Carole Miller, M.D.

Neurological Surgery is unique among the surgical specialties. It employs some of the basic techniques of other surgical disciplines, but has evolved its own particular attributes due to the specialized areas it concentrates on, namely the brain, the spinal cord, the peripheral nerves and their coverings. Neurological Surgery has much more in common with Neurology and Neuroscience than with General Surgery and the other surgical specialties. This is evident in the major role Neurological Surgery has played in the development of the neurosciences at The Ohio State University.

Neurosurgery and Neurology have been closely entwined since their inception at Ohio State in the early 1930’s. Dwight M. Palmer, MD, was the individual who contributed early and sustained his effort over three decades. Dr. Palmer served as chairman of Psychiatry and Neurology and was administrative chief of Neurosurgery at The Ohio State University from 1945-1951. Dr. Palmer set the educational tone in the clinical neurosciences.

A straight-A student Palmer attended both undergraduate and medical school at The Ohio State University, and took additional training in neuroanatomy and pathology. Dr. Palmer published scientific articles in all of the standard American neurological and psychiatric journals of his day. His former students remember him as a gentleman who was scholarly, yet soft-spoken and kind to his patients. He regularly taught at the bedside and in the clinic. He was voted “Man of the Year” for the class of 1947.

He facilitated the recruitment of J. Norman Allen, MD, who further extended the development of Neurology as a distinct discipline and eventually as a separate department in the early 1980’s. Neurosurgery became a Department on January 1, 2004 with Dr. E. Antonio Chiocca as the first departmental chairman (Fig. 1).

Figure 1. Dr. E. Antonio Chiocca, first Chairman of the Department of Neurosurgery, March 1, 2004.

Recognizing the need for detailed training and special qualifications for the practice of Neurological Surgery, representatives of The Society of Neurological Surgeons and the Harvey Cushing Society (now the American Association of Neurological Surgeons-AANS) held an informal meeting on March 27, 1939. This group was later enlarged to include representatives from the Section on Nervous and Mental Disease of the AMA, the section on Surgery of the AMA, the American Neurological Association and the American College of Surgeons. It was unanimously decided by this enlarged group that a separate board should be formed for certification in Neurological Surgery. The American Board of Neurological Surgery was approved in 1940 as a new examining board in medical specialties by action of the Advisory Board of Medical Specialties (reorganized in 1970 as The American Board of Medical Specialties) in collaboration with The Council on Medical Education of the AMA. The broad’s aim is to encourage the study, improve the practice, elevate the standards, and advance the science of neurological surgery and, thereby, to serve the cause of public health.

Dr. Harry E. LeFever was the founder and mentor for Neurosurgery at Ohio State. He attended Ohio University in Athens, OH and Jefferson Medical College in Philadelphia (Fig. 2).

Figure 2. Dr. Harry LeFever.

Dr. LeFever received his medical degree in 1925, and then studied with Dr. Harvey Cushing in Boston and with Dr. Thierry de Martel and Dr. Clovis Vincent in France. After returning to Columbus in 1932, Dr. LeFever decided to limit his practice to Neurosurgery, which was unusual for the time. His father, a family practice physician in southern Ohio, advised him against limiting his practice to Neurosurgery. He was told that he would starve and not be able to support his family. The senior Dr. LeFever had been in practice 30 years and had seen only one brain tumor.

The Neurosurgical Out-Patient Clinic at Starling Loving Hospital (Old University Hospital) was established about 1934. Additional surgeons joined Dr. LeFever in ensuing years with the resulting formation of a combined medical school department of Neurological Surgery, Neurology, and Psychiatry in 1945. The separate division of Neurological Surgery within the Department of Surgery was created in 1951 with the opening of the then new University Hospital, now Doan Hall. This Division was led to national prominence under the leadership of Dr. William E. Hunt (1963-89) followed by Dr. Michael E. Miner (1989-2002).

By 1937, Dr. LeFever had established his neurosurgery practice at White Cross hospital, now Riverside Methodist Hospital, and Ohio State University Hospital. In 1942, he left his practice to serve in the military as a Naval  Lt. Commander in WWII. He returned to Ohio State after his discharge from the service in 1946 and immediately locked horns with the new chief of Surgery, Dr. Robert M. Zollinger. At this time Dr. Dwight Palmer, a Neurologist, was the administrative chief of Neurosurgery. Dr. Zollinger had also spent time on Neurosurgery at the Brigham Hospital in Boston with Harvey Cushing. At that time it was not unusual for general surgeons to do Neurosurgery. This made for interesting times.

Dr. LeFever is described as an inspiring teacher and motivated a generation of OSU medical students to pursue careers in Neurosurgery. During the 1950’s he was joined by three greats who achieved local and national fame in Neurosurgery; William E. Hunt, MD,(Fig. 3) John N. Meagher, MD, and Martin P. Sayers, MD(Fig. 5). Dr. LeFever had inspired all three. Drs. Hunt and Sayers were mentored by Dr. LeFever as students and returned to Columbus to practice with him. Dr. Meagher did his residency in Columbus with Dr. LeFever, and was the first full time faculty member of the division of Neurosurgery.

The transmission of excellence in neurosurgery continued long past Dr. LeFever. At least 20 neurosurgeons were directly inspired by him including Charles Rossel, Dr. James Barnes, Dr. Robert Hess, Dr. Joel White, and Dr. Calvin Early (later Chief of the Naval Residency program at Bethesda). The early Development of the Division of Neurosurgery was directly related to his efforts. Dr. LeFever is described by one of his protégés, Robert M. Hess, as gracious, witty, urban, and fluent in French. With his bow tie and lapel pocket-handkerchief, our first neurosurgeon had savoir-faire and it was said he could cure patient by his manner alone. As Bob Hess said in 1997, “Although 36 years have passed since his death, I remember him with admiration and respect.”

Figure 3. Dr. William E. Hunt Chairman of the Division of Neurosurgery 1963-1989.

Dr. William E. Hunt (Fig. 3) followed Dr. LeFever as Chief of the Division in 1963. Dr. Hunt was born in Columbus, Ohio and graduated from Ohio State in 1943. He received his Medical Degree from OSU in 1945. Dr. Hunt served in the Army as a general surgeon following internship and then did his residency with Henry Schwartz in St. Louis, at Washington University.

He returned to Columbus in 1953. Tolosa-Hunt Syndrome, granulomatous inflammation of the cavernous sinus, and the Hunt-Hess scale for aneurysms are named for Dr. Hunt. Dr Robert Hess was a resident who worked on this with Dr. Hunt, and the article was published in the Journal of Neurosurgery in 1969. Dr. William E. Hunt received the 1st Gold Medal presented by the Neurosurgical Society of America for lifetime achievement in Neurosurgery in 1998 (Fig. 5).

Figure 4. Dr. William E. Hunt, 1998, recipient of the NSA gold medal for lifetime achievement in Neurosurgery.

Dr. Martin P. Sayers (Fig. 5) returned from his residency with Francis Grant at the University of Pennsylvania, and decided to specialize in Pediatric Neurosurgery. He was one of the earliest practitioners of this subspecialty and made Columbus Children’s Hospital one of the preeminent pediatric Neurosurgery services.

Figure 5. Dr. Harry E. LeFever, center, 1st Chairman, Division of Neurosurgery; Dr. Martin P. Sayers (far right) Chief of Pediatric Section of Neurosurgery; Warren Leimbach, next to Dr. Sayers, trained with Dr. LeFever and practiced in Columbus for 30 years. Far left, Dr. Zinnur Rollas, trained with Dr. LeFever and became chief of Neurosurgery in Ankara, Turkey. Dr. Ken Abbott, 2nd from left, trained at the Mayo Clinic and became the chairman of Neurosurgery at Loma Linda in California.

In the early 1970’s, Dr. Hunt, with the efforts of many scientists, including George Bingham, MD, PhD, received an NIH grant to study the basic science of spinal cord injury. This pulled together Neuroanatomy, Neurophysiology, Neurology, and Neurological Surgery. This collaborative effort led eventually to the development of a Neuroscience Department at Ohio State. Neurological Surgery was critical in the success of this program. This collaborative effort has been ongoing since that time. As a result of this effort Ohio State Neuroscience is now internationally recognized as a leader in the field of Spinal Cord Injury, and the model developed for standardization of lesions of the spinal cord was developed here at Ohio State. Seminal work in spinal cord injury has been was done under the auspices of the division of Neurological Surgery and the basic neurosciences. Dr. Donald Behrmann, as a Neurological Surgery resident, helped develop this model and ultimately also received a Ph.D. as well as completing his Neurological Surgery residency. Neurological Surgery still enjoys a close relationship with the Neuroscience Department. (http://ngsp.osu.edu/) The current chairman of the Department of Neuroscience, Dr. Michael Beattie, had a joint appointment in Surgery; the division of Neurological Surgery with Dr. Hunt. Dr. Hunt retired in 1991. After his death in 1999, an endowed fund supporting the Neurosciences was established from the Charlotte Curtis Hunt Charitable Trust. The Neuroscience Department is the recipient of a $2,000,000 gift from the estate of Dr. William Hunt and Charlotte Curtis Hunt. The Chairman of the Neuroscience Department to advance the educational goals of the department.

Figure 6. Michael E. Miner, MD., Ph.D.

Dr. Michael E. Miner (Fig. 6) became chairman of the division of Neurological Surgery on the retirement of Dr. Hunt in 1989 and remained chairman until 2002.  Dr. Miner did all his training at the University of Kansas.  He subsequently did pediatric and trauma neurosurgery before becoming chief at The Ohio State University.  Dr. Miner trained several excellent clinical neurosurgeons and continued the strong clinical emphasis of the Neurosurgery program.

Dr. E. Antonio Chiocca holds the Dardinger Family Endowed Chair in Oncological Neurosurgery. His appointment strengthens the clinical, research, and educational missions of Neurosurgery and complements this exceptional interdisciplinary history at The Ohio State University. Dr. Chiocca is an outstanding, energetic physician-scientist who is nationally recognized as a brain tumor specialist and leading investigator in the use of gene therapies for brain tumors and other central nervous system disorders. His research interests include engineering more efficient "tumor-killing" genes and defining more selective viruses that could be used to deliver therapeutics directly to tumors. He is principal investigator on more than a dozen research projects on a variety of brain tumor therapies, many of them funded by the National Institutes of Health, has authored or co-authored more than 100 articles and book chapters, and holds three patents, with four others pending. Dr. Chiocca brings with him both grants and research faculty and will position the Medical Center to attract additional external research support. The new department will grow quickly with the recruitment of additional specialists in other elements of the discipline, including trauma, movement disorders, spine surgery and vascular disorders. The bolstered staffing of the department and high-caliber research will translate into an enhanced educational environment for medical students, more clinical training opportunities for students and residents, and more patients seeking treatment at OSU Medical Center for a wider range of disorders and injuries.

The study and practice of Neurosurgery has come a long way over the past 70 years. New diagnostic tools, particularly MRI, have furthered our knowledge and controlled studies have showered us with effective new therapies. The pioneers have left a lasting legacy of knowledge and research, which assure a strong and progressive tomorrow for Neuroscience and Neurosurgery at Ohio State.

History of OSU Neurosurgery Slides Presentation. [opens in new window]

Source: The Medical Heritage Center, House Call, Spring 2002, Vol. 5 No. 3; Pioneers of Neuroscience in Central Ohio, George W. Paulson, MD.
Background music: OSU Battle Cry

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