History of Hawaii Neurosurgery

By Bernard Robinson M.D.

The History of Hawaii Neurosurgery is a relatively comprehensive treatise describing the evolution of the availability neurosurgical care in Hawaii. This history began before Hawaii became the fiftieth state of the USA and ends in the year 2021 when the book was published. It is an interesting story for those who like history and those needing a reference on the subject of Hawaii’s neurosurgical history.

• Language: English
• Publisher: WestBow Press
• Release date: Jun 14, 2021
• ISBN: 9781664234260

Bernard Robinson M.D.

Dr. Bernard Robinson was the first Afro-American neurosurgeon trained by the USA military. His first assignment as a neurosurgeon was Tripler Army Medical Center in Hawaii. His wife and he elected to live in Hawaii where he met and befriended Dr. Ralph B. Cloward, Hawaii’s first neurosurgeon. Dr. Robinson also interacted in some way with most of Hawaii’s neurosurgeons. When he became president of the Hawaii Medical Association in 2016, he sought more information regarding the history of Hawaii neurosurgery. Finding negligible information on the subject, he realized that he was best equipped to research and write the history of Hawaii’s military and civilian neurosurgical history since they were significantly intertwined. Dr. Robinson also published a prior history of the personal lives of his family called “Two Ropes”. Dr. Robinson retired from active neurosurgical practice in 2016 and currently resides with his wife in Hawaii.

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Copyright © 2021 Bernard Robinson, M.D.

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the information contained in this book and in some cases, names of

people and places have been altered to protect their privacy.

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ISBN: 978-1-6642-3425-3 (sc)

ISBN: 978-1-6642-3424-6 (hc)

ISBN: 978-1-6642-3426-0 (e)

Library of Congress Control Number: 2021909631

WestBow Press rev. date:  06/08/2021

CONTENTS

Preface

Acknowledgments

Introduction

Chapter 1     Hawaii before Hospitals and Clinics

Chapter 2     First Hospitals and Clinics

Chapter 3     Synopsis of the Origin of Hospitals in Hawaii

Chapter 4     Chronological Arrival and Contributions of Neurosurgeons Choosing to Live and Work in Hawaii

Appendix A   Dr. William Won’s Personal Submission of Hawaii’s Neurosurgical History

Appendix B   Submission of History by Dr. Raymond Taniguchi

Appendix C   Dr. Calvin Kam’s Personal Submission of Hawaii Neurosurgical History

Appendix D   Submitted Information from Dr. Maxwell Urata via Email

Appendix E   Personal Neurosurgical History Submitted by Dr. Maurice Nicholson

Appendix F   Personal Neurosurgical History Submission of Dr. Joel Feigenbaum

Appendix G   List of Civilian Hawaii Neurosurgeons from Date of Entering Civilian Practice

Appendix H   List of Military Neurosurgeons (Tripler Army Medical Center)

Bibliography

PREFACE

As much as possible, I attempted to write History of Hawaii Neurosurgery as a chronological narrative beginning at a time before neurosurgery existed in Hawaii and going through to the present. Interestingly, I found it to be impossible to adhere to strict chronology from the time of my arrival to work in Hawaii in 1980. The task was challenging because some events happen simultaneously and it becomes difficult to describe such things sequentially. Therefore, my telling of Hawaii neurosurgical history required jumping back and forth in time to make the narrative more understandable.

I used all identifiable sources to write History of Hawaii Neurosurgery. My main source of historical material came directly from verbal and written reports to me by former and current Hawaii neurosurgeons. I formally and informally requested submission of individual historical material and stories from every practicing Hawaii neurosurgeon I could reach. I also reached out to retired and active neurosurgeons, even those who had permanently moved away from Hawaii. All available published material I could find to augment my database and fact-check my material was utilized. I even sought and obtained information from present and former physician leaders and administrators who had hired neurosurgeons to work in Hawaii.

A separate and distinct section of eight appendices follows the primary manuscript of History of Hawaii Neurosurgery. These appendices are comprised of the documents submitted by the Hawaii neurosurgeons who responded to my request for their historical information. Two lists of neurosurgeons who worked any length of time in Hawaii are included in the appendices. One is a list of civilian neurosurgeons; the other is a list of military neurosurgeons. Some names are on both lists because these people are military neurosurgeons who left military service and continued to practice in Hawaii. In order to get the most accurate number of neurosurgeons who lived and worked in Hawaii, one would have to count military neurosurgeons only once since they appear on both lists. Based on the best data available, it appears that the total number of neurosurgeons who have lived and worked in Hawaii is seventy-five.

ACKNOWLEDGMENTS

I express my sincere appreciation of and gratitude to Ms. Mabel Trafford, Tripler librarian, for her stellar help that far exceeded the requirements of her job description. Without her help, it is likely that this project would not have progressed beyond the concept stage. I also give special thanks to Drs. Raymond Taniguchi, Calvin Kam, William Won, and Maxwell Urata for their help and encouragement, which confirmed to me that this project was worth doing. A special note of thanks is extended to Dr. Maurice Nicholson, who promptly responded to my request for his historical information and insights relating to his contribution of operationalizing the first and only Gamma Knife radiosurgical treatment unit in Hawaii. I wish to thank all my friends and colleagues who tolerated my pushing them to supply promised personal and professional information sufficient to get the project completed in a reasonable time frame. Lastly, I profoundly express thanks to my wife, Shirley, who tolerated my taking over our study for yet another book project.

INTRODUCTION

I am Dr. Bernard Robinson, a neurosurgeon who came to Hawaii in June of 1980 as a United States Army neurosurgeon. I had just completed residency training at the original Walter Reed Army Medical Center located in Washington, DC. I was the first African American trained by the military of the United States of America to be a neurosurgeon. I used to try to play that ethnocentric fact down because all I wanted to be was the best neurosurgeon I could possibly be. That was my dream, but my reality was to be a bit more challenging than I had anticipated. I was assigned to the Tripler Army Medical Center in June of 1980. My rank at the time was major. Before leaving Walter Reed for Tripler, I became well aware of a problem of insufficient neurosurgical staffing at Tripler. This problem had become acute around the middle of 1978. Before leaving Washington, DC, I was advised that I was unofficially destined to return to Walter Reed as a staff faculty member after completion of a three-year tour of duty at Tripler. However, prevailing circumstances led to my spending my entire postresidency neurosurgical career in Hawaii.

Once I got to Hawaii, I never left, and I never returned to Walter Reed to work as a neurosurgical teaching staff member as planned. Thirty-six years later, in 2016, as president of the Hawaii Medical Association, I developed a desire to research the history of neurosurgery in Hawaii. I started with Google and was surprised to see the following sentence as the result of my search in late 2017: There is very little written about the history of neurosurgery in Hawaii. Further serious investigation into Hawaii’s neurosurgical history led me to realize the fact that I had personally known and was befriended by the first full-time Hawaii neurosurgeon, Dr. Ralph B. Cloward. Upon my arrival in Hawaii, he had welcomed me and offered useful information about how a mainlander might best succeed in the beautiful island state of Hawaii. He further offered that Hawaii was a weird and wonderful place. My experience in Hawaii helps me to understand what Dr. Cloward had said to me. I can only add that Hawaii is indeed quite wonderful, but it really does have its own unique local mystique and special way of doing things.

Additionally, with few exceptions, I have personally met almost all the Hawaii neurosurgeons from Dr. Cloward onward. The few exceptions are the neurosurgeons who arrived after my retirement from neurosurgery in 2016, or those who had either retired, died, or left Hawaii before I had gotten a chance to interact with them (namely, Dr. Lowrey and Dr. Bennett). As it turns out, a lot of Hawaii’s neurosurgical history is affiliated with Tripler Army Medical Center. My professional affiliation with both the military community and the civilian community afforded me the opportunity to complete full and synchronous military and civilian neurosurgical careers in Hawaii. With more than twelve years of active military service behind me, I transferred from the active duty US Army into a Tripler-based US Army reserve unit in 1984. This allowed me to take a full-time civilian neurosurgical position with Kaiser Permanente while completing my military career, which was sufficient to earn a military retirement as a US Army colonel. During official military leave and vacation time, I had previously worked part time for Kaiser Permanente while still on active duty from 1981 to 1984. I also performed my reserve military duty at Tripler. I retired as a full colonel in 1996. My experience led me to the natural conclusion that I would be the one most capable of writing the most complete and creditable history of Hawaii neurosurgery that included both civilian and military neurosurgical practice. This still required research and meticulous corroboration of the limited but available information. The result is what I believe is the most factual and chronologically astute historical account of Hawaii’s neurosurgical history. History of Hawaii Neurosurgery affords much more information than what was readily available to me in the published literature up to 2016. This proved to be true for both military and civilian neurosurgical history in Hawaii. My interest in Hawaii neurosurgical history proved to be quite timely, as discussed below.

I started my research by trying to call the Hawaii State Board of Medical Examiners, on which I had once served as a board member (appointed by Governor Benjamin J. Cayetano in 1994). The design and rules of Hawaii’s automated state computer system prevented me from making any progress worth the time invested. The reality of the phone-answering policy at the office of the State Board of Medical Examiners made talking to a live person equally unproductive. I next made inquiries of the Tripler Medical Staff Office but was told that historical records of medical staff were kept for only seven years. Additionally, current records were computerized and accessible only by those with a computer access card, which I no longer possessed. There were no known older paper records anywhere locally. I was told that such prior paper records were probably destroyed. I made inquiries of the official Tripler historian, who was unable to help, but was referred to a military office in St. Louis, Missouri. I successfully reached that office, but without obtaining useful assistance. I got the bright idea of checking with the Tripler Security Office and was received enthusiastically. I was told about a time capsule not due to be opened for about five more years, or around the year 2021. More importantly, the Tripler provost officer’s suggested that I checked with the librarian, Ms. Mabel Trafford, who turned out to be the jackpot for useful information. She had several boxes of old declassified Tripler administrative records destined to be destroyed. These records contained annual reports from every chief of service dating back to 1951. Some of these chiefs’ reports included neurosurgical chief reports from 1962 through 1996. These annual reports were evidently required to be performed each year by all chiefs of medical and surgical services at Tripler, but reports from some years were missing and perhaps were never performed. I even found my own annual reports from when I was chief of neurosurgery at Tripler from 1981 to 1984. I advised Ms. Trafford of the value of these historical records, but value is a relative term. These records were a conglomeration of administrative records, social events, and old public relations documents—a treasure trove that became the backbone of this project. Ms. Trafford provided me with a book transport cart, upon which I placed the boxes of material for easy access. She also afforded me the quietest corner of the library to work with the material for several weeks. She provided whatever assistance she could spare to help me glean information from these old records. Ms. Trafford had not yet moved to permanently destroy these boxes of records because another physician had also discovered them in his quest to write a history of Tripler Army Medical Center. I happened to come along before he had time to work with the records for his project. I spent two weeks gleaning information that became a major core of this historical manuscript, History of Hawaii Neurosurgery.

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Old Tripler records earmarked for destruction

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Old Tripler records earmarked for destruction—on cart

The Tripler library records revealed that the first three full-time civilian Hawaii neurosurgeons worked also as consultants for Tripler. These were Dr. Ralph B. Cloward followed by Dr. John Lowrey and Dr. Thomas Bennett. In the early days of Tripler (prior to 1962), there were no military neurosurgeons assigned by the military to live and work in Hawaii.

I spent the latter quarter of 2017 and all of 2018 and 2019 contacting neurosurgeons who were documented in these old Tripler library records. I also searched Google for those I reached and those whom I could not contact. These included military and civilian neurosurgeons. The retired neurosurgeons were much more responsive and informative than the younger neurosurgeons. I imagine that the retired neurosurgeons (including me) had more time to contribute to non-income-bearing ventures than our younger and still hardworking colleagues.

History is less than stimulating unless the reader has a specific interest or need for the historical information. Before commencing with this project, I consulted with Drs. Raymond Taniguchi and Calvin Kam, the two neurosurgeons who supported me most after I left the military to join the Hawaii Permanente Medical Group (Kaiser Permanente–Hawaii). We met at my home in late 2017, and they were very supportive of the project. We agreed that History of Hawaii Neurosurgery should concentrate mostly on portraying the positive contributions of our Hawaii neurosurgical colleagues. Also mentioned in the book are key professionals who were not neurosurgeons but who contributed substantially to the advancement of neurosurgery in Hawaii. Drs. Taniguchi and Kam were gracious in supplying information from their memories, as well as from their old personal files and keepsakes. They also advised that I get Dr. William Won involved. I reached out to Dr. Won, who arranged to have lunch with me at the Oahu Country Club, of