Architecture of Neurology: Establishment of the Montreal Neurological Institute as a Transnational History

Abstract

The Montreal Neurological Institute (MNI) is often framed as a triumph of North American medical innovation, an institution converging research, clinical care, and neurosurgery under the leadership of Wilder Penfield. Such narratives fail to account for Penfield’s emotional labor and the networks of expertise that shaped the MNI. Using primary sources that reveal the transnational influences embedded in its design, this paper interrogates the foundation and evolution of the MNI particularly by looking at the early years of Penfield’s career. It situates the MNI within the broader historiographies of medical space and scientific mobility drawing from Penfield’s letters to illustrate the early influences that led to the establishment of the MNI. It proposes that history of emotions and history of mentalities can be effective methodologies to understand the diverse medical research communities of the early 20th century. Using his letters to his mother, Jean Jefferson Penfield, this paper interprets the emotional states of a young, self-doubting Penfield within a network of renowned neurologists of that period. In a wider context, through the case study of the MNI, this paper demonstrates that international collaboration and the physical mobility of researchers – as in the example of the American-born Penfield’s global journey in search of knowledge and his path to becoming a naturalized citizen of Canada – are essential for the advancement of scientific research.

Introduction

The Montreal Neurological Institute (MNI) is often framed as a triumph of North American medical innovation, an institution where research, clinical care, and neurosurgery converged under the leadership of Wilder Penfield. This narrative, however, fails to account for the transnational networks of expertise and institutional design that shaped its formation. Moreover, an approach that focuses on his contributions merely as that of a scientific mind does not consider Penfield’s emotional investment in the institution. Surely, Penfield’s vision for the MNI was deeply informed by his European training and his strategic engagement with the Rockefeller Foundation (RF), an institution that played a role in defining the MNI’s spatial and functional priorities. The building itself, designed by the Montreal-based architectural firm of Ross and Macdonald, was the product of negotiations between Penfield’s ideals and the RF’s funding constraints, reflecting a global conversation on the integration of medical research, surgical practice, and patient care. However, the MNI was also the product of emotional labor on Penfield’s part – the crescendo of his life that finally brought everything together. The MNI was not only a combination of the study, research, and practice of neurology but also what Penfield considered his greatest achievement as understood from his memoirs and correspondence.

This paper interrogates the foundation and evolution of the MNI, using archival drawings, correspondence, and funding documents to reveal the institutional compromises and transnational influences embedded in its design. It situates the MNI within the broader historiographies of medical space and scientific mobility. It draws from Penfield’s letters to illustrate the personal and emotional dimensions of scientific mobility and institutional formation. In a wider context, the case study of the MNI demonstrates that international collaboration and the physical mobility of researchers are essential for the advancement of scientific research.

Scholarly work on the history of the MNI and the life and times of Penfield are, for the most part, inseparable. Numerous publications and dissertations by William Feindel, Richard Leblanc [1], Yvan Prkachin [2], Delia Gavrus [3-5], Annmarie Adams [6,7], Zoe M. Adams, and Joseph J. Fins [8] consubstantiate the history and the built environment of the institution with that of the individual. Given the crucial role Penfield played in the establishment of the MNI, this is a fathomable outcome in any project dealing with this subject matter. However, Penfield’s earlier life before moving to Montreal, particularly his time in Europe, and his experiences as a young scientist and physician are rarely given the emphasis they deserve.

This paper traces the roots of the MNI in Penfield’s early years as a neurologist and neurosurgeon in search of new knowledge and methods around the world. It aims to understand the causes and effects of scientific mobility and tries to identify the patterns that impact both the individual scientist and the scientific community.

Sources, Methodology, and Theoretical Framework

This paper makes use of correspondence and other documentation found at the Osler Library of the History of Medicine at McGill University and Canadian Centre for Architecture (CCA) in Montreal, the Rockefeller Archive Center (RAC) in New York, and the Archives of the Cajal Institute in Madrid. Among the primary source material, Penfield’s letters to his mother particularly stand out. Penfield wrote to his mother, Jean Jefferson Penfield, on a regular basis. In a forthcoming essay, Annmarie Adams presents the letters exchanged between the two as documents that “reveal a vulnerable side” of the highly regarded physician who openly shared his insecurities with his mother [9]. For Wilder Penfield, writing to his mother was a respite and a connection to home regardless of where he was geographically [9]. Hence, the collection of correspondence found at the Osler Library of the History of Medicine at McGill University creates an opportunity to understand Penfield’s legacy from a history of emotions perspective and provides clues about his emotional connection to the MNI [9]. As this paper discusses, these letters also open new possibilities to explore the scientist/physician of the early twentieth century as an individual with internal states composed of hopes, fears, anxieties, and desires navigating societal norms rather than a purely rational and determined scientific mind striving to achieve certain goals. In this context, this paper emphasizes the verb “feel” when referring to Penfield’s expressed inner states in line with historian Rob Boddice’s definition of the word “feeling” as an expression of “the senses and of internal states that may or may not manifest as emotions [10, p.52-3].”

The work of architectural historian Annmarie Adams demonstrates that Penfield was deeply attuned to the sensory aspects of space, a sensitivity that played a substantial role in his scientific experiences and ultimately shaped his architectural vision when he set out to establish the MNI [6,7]. In a similar manner, this paper applies history of emotions and history of mentalities methodologies to interpret Penfield’s expressions of career-related anxieties and insecurities in the aforementioned letters. From a history of mentalities perspective, such manifestations not only point to the individual’s inner world, but also to group dynamics and the society at large. In historians Peter and Carol Stearns’s terms, Penfield’s letters from this period can assist us in writing an “Emotionology” of the period that provides an understanding of cultural norms and standards of that period [11]. In this regard, this paper borrows the term “emotional community” from historian Barbara Rosenwein’s work to refer to the diverse networks in which Penfield was trying to situate himself [12]. The paper also refers to “emotional regimes” – a term William Reddy defines as a “set of normative emotions and the official rituals, practices, and emotives that express and inculcate them [13].” While Penfield’s letters provide clues about the emotional regimes that governed the English-speaking scientific community of the early 20th century, they also hint at the diversity of networks that existed outside this realm at that time and reveal Penfield’s desire to explore different emotional communities. From an architectural history perspective, this paper builds on the extensive work of Annmarie Adams and William Feindel as it interprets some of the design choices for the MNI as reflections of Penfield’s inner world [6,7].

Wilder Graves Penfield (1891-1976) – The Foundational Years

Wilder Penfield was born in 1891 in Spokane, Washington where his father, Charles Samuel Penfield, practiced medicine. At the age of eight, he moved to Hudson, Wisconsin with his mother and siblings where his mother, Jean Jefferson Penfield, later established a private school [14-16]. His mother was a major influence in Wilder Penfield’s life particularly in decisions regarding his education.

For Wilder Penfield, writing to his mother was a respite and a connection to home regardless of where he was geographically [9,14]. As an educator, Jean Jefferson Penfield had a roadmap planned for her son, Wilder Penfield, which took him to Princeton University where he excelled both academically and athletically as an undergraduate (Figure 1), then in 1914 to Oxford University’s Merton College where he worked in Charles Sherrington’s laboratory as a Rhodes Scholar. It was under Sherrington’s supervision that Penfield became aware of scientific work carried out in non-Anglophone parts of the world. In particular, the work of Madrid-based Santiago Ramón y Cajal and his student Pío del Río Hortega inspired him [14-16].

Figure 1.

Wilder Penfield as a student at Princeton University. Source: Flickr Commons project, 2008.

While Cajal and Río Hortega’s work were significant milestones in the field, the language barrier was one of the obstacles Penfield had to overcome to understand these latest developments and apply them to his own research. He teamed up with one of Sharrington’s assistants, Harry M. Carleton, to translate some of Cajal’s articles into English using a Spanish dictionary [2, p.45]. Penfield wrote about his deep admiration for the Spanish school in a letter to his mother where he shared with her that Carleton called Penfield “Ramon” after Cajal, and Penfield called Carleton “Pío” after Río Hortega while working in the laboratory [17].

Upon his return from Britain, Penfield followed in his father’s footsteps to become a physician and pursued medical education at Johns Hopkins University. In the summer of 1915, he served at a Red Cross Hospital in France where he became fascinated with the art of surgery [14-16]. His plan in 1916 was to spend the summer holiday in service again, however he got injured onboard SS Sussex which a German U-boat torpedoed on its way to France [14-16]. After his medical school graduation in 1918, he completed his internship in Boston’s Peter Brent Brigham Hospital where he worked under Harvey Cushing (who later became the Sterling Professor of Medicine at Yale School of Medicine). In 1921, he received an offer from Johns Hopkins in Baltimore but as life seemed “more attractive” in New York [14, p.76-8], he chose to practice surgery at the Presbyterian Hospital in New York City where he remained for 7 years [14-16]. He later became affiliated with the Neurological Institute of New York as well. Despite everything New York had to offer, Penfield was not fully satisfied with his work which required him to perform the duties of a general surgeon besides neurosurgery while opportunities for research and discovery were scarce. He became increasingly frustrated with the limitations of surgical practice that could only help a handful of patients if they were lucky [14-16]. In the autumn of 1923, he was finally given the authorization to work exclusively on brain surgery. However, his research toward a better surgical operation for the cure of epilepsy remained unsatisfactory: “My results were mediocre. I had come to a dead end, and I knew it [14, p.90].” Around that time, he recalled Sherrington’s words at Oxford: “Don’t give up until you have tried the methods of Ramón y Cajal [14, p.92].” When he announced to Allen Whipple, his supervisor at the Presbyterian Hospital, his decision to take six months off to go to Madrid and study the Spanish methods, Whipple’s lighthearted reaction reflected a common attitude of the time: “Madrid! For bullfights perhaps, and for art certainly. But I’ve never heard of anyone going to Madrid to study anything medical or scientific [14, p.93].” Nevertheless, Whipple granted him the 6-month permission to leave his position to work with Cajal and Río Hortega in Madrid.

The “Others” Behind Penfield’s Work

The disillusionment he faced in New York convinced Penfield that he had to return to research and given his fascination with the work of Cajal and Río Hortega, the best place to do this was Spain [14-16]. As a Rhodes scholar at Oxford in 1915, Penfield attempted to replicate the work of Santiago Ramón y Cajal, the Spanish neurologist who had been awarded the Nobel prize in Physiology or Medicine in 1906 for his work on the structure of the nervous system [2, p.45], [14]. Cajal, an artist turned scientist, had developed staining methods to visualize neuroglia. Since his work was more accessible in the Spanish-speaking world, South America had the advantage of sending their scientists to study with Cajal and his student Pío del Río Hortega in Madrid. Upon their return from Spain, these South American scientists were able to spread the Spanish methods in their own countries [18]. Neurology in the English-speaking world during this time was in an existential crisis. Penfield was aware of this situation as evidenced in his letters to his mother as well as his correspondence with the British neurologist Francis Walshe [19]. Furthermore, Penfield’s eagerness to travel across Europe to discover alternative approaches to the research and practice of neurology is a testimony to how he felt about the condition of his field.

In 1924, a 33-year-old Penfield set sail for Madrid from New York. While on board the French liner, the SS Rousillon headed to Vigo, Spain, he confided in his mother about his self-doubt and the uncertainties regarding his career. He wrote:

I can get no farther until I learn something about neuroglia cells in Madrid […] My ability to build up a practice is very doubtful. […] The point is I have done nothing to justify consulting practice. These articles have all been pot boilers. I’ve done nothing but prepare and still I am preparing. I do not see the way toward hydrocephalus or epilepsy or any worthwhile problems and so I go on trying to learn, hoping the method will become apparent. But there is not the slightest guarantee that any clue lies in the direction I am taking. I am at the height of my power and still reaching out for new weapons----using none.

Anyway, our bridges are burned. Our blue flower is truth. Only by finding it shall I succeed. Financial success and all that that means to our family would follow finding and applying truth. But when I get the last weapon in Madrid, shall I be able to see how to use it, or will it be the wrong weapon. Will it lead to different problems and not back to hydrocephalus! [17]

Later in his letter, Penfield wrote to his mother about his concerns of not being able to communicate in Spanish in the laboratory environment as well as his financial worries. The journey to Madrid was filled with risks and uncertainties. Helen Kermott Penfield, his wife, was with him during this time and the duo studied Spanish together. The details provided in Penfield’s letters about the value of his wife’s companionship is reminiscent of a pattern observed in the contributions of the uncredited hidden labor of female companions of male scientists, such as the work of Milena Marić that helped establish Albert Einstein’s career, in the history of science [20,21]. While Helen Kermott Penfield was not a scientist herself, she had an eagerness to learn as evidenced in her husband’s comments about how she outperformed him as they studied together: “One would think that she was going to work with Cajal [17].” She was also an avid reader and kept extensive records of the books she read [22]. As understood from Penfield’s letters, the duo read together almost as a therapeutic practice not only to combat the psychological pressures but also to ease the physical pain of seasickness during their journey to Madrid [17]. Penfield’s wife, who he commended both as a study partner and a financial manager at times of economic hardship, stood in contrast with the instability of this journey and the ship in motion that made him sick. When Penfield fell ill, she took over the task of reporting the latest developments to her mother-in-law, Jean Jefferson Penfield. This episode in the couple’s life encapsulates the affective uncertainties of scientific mobility. The anxieties Wilder Penfield experienced were not just personal; they were shaped by the emotional regimes governing scientific careers in the early 20th century.

When the Penfield family arrived in Madrid in 1924, the new building of the Cajal Institute was being built with funds provided in 1920 by the King of Spain, Alfonso XIII [23]. The older building where Penfield worked mainly with Río Hortega was across the construction site (Figure 2). Both Wilder and Helen Penfield were highly observant of their surroundings as understood from their correspondence. During their time in Spain, particularly Helen Penfield wrote detailed descriptions of the apartment the couple rented and even drew a plan of it for a friend in a letter dated May 4, 1924 [24].

Figure 2.

Highlighted in yellow is where Penfield worked with Cajal and Rio Hortega in 1924, and the one in green is the new Cajal Institute building that was being constructed while he was there. Source: Legado Cajal.

During their time in Spain, the couple were accompanied by their two children, Ruth Mary and Wilder Jr., as well as the family’s housekeeper, Alice. Helen Kermott Penfield’s correspondence reveals that the Penfields’ finances and therefore living conditions were not as dire as her husband was relating to his mother. The main cause of Wilder Penfield’s frustration was his uncertain future in neurology, and the pursuit of knowledge in hopes of finding answers to neurological problems such as epilepsy and distinguishing himself in the field – a cause for which he left his comfortable life in New York City and set sail for Spain.

While Penfiled’s eagerness to become a pioneer in neurology was not rare among his contemporaries in the field, the path he chose differed dramatically. He had been dreaming of working with Cajal since his time in London but never had the opportunity due to lack of funds [14, p.93]. Now that he finally achieved financial stability as a surgeon in New York, he could realize that dream. Prkachin writes that Penfield was the first known English-speaker to train in Madrid [2, p.18]. However, records available outside the realm of North America show that the Swiss-educated Australian physician Laura Forster trained with Cajal in Madrid in 1911, 13 years prior to Penfield [25]. When Penfield penned his memoires at old age, he poignantly titled the chapter dedicated to his time in Spain “Keys to Understanding [14, p.90-113].” In retrospect, his time in Madrid must have felt like the key moment in his training. Coincidentally, in 1933 as an editor of the Archives of Neurology and Psychiatry, he wrote to Cajal asking him to contribute an article to the journal on the training of a neurologist [26].

After his time in Madrid, Penfield returned to New York where his dissatisfaction persisted. A few years later, he accepted a position at the Royal Victoria Hospital (RVH) in Montreal. Prior to moving to Canada in 1928, the Penfield family went on yet another European expedition. This trip was to Germany where Penfield could learn the surgical methods of the legendary German neurosurgeon Otfrid Foerster in Breslau, who was no stranger to training students from the United States. Foerster had been the physician of Vladimir Ilyich Lenin, and he received funding from both the Soviet Communist Party and the RF. In 1928 Penfield also had an RF fellowship in exchange for which he was tasked with preparing a report on the condition of neurology, neurosurgery, and neurohistology in Central Europe [27]. During his time in Germany, he traveled to surrounding countries and Scandinavia to visit neurological institutes for his report. Founded by neurologists Cecile Vogt and Oskar Vogt in 1914, the Kaiser Wilhelm Institute for Brain Research, Penfield thought, was the most efficient in its design to accommodate neurological research. However, he found it to be too far removed from patients and from the practice of general medicine and surgery. This was the opposite of the problem with the New York Neurological Institute and the National Hospital at Queen Square, London which neglected research while mainly focusing on surgery, and particularly that of tumor removal [14, p.173-4]. Around this time, Penfield’s vision for the ideal design of a neurological institute started to blossom. He believed that the survival of the field, as evidenced by his correspondence with his British colleague Francis Walshe, depended on the convergence of research with therapy, and of clinical practice with experimental discovery [28].

Funding the Montreal Neurological Institute

With his vision for a hybrid neurological hub, Penfield sketched the ideal design of his dream institute on a piece of paper carrying the letterhead of the Biltmore Hotel in New York City in 1929 [29, p.441] (Figure 3). Around the same time that year, he initiated his pitch to the RF by writing to Richard Pearce – the Director of the Medical Sciences Division of the RF. His first letter of request presented the project as a research institute like the ones established in Europe in the last three decades, in which the RF clearly had an interest. After all, it was the RF that provided Penfield with the funds needed to prepare his 1928 report. While Penfield was aware of RF’s mission for the advancement of neurological research in North America, he also knew that they had the strict policy of never investing in hospital projects. He strategically downplayed the psychiatric and patient-care aspects of the project by assuring Pearce in his letter that “patients would be taken to the Institute only for the study and investigation of neurological conditions [30].” Despite this framing, Penfield never intended to build a research-exclusive facility; his personal papers and later architectural decisions reveal a consistent commitment to integrating surgery, pathology, and patient treatment. Pearce was not convinced that the project was dedicated solely to research without any clinical care component. Thus, the RF rejected Penfield’s initial proposition.

Figure 3.

The 1929 sketch for a neurological institute by Penfield. Source: MNI Archives.

By 1932, Alan Gregg replaced Pearce at the RF. Gregg was more sympathetic to Penfield’s ideas and with his support, the RF granted Penfield USD 1,232,000 to realize the neurological institute project in Montreal. Historian Delia Gavrus attributes Penfield’s success at this time both to policy shifts in the RF and to Penfield’s ability to befriend key figures such as Gregg [3-5]. This interpretation is further supported by Penfield and Gregg’s correspondence in later years which suggest that the Gregg and Penfield families maintained a very close relationship for many years after 1932 [19].

Although the RF funding was not announced until April 1932, the earliest drawings by the Montreal-based architectural firm Ross and Macdonald found at the Canadian Centre for Architecture (CCA) are dated November 26, 1931 as the RF funding was secured by that time [31]. An RF memorandum dated April 13, 1932, announcing the funds allocated for the establishment of the MNI emphasized two main points: 1) The status of teaching and research in neurology in North America has been conspicuously behind that in other countries; 2) Establishing a properly balanced neurological institute at a Canadian university would present especially favorable opportunities for influencing both English and American neurology [32]. The RF recognized the shortcomings of neurological research in North America and regarded Canada as the ideal location for the project to advance this field in the English-speaking world. This conceptualization suggests that the RF viewed Canada both as a domain of Britain and an extension of the US. Thus, according to the RF team, the soon-to-be established MNI was mainly to serve the Anglophone world despite being situated in a bilingual city. However, the American-born Wilder Penfield, who became a naturalized citizen of Canada in 1934, did not exactly agree with this vision. He imagined the MNI as an international hub that was uniquely Canadian, and he clearly expressed this in the speech he delivered at the opening of the MNI in 1934:

And yet this inauguration is not of a colonial branch of London’s National Hospital, not a lesser Salpêtrière springing up in the new world, not an upshoot from an aberrant American root which has tunnelled its devious way across the unguarded border. We dare to hope that this is the inauguration of an institute of medicine that is characteristically Canadian, the birth of a Canadian School of Neurology [33, p.54].

Although the RF granted funds to Penfield’s project, they did so on the condition that none of the resources they provided would be used in clinical care, which was not acceptable for Penfield. The RF only agreed to finance the research and education-related sections of the project and committed to support fellowships for researchers in the years to come – however, they would not be involved in financing any of the clinical practice or patient care – the patient wards and clinical features of the project were ultimately financed by the city of Montreal, the province of Quebec, and private donors. In a sense, the city and the province, and its citizens were collectively patrons of the MNI helping create a hospital out of what would otherwise be merely a research institute not necessarily engaged in direct service to its immediate community. In his opening speech on September 27, 1934, Penfield expressed his gratitude to the city and the province as well as the individual donors who answered his call for help, and between the lines he critiqued the RF for their questionable approach to giving as he emphasized how they “endowed the laboratories without undertaking any direct responsibility for the sick poor [33, p.41].”

The Architecture of the Montreal Neurological Institute

Like the RVH, the MNI was to be affiliated with McGill University. Sir Arthur Currie, the Principal and Vice Chancellor of McGill at the time, was able to secure a plot on University Street that was large enough to accommodate Penfield’s requirements. The MNI was initially meant to be built adjacent to the RVH, but this idea was abandoned since a new development on the site could create problems such as blocking the view of paying patients staying in the hospital’s Ross Memorial Pavilion [29, p.442]. This point was a concern particularly for William Chenoweth, the Hospital Superintendent [29, p.442], rather than that of Penfield himself. The plot on University Street proved to be optimal and Ross and Macdonald’s final design complemented the Scottish baronial style of previous RVH structures designed by the firm, as well as the earlier buildings by Henry Saxon Snell and the Maxwell brothers [29, p.458] (Figure 4).

Figure 4.

View of Montreal Neurological Institute, Montreal, Quebec, 15 December 1933. Source: CCA, Ross & Macdonald Fonds, ARCH285313.

The MNI’s ground floor had a recessed entrance leading to a Reception Room. To its north was a double-loaded corridor featuring study spaces, and, to its south was the main attraction of the floor: a 150-seat amphitheater, adjacent to an elaborate photographic department arranged by English medical photographer H.S. Hayden [29, p.450]. The second and third floors housed identical public patient wards named after the first two donors who answered the call to match the RF funds: J.W. McConnell and Sir Herbert Holt [29, p.450]. The wards featured nursing stations with glass panels that allowed nurses to easily monitor the patients. The fourth floor offered semi-private and private patient rooms [29, p.450]. The surgical spaces were concentrated on the fifth floor. The Operating Room 1 was distinct in the building’s massing, and it included a glassed-in viewing area with a pit underneath it designed for a specialized Ross telephoto camera system for recording surgeries. The sixth floor housed the laboratories, a library, and Penfield’s office [29, p.450]. The seventh floor was home to the animals used in research at the MNI, the physiology laboratories were also on this level [29, p.453]. The top floor above this one had five bedrooms for residents and trainees [29, p.453].

Penfield recognized the advancements in surgery in the US, and the surgical spaces in the MNI reflected this recognition. With his colleague Colin Russel and the architect Robert Henry Macdonald he visited the facilities of the Yale School of Human Relations, New York Presbyterian Hospital Neurological Institute, the Cleveland Clinic Hospital, and the Lakeside Hospital in Cleveland in July 1932 to observe how they were designed and the different kinds of technological innovations they incorporated [6, p.224-5]. These visits helped Penfield to identify both the best practices and what to avoid [6, p.224-5]. At Yale University, patient wards of the Yale New Haven Hospital, the distinctive arrangement of the surgical spaces in the Farnam Memorial Building, and controversial Yale psychologist Robert Yerkes’ animal quarters particularly caught his attention [6, p. 225].

Penfield’s attentiveness to design features of hospitals and research facilities certainly did not begin with his 1932 tour of the US. His journey to becoming a visionary neurologist was filled with uncertainties and self-doubt as a scientist in training across Europe and North America. The spaces he utilized as a trainee at Oxford and Cajal Institute, and at the research institutes he visited in Europe in 1928 must have influenced his decision to provide ample accommodations for the wandering scientists-in-training at the MNI. An unrealized 1931 proposal by Ross and Macdonald display a building that would feature tunnels connecting to the Internes Building, which was designed by the same firm. Training of physicians, surgeons, and scientists was a priority in the MNI. Even though the 1931 proposal was abandoned, training and the connectivity of trainees remained a priority in the later renditions. When the building opened in 1934, it was clear that its design paid attention to the comfortable accommodation of research fellows by providing them with living quarters that allowed sufficient room for entertainment and leisurely activities – including the incorporation of a squash court in an area originally intended for additional laboratories [33, p.51] (Figure 5). In line with his internationalist world view, Penfield wanted to create an institution dedicated to training “wandering students from any part of the world [33, p.51].”

Figure 5.

Ross & Macdonald’s working drawing for the MNI’s seventh floor. Floor plan displaying the squash court, Nov. 20, 1932. Source: CCA, Ross & Macdonald Fonds, ARCH33440.

Penfield admired the pioneers of neurology he learned from and worked with. He often questioned whether he could ever be just as significant in the history of the field. This emotional state translated into the interiors of the MNI most visibly in the foyer of the building featuring a frieze displaying the names of a selection of pioneering neurologists chosen in consultation with the international neurological community [6,8,14,33] (Figure 6). In his opening speech, Penfield acknowledged that the names included here were by no means a complete list. Among the names left out was Otfrid Foerster, Penfield’s mentor in Germany whose neurosurgical techniques inspired him to develop the epilepsy treatment which later came to be known as the “Montreal Procedure.” Although his name was not on the walls of the MNI, in his opening speech Penfield praised Foerster, who in his opinion deserved to be included more than Wilhelm Heinrich Erb: “Erb was selected as the representative of German clinical neurology, a school too important to overlook, although he embodied its modern virtues less completely than Foerster [33, p.45].”

Figure 6.

Foyer of the MNI building. Source: The History of Medicine Topographical Database.

The foyer of the MNI building continues to fascinate visitors today. Besides the frieze that functions as the neurological wall of fame, it is filled with symbolic elements referencing the brain [6,8]. Penfield’s correspondence with the decorator of the project, Barnet Phillips, provides insights into Penfield’s active involvement in the design process [6]. The ceiling of the foyer depicts the neuroglial cells found in the cerebellum. Interestingly, Phillips modelled these patterns after a drawing by Italian pathologist Camillo Golgi, rather than Cajal’s drawings. At the center of the patterns of neuroglial cells is a ram’s head surrounded by four hieroglyphic figures symbolizing the brain [6,8]. The furniture and other elements of the foyer are similarly neuro-inspired: The radiator grates mimic the French neuroanatomist Jean Nageotte’s nerve fibers, the lamp stands resemble the spine, and there is even a table with a surface that features a cross-section of the human brain’s hemispheres [6,8]. As the pièce de resistance of this space stands a marble replica of Louis-Ernest Barrias’ 1899 statue La Nature se dévoilant devant la Science (Nature Unveiling Herself Before Science), the original of which Penfield saw in Paris [6].

Epilogue

Penfield’s major claim to fame in the annals of neurology and neurosurgery came with his development of the “Montreal Procedure” which enabled surgeons to operate on epileptic patients using local anesthesia to stimulate certain parts of the brain and to locate and destroy the cells where seizures originated [15,16]. While many consider this surgical technique as his most significant contribution to the field of neurology, the central position of the MNI in his memoires reveal that Penfield regarded it to be his magnum opus.

Prkachin attributes Penfield’s openness to ideas from different parts of the world to a distaste of “nationalistic chauvinism that came to characterize many scientific communities in the years between the World Wars [2, p.27],” and defines him as a scientist who embraced “a vision of collaboration in which interdisciplinarity was linked with internationalism [2, p.27].” To realize this vision, Penfield mastered several foreign languages and explored different styles of conducting research and medical practice around the world. What set him apart from his peers in the neurological community was his curiosity for sources of knowledge from every corner of the world. Later in his life, in 1943 and 1962, this characteristic of Penfield’s took him to the People’s Republic of China (PRC) and the Union of Soviet Socialist Republics (USSR) where he assessed the conditions of medical research and hospitals in those countries. In fact, his trip to PRC in 1962, during the Cold War, was upon the official invitation of Mao Zedong [1].

As the MNI evolved and expanded, Penfield continued to make room for artistic expressions celebrating the history of neurology and the names of those who contributed to the field’s advancement. Upon the completion of the MNI’s McConnell Wing in 1953, he commissioned Mary Harris Filer, an artist who once worked at the MNI as a nurse, to paint a mural for one of the meeting rooms in this new extension. Filer’s mural titled The Advance of Neurology, features numerous figures from Galen to Filer herself depicted both as the patient and the nurse [34] (Figure 7). Today, the buildings of the MNI feature many works of art as well as a Healing Garden in its North Wing, commissioned by Norah Almanqour, a former patient of the MNI from Iran.

Figure 7.

The Advance of Neurology, 1953 by Mary Harris Filer. Source: The History of Medicine Topographical Database.

By tracing a history of Penfield’s scientific mobility and eventual migration to Canada from the US, this paper offers new perspectives to understanding the MNI’s origin story. This institution was not established as a static product of North American medical innovation; rather it was carefully designed as a dynamic site shaped by transnational exchanges, funding negotiations, and shifting spatial priorities. Penfield’s strategic engagement with the RF, his international training, and his commitment to integrating research and patient care all contributed to the creation of a research hub that was simultaneously local and global, shaped by both practical constraints and visionary ambition. Penfield’s scientific mobility enabled him to build bridges between diverse emotional communities with differing interests, he connected the Spanish School with the English-speaking world and the RF priorities with public interests. In the manner he created an institute that brought research, clinical practice, and surgery together, his vision for the MNI converged art, architecture, science, and medicine with elements such as the design details of the building’s foyer or the attention given to the art of photography as an intricate part of clinical and surgical practice.

Penfield’s personal papers and correspondence provide a great opportunity to write transnational histories and to explore the career of a scientist/physician from a history of emotions perspective. This study recommends future research that utilizes sources available outside the English-speaking world to explore emotions, space, and transnational history, and to highlight entangled histories rather than confine analysis within national or disciplinary boundaries. Moreover, further research on the lives and careers of scientists and physicians who benefited from scientific mobility can yield perspectives that are especially relevant in contexts where such mobility is threatened. Penfield’s journey that led him from self-doubt to scientific discovery is a testament to requirements in scientific research that are still valid today: ability to travel, international collaboration, and open-mindedness. In this regard, it is rather fitting to conclude this paper with the title of Penfield’s memoires, which could be considered a three-word synopsis of his life and work – a summation of both the progression of his career and the story of the MNI forged through networks, negotiations, collaborations, and a glimmer of hope in the deeply felt uncertainties of scientific practice: No Man Alone.

Glossary

CCA

Canadian Centre for Architecture

MNI

Montreal Neurological Institute

RAC

Rockefeller Archive Center

RF

Rockefeller Foundation

RVH

Royal Victoria Hospital

Author Contributions

UT Conducted an exhaustive literature review, collected and processed the archival data and other primary sources, performed the analysis, wrote the manuscript.

Funding Statement

Postdoctoral fellowship award granted by the Social Sciences and Humanities Research Council of Canada. Previous doctoral research on the RF-funded medical institutions funded by the RAC research stipend, the American Research Institute in Turkey, and the Vehbi Koç Foundation.