How a Scoville aneurysm clip fought in the Cold War and helped to establish neurosurgery in Iceland.

It can be said that the specialty of neurosurgery in Iceland had its beginnings on November 30, 1971, with the arrival of a huge American C-130 Hercules aircraft. It was carrying a small package containing Scoville aneurysm clips. They were sent to the late Bjarni Hannesson (1938-2013), who had received his neurosurgical training in 1967-1971 at the Dartmouth-Hitchcock Medical Center (then known as Mary Hitchcock Memorial Hospital and located in Hanover, New Hampshire). He used one to clip the right posterior communicating artery aneurysm of a 34-year-old fisherman, who recovered well. The apparent reason for the use of such a huge aircraft for such a small payload is to be found in the sociocultural politics of the Cold War. It involved the continued presence of the American base at Keflavík, where the C-130 landed. The base was under pressure to be closed by Iceland's left-leaning, nominally communist government. The C-130's arrival generated welcome publicity for the continued operation of the American base, which is still there.

Singing by speechless (aphasic) children: Victorian medical observations.

In the second half of the nineteenth century, British clinicians made observations regarding the ability of individuals with impaired language abilities to sing or hum. One notable publication was of two cases of children briefly observed by John Hughlings Jackson (1835-1911) in 1871. These children were speechless but could produce some musical expression. Other such cases attracted the attention of Victorian clinicians who were actively pursuing theoretical questions regarding the organization of brain function and laterality. The presence of musical expression in children who failed to develop spoken language was seen as a notable symptom for early practitioners of pediatric neurology.

Harvey Cushing's paradigmatic contribution to neurosurgery and the evolution of his thoughts about specialization.

The modern era of neurosurgery began in 1879 with the amalgamation of three technologies: anesthesia, antisepsis/asepsis, and cerebral localization. However, when Harvey Cushing (1869-1939) took his first tentative steps toward a neurosurgical career in 1901, the outlook for the field was dismal, because mortality and morbidity rates were horrific. For brain tumors, surgical mortality rates were 30-50%. I will argue that Cushing made intracranial surgery clinically effective, rather than just feasible, by adding a critical fourth technology: knowledge and control of intracranial pressure (ICP). During his Wanderjahr in Europe (1900-1) Cushing came to understand ICP in biophysical terms. At Johns Hopkins, these lessons were quickly translated to acute human traumatic cases (1901-4) and then to tumor patients with raised ICP (1903-5). By 1910, he had accumulated enough tumor cases (180) to have convincing statistics. His mortality rate for tumors was 10-15%. Nonetheless, the successful paradigm was not fully instantiated until a community of practitioners formed a neurosurgical society in 1920. As this process unfolded, Cushing's ideas about specialization also evolved in interesting ways.

Inclusiveness and coherency in the history of the neurosciences.

The International Society for the History of the Neurosciences (ISHN) defines "neurosciences" broadly, and we want to encourage the widest possible range of scholarly approaches to our subject. However, this deliberate inclusiveness could potentially cause problems with internal coherency in our organization and in the scholarship that we are trying to create. In other words, we need to avoid the pitfalls of the internalist-externalist tension without losing the benefits of both perspectives. In fact, I think that there is a large and interesting "gray zone," where the boundary between these supposedly separate approaches is both artificial and porous. This should be one of the most rewarding intellectual domains for the study of neuroscience history, because our subject is always culturally loaded by the mind/body problem and by the assumptions that it entails. Of course, neuroscience history is also influenced by all of the other cultural and scientific aspects of the milieus in which it is conducted. Understanding neuroscience history in all of its multiple historical contexts will require the participation of a wide range of scholarly viewpoints. To keep ourselves coherent in the process, we will have to educate each other.