NEUROLOGY & NEUROSURGERY

Houston Methodist Remembers Dr. Robert Grossman — One of Neurosurgery's Godfathers

Oct. 20, 2021 - Todd Ackerman

The world of neurosurgery lost one of its most prestigious leaders this month with the death of Dr. Robert Grossman, a revered figure who made pioneering advances in the treatment of epilepsy and Parkinson's disease.

Dr. Grossman, head of neurosurgery at Houston Methodist for more than 30 years, performed thousands of neurosurgical operations, trained hundreds of neurosurgeons, wrote prolifically for medical books and scientific journals, and led many of the field's most prestigious societies and boards.

"He was a real godfather, a powerhouse in organized neurosurgery," says Dr. Gavin Britz, director of Houston Methodist Neurological Institute and chairman of the Department of Neurosurgery. "He was well known to all for his involvement as one of the field's top political leaders."

Dr. Grossman, who died Oct. 7 at the age of 88, is also remembered for his role at Parkland Hospital on Nov. 22, 1963, the day President John F. Kennedy was shot. Dr. Grossman and a colleague made the first examination of the head wound they immediately knew would be fatal.

In an email announcing Dr. Grossman's death to hospital system employees, Houston Methodist President Dr. Marc Boom praised his "incredible work ethic" and "passion for medicine and helping his patients." He wrote that "while [Dr. Grossman] will be remembered as a truly gifted surgeon, those who knew him personally will also remember his warmth, his wit and his desire to make the world around him a truly better place. He had a genuine gift to make every person he met feel special, too."

One of neurosurgery's important pioneers

As one of the first researchers to examine and record brain signals during surgery, Dr. Grossman developed the tools necessary to best analyze the abnormal signals generated by the brain in epilepsy patients. This breakthrough was responsible for the successful development of epilepsy surgery, which now can markedly reduce or eliminate intractable seizures with minimal to no side effects.

Dr. Grossman also developed a system to comprehensively map the brain and its functions, an advance that led to the development of technology that enabled wiring the brain to a computer. This technology allows patients to move a mouse and type without making motor movements.

"People had put electrodes on the brain and recorded simple things, but Dr. Grossman was one of the first to actually say, 'OK, what do we know about electrophysiology and how can we apply this to recording and properly analyzing signals in the brain?" says Dr. David Baskin, a Houston Methodist neurosurgeon. "He developed a whole system of laying electrode grids on the brain once you opened the skull, methods to analyze the complex signals generated by the brain and new ways to link the brain to external machinery — all of which is now used routinely for epilepsy and serves as the foundation for brain computer interfaces."

Dr. Grossman also was instrumental in developing techniques for successfully treating Parkinson's disease with deep brain stimulation. His role involved unraveling the pattern of abnormal electrical signals in Parkinson's disease — a mystery until then — enabling surgical treatment to be directed at the elimination of such specific signals deep in the brain.

Dr. Baskin, director of Kenneth R. Peak Center for Brain and Pituitary Tumor Treatment and Research at Houston Methodist Hospital, tweeted that the passing of Dr. Grossman has left "a hole in my heart. His brilliance, kindness, compassion and commitment to his patients and to all of us were unprecedented. His was a life well lived and one that will positively influence the lives of his patients and his trainees for many decades to come."

Consistent with his wish to never retire, Dr. Grossman in his last years remained an active member of the Houston Methodist research community despite his own battle with Parkinson's. The family obituary noted it was "a sadly ironic diagnosis for a man who dedicated his life to the treatment of neurological disorders."

"Like everything else in his life, Dr. Grossman faced it bravely, squarely and gracefully," says the obituary.

Formative experiences growing up in New York

Dr. Grossman was born Jan. 24, 1933, in the Bronx, the only child of immigrant parents, Ferenc and Vivian. Ferenc, born in Hungary, was a family practice doctor, and Vivian, born in Lithuania, was a grade school teacher.

Ferenc never refused a patient and would treat them even if they could not afford to pay, the family obituary notes. In return, grateful families would leave baskets of eggs or bottles of milk on the family's doorstep. The legacy left an indelible mark on the young Grossman, who would go on to make house calls, too, taking his old-school black doctor's bag to the homes of patients who needed help.

His parents nurtured the young boy's interest in science, math, poetry, literature, philosophy and classical music, and he began college — Swarthmore — when he was just 16. He met his future wife, Ellin, when he was 16 and she was 15.

Dr. Grossman received his medical degree from Columbia University College of Physicians and Surgeons, then did his surgical internship at The University of Rochester Medical Center.

He served as captain in the Medical Corps in the U.S. Army Reserve before going to work at the Walter Reed Army Institute of Research in Washington, D.C. From there, he became a resident and then chief resident at the Neurological Institute of New York at Columbia-Presbyterian Medical Center.

Upon finishing his residency in 1963, Dr. Grossman obtained his first neurological professorship at the University of Texas Southwestern Medical School in Dallas, whose affiliated hospitals included Parkland, one of the nation's best known public hospitals. It was there that the 30-year-old Dr. Grossman, chief neurosurgeon, received a phone call on that fateful November day, summoning them to trauma room one.

Eyewitness to one of 20th century's seminal events

There, the two neurosurgeons saw President Kennedy making some "gasping breaths," Dr. Grossman said in a 2003 interview. They picked up his head to examine the wound and saw a mass of white where part of the skull had been blown open.

In the interview, Dr. Grossman said, "As soon as I saw that, I said to myself, 'This is not a survivable wound.' "

Dr. Grossman did interviews in conjunction with an eyewitness account he wrote in the journal Neurosurgery. The account, written to establish "a reasonable hypothesis regarding the pathological mechanisms that killed President Kennedy," concludes that the preponderance of evidence shows President Kennedy was shot from behind and supports the Warren Report's conclusions.

It also touched on the jolt the assassination caused.

"We were profoundly shocked by the events," Dr. Grossman wrote in Neurosurgery in 2003. "Our immediate concern was knowing what would happen to our country. We did not know whether the assassination was an initial step that would be followed by a military attack on our country or whether the Russians, the Cubans, the Right, the Left, or some hate group had performed the murder. The idea that the murder was the work of a group rather than a lone individual dominated our thinking."

President Kennedy's death wasn't Dr. Grossman's last brush with the event's history. Two days later, he was called in to examine the body of accused assassin Lee Harvey Oswald, who'd been shot by nightclub owner Jack Ruby while in police custody. Dr. Grossman, asked to look for signs of a spinal cord injury, found no such damage, and Oswald died soon afterward in the operating room.

A powerhouse in organized neurosurgery

In 1969, Dr. Grossman returned to New York to become professor of neurological surgery at the Albert Einstein College of Medicine. Four years later he returned to Texas to join the University of Texas Medical Branch at Galveston.

In 1980, Dr. Grossman was appointed chief of neurosurgery at Houston Methodist and chairman of neurosurgery at Baylor College of Medicine. He left Baylor in 2005, but remained chairman of neurosurgery at Houston Methodist until 2013. He founded and served as first director of the hospital's Neurological Institute in 2005.

He also founded the North American Clinical Trials Network for Spinal Cord Injury to advance the quality of care and quality of life of people with spinal cord injury through the availability of experimental therapies showing evidence of safety and effectiveness.

During his career, Dr. Grossman served as chairman of the American Board of Neurological Surgeons and president of the Society of Neurological Surgeons. He also served on the editorial boards of Neurosurgery, the Journal of Neurosurgery and World Neurosurgery and helped found the Houston chapter of the Epilepsy Association Texas.

Top honors received by Dr. Grossman include the Cushing Medal from the American Association of Neurological Surgeons in 2007 and the Albert and Ellen Grass Foundation Prize and Medal from the Society of Neurological Surgeons in 1988.

Dr. Boom notes that Dr. Grossman's mentorship extended beyond his students, and that he was famous for sharing "pearls of wisdom" that "made a lasting impression on the youngest student and the most seasoned surgeon."

"He was just a giant in the field," says Dr. Stanley Appel, Houston Methodist's long-time chairman of neurology. "He had this soft, kind exterior, but underneath was someone insistent, persistent and accomplished, and who would always get the job done."

Dr. Grossman is survived by his wife Ellin, their three children and nine grandchildren.