Bulletin of the history of medicine
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Biography Historical Article
Harvey Cushing's paradigmatic contribution to neurosurgery and the evolution of his thoughts about specialization.
The modern era of neurosurgery began in 1879 with the amalgamation of three technologies: anesthesia, antisepsis/asepsis, and cerebral localization. However, when Harvey Cushing (1869-1939) took his first tentative steps toward a neurosurgical career in 1901, the outlook for the field was dismal, because mortality and morbidity rates were horrific. For brain tumors, surgical mortality rates were 30-50%. ⋯ His mortality rate for tumors was 10-15%. Nonetheless, the successful paradigm was not fully instantiated until a community of practitioners formed a neurosurgical society in 1920. As this process unfolded, Cushing's ideas about specialization also evolved in interesting ways.