Charles G. Drake

1978, Washington DC

Charles George Drake was born on July 21, 1920, and received his early education in Windsor, Ontario. A teacher remembers Charlie as "the most thoughtful and determined student" he had ever known, and these personality traits perhaps more than anything else characterize the man and his career. At the age of 18, he moved to London, Ontario, and graduated in 1944 from the Faculty of Medicine at the University of Western Ontario. He initially planned a career in internal medicine but while interning at the Toronto General Hospital a senior resident became ill, and Charlie was recruited to be the only houseman on the neurosurgical service. This contact with the Toronto School of Surgery and that quiet genius of Canadian neurosurgery, Kenneth G. McKenzie, changed the direction of his life. Drake was fascinated with McKenzie the surgeon, and drawn to McKenzie the man, for they had much in common, a passion for fishing and the outdoors, a natural athletic ability, and a contemplative determination in their approach to a problem. McKenzie, a general surgeon converted late to neurosurgery, recognized the need for fundamental training in neurobiology and influenced Drake to begin his training in the growing field of neurophysiology, culminating in a year with John Fulton at Yale University. During this year Drake studied the functional motor localization of the cerebellum. A year of general surgery with Angus McLaughlin was followed by 2 years of clinical training with McKenzie and Botterell on the busy Toronto General neurosurgical service, where he learned the art and craft of neurosurgery. McKenzie and Botterell recognized the exciting future in the surgical treatment of intracranial aneurysms and arteriovenous malformations (AVM) and encouraged Drake to seek solutions to the then many unsolved problems in their management.

During this period, Charlie courted and married a beautiful student nurse, Ruth Pitts. In 1951, he, Ruth, and their first child, John, traveled to Great Britain to study neurology at the National Hospital at Queen's Square and to meet and observe the leading neurosurgeons of Europe of the time, including Sir Hugh Cairns, Norman Dott, Gustav Norlen, and Herbert Olivecrona.

In 1952 Drake returned to London against the advice and conventional wisdom of many, as the first and for some years the only neurosurgeon in Southwestern Ontario. He joined the staff of the Faculty of Medicine at the University of Western Ontario, where his natural ability, sound training, and the continued support of Professor Angus McLaughlin (who he was to succeed as the chairman of the Department of Surgery 22 years later) ensured success. He was soon recognized as an excellent neurologist and a bold and uncommonly skillful surgeon. His practice flourished, but he avoided the hazard of being overwhelmed and diverted by the large number of cases by training general surgeons and orthopedists to assist in the care of patients with trauma of the nervous system. Working alone, he was early to recognize the need for expert associates. In Paul New, and later John Allcock, he was fortunate to have the guidance and assistance of two of the pioneers of modern neuroradiology. In Ronald Aitken, he had a gifted and perceptive anesthetist who developed and perfected many of the techniques which permitted the direct attack on many heretofore unapproachable vascular lesions of the nervous system. Appreciating the enormous resources he had in the many patients under his care, Drake worked diligently at new approaches and new solutions to old problems, meticulously perfecting his technique and carefully recording his results. Out of this effort came a series of publications, in 1978 numbering more than 70, covering a wide breadth of neurosurgery, characterized by lucid technical descriptions and a candid, honest style which emphasized failures as well as triumphs.

It was the intracranial aneurysm and AVM that were to become the focus of his energies, and for the next 25 years he set a standard for the world in the treatment of these common and deadly lesions. Drake, Allcock, and Aitken furthered our understanding of aneurysms and subarachnoid hemorrhage with their astute observations on vasospasm, the tragedies of early operation, the important of magnified vision and postoperative angiography, and the safety and limits of intentional, deep hypotension to make the exposure and dissection safe and even possible. In 1978, he had operated on more than 1000 aneurysms and since his first attack on a superior cerebellar artery aneurysm in 1958 to 1978, he had operated on more than 600 aneurysms arising from the vertebralbasilar system. By 1978, he had operated on more than 150 AVMs, and his success in dealing with aneurysms and AVMs of all sizes and at all sites is unparalleled. It is perhaps more important that he has openly shared the triumphs and tragedies of his large surgical experience and thereby assisted the development of this exciting field for all neurosurgeons.

These surgical accomplishments would suffice for most men, but Charlie was early recognized by his peers as a leader and spokesman. He has given unselfishly of his time and effort to neurosurgery, surgery, and the community of medicine. He has been president of the Royal College of Physicians of Canada, president of the American Association of Neurological Surgeons, president of the World Federation of Neurological Surgeons, president of the Canadian Neurosurgical Society, member of the Board of Regents of the\American College of Surgeons, chairman of the Editorial Board of the Jour_nal of Neurosurgery, and visiting professor and guest lecturer in most of the countries of the world. These duties have been carried out with good humor and wisdom while maintaining a demanding and rigorous neurosurgical practice.

Perhaps his most proud professional achievement, however, was the development of the Department of Clinical Neurological Sciences at Western. In 1969, Drake and his longtime friend Henry Barnett joined Neurosurgery, Neurology, Neuropathology, and Neuroradiology into one cohesive unit. This department, now the second largest in the medical school, has effectively removed the artificial barriers between medical and surgical neurology to provide the optimum care for patients and a foundation for clinical and basic research into neurologic disease.

What makes Drake unique? Of course, he possesses those qualities necessary in every surgeon. He has good hands and excellent surgical technique, not dainty or flashy but solid and workmanlike. He has an uncanny perception of surgical anatomy and is able to decipher the most complex anatomical situation, even in the most confining exposure, with apparent ease. He is a good neurologist. He is capable of exceptionally hard work and possesses unusual stamina which enables him to operate on 8 or 10 major cases every week and stand at the operating table for 10 or 12 hours and still be able to work at the same pace at the end of the case as he did at the beginning. He has always set a high standard for himself and for others to keep good records. He has kept handwritten notes and drawings on every major case that he has operated upon, highlighting the clinical history and physical findings and the details of the operation, postoperative course, and follow-up. These running track sheets, assembled into large looseleaf books, have been the foundation for the published reports of results over the years.

Perhaps his most unique characteristics which distinguish a great neurosurgeon fl:om the rest are his single-mindedness and determination. He is able to concentrate and return again and again to a problem until a solution is found. He is not easily dissuaded by the attempts and failures of others or what at first appears to be an impossible situation. Moreover, he is able to learn and grow from an error, adversity, and apparent defeat. When one looks back over his pioneering efforts in the surgical treatment of aneurysms and AVMs of the posterior circulation, one realizes that most of us would soon have given up, for there were many early disasters. But success surely depends on reflection, perseverance, endurance, and the ability to start up fresh and enthusiastic after each disappointment. Charlie brings a large measure of all of these qualities to every problem.

For those of us who have had the privilege of working with Charlie, he is known as a wise physician, intuitive neurologist, and a superb, decisive neurosurgeon. He is determined to push back the frontiers of neurosurgery by thoughtfully responding to new and different ideas. He continually asks "How can we do this better?" while stressing safety, reason, and judgment.

Charles Drake is a man of many interests and diverse skills. He handles his airplane, shotgun, fly rod, and squash racquet with the same care, dexterity, and enthusiasm with which he handles an aneurysm clip. He has enjoyed marvelous support from his gracious and understanding wife and lively family. He and Ruth have raised four fine sons and proudly exclaim the virtues of their two grandsons.

It was a privilege to recognize Charles Drake as the honored guest of the Congress of Neurological Surgeons, for he in turn adds distinction and honor to this organization.