INSIGHT: Mind on the brain
Medical history on display: the ethics of appreciating the Cushing Center
Xander de Vries
“Do you need a little darkness to get you going?” – Mary Oliver, “The Fourth Sign of the Zodiac”
Give into that low, fizzing, queasy feeling, and it gets easier. Resist the urge to shield your eyes from the brains in labeled jars that are meticulously preserved and line the room from wall to wall. Let your mind wander and take a turn to the grotesque, and you might think these are brains from nothing less than a zombie cult. You glance at the portraits on the walls, all depicting the same man, and realize the cult’s leader is the real subject of this shrine; and he is to blame for this discomfort. Your nausea sharpens. You may even throw up into the drawer you open containing the bones of a 5-month-old fetus. However, your confusion about how to feel has faded; you have chosen a stance over the in-between. Now, you can conclude: This headquarters for a horror story is as foreign to beauty as you are to the universe contained in this room.
Quiet confrontation is the mechanism of the Cushing Center, located in the basement of the Medical Library at Yale University. The museum is named after Harvey Cushing, the pioneering neurosurgeon who treated the patients whose remains are on display. Just one jarred brain would have been sufficient to provoke me on my visit, but here there are 550 jars of whole brains, scalloped brains and lone spheres of tumors. Most lie on a spectrum between charred and pristine. Others are frayed like hamster cage bedding. They are all nestled side-by-side on shelves that wrap around the ceiling’s perimeter. There’s J. Wilcox, R. Macmellon, F. Delano, H. Dodds, T. Condon; medulloblastoma, carcinoma, craniopharyngioma, meningioma, multiple glioblastoma. I feel ambushed, but the brains themselves are indifferent or unaware. They simply sit, modestly sunken in their amber, formalin brine. Detached from responsibility for their imposing presence, the jars glow over spotlights and in my face. They have accepted the permanence of their –omas, their enigmatic tumors, and I think: should I be acquiescent too?
My first inclination was yes. Because the museum implores us to admire, I felt I should not only accept the museum, but also applaud it. The space isn’t sterile; soft, cherry wood walls, shelves and tables have replaced the stale white drywall and linoleum of hospitals where the brains were once kept alive. Typewritten names label jars and exude intimacy despite the facelessness of the remains they contain. Cushing’s intricate and impressive anatomical drawings, mostly found in drawers, include facial details, like one patient’s wooly moustache. Even more surprising are the efforts to make the space child-friendly. In one corner, an enlarged drawing of several jars made by middle school students sits on display in between staged photographs of patients in hospital gowns. Written on the jars is a thank you message and the note “I HAVE A BRAIN, TOO!” Near the entrance, activity sheets, including a word search and scavenger hunt, are laid next to the guest book. The comments left in the scribbles include: “BRAINS!” zombie sketches (confirming I am not alone in my interpretation), “death” and “I LOVE brains.” For kids, there are even assembly instructions for a brain hemisphere hat, inviting them to pretend their own brains lie outside their heads by folding paper that maps their anatomy.
I turn to a frame with six photographs, one of which is a black-and-white portrait of a patient with a disturbing malformation. His scalp suctions inward, and the maze of folds in his cortex are hugged by the skin on top of his head. It’s as if his skull has disappeared. His brain hemisphere hat is no origami. It’s the real deal. Dark hair buds sparsely in the grooves, creating the illusion of a shadow. He is frowning more with his crown than he ever could with his face. Neither his name nor his condition is listed anywhere, rendering the photo more of an art piece than evidence.
Neighboring this portrait are photos of his skeleton, dismembered skull, vertebrae and clavicle juxtaposed with normal-sized bones. Across from this frame lies a glass case containing a whole skeleton, nearly seven feet tall and strikingly similar to the man from the portrait. He hangs daintily from a rod drilled into his skull, impaled by his disease.
The Cushing Center is far from being a natural history museum. The place is far too infused with affection. Artwork from Cushing’s personal collection, like a print with 12 different drawings of lips, is draped across the exhibit and obstructs any comparison between this space and, say, the Peabody Museum. However, the material displayed in the Cushing Center is too punishing and funereal for an art museum. It would be wrong to appreciate Harvey Cushing’s specimens as samples of his creative expression.
According to a 600-page biography in the middle of the museum –– and every Cushing biography –– Harvey Cushing is the father of neurosurgery. He identified countless tumors, instituted neurosurgery as its own discipline, spearheaded surgical techniques, maintained and steadily reduced low surgical mortality rates, and vastly expanded our understanding of the pituitary gland and its disorders. He insisted on preserving tumors and other specimens for future study because of his characteristic obsession with documentation. Oh, and he won a Pulitzer Prize for his biography of Sir William Osler, a fellow father in medicine. Noteworthy, preeminent, respected –– he is all these words.
Yet, I think I hate him. In the rotunda two floors above the museum, a gold inscription describes Cushing as an “Inspiring Teacher Pathfinder in Neurosurgery Master of the Science and Art of Healing.” Turning 360 degrees to read the whole dedication, I nearly laugh out loud. Could someone who incises and bottles the stuff of our minds for a living be so inspiring? On my descent into the museum, I encounter a blown-up image of Cushing posing with intent, one knee slightly in front of the other. His eyes scathe, his forehead extends and his nose is downturned. He stares down his patient, who, unlike Cushing, looks at me. The man is shirtless, docile, and lost. Then, upon entry to the museum, Cushing refuses to make eye contact yet again. In the first photo that greets me, he stands alone, his gown only half on, nonchalant and staring into the distance. If he is a god, he knows it.
Cushing’s air of scientific egotism is not exactly remedied by surrounding portraits: a woman tries to cover herself with a slipping bedsheet, her eyes both undirected and always on me; a toddler with a crumpled head, held between the hands of a distant, headless nurse; a girl, smiley and woozy, hand over her heart, who is almost more heartbreaking to me because she seems oblivious to her illness and her destiny in a jar.
Harvey Cushing was no god, nor was he a sadist, but his contributions are lauded by this space in a way that compels me to reciprocate with an equally naïve but opposite response: rebellion. What I skeptically intuited and what the museum does not explicitly detail is the means through which Cushing obtained his collection. Indeed, it takes both cunning and ludicrousy for someone to commit to creating such a registry. According to Michael Bliss’s biography of Cushing, he often bypassed patient consent for operation and autopsy and bribed patients’ families or undertakers. Without this underhanded moral violation for the sake of science, this testament to human suffering would not exist.
I am not a medical student well- versed in how to stomach such a flesh overload and therefore found myself drifting between admiration and disgust; however, someone who, say, frequents the medical library is likely more comfortable with the biological bluntness of the museum. For these students the brain collection has a reasonable allure. Before they were in the Cushing Center, the brains, located in the basement of the Harkness Hall dormitory, were the end-goal of medical students’ breaking-and-entering quests through dusty crawlspaces. And now, the majority of comments in the Cushing Center guest book are written by recent medical school graduates and those aspiring to or practicing in neuroscience.
More than I am angered by the involuntary collection and display of these brains, I am unraveled by the involuntary affliction of these patients by their radical diseases. It is just much simpler to be angry at Cushing. This confrontation that visitors must face is the museum’s strength. Ten feet below a reading room where students abstract knowledge on human anatomy, the Cushing Center unabashedly presents a corner of medical history in its rawest –– and most uncomfortable –– form. It represents both the quintessence of human intelligence and an ugly reminder that our minds are just brains.
In my senior year of high school, during a special wellness-themed week, my eccentric but well-intentioned biology teacher had the bright idea of making a sculpture to display near the school entrance. Her medium: goat brains. She elevated three of the mouse-shaped, gummy organs onto a base of brown Play-Doh. She pierced them with toothpicks, joined by a paper banner inscribed in marker with a wellness mantra. Somehow, the sculpture stayed –– and decayed –– on display for weeks. Whenever I walked by, a smell damp and offensive hijacked the air. A combination, I imagine, like marijuana and sulfur dioxide. Yet I cannot remember the mantra because I was so preoccupied by my teacher’s unpalatable creation. But now I wonder: even if we cannot see the sculpture’s beauty, doesn’t our repugnance make it an art in itself?