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Walter Edward Dand was born on April 6, 1886 in Sedalia, Missouri, United States; the only child of John and Rachel (Kilpatrick) Dandy, who had come to the United States two years earlier from Barrow-in-Furness, Lancashire, England. A member of the fundamentalist Plymouth Brethren, John Dandy had been a railroad man in England. In America he became a locomotive engineer on the Missouri-Kansas-Texas Railroad and in time the engineer of its celebrated passenger train, the Katy Flyer.
Dandy graduated from the local high school in Sedalia at the head of his class. He enrolled at the University of Missouri, where he earned part of his expenses by working in the science laboratories and as an assistant to the zoologist Winterton C. Curtis. Dandy had probably already determined on a career in medicine, since he chose a number of classes in the biological sciences and while still an undergraduate took several preclinical courses at the university's medical school. Curtis and other Johns Hopkins alumni at Missouri urged him to continue his studies at the Johns Hopkins University School of Medicine; and with their aid, after receiving the Bachelor of Arts degree in 1907, Dandy entered the second-year class at Johns Hopkins. Before graduating he published his first paper, a study of the nervous and vascular systems of a young human embryo. He received the Doctor of Medicine degree in 1910 and was chosen by Harvey Cushing as his surgical assistant for the year 1910-1911 in the Hunterian Laboratory of Experimental Medicine. There, experimenting with dogs, Dandy began studying the blood and nerve supplies of the pituitary body, the subject of his second paper, published in 1911 with Emil Goetsch. His research earned him the Master of Arts degree that year.
In 1911 was appointed to the house staff of the Johns Hopkins Hospital (where William S. Halsted was chief of surgery) to serve for a year as Cushing's clinical assistant in neurosurgery. During Dandy's first year at the Hunterian, a series of clashes began between him and Cushing, which developed into a lifelong personal conflict. Dandy himself remembered that the first incident occurred when some experiments he had been carrying out on the production of glycosuria in rabbits by stimulation of the sympathetic nerves produced results that contradicted a theory of Cushing's. Both men were highly competitive, and later disagreements, stemming in part from arguments over priority and in part from marked differences in temperament, increasingly marred their relations.
In 1912, when Cushing left Johns Hopkins to become professor of surgery at Harvard and surgeon-in-chief at the new Peter Bent Brigham Hospital, he informed Dandy, with very little warning, that he was not being taken to Boston. Dandy was allowed to remain at the Johns Hopkins Hospital at first on an unofficial basis, but soon received an appointment to Halsted's service and later became resident surgeon (1916 - 1918). During these and the succeeding years he carried out the brilliant work that eventually brought him recognition as Cushing's equal in surgery.
At the Hunterian, Dandy had already begun research, in collaboration with Kenneth D. Blackfan, on the mechanism and pathology of hydrocephalus. In 1913 they published the first in a series of papers that demonstrated the mode of circulation of the cerebrospinal fluid and for the first time provided a physiological basis for diagnosing hydrocephalus and treating the disorder by surgery. The work gave Dandy an international reputation.
Dandy made even more important advances, when in 1918, after several years of research on brain tumors, he introduced ventriculography, a diagnostic method that many regard as the greatest single contribution ever made to neurological surgery. He showed by animal experiment that if some of the cerebrospinal fluid were removed from the cerebral ventricles and replaced by air, the outline of the ventricles would appear clearly on X-ray film. Abnormalities in contour could reveal the presence and exact location of lesions such as tumors, otherwise undetectable, so that early diagnosis and surgical removal would be possible.
Some months later Dandy reported another important diagnostic procedure, pneumoencephalography, which by injecting air into the spinal canal made possible the study through X-ray films of the subarachnoid space, sometimes affected directly or indirectly by brain lesions.
In 1922 Dandy announced a new surgical approach to the removal of tumors of the acoustic nerve, a method that involved total extirpation of the tumor and greatly reduced the formerly high mortality rate. His successful surgical method for the treatment of trigeminal neuralgia, a disease characterized by excruciating facial pain, represents one of his most brilliant and original contributions. His procedure, reported in 1925, had a mortality rate close to zero and did not produce the facial palsies, corneal ulcers, and partial paralyses that had sometimes followed the classical operation.
Two years later he introduced a curative operative procedure for glossopharyngeal neuralgia (tic douloureux), another form of facial neuralgia. One of Dandy's greatest accomplishments was the development of an operation that would often permanently cure Meniere's disease, the symptoms of which include violent attacks of dizziness, nausea, and progressive deafness. In 1928 he reported nine such operations, all successful. The procedure involved dividing the fibers of the anterior part of the acoustic nerve and did not impair hearing.
Among Dandy's other contributions were his surgical cures for intracranial aneurysms, his demonstration that a ruptured vertebral disk was often the cause of pain in the lower back and leg, and his devising of new diagnostic tests and operative procedures for this ailment.
In addition to many papers, he published five books: Benign Tumors in the Third Ventricle of the Brain: Diagnosis and Treatment (1933), Benign, Encapsulated Tumors in the Lateral Ventricles of the Brain: Diagnosis and Treatment (1934), Orbital Tumors: Results Following the Transcranial Operative Attack (1941), Intracranial Arterial Aneurysms (1944), and Surgery of the Brain (1945), a monograph of more than six hundred pages.
Although after 1918 Dandy engaged in private practice, he retained a lifelong connection with the Johns Hopkins medical school, holding a succession of professorial posts in neurological surgery, and with the Johns Hopkins Hospital, where his last appointments were as visiting surgeon in neurosurgery (1928 - 1946) and neurosurgeon in the diagnostic clinic (1941 - 1946).
Dandy never lost his scientific curiosity, and before his final illness was working to determine just where the center of consciousness was located in the brain, the subject of his last publication. He died in Johns Hopkins Hospital a few days after his sixtieth birthday, of a coronary occlusion, and was buried in Druid Ridge Cemetery, Baltimore.
Walter Edward Dandy is considered one of the founding fathers of neurosurgery. He has been credited with several discoveries, such as surgical treatment of hydrocephalus and of trigeminal neuralgia, as well as glossopharyngeal neuralgia, a diagnostic methods of ventriculography and pneumoencephalography, a new surgical approach to the removal of tumors of the acoustic nerve, development of an operation that would permanently cure Meniere's disease, and the first clipping of an intracranial aneurysm. During his neurosurgical practice, Dandy published five books and more than 160 articles, and performed about thousand operations per year. The Walter E. Dandy Neurosurgical Society (WEDNS) was founded in St. Louis, Missouri in 2011.
Dandy was a pragmatist by temperament and apparently had no interest in organized religion.
Dandy was a brilliant diagnostician, and he displayed great originality and imagination in devising new surgical techniques, as well as courage in applying them. He possessed acute powers of observation and a beautiful surgical technique reflected in an economy of movement. A complex man, Dandy was often hot-tempered and demanding, and at times petty. On other occasions he could be gracious and considerate to patients, residents, and medical students. He was a pragmatist by temperament and apparently had no interest in organized religion.
Aside from his family and career, Dandy's interests centered in golf, which he played at least once a week, tennis, bridge, baseball, and boxing. He was an avid reader of history and biography, particularly of works dealing with the Civil War. As a baseball fan, he took pride in having developed during his later years a protective cap that had pockets on either side into which plastic cups could be inserted before a player came to bat.
Quotes from others about the person
Irving J. Sherman: "Historians are uniformly effusive in praise of Dandy's research and surgery, but they are less kind with regard to his personality, no doubt because they did not know him personally . .. Dandy never charged schoolteachers, clergy, other medical workers, or patients who had no money to pay. At times, he also gave money to patients to help them with the expense of coming to Baltimore. . .. There were stories of Dandy being dictatorial and demanding perfect service for his patients, and these were true. There were other stories, also true, of Dandy having outbursts of temper when "things did not go right in the operating room, " firing assistant residents, scolding personnel, and occasionally throwing an instrument. However, during my time on the general surgery and neurosurgery housestaff (1940-1943), I never observed such incidents. . .. although Dandy was at times dictatorial and demanding, his actions made it obvious that he cared deeply for our welfare, although not about how hard we worked. "
At the age of thirty-eight, on October 1, 1924, Dandy married Sadie Estelle Martin of Baltimore. Their children were Walter Edward, Mary Ellen, Kathleen Louise, and Margaret Martin.
