Joseph Buford Pennybacker CBE MD FRCS (1907-1983): Continuing Sir Hugh Cairns’ Oxford Legacy and Pioneer of the Modern Management of Cerebral Abscesses

Abstract The authors examine the life and contribution of Joseph Buford Pennybacker to British neurosurgery and the modern management of cerebral abscesses. Pennybacker’s inspirational journey began with him aspiring to Ephraim McDowell. It saw him cross the Atlantic, learn medicine at Edinburgh, train in neurology at Queen Square in London and learn neurosurgery under Sir Hugh Cairns in Oxford. He navigated a successful career through World War Two and together with Cairns established the Radcliffe Infirmary in Oxford as a highly esteemed neurosurgical unit. By increasing the operative tempo yet uncompromising the meticulousness of his operative technique, Pennybacker challenged the Halstedian and Cushing traditions. The pioneering Pennybacker system of managing cerebral abscesses stood the test of time and the ethos of pre-operative imaging, intervention and post-operative monitoring - clinically, biochemically and with imaging results remains today. Not only did he contribute significantly to British neurosurgery and the training of both home-grown and international neurosurgeons, he was a remarkably kind-hearted and calm person. These qualities inspired many of his contemporaries and junior colleagues and we hope will continue to do so for generations to come.