Harvey Cushing’s Legacy Rests at the Intersection of Art and Science

How did a mysterious collection of 450 human brains, along with rare books, memorabilia and photographs, find its final home in the sub-basement of the Harvey Cushing/John Hay Whitney Medical Library (CWML) at Yale School of Medicine (YSM)?

The brains are from deceased patients of Dr. Harvey Cushing, who was a Yale College graduate and YSM Sterling Professor of Medicine in Neurology, as well as one of the namesakes of the YSM library. Cushing performed more than 2,200 neurological operations over 30 years and is regarded as the father of modern neurosurgery.

“This groundbreaking physician saved lives even though he was working with the most basic tools, so for his collection to be stored in a basement might seem odd, to say the least,” said Cushing Center coordinator Terry Dagradi. The Cushing Center opened in the library sub-basement in June 2010, 71 years after Cushing’s death.

The catalyst for Cushing starting to collect brains occurred in 1902, when a pituitary cyst he had removed from a patient was misplaced. From that point on, Cushing insisted the brain of each deceased patient remain catalogued, along with corresponding journals that meticulously documented each case.

More than a century later, about 700 brains have survived from the original Cushing Brain Tumor Registry collection, 450 of which are on display in the Cushing Center. The specimens have been preserved in formalin and stored in square-shaped jars and have taken on different shades of bright orange and yellow depending on the contents of the jar.

Cushing authored the 1926 Pulitzer Prize-winning biography of his mentor, Sir William Osler (London: Oxford University Press, 1925), and curated an extensive collection of rare literature, considered by medical historians to be some of the most unique texts in scientific history. The 15,000 volumes encompass the histories of medicine, astronomy and nature. When Cushing bequeathed the collections to Yale, he requested the creation of a library that would be equal parts education and exhibition.

In 1932, a year after his 2,000th surgery, Cushing retired from the Peter Bent Brigham Hospital in Cambridge, Massachusetts, and began slowly organizing his salvaged brain specimens. With the help of his assistant, Dr. Louise Eisenhardt, Cushing moved his collection to New Haven after returning to Yale as Sterling Professor of Neurology in 1933, where he continued to use the specimens for research.

When Cushing died in 1939, Howard M. Hannah of Cleveland, whose only son had succumbed to a neurological tumor, richly endowed the Cushing Brain Tumor Registry, according to “Gone But Never Forgotten: Renaissance of the Harvey Cushing Brain Tumor Registry,” written by YSM alumnus Christopher Wahl. The endowment enabled the collection to remain at Yale.

Eisenhardt oversaw the collection, then stored in the Brady Basement of the pathology department, which served as a tremendous resource for students studying for exams. When Eisenhardt died in 1967, Dr. Elias Manuelidis took over curation. Because of space constraints and diminished interest in the collection, Manuelidis eventually had to find a new location for it.

In 1979, the brains, along with Cushing’s photographs, were moved to the basement of Edward S. Harkness Hall, a dormitory for YSM students. The collection was essentially ignored in its new location with one exception: For the next few decades, a visit to see the brains became a rite-of-passage for medical students, who signed their names to a poster in the room that read “Leave only your name, take only memories.” One of the students who lived in Harkness Hall and participated in this rite-of-passage was Christopher Wahl. The experience was transformational for him, leading him to write his required thesis on the collection.

Supported by a donation to YSM from Dr. Albert Diddle, who stipulated that the donation must go to a student working on a project that would directly benefit the institution, as well as funding from the James G. Hirsch, MD, Endowed Medical Student Research Fellowship and the National Institutes of Health Cancer Research Grant, Wahl was able to conduct a year of research for his thesis: “The Harvey Cushing Brain Tumor Registry: Changing Scientific and Philosophic Paradigms and the Study and Preservation of Archives.”

Dagradi was then working as a photographer at YSM and first became involved with the collection when Wahl brought boxes of glass plate negatives to her department to have prints made for his thesis exhibition. The negatives were images of Cushing’s patients and proved to be an unintentional historic archive and treasure. Dagradi and Dr. Dennis Spencer, former chair of the department of neurosurgery and advisor on Wahl’s thesis, soon became central members of the project team that created the Cushing Center.

Students in YSM’s Physician Assistant Online Program toured the Cushing Center with Dagradi to learn about Cushing’s contributions to modern medicine during their first on-campus immersion in March 2018.

Dagradi explained to them how the museum-like space was designed to reflect Cushing’s curiosity and attention to detail and that it was the intersection of art and science that initially drew her to the exhibit. “I was really struck by the beauty and power of the collection in terms of a time capsule,” she said.

Turner Brooks, an adjunct faculty member of architecture at Yale University, designed the exhibit to emulate the satisfaction of discovery for medical students and campus visitors. Discovery drawers and cabinets stretch across the room at a height that allows even the youngest of attendees to engage. Each drawer contains a glass-covered display of photographic materials, snippets of memoirs and salvaged objects from patients and colleagues. Dagradi has described Brooks as “both a magician and a visual poet, so he came up with this beautiful and engaging design for the center.”

At the center of the exhibit is an upright glass case that contains Cushing’s white coat, a medallion from his retirement ceremony and a bronze cast of his right hand. Below the artifacts rests a photo of a young Cushing performing a backflip off a university building with a lit cigarette in his mouth—a moment, according to Dagradi, that perfectly captured his self-assured nature. “Here, he’s demonstrating his athletic abilities,” she said. “He was confident and he loved recording everything.”

Many of the exhibition photographs capture Cushing’s patients’ faces, hands, scars and the progression of their diseases, and they pay particular attention to possible external clues to their conditions. Identifying neurological disorders was in its infancy; the use of X-ray was a new technology available. It is unclear if Cushing himself was the photographer of all the photos, but for over three decades the collection grew to more than 15,000 5×7 glass and film negatives, which are currently being digitized and archived.

“Once in a while, you’ll see a photo of a kid trying to smile or give something to the camera,” Dagradi said, looking through the thousands of portraits. Having your photo taken was much less common during the early 20th century, so “it’s unlikely that any of the patients would have been photographed otherwise. Cushing knew that there was nothing more important than paying absolute attention to his patients, the details of their lives and their symptoms. We have different means of medical discovery now, but for him this was the best way.”

Citation for this content: Yale School of Medicine Physician Assistant Online Program