History of the Department

Neurological Surgery has had a presence at the University of Rochester for three-quarters of a century. The history for the Department of Neurological Surgery must be considered within the excellent academic traditions of the University of Rochester Medical Center.

Neurosurgery had its beginning at the University of Rochester on October 26, 1926 when Dr. Harvey Cushing came from Boston to preside over the first surgical clinic at the new Strong Memorial Hospital. The academic focus of that initial conference was pituitary tumors. In 1928, Dr. William P. Van Wagenen joined the full-time faculty, specializing in Neurosurgery. He had trained in both neurological surgery and general surgery under Dr. Harvey Cushing. His initial appointment was as an Instructor in the Department of Surgery, but in 1930 he was made an Assistant Professor of Neurological Surgery, the first mention of that specialty in the medical school catalogs of this Medical Center. In 1931, the Abner Perry Hard Fund was established to support a research fellow in Neurosurgery as a result of a gift to Dr. Van Wagenen from Mrs. Louise Hard. Of interest, this was the first such fund in the Department of Surgery and was used to recruit trainees from across the United States. The first recorded Neurosurgical Residency appointment at this Medical Center was in 1933, a graduate of Cornell Medical School and a veteran of three years of surgical training at Duke University and Memorial Hospital in New York City.

Dr. Van Wagenen was one of the prime movers in the organization of the Harvey Cushing Society and served as its first president. (The first Society meeting was in 1931 in New Haven and the organization continues to this day as the American Association of Neurological Surgeons.)

By the fall of 1939, the American College of Surgeons had approved 18 programs in Neurological Surgery in this country, and the University of Rochester Medical Center was one of those sites.

Dr. Frank P. Smith, a 1941 graduate of the University of Rochester Medical School, trained in Neurological Surgery under Dr. Van Wagenen directly after World War II, completed his training in 1948, and then spent an additional year as a Fellow in Neurosurgery at the University of California in San Francisco. Dr. Smith was invited to return to the Faculty in 1949 as an instructor in Neurological Surgery.

When Dr. Van Wagenen retired in 1954, the Division of Neurological Surgery was officially formed within the Department of Surgery. Dr. Smith was promoted to the rank of Assistant Professor and made head of the Division, initially as acting head and then in the 1956 appointment as Chief of the Division and Associate Professor. During Dr. Smith's two decades as Chief, he was very involved in clinical research on surgery for pain, for arterial chemotherapy to brain tumors, and on the surgical approach for the treatment of cerebral aneurysms. Dr. Smith was the first President of the Upstate New York Neurosurgical Society, was President of the Neurosurgical Society of America in 1969, and was Vice-President of the Society of Neurological Surgeons in 1974, as well as serving on the Board of Directors of the American Association of Neurological Surgeons.

In 1974, Dr. Joseph McDonald was appointed as Chief of the Division, succeeding Dr. Frank Smith. Dr. Shige-Hisa Okawara, who had been doing outstanding work in stereotactic surgery at the University of Iowa, was recruited by Dr. McDonald and was joined a few years later by Dr. Curtis Nelson. Over the next few years, the Residency Program grew in size to 5-6 residents and permitted not only improved clinical training, but also more time for productive research assignments by the residents. Over the next ten years, there was considerable clinical research describing endocrinologic and autonomic changes with patients with head injuries as well as the surgical management of severe open head injuries. Dr. Okawara did studies on primate brain tumors in conjunction with the Department of Anatomy. Dr. McDonald developed successful surgical approaches to the heart's autonomic nerve supply to treat patients with prolonged QT Syndrome, a cause of sudden death. In 1968, Dr. McDonald organized a national neurosurgical committee to study methods of cost containment at the request of Dr. Donald Matson, who was then President of the Cushing Society.

Dr. McDonald stepped aside at the age of 65 in 1990 and was replaced by Dr. Eugene George who had been Chairman of Neurosurgery at the Walter Reed Army Hospital and Director United States Army Neurosurgical Residency Program. Dr. George left in 1993 and Dr. Okawara was appointed as Interim Chair.

As a result of the long-standing interest of Dr. Frank P. Smith in Neurological Surgery and after many discussions, the decision was made by the President of the University, Mr. Thomas Jackson, and by Dr. Jay H. Stein, Vice Provost for Health Affairs, to create a separate department of Neurological Surgery. In 1998, Dr. Robert Maciunas was recruited to this post and became the third Frank P. Smith Professor of Neurosurgery and the first Chair of Neurosurgery. Dr. Maciunas had been a professor at Vanderbilt University with considerable reputation and experience in stereotactic and image-guided neurological surgery. Dr. Maciunas left in early 2001 and Dr. Richard I. Burton was appointed Dean's Professor and Acting Chair in November 2001.

Dr. Webster H. Pilcher was appointed the second Chair of Neurological Surgery and the fourth Frank P. Smith Professor in April, 2002. Dr. Webster Pilcher completed his residency at the Medical Center in 1989 and then spent a year at the University of Washington as a fellow in epilepsy surgery. He returned to the University of Rochester faculty in the fall of 1990, recruited to facilitate the development of an interdepartmental Epilepsy Center that is flourishing today in conjunction with the Department of Neurology.

The Frank P. Smith Endowed Professorial Chair in Neurological Surgery was established in 1980 and its occupants have been Dr. Joseph V. McDonald from 1981 to 1990, Dr. Eugene George from 1990 to 1993, Dr. Robert Maciunas from 1998 to 2000, and Dr. Webster Pilcher, beginning in 2002.