This jet age we are now living in is no different. The times are still turbulent and every day brings a new crisis. The fact is that Rome in any age could not be built in a day. We recognize our need to take the long view toward the rapidly changing scene.
The acquisiton of a proper perspective on neurosurgery might well start with statistics. The same fact is apparent when one considers the proportion of neurosurgeons in medical faculties or the Association of American Medical Colleges. One hastens to emphasize that numbers are of only relative importance.
It has been said that astronomically speaking, man is an atom, but that also astronomically speaking, man is the astronomer. The most constant thing about life—whether we are speaking of our country, medicine in general, or neurosurgery in particular—is change. Of the country, let us consider the fact that just about 40 years ago Lindbergh flew across the Atlantic and became an international hero and a household name. A movie was made of his life in , and it was found necessary, because so few young people knew anything about him, to put on an intensive campaign to stir up interest.
The median age of members of the Harvey Cushing Society is 47; many things well established in our memories are without significance to millions of Americans: Most Americans today cannot remember Pearl Harbor. A very large proportion of people have no first-hand recollection of the Great Depression. The Southwest Research Foundation of San Antonio and Houston says that we will experience such a change in our national population that a complete alteration in our social organization seems inevitable. One of the biggest questions will be: As youth comes to the front, the most urgent question is this: Neurosurgery has changed, as is evident from the illustration of the growth of the Harvey Cushing Society Fig.
The official attitude of this Society has changed: Those days would have been without the Bovie unit, antibiotics or the sulfonamides, Gelfoam or Oxycel, Pantopaque, angiography, steroids, urea or mannitol, hypothermia, reliable stereotaxic surgery, radiofrequency generator, radiology in its present form, radioactive compounds, dependable shunts for hydrocephalus, and a variety of other developments now available and may others soon to be on hand, without which we think we could not do satisfactory work.
Obviously, change and progress have been accelerated by specialization, but specialization by scientists may lead to loss of perspective. And the need for perspective was never greater than it is now for medicine as a whole and for our own field of neurological surgery as we consider it today. We are faced with serious problems of communication among men specializing in neurosurgical research, in neurosurgical practice, and even in special areas of neurosurgical practice.
The divisive forces of specialization create problems for each specialty. The objective of scholarly effort in the sciences is to discover the fewest basic principles that will provide explanations for natural phenomena. We are not likely to realize goals if we indulge in a myopic concentration on specialized segments.
We need men of perspective who can stand back and perceive the whole. All physicians must have some insight into the vastly important research aspect of medicine, if only because those who practice medicine and those who do research can no longer be kept separate. What affects one affects the other. We must make science and scientists, medicine and physicians, an integrated whole.
This frustrating state of affairs appears to be the price we are compelled to pay for the extraordinary complexity and sophistication of our learning and of our seemingly immoderate desire to advance knowledge…. In the present state of learning and technology, the specialist is our chief hope for advancing knowledge and improving practice, but originality is not stimulated by narrowness. The history of learning affords us many instances which suggest that unusual and important developments in the arts and sciences arise often from a stimulus outside the particular art or science itself.
The failure to see experience outside the scheme of a limited discipline impoverishes the mind, and so, in the very interests of specialization itself it becomes necessary to provide for breadth in the education of the specialist—a paradox which is very troublesome to those who are involved in advanced and professional education.
We seek for our discipline strength and a valid perspective of our capabilities. A little dreaming and retirement to the ivory tower on Cloud Nine albeit an atomic cloud may be of value Fig. But we must avoid the temptation to project ourselves as inflated, heroic figures Fig. To put a false front on a shanty will be of no value Fig. Only by building a strong structure behind an appropriate facade can our specialty achieve the position it deserves Fig.
Our goals will not be accomplished by issuing impressive commandments without adequate background and strength. Moses failed at this, temporarily. We will reach no position of importance by opposing progress.
The world is increasingly complex, but we are given increasingly complex instrumentation with which to understand and control it, and we should get on with the task. A friend and prominent minister, in referring to an active woman in his congregation, said: Ours is a relatively young Society and we may be impatient. In considering what neurosurgery has accomplished, what it is accomplishing, and what it seeks to accomplish, it would be well to set up a ledger sheet to see the assests and debits of the present position of neurosurgery. Surgery of the nervous system is a definable and widely recognized discipline.
It is recognized by medical and lay mind alike, and this was true even in the days before Ben Casey. Who, in any civilized nation of the world, does not know the difference between surgery and medicine, between neurosurgery and cardiac surgery, between obstetrics and pediatrics? Neurosurgery is well defined, and in having that clearly set down, we, who are anxious for proper recognition of neurosurgery and for its deserved representation, are fortunate.
It is much easier to devote one's energies to furthering the field of surgery of the nervous system and to obtaining the cooperation of many others in doing so than it is to seek recognition for surgery of the reticulo-endothelial system. The latter may come into its own at some future time but it isn't here yet. Surgery of the nervous system has inherited from its predecessors a tradition of broad education in surgery and neurology and a prolonged period of increasing responsibility in the training period in which men have been equipped to handle independently, with skill and competence, those complex and difficult problems which are the hallmark of neurosurgery.
This field has never attracted those interested in quick or easy training, or those who might see the way clear to relaxing into an easy routine as soon as their training is done. Training programs in the United States have produced in large numbers highly skilled and competent neurosurgeons for the practice of this art. In large measure, these men have been endowed as teachers for they learned the value of scholarship, and, to a greater-than-average degree in medical education, these men have had experience and interest in research.
Boards of certification in medical specialties in this country were brought into being to perform a job which was not being done by the medical schools or by organized medicine. If there has been recent criticism of such boards of certification, is it possible that the critics have lost their perspective regarding the work of the boards? The American Board of Neurological Surgery was one of the early boards, and it has performed ably to maintain the high standards established in neurosurgery before its formation.
The insistence of the Board on a certain degree of demonstrable surgical competence has served to fill this nation with a continuing supply of well-trained surgeons specifically equipped to handle the problems presented by the nervous system. The Study Commission supported by the Harvey Cushing Society established a written examination to be given before the final oral examination. A report of this Commission is part of our Annual Meeting. We are indebted to Dr. Howard Brown, and Dr. Leo Davidoff, the members of the Study Commission, for their devotion to this cause. A continuing dialogue between training program directors, as well as between the directors and the American Board of Neurosurgery, is important to the training of neurosurgeons in this country.
Initially, a meeting of program directors was called by the Board to acquaint all concerned with the proposed voluntary written examination. This proved to be so successful that the program directors now meet annually before the Cushing Society meeting. The exchange of information, the flexibility with which new ideas and techniques can be introduced in training, the willingness of the Board to accept suggestions from the directors, all represent strength to neurosurgery.
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There are over 1, board-certified neurosurgeons in the United States, most of whom are in practice. There are about in the process of training or certification, and a relative few who are practicing but not certified. The total reaches nearly 2,, a significant number of trained surgeons devoting their efforts to the diseases and afflictions of the nervous system. Of varying sizes and purposes, the five national neurosurgical societies compose a formidable group that is working through different pathways, but in healthy cooperation for the benefit of all neurosurgery.
They were formed over the last 50 years in the following order:. It is essential that these societies know the short- and long-term goals of the others, and a fruitful exchange of information has taken place in the last three years to foster this type of cooperation. In addition, there are regional societies throughout the nation, and a wide variety of smaller travel clubs and research societies in which the interchange of information is on the most basic level. There are more than 40 societies of neurosurgery of one kind or another. Created by this Society more than a quarter of a century ago, the Journal of Neurosurgery occupies a unique position in this country and abroad.
It was brought to full bloom by the late Louise Eisenhardt, continually nourished and shaped during recent years by Paul Bucy, and is now so ably sustained and maintained by Henry Heyl. It is a strong asset to neurosurgery from any vantage point. It actually reflects the strength of our specialty for it can publish only the papers it receives; the caliber of manuscripts emanating from neurosurgery in this country and abroad is excellent. Heyl's success in reducing the publishing time of manuscripts is essential to the proper reflection of this vitality in neurosurgery.
The exciting innovations being introduced by The National Library of Medicine, of which Barnes Woodhall is a vital part, will undoubtedly tie in with the progress of the Journal of Neurosurgery. Our Journal , too, is manageable and flexible; we can be part of an exciting ongoing program. Research is essential to progress. The spectacular success of applied research during World War II led to the fallacy entertained by many that any problem could be solved by gathering enough scientists and giving them enough money.
Great scientific steps originate in the minds of scientists, not in the minds of those who give or seek funds for support of research. Progress can be made by attracting and supporting gifted research men, and then leaving them alone. The narrowness of a discipline is the result of intrinsic pressures to deepen the understanding of the discipline. The pressures resulting in greater breadth are extrinsic, often stemming from society itself, or from other special disciplines. They tend to bring a particular specialty into interaction with other contributing specialties and to broaden its applicability.
There are over 50 active neurosurgical laboratory centers in this country. The largest proportion of these are in academic centers and are supported by Public Health Service funds from the National Institute of Neurological Diseases and Blindness, although there is also strong support from private philanthropy, and from national and state voluntary health organizations. From the point of view of the future of neurological surgery, this represents the greatest strength and the most rapidly growing aspect of our progress. It is also the most difficult factor to quantitate.
Training programs in neurological surgery are healthy. There is a commendable percentage of highly selected trainees from other countries; American neurosurgery has always had a significant interest in these men. He lives in Northshire, just north of Tallahassee up Centerville Road, in a big beautiful two-story country home that sits behind a row of beautiful columns at the end of a long driveway. Up in the country, with the green fields of grass and all those picket fences … land where a man can breathe, and it feels good. It is not surprising, then, that Geissinger settled here when he did.
It was , four years after his premature retirement from neurosurgery, and his wife, Valencia, was fighting terminal lung cancer. He began a daily routine of working from sunup to sundown on his cattle ranch in Monticello.
A matter of life and death: William Boyd on the rise of the surgeon-memoir
And, to say the least, the mile drive home was not something Geissinger ever cared to get a jump on. One grandfather was a community physician who cared for young Jim in wartime s Pueblo, Co. His other grandfather taught shop at a local high school who farmed as a hobby. Geissinger has become a man of medicine, agriculture and art, and also of nature and sport — by definition, a true Renaissance man. As a young man practicing medicine, Geissinger completed a handful of wood projects with impressive results.
But, in the hectic no-free-time life of a neurosurgeon, hobbies, if not abandoned altogether, quickly find their place on back burners. Then Geissinger got serious about woodworking, which seems appropriate — because a surgeon with too much free time on his hands is apt to find a good way to put those talented hands to use.
To compensate for a natural hand tremor possessed by all humans, surgeons learn to time their every movement with the rhythm of their own heartbeat and breathing. When Geissinger got into woodworking, he built a wood shop on his Monticello property and filled it with professional tools and cutting machines. One of his tools, a table saw, was discontinued by the manufacturer because it is so dangerous. But, not to worry, for Geissinger is highly skilled in this specialized art.
His successful completion of a Windsor chair-making course given at the Windsor Institute in New Hampshire was like earning a post-graduate degree in woodworking. Showing of 7 reviews. Top Reviews Most recent Top Reviews. There was a problem filtering reviews right now.
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Please try again later. Kindle Edition Verified Purchase. Starting out as a young man leaving home to study for a life in neurosurgery, through his forced retirement at the peak of his career from an occupational acquired illness,Geissinger's memoir provides a very personal insight into the mind and motivation of a man at a unique transition in neuroscience.
The excitement of the surgical challenges dissecting the nervous system is palpable. As the story progresses, we learn that his talents extended well beyond medicine. A fascinating read, particularly for any aspiring physician. I loved this book! I was lucky enough to work with the author for several years in the operating room. Hearing some of his personal memories bring memories back to me. Geissinger truly was a gifted and dedicated surgeon and this book shows the depth of his dedication and personal integrity.
Thank you Doctor for writing this wonderful book. One person found this helpful. I had the pleasure of working with Dr.
WomenInScience | Neurosurgery | Stanford Medicine
He was a brilliant neurosurgeon, and I am not surprised that his book is so well-written and interesting. I appreciated the opportunity to read about his life and his career. From the ground up the building of a neurosurgeon to his disappointing departure of his dream profession. I knew him and I loved every page. The odyssey of a young man's education to become a physician and his training to become a surgeon.
His association with a competent colleague in a private practice provides illuminating cases of neurologic problems described in enviable recall over the years. The disparate nature of his avocations is unique. The "hands on" creation and mainttenance of a ranch producing purebred breeding cattle is one time consuming but satisfying diversion. His artistry in designing and handcrafting exquisite wood furniture using traditional tools and techniques is arresting. All this is described in meticulous detail against a background of heart rending mishaps.
There is no hint of imperious self importance. Finally there are provocative comments on the current status of medical practice and the whole health industry. There is much in the book for thought provoking admiration for anyone in medicine.