Wilder Penfield: Influences on the Life of a Neurosurgeon

Erin P. Flynn
Simon Fraser University


The work of Dr. Wilder Penfield was of utmost importance to the study of neurology. Dr. Penfield was the founder and first director of the Montreal Neurological Institute, a research and treatment center of neurological disorder associated with McGill University. Dr. Penfield’s philosophy of treatment and research was revolutionary for his time. His extensive work on epilepsy and the human neo-cortex was influential to many disciplines, including psychology. This paper will provide an account of the major influences that had an impact on Dr. Penfield's life. A brief biography, with a breakdown of the influence of family, teachers, and circumstances following how Dr. Penfield developed his unique approach to neurosurgery, which eventually led to the concept and construction of the Montreal Neurological Institute. The relevance of Dr. Penfield’s work at the Montreal Neurological Institute to Canadian psychology will then be briefly examined.

Wilder Penfield was born in Spokane, Washington in January, 1891 (Pratt, 1956). He was the son of Charles, a homeopathic doctor from Ohio, and Jean, a young socialite from Wisconsin, who met at Oberlin College and married in 1881 (Pratt, 1956). Under advice from doctors, Charles Penfield traveled west for a "fresh-air" of an undiagnosed stomach ailment (Lewis, 1981). He reached Spokane in 1883, set up medical practice there, and then had Jean join him. Success in Spokane, for the Penfields, was due to the vast migration of people along the Pacific coast during the gold rush of the late 1800’s (Lewis, 1981). Wilder was born and raised in Spokane, with two older siblings, until the age of eight when his parents separated and his mother took Wilder and his siblings back to Wisconsin (Lewis, 1981). Wilder visited his father in Spokane five years later to spend a few weeks hunting and camping (Lewis, 1981). Penfield (1977) would later credit this camping and his father’s genes for his "surgeon’s hands".

While in church one day, when Wilder was young his mother overheard a student talking about the Rhodes Scholarship, a scholarship donated by wealthy South African Cecil Rhodes for students of the English speaking world (Lewis, 1981). Winners of this scholarship had their tuition paid for at Oxford College in England. Wilder and his mother decided that he would attempt to win this scholarship, and they planned out Wilder’s next years accordingly (Lewis, 1981). Wilder attended Galahad High School, a private school which was opened by his mother in the year that Wilder graduated from elementary school (Pratt, 1956).

The biggest influence on Wilder Penfield’s young life was that of his mother, Jean. Jean taught Wilder that there was a purpose for him on earth, and that it was up to him to find out what it was (Lewis, 1981). Jean always motivated Wilder to become a Rhodes Scholar by encouraging his excellence in school, prayer, athletics and leadership (Lewis, 1981). In his autobiography, entitled No Man Alone, Penfield writes of his mother:

The fact that my mind was really that of a poddler, and that my gangling body was slow and awkward, would be, it seemed, no obstacle whatever. She would never have admitted these obvious facts to be defects in her son. She knew I could do it. (p. 3)

Penfield continues to say his mother had an excellent mind and could talk about anything. Jean also stressed the importance of Christian morality and ethics throughout Wilder’s life (Lewis, 1981). Penfield dedicated his autobiography to the memory of his mother.

After high school Penfield attended Princeton University where he was active in school politics and a member of the varsity football team (Pratt, 1956). Penfield had difficulty as a young man deciding upon a career choice. He was torn between the ministry, a career option greatly influenced by his strong Christian upbringing, (Lewis, 1981), and medicine, a science which intrigued Penfield. However, he was ashamed of this latter interest because he believed his father failed at medicine and that this failure was what caused his parents separation (Penfield, 1977). Penfield’s choice to study science and medicine over the ministry was a result of his own growing doubt about Christianity and the quality of future church leaders (Lewis, 1981). It was also the result of studying under Edward Conklin at Princeton. Conklin was a biology professor who remained a very religious man, and who was deeply concerned with the relation between science, ethics, and religion. In No Man Alone, Penfield (1977) credits Conklin with arousing his interest in science. In addition, Penfield believed part of his interest in medicine was genetic. When talking of his father, Penfield (1977) stated, "My surgeon’s hands are his hands, and who knows what else of him may be in my genes?" (p. 24).

Penfield graduated from Princeton in 1913 with an honors degree in philosophy (Lewis, 1981). After unsuccessfully applying for the Rhodes Scholarship in his junior and senior years, he was awarded the scholarship on his third application and went to Oxford in January, 1915 (Lewis, 1981).

Penfield arrived in England during the first World War and while there he traveled to France during semester breaks to work in military hospitals. This was Penfield’s first exposure to practicing medicine and examining war injuries - he was both learning and treating (Lewis, 1981).

Penfield completed his first two years of medical school at Oxford (Pratt, 1956). While at Oxford, He studied under Sir William Osler, a compassionate and brilliant man who served as a model of a perfect physician for him (Lewis, 1981). Osler, who founded Johns Hopkins hospital and occupied the chair of medicine at McGill in Montreal, was described by Penfield as being "...a doctor who contributed more than anyone, in his time, to the art of the practice of medicine. He was the great humanitarian in our profession. Physicians and students admired him and strove to imitate him. Patients loved him." (p. 36).

Penfield also studied under Sir Charles Sherrington at Oxford, where Sherrington serverd as a model of a perfect scientist for Penfild (Lewis, 1981). Sherrington's work on the physiology of the nervous system inspired Penfield’s interest in it. When talking of Sherrington, Penfield (1977) stated, "I looked through his eyes and came to realize that here in the nervous system was the great unexplored field..." (p. 36).

Developments of the late 1800’s allowed for better study of this "unexplored field". Antiseptics were invented, which allowed infection-free operations. Advances in anesthesiology allowed painless surgery. Hughlings-Jackson had completed localization of function studies which gave evidence that specific areas of the brain were responsible for specific psychological functions, and it was, therefore, important to find out what these specific areas were (Lewis, 1981). These innovations allowed and encouraged extensive neurological research to be undertaken.

Penfield returned to the United States to attend medical school at Johns Hopkins University. In 1917, after Penfield’s third year in medicine, the United States entered World War I (Pratt, 1981). Penfield went back to France with his new wife, Helen, to work in Red Cross Hospitals (Lewis, 1981). After a period of performing minor surgery, such as shrapnel removal, Penfield once again returned to the United States to finish his medical degree at Johns Hopkins (Lewis, 1981).

His decision to become a surgeon was undoubtedly influenced by the experience he got while working in military hospitals. Although not possessing a medical degree yet, he performed minor surgery and wrote to his mother about how much he enjoyed the responsibilities (Lewis, 1981). Wilder’s decision to specialize in brain surgery was an inevitable result of his interest in studying neurology and surgery. As well, Penfield interned for general surgery under Dr. Harvey Cushing, who was considered to be the leading brain surgeon in the world at the time (Lewis, 1981).

Penfield’s approach to becoming a neurosurgeon was unique for his day. The common practice for learning neurosurgery at the time was as a subspecialty of general surgery. Penfield’s plan was to master the basic approaches to the nervous system (such as neuroanatomy, neurophysiology, etc...) and clinical neurology and only then attempt to specialize in brain surgery. In concordance with this plan, Penfield returned to Oxford to earn a Bachelor of Science, again studying neurophysiology under Sherrington (Lewis, 1981). He was trained in neurosurgery in New York for four years (Lewis, 1981). He also traveled to Spain to study neuron staining under Nobel Prize winner Ramon y Cajal (Pratt, 1956).

Penfield’s unique approach to learning brain surgery was also influenced by Sir Charles Sherrington. who encouraged students and attempted to make them feel like contributors to science rather than mere apprentices of science (Lewis, 1981). Penfield admired this teaching style and the scientist behind it. Contributing to scientific theory was just as important to Penfield as was treating the ill.

In 1927 Penfiled received a letter from Dr. Edward Archibald, Canada’s leading brain surgeon, professor of surgery at McGill and surgeon-in-charge of neurosurgery at the Royal Victoria hospital offering him a position (Lewis, 1981). He agreed to take the job but first traveled to Germany to study with Otfrid Foerster, a neurosurgeon who was doing surgery on people suffering from epilepsy (Lewis, 1981).

Penfield began work in Montreal in October, 1928 (Pratt, 1956). In 1929, he proposed plans for a neurological institute that emphasized both research and treatment. Funding from the Rockefeller Foundation and local endowments allowed construction of the Montreal Neurological Institute, which opened its doors in September 1934 (Lewis, 1981). Penfield and his wife became Canadian citizens the same year the Montreal Neurological Institute opened. While watching a performance by the Madrid Symphony Orchestra in 1932, Penfield was impressed by the "harmonious whole" of the Spanish orchestra (Pratt, 1956). He decided that rather than bringing in foreign scholars and persuading them to stay in Canada, he would educate young Canadians and make a neurological institute of Canadians for Canadians (Pratt, 1956). For this reason, it was important that he and his wife became Canadian citizens.

Penfield’s research at the Montreal Neurological Institute on epilepsy and the human neocortex has been extensive and influential to many disciplines. Penfield’s interest in epilepsy probably stemmed from the fact that his sister, Ruth, suffered from the condition. Penfield recalled when he was a child,

...listening in terror to the sound of a convulsion, standing outside the room in which she slept. A doctor came, and as he entered the room, I was horrified to get a fleeting \tab glimpse of Ruth lying unconscious on the bed. I heard it said, erroneously of course, that this was all due to "nerves". I wondered what that meant... (p. 209)

In 1934, Penfield performed brain surgery on his sister to remove a tumor which would have blinded her. He removed the largest piece of brain he had to date from his sister’s frontal lobe (Lewis, 1981). Her condition improved directly following the surgery (Pratt, 1956). Penfield proved his devotion to a philosophy of research and treatment by setting aside personal feelings and reporting the details of his sister’s case for the benefit of other surgeons (Pratt, 1956). In addition, Penfield’s interest in epilepsy could have been the result of his observations in the military hospitals, that war injuries to the head often later produced symptoms similar of epilepsy (Lewis, 1981).

Penfield’s research, and research on the human brain in general, is obviously very important to the study of psychology. Understanding how biology and physiology affect behavior has become one of the key elements of the discipline. Sections of psychology, such as physiological, comparative and evolutionary, all rely directly on biological research. Neuropsychology, the study of the relationship between brain function and behavior (Kolb & Wishaw, 1996), is the section that was influenced most directly by Penfield’s work. Within this section, there are at least two approaches. The "Canadian School" of neuropsychology emphasizes research and has a flexible selection of tests which are based on theory. The "American School" of neuropsychology emphasizes assessment, and the same battery of tests is given to all patients (Watson, 1997). Penfield’s philosophy of research and treatment has become a "Canadian" perspective.

Many influences during the course of his life caused Dr. Penfield to become a prominent neurosurgeon who pioneered a new methodology of studying neurology emphasizing research and treatment. His mother Jean encouraged him, while growing up, to become a Rhodes Scholar. Professor Edward Conklin inspired Penfield to study science rather than the ministry. Penfield also credits genetic similarity between himself and his father for their shared interest in medicine. Sir William Osler was, to Penfield, the perfect physician, one who was worthy of imitation. Sir Charles Sherrington arouse interest of the nervous system in Penfield. An "unexplored" nervous system could be better studied with innovations of the time such as antiseptic, anesthetic, and the theory of localization of function.

Wilder Penfield’s interest in surgery was influenced by his medical exposure in military hospitals in World War I, while his decision to specialize in brain surgery was a result of his interest in neurology and surgery. His internship under the direction of Dr. Harvey Cushing, the world’s leading brain surgeon of the time also had a big impact on him becoming a surgeon. Penfield’s approach to learning neurosurgery was also inspired by Sir Charles Sherrington, who had encouraged his students to contribute to science, not simply being apprentices of it. Penfield’s research on epilepsy was influenced by his sister’s epileptic condition and by his observations that wounds to the head often later produced signs of epilepsy. The study of psychology has been advanced by Penfield's work on the brain, and his scientific philosophy of research and treatment has founded the "Canadian School" of neuropsychology. Wilder Penfield and his scientific philosophy have become "Canadian" through their legacy at the Montreal Neurological Institute.


References

Kolb, B. & Wishaw, I.Q. (1996). Fundamentals of Human Neuropsychology. New York: W.H. Freeman and Company.

Lewis, J. (1981). Something Hidden: A biography of Wilder Penfield. Toronto: Doubleday Canada Limited.

Penfield, W. (1977). No Man Alone: A Neurosurgeon’s Life. Boston: Little, Brown and Company.

Pratt, V.W. (1956). Canadian Portraits. Toronto: Clarke, Irwin and Company Limited.

Watson, N. (1997). Psychology 387 Lecture Notes. Lecture 1: What is Neuropsychology? Neil Watson: SFU.