Founded in 1811, the Massachusetts General Hospital (MGH) is the third oldest general hospital in the United States. The 907-bed medical center offers sophisticated diagnostic and therapeutic care in virtually every specialty and sub-specialty in medicine and surgery. Among these specialties, the MGH Neurology Service has a long and rich history of treating patients throughout New England and the world, and researching their diseases.
While the official Neurology Department was not formally established until 1911, James Jackson Putnam was named “Physician to Out Patients with Diseases of the Nervous System” in the early 1870s. He has been called the pioneer neurologist of New England and remained active treating patients and contributing medical writings until 1912. E. Wyllys Taylor was named chief the year Putnam stepped down. In 1926, a Neurological and Neurosurgical Ward opened after decades of discussion, and a year later James B. Ayer was made chief of the service. Charles S. Kubik succeeded him in 1946, followed by Raymond Adams – who was invited to return from Boston City Hospital as Chief in 1951.
Trustees of the hospital have long documented support for research as an essential and imperative part of the hospital’s function, and these early leaders in the MGH Neurology Department fostered such exploration. Early laboratories include neuropathology, cortical (psychological) testing, the first laboratory of electroencephalography in a US hospital, and the first spinal fluid lab in the country. In 1951, Dr. Adams fostered the study of how immunology could clarify a number of neurologic diseases, notably multiple sclerosis. Researchers at that time pair investigated blood-nerve barriers, the basic processes of delayed cellular immunity and created the first experimental model of Guillian Barré syndrome, experimental allergic polyneuritis.
In addition, many diseases received their first or most definitive clinical or pathologic descriptions through the astute observations of MGH neurologists. For example, early MGH researchers proved the mechanism for delirium tremens and Korsakoff’s psychosis, identified the neuropathology of nutritional optic neuropathy, defined cerebellar hemorrhage as a clinical entity for the first time. Due to the painstaking work of Dr. C. Miller Fisher, many of the lacunar stroke syndromes were identified, as well as the pathogeneses of small vessel infarction and carotid stenosis.
Many young neurologists have graduated from the esteemed Neurology residency program, with careful attention going towards scientific study. In late 1952, Dr. Adams helped establish a division of pediatric neurology at the MGH. Throughout the 1970s and 80s, researchers developed a relationship with the Fernald State School in Waltham with the Shriver Center to study diagnosis, treatment and prevention of neurologic diseases causing mental retardation and other disabilities. Dr. Adams retired in 1978 and Joseph Martin assumed the position of chief.
In 1989, Dr. Martin left to become provost at UCSF, and later Dean of Harvard Medical School. In 1991, Dr. Anne B. Young became MGH’s first female chief at the hospital, and the only female chief of neurology at an academic hospital in the country. She is a world renowned expert in Huntington’s and Parkinson’s diseases. She was recruited to MGH as chair of neurology in 1993. In 1995, she and Dr. Martin A. Samuels (Chair, Brigham and Women's Hospital) established the Partners Neurology Service that leads in establishing joint and common programs to promote quality improvement and efficiency. The Massachusetts General Institute for Neurodegenerative Disease (MIND) was founded in 2001 by Dr. Young. She directs the program with a mission to translate laboratory discoveries into prevention, treatment and cures for Alzheimer’s disease, ALS, Huntington’s disease, Parkinson’s disease and other neurodegenerative diseases.
The MGH remains committed to strong clinical excellence and training the next generation of neurologists and neuroscientists. Today there are over 80 clinical neurologists and over 200 research neurologists at the MGH, as well as 51 residents, and 8 divisions encompassing all major subspecialties of neurology. MGH has a strong commitment to research, with a hospital-wide annual budget of over $500 million. It has the largest hospital-based research program in the country.
The Brigham and Women's Hospital is the product of a 1975 merger among three eminent Boston academic centers: The Peter Bent Brigham Hospital (1911), the Robert Breck Brigham Hospital (1914) and the Boston Hospital for Women, itself the result of a merger of the Boston Lying-In Hospital (1832) and the Free Hospital for Women (1875). As the medical/surgical member of the founding institutions, it was in the Peter Bent Brigham Hospital that neurology took root.
When the Peter Bent Brigham Hospital opened in 1913, Harvey Cushing was named the surgeon-in-chief. Cushing, the founder of modern neurosurgery, stayed at the Brigham until 1933. During the Cushing era, Henry Christian was the physician-in-chief, during which time there was no neurologist on the staff. When Soma Weiss succeeded Christian as the Hersey Professor and Physician-in-Chief at the Brigham, he recruited John Romano, then at the Boston City Hospital, together with Eugene Stead and Charles Janway to be on the full-time faculty; Stead for general medicine, Janwey for infectious diseases and Romano for neurology and psychiatry. For the next three years, Houston Merritt, also from the Boston City Hospital, made Tuesday afternoon rounds with John Romano on all the neurological patients identified during the week. In 1941, George Engel arrived at the Brigham where his studies with John Romano on delirium and syncope grew into what was to be the birth of psychosomatic medicine in North America, work that was then continued by Drs. Romano and Engel at the University of Cincinnati and the University of Rochester.
Throughout the rest of the 1940s and early 1950s, neurological consultations were carried out by a number of distinguished neurologists including Augustus Rose, Derek Denny-Brown, and Raymond Adams all based at the Boston City Hospital. Dr. Roy Swank, a specialist in multiple sclerosis based most of his practice at the Brigham until the mid-1950s. In 1956, George Thorn, the Hersey Professor and Physician-in-Chief who had succeeded Soma Weiss, recruited H. Richard Tyler to become the first truly full-time neurologist at the Brigham. Dr. Tyler had completed his internship at the Brigham followed by neurological training under Derek Denny-Brown at the Boston City Hospital. Dr. David M. Dawson joined Tyler shortly thereafter, followed by H. Harris Funkenstein in stroke and Mark Hallett, the founding director of the clinical neurophysiology laboratories.
During the Tyler era, the neurology division remained in the department of medicine, but grew impressively with the addition of a major basic research program led by Dennis Selkoe in Alzheimer disease and Howard Weiner in multiple sclerosis. From the early 1960s onward The Brigham was part of the Harvard Longwood Neurology Training Program which graduated many of the leaders of academic neurology.
In 1988, Martin A. Samuels succeeded Tyler as neurology division chief and in 1995 an independent Department of Neurology was created at the Brigham. Partners HealthCare system was created in 1995 with its anchor academic medical centers of the Brigham and the MGH. The Partners Neurology Training Program began shortly thereafter, graduating its first cadre of residents in 2000.