Dr. Al Rhoton, Jr.: Friend, Mentor, and Colleague

Albert L. Rhoton was born in the hard years of the Great Depression of the United States, in the Kentucky hills of Appalachia, to strong parents with little means. His character was shaped by the struggles of his family to survive and advance themselves through hard work and education. From these humble beginnings, Dr. Rhoton rose to become an icon in neurosurgery because of his leadership skills and tremendous contributions to neurosurgical education and research. Along his career path he remained a humble and caring individual who recognized and respected others. He was unselfish with his time to speak to those who sought his advice, and gave of himself tirelessly to share his knowledge and life experiences of an academic neurosurgical career spanning a half century.

In his 1990 American Association of Neurological Surgeons (AANS) presidential address, Neurosurgery in the Decade of the Brain, Dr Rhoton spoke of the miracle of neurosurgery, “I would like to reflect on the joy and excitement of being allowed to participate in the miracle we call neurosurgery. In my early years, I never imagined that life would yield such an exciting mission as being a physician or a neurosurgeon. Our work is done in response to the idea that human life is sacred, that it makes sense to spend years of one's life in study in order to be able to help others. Our training brings into harmony a knowledgeable mind, a skilled set of hands, and a well-trained eye, all guided by a caring human being. The skills we use have been described as the most delicate, the most fateful, and to the layman, the most awesome of any profession.” On acquiring the skills of a well-trained neurosurgeon: “Competence and compassion need to be developed simultaneously, as the giant oak develops its root system along with its leaves and branches. Competence without compassion is worthless.” As a religious experience: “The brain is the crown jewel of creation and evolution. It is a source of mystery and wonder. Mind and brain are the source of happiness, knowledge, and wisdom. The brain is not the seat of the soul, but it is through the brain and mind that we become aware of our own soul.” A prayer for physicians sent to him by one of his patients: “Lord, Thou Great Physician, give skill to my hands, clear vision to my mind, kindness and sympathy to my ears. Give me singleness of purpose, strength to lift at least a part of the burden of my suffering fellow men, and a true realization of the rare privilege that is mine.”

Our paths crossed through our leadership roles in organized neurosurgery, having both served as President of the AANS and North American Skull Base Society. He was a senior advisor and role model for me as I followed his large footsteps. Teaching roles in various skull base courses with Dr. Rhoton in the 1990s influenced my starting the annual North American Skull Base Society Resident Skull Base course in Memphis in 2002. He faithfully attended every course we held to give his three-dimensional (3D) neuro microanatomical lectures, teach, and inspire the faculty members and each resident that attended. The faculty of our annual courses felt privileged to work with him. It was an honor, and we each looked forward to these annual courses, for he treated us as family ([Figs. 1] [2] [3]).

Fig. 1 Some of the usual faculty at the many skull base dissection courses held in Memphis; from left to right: Drs. Franco DeMonte, Anil Nanda, Michael Link, Dr. Rhoton, Jon Robertson, John Golfinos, and Bill Couldwell.

Fig. 2 Dr. Rhoton enjoyed instructing in the lab as much as giving his 3-D lectures in the auditorium.

Fig. 3 Push up contests were often on the agenda in Memphis, which Dr. Rhoton usually won, even though he was well into his 8th decade.

Recognizing the importance of preserving Dr. Rhoton's 3D neuro microanatomical lectures for future neurosurgical education, I began to discuss with him how this might occur in 2008. He was reluctant to work with either of the two major neurosurgical organizations because of personal and political loyalties, which I understood. The complexities of archiving the enormous volume of his neuroanatomical material in a format that could accurately present his life's work as he wished, had too many challenges: How much would it cost? Who would do the work? Would he retain ownership and have control of how his lectures would be presented?

The turning point came with the introduction of 3D televisions and their associated digital formats in 2010 that could be used to display his stereoscopic images synchronized with a recording of his voice to preserve his wonderful 3D lectures. With financial backing and the support of the leadership of the AANS, Dr. Jeff Sorenson, Dr. William Couldwell, and I began the process which led to the development of the Rhoton Collection. To move forward with this project required the acceptance on the part of Dr. Rhoton that this was the right way to preserve his wonderful legacy of neuroanatomical instruction. His desire was to have his life's work serve as a teaching platform, available to everyone worldwide at no cost. Our commitment was to achieve his wish and honor our mentor and friend.

Every enhanced lecture prepared by Dr. Sorenson for the Rhoton Collection was personally reviewed and approved by Dr. Rhoton. This required multiple visits by our team to Gainesville spanning a period of 5 years. Dr. Rhoton trusted Dr. Sorenson to be the producer and director of the Rhoton Collection. His long hours of work, technical and artistic skills, made this effort possible.

The numerous weekends that I traveled with Dr. Sorenson to Gainesville were precious times spent with Dr. Rhoton. At the end of the day working on lecture material at the Brain Institute, we would go to Dr. Rhoton's favorite local restaurant, Mildred's Big City Food. There we would discuss the various stages of the Rhoton Collection, and he was always excited to tell us about new neuro microanatomical studies that his fellows were producing in his laboratory. But more importantly, we talked about each of our careers spanning three generations, our friends, and our families.

Our last visit came 2 weeks before his death. He was pale and weak, but his mind was sharp. We spent the morning at the Brain Institute reviewing a lecture on orbital anatomy he had prepared during the past year that would be ready for release at the coming 2016 AANS annual meeting. Later that evening we met for our usual dinner at Mildred's Big City Food. We had a great time. It was raining as we left the restaurant, but no one rushed to leave. Dr. Rhoton hugged each of us, and wished us safe travel home.

The measure of a man's attributes can be judged by the depth of the friendships which he has made. Albert L. Rhoton's friends were legion and their feelings ran very deep. Among the bright miles which good fortune has at times cast in my direction, I consider being counted among his friends and colleagues the brightest of all.