Department of Neurological Surgery celebrates 100 years

The Department of Neurological Surgery at Washington University School of Medicine celebrates its 100th anniversary this month. Over the past century, it has become internationally known for its groundbreaking basic and clinical research, dedication to patient care and outstanding training of residents.

Ralph Dacey, MD, the Henry G. and Edith R. Schwartz Professor and head of Neurological Surgery, and unofficial department historian Robert Grubb, MD, professor emeritus of neurological surgery, date the department’s origins to the 1911 arrival at the School of Medicine of Ernest Sachs, MD, who became the first professor of neurological surgery in the world in 1919.

“Sachs trained in neurosurgery in 1907-09 under Sir Victor Horsley in London, and Horsley is widely regarded as the father of modern neurological surgery,” Grubb says. “That gives our department a pretty distinguished lineage — it was one of the first modern neurological surgery departments to develop.”

The department recently published Grubb’s book, Neurosurgery at Washington University: A Century of Excellence. His personal interest in history has led him to preserve historic departmental documents and other memorabilia, such as In Mortal Combat with Dr. Henry Schwartz and Staff, a 1961 documentary produced by Laclede Gas.

The film, which aired on St. Louis television stations, took footage of Washington University neurosurgeons and other physicians at work at Barnes Hospital and mixed it with a fictional narrative about a housewife diagnosed with a brain tumor.

Dacey, the current head of the department, is only the fourth person to lead it in its first 100 years. Sachs, the founder, was succeeded by Henry Schwartz, MD, in 1946 and Sidney Goldring in 1974. Dacey became head in 1989.

“It’s an outstanding department, and people tend to stay with it,” Dacey says. “We’re very good at all the things neurological surgery departments can do: we provide complex patient care, we do research on important neurosurgical problems and we teach tomorrow’s neurosurgeons.”

Between 1921-1974, Grubb says, 56 neurological surgery fellows or residents trained with Sachs or Schwarz. Twenty-six of those trainees became chairmen of other departments of neurological surgery, and eight were full professors. Many of these students and other, more recent graduates came back to St. Louis earlier this month for an anniversary symposium and dinner.

“Training of neurosurgeons is an intense process, and that often leads to deep bonds among students and their mentors,” Dacey says. “So we celebrated both the past accomplishments of the department and what we’re working on now, and we had an informal reunion.”

The department continues to be a pioneer among its peers at U.S. medical schools. More than 40 of the world’s top neurosurgeons met in St. Louis in August to discuss one such pioneering effort: the installation of a movable high-field intraoperative MRI (IMRI) scanner between a pair of specially designed neurosurgical operating suites at Barnes-Jewish Hospital.

The scanner, the eighth of its kind installed in a U.S. hospital, allows surgeons to evaluate whether they’ve been able to fully remove a neurological tumor while still in the operating room.

“The IMRI really impacts what we do quite a bit,” says Michael Chicoine, MD, the August A. Busch, Jr. Professor of Neurological Surgery. “It’s an amazing and enabling technology that we’re also putting to use in other contexts, including surgeries for epilepsy and Parkinson’s disease, drainage of cysts and the placement of catheters and tubes in the brain.”