AANS Neurosurgeon : Timeline

Volume 20, Number 1, 2011

Why Study Neurosurgical History?

Because It's There and Other Reasons

Michael Schulder, MD

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Napoleon corbis rm Napoleon crowned by Victory in a detail from “The Apotheosis of Napoleon I, or The Triumph of 1810” by Jean-Pierre Cortot. © Craig Aurness/Corbis

Why study the history of any particular subject? A simple answer is because someone wants to. Once a place, nation, idea or discipline has existed long enough and has had some measurable impact on the world, historians get to work.

Study of the history of medicine, and of neurosurgery in particular, is worthwhile on several counts. Such study can broaden perspectives on how to manage technological and socioeconomic change, according to AANS Historian Samuel Greenblatt. Potentially, it may have a “humanizing” effect: A greater understanding of how illness was treated in the past can inspire medical students and doctors to become more sensitive to patients’ needs. In addition, a dose of humility gained from knowledge of our predecessors’ struggles can be a stabilizing influence on the physicians of today and tomorrow.

Before neurosurgery was recognized as a specialty, one relevant procedure was studied extensively. Beginning with Paul Broca, the French surgeon who associated aphasia with injury to the inferolateral frontal lobe, several authors in the 19th century explored the significance of prehistoric skull trephination. These writers prepared the ground for later historical reviews of neurosurgery. These were written in the 1950s by neurosurgeons Earl Walker and Gilbert Horrax, among others, half a century after the inception of modern neurosurgery. As in many historical works written then, these histories tended to catalog rather than analyze landmark developments and the individuals who achieved them.

These earlier efforts have proven invaluable. That there now exists a body of neurosurgical history upon which we can draw suggests another benefit of such study: It preserves for posterity the voices of neurosurgeons along with their deeds. In 1896 Roswell Park, a pioneer of intracranial surgery, noted:

What a disgrace it is that, while to the great murderers of mankind, men like Napoleon in modern times and his counterparts in all times, the world ever does honor…and writes volumes of encomiums and flattering histories, the men to whom the world is so vastly more indebted for all that pertains to life and comfort are scarcely ever mentioned save in medical history, while the world at large is even ignorant of their names.

Future medical historians will analyze the development and impact of such advances as spinal instrumentation, stereotactic radiosurgery and endovascular neurosurgery. They will view these improvements as neurosurgical contributions to the extent that we take a part in writing our own history.

Neurosurgery is a young field, barely a century old. The specialty is a small part of medicine as a whole, smaller still of civilization. Big changes are happening in neurosurgery as in medicine, and the only guarantee is that things will look very different in the future. To know where we are going as a specialty, we have to know where we have been. How better to know ourselves than through the words of neurosurgeons engaging in analysis of the specialty’s past, and of the present as it passes into history?

Michael Schulder, MD, FAANS, is editor of the AANS Neurosurgeon. He is vice chair and professor of neurosurgery at the Hofstra University School of Medicine in partnership with North Shore LIJ, Manhassett, N.Y. The author reported no conflicts for disclosure.