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San Francisco: Departments
Neurological
Surgery
Neurology
Nursing
Neurological Surgery
The growth and development of the Division
of Neurological Surgery was intimately related to the career of
Dr. Howard C. Naffziger who organized the specialty of neurological
surgery when he returned to the University's School of Medicine
in 1912 from Johns Hopkins University. Neurological surgery was
in its infancy as a specialty during these early years, but, under
Dr. Naffziger's guidance, it flourished in San Francisco and in
the School of Medicine, culminating in the creation of a separate
Department of Neurological Surgery in 1947. In 1955, the department
once again became a division within the Department of Surgery.
Concurrent with these administrative changes,
there developed an increasing liaison between the Department of
Neurology and the Department of Neurological Surgery in undergraduate
instruction so that by the 1960's, essentially all undergraduate
instruction was a joint responsibility equally shared between the
two departments. Because of the increasing specialization in medicine
as a whole, as well as within the field of neurological surgery,
gradually the concept evolved that neurological surgery per se
was not a suitable subject for undergraduate instruction except
in elective courses which later were established. The neurological
surgeons, therefore, joined with the neurologists on the faculty
in teaching a general course of neurology in the third year, and
offering only an elective course in neurological surgery in the
fourth year.
As is the case with all fields of medical endeavor,
research in neurological surgery changed a great deal. Initially,
as the specialty grew, the major effort was in the development of
technical surgical procedures and the amassing of clinical information
about the disease entities which were treated. This phase of development
was largely accomplished, although new techniques were still being
developed in the 1960's. The major shift in emphasis was toward
both laboratory research, primarily neurophysiological in nature,
and in later years, joint research efforts with other fields, such
as electronic engineering and physics, and the utilization of computer
techniques in the study of such complex problems as the epileptic
discharge.
By the mid-1960's it seemed probable that, in the
future, neurological surgery would find itself working more and
more closely with engineering and the behavioral sciences, and in
both teaching and research the neurosurgical faculty would find
themselves operating as part of a team. source
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Neurology
Until the turn of the century the clinical
teaching and service aspects of neuropsychiatry were covered by
a single faculty member who was a member of the Department of Medicine.
The growth of neuropsychiatry paralleled that of the medical school,
and shortly before the Second World War period, it was represented
by nine part-time staff members. This pattern of growth, however,
failed to take into consideration either the development of neurology
and psychiatry as separate clinical specialties or the necessity
of developing neurological research as an integral part of a teaching-research
center.
The first break in the old pattern occurred in
1942 with the establishment of a Department of Psychiatry, which
was housed in the Langley Porter Clinic. The next development occurred
as the result of a survey initiated by the Curriculum Committee
of the School of Medicine, which recommended a strengthened and
integrated development of neurological instruction. Neurology finally
was established as a separate department in 1946. Dr. Charles Aring
was invited to be chairman, and an inpatient service of six beds
was created.
After further changes in arrangements for the
department, Dr. Robert Aird accepted the chairmanship in 1947. A
full-time staff of four members was slowly assembled, which included
the late Dr. Robert Wartenberg. The undergraduate teaching was reorganized
with emphasis on bedside teaching instead of the previous more didactic
methods. Courses in the second, third, and fourth years were developed,
an active research program was organized; and a small postgraduate
program in neurology was established.
With the opening of Moffitt Hospital in 1955,
the neurology inpatient service was expanded to 12 beds, and the
postgraduate training program in neurology was further developed
under a grant from the National Institutes of Health. Teaching services
at San Francisco General Hospital, the Ft. Miley Veterans Administration
Hospital, and in neuropediatrics at Moffitt Hospital were established
within the next eight years. Research in the fields of neurophysiology
and neurochemistry were greatly strengthened in this same period.
The growth of the department can be summarized
in the following statistics: from one full-time faculty member in
1947 to eight in 1965; from six beds in 1947 to 54 in 1965; from
an initial budget of $30,766 in 1947-48 to $367,678 in 1964-65 (teaching
funds and research budgets included); from an annual average of
14 research papers and occasional public lectures by two authors
in 1947-48 to 40 research papers and 90 public talks by 12 authors
in 1965. source
Nursing
See Colleges and Schools, School
of Nursing.
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