Dinner at Keen's: The Founding of the American Society of Neuroradiology

Michael S. Huckman

The program of the Vth Symposium Neuroradiologicum held in Brussels in 1957 was notable for the absence of any significant number of papers from North America. This was clearly a European meeting. The center of the neuroradiologic universe was still in Scandinavia, but more and more radiologists flocked there to learn its arcane techniques and applied them in Italy, France, Germany, England, and the United States.

At the VIth Symposim, presided over by Professor Giovanni Ruggiero in Rome, the Europeans got their first chance to hear about the progress in this specialty being made in North America. A plethora of papers were read by such names as Chase, Leeds, Taveras, Potts, Pribram, LeMay, Hanafee, Newton, McRae, and DiChiro. It was obvious that a quantum leap had been made, and the presidency of the VIIth Symposium, to be held in New York in 1964, was awarded to Juan Taveras who, at the time, was Director of Neuroradiology at the Neurological Institute of Columbia-Presbyterian Medical Center in New York.

It was obvious at once to Taveras that support for this endeavor would be enhanced by a formal organization of those radiologists in North America primarily engaged in neuroradiology, and he intended for it to be in existence at the time of the symposium, which was to be 2 years later (J.M. Taveras, personal communication). Taveras had recently succeeded in establishing the first National Institutes of Health (NIH)–funded neuroradiology fellowship program in North America (1), and radiologists at the Neurological Institute of New York were rapidly gaining control of both performance and interpretation of arteriograms, pneumoencephalograms, and myelograms, a practice that was already long-established in Europe.

Gordon Potts (D.G. Potts, personal communication) described Taveras' motivation to form a society as twofold: “First, he [Juan] felt that there should be a society that would bring together all neuroradiologists in North America to exchange ideas and to have some unity of purpose as we planned the future of the specialty. Second, he wanted those neuroradiologists to participate in the planning of the symposium, which he felt had the potential to enhance the international recognition of neuroradiology in North America.”

With the symposium as the pressing immediate need, Taveras issued invitations for a dinner meeting in New York for the evening of April 19, 1962. He was careful to choose individuals who represented strong programs and a broad geographic diversity, and he contacted all those he knew were practicing full-time neuroradiology. He invited Dr. Arthur Child, neuroradiologist at the Montreal Neurological Institute, but Child declined, having already retired.

Ernest Wood, Taveras' predecessor and successor at Columbia, came from Chapel Hill where he was Chairman of the Department of Radiology at the University of North Carolina. From his own staff at the Neurological Institute, Taveras invited Norman Chase and D. Gordon Potts, and one of his neuroradiology fellows, Norman Leeds. Mannie Schechter came from cross-town neighbor, St Vincent's Hospital. A genial South African, he had trained with James Bull and George du Boulay at Queen Square in London, and was an early advocate in North America for the performance of procedures by radiologists.

Giovanni di Chiro, recuperating from spinal surgery that left him paraplegic, journeyed from Bethesda where he was Director of Neuroradiology at the NIH. Eugene Leslie attended from the University of Buffalo. He had held the first NIH fellowship for training in neuroradiology outside the United States. During his preceptorship with James Bull at Queen Square in London, he was a contemporary of Schecter's (E.V. Leslie: personal communication). Donald McRae, neuroradiologist at the Montreal Neurological Institute, was the sole Canadian representative. McRae had served as president of the Vth Symposium Neuroradiolgicum in Brussels in 1957 and was generally regarded as the “father of Canadian neuroradiology.”

At the Annual Postgraduate Course in Neuroradiology at the Neurological Institute in 1956, Taveras had met Fred J. Hodges III, one of the registrants. Hodges had spent time in Göteborg, Sweden studying neuroradiology with Ingmar Wickbom, and in 1962, was the neuroradiologist at the Edward Mallinckrodt Institute of Radiology in St. Louis where, at that time, Torgny Greitz was spending a sabbatical year. Taveras invited Hodges to attend the dinner and requested that he prepare minutes of the meeting (F.J. Hodges, personal communication).

The Midwest also was represented by two Minnesotans, Harold O. Peterson and Colin B. Holman. Peterson was Professor of Radiology at the University of Minnesota and had put on the first post-graduate course in neuroradiology in North America in 1939 (2, 3). Holman headed the expanding group of neuroradiologists that was gaining national prominence at the Mayo Clinic. He recalled (C.B. Holman, personal communication) the evening in New York and remarked that “I don't think we knew each other very well. Certain of us were well acquainted due to other societies or having worked together once or twice a year at the board (American Board Radiology [ABR]) examination.” Holman had been friendly with Ernest Wood, having served near him during World War II.

The group was completed by two Californians who were known for promoting the use of catheter cerebral angiography. Thomas Hans Newton had recently returned from training in London at Queen Square and Atkinson Morley's (where he first met Gordon Potts), and William Hanafee had studied catheter angiography with Per Amundsen in Norway. Both had introduced the techniques to doubting neurosurgeons at the University of California, San Francisco and University of California, Los Angeles, respectively.

Arrangements for the dinner were made by Norman Chase who, even in those years, was known for his discriminating taste in selecting restaurants. He selected Keen's English Chop House in downtown Manhattan. Founded in 1885, it was a “gentlemen's only” restaurant until it was “invaded” by the infamous British actress, Lillie Langtry, in 1901. It is in operation to this day (72 West 36th Street) as the only survivor of the Herald Square Theater District, and is renowned for “mutton chops, steaks, and single malt Scotch whiskey.”

Norman Leeds recalled that the dinner was held in a private dining room on the second floor of the restaurant. All were seated at one long table and, as one would have expected, the meal was beef (N.E. Leeds, personal communication). Hans Newton remarked that sitting at one table made it “easy to discuss the possibility of forming a small society of like-minded people (T.H. Newton, personal communication).” The discussion continued after the dinner had been served.

Taveras led the discussion. Leeds recalled “he had already spoken to the invited neuroradiologists about their opinions on the need for the formation of a society.” According to Potts, “As with almost all significant meetings, its success, I believe, resulted from Juan's discussions with various founding members before and after that meeting.” Taveras had prepared a brief document outlining the formation of the Society that was unanimously adopted after minor modifications.

Much of the discussion centered on plans for the upcoming Symposium Neuroradiologicum, which was expected to attract about 1000 registrants. Potts recalls that “one of the ideas originated that evening at Keen's was the breakfast session for speakers at the symposium to acquaint them with the rules for presentation, time limits, slide loading, podium controls, etc. Some registrants at the symposium later claimed that it was the first international meeting they had attended where not a single slide was upside-down!”

Other decisions made that evening were to hold annual meetings in conjunction with other major radiologic societies such as the ARRS and the Radiological Society of North America, and to require 2 years of fellowship and certification by the ABR for senior members, but to offer junior membership to increase the size of the Society (The first meeting of the Society, separate from other societies, was the Third Annual Meeting in Atlantic City in 1965.).

The meeting at Keen's also encouraged North American neuroradiologists to begin preparation of papers for presentation at the symposium. The final item of the evening was to elect officers. Juan Taveras was the obvious and unanimous choice to be the first president, Mannie Schecter was elected vice president, and Norman Chase was elected secretary/treasurer.

Hodges recalled being “lukewarm concerning the need for and likely success of such an organization but was impressed by the gathered founding members.” All recalled leaving the meeting with a sense of optimism, but in retrospect, find themselves amazed by the growth and success of the society. Holman remembers that it was a time when neuroradiologic procedures were controlled by neurosurgeons and provided a significant part of their incomes. As a result, the establishment of the American Society of Neuroradiology (ASNR) was not looked favorably upon by most of the older neurosurgeons. “I believe there was general agreement that we needed our own neuroradiologic society, not only to protect our own interests, but to lead in the teaching of this special radiology to others.” Holman also recalled, “We knew we needed a strong leader who would be located near the area in which there were likely to be the most neuroradiologists, and one who would have a firm commitment from his institution to support it, or at least allow it. I think all of us hoped Juan would be such a person, and indeed he has always been.” Potts recalled that in spite of the optimism, at the time all 14 members felt “there was an urgent need to attract talented trainees into the field of neuroradiology and to develop a larger number of top-quality training programs.”

Following the meeting, Taveras received letters from several of the attendees. In reminiscing, he recalled that, “They expressed their appreciation for having been invited and promised to collaborate with the ASNR, and expressed assurances that the ASNR would be a success. As you well know, it has become a much greater success than even I dreamed of at the time.”

From an intimate meeting of 14 radiologists seated at a single table, the ASNR has grown to a membership of over 2000, publishes a journal with worldwide circulation of 7000, holds an annual meeting with attendance in excess of 3000, oversees a well-funded foundation to support the research efforts of young investigators, and has among its membership numerous department chairs and major officeholders in prestigious national and international medical organizations. It was the first organized subspecialty society in radiology and, during its 38-year existence, has set an example of establishing training standards and educational programs that have been emulated many times by younger radiologic subspecialty societies.

References

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Taveras JM. Development of the first fellowship training program in neuroradiology in North America. AJNR Am J Neuroradiol 1991;12:587-590
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Peterson HO. The early history of neuroradiology at the Medical School of the University of Minnesota, 1937–1939. AJNR Am J Neuroradiol 1992;13:873-877
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Kieffer SA. Harold O. Peterson, MD: a life in neuroradiology. AJNR Am J Neuroradiol 1993;14:1427-1435
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