Where
der's no respechs, der's no nothings."

THE EVENING YEARS -/

Vesal bibliography. God bless your innocence!" Despite
Klebs' apprehensions, Dr. Gushing went on with the project,
and a picture of him at work comes, strangely enough, from
a letter from Klebs: "Your good letter of July 13 without any
steamer indication got here on the zzd at the same time as
John's July 14 'Clipper* letter and Sir Henry's [Viets] 'Aqui-
tania' letter of July 1 4, all of which must be terribly disappoint-
ing to dear old John [there was ever a race to get letters back
and forth by the fastest means]. At any rate he gives me a
much better description of your present activities than you do
yourself and for this I am very grateful. Sitting behind an im-
mense, oilcloth covered table with documents spread all over
and fortifications of reference books a la Vauban, for sixteen
hours a day, would merit the brush of a Vermeer."

While Dr. Gushing was thus engaged, anyone who called
and was suspected of having a knowledge of Latin might very
likely be set to translating a difficult passage. This happened to
one of his former colleagues from Boston, Dr. Frederick T.
Lewis, whose visit coincided with one from Herbert M. Evans
of California, with whom Gushing shared an interest in rare
books and, since Hunterian days, in the pituitary. 3

Shortly after the visit of these friends, Dr. Gushing had word
that he had received a most unusual honor election to hon-
orary fellowship in the Royal College of Physicians of Lon-
don. Until he had a reply to his letter of acceptance and appre-
ciation, he did not realize that he was the only surgeon who
had ever been so recognized. "I shall have to watch my step
carefully," he wrote H. M. Barlow, the Secretary, "lest I do
something in my remaining years to cause the College to regret
its action." During the year he was also granted honorary fel-

8 Dr. Evans had long been working on the growth hormone of the ante-
rior pituitary an impure extract of which Dr. Gushing had tried in the
summer of 1929 on John and the others whose growth he hoped to stimu-
late. When Evans* paper announcing his success in obtaining a pure
extract was published, Dr. Gushing wrote: "It [the paper] is admirably
presented and most convincing, and I think it is the best thing you have
ever done. It shows how worthwhile is slow maturity of thought on
such a complex subject and is worth dozens of papers on isolated facts."

$20 HARVEY GUSHING

lowship in the Societe Suisse de Neurologic, the Societe
d'EndocrinoIogie of Paris, and in the Royal Society of Medi-
cine of Edinburgh.

While the Yale Corporation was sitting in June of 1939,
Gushing wrote to Klebs in a state of some excitement: "I am
expecting to hear from them any minute to the effect that they
have allocated a half million dollars to us, that Atterbury will
immediately go ahead to modify his plans for the Y-shaped
building in the middle of the present Medical School group and
to enlarge it to hold a possible 400,000 books instead of the
200,000 his plans originally called for, and that they propose
to start building immediately." He later added, after the good
news had come: "I think I ought to say that it was our friend
Lefty Lewis who apparently pushed the library program
through the Corporation of which he is the youngest and most
enthusiastic member. He frequently asks about you."

Klebs, too, was delighted, and satisfied with the ultimate
decision not to have a separate building: "I am not at all sorry
that the grand plans that you had about the Library cannot
materialize. The simpler they are, the better they will please
me. . . , We have now to put all our trust in John and I think
we can do it with a good conscience. He has wonderful vitality
and I am so glad to hear that he works in close cooperation and
sympathy with Knollenberg who also seems to me a very
promising fellow. Of course we old fellows have to take a back
seat but I think we are very lucky to have such fine young men
working in line with our ideals."

The declaration of war depressed Gushing deeply, and al-
though he had the engrossing preoccupation of Vesalius and
the revising of the Library plans, he could not keep his mind
off his many friends and pupils in Europe. He was further
upset to hear of the deaths, just two months apart, of Charles
H. and William J. Mayo, to whom he had long been devoted,
and he immediately tried to express his feelings in an apprecia-
tion.

On September 1 1 he wrote Klebs with something of his old
light touch:

THE EVENING YEARS $21

I have been sadly remiss as a correspondent of late. Altogether
too much time has been passed glued to the radio a habit easily-
acquired. But I have now sworn off, and the world can go to the
bow-wows for all my listening in can prevent. I will hear news
about it when it is all over.

Just twenty-five years ago W.O. and I were planning to par-
ticipate in the Brussels celebration [of the birth of Vesalius]
planned for December 1914, This summer, which has gone on the
wings of the wind, I have, as you well know, given over once more
to Vesalius whose books are sprawled all over the dining room
table, expanded with extra leaves to fill the room. I begin to think
he is a dangerous man to deal with, for renewing my acquaintance
with him seems to have now precipitated World War No. 2.

But a letter from Mrs. Gushing to an old friend, Captain Frank
Pleadwell, late in October told in retrospect the true state of
affairs: "What good times we used to have when we both lived
in Boston and the bibliophiles got together. Harvey was
happy in New Haven too. His association with the Library and
the Elizabethan Club gave him such pleasure. His book on
Vesalius written last summer in a terrific burst of energy, he
left almost finished and Billy Francis has consented to write the
last part. He did so want to finish it but he never could con-
centrate after the war started."

During the evening of October 3, Dr. Gushing had an attack
of pain around his heart much sharper than the warnings he
had had occasionally during the summer. By noon of the 4th
he was admitted to the hospital. Signs of heart block developed
during the evening and he was placed in an oxygen tent. He
smiled when his nephew Edward H. Gushing arrived the next
day from Cleveland, and again on the 6th when the news was
brought to him that the building of the Library, threatened by
the war, would proceed regardless. Early the next day he died.

On October 9, in the Center Church on the New Haven
green there gathered from far-scattered places many friends
of Harvey Gushing to pay their final tribute. The majestic
strains of Sibelius' Fmlandia swelled from the open doorway
of the church. Outside, automobiles moved swiftly along Tern-

322 HARVEY GUSHING

pie Street far more swiftly than the horse-drawn vehicles
which had pursued their leisurely way along the same street
that autumn over a half century before when, as an eager boy,
he had come from Cleveland to enter Yale College as a fresh-
man. But the yellow leaves dropping quietly in the clear sun-
shine of the perfect autumn afternoon were from the same
elms that had shaded him in his youth and on the many occa-
sions of his return to the scene of those happy days.

As the simple service proceeded, more than one must have
let his mind wander back through the years to think how far
the Ohio lad had traveled since first he came to New England,
the home of his forebears. The journey ended where it had
begun in the Western Reserve when his ashes were taken to
the hilltop where his mother and his father, his sister and his
brothers had preceded him, to the hilltop where Dr. Kirke had
planted crocuses to keep memory green with each returning
spring.

"BE YOU BUT BRAVE
AND DILIGENT"

Chapter XXVIII

H

.IS DREAM FOR HIS BOOKS WAS

realized, and the Historical Library will be his most enduring
monument. The Rotunda from which one enters the Library-
was the gift and tribute of his classmates in '91. And carved in
stone over the fireplace are words of eloquent beauty in which
his friend, the Reverend George Stewart, captured the essence
of his hope for the future of his books the essence, as well, of
his own gallant search for truth:

Here, silent, speak the great of other years,
the story of their steep ascent from the
unknown to the known, erring perchance
in their best endeavor, succeeding often,
where to their fellows they seemed most
to fail;

Here, the distilled wisdom of the years, the
slow deposit of knowledge gained and writ
by weak, yet valorous men, who shirked
not the difficult emprize;

Here is offered you the record of their days
and deeds, their struggle to attain that
light which God sheds on the mind of
man, and which we know as Truth.

Unshared must be their genius; it was their
own; but you, be you but brave and dili-
gent, may freely take and know the rich
companionship of others' ordered thought.

HARVEY GUSHING

His death was not the end. Harvey Gushing, like a truly
great teacher, had merely turned over his work to his pupils.
You will find them in clinics and operating rooms the world
over. And in his library you will encounter scholars at work
among the rich materials whose collection had been his lifelong
pleasure, and students and interns reading quietly or, worn out
by a bedside vigil, asleep with a book in their laps. The after-
noon sun, slanting through the clerestory windows near the
arched ceiling, lights up the face of Vesalius in his portrait
over the fireplace on its way to the shelves where his great
book, De humani corporis -fabric^ stands in its many editions.
"Though lives die, the life is not dead; and the memory of lives
such as these will be reverently and forever shared not by a
profession alone, not by a nation alone, but by the universal
brotherhood of man."

BIBLIOGRAPHY AND SOURCES

IN WRITING THIS BIOGRAPHY I HAVE BEEN

grateful that the Gushing family were constitutionally op-
posed to throwing anything away. Dr. Henry Kirke Gushing
saved many of the letters Dr. Erastus wrote him in medical
school; Betsey Maria Williams kept those her father wrote
to her whenever he was away from home. They both pre-
served all the weekly letters Harvey wrote to them from 1887
on. The files also contain deeds, cuttings, programs, photo-
graphs, and all manner of other memorabilia that make the
way of the biographer easier. Mrs. Harvey Gushing likewise
saved Dr. Cushing's letters; and there are fourteen file drawers
of letters to and from other correspondents between 1891
and 1939. The bound manuscript materials include the
following:

Memorabilia of Erastus Gushing and Mary Ann Platt

Memorabilia of Betsey M. Williams (Gushing) and her Fore-
bears

Memorabilia of Henry Kirke Gushing

(These three volumes were put together by Dr. Gushing
during the last -four years of his life)

The Western Reserve and Its Medical Traditions
Yale College 2 scrapbooks
Harvard Medical School 15 course notebooks
Baltimore i scrapbook

$26 BIBLIOGRAPHY AND SOURCES

Diaries:

Harvard Medical School 1893-94

Columbian Exposition 2893

Havana 2894

England 2894

'Bermuda 2895

Canada 2896

Le Puy 2900

European Notes 2900-023 vols.

Oxford 29042 vols.

Budapest 29092 vols.

Clinical Society Tour 29223 vols.

Harvard Unit in Paris 29254 vols. (all handwritten)

Base Hospital No. 5, 2925-279 vols.

Rome and the Physiological Congress 2932

Correspondence and memorabilia of

William S. Hoisted 2 vol.
William H. Welch-4 vols.
S. Weir Mitchell 2 vol.
Leonard Wood 2 vol.
James Ford Rhodes 2 vol.
Arnold C. Klebs4 vols.
Sir William Osier 2 vol.

Correspondence on University and Hospital Appointments

Pamphlets on Full-time for Clinicians

Correspondence and Papers on Full-time

Letters about the Osier Biography (1925-29) 2 vols.

The Annual Reports of the Peter Bent Brigham Hospital
1914-33 have been most helpful. Dr. Cushing's published
works, both clinical and nonclinical, have been an excellent
source oftentimes of historical background. In addition, I
have consulted the following:

BIBLIOGRAPHY AND SOURCES ^27

[Bagg, L. H.] Four Years at Yale. By a graduate of '69. New
Haven, Charles C. Chatfield & Co., 1871. xiv, 713 pp.

Beecher, H. K. "The First Anesthesia Records (Codman,
Gushing)." Surgery, Gynecology and Obstetrics, 1940,
77; 689-693.

Bernheim, B. M. The Story of the Johns Hopkins; Four Great
Doctors and the Medical School They Created. New York,
McGraw-Hill Book Co., 1948. xi, 235 pp.

- . A Surgeon's Domain. New York, W. W. Norton
and Co., 1947. 253 pp.

Cheever, David. "The Turn of the Century and after." New
England Journal of Medicine, 1940, 222: i-n.

Flexner, Simon and Flexner, J. T. William Henry Welch and
the Heroic Age of American Medicine. New York, The
Viking Press, 1941. x, 539 pp.

Fulton, J. F. Harvey Gushing: A Biography. Springfield, 111.,
Charles C Thomas, 1946. xiv, 754 pp., 64 plates.

Garrison, F. H. John Shaiv Billings. A Memoir. New York,
G. P. Putnam's Sons, 1915. v, 432 pp.

Gumpert, Martin. Trail-Blazers of Science: Life Stories of
Some Half-Forgotten Pioneers of Medical Research. Tr.
from the German by Edwin L. Schuman. New York,
Funk & Wagnalls Co., 1936. viii, 303 pp.

Jefferson, Geoffrey. "Harvey Gushing." Manchester Univer-
sity Medical School Gazette, 1943, 22: 37-45.

Livingston, W. K. "Harvey Gushing. April 8, i869-October
7, 1939." Western Journal of Surgery, Obstetrics and
, 1939,47,716-718.

MacCallum, W. G. William Stewart Hoisted, Surgeon. Balti-
more, The Johns Hopkins Press, 1930. xvii, 240 pp.

Paget, Stephen. Sir Victor Horsley. A Study of his Life and
Work. London, Constable and Company, 1919. xi, 358 pp.

$28 BIBLIOGRAPHY AND SOURCES

Price, Lucien. "Olympians in Homespun." The Atlantic
Monthly, 1926, 757: 433-44?-

Rand, C. W. "Doctor Gushing as I Knew Him." Bulletin
of the Los Angeles Neurological Society, 1940, j: 1-8.

Stalker, Hugh. "The Warrens of New England and Their
Friends." New England Journal of Medicine, 1940, 222:

Stevenson, R. S. Review of Harvey Gushing: A "Biography
by John F. Fulton. Medical 'Bookman and Historian, 1947,
u 41-44.

ACKNOWLEDGMENTS

I wish to express my appreciation to the following:

Charles C Thomas for permission to quote from John F.
Fulton's Harvey Gushing. A Biography; Gushing and Eisen-
hardt's Meningiomas; A Bibliography of the Writings of Har-
vey Cushing; and from Harvey Cushing's Seventieth Birthday
Party, April 8, 1939.

The Oxford University Press for permission to quote from
Harvey Cushing's The Life of Sir William Osier.

Little, Brown and Company and The Atlantic Monthly Press
for permission to quote from Cushing's "From a Surgeon's
Journal 1915-1918, and from Lucien Price's We Northmen.

The Manchester University Medical School Gazette for per-
mission to quote from Geoffrey Jefferson's "Harvey Cush-
ing."

The Bulletin of the Los Angeles Neurological Society for
permission to quote from Carl Rand's "Dr. Cushing as I Knew
Him."

The Medical 'Bookman and Historian for permission to quote
from R. Scott Stevenson's review of Harvey Cushing. A Biog-
raphy.

The Rowfant Club of Cleveland for permission to reproduce
four illustrations from A Visit to Le Puy-en-Velay and to
quote from Henry Kirke Cushing. A Memorial

And, finally, to all who have generously allowed me to quote
from their letters and writings, published and unpublished.

329

INDEX

Archibald, Edward, 20971

Arderne, John, 269

Armitage, George, 280, 315

Arthur Dean Bevan Lecture, 276

Asepsis, 44, 95

Asher, Leon, no, 268, 280

Asher, Mrs. Leon, 268

Atterbury, Grosvenor, 34, 36, 51, 87,
163; visit to Le Puy, 98-9; plans
for medical library, 298, 311

Babb, J. T., 314

Abernethy, John, 199
Acland, Sir Henry, 129
Acromegaly, 159, 172, 249
Addison, Thomas, 96
Adiposity, asexual, 159, 160
Adson, A. W., 20972
Aesculapius, 239
Agassiz, Louis, 179
Altschul, Frank, 310
American Ambulance, Paris, 186 et
seq.; organization, 186; Harvard
Unit arrives, 187
American Association for the Ad- Babinski, J. F. F., Sign of, 285

vancement of Science, 276 Bach, Johann Sebastian, 309

American College of Surgeons, 228 Bacon, Robert, 186
American Expeditionary Forces, Bagdazar, Dimitri, 280

199 Bagley, Charles, Jr., 20971

American Journal of Science, 19 Bailey, Percival, 182, 206, 214, 230-1,
American Medical Association, 155, 240, 241, 274, 280, 316

161, 171, 261, 267, 300 Baldwin, Mrs. A. D., 32, 63

American Neurological Associa- Baldwin, H. P., 221

Baldwin, H. T., 55
Society, Balfour Lecture, 278

Ballance, Sir Charles, 183, 22972
Baltimore, dining habits, 73; Druid
Hill Park, 73; fire, 142, 149; mar-
ket, 73
Balzac, Honore de, 309

tion, 140, 155, 182, 230
American Physiological

141, 160, 177
American Red Cross, 192
Amerman, G. L., 54, 56
Amsterdam. University, 316
Anderson, N. M., 15-17

Anesthesia, discovery of, 44, 95; Banks Memorial Lecture, 163
early use of at M.G.H., 48; local, Banta Publishing Company, 316
86; see also Ether charts Banti, Guido, 108

Angell, J. R., 213, 272, 298, 308, 312; Banti's disease, 88, 108
letter from HC, 283; letter to HC, Barker, L. F., 119, 147
283, 290 Barlow, H. M., 319

331

$$2 INDEX

Barlow, Sir Thomas, 183 Boston Medical Library, 272

Barlow, W. J., 170 Boston Public Library, 60, 287

Bartlett, Elisha, 234 Boston Surgical Society, 229, 289

Base Hospital No. 5, see U. S. Boston Symphony Orchestra, 41,

Army. Base Hospital No. 5 179

Basophilism, pituitary, 284-5, 2 ^9 Bottazzi, Filippo, 268

29572, 306, 316; Cushing's disease, Bovell, James, 234

284 Bo vie, W. T., 247

Bassett, J. Y., 234 Bowditch, H. I., 40

Bastianelli, RafFaele, 315 Bowditch, H. P., 40, 46, 100

"Battle of Boston Common," 192, Bowditch, V. Y., 40

303 Boyd, W. W., x, 278

Bayne-Jones, Dr. and Airs. Stan- Boyle, Robert, 199

hope, 298, 314 Boylston Medical Society, 43

Beattie, John, 274 1 Bradford, E. H., 61

Beaumont, William, 234, 237, 283, Bradford, William, II, 128

293; Memorial Highway, 306 Brain Tumor Registry, 296, 306

Beaumont Medical Club, 283, 293, Brain tumor statistics, 113, 134, 166,

298 184, 193-4

Beevor, Charles, 134 Bremer, Frederic, 182, 206, 268, 274;

Bell, Sir Charles, 40, 127, 128, 261 280

Bellevue Hospital Medical College, Brewster, Robert, 149

75, 158 Bridges, Robert, 273

Bergman, Ernst von, 98, 135 Brigham, P. B., 170

Berkshire Medical School, Pitts- Bright, Richard, 96

field, 6 British Medical Association, 143

Berne. University, 100, 280, 316 British Museum, 144

Bevan Lecture, 276 Broadbent, Sir William, 96

Bigelow, Mrs. A. F., 217, 225 Brodel, Max, 83, 90, 315

Bigelow, H. J., 229; Bigelow medal Brooks, Phillips, 63

recipients, 228-9; awarded to HC, Brow, G. R., 275

289 Brown, Graham, 281

Billings, J. S., 74, 77, 170, 234 Browne, G. Buckston, 276

Bishop, C. C., 282 Brown-S^quard, C.-E., 95

Blake, F. G., 213, 290, 294 Brown University, 33

Blood pressure and intracranial Brownie Club, 54-5

pressure, 106, 107, 109, 115, 134; Brussels. University, 316

changes in surgical cases, 118; in- Budapest. University, 316

troduction of blood-pressure de- Bulfmch, Charles, 44, 67

terminations in U.S., 138-9 Burrell, H. L., 117

Bloodgood, J. C., 8 1, 117, 118 Burton, Robert, 234
Boardman, Josephine, 32

Boardman, Nina, 32 Cabot, A. T., 160, 161, 167, 214

Bologna. University, 108 Cadwallader, Thomas, 128

Bolton, C. B., 241 Cairns, Hugh, 195, 248, 254, 279,

Bolton, C. C., 241 280, 287, 315, 317

Boothby, W. M., 189 Cajal, S. Ramon y, see Ramon y

Bordley, J. E., 221 Cajal, S.

Boston City Hospital, 170, 180 Calkins, G. N., 47

Boston Medical History Club, 213 Cambridge University, 183, 316

INDEX 535

Cameron Prize Lectures, 241 The Club, New Haven, 296

Camp, Walter, 212 Club of Odd Volumes, 179, 266

Cannon, Ida M., 4 Cobb, Farrar, 16

Carlyle, Thomas, 176 Cochran, A. S., 2987*

Carmalt, W. H., 213 Cochrane, Alexander, 169, 174, 175

Carnegie Foundation for the Ad- Codman, E. A., 42, 43, 46, 49, 50, 54,

vancement of Teaching, 166, 203 62; letter to HC, 42
Carnegie Institution of Washing- Codman, E. D., 246

ton, 146 Cohn, Dr. and Mis. E. J., 268

Carr, J. B., 148 Cohnheim, Julius, 75

Carrel, Alexis, 132, 189 Colgate, Samuel, 33

Carroll, R. S., 13-14 Columbia University. College of

Castiglioni, Arturo, 293 Physicians and Surgeons, 75, i8<5;

Casualty Clearing Station No. 47, Neurological Institute, 135

195 Coleman, C. C., 20972

Cavendish Lecture, 215 Columbian Exposition, Chicago

Cazin, J. C., 51 (1893), 51, 53

Cerebellar tumors, 140, 252, 254; Committee on the Costs of Medical

dressings in, 261 Care, 300

Cerebral localization, 95, 134 Committee on Economic Security.

Cerebrospinal fluid pressure, studies Medical Advisory Committee,

on, 140, 151, 166, 241 299-300

Chapin, Mrs. H. B., 191 Conant, J. B., 291, 295, 206

Chapin, Mr. and Mrs. Robert, 34, Conant, W. M., 66

87, 197 Cooper, Sir Astley P., 40

Chapman, R. W., 231, 232 Cordotomy, 135

Chapman, Mrs. R. W., 232 Cordus, Valerius, 317

Charcot, J.-M., 193 Corey Hill Hospital, Brookline, 177

Charity Hospital, Cleveland, 53 Cornell University, 12
Charles II, 4 Corot, J. B. C., 51

Cheever, David, 80, 205; presenta- Councilman, W. T., 45, 54, 75, 117,

tion of Bigelow Medal to HC, 289 138, 155, 161, 179, 192, 237, 289
Children's Hospital, Boston, 52, 57 Crehore, Mrs. J. D., 61
Childs, S. W., 34, 39; Childs Fund, Crehore, Mary L., 61

296 Crichton-Browne, Sir James, 96

Chipault, Antony, 135 Crile, G. W., 138, 156, 186, 187, 230

Chittenden, R. H., 36, 37, 39, 197, 306 Cross, W. L., 306
Christian, H. A., 170, 175, 179, 182, Crowe, S. J., 13672, 151, 159, 161

229, 272, 290 Crowell, Katharine Stone, see Cush-

Cicero, 302 ing, Mrs. Harvey

Cleveland, Grover, 33 Crowell, Mrs. W. E. (mother of

Cleveland Academy of Medicine, KG), 37, 38, 85, 120, 162

141 Crummer, Mrs. LeRoy, 293

Cleveland. Central High Shcool, 13 Cummings, H. S., 29971
Cleveland Manual Training School, Curley, J. M., 192

15 Gushing, Alice K. (sister of HC),

Cleveland Medical College, 6, 7 7, 13

The Club, Boston, 178; membership, Gushing, Alleyne M. (brother of

179 HC), 7, 12

INDEX

Gushing, Barbara (daughter of

HC), 225, 226, 273, 301, 307;

birth, 194; letters from HC, 227,

294; letter to HC, 227
Gushing, Betsey (daughter of HC),

see Roosevelt, Mrs. James
Gushing, David, Jr. (great-grand-

father of HC), 4, 5, 49, 84, 126,

128
Gushing, Mrs. David, Jr. (Freelove

Jenks),4
Gushing, Edward F. (brother of

HC), 7, 12, 42, 48, 56-8, 60, 61, 68,

70, 72, 82, 83, 84, 87, 93, 121, 122,

168, 172, 173; engagement, 80;

marriage, 82; birth of son, 86; ill-

ness and death, 171; letter from

HC, no; letters to HC, 69, 169
Gushing, Mrs. E. F. (Melanie Har-

vey), 32, 70, 72, 80, 86, 87
Gushing, Edward H. (Pat, nephew

of HC), 87, 276, 315, 321; birth,

86
Gushing, Erastus (grandfather of

HC), 4, 5, 6, 7, 13, 49, 84, 126, 172,

181; death, 51
Gushing, Mrs. Erastus (Mary Ann

Platt), 5
Gushing, George B. (brother of

HC), 7
Gushing, Harvey

BIOGRAPHY AND CHIEF EVENTS

Early ^ years: Birth, 4, 11; early edu-
cation, 13-17, broken wrist, 14;
camping trips to Maskenoza, 15-
17; Yale College, 18 et seq.; grow-
ing interest in medicine, 36-37

Medical school and residencies
(1891-1902): Harvard Medical
School, 39 et seq.; first dissec-
tion, 41-2; extra work, 45, 46, 47,
54, 61; anesthetist, 48; contem-
plates leaving medical school, 48;
ether charts, 49; votes for first
time, 56; trip to Havana, 56-7;
trip to England, 58-60; trip to
Bermuda, 61-2; appointment at
M.G.H., 62; witnesses first brain
operations, 62-4; interest in neu-

Medical school (cont.)
rology, 64; graduation cum latide,
65; internship at M.G.H., 66-9;
Canadian trip, 70-3 ; assistant resi-
dency at Johns Hopkins, 70 et
seq.; first professional paper, 79;
appendectomy, 82-3; engagement,
83; designs bookplate, 84; instruc-
tor in surgery, 85; work on local
anesthesia, 86; trip up Great
Lakes, 87; operation for typhoid
perforation of gut, 88; first sple-
nectomy, 89; initial Gasserian
ganglion resection, 90; offered
post at Western Reserve, 90

Wander jahre (1900-1902): Sails for
Europe, 93 et seq.; visits Horsley,
94-6; centenary of Royal College
of Surgeons, 97; International
Medical Congress (Paris), 98; Le
Puy-en-velay, 98-9; work in
Berne, 100 et seq.; first historical
paper, 107; "grand tour" of Italy,
107 et seq.; secures blood-pres-
sure apparatus, 109; work with
Sherrington, no-n

Johns Hopkins Hospital (1902-
1912): Decides upon future ca-
reer, 113; settles at 3 W. Franklin
Street, 114; first lecture (Philadel-
phia), 115; seeks opportunity at
Harvard, 117; post offered at
University of Maryland, 117-18;
marriage, 118-19; birth of first
child (William), 120; death of
mother, 120-1; beginnings of a li-
brary, 123 et seq.; book bills
(1902-1907), 127; early brain op-
erations, 132 et seq.; first pituitary
tumor, 137; blood-pressure stud-
ies, 138-9; calls to Jefferson Medi-
cal College and Yale, 141; trip to
England (1904), 143; Osier leaves
Hopkins, 144-5; Hunterian Lab-
oratory, 146 et seq.; course in
comparative surgery, 150-1; birth
of Mary, 154; calls to University
of Virginia and New York Hos-
pital, 154; first treatise on brain
surgery, 155, 157-8; move to 107

INDEX

Johns Hopkins Hospital (cont.)
East Chase Street, 156; birth of
Betsey, 156; portrait by Tarbell,
157; neurological assistant, 158;
calls to Rush Medical College
and Bellevue Medical School,
158; growing interest in pituitary,
159-61; trip to Europe (1909),
164; first complete extirpation of
tumor, 167; father's death, 168;
calls to Washington University
and Harvard, 167-9; birth of
Henry, 170; trip to England
(1911), 171; death of brother
Ned, 171; second call to Western
Reserve, 171; pituitary volume
published, 172-3; interest in oph-
thalmology, 174

Harvard Medical School (1912-
1933)' Move to Boston, 177;
opening of Brigham, 179; full-
time plan, 1 80 et seq.; Harvard
Unit to Paris, 186; preparedness,
192; acoustic tumor monograph,
193; birth of Barbara, 194; Base
Hospital No. 5, 194 etseq.; threat-
ened court martial, 199; transfer
to AJE.F., senior consultant in
neurosurgery, 199; attack of poly-
neuritis, 200-02; plan for national
institute of neurology, 203; death
of Osier, 204; citations by British
and General Pershing, 204; com-
mences Osier biography, 205;
France awards Chevalier, Legion
d'Honneur, 215; Bill's death, 223;
receives D.S.C., 230; third call to
Western Reserve, 230; offered
Halsted's chair, 230; Pulitzer
Prize for Osier biography, 235;
monograph on gliomas, 240; es-
tablishes fellowships at the Hop-
kins, Yale, and Harvard, 246;
electrocautery in brain opera-
tions, 247-8; loss of General
Wood, 249-50; Officier, Legion
d'Honneur, 265; Consecratio Me-
dici published, 266; sixtieth birth-
day, 267; dedication of Osier
Library, 268; trip to Holland,

Harvard Medical School (cont.)
Sweden, and Switzerland (1929),
269-70; dedication of Welch Li-
brary, 270; Betsey married, 274;
studies on hypothalamus, 274-5;
trip abroad (1930), 274-5; hos-
pitalization, 277; zoooth tumor
operation, 278; 40th Yale re-
union, 279; International Neuro-
logical Congress (Berne 1931),
279; final report on neurological
surgery, 280; fourth call to West-
ern Reserve, 282; description of
pituitary basophilism (Cushing's
disease), 284; HC Society formed,
285; last operation, 286; retire-
ment from Harvard, 286; trip
abroad (1932), 286-7

New Haven (1933-1939)'. Return
to Yale, 290-2; trip to London
and Paris ( 1 93 3 ) , 292 ; hospitaliza-
tion for ulcer, 293; Brain Tumor
Registry, 295-6; plans for library,
297-8; Medical Advisory Com-
mittee, 299-300; From a Surgeorfs
Journal published, 303-5; Con-
necticut tercentenary,3o6; Henry's
marriage, 308; Emeritus professor,
310, 312; president, Elizabethan
Club, 313; last trip abroad (1938),
315; list of honors, 316; rneningi-
oma monograph published, 316;
yoth birthday party, 317-18; Ve-
salius biobibliography begun, 318;
funds for library secured, 320;
illness and death, 321

INTERESTS

Books: 46-7, 60, 69, 83-4, 123 et seq.,

163, 165, 187, 215, 261, 270-3, 287,
298, 309 3*7 32i; bookplate, 84;
libraries, 37, 60, 143, 180, 265, 269,
313-14; plans for library at Yale,
297-9, 310-11, 320, 323-4

Drawing, art, and architecture: 20,
36, 50-1, 62, 83, 99, loo, 108, 109,

164, 286-8

Music: 41, 259, 264-5, 309

2$6 INDEX

Natural history, etc.: 14, 16, 43, 45, Qualities (cont.)

50, 70-1, 73, 98, 102, 104, 187, 189, 303; whimsy, 227, 266, 285, 294;

194 wit, 13

Sports: baseball, 13, 26, 28-30 & ^^

82, 212, 219; croquet, 314; foot-

ball, 24-5, 212; tennis, 212, 233, Administrative, 208; drawing, 20,

314; tumbling, bars, etc., 13, 30 50, 53, 55, 64, 83; investigator,

Professional: early interest in medi- 174* 2 ?8; in creating esprit de

cine, 36-7; first dissection, 42; corps, 260-2, 267, 285; lecturer,

physiological chemistry, 36-7; 183, 215, 242, 249; surgical skill,

orthopedics, 61; interest in brain 88, 89, 193, 205, 248, 254, 285;

surgery and neurology, 48-9, 62, teaching, 137, 206, 245-6, 260-2;

86, 94-6, 98, 106, iio-ii, 113; writing, 45, 50, 62-3, 107, 144, 184,

X-ray, 68, 79; bacteriology, 81, 235-9

8 9 ; Ophthalmology, 174, 266 MISCELLANY

QUALITIES AND CHARACTERISUCS Diajy

Ambition to excel, 26, 42, 45-6, 54, 186; food and drink, 16, 19, 22,

57, 61, 66-7, 78, 91, 117, 263; 3 r - 2 > 207, 224, 281; inability to

charm, 13, 33, 66, 215, 225, 260; spell, 13, 20-2, 28; profanity, 265;

concentration, 41-2, 133, 136; religion, 12, 63, 108, 267

courage, 133, 136, 167, *f,< =riti- PROTESSIONAL PRECEPTS
cal attitude, toward self, 48, 50,

105, 162, 250, toward others, 66, Belief in importance of :

67, 96, 98, no, 133, 209; dramatic appraising results, 136, 208
sense, 27, 34, 261, 280; generosity, autopsies, 136, 175

54, 79, 212, 221, 241, 246, 258; hos- consideration for patients, 71, 87, 91,

pitality, 178, 216; humor, 55, 62, 132, 186, 251 et seq., 262, 316; for

68, 143, 233, 263, 273-4, 277, 301; students, 180, 208, 211, 229, 243-6
impatience, 177, 219, with new detailed histories, 136, 150, 195, 207,
surroundings, 18, 39, 70, 73, 94, 2 4p 3*6" .

100, with people, 91-2, 175, with emphasis on practical m medical

regimentation, 185-6, 198; inde- education, 147 et seq., 208, 209,

pendence, 17, 109; optimism, 209; 2 45i dangers of specialization and

patience, 186, 201-2, 261; patri- **> S reat re on
otism, 19,; perseverance, 23, 27-
30, 135-6, 148 et seq, 189, 231,

252 etseq.; pride, 113, 162, 174, follo on ti 6

109; reformer, 49, 82 208; scien- heakh ^^

tific acumen 160, 278 284; self- w h standardSi ^ ;> 26o

confidence, 85 91; self-control, ^0^ backgrounds of medicine,

33, 55-6; self-disciphne, ^ 52, ^ ^ ^ 2 ^ ^

55-6, 62, 201, 223, 246, 293; senta- 323

ment, 38, 42-3, 64, 67, 213, loyalty laboratory experimentation, 147 et

to Yale, 38, 42-3, 82, 212, 292, 312; se ^ 207 , 209

stubbornness, 174, 278; taskmaster, meticulous work, 42, 133, 137, 185-6,

91, 136-7, 261; temper, 13, 14, 81, 207,316

265; thoroughness, 64, 132, 133, postgraduate study, 246; contacts

136-7, 158, 173, 186, 195, 205, 238, outside hospital, 229

INDEX

professional meetings, 142, 211; care Gushing, Mary Benedict (daughter
in arranging meetings, 156, 211-13 of HC), 202, 218, 224; birth, 154;

Gushing, Mrs. Harvey (Katharine letters to HC, 224-5
S. Crowell), 32, 37, 38-9, 43, 51-2, Gushing, Mary Platt, see Gushing,
53. 55i 5<5, 57* <*3, 80, 82-3, 84, 87, Mrs. Erastus
88, 93, 116, 119, 121, 122, 128, 142, Gushing, William E. (brother of
i55i 157* I<Sl l6 5 i?o, i?5 *77> HC), 7, 8, 12, 84, 121, 168
178, 198, 216, 217, 218, 224, 225, Gushing, Mrs. William E. (Carolyn
273, 297, 321; engagement, 83, an- Kellogg), 121
nounced, 116; marriage, 118-9; re- Gushing, William Harvey (son of
lationship with children, 216, 218; HC), 142, 202, 218 et seq.; birth,
trips abroad (1909), 163; (1922), 120; death, 223, 247; fellowship,
214; letters from HC, 55, 69, 73, 246; letters from HC, 220, 221,
83, 85, 91, 102, 103, 105, 107, 112, 222; letters to HC, 220, 221, 223
114, 116, 117, 121, 142, 161-3, 172, Gushing bookplate, 84
176, 202, 218, 219, 223, 226, 231, Cutler, E. C., 198, 200, 205, 231, 267,
233* 2 8i 282,287

Gushing, Henry Kirke (father of Cuder, Mrs. E. O, 231
HC), 5-8, 9, 10, 11, 12, 14, 23, 27,

28, 32, 42, 48, 67, 73, 87, 116, 128, Dakin, H. D., 200; letter to HC, 303
149, 169, 172, 175, 181, 218, 322; Dana, R. H., Jr., 179
education 5-7; marriage, 7; list of Dandy, W. E., 151, 210
children, 7; advises HC to study Darrach, William, 195-6
abroad, 93; stirs HC's interest in Dartmouth College, 316; Medical
books, 126; Laboratory of Re- School, 237
search, 160; illness and death, 168; DavidofT, L. M., 263
tribute of Rowfant Club, 168; Davy, Sir Humphry, 97
letters from HC, 24, 27, 28, 30-5, Day, G. P., 294
45-6, 64, 67, 96, 101, 104-6, 114, DeBury, Richard, 131
120, 124, 125, 127, 128, 139, 140, Decompression for brain tumors, 95
148, 149, 154-5, 157, 161, 163; let- DeCoppett, Gaston, 280
ters to HC, 25, 27, 29, 43, 52, 67, Delavan, Bryson, 36
81-2, 83, 90, 114, 120, 122, 126, Delta Kappa Epsilon Fraternity, 34
128, 148, 157; letters from KG, Penny, F- P- 55

119, 148, 160 j? bete V 73 I I74s l82

Gushing, Mrs. Henry Kirke (Bet- Irsay, Stephen, 274

sey Maria Williams), 6, 7, 8, 9, 2^' Ge rg % "?

li H, 67, 122, 6; early life, 9; g^T E zsf ^ *'

marriage, r illness ,20; death, g^&*k ^

121; letters from HC, 31-5, 47, 67, Dor L^ ^ y * "

68, 81, 84, 90; letters to HC, 22, DQ ^ N ^^

25-6, 30, 87, o Dowman, C. E., 209*7

Gushing, Henry Kirke (son of Dryden, John, 130; funeral card,

HC), 221, 223, 225, 226; birth, I30? I44

170; marriage, 308 Dublin University. Trinity College,
Gushing, Mrs. H. K. (Marjorie Es- 249 , 316

tabrook), 308 Dwight, Timothy (1752-1817), 19

Gushing, Henry P. (brother of Dwight, Timothy (1828-1916), 19,

HC), 7, 12; letter to HC, 168 36, 38

INDEX

Edinburgh. University, 249, 316
Edsall, D. L n 169
Eiselsberg, Anton von, 193
Eisenhardt, Louise, x, 193, 241, 278,

288, 295, 29672, 306, 317
Electrocautery, 247-8, 249
Elihu, 221
Eliot, C. W., 40, 179; letter to HC,

i ij
Elizabethan Club, Yale, 283, 298,

313,321

Elliot, J. W., 63, 64, 66, 68, 214
Elsberg, C. A., 135, 20972
Emerson, R. W., 179
Endocrinology, 160, 172
Ether charts, 49, 62
Evans, H. M., 151, 274, 319

Fabricius, H. ab Aquapendente,

109, 127

Farraday, Michael, centenary, 281
Ferrier, Sir David, 95, 241, 249
Ferguson, M. W., 254-5
Finney, J. M. T., 92, 100, 2290
Fishbein, Morris, 267; letter from

HC, 301
Fiske, John, 60
Fitz, R. H., 82
Fitz, Reginald, 265
Fitz, Mrs. Reginald, 304
Fletcher, Sir Walter M., 234, 268,

276

Flexner, Abraham, 153, 166
Flexner, Simon, 75, 89, 92, 156, 213,

241

Flint, J. M., 213, 220
Foerster, Otfrid, 22972, 276, 279, 280
Ford, W. C., 144
Fracastoro, Girolamo, 283
Francis, W. W., x, no, 115, 231,

232, 233, 235, 268, 296, 317, 318,

321

Francis I, 197
Franklin, A. W., 275
Franklin, Benjamin, HKCs collec-

tion of, 88

Frazier, C. H., 135, 20972
Fremont-Smith, Frank, 280
French, E. D., 84
Fritsch, G., 95

Fritsche, 159

Frohlich, Alfred, 137, 164

Frohlich's syndrome, 159

Fry, C. C., 314

Full-time plan, 180 et seq.

Fulton, J. F., x, 12672, 215, 232, 233,
25^ 262 2 7 2 2 74> 2 75, 279, 280,
281, 285, 286, 294, 297, 311, 313,
3 19, 320; literary executor of HC,
311; letters from HC, 272, 273,
276, 277, 278, 285, 290, 314, 321;
letters to HC, 273, 283, 284, 288

Fulton, Airs. J. F. (Lucia P. Wheat-
land), 232, 294; letter from HC,
274

Futcher, T. B., 114, 119, 120, 156,
315

Galen, 108, 296

Galvani, Luigi, 308

Gardner, Isabella Stewart, 176; Mu-

seum, 287

Garfield, Abram, 54, 62, 63
Garrett, Mrs. Robert, see Jacobs,

Mrs. H. B.

Garth, Sir Samuel, 130, 144, 239
Gask, G. E,, 22902, 315
Gasserian ganglion, 96, 138; contri-

buttons of Spiller and Frazier,

135; HC's first case of resection,

oo; report on nine cases, 118; on

first twenty, 142
Gates, F. T., 146
Gay, John, 239
Gehner, R. F., 316
General Education Board, 181, 182,

203
General Hospitals, No. n, 194; No.

13, 191

Gershwin, George, 255
Gerster, A. G., 135
Gesner, Conrad, 234
Gigantism, 159, 172
Gildersleeve, B. L., 74
Gilman, D. C., 74, 147, 234
Gilman, P. K., 150
Glasgow. University, 249, 316
Glenn, F. N., 282
Gliomas, 240-2
Godlee, Sir Rickman J., 95

INDEX

Goetsch, Emil, 151, 173, 174, 177
Goodhue, Josiah, 237
Goodwillie, Barney, 73
Goodwillie, Harriet, 32
Goodwillie, Mary C., 32, 43, 55, 63,

73,80

Goodwillie, Thomas, 73, 266
Goodwillie, Mrs. Thomas, 266
Gouraud, Gen., 215
Gowers, Sir William, 95, 96
Graham, E. A., 22972
Graves, W. P., 33
Gray, Mis. P. H., 241
Greenwood, Allen, 200
Gregg, Alan, 267
Grolier Club, 128
Gross, S. D., 12972, 214
Gross, S. W., 129
Gumpert, Martin, 309
Gunther, R. W. T., 315
Guy's Hospital, London, 96, no
Gwyn, N. B., 79, 89

Hadley, A. T., 141

Haight, G. S., 314

Haight, Mrs. G. S., 314

Hales, Stephen, 129

Haller, Albrecht von, 101, 107, 127

Hallerianum, 101

Halsted, W. S., 69, 73, 86-7, 80-1,
83, 85-6, 91, 97, 106, 112-14, 116,
117, 136, 152, 153, 158, 214; co-
caine addiction, 75, 86; operative
technique, 76, 8r; operates on
HC, 82; dinner party, 84; illness
and death, 228; HCs tribute, 228,
237; letters to HC, 82, 92, 118,

*73> 2'3

Halsted, Mrs. W. S., 84
Hanna, H. M., 148, 149, 160, 296
Hanna, M. A,, 148
Harding, W. G., 230
Harrington, F. B., 49
Harrison, Benjamin, 33
Harrison, R. G,, 213
Harrison, Reginald, 88
Hartley, Frank, 135
Hartmann, Henri, 98, 293
Harvard Cancer Commission, 161,

2 47

Harvard Law School, 12, 39, 41
Harvard Medical School, 39 et seq.,

117, 139, 169, 170, 184, 197, 208, 229,

286; Arthur Tracy Cabot Fellow

and Surgical Laboratory, 152,

201, 206, 208; Base Hospital No.

5, see U. S. Army; elective clin-

ics, 246; founding, 40; i5oth an-

niversary, 291; library, 180, 265;

Unit, 184, 187
Harvard Medical Society, 211-12,

229, 274
Harvard University, 25, 29, 30, 33,

179,208,279,308,316
Harvey, A. F. (cousin of HC), 15
Harvey, Mr. and Mrs. E. H., 70
Harvey, Mrs. H. A. (Mary Gush-

ing Williams, sister of BMC), 23
Harvey, Melanie, see Gushing, MTS.

E. F.
Harvey, P. W. (cousin of HC), 12,

15, 16, 18, 19, 22, 23, 24, 25, 33,

34, 44, 225, 236

Harvey, S. C., 20972, 213, 279, 307
Harvey, William, 109, 127, 234; De

motu cordiSy 12772, 143
Harvey Gushing Society, 296, 306,

311, 317-18; formation, 285
Harvey Lectures, 171, 289
Hawthorne, Nathaniel, 46, 179
Head, Sir Henry, 164, 276
Head, Lady, 276
Health insurance, 299-300
Hedin, Alma, 269
Hedin, Sven, 269
Heidenhaim, R..P. H., 75
Helmholtz, H. L. F. von, 199
Henderson, W. R., 315
Hendrickson, G. L., 283
Henry VHI, 197
Henry, Patrick, 129
Henry E. Huntington Library, San

Marino, Calif., 276
Herpes zoster, 138
Herrick, Frank, 27
Herrick, M. T, 186
Herter Lectures, 159
Heuer, G. J., 158, 20977, 214, 229
Hewes, H. F., 55
Hewetson, J M 234

340

INDEX

Higginson, H. L., 179, 192

Hill, Sir John, 3 17

Hill* Sir Leonard, 152

Hill, R. H., 232

Hippocrates, 76

Hiisch, O., 183*2

Hitler, Adolf, 316, 317

Hitzig, E., 95

Hodgkin, Thomas, 96

Hogan, Lucy H., 3, 4

Holmes, Gordon, 164

Holmes, O. W. (1808-94), 13, 4,

179, 214

Holmes, O. W. (1841-1935), 179
Holyoke, E. A., 238
Homans, John (1836-1903), 62, 66,

214
Homans, John (1877- ), 158, 159,

160, 161, 180, 205, 278, 307
Hoover, C. F., 22972
Hoover, H. C., 272, 288
Hopkins, H. L., 29972
Hopkins, Johns, 74
Hoppe-Seyler, Felix, 75
Hopper, DeWolf, 73
Hoppin, G. B., 3772
Horrax, Gilbert, x, 201, 205-6, 20972,

210, 217, 248, 278, 290, 307
Horsley, Victor, 63, 93, 94-6, 134,

143, 159, 171, 173, 194, 234, 241;

first brain operation, 95; founder

of brain surgery, 135; letters to

HC, 152, 158

Hortega, Pio del Rio, 240
Howard, C. P., 234
Howard, H. B., 182
Howe, Al A. DeW., 179, 266
Hughes, C. E., 230
Hunter, John, 40, 97, 127, 129, 149,

164, 199

Hunter, Jordan, 64
Hunter, William, in, 127, 149
Hunterian Laboratory, 146 et seq.,

r 54> J 55 *58, 173; fellowship, 246
Hunterian Museum, Glasgow, in
Hunterian Museum, London, 96,

164
Hurd, H. M., 112, 113; letter to

HC, 152

Hutchinson, Sir Jonathan, 96, 97,

2 34

Hyperpituitarism, see Hypophysial
disorders

Hypophysis, 161, 172, 174, 182, 241,
289; disorders of, 137, 159-60, 172,
182, 214, 249, 262; hyperpituitar-
ism, 172; hypopituitarism, 172;
function, 159; HC's monograph
on, 171-3

Hypopituitarism, see Hypophysial
disorders

Hypothalamus, 274; excitability,
275; relation to visceral func-
tion, 278, 286

Infantilism, sexual, 172

Ingraham, F. D., 280

International Medical Congress,
i3th (Paris 1900), 98, 142; i6th
(Budapest 1909), 164-5; I 7 t h
(London 1913), 183

International Neurological Con-
gress, ist (Berne 1931), 279-80

International Ophthalmological
Congress, 270

International Physiological Con-
gress, i3th (Boston 1929), 268;
i4th (Rome 1932), 286

Intestinal perforation, laparotomy
for, 88, 89, 115

Intracranial hemorrhage, in new-
born, 140; with birth marks, 155

Intracranial tumors, 193, 240-2

Jackson, Chevalier, 22972
Jackson, J. H., 104
Jackson, J. Hughlings, 95
Jackson, James (1777-1867), 40, 44
Jackson, James (1819-87), 40
Jacobs, H. B., 92, 96, 114, 118, 119,

H5

Jacobs, Mrs. H. B., 119
Jacobson, Conrad, 151, 174, 177,

205

James, Henry, 179
James, William, 179
Jefferson, Geoffrey, 193, 210, 245,

249, 275, 280, 311, 315, 317
Jefferson, Mrs. Geoffrey, 249, 311

INDEX

341

Jefferson Medical College, Philadel-
phia, 95, 115, 141, 242, 316

Jenner, Edward, 237

Joffre, J. J. C., 196

Joffre, Mme., 196

Johns Hopkins Hospital, 45, 70 et
seq., 94, 208, 211, 213, 254; found-
ing, 74; HCs first visit to, 69

Johns Hopkins University, 74, 118,
1 60; Medical School, 77 et seq.,
1 80, 230; entrance requirements,
77; opening, 77; system of resi-
dencies, 77, 179

Johns Hopkins Historical Club, 86,
123, 144, 156, 270

Johns Hopkins Hospital Bulletin,
86, 107

Johns Hopkins Medical Society, 86

Johnson, J. B., 234

Joslin, E. P., 42, 52, 55, 57, 60, 174,

Kanavel, A. B., 20972

Keen, W. W., 95, 97, 115, 135, 141,

192, 228; System of Surgery, 155,

157-8; letter to HC, 157
Keith, Sir Arthur, 164, 276
Keller, A. D., 285
Keller, Deane, 314
Kellogg, W. R, 148
Kelly, H. A., 77, 83, 86, 125, 140;

letter from HC, 267
Kendall, L. G., 282
Keogh, Andrew, 298, 313
Keynes, Geoffrey, 276, 287
Kilgour, F. G., x
Kitchel, C. L., 31
Kit-Kat Club, 129, 130
Klebs, A. C., 269, 271, 274, 275, 276,

279, 281, 286, 293, 207, 310, 316,

318; letters from HC, 280, 305,

311, 315, 317, 320; letters to HC,

310, 318, 320
Klebs, Edwin, 159, 281
Knollenberg, Bernhard, 313-14, 320
Koch, Robert, 75
Koch Institute, Berlin, 146
Kocher, Albert, 100, 189
Kocher, Theodor, 93, 99, 100, 104,

106, 109, 1 10, in, 164, 175, 281

Krause, Fedor, 193

Kraus, E. J., 284

Kronecker, Frau, 101

Kronecker, Hugo, 75, 101, 104, 106,

107, 109, 164, 175, 208, 277, 281
Kronecker, Lotte, 101
Kiittner, Herman, 193

Ladd,G.T., 19, 35, 36

Lakeside Hospital, Cleveland, 53,

22972

Latchkeyers, 114, 115
Leake,' C. D., 211-12
LeBourgeois, Elizabeth, 38
Leeds. University, 316
Legion d'Honneur, Chevalier

awarded HC, 215; Officier, 265,

316

Leidy, J., 234
Lelli, Ercole, 109
Leriche, Rene, 22972
Lewis, D. D., 22972, 242
Lewis, F. T., 319
Lewis, Sinclair, 311
Lewis, W. S., 273, 320
Lie, Jonas, 268
Lie, Sonja, 268
Liebel, G. H., 248; Liebel Flarsheim

Company, 248

Light, R. U., x, 278, 280, 281, 305
Linacre, Thomas, 234
Lincoln, Abraham, 192, 249
Lindau, Arvid, 269
Lindau's disease, 269
Lindbergh, C. A., 132
Lippincott, J. B., 172
Lister, Joseph, ist Baron, 44, 95, 98,

199, 229, 241; centenary, 249
Lister Medal, 275
Lister Memorial Lecture, 274, 275
Liston, Robert, 40
Livingood, L. E., 89
Livingston, W. K., 263
Livingstone, Sir Robert, 315
Locke, John, 154, 234
Lohmann, C. A M 295
London, Hospital for the Paralysed

and Epileptic, Queen Square, 95,

134
Long, C. N. H., 275

INDEX

Longfellow, H. W., 179

Louis, P.-C.-A,, 40, 234

Lowell, A. L., 169, 179, 182, 215, 282

Lowell, J. R,, 179

Ludwig, Carl, 75, 277

Ludwig, F. G., xi, 296

Lusitania, sinking of, 191

Lusk, Graham, 197

Lycee Pasteur, 186

MacCallum, J. B., 234

MacCallum, W. G., 97, 143, 149,
155, 164; letters to HC, 125, 177

McCrae, John, 196, 234

McCrae, Thomas, 87, 91, 92, 94,
106, 143, 144, 196, 242, 306

Macewen, Sir William, 135, 165,
241, 249; first diagnosis of brain
tumor, 95

Mackail, J. W., 302

McGill University, 232; Neurolog-
ical Institute, 296; Osier Library,
268

McKnight, Dodge, 51

McLaughlin, E. T., 31

McLean Hospital, see Massachu-
setts General Hospital

McPherson, Aimee, 300

Mahoney, C. G, deGutierrez, 282

Malloch, Archibald, 232

Maloney, John, 63

Marie, Pierre, 159, 214

Martel, Thierry de, 195, 265, 279,
280, 315

Martin, N. S., 74

Martin, Paul, 214, 265, 280, 315

Maryland. University, 117, n 8, 140;
Book and Journal Club, 125

Maryland Club, 87, 170, 278-9

Masefield, John, 234

Maskenoza Island, 15-17

Massachusetts General Hospital, 3,
4, 44, 48, 57, 61, 62, 64, 67, 73, 79,
80, 82, 96, 170, 1 80; Convalescent
Home, Waverly, 63, 64; ether
charts, 49, 62; founding, 44; HC's
fondness for, 61, 67; HC's intern-
ship, 66-9; psychiatric division
(McLean Hospital), 64; 75th an-
niversary of use of ether, 213

Massachusetts Institute of Technol-
ogy, 39 45, 47, 54, 62

Massachusetts Medical Society, 182

Matas, Rudolph, 22972

Maximilian II, 317

Mayo, C. H., 139, 156, 236; death,
320

Mayo, W. J., 98, 142, 229, 236;
death, 320; letters to HC, 139, 299

Meagher, R. H., 277, 280, 281, 282

Medical and Chirurgical Faculty of
Maryland, 118

Medical Research Committee, meet-
ings in Paris, 200, 201

Medical Society of London, 249

Medulloblastomas, 231, 240, 252,

255, 269

Meissonier, J. L. E., 51
Meningiomas, 64, 167, 215, 240, 254,

256 et seq., 266; monograph on,

256, 259, 289, 295, 310, 314, 316
Metabolism, 173, 174
Michaud, Jeanne, 105, 164
Michaud, Louis, 164

Miles, W. R., 306

Millet, J. F., 51

Mills, C. K., 135

Milton, John, 126

Mitchell, J. F., 91

Mitchell, J. K., 135

Mitchell, Mrs. Lawrence, 294

Mitchell, S. Weir, 119, 135, 234, 314

Mix, C. L., 42

Mixter, W. J., 20972, 211

Monakow, C. von, 175

Montagu, Lady Mary WortJey,
128

Montreal Medico-Chirurgical Soci-
ety, 142

Moore, E. H., 20, 31

Morelle, Jean, 275, 280, 315

Morgan, J. P., 163

Morgan, John, 128

Morgenthau, Henry, Jr., 299

Morris, G. S., 74

Morton, W. T. G., 44

Mosso, Angelo, 107, in

Motley, J. L., 41, 179

Moynihan, Berkeley, Baron, 275

Muirhead, A. M., 317

INDEX

Mundinus, 125
Munro, J. C., 151
Mussolini, Benvenuto, 286
Mutter, Lecture, 115

Naffziger, H. C., 209/7

Nager, F. R., 270

National Academy of Sciences, 192,
305, 306, 310

National Institute of Neurology,
203, 205, 296

National Institute of Social Sci-
ences, 306

National Research Council, 192

Nettleton, Mary, see Haight, Mrs.
G. S.

Neurological Institute, Montreal,
296

Neurological surgery, beginnings,
95-6; experimental work, 95, in,
134; in World War I, 158, 186,
195; HC's first interest, 63; HC's
reports on field of, 141, 166; final
report, 279; treatise on Surgery
of the Head, 157-8; others in
field, 134-5; technical advances,
134, 138, 195, 210; techniques in,
166, 195, 247

New England Surgical Association,
248

New York Academy of Medicine,
28777

New York Hospital, 6, 36, 154

New York Neurological Society,
284

Newton, Isaac, 129

Noyes, W. S. G., 47

Nystrom, Gunnar, 22972

Ochsner, A. J., 98, 142

Oldberg, Eric, 133

Olivecrona, Herbert, 280

Oljenick, Ignaz, 269, 275, 281, 315

Ophthalmological studies, 174

Ortschild, J. F., 151

Osier, E. Revere, 195, 234, 266;

death, 196, 204; library, 242
Osier, Lady, 114-15, 118, 129, 155,

191, 204, 205, 215, 232; death, 266;

letter to KG, 196

343

Osier, Sir William, 69, 76-7, 83, 86,
89, 92, 96, 97, 106, 108, 1 10-12
114, 115, 119, 125, 129, 154, 156,
170, 171, 183, 190, 191, 194, 196,
215, 260, 262, 266, 321; stirs HC's
interest in books, 84, 123-4, 126, in
writing, 106-7, ^o; takes HC
abroad, 143-4; accepts Regius
professorship at Oxford, 144;
valedictory address at Hopkins,
145; Silliman Lectures (Yale),
182; ceremony at PBBH, 182;
death of son, 196; death, 204;
HC's tribute, 204-5; biography,
205, 215, 219, 225, 229, 231 et seq.;
library catalogue, 232; library
dedication, 268; letters to HC,
133, 173; Principles and Practice
of Medicine, 45, 77, 146, 156

Osier Club, London, 268, 275, 317

Oughterson, A. W., 307

Oxford University, 60, 142, 144,
183; confers degree on HC, 315,
316

Page, Mrs. Calvin G., 290
Paget, Sir James, 214
Painter, C. F., 42, 43, 46, 51, 55, 68
Paradise, Mr. and Mrs. Burton, 314
Pare, Ambroise, 84, 283
Paris. University, 292, 316
Parkinson, James, 96
Parsons, Richard, 12
Pasteur, Louis, 146, 229, 241
Pasteur Institute, Paris, 146
Pathology, first chair in, 75
Pattison, A. R. D., 315
Pavlov, I. P., 269, 279, 286, 297
Payne, J. F., 234
Payne, O. H., 160
Peck, Tracy, 31
Penfield, W. G., 280, 296
Pennsylvania. University. Medical
department, 6, 76, 77, i28, 180
PercivaTs Code of Ethics, 212
Perkins, Frances, 299
Perkins, Henrietta T., x
Perry, Bliss, 179
Pershing, Gen. J. J., 199, 204

344

Peter Bent Brigham Hospital, 170,
174, 177 et seq., 262; Board of
Trustees, 174, 182; founding of,
170; Harvey Gushing Fellowship
Fund, 246; HC retires from, 286;
Osier gives blessing, 182; world
center of neurological surgery,
184

Petit-Dutaillis, Daniel, 280

Phelps, W. L., 295

Philadelphia Neurological Society,
141

Pilcher, L. S., 125

Pituitary gland, see Hypophysis

Pleadwell, Capt. Frank, 321

Poland. Lwow University, 316

Porter, C. A., 69, 162

Porter, C. B., 48, 49, 50, 66

Potter, N. B^ 55

Power, Sir D'Arcy, 22977, 275, 315

Price, Lucien, 9, 238, 309

Putnam, C. R. L., 55

Putnam, T. J., 253, 280, 285

Putti, Vittorio, 22972, 270, 317

Quinby, W. C., 20572

Raab, William, 284

Ramon y Cajal, S., 240, 297

Rand, C. S., 261-2

Ray, B. S., 282

Raynaud, Maurice, 2737*

Raynaud's disease, 4, 273, 294

Recklinghausen, F. D. von, 75

Reed, Walter, 75, 89

Reford, L. D., 151

Reid, Edith G. (Mrs. H. F.), vii,
266

Rembrandt van Rijn, 164

Remsen, Ira, 74

Rennie, T. A. C., 264

Reunion Neurologique Internation-
ale, Annuelle, 3me (Paris 1922),
214

Reverdin, Auguste, 99

Revere, Paul, 196

Reynolds, H. J., xi

Reynolds, J. P., 174

Rhodes, J. F., 178, 179, 184, 237

INDEX

Richardson, M. H., 46, 68, 97, 117,

158, 170

Riddoch, George, 315
Riva-Rocci, Scipione, pneumatic

cuff, 109, 138
Rixford, Emmet, 229^
Robb, Hunter, 69
Robbia, Luca della, ro8
Rochester. University, 279, 316
Rockefeller, J. D., 146
Rockefeller Foundation, 146, 153,

156, 181, 203
Rockefeller Institute for Medical

Research, 75, 146
Rolleston, Sir Humphry D., 97
Rollins, C. P., 311
Rontgen, W. C., 68
Roosevelt, F. D., 268, 288, 295, 299,

300, 308; letters from HC, 300,

301, 307; letters to HC, 302, 307
Roosevelt, Mrs. F. D., 268
Roosevelt, F. D., Jr., 268, 307
Roosevelt, James, 268, 274, 307
Roosevelt, Mrs. James (Betsey

Gushing), 157, 162, 226, 248, 273,

307; birth, 156; engagement, 268;

marriage, 274; letter to HC, 226
Roosevelt, John, 268
Roosevelt Hospital, 51
Ross, J. P., 262,315
Roux, Cesar, 99, 100
Roux, Emile, 293
Rowfant Club, 9972, 128, 168, 329
Rowland, H. A., 74
Royal Academy of Medicine of

Ireland, 249
Royal College of Physicians, 244,

319

Royal College of Surgeons (Edin-
burgh), 171

Royal College of Surgeons (Lon-
don), 183, 275; centenary celebra-
tion, 97

Royal College of Surgeons in Ire-
land, 199

Royal Library, Stockholm, 269

Royal Society, 290

Royal Society of Medicine (Edin-
burgh), 320

INDEX

345

Royal Society of Medicine (Lon-
don), 249

Rubber gloves, introduction of, 76
Rush Medical College, 158
Russell, Dorothy M., 256-9

Sabin, Florence, 162

Sachs, Bernard, 135

Sachs, Ernest, x, 134, 158, 21072, 211

Sage, Henry, 39-40, 41, 42, 45

St. Bartholomew's Hospital, Lon-
don, 96, 229; HC made Perpetual
Student, 214

St. Hildegarde, 197

St. Thomas's Hospital, London, 96,
229

Sargent, C. S., 219

Sargent, J. S., 77

Saturday Club, 178, 179, 192, 207,
266

Saunders, Lawrence, 315

Schafer, E. A., see Sharpey, Schae-
fer, Sir Edward A.

Schaltenbrand, Georges, 279, 280,

3i5

Schedel, Hartmann, 270
Schneekloth, Gustave, 178, 207, 219
Schreiber, Frederic, 280, 31872
Schuman, Henry, xi, 12671
Schwab, S. I., 201
Scroll and Key, 27, 34, 37, 38
Scudder, C. L., 42, 45, 46
Sears, H. F., 47
Sharpey-Schaefer, Sir Edward A.,

I34 , 159, 241
Shattuck, F. C., 50, 180
Shepley, Julia H., x, 195, 202, 205,

231, 233

Sherman, S. P., 235
Sherrington, Air. and Mrs. Carr,

232
Sherrington, Sir Charles S., iio-n,

134, 215, 232, 265-, 275, 279, 280,

281, 287, 297

Shock, avoidance of, 118
Shryock, R. H., 28271
Sibelius, Jean, 309, 321
Sigerist, H. E., 281, 282, 293
Silliman, Benjamin, 19-20, 32
Silliman Lectures, 182

Silver clips, 170

Sinclair, Upton, 300

Singer, Charles, 197

Sjoqvist, Olof, 318

Skull and Bones, 27, 34, 222

Smith, F. Hopkinson, 51

Smith, G. H., 31872

Smith, G. M., 311

Smith, Nathan, 224, 237

Smith, Theobald, 89

Societ^ d'Endocrinologie, Paris, 320

Societe Suisse de Neurologic, 320

Society of British Neurological
Surgeons, 249

Society of Clinical Surgery, 98, 155,
171, 175; formation, 142

Society of Neurological Surgeons,
21 1 ; formation, 209-10

Solley, J. B., 104

Sosman, M. G, 231

Spanish-American War, 86, 88

Spiller, W. G., 90, 135

Spinal cord tumor, Horsley's first
operation, 95; HCs, 139

Splenectomy, 89

Spurling, R. G., 285

Stagg, A. A., 25

Stanton, Madeline E., x, 205, 248

Starr, C. L., 22972

Starr, M. Allen, 135

Sterling Grammar School, Cleve-
land, 13

Stevenson, R. L., 69

Stevenson, R. Scott, 287-8

Stewart, George, 323

Stiles, Sir Harold J., 229

Stille, Alfred, 234

Stimson, Henry, 36

Stirling-Maxwell, Sir John M., 163

Stokes, Anson, 295

Stone, A. K., 50

Storer, Malcolm, 213

Strasbourg. University, 316

Strathcona, ist Baron (Donald A.
Smith), 183

Streeter, E. C., 213, 311

Strong, R. P., 201, 304

Strong, W. T., 31

SudhofF, K. F. J., 274

Sydenham, Thomas, 76, 234

346 INDEX

Sylvester, J. J., 74 i*5, 318, 321; Tabulae sex, 163;

Syme, James, 40 wood blocks for Fabrica, 287

Symonds, C. P., 206 Viets, H. R., 286, 287, 319
Syracuse. University, 316; College Vincent, Clovis, 265, 315

of Medicine centenary, 295 Vinson, R. E., 282

Virchow, Rudolf, 98

Taneyhill, G. L., Jr., 148 Virginia. University, 154

Tarbell, E. C., 157, 162 Visual fields, alterations in, 166, 171;
Tavern Club, 178, 192 in brain tumors, 174, 182, 266, 270

Taylor, A. W., 21072 Vivisection Commission (England),
Taylor, EiEe J., 91 152

Teel, H. ML, 285

Thackeray, W. M., 58, 90 Wagner, Richard, 309

Thayer, W. S., 201, 205, 268 Wagner, W., 134

Thomas, C. C, 315, 316 Waldeyer, Wilhelm, 75

Thomas, H. M., 113 Walker, C. B., 174, 182

Thompson, K. W., 29572 Wallace, Sir Cuthbert, 198, 22972,
Thorns, Herbert, 283 315

Tic douloureux, 90; see also Tri- Wallace, Henry, 22972, 301

geminal neuralgia Waller, Erik, 269

Tinker, C. B., 311 Walpole, Horace, 183

Titian, 124, 165 Warren, J. C. (1778-1856), 40, 44

Townsend, J. B., rn Warren, J. Collins (1842-1927), 40,
Trigeminal neuralgia, 90, 135, 138, 44, 97, 117; letter to HC, 173

205; ganglionectomy, 90, 118, 161 Warren, John (1753-1815), 40

TroUope, Anthony, 145 Warren, Jonathan M. (1811-1867),
Trudeau, E. L., 234 40

Tudor and Stuart Club, 242 Warren, Joseph, 40

Turner, G. G., 22972 Washington University, St. Louis,
Typhoid fever, 57, 89; intestinal 316; Medical School, 167, 169

perforation, 88 Watzka, Adolph, 318

Wednesday Evening Club, 178

Union Boat Club, 52 Weed, L. H., x, 151, 174, 176, 177,
Union College, 5 178, 214, 217, 230, 241, 242; letter

U. S. Army. Base Hospital No. 5, to KC, 246

194, 196, 205; Surgeon General's Weeks, E. A., 185, 303; letters from

Library, 302, 308 HC, 304, 305, 309; letters to HC,

University College Hospital, Lon- 304

don, 94; Medical Society, 292 Weir Mitchell Lecture, 184

Welch, W. H., 35, 74-5. 77, 86, 89,

Valverde, Juan, 187 91, 93, 112, 156, 160, 170, 181, 213,

Van Wagenen, W. P., 257, 285, 296 232, 237, 243, 272, 276, 279, 280,
Vedder, Elihu, 70 281, 282, 299; library, 242, 270;

Ventriculography, 210-11 illness, 289; death, 295; HC's trib-

Vermeer, Jan, 176, 287, 319 ute, 295; letters to HC, 154, 184

Vesalius, Andreas, 108, 123-6, 165, Welch Lecture, 279

187, 321, 324; beginning of HC's Wellesley College, 52

collection, 125; De humani cor- West, Olin, 300

ports -fabrica, 123, 124, 125, 163, West London Medico-Chirurgical

287, 324; HC's biobibliography, Society, 215

INDEX

341

Western Reserve of Connecticut,
i-io, 238, 321

Western Reserve University, 7, 12,
160, 171, 186, 203, 238, 316; HC of-
fered post, 90, 171, 230, 282; Henry
K. Gushing Laboratory of Re-
search, 1 60

Wheeler, A. M., 35

White, F. W., 42, 43

White, J. C., 306

Whitman, Walt, 185

Whytt, Robert, 128

Wiegand, Willy, 28772

Wilkie, D. P. D., 22972

Williams College, 19; Medical De-
partment, see Berkshire Medical
School, Pittsfield

Williams, Betsey Maria, see, Gush-
ing, Mrs. Henry Kirke

Williams, E. P. (uncle of HC), 58

Williams, Mrs. E. P., 58, 63

Williams, Edward (cousin of HC),

15, 38

Williams, Edward, 60
Williams, Ray, 32, 63
Williams, Reba, see Baldwin, Mrs.

A. D.

Williams, William, 6, 9
Wilson, Woodrow, 192
Wing, Mr. and Mrs. D. G., 314
Winters-night Club, 178
Winternitz, M.C., 213, 272, 274, 298
Wisconsin State Medical Society,

118, 138

Witte, E. E., 299, 301
Wolfs Head, 221, 222
Wood, Gen. Leonard, 160, 162, 167,

192, 196, 230, 249, 250, 254
Woodruif, L. L., 317
Wright, Sir Almroth E., 315
Wright, William, 287
Wiirzburg, University, 68

X-rays, discovery of, 68; use at the
Hopkins, 79, 82

Yale Journal oi Biology md Medi-
cine, 31822
Yale Medical Alumni Association,

M5

Yale Medical Society, 293
Yale University, 13, 18 et seq^ 42,

82, 155, 182, 183, 203, 219, 221, 222,

292, 316, 322; School of Nursing,
91; Sheffield Scientific School, 20,
36, 37, 221, 222; Trurnbull Col-
lege, 298

Yale University. Library, 37, 292,
298, 310, 313-14

Yale University School of Medi-
cine, 141, 212-13, 220, 237, 272,
292 et seq.; dedication of Sterling
Hall of Medicine, 243; Historical
Library, 195, 323-4, plans for, 297,
320, authorized, 320

Yerkes, R. M., 158

Young, Tom, 24, 33