Beyond ‘burnt toast': Eric Andrew-Gee probes the story of Penfield and Cone in The Mind Mappers

Globe and Mail

2 days ago

'I can smell burnt toast.' Most Canadians over 30 remember the 1991 Heritage Minute short that celebrated the revolutionary Dr. Wilder Penfield, who experimented on the brain's temporal lobes in the 1930s.
Less well remembered is his partnership with the Iowa-born neurosurgeon William Cone. It was this collaboration that enabled Penfield to turn the Montreal Neurological Institute, familiarly known as the Neuro, into a global epicentre for brain research between the late 1920s and late 1950s.
In his new book, The Mind Mappers, The Globe and Mail's Eric Andrew-Gee brings the unusually symbiotic relationship between this odd couple compellingly to life, giving due respect to Cone, whose life ended tragically inside the institution to which he had devoted the best part of his career.
The partnership of these two neurosurgeons in Montreal seems like one of those perfect alignments of serendipity. How does it come about?
Cone and Penfield had these eerily parallel childhoods. They were both raised in the American Midwest in the turn of the 20th century. Penfield's father had abandoned the family after going bankrupt as a feckless doctor in Spokane, Washington. He packed his family up on a train, sent them to live with his wife's family and then never joined them. Cone's father contracted typhoid fever and died when Cone was 2. They both grow up with stories of medical greatness in their families, but also medical failure.
When they finally cross paths at Presbyterian Hospital in New York in the 1920s, their heads are in a very similar place. Penfield is one of a couple dozen practising neurosurgeons in the world, and he's basically learning on the fly because there's no one to teach him. That's the state of neurosurgery at the time. It was so rudimentary, so crude, so dangerous for patients, and so heartbreaking for practitioners who were constantly losing patients.
Cone arrives as a research fellow. He's interested in the brain from his medical training in Iowa. His grandmother had died of a brain tumour, so he had the brain on the brain. Penfield wonderfully describes this moment when he sees Cone walking down this stairwell in the hospital. In retrospect, he realizes this is the moment that set the course of his life. They immediately realize there's chemistry there, although they're polar opposites.
The differences are striking. There seems to have been a kind of symbiosis through opposition.
Penfield's this tall, dapper, handsome, athletic guy. Very outgoing, charismatic and well-spoken. Cone is none of those things. He's stocky and socially awkward. He might be diagnosed with Asperger's nowadays. He prefers tinkering in his workshop, inventing new surgical tools, and sitting with patients, holding their hands. Penfield is an excellent doctor and cares about patients, but he also has grand philosophical visions of what the study of the brain could be.
It's a perfect match because one is very hands-on and practical and one is a silver-tongued orator and scientific visionary. When Penfield is recruited by the Royal Victoria Hospital in Montreal, his one condition is they hire Cone too.
You started off researching Penfield, and then stumbled upon this little-known character, Cone, who effectively ends up the hero of your book. Tell me about that discovery.
There's an internal history of the Neuro – a coffee-table sort of book – with a chapter on Cone that describes this figure who's probably the greatest neurosurgeon of his generation. The master of masters. Incredible judgment, incredible dedication and the most patient-oriented doctor anyone had ever met.
Thanks to his extraordinary gifts as a doctor, he made possible the scientific leaps that had originally gotten me interested in Penfield's work. Then, in his early 60s, he dies suddenly in his office in tragic circumstances that bring the golden age of the institute to an end.
I got the sense that this was a great archetypal story, this master-and-apprentice relationship. As a storyteller I was hooked, but as a person I was just so moved by Cone's saintliness, by the fact that this medical hero who was at the heart of one of the great stories in Canadian science was totally forgotten.
He really comes to life in the book, which is remarkable given the lack of paper trail.
Penfield had a sense of his legacy, so he kept every piece of paper that crossed his desk, and a journal. Cone has virtually none of that. He hated to write because it slowed him down. He wouldn't even write patents for the surgical tools he invented. It could have made him tons of money. People would badger him to write back about a simple, 'Are you coming to this medical conference?'
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So virtually everything we know about Cone comes from Penfield's archive, from their correspondence, because he did write to Penfield. Their correspondence is extraordinary. Tender longing when they're apart. It was in the clipped style of mid-century Protestant North American men, but it's nonetheless revealing.
To that point, there's a strong suggestion that Cone's devotion to Penfield – he turns down the opportunity to run his own institute to stay on as Penfield's second-in-command, for substantially less pay – might have been more than platonic.
Male friendships can be as fraught and turbulent as any love affair. I do think Cone's feelings ultimately tipped over into the romantic. I don't know if he ever acknowledged that to himself. Almost certainly not to Penfield. It was illegal to be homosexual in Canada at that time.
There's all this circumstantial evidence that his love for Penfield was something more than platonic. He had this bitterly unhappy marriage, had no children. On its own, that doesn't tell you much, but then there's the tone of the letters to Penfield.
When Penfield doesn't appoint Cone his successor when he decides to retire, it devastates him. Probably it wasn't the right role for Cone in some way, but the way Penfield went about it felt to Cone like a stab in the back.
He has a meltdown. He falls into a deep depression in the years after this rift. And I'm not sure the scale of his reaction makes sense if his feelings for Penfield were merely platonic.
What are Cone and Penfield's greatest achievements – either singly or together?
Cone made the hospital hygienic, functional, medically sound, so that people wanted to come there and be cured. But it was Penfield's ideas that made their legacy.
Penfield had a sister who had a brain tumour in her frontal lobe that caused seizures. In 1928 he and Cone operated on her at the Royal Victoria Hospital and she almost died. Penfield was a little too aggressive and carved out about an eighth of her brain without really knowing what the frontal lobes did.
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She survived the operation, but the tumour grew back and she died. In the meantime, her personality changed. She became, as he described it, like a lump of putty.
Penfield realized he'd been reckless, and that he needed to map the brain if he was going to be an effective surgeon. That's what he and Cone did, and that's their greatest achievement. They were like the early cartographers. They developed this procedure for treating epilepsy that would simultaneously map the brain.
In the course of doing this, they were also figuring out what different regions of the brain were responsible for. And this is absolutely crucial, not only for surgeons to know where not to cut, but for the treatment of neurological conditions. It was the mind-body problem that had always puzzled philosophers and scientists: Is there a ghost in the machine, different from our gray matter, that makes us?
This interview has been condensed and edited