The brain cutter

Christopher Gardener

Harvey Cushing was a passionate collector, mostly of books; the 7,000 rare medical volumes he bequeathed to Yale became the core of its medical historical library. The Cushing Center displays other curiosities from his collections, including several skeletons and skulls of animals. View full image

Then one night in 1991, a group of medical students went drinking at Mory’s, and someone passed along a story about a roomful of brains in the basement of their dormitory. Later that night, says Christopher Wahl ’96MD, now an orthopedic surgeon, they went to investigate, spiritually fortified and still in their jackets and ties. Getting there meant clambering over ductwork, past barrels of food supplies for a former Cold War bomb shelter, and picking a lock with a paper clip. Then, in a room illuminated by bare lightbulbs, they found themselves amid shelf after metal shelf of brains and tumors in carefully labeled jars. Against a wall were rickety stacks of glass photographic images that struck Wahl, then a first-year med student, as “super-creepy”—patients with their hands splayed out across their chests in an almost cult-like pose, children stripped bare to reveal horrific deformities, people with heads blown out by the sort of tumors rarely seen in the modern medical era.

A few months later, Wahl took a course in medical history and another lightbulb came on, in his head. “I went to Dennis Spencer, then section chief of neurosurgery, and said, ‘You know, Harvey Cushing’s brains are in the sub-basement of the dormitory,’ and he almost choked.” Spencer says choking was a natural response to the notion of inebriated, lock-picking students visiting the storage room late at night. But he offered Wahl a yearlong fellowship to sort through the collection, and Wahl soon found himself moving from riveting photographs to records of the patients in the photographs to the specimens taken from their bodies. “It seemed so poignant,” he says now. “Sometimes you need to have the patina of something being left and forgotten for a long time for it to be meaningful. You realize how much things have changed and how incredibly brave these patients were, and how much of an innovator Harvey Cushing was. He must have had a phenomenal ego to continue operating in the face of what was, when he began, almost always fatal surgery.”

Soon after, Yale began a campaign to draw attention to the medical school’s neurosurgical accomplishments. But an outside publicist fixated instead on brains in the basement, and the story ended up as a student caper on the front page of the Wall Street Journal (“Many Special Minds Are Found at Yale”). The university development office predictably flipped out, according to Wahl, demanding that he play up the academic research and hold the caper. They worried, he says, that the publicity would offend the Cushing and Whitney families (joined by the marriage of one of Harvey and Kate Cushing’s daughters) and imperil the endowment supporting the medical school library, which had only recently become known as the Harvey Cushing/John Hay Whitney Medical Library.

For Spencer and Wahl, the larger worry was that someone would declare the Tumor Registry and its precariously stored jars of human tissue in formaldehyde a health hazard, to be destroyed. Late-night visits to the brain room meanwhile became a student ritual, with visitors now leaving their signatures on a “Brain Society” whiteboard: “José ‘Hole in the Head’ Prince,” “Vivian ‘full frontal lobe’ Nereim,” “Josh Klein-oid Process,” and the unforgettable “Hana ‘I don’t even fucking go here’ Capruso.” The last may have been a reminder that the medical school couldn’t count indefinitely on the good will of its students to keep the collection intact.

Spencer, now the Harvey and Kate Cushing Professor of Neurosurgery and chair of the Department of Neurosurgery, is a genial, white-bearded figure with a passion for Harley-Davidson motorcycles. He does not fit the “high priest” mold. When he’s not in biker leathers, he wears silk suspenders, and a silver seahorse brooch on the pocket of his shirt. (The brooch, he says, belonged to his late wife and colleague, Yale neurologist Susan Spencer; its tail resembles the structure of the hippocampus, the focus of his work treating severe epileptic and other seizures.) During 2003–04, still fretting about the Tumor Registry, Spencer served as interim dean of the medical school.

“Institutions have things buried all over the place,” he says, and one of the forgotten treasures he unearthed during his term was an endowment left by the grateful family of a Cushing patient, to protect his legacy. It had grown over 70 years, enough to put the medical school’s staff photographer, Terry Dagradi, to work scanning and cataloguing and thinking about the glass photographic slides. In the days before CAT scans and MRIs, Cushing had used photographs as diagnostic tools, because certain disorders of the brain reveal their location by symptoms that show up in the face or in the cartilage of the hands and feet. But Dagradi was taken with the small human gestures that had slipped into what were meant purely as clinical photographs—the way one man holds a hand to the side of his face, bends his head to the opposite side, and winces, as if from an unbearable toothache; or the way an older woman holds her hand up in front of her, showing her palm, as if to say, “Don’t touch me.” “A lot of it was accidental,” says Dagradi, now curator of the Cushing Center. Whoever took the pictures “wasn’t trying to create an artistic image. But it’s such a lovely time capsule.”

The rediscovered endowment was also almost large enough, with additional help from the Cushing and Whitney families, to make a proper home for Cushing’s legacy. The medical school eventually settled on an odd pie-slice of basement beneath the library and chose an idiosyncratic architect, Turner Brooks ’65, ’70MArch, an adjunct professor at the Yale School of Architecture, to bring it to life. “We all felt that going underground worked quite well,” says Dagradi. “It doesn’t really need light, and there’s a mystery that Turner kept alive in this place that you felt when you were in the other place,” beneath the dormitory.

The effect is a bit like a grotto, with the ramp sweeping you down and releasing you into what Brooks calls “the pools and back eddies” of the main floor, where undulating cabinet fronts hold drawers full of specimens—an old Chinese surgical kit, a box containing the skulls of human fetuses. Glass cases on top display some of Cushing’s books—a first edition of Copernicus open to his model of the heliocentric universe, and another of Darwin’s Expression of the Emotions in Man and Animals.

“It’s not like putting on headphones and getting a guided tour,” says Brooks, “but you get pulled along by the current and make discoveries along the way. Gaston Bachelard in The Poetics of Space had this image about opening an armoire, and it keeps opening. You find drawers within drawers, and you hear a symphony playing somewhere inside.” And all around the room, in a curving line, the brains look down.

Each jar had to be emptied, cleaned, refilled with new preservative, and sealed, says Dagradi, “and when we first started cleaning, it was like, ‘Oh no, it’s too clear. It’s not going to have that beautiful honey color.’” But the specimens soon leached out into the new preservative and the jars took on their own individual glow. In places, they are like stained glass, particularly a glass wall of specimens that screens off a seminar room at the far end of the space. There, says Brooks, telemedicine will give future students a window on brain surgery around the world. But they’ll also look back, from time to time, through the wall of specimens, and thus through the history of brain surgery as pioneered by Harvey Cushing.

This past June, members of the Society of Neurological Surgeons, which Cushing founded, came to New Haven from around the world for their annual meeting, and held a reception in the new Cushing Center. Brooks came, too, and brought his five-year-old daughter, who looked up in wonder at the long line of brains lit up around the room. “She said, ‘Are they still thinking?’ and the comment reverberated around the room,” Brooks recalls. “And in my imagination, all the brains began to fizzle.”