Neurological Surgery at the Medical University of South Carolina
Antebellum Charleston became the region’s economic and cultural epicenter quickly from its founding in 1670 and in 1823 received a state charter to form a medical school. This represented the first medical college south of Baltimore in the United States; since its founding the University represents the sixth oldest continually-operating medical school in the United States, barring the Civil War period (1861-1865). Opening exercises occurred on November 24, 1824.
Neurosurgical procedures were performed at the institution before the presence of specialized neurosurgical services, as can be deduced from reading early nineteenth century student theses describing procedures to relieve elevated intracranial pressure. The early College attracted notable faculty. Dr. Francis Lejau Parker (1836-1913) reported a case that was credited by the journal Science in 1931 as the first successful repair of an injured nerve: he sutured a posterior interosseous nerve that had been severed sharply in an accidental trauma; the patient enjoyed complete motor recovery.
By 1856 the new Roper Hospital was established with one hundred beds, providing the primary teaching grounds for the College. The Medical College suffered in repute however from the Flexner Report of 1909 and this may explain the reorganization into a state institution in 1913. Separating itself from the proprietorship of the Medical Society of South Carolina, the College rose quickly to a “Class A” institution by 1916. In 1955 The Medical College Hospital opened with five hundred beds constructed through state and federal funding. In 1967 the dental school opened on land formerly occupied by the Porter-Gaud School, and the College earned its new status as the Medical University of South Carolina.
Dr. F. E. Kredel (1903-1961) is remembered as the University’s first “Brain Surgeon”. He served as professor of surgery at MUSC from 1937 to 1961, having worked closely with Cushing in 1927 and 1928. Cushing credited him as being the first to successfully culture glioma cells in artificial media. Later Kredel earned recognition in cerebrovascular history for pioneering revascularization techniques including that of encephalomyosynagiosis.
Dr. Julian R. Youmans (1928 to present) arrived in 1963 at the age of 35 to become the youngest chief of neurosurgery in America. He represented MUSC’s first residency-trained neurosurgeon. Dedicated neurosurgical care at MUSC was thus founded in 1963 as a division of General Surgery. In his first year, Youmans took continuous neurosurgery call with the assistance of the general surgery residents, and in 1964, successfully petitioned the American Board of Neurological Surgery to launch the residency program. Dr. Russell Travis became the first resident to join the department on July 1, 1964, and he would later serve as President of the AANS from 1996 to 1997. Large NIH grants toward cerebrovascular research launched the neuroscience laboratories and the division flourished.
When Dr. Youmans departed MUSC to chair the University of California at San Diego, Phanor L. Perot Jr. joined MUSC in 1968 as the new Chief of Neurosurgery. A trainee (1956 – 1961) of Drs. Wilder Penfield, Theodore Rasmussen and William Cone, Perot left the Montreal Neurological Institute to return to the American South. The possibilities of expansion in neurosurgical clinical and research services at Charleston attracted the Louisiana-born man. His research program, boosted by interdisciplinary collaboration and recruits from the Montreal Neurological Institute, drew decades of continuous NIH funding and resulted in foundational clinical studies for the management of acute spinal cord injury.
Dr. Perot and Dr. Thomas Ducker carved out an intensive care unit in 1972 specifically for the care of patients suffering neurological trauma. The first unit of its kind in the State of South Carolina. In 1977 the Division achieved Departmental status at MUSC, securing Dr. Perot’s legacy as the founding Chairman. Ludwig Kempe arrived in 1973 and would describe the transcallosal technique for ventricular tumors while Perot described the transthoracic approach to thoracic discectomy. In Perot’s tenure residency retention surpassed 90percent, and from this legacy, excellent neurosurgical training has become the department’s hallmark and point of pride. Perot served as President of the Society of Neurological Surgeons from 1988 to 1989 and later as founding vice president of the World Federation of Neurosurgical Societies from 1989 to 1993.
In 1997 Dr. Stephen Haines succeeded Perot as Chairman while championing evidence-based practices on the national neurosurgical stage. Upon Haines’s departure to lead neurosurgery at the University of Minnesota, Dr. Sunil Patel accepted Chairmanship. Patel had completed his training in neurosurgery under Perot, at the same institution, in 1991. He was then awarded the Sugita Scholarship and spent three months in Nagoya, Japan learning neurovascular surgery from Professor Kenichiro Sugita. He additionally trained as a fellow in Cranial Base and micro-neurosurgery with Dr.’s Laligam Sekhar, Peter Jannetta and Hae Dong Jho in Pittsburgh. Patel initiated the Brain Tumor Program at the Hollings Cancer Center and developed Skull Base surgery at this institution. In 2002, he became Vice Chair of the Department under the chairmanship of Stephen Haines, MD, and in 2004 became the first Clinical Chair of the newly developed Department of Neurosciences at the same institution. In recent years Patel led the formation of the Zucker Institute for Applied Neurosciences (ZIAN) - a self-sustaining, commercially-minded technology accelerator engine –within Neurosciences at MUSC.
Under Patel’s Chairmanship, Dr.’s Raymond Turner and Alex Spiotta were recruited from the Cleveland Clinic to work with neuroradiologists Dr. Quill Turk and Imran Chaudry to develop the Endovascular Neurosurgery Program. The group has catapulted MUSC neurosurgery to international leadership in Neuro-endovascular surgery.
Despite extraordinary growth in infrastructure and scientific knowledge, the age-old traditions of medicine continue as they did two centuries ago in Charleston, with the oft-repeated departmental mantra still reverberating in the halls and on the wards:
“The art of patient care… is caring for the patient.”
Krishna, Vibhor, et al. "History and current state of neurosurgery at the Medical University of South Carolina." Neurosurgery 69.1 (2011): 145-153.
Waring, Joseph I. "History of the Medical University of South Carolina." Southern medical journal 67.8 (1974): 888.
The Society of Neurological Surgeons. Sunil J. Patel, MD FAANS. Accessed Nov. 29, 2017. Retrieved from The Society of Neurological Surgeons
The Society of Neurological Surgeons. Phanor L. Perot, Jr., MD PhD. Accessed Nov. 29, 2017. Retrieved from The Society of Neurological Surgeons
Dr. Phanor L. Perot Jr. Obituary. Published in Charleston Post & Courier on Feb. 4, 2011. Accessed Nov. 29, 2017. Retrieved from Phanor Perot Obituary