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Eric Oldberg
Historical Vignette
Eric Oldberg For those neurosurgeons who came after the original members of the Society of Neurological Surgeons, the history of neurological surgery in North America tends to center on the names Cushing and Elsberg, as well as Penfield and Dandy. However, neurosurgeons of the next generation, trained by Cushing and others, were of equal ability and in some ways more multifaceted, with accomplishments that largely have been overlooked. One of these second generation neurosurgeons is Eric Oldberg. His brief biography, written by Paul Bucy and Oscar Sugar, appeared in Surgical Neurology in 1987 [1] and in the 1984 Society of Neurological Surgeons 75th Meeting Anniversary Volume, but it tells us little about Dr. Oldberg’s remarkable accomplishments. Eric Oldberg was born on November 7, 1901, in Evanston, Illinois. His mother was Mary Sloan Oldberg and his father was Arne Oldberg, composer, pianist, and dean of Northwestern University School of Music. While attending elementary and high school in Evanston, Eric planned to become a professional pianist, but then decided on a career in medicine. He became engaged to a pianist, Hilda Edwards, when they were both 20 years of age and students at Northwestern, but they were not to be married for another 10 years. During that interval, she became a concert artist and he became a neurosurgeon, being the last surgical house officer to serve alone as resident under Dr. Cushing (1929 – 1930). He subsequently received a traveling Guggenheim fellowship and studied in both Germany and Oxford. Dr. Oldberg was one of the original 23 members of the Harvey Cushing Society, and became president of that Society in 1942. He developed a combined service for neurology and neurological surgery as professor and head of that department at the University of Illinois at Chicago. He trained an outstanding group of residents, many of whom are leaders in North American neurosurgery today. But his interests ranged far outside neurosurgery and medicine. To understand Eric Oldberg, it is important to quote some of the things he said about himself and his beliefs. In an article printed in the commemorative volume, 1931–1971, of the Eric Old0090-3019/99/$–see front matter PII S0090-3019(98)00034-2
berg Alumni Association (appearing first in the Chicago Tribune on June 7, 1959) he said: I myself am, of course, a doctor. I am exceedingly proud of my profession and I have seen many instances of its devotion to duty and mankind which have been quite overwhelming. They have been unrelated to any thought of reward, unrelated to any thought of personal comfort or adequate rest, and even unrelated to personal health and family responsibility. But we doctors, possibly because most of us are dedicated men and women who seem to live, sleep and talk medicine, have allowed ourselves to become segregated from the community to such an extent that we are seldom even thought of when it comes to being ask to participate in anything outside the field of medicine . . . Now what can we do about the separation and segregation of which I have been speaking? One must call the attention of the doctors to their own failings. They ought to be willing to place themselves at the disposal of any civic or social endeavor for which they have talent. They ought to live their social lives, not by invariably inviting other doctors and their wives to dinner, but by sometimes inviting their friends in the business, the legal and other worlds to dinner, the theater, the concert, and elsewhere.
Obviously, Eric Oldberg meant what he said and acted on it. He served as president of the Chicago Board of Health for 19 years and was president of the Chicago Health Review Foundation. From 1952 to 1963, he was president of the Chicago Orchestra Association. In this position he was effective in influencing the progress of the Chicago Symphony Orchestra, one of the outstanding orchestras of the country at that time. He served on the Board of the Lyric Opera in Chicago and although he was a staunch Republican, he served for more than 20 years as confidant and advisor to Democratic Mayor Richard J. Daley on such matters as the arts and health. He received the Chicago Medal of Merit, and Loyola University gave him a citation for civic leadership in 1966. Although the following, which came from Newton Minow (personal communication), may be apocryphal, it certainly might have happened, and it is too germane with regard to Dr. Oldberg not to be quoted here: The story goes that a hospital administrator, having read a report by a survey organization brought in by the President of the Board to “help the administrator,” decided to return © 1999 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
Historical Vignette
the favor by “helping” the president . . . [who] . . . happened also to be chairman of the board of directors of a symphony orchestra. The administrator sat through a concert or two and then wrote the following “survey”: For considerable periods the four oboe players had nothing to do. Their number should be reduced and their work spread more evenly over the whole concert. All twelve first violins were playing identical notes. This seems unnecessary duplication. The staff of this section should be drastically cut. If a large sound volume is required, it could be obtained by electronic amplifier apparatus. Much effort went into playing semiquavers. This seems an excessive refinement. It is recommended that all notes be rounded to the nearest quaver. This would make possible more extensive use of trainees and lower grade operatives. There seems too much repetition of some musical passages. Scores should be pruned. No useful purpose is served by repeating on horns a passage already played by strings. It is estimated that if all redundant passages were eliminated the two-hour concert could be reduced to 20 minutes, and no intermission needed. The conductor agrees generally with those recommendations, but thinks there might be some falling off in box office receipts. In that event, it should be possible to close sections of the auditorium, with a consequent saving of overhead, lighting, attendants, et cetera.
Despite his cultural interests, Eric Oldberg was primarily a neurosurgeon, and the education of neurosurgeons was one of his major interests. Speaking of that education at the Eric Oldberg Alumni Association meeting in 1971, Oldberg said: (based on an earlier published chapter) [2]: My education in neurosurgery began with Harvey Cushing . . . Harvey Cushing was a remarkable man. My own senior residency with him began September 1, 1929, and ended October 1, 1930 —though I spent all the optional time I had on his service, during my House Officership and Assistant Residency in General Surgery . . . Prior to my sojourn in Boston, I had worked for some months with Loyal Davis . . . himself much influenced by his contact with Cushing. The Cushing service was unique, and none like it exists today. It consisted virtually entirely of brain tumors. During my incumbency, the number of brain tumors in the house at [any] one time ranged from a maximum of fifty-six to a minimum of twelve. We histologically verified 186 tumors in my year! There was only an occasional tic case, as a gift to Gil Horrax, two or three cord tumors for him, a disc (diagnosed and believed to be a chondroma), a head injury or two, and almost no medical neurology . . . We did our own neurology, there being no medical neurologist on the staff of the Brigham, our own ophthalmology, and fortunately we could collaborate in radiology with that master in the field, Merrill Sosman . . . The result of this manner of training was as remarkable as was Cushing, and though I would revise and extend it, I wouldn’t trade it if I had to do it over again. It made one self-reliant, it made one a real sophisticate in brain tumors, since he was constantly surrounded by them in various states of coma and paralysis; and, since in the course of a year of eighteen-hour days, and seven-day weeks, one was incidentally required to know and record daily the exact number of diopters of choked disc in every patient both pre- and post-operatively,
Surg Neurol 101 1999;52:100 –2
and to take visual fields on a tangent screen on everyone (even tic cases before and after operation!), it made one a pretty expert ophthalmologist.
After expressing concern for the rapid rise in neurosurgery and psychiatry at the expense of neurology, Oldberg continued: Where does this leave the neurosurgeon, and modern training for him? In my view, it demands two new distinct and definite broadening elements. Leaving surgical techniques aside, it demands that the young neurosurgical trainee receive his education in a place where he is constantly exposed to nonsurgical, as well as surgical, neurological cases. And, it demands that he cohabit with, and reach a rapprochement with, competent medical neurologists, who must be developed in greater numbers, and who must mostly devote their skills and acquire their experience, in the diagnosis and management of diseases, defects, genetic aberrations, and metabolic abnormalities of the nervous system. Only in this way can the young surgeon, or the young neurologist, hope to advance his own knowledge, learn to sort the wheat from the chaff, and, hopefully, become an agent of new excursions in the realm of research and discovery . . . Strangely, in medical neurology, that 20th century orphan until recently, which has just begun its own resurgence, we find a large body of resistance to the kind of neurosurgical training I have advocated. I prefer to interpret this as a defensive psychology and an attitude that will gradually dissipate. There is enough work to be done for all of us; and it is neither healthy nor fruitful for jealousies and intellectual arrogance on either side, to separate us. In summary, I would say that the education of a neurosurgeon today, whether he is to be an academician, a researcher, or a garden-variety clinician, should be in the direction of making a surgically oriented neurologist and doctor out of him. And lastly, a discussion of the education of a neurosurgeon would not be complete without a word about the man himself, and his attitude toward his patients and their families. He should be taught to realize that patients who come under his care, are in trouble— often very bad trouble, as are their families. He should imbue these people with confidence, by his manner, he should spare them unnecessary expense, by getting busy, and seeing that the essentials are promptly done and that the non-essentials are kept to a minimum. He should be fastidious in dress and language, and should avoid ambiguity and uncertainty, but never substitute cockiness and arrogance. He should be humble but honest and selfconfident. It is well if he has other interests and can converse on other topics than medicine. And, he should never forget that he is not treating a disease or condition, but “a whole person.”
Like most of those who worked under Harvey Cushing, Dr. Oldberg told many charming vignettes [3]. . . . About once out of every three Sundays, I would receive a call about 9 A.M. and the stentorian voice would come over the telephone, “Oldberg, come out to lunch,” and that was the end of [any] time I had set aside for catching up. There was always one consolation. This was the possibility that there would be some foreign luncheon guest who had never seen
102 Surg Neurol 1999;52:100 –2
corn on the cob. All during the season, it was Dr. Cushing’s delight to serve these gentlemen with a well-buttered cob, and then watch them try to eat it with the least possible spattering, sucking noises, and bits of whatever it is between the teeth. Only those close to Dr. Cushing knew the malicious glee with which he watched the embarrassed debacle. When I came to the Brigham as a house officer, I brought with me several books of piano music for four hands. Marshall Fulton . . . was then a resident in medicine at the Brigham, and we used to play these pieces, Marshall on the treble, and I on the bass, in the upstairs sitting room of the Brigham house staff quarters. Dr. Cushing heard about this, and we were ordered to appear at his house in the late morning one Sunday to exhibit our prowess and to stay for lunch. No one could have felt more embarrassed about this than Marshall and I, but orders were orders, so we took some Mozart overtures and went out to the Cushing house to perform for him on his ancient and untuned upright piano. Now the effect of our efforts, not to mention those of the great composer, was that John Fulton and Dr. Cushing, who sat alongside, spent the whole time discussing the speed with which the visual input from the printed musical score could be transferred to cortical impulses and sent along down the peripheral nerves to make our fingers wiggle so fast. When it was all over Marshall and I heaved a sigh of relief, our only real regret being that cocktails were not a part of the luncheon ritual.
At the Peter Bent Brigham Hospital 50th Anniversary celebration in 1963, Dr. Oldberg reminisced about other aspects of Cushing’s character and skills: Dr. Cushing was, as a matter of fact, a very poor extemporaneous speaker, and he was a very poor teacher by way of lectureships . . . He had absolutely no plan for teaching the seniors neurological surgery. He was interested in the pituitary body. And so, the very first lecture that we had from him— he only gave about three to the seniors— had to do with acromegalics. And I was to find a series of acromegalics and bring them in here. He was up in front and he was nervous as the devil. He was terribly nervous, just appearing before a lot of senior medical students. And instead of lecturing, he started to point to various people here and there, and ask them questions which they were obviously too scared to answer. And the net result of it was, at the end of the hour—which was at 8:00 o’clock on a Saturday morning—when he gave the lecture, I don’t think that anybody learned much of anything at all. The same thing was true of the Cabot Clinics which were given in this same room here. If Cushing were in on some of the
Alexander
cases and sat somewhere along here and Dr. Cabot was down reading the transcript about the case and Dr. Wolbach was up there about to show slides and to prove everybody wrong, Dr. Cushing’s discussions were poor. I have to say that because I am leading up to what really made him a great teacher. Any of you who knew him and heard him speak in public know that he always read everything. He worked terribly hard on every essay that he gave. He wrote them, and he rewrote them, and he had various people proofread them, and, when the thing was finally finished, it was a gem; but it was read. He did not speak extemporaneously, and he was not a good speaker in that sense of the term at all. Now, why was he great? He was not a Nobel Prize winner. He never discovered anything like insulin, or something of that sort. But he was a man of tremendous courage, tremendous will to work, with an intuition that was remarkable. The operating table was absolutely sacred. No one said anything, including Cushing. No one was allowed to say anything. And yet, I remember a few occasions in which, literally, tears were close to my eyes to see that man’s face, without multiple transfusions and gelfoam and all of the other ancillary things that we have now, a big opening in the sagittal sinus or something like that, and stand there with his thumb on the opening for a couple of hours, and finally conquer the problem. It was the learning that you got from Cushing—it was the learning that you got from watching him, and then from emulating him, if you possibly could, and if you had what it takes; and, if you had anything of the same characteristics in yourself, in trying to eumulate what he had done in his life.
Eric Oldberg—musician, neurosurgeon, civic servant, a Harvey Cushing resident. I had known him only casually; now my recognition of his importance to neurosurgery has been greatly enhanced by my research for this historical vignette. Eben Alexander, Jr., M.D. Winston-Salem, North Carolina REFERENCES 1. Bucy PC, Sugar O: Eric Oldberg. Surg Neurol 1987;28: 1–2. 2. Oldberg E. The education of a neurosurgeon. In: Horizons in Neurological Education and Research. Springfield, IL: Charles C. Thomas, 1965:18 –23. 3. Oldberg E (contributor). A selection of Harvey Cushing anecdotes. Collected and edited by Heyl HL. J Neurosurg 1969;30:366 –7.
Eric Oldberg For those neurosurgeons who came after the original members of the Society of Neurological Surgeons, the history of neurological surgery in North America tends to center on the names Cushing and Elsberg, as well as Penfield and Dandy. However, neurosurgeons of the next generation, trained by Cushing and others, were of equal ability and in some ways more multifaceted, with accomplishments that largely have been overlooked. One of these second generation neurosurgeons is Eric Oldberg. His brief biography, written by Paul Bucy and Oscar Sugar, appeared in Surgical Neurology in 1987 [1] and in the 1984 Society of Neurological Surgeons 75th Meeting Anniversary Volume, but it tells us little about Dr. Oldberg’s remarkable accomplishments. Eric Oldberg was born on November 7, 1901, in Evanston, Illinois. His mother was Mary Sloan Oldberg and his father was Arne Oldberg, composer, pianist, and dean of Northwestern University School of Music. While attending elementary and high school in Evanston, Eric planned to become a professional pianist, but then decided on a career in medicine. He became engaged to a pianist, Hilda Edwards, when they were both 20 years of age and students at Northwestern, but they were not to be married for another 10 years. During that interval, she became a concert artist and he became a neurosurgeon, being the last surgical house officer to serve alone as resident under Dr. Cushing (1929 – 1930). He subsequently received a traveling Guggenheim fellowship and studied in both Germany and Oxford. Dr. Oldberg was one of the original 23 members of the Harvey Cushing Society, and became president of that Society in 1942. He developed a combined service for neurology and neurological surgery as professor and head of that department at the University of Illinois at Chicago. He trained an outstanding group of residents, many of whom are leaders in North American neurosurgery today. But his interests ranged far outside neurosurgery and medicine. To understand Eric Oldberg, it is important to quote some of the things he said about himself and his beliefs. In an article printed in the commemorative volume, 1931–1971, of the Eric Old0090-3019/99/$–see front matter PII S0090-3019(98)00034-2
berg Alumni Association (appearing first in the Chicago Tribune on June 7, 1959) he said: I myself am, of course, a doctor. I am exceedingly proud of my profession and I have seen many instances of its devotion to duty and mankind which have been quite overwhelming. They have been unrelated to any thought of reward, unrelated to any thought of personal comfort or adequate rest, and even unrelated to personal health and family responsibility. But we doctors, possibly because most of us are dedicated men and women who seem to live, sleep and talk medicine, have allowed ourselves to become segregated from the community to such an extent that we are seldom even thought of when it comes to being ask to participate in anything outside the field of medicine . . . Now what can we do about the separation and segregation of which I have been speaking? One must call the attention of the doctors to their own failings. They ought to be willing to place themselves at the disposal of any civic or social endeavor for which they have talent. They ought to live their social lives, not by invariably inviting other doctors and their wives to dinner, but by sometimes inviting their friends in the business, the legal and other worlds to dinner, the theater, the concert, and elsewhere.
Obviously, Eric Oldberg meant what he said and acted on it. He served as president of the Chicago Board of Health for 19 years and was president of the Chicago Health Review Foundation. From 1952 to 1963, he was president of the Chicago Orchestra Association. In this position he was effective in influencing the progress of the Chicago Symphony Orchestra, one of the outstanding orchestras of the country at that time. He served on the Board of the Lyric Opera in Chicago and although he was a staunch Republican, he served for more than 20 years as confidant and advisor to Democratic Mayor Richard J. Daley on such matters as the arts and health. He received the Chicago Medal of Merit, and Loyola University gave him a citation for civic leadership in 1966. Although the following, which came from Newton Minow (personal communication), may be apocryphal, it certainly might have happened, and it is too germane with regard to Dr. Oldberg not to be quoted here: The story goes that a hospital administrator, having read a report by a survey organization brought in by the President of the Board to “help the administrator,” decided to return © 1999 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
Historical Vignette
the favor by “helping” the president . . . [who] . . . happened also to be chairman of the board of directors of a symphony orchestra. The administrator sat through a concert or two and then wrote the following “survey”: For considerable periods the four oboe players had nothing to do. Their number should be reduced and their work spread more evenly over the whole concert. All twelve first violins were playing identical notes. This seems unnecessary duplication. The staff of this section should be drastically cut. If a large sound volume is required, it could be obtained by electronic amplifier apparatus. Much effort went into playing semiquavers. This seems an excessive refinement. It is recommended that all notes be rounded to the nearest quaver. This would make possible more extensive use of trainees and lower grade operatives. There seems too much repetition of some musical passages. Scores should be pruned. No useful purpose is served by repeating on horns a passage already played by strings. It is estimated that if all redundant passages were eliminated the two-hour concert could be reduced to 20 minutes, and no intermission needed. The conductor agrees generally with those recommendations, but thinks there might be some falling off in box office receipts. In that event, it should be possible to close sections of the auditorium, with a consequent saving of overhead, lighting, attendants, et cetera.
Despite his cultural interests, Eric Oldberg was primarily a neurosurgeon, and the education of neurosurgeons was one of his major interests. Speaking of that education at the Eric Oldberg Alumni Association meeting in 1971, Oldberg said: (based on an earlier published chapter) [2]: My education in neurosurgery began with Harvey Cushing . . . Harvey Cushing was a remarkable man. My own senior residency with him began September 1, 1929, and ended October 1, 1930 —though I spent all the optional time I had on his service, during my House Officership and Assistant Residency in General Surgery . . . Prior to my sojourn in Boston, I had worked for some months with Loyal Davis . . . himself much influenced by his contact with Cushing. The Cushing service was unique, and none like it exists today. It consisted virtually entirely of brain tumors. During my incumbency, the number of brain tumors in the house at [any] one time ranged from a maximum of fifty-six to a minimum of twelve. We histologically verified 186 tumors in my year! There was only an occasional tic case, as a gift to Gil Horrax, two or three cord tumors for him, a disc (diagnosed and believed to be a chondroma), a head injury or two, and almost no medical neurology . . . We did our own neurology, there being no medical neurologist on the staff of the Brigham, our own ophthalmology, and fortunately we could collaborate in radiology with that master in the field, Merrill Sosman . . . The result of this manner of training was as remarkable as was Cushing, and though I would revise and extend it, I wouldn’t trade it if I had to do it over again. It made one self-reliant, it made one a real sophisticate in brain tumors, since he was constantly surrounded by them in various states of coma and paralysis; and, since in the course of a year of eighteen-hour days, and seven-day weeks, one was incidentally required to know and record daily the exact number of diopters of choked disc in every patient both pre- and post-operatively,
Surg Neurol 101 1999;52:100 –2
and to take visual fields on a tangent screen on everyone (even tic cases before and after operation!), it made one a pretty expert ophthalmologist.
After expressing concern for the rapid rise in neurosurgery and psychiatry at the expense of neurology, Oldberg continued: Where does this leave the neurosurgeon, and modern training for him? In my view, it demands two new distinct and definite broadening elements. Leaving surgical techniques aside, it demands that the young neurosurgical trainee receive his education in a place where he is constantly exposed to nonsurgical, as well as surgical, neurological cases. And, it demands that he cohabit with, and reach a rapprochement with, competent medical neurologists, who must be developed in greater numbers, and who must mostly devote their skills and acquire their experience, in the diagnosis and management of diseases, defects, genetic aberrations, and metabolic abnormalities of the nervous system. Only in this way can the young surgeon, or the young neurologist, hope to advance his own knowledge, learn to sort the wheat from the chaff, and, hopefully, become an agent of new excursions in the realm of research and discovery . . . Strangely, in medical neurology, that 20th century orphan until recently, which has just begun its own resurgence, we find a large body of resistance to the kind of neurosurgical training I have advocated. I prefer to interpret this as a defensive psychology and an attitude that will gradually dissipate. There is enough work to be done for all of us; and it is neither healthy nor fruitful for jealousies and intellectual arrogance on either side, to separate us. In summary, I would say that the education of a neurosurgeon today, whether he is to be an academician, a researcher, or a garden-variety clinician, should be in the direction of making a surgically oriented neurologist and doctor out of him. And lastly, a discussion of the education of a neurosurgeon would not be complete without a word about the man himself, and his attitude toward his patients and their families. He should be taught to realize that patients who come under his care, are in trouble— often very bad trouble, as are their families. He should imbue these people with confidence, by his manner, he should spare them unnecessary expense, by getting busy, and seeing that the essentials are promptly done and that the non-essentials are kept to a minimum. He should be fastidious in dress and language, and should avoid ambiguity and uncertainty, but never substitute cockiness and arrogance. He should be humble but honest and selfconfident. It is well if he has other interests and can converse on other topics than medicine. And, he should never forget that he is not treating a disease or condition, but “a whole person.”
Like most of those who worked under Harvey Cushing, Dr. Oldberg told many charming vignettes [3]. . . . About once out of every three Sundays, I would receive a call about 9 A.M. and the stentorian voice would come over the telephone, “Oldberg, come out to lunch,” and that was the end of [any] time I had set aside for catching up. There was always one consolation. This was the possibility that there would be some foreign luncheon guest who had never seen
102 Surg Neurol 1999;52:100 –2
corn on the cob. All during the season, it was Dr. Cushing’s delight to serve these gentlemen with a well-buttered cob, and then watch them try to eat it with the least possible spattering, sucking noises, and bits of whatever it is between the teeth. Only those close to Dr. Cushing knew the malicious glee with which he watched the embarrassed debacle. When I came to the Brigham as a house officer, I brought with me several books of piano music for four hands. Marshall Fulton . . . was then a resident in medicine at the Brigham, and we used to play these pieces, Marshall on the treble, and I on the bass, in the upstairs sitting room of the Brigham house staff quarters. Dr. Cushing heard about this, and we were ordered to appear at his house in the late morning one Sunday to exhibit our prowess and to stay for lunch. No one could have felt more embarrassed about this than Marshall and I, but orders were orders, so we took some Mozart overtures and went out to the Cushing house to perform for him on his ancient and untuned upright piano. Now the effect of our efforts, not to mention those of the great composer, was that John Fulton and Dr. Cushing, who sat alongside, spent the whole time discussing the speed with which the visual input from the printed musical score could be transferred to cortical impulses and sent along down the peripheral nerves to make our fingers wiggle so fast. When it was all over Marshall and I heaved a sigh of relief, our only real regret being that cocktails were not a part of the luncheon ritual.
At the Peter Bent Brigham Hospital 50th Anniversary celebration in 1963, Dr. Oldberg reminisced about other aspects of Cushing’s character and skills: Dr. Cushing was, as a matter of fact, a very poor extemporaneous speaker, and he was a very poor teacher by way of lectureships . . . He had absolutely no plan for teaching the seniors neurological surgery. He was interested in the pituitary body. And so, the very first lecture that we had from him— he only gave about three to the seniors— had to do with acromegalics. And I was to find a series of acromegalics and bring them in here. He was up in front and he was nervous as the devil. He was terribly nervous, just appearing before a lot of senior medical students. And instead of lecturing, he started to point to various people here and there, and ask them questions which they were obviously too scared to answer. And the net result of it was, at the end of the hour—which was at 8:00 o’clock on a Saturday morning—when he gave the lecture, I don’t think that anybody learned much of anything at all. The same thing was true of the Cabot Clinics which were given in this same room here. If Cushing were in on some of the
Alexander
cases and sat somewhere along here and Dr. Cabot was down reading the transcript about the case and Dr. Wolbach was up there about to show slides and to prove everybody wrong, Dr. Cushing’s discussions were poor. I have to say that because I am leading up to what really made him a great teacher. Any of you who knew him and heard him speak in public know that he always read everything. He worked terribly hard on every essay that he gave. He wrote them, and he rewrote them, and he had various people proofread them, and, when the thing was finally finished, it was a gem; but it was read. He did not speak extemporaneously, and he was not a good speaker in that sense of the term at all. Now, why was he great? He was not a Nobel Prize winner. He never discovered anything like insulin, or something of that sort. But he was a man of tremendous courage, tremendous will to work, with an intuition that was remarkable. The operating table was absolutely sacred. No one said anything, including Cushing. No one was allowed to say anything. And yet, I remember a few occasions in which, literally, tears were close to my eyes to see that man’s face, without multiple transfusions and gelfoam and all of the other ancillary things that we have now, a big opening in the sagittal sinus or something like that, and stand there with his thumb on the opening for a couple of hours, and finally conquer the problem. It was the learning that you got from Cushing—it was the learning that you got from watching him, and then from emulating him, if you possibly could, and if you had what it takes; and, if you had anything of the same characteristics in yourself, in trying to eumulate what he had done in his life.
Eric Oldberg—musician, neurosurgeon, civic servant, a Harvey Cushing resident. I had known him only casually; now my recognition of his importance to neurosurgery has been greatly enhanced by my research for this historical vignette. Eben Alexander, Jr., M.D. Winston-Salem, North Carolina REFERENCES 1. Bucy PC, Sugar O: Eric Oldberg. Surg Neurol 1987;28: 1–2. 2. Oldberg E. The education of a neurosurgeon. In: Horizons in Neurological Education and Research. Springfield, IL: Charles C. Thomas, 1965:18 –23. 3. Oldberg E (contributor). A selection of Harvey Cushing anecdotes. Collected and edited by Heyl HL. J Neurosurg 1969;30:366 –7.