William H. Sweet, Professor of Surgery, Emeritus, Harvard Medical School and former Chief of the Neurosurgical Service, Massachusetts General Hospital, died on January 22, 2001. He was 90 and had had a career matched by few others in his chosen specialty. He was one of the great figures in world neurosurgery, that specialty of surgery that deals with diseases of the brain and its coverings, the spine and spinal cord, and the blood vessels to these structures. His life was characterized by an unswerving dedication to truth and scientific progress, intense intellectual activity, and an unwavering belief that we can understand and cure human disease. He made particular contributions to the study of brain tumors, pain, cerebrospinal fluid physiology and brain imaging.
Born in Kerriston, WA, on Feb 13, 1910, William Sweet graduated first in his class from the University of Washington in 1930 and entered Harvard Medical School the next year. In his second medical school year, he was awarded a Rhodes scholarship and spent two years at Magdalen College, Oxford University. He then returned to Harvard and received his M.D. degree in 1936. He trained in neurology and neurosurgery with Percival Bailey at the Billings Hospital at the University of Chicago. In 1940 he joined the neurosurgical staff at the Massachusetts General Hospital.
His work was interrupted when he joined the British Emergency Medical Services in 1941 as a volunteer, serving until 1945. In 1946 he became board certified in both Neurology and Neurosurgery. He then resumed his career in academic neurosurgery at Harvard as a staff neurosurgeon at the MGH, and concurrently as the first Chief of the Neurosurgical Service at New England Medical Center. In 1961 he became Chief of the Neurosurgical Service at the Massachusetts General Hospital following his mentor, James White. During more than sixty years of service at that hospital, he made significant contributions to both basic research and clinical care in neurosurgery. From his first published paper in 1938 to his last in 1999, his bibliography of 538 articles, chapters, and monographs reflects the broad range of his interests, the variety of his innovations, and his continuing development over time. His reporting is noteworthy for his honest assessments of his failures as well as of his successes. His basic and clinical studies improved the care of patients with chronic pain, disorders of the cerebrovascular system, cerebrospinal fluid disorders, and brain tumors. In a landmark collaborative effort having far-reaching ethical and medical importance he was, with Henry Beecher and others, a central figure in defining criteria for the diagnosis of brain death.
Sweet was one of the first academic neurosurgeons to stress the importance of including basic research in a clinical neurosurgical department. Having set up the laboratories for his own lines of investigation, he brought in others to pursue their work in the departmental framework. In an early departure from the customary clinical focus of neurosurgical training, his program was redesigned and lengthened to provide residents with required periods devoted to purposeful laboratory experience. The belief that neuroscientists had an important place in neurosurgery became a model for a few leading departments in the country and contributed significantly to the neuroscientific revolution that has remarkably changed our approach to neurosurgical disease. His active participation in neuroscience included joining with F.O. Schmitt of M.I.T. to create the Neuroscience Research Program which led ultimately to the recognition of neuroscience as one of the most important and exciting areas of biomedical research.
Perhaps his major contribution to applications of science in medicine was his commitment to the interface of radiobiology and neurosurgery. In the 1940s he began investigating biological applications of particle physics and radioactive isotopes to human diseases. In 1951 he established one of the first radioisotope brain scan research laboratories in the country, which was the first such laboratory to be utilized routinely for clinical localization in the diagnosis of focal brain tumors. He gathered around him a cadre of brilliant physicists interested in medical applications of nuclear physics, and in 1953, with Gordon Brownell, he invented the positron emission tomography scan, or PET, which has become an invaluable instrument in body and brain imaging. During this same period he applied his interest in harnessing atomic energy for therapy by developing the concept of boron neutron capture therapy. This innovative therapeutic modality used the capacity of neutrons to destroy tissue that had boron uptake. It was an intriguing concept that is still being developed today to treat malignant gliomas of the brain. Later, he was central to creating the proton therapy unit at Harvard, a unit that has now become the Northeast Proton Therapy Center. It was typical of Sweet’s leadership that he gave the proton project over to junior colleagues to pursue its full development.
His interest in atomic energy was strengthened by his relationship to Associated Universities Inc (AUI), a non-profit, university-based research management organization that founded and operated Brookhaven National Laboratory and the National Radio Astronomy Observatory, the world leader in all phases of radio astronomy. Designated by the President of the University to represent Harvard on its board, Sweet had an active relationship with AUI for nearly forty years, first as a Trustee and later as an Honorary Trustee.
Dr. Sweet’s scientific interests included many other important areas of brain function. His work on the physiology of cerebrospinal fluid formation and dynamics led to a D.Sci. degree from Oxford University.
In the field of intractable chronic pain, he introduced the use of electrical stimulation to suppress sensory pain mechanisms. In the field of facial pain, his pioneering techniques included radiofrequency lesions of the trigeminal nerve to relieve the agonizing pain associated with tic douloureux.
Not only did his patients benefit from his superb surgical skills but he taught these skills to neurosurgical residents who are now practicing throughout the world. Many of these trainees carry on advances that he pioneered in the field of neurosurgery. He also provided an active fellowship program to help the improvement of neurosurgical care in other countries. In special recognition of this program’s contribution to the development and progress of neurosurgery in Japan, he received the Emperor of Japan’s Order of the Rising Sun in 1983. In consequence of his wide-ranging contacts and his familiarity with important work going on around the world, he was invited to co-edit with Henry W. Schmidek the first three editions (1982, 1988, and 1995) of the textbook, Operative Neurosurgical Techniques: Indications, Methods, and Results
Dr. Sweet was an active participant in the major national and world neurosurgical and neuro-scientific organizations, serving as the president of some.
For his accomplishments he received the highest awards given in the field of Neurosurgery in this country including: Honored Guest of the Congress of Neurological Surgeons, the Cushing Medal of the American Association of Neurological Surgeons, and the Distinguished Service Award of the Society of Neurological Surgeons. Other honors included Honorary Fellow of the Royal College of Surgeons (Edinburgh) and honorary degrees from Université Scientifique et Médicale de Grenoble (France) and The Ohio State University.
As well as being an accomplished neurosurgeon and academician, Dr. Sweet had a profound effect on his children. At his funeral, his son David said, “In my eyes, he was the pattern of all virtue. I didn’t understand just what virtue was until much later when my feelings were captured and given concrete form as I read the great classical authors. They all agreed … that courage, temperance, justice and wisdom were the primary human virtues…when they described a good man, they described father.”
It is only now, a generation after his ascendancy that we can begin to assess Sweet’s full impact. At the beginning of his career in the 1930s, neurosurgery was a fledgling specialty, and there was little interaction between its clinical practitioners and neuro-investigators. Over the next sixty years, his innovations in diagnosis and surgical techniques, combined with his insistence on the integration of clinical and research efforts, contributed significantly to neurosurgery’s progress to becoming a mature discipline.
He is survived by David, Gwen, and Paula, the children of his first marriage, and by his second wife, Elizabeth, who for twenty-three years provided encouragement and support for his professional efforts and anchored the happy equanimity of his home.
Peter M. Black, Chairperson
Robert E. Hughes
Robert L. Martuza
David B. Nathan
David R. Sweet
Daniel C. Tosteson
Nicholas T. Zervas