Wilder Penfield was a pioneer of brain surgery who mapped the human brain, showing which parts of it are most strongly associated with functions such as the different senses, different body movements, and speech.
Penfield was the first to show that muscles respond on the opposite side of the body to the controlling brain hemisphere.
Beginnings
Wilder Graves Penfield was born into a devout Christian family on January 26, 1891 in Spokane, Washington, USA.
His father was Charles Samuel Penfield, a physician. His mother was Jean Penfield, née Jefferson, a writer and Bible teacher. The couple had two sons and a daughter – Wilder was their youngest child.
When Wilder was eight years old, his father’s medical practice ran into financial problems: too often he was neglecting his patients, preferring to go on hunting trips in the wilderness.
Wilder’s mother left Spokane with her children and traveled to her hometown of Hudson, Wisconsin, to live with her parents there.
Little Acorns
At age 13, Wilder’s mother planted a seed in his mind that the finest thing he could do would be to win a Rhodes Scholarship for the University of Oxford in England.
The following year, in 1905, Wilder’s mother helped found a private school for boys in Hudson – Galahad School. Wilder and his mother moved to live in the school. His older sister Ruth married a teacher and moved there too.
Wilder loved the school and performed well both academically and at sport.
Princeton
In 1909, age 18, Wilder Penfield began a bachelor’s degree at Princeton University in New Jersey. Princeton was a strategic move: Penfield believed he had a better chance of winning a Rhodes Scholarship from New Jersey than from the more populous states that were home to the other Ivy League universities.
After two years at Princeton, Penfield half-heartedly decided to major in philosophy and, apart from winning a Rhodes Scholarship, had no real objectives for the future.
He had sworn not to study medicine – his father’s failure was a sore point. However, reading William James’s Principles of Psychology, he realized that his true interest was in the brain and the mind. He now that, like his father, he would study medicine.
In his senior year, his classmates voted him ‘best all-round man.’
Penfield graduated with honors in June 1913. He failed to win a Rhodes Scholarship and began working (schoolteacher, tutor, and head football coach at Princeton) and saving, intending to begin a medical degree.
Penfield at Princeton in 1913.
It’s All Greek to Me
At the beginning of 1914, Penfield received wonderful news: he had been awarded a Rhodes Scholarship. Now he could go to Oxford. He applied to Merton College, Oxford and was accepted on condition that he could pass their entrance examination… in Greek! Penfield had never studied Greek, but could not avoid abiding by the college’s 700-year-old tradition. After some serious cramming, he sat the exam in the spring of 1914… and failed.
Learning Greek Surrounded by the Dead
Merton College told Penfield he could try again in September. In the meantime, he enrolled at Harvard University in Boston for medical training. A medical lecturer told him if he came along at 8 a.m. every morning, he would give him a daily hour-long Greek lesson. And so every morning, surrounded by dead bodies awaiting dissection by students, Penfield learned Greek. He passed the exam in September. In fact, he was one of the last ever to pass it – within a few days he was informed the Greek exam had been abolished!
Oxford and the Brain
Penfield arrived in Oxford in January 1915. Britain was fighting in World War 1 and his classes were small – most young Britons had enlisted in the military. He took rooms in the most ancient part of his college – a thirteenth century building in which he found the conditions were primitive: his bedroom was colder than any he had ever lived in; there was no running water, and no indoor toilet.
At Oxford, he came under the academic influence of the great physician Sir William Osler, one of the founders of Johns Hopkins Hospital in Baltimore, Maryland, and future Nobel Prize winning neurophysiologist Charles Sherrington.
He also took up rugby, writing:
“A fellow said ‘dammie’ when I bumped him yesterday, which is the first oath I’ve heard since coming here. Next time I’ll bump him hard and see what is joggled out of him.”
War
In the spring vacation of 1916, Penfield sailed for France to give medical aid to wounded soldiers. His ship was torpedoed, the explosion blowing him high in the air and badly shattering his left leg. Many of his fellow passengers were killed. Thankfully he was rescued from the sea, after which he spent a month being treated in a British hospital. He then spent several weeks recuperating in Sir William Osler’s home.
Penfield recovering in hospital after his ship was torpedoed.
Penfield was on crutches for six months, after which he walked with a cane for some further months. He graduated from Oxford with a bachelor’s degree in physiology and returned to America in the fall of 1916 to study medicine at Johns Hopkins University. He spent most of 1917 volunteering with the Red Cross in France, before returning to complete his degree. He graduated as a medical doctor in June 1918, age 27, and began work as an intern at the Peter Bent Brigham Hospital in Boston.
The Irresistible Brain
Penfield could not shake off the feeling that his destiny was in human brain research and he believed that Charles Sherrington in Oxford could teach him more than anyone else. With a year of his Rhodes Scholarship left, he crossed the ocean to Oxford again, this time accompanied by a wife, two young children, and his mother. He called on Sherrington and asked for research work, which Sherrington was pleased to give him.
After a year, Sherrington secured funding for Penfield to continue working at Oxford. Penfield also spent time in London’s hospitals – each week cycling 50 miles to return to Oxford for the weekend. He decided to become a neurosurgeon, performing surgery on the brain and other parts of the nervous system.
In June 1921, Penfield began work as a neurosurgeon in New York’s foremost teaching hospital, the Presbyterian Hospital, where he also had time to carry out research.
His first patient, a young boy from Italy, had a brain tumor. After examining him, Penfield had the unenviable duty to tell the boy’s parents that the tumor was too deep in the brain to operate and that their son was probably going to die, which he did at home two weeks later. On the day of the funeral, Penfield and his assistant interrupted a family gathering at the boy’s house to request permission to take the boy’s brain in the hope that they would learn enough to prevent another young boy dying. Permission was given. They removed the brain in a back room of the boy’s house then made him look good again. This was Penfield’s first autopsy on one of his own patients.
In the fall of 1921, Penfield carried out his first two brain operations – one on a brain abscess, the other on a malignant tumor. Both patients died. They would probably have died anyway, but Penfield took no consolation from this.
“Brain surgery is a terrible profession. If I did not feel it will become very different in my lifetime, I should hate it.”
Spanish Lessons
Penfield in 1926.
In the spring of 1924, Penfield and his family sailed for Spain. He took Spanish lessons before he left, and continued learning on the ship. He spent 18 weeks at the Cajal Institute in Madrid learning modern scientific techniques in studying brain cells.
By the time he returned to New York he felt he had acquired enough scientific knowledge to begin making his own fundamental contributions to neurosurgery.
Canada, Germany, and Brain Operations under Local Anesthetic
Penfield worked as a neurosurgeon in New York until 1928, when he was appointed Professor of Neurological Surgery at McGill University in Montreal, Canada. He became the city’s first neurosurgeon, working at the Royal Victoria Hospital. Moreover, the Rockefeller Foundation had hinted that he would become head of a new neurological institute and hospital it was planning to found at McGill – this took place in 1934. Penfield worked at the institute until he retired in 1960, age 69.
In the spring of 1928, Penfield traveled to the city of Breslau, then in Germany, now in Poland. There he met 12 patients suffering from post-traumatic epilepsy resulting from brain damage caused by an external force, such as a blow to the head. Using methods he had learned in Spain, Penfield examined scarring in the patient’s brains. Professor Otfrid Foerster showed Penfield his method of performing brain surgery using only local anesthesia to access the brain, which itself feels no pain, and how the brains of patients who remained awake during surgery could be stimulated gently with electricity.
Mapping the Brain
For Penfield, back in Montreal, surgery on wide-awake epilepsy patients opened the door to greater understanding and mapping of the brain. He adapted Foerster’s method so that with electrical stimulation he could locate precisely the primary sensory and motor areas, which he did not want to cut into while operating. This allowed him to use his scalpel safely to remove scar tissue caused by trauma to the head. This became known as the Montreal procedure. Sometimes electrical stimulation induced an epileptic seizure, allowing Penfield to locate the epileptic focus precisely for removal. The Montreal procedure is the basis of modern temporal lobe epilepsy surgery.
As he worked, Penfield recorded the stimulation points, the patient’s response, and his own observations; he also kept a photographic record. In the 1930s he began developing maps showing how different brain functions seemed to be localized in different parts of the brain.
In 1938, he found that by stimulating different locations on the outer part of the brain – the cerebral cortex, responsible for higher functions such as perception, cognition, and language – patients would sometimes re-experience events from earlier in their lives.
“I was probing a woman’s brain with an electrode when she said she heard a melody. I was so astonished I restimulated the same spot some 30 times. Each time she heard the same melody…”
“A 12-year-old boy cried out. “Oh gosh! There they are, my brother is there. He is aiming an air-rifle at me… My mother is telling my brother he has got his coat on backwards. I can just hear them.””
Brain Lobes
The four major lobes of the cerebral cortex. The temporal lobe processes inputs from the senses.
When their temporal lobes were stimulated with an electrode, almost 10 percent of Penfield’s patients experienced phenomena such as smells, dreams, sounds, sights, and the feeling that parts of their body were being touched. These experiences stopped when the electrode was removed.
Electrocorticography
Penfield’s mapping work was enhanced by a technique called electrocorticography he developed with Herbert Jasper. In 1951, they published their classic work Epilepsy and the Functional Anatomy of the Human Brain describing how epileptic patients could be cured by surgery and how they had mapped the functions of different locations in the brain.
Electrocorticography. A grid of many individual electrodes is placed on the surface of the exposed brain. This allows the electrical activity in the cerebral cortex to be recorded. Penfield used data gathered from the grid to draw detailed brain maps relating location to function. Image by Blausen.com staff (2014).
A modern imaging map of the brain’s motor cortex, consistent with the Penfield’s discoveries.
Success
After he retired, Penfield looked back on his use of the Montreal procedure. He had personally operated on 1,000 patients of whom half were completely cured of epilepsy and 25 percent were improved.
Honors
In 1991, Canada issued a postage stamp to commemorate Penfield’s 100th birthday.
1948: United States Medal of Freedom with Silver Palm
1950: France’s Croix de la Legion d’honeur
1950: Foreign Honorary Member of the American Academy of Arts and Sciences
1951: Flavelle Medal
1953: Britain’s Order of Merit
1961: Lister Medal
1967: Companion of the Order of Canada
1968: Gold Medal of the Royal Society of Medicine
1968: American Medical Writers’ Association Honor Award
Personal Details and The End
In June 1917, in Hudson, Wisconsin, Penfield married Helen Kermott, a physician’s daughter. They were a devoted couple. They had two daughters and two sons: Ruth Mary, Priscilla, Wilder Graves Jr., and Amos Jefferson.
With the family’s move to Montreal, Penfield bought a farm about 75 miles (120 km) east of the city in East Bolton on Sargent’s Bay, Lake Memphremagog. This became a rural retreat for the family. The money for the farm came from $15,000 the German government paid Penfield in 1928 as compensation for the shattered leg he suffered when his ship was torpedoed. Penfield became well-known in the rural community as someone who would willingly help deliver babies, perform surgery, or give any sort of medical aid he could.
In 1934, when he was appointed director of the Montreal Neurological Institute and Hospital, Penfield took Canadian citizenship.
In 1960, age 69, Penfield retired from his work. He believed that an active mind was a healthy mind and he kept his own active by authoring two novels and two collections of essays.
Wilder Penfield died age 85 of abdominal cancer on April 5, 1976 at Montreal’s Royal Victoria Hospital. His ashes were buried on the family’s farm on Lake Memphremagog. His wife Helen died a year later; her ashes were buried beside his.
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Further Reading
Wilder Penfield
No man alone : a neurosurgeon’s life
Little, Brown & Company, Boston, 1977
John Eccles and William Feindel
Wilder Graves Penfield. 26 January 1891-5 April 1976.
Biographical Memoirs of Fellows of the Royal Society vol. 24, pp 473-513, 1978
Jefferson Lewis
Something Hidden: A Biography of Wilder Penfield
Doubleday Canada Limited, 1981
Denis Brian
Genius Talk: Conversations With Nobel Scientists and Other Luminaries
Plenum Press, New York, 1995
Creative Commons
Electrocorticography. Image by Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014“.