Eric Andrew-Gee is the Quebec correspondent for The Globe and Mail and author of the new book, The Mind Mappers: Friendship, Betrayal and the Obsessive Quest to Chart the Brain.
William Cone, right, apprenticed in New York under Dr. Wilder Penfield, left. The two founded the Montreal Neurological Institute, where they would train neurosurgeons from diverse backgrounds who were turned away by racist U.S. medical schools.Osler Library of the History of Medicine/McGill University
Like every Canadian kid raised on TV in the 1990s, I thought I knew about Wilder Penfield. He was the Montreal doctor from the Heritage Minute who found the source of a woman’s seizures by touching her brain and making her smell burnt toast.
It was only recently, as a journalist in my early 30s, that I began to understand Penfield was something more than a curiosity, someone whose story was more dramatic, heartbreaking and significant than a hokey TV spot could capture.
My first inclination came when I kept stumbling across his name while researching everything from addiction to amnesia to human identity. It seemed he had left his mark on every corner of the brain.
When I began digging into the Penfield legend after moving to Montreal, I discovered that his scientific achievements were a quintessentially Canadian tale of teamwork, diversity, linguistic duality and the beginnings of socialized medicine. Whatever the Heritage Minute suggested, the burnt toast guy did nothing alone. What he achieved could only have happened with the help of a tragic, forgotten partner. And it could only have happened here.
Wilder Penfield was an immigrant, like a lot of Canada’s heroes. Born in the railway boom town of Spokane, Wash., in 1891, he moved to his mother’s native Wisconsin at the age of 7 when his feckless physician father abandoned the family, a wound he carried all his life.
Young Wilder got a Rhodes Scholarship and, while at Oxford, fell under the spell of the legendary Canadian doctor William Osler, who served as a surrogate father figure and gave the American his first real exposure to the country that would become his own.
While working as a young neurosurgeon in New York, at a time when the profession was a combination of elevated guesswork and butchery, he was scouted by a suave Montreal physician named Edward Archibald who thought the up-and-coming American could take over brain surgery at the city’s grand and Gothic Royal Victoria Hospital.
A restless adventurer at heart, with a searing ambition to succeed in medicine where his father had failed, Penfield had one main condition: The hospital would have to hire William Cone as well.
Cone was his apprentice in New York, a rural Iowan who was preternaturally good with his hands and equally consumed with becoming a master healer because of a scarring family tragedy. When Cone was just two, his father died of typhoid fever after drinking from the tin cup of a public water fountain. William’s grandfather, a renowned country doctor, could only watch on helplessly. It was the beginning of Cone’s lifelong war against microbes that would help make him one of Canada’s greatest physicians.
Despite their similar backgrounds as fatherless Midwesterners, he and Penfield were opposites in many ways. Where Penfield was tall, handsome and charming, Cone was stocky, homely and socially awkward. While Penfield was beginning to quest after philosophical problems related to the brain – like the connection between body and mind, and finding the seat of the soul – Cone was a surgeon’s surgeon, obsessive about technique and patient care.
The men complemented each other perfectly. They were partners who were also becoming best friends, spending Christmases together, signing their pining letters to each other “Love, Wide” and “Love, Bill.” They liked to say that they worked together in “double harness.”
The pair started recruiting talent from all over the world to join them at the Royal Victoria. Joining the men in Montreal were scientists from the Soviet Union, in part because anti-Communist hysteria was less rampant in Canada, and the British pathologist Dorothy Russell, despite the prevailing sexism of the field.
Within a few years Cone and Penfield had founded the Montreal Neurological Institute, a petri dish of brilliant ideas from every branch of brain science where they would train the first Chinese, Indian, Arab and African-American neurosurgeons, after several of the latter were turned away by racist U.S. medical schools.
“They took you no matter if you were polka-dotted or landed from Mars,” recalled the Arizona surgeon Mark Preul, who trained at The Neuro. “They looked for one thing and that was talent.”
Montreal in the 1930s was a colourful, cosmopolitan metropolis, packed with jazz clubs and gambling dens and brothels, along with newcomers from all over the world. The streets of the Plateau were fragrant with Romanian Jewish smoked meat and the honeyed smoke of bagel ovens. Great fortunes jostled against abject poverty, the two often demarcated by language.
Although Cone and Penfield were adoptive members of the anglophone elite, they took pains to collaborate with the Paris-trained neurologists of francophone Montreal and eventually worked toward a bilingual institute by training some of the first French-Canadian neurosurgeons at a time when medicine in Quebec was largely segregated into two solitudes.
The basis of their growing fame was the so-called Montreal procedure, which treated epilepsy by exploring the surface of a patient’s brain with an electrical wand to trigger a seizure that would tell Penfield where to cut. It was only possible because the cortex doesn’t feel any pain; you would need another brain to register the sensation.
In the course of these operations, the surgeons also began eliciting other fascinating responses from patients that illuminated the location of essential human faculties. When the electrode touched a certain spot, the person would jerk their left arm; another spot would prompt an involuntarily “ahhhh”; yet another would make crosses appear suddenly before a patient’s eyes. Some people even experienced full-fledged cinematic memories – bringing their first child home from the hospital, or being accosted by a strange man as a kid – that began and ended with the touch of the electrode.
These spontaneous reactions, like notes played on a keyboard, allowed Cone and Penfield to map large areas of the brain for the first time. The Montreal procedure – which was only ever done with the patient’s consent in the hopes of curing their epilepsy – also illuminated the ancient mind-body problem, suggesting how much of our experience and identity emerges from discrete slivers of grey matter.
It was not by coincidence that these astonishing discoveries were happening in Canada. Penfield was falling in love with the country’s dual French and English societies, its rugged landscapes, even its winters. He took Canadian citizenship in 1935 and his kids were raised bilingual. He felt that his new home, with its many cultural tributaries, was contributing directly to the progress he was making in his work.
Cone was allergic to paperwork and never bothered to get his citizenship, but he became a Canadian war hero all the same. When the country set up an overseas neurological hospital in England during the Second World War, it was Cone who was chosen as its chief surgeon over his mentor Penfield. In a press baron’s rural estate, the Boss, as he was known, managed to kit out a state-of-the-art medical facility and save hundreds of lives with surgical tools he often invented himself, as Nazi bombs fell all around them.
Cone’s British colleagues could hardly believe the skill and dedication he displayed under such extreme duress. As one professor from the University of Manchester wrote to Penfield, “I can’t make out whether Bill Cone is the greatest surgeon I have ever met or whether I am just a damn fool.”
Jealousy at the star turn of his long-time number-two made Penfield bristle and vent privately to his diary. Cone returned from the war emboldened and less willing to play helpmeet around the institute. The men began to drift into separate orbits: Penfield and his staff increasingly preoccupied with epilepsy and brain mapping, Cone’s people continuing to work on refining the technique of surgery and taking exceptional care of their patients. It was two solitudes all over again.
The 1950s still dawned as a golden age at The Neuro, after one of Quebec’s leading tycoons and most notorious political figures struck a very Canadian deal to secure enough money for the institute to thrive. J.W. McConnell was a sugar baron, publisher of the Montreal Star newspaper, and long-time patron of Penfield’s who had donated huge sums to facilitate the surgeon’s research. In the fall of 1949, the two men visited the notoriously corrupt and parsimonious premier Maurice Duplessis in Quebec City, where the politician asked McConnell what he was prepared to do in exchange for an increase in funding to the institute. Penfield was not allowed to hear the answer, but before the next election $100,000 in cash packaged neatly in cartons arrived at the premier’s office, care of his favourite businessman.
It was a different time, more than a decade before Medicare, when government grants for hospitals were increasing but many people still worried about being bankrupted by medical costs. Cone was famous around The Neuro for waiving payment for hard-up patients, sometimes to the annoyance of the more administratively minded Penfield.
There was hardly any length The Boss wouldn’t go for the people in his care, whether sharing a calming cigarette with them in the middle of the night – again, it was a different time – or finding them a job and housing if their condition caused a disability. He changed bedpans, inserted catheters, and gave sponge baths himself. Sometimes his only sleep came in the form of naps stolen in coat closets around the hospital.
The toll of this grinding schedule and his growing estrangement from Penfield – the mentor and best friend he loved so much – weighed heavily on Cone’s mental health as the 1950s wore on.
But even when Cone was at his lowest, he could still be stimulated by the beauty of his adoptive home, the city and the country that did so much to make his and Penfield’s pioneering work possible. The sight of Mount Royal in autumn, when the trees on the mountain’s slopes erupt in spectacular flaming reds and oranges, made him feel lucky to be an honorary Canadian.
“The weather has been glorious and the colouring in the leaves brilliant,” he boasted to a colleague in St. Louis one fall. “Is there any place in the world where you would rather be than in Montreal … ?”