Paul Fusco/University of California, San Francisco Archives & Special Collections via The New York Times
NEW YORK — Charles Wilson, a pioneering and virtuosic San Francisco neurosurgeon who used operating rooms like stages, sometimes performing as many as eight surgeries a day, all while building a leading brain tumor research center, died Feb. 24 in Greenbrae, Calif. He was 88.
His wife, Frances Petrocelli, said he had been living in a skilled nursing facility and had recently developed a heart problem.
During more than 30 years at the University of California San Francisco Medical Center, Dr. Wilson worked on parallel tracks: in the operating room and in his research center, where he and colleagues sought to advance the treatment of glioblastomas and other tumors.
Dr. Alex Valadka, chairman of neurosurgery at Virginia Commonwealth University, compared Dr. Wilson to the renowned cardiologist Michael E. DeBakey, who turned Baylor College of Medicine in Houston into a major center for heart surgery and research.
“Through a work ethic that would kill almost anyone, Wilson built academic, training, and research programs,” Valadka, who is also president of the American Association of Neurological Surgeons, said in a telephone interview. “And then there was his clinical work. He was technically excellent. He set the bar.”
Dr. Wilson sometimes worked in three operating rooms simultaneously: Residents would surgically open and prepare patients for his arrival, and he would then enter to seal an aneurysm or remove a tumor before moving on to the next case.
“He never spent much more than 30 or 60 minutes on each case, and we were left to close the case and make sure everything was OK,” Dr. Mitchel Berger, a former resident who is chairman of UCSF’s neurosurgical department, said in an interview. “It was unorthodox, but it worked. He demanded excellence and we gave him excellence.”
They also gave him silence. He allowed no music, no ringing phones, and no idle chatter. Scrub nurses were expected to anticipate his requests.
“He would manage any break of silence with a stern look,” said Dr. Brian Andrews, a neurosurgeon who was one of Dr. Wilson’s residents and also his biographer, with the book “Cherokee Surgeon” (2011). (Dr. Wilson was one-eighth Cherokee.)
Dr. Wilson became world renowned for excising pituitary tumors through the sinus in a surgery called transsphenoidal resection. He had embraced the procedure, which had been done for decades, after being displeased with results that UCSF surgeons had achieved using another technique.
His zeal to understand the operation had led him one day to call the chairman of neurosurgery at the University of Florida, in Gainesville, with an unexpected request: Could the chairman acquire 100 cadaver heads, regardless of the cost, and bring them to the university’s laboratory so that Dr. Wilson might then fly there to study the anatomy he would encounter in the surgery?
“Sometime later, when the laboratory was fully stocked, Charles traveled on a Friday to Gainesville and, over a weekend, practiced his technique on each and every one of the cadavers,” Andrews wrote in the biography.
The writer Malcolm Gladwell, in a profile of Dr. Wilson in The New Yorker in 1999, described one of those pituitary cancer surgeries. Looking at a tumor through a surgical microscope, Dr. Wilson used an instrument called a ring curette to peel the tumor from the gland.
“It was, he would say later, like running a squeegee across a windshield,” Gladwell wrote, “except that in this case, the windshield was a surgical field 1 centimeter in diameter, flanked on either side by the carotid arteries, the principal sources of blood to the brain.”
A wrong move could nick an artery or damage a nerve, endangering the patient’s vision or his life.
When Wilson saw bleeding from one side of the gland, he realized he had not gotten all of the tumor. He found it and removed it. The surgery took only 25 minutes. He performed the surgery more than 3,300 times.
He told Gladwell he had a special feel for surgery that he could not entirely explain.
“It’s sort of an invisible hand,” he said. “It begins almost to seem mystical. Sometimes a resident asks, ‘Why did you do that?’” His response, he told Gladwell, was to shrug and say, “Well, it just seemed like the right thing.”
Charles Byron Wilson was born on Aug. 31, 1929, in Neosho, Missouri, a farming community in the Ozark Mountains with a population of 5,000. His father, Byron, was a pharmacist who owned a local drugstore; his mother, the former Margaret Polson, also worked there.
Wilson graduated from the Tulane School of Medicine and spent a year as a pathology resident at Charity Hospital, also in New Orleans, where he gained expertise in removing brains as well as hearts, lungs and abdominal organs. He considered becoming a pathologist, but he also wanted to help living people.
“I was deeply interested in neuropathology, the art of diagnosis, and the precision of surgery,” he said in “Cherokee Surgeon.” “Neurosurgery brought all of my interests together, and it just felt right.”
After a residency in neurosurgery that had been jointly offered by Tulane and the Ochsner Clinic (now part of the Ochsner Health System), Wilson became a neurosurgery resident at the Veterans Administration Medical Center in New Orleans. He later returned to Charity as chief resident, taught neurosurgery at Louisiana State University and, in 1963, joined the University of Kentucky, where he started its division of neurosurgery.
He joined UCSF in 1968 as chairman of its neurology division and soon expanded the brain tumor research he had begun in Kentucky.
Dr. Wilson continued to operate into his early 70s, retiring in 2002 after performing one last pituitary tumor surgery.
He had already planned for his retirement. He had cofounded the Global AIDS Interfaith Alliance, which develops health care programs in African countries greatly affected by AIDS, tuberculosis, and malaria. And he helped raise money and set policy for Clinic by the Bay, which provides free medical services to uninsured working people in the Bay Area.
In addition to his wife, Dr. Wilson leaves his daughter, Rebecca Cohn; his son, Byron; a stepdaughter, Kathryn Petrocelli; and six grandchildren. Another son, Craig, died in 1983. Dr. Wilson’s three previous marriages ended in divorce.
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