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1. Dr. Light's description of the case


This book is a copy of a case history of one of Dr. Cushing's patients operated on during the last two weeks of his active surgical career, August, 1932. It was copied for me by the hospital stenographers as an example of the type of record that was kept for Dr. Cushing's patients.

Four different history and examinations are recorded, first by Dr. Shambaugh who was probably a House Officer, but later became a leading otologist; by Bronson Ray who was Cushing's last full-year resident; by myself as associate resident with Ray; and by Dr. Pattison, who was a voluntary graduate assistant from Newcastle, England. The patient was admitted August 2, ventriculogram was done on August 10th, and craniotomy followed, opening and closing being done by Dr. Horrax and the exploration by Dr. Cushing. A third ventricle tumor was expected but was not reached and the patient was discharged August 31. She returned in January, 1933 for the last time, and on the 24th was reoperated. I did the opening and closure and Dr. Elliott Cutler explored and removed a portion of the tumor. She died in the hospital and an autopsy was done March 31st by George Hass. The final diagnosis was a rapidly growing glioblastoma. I requested one-half of the brain and this was given. As of today, I have no idea where it is.

There are a number of interesting features in this case history, not least of which is the extensive stenographic work involved. The country was deep in depression and hospital money was scarce. I have a letter from the superintendent of Peter Bent Brigham Hospital asking if I would cover my half of a new piece of surgical equipment, the cost of which was $1.50. The expenditure of 75 justified two letters! Nurses were paid $6.00 for a 12 hour day and could not find work. Yet these detailed case histories continued. It was a rude shock, however, for the Brigham-trained surgeons (Glenn, Meagher, Ray and Mahoney) who went to the newly-opened New York Hospital and found that they had to do all of their case writing by hand.

August 1, 1985

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