A utopian idea: Cushing, Bailey, Penfield, and the National Institute of Neurological Diseases and Blindness

Toward the end of the First World War, Harvey Cushing conceived of a National Institute of Neurology (NIN) that would integrate neurology, neurosurgery, psychiatry, and allied disciplines within a single institution. It would first be established for the care of American casualties in an existing military hospital in France, and then relocate to the United States. Cushing was unsuccessful in acquiring funding for this project despite appeals to the army and to the Carnegie and Rockefeller foundations. By 1920 the idea had faded from memory. In 1933 Wilder Penfield was successful in obtaining funding from the Rockefeller Foundation for the creation of the Montreal Neurological Institute (MNI). The MNI's faculty held full-time university appointments and they limited their practice to the institute, where their offices and clinics were housed, and to adjoining research laboratories in neuroanatomy, neurochemistry, neurophysiology, and neuropsychology, as Cushing had envisioned. In this paper the argument is made that although Cushing's plan for the NIN was premature, the success of the MNI proved its feasibility. In addition, the MNI's success in integrating clinical care and research within a single institution was a model for the National Institute of Neurological Diseases and Blindness and drove its first clinical research program.