figure a

It is impossible for all of us involved in pediatric neurosurgery not to feel sadness and a deep sense of loss at the death of Luis Schut on January 31, 2018. At the same time, as members of the profession and as human beings, we are aware of the pleasure we all obtained from knowing Luis. He was a consummate friend, colleague, and teacher to many of us and will continue as a presence in our lives. Luis was involved in the development of pediatric neurosurgery from an almost hidden specialty in the 1950s and 1960s being performed by only a few people in the world to a well-recognized subspecialty of neurosurgery by the time he retired. He left a potent legacy in the many residents and fellows that he taught, many of whom became leaders in pediatric neurosurgery, following in Luis’ footsteps.

Luis’ career has the ring of a novel. Born in Argentina, he went through medical school in Buenos Aires during the presidency of Juan Peron where, according to Luis, the job of the medical students was to go on strike because all they got to eat was steak and to push the tanks in the military parades. After medical school, Luis and Tina, his wife and life companion, left Argentina and emigrated to the USA in 1955. He completed his neurosurgical training at the University of Pennsylvania under Professor Groff having been the last resident chosen by Professor Grant. He, along with Dr. Mishkin from radiology and Dr. Silberberg from neurology, went to Queen’s Square and Great Ormond Street in London to round of his education in neuroscience but also in good wine, good food, and living style. One of Luis’ jobs was to translate a Scottish registrar’s speech into English for his London colleagues. Quite impressive!

In 1962, Luis joined the neurosurgery faculty at The University of Pennsylvania joining Eugene Spitz at The Children’s Hospital of Philadelphia where he was involved with the implantation of the first successful valve (the Spitz-Holter valve) for the control of hydrocephalus. CHOP became the early center for this modern treatment of hydrocephalus. Luis took over as chief of pediatric neurosurgery in 1967 after Dr. Schulman, who had replaced Dr. Spitz, left for New York to be the chairman at Albert Einstein University.

“I would be remiss if I did not, on this occasion, express my appreciation to Dr. Luis Schut who was happy to come here (CHOP) as Chief of Neurosurgery in 1966. Dr. Schut provided not only leadership so ably demonstrated in Pediatric Neurosurgery but was a real factor in helping me realize the goal I set for Pediatric surgery in general in this institution.” (Dr. Koop; Opening Remarks; ISPN 9/13/1982).

Under Luis’ tenure, the program at CHOP became increasingly diverse and, after the movement of the Children’s Hospital to its new building in 1974, became recognized as one of the premier pediatric neurosurgery programs in the world. Luis established one of the first fellowships in our specialty and became a fixture on the international circuit, sought after not only for his informative and amusing lectures but for his presence as a genuinely nice man. He was as popular and respected overseas as he was in the USA and became firm friends with the leaders of pediatric neurosurgery around the world. He was recognized as “one of only a handful of faculty members responsible for establishing CHOP as a landmark children’s hospital” (Bonnem S.: The Children’s Hospital of Philadelphia, 1974–1994: Two Decades An informal report. 1995). Dr. Schut lectured in 24 countries and 5 continents. He published over 100 scientific peer-reviewed papers and innumerable book chapters. Luis was a man who had a deep place in his heart for children, all children, and his belief that they should have access to the health care they required was a strong motivating factor in Luis’ life. I never saw him turn a child away and he passed that deep concern and love of children to all the colleagues he worked with and trained.

Luis was an excellent technical neurosurgeon but also a thoughtful one. “Ask whether operating on this child is the best treatment” was a question drilled into all his trainees. It was Luis’ ability, despite an ego of his own, to attract and foster the best people around to work with and he had an early realization of the importance in pediatrics of developing teams to accomplish the complicated and multifaceted approaches necessary. He and Dr. Mary Ames established the earliest myelomeningocele multi-discipline clinics in the USA. This became the model for care of these children. This was followed by similar team development for treating head injuries, brain tumors, and craniofacial anomalies. Two of Luis’ finest qualities were humility and honesty in his professional work. He was enormously supportive of all the progress made by his trainees and encouraged us all to surpass his own achievements, a difficult if not impossible task. Many mentors are threatened by their best students and the indulgence in “schadenfreude” is an all-too-common response within our profession. In contrast to this, Luis would suffer with his trainees and take to heart, as if they were his own, any complications or poor outcomes. Soon after I finished my training, Dr. Larry Marshall and I did a complex AVM operation that lasted 30 h. Luis never left the hospital but also never scrubbed in although he would frequently appear in the OR to tell us that the lesion was bleeding and could we please stop the blood loss, also how could it take so long to do such a simple case? That degree of support was, in my experience, almost unique to Luis.

Luis served in every leadership position in pediatric neurosurgery. He was a founding member of the ASPN, the ISPN, and the American Board of Pediatric Neurological Surgery. He was also president of the ISPN and the ASPN and Chairman of the joint section on Pediatric Neurosurgery of the AANS and CNS. In the early days of the development of pediatric neurosurgery in the USA, Luis along with Fred Epstein, Don Reigel, Harold Hoffman, and Tony Raimondi made up a cadre focused on the establishment and development of pediatric neurosurgery. Despite his many senior positions within pediatric neurosurgery, Luis did not enjoy his role as a politician. As an outside observer, it was clear that while the others complained, somewhat bitterly on occasion, especially over a glass of good wine, about Dr. Raimondi, nonetheless, there usually was an immediate response to his summonses and he was the tacit leader. It was this group who led the fight for the establishment of pediatric neurosurgery as a subspecialty and who achieved their goal leaving the rest of us a lasting legacy to cherish and build on.

Luis’ ability to drift comfortably in his own current and enjoy, but not intrude upon the lives of others, may be no better reflected than in the picture of him in his sail boat, rather frantically sometimes doing everything—steering, fixing the sails, plotting the course—while Tina sat quietly drawing in apparent complete ignorance of any impending disaster. Luis was a caretaker of us all and this was another of his endearing qualities. Lest we make him too much of a saint there was a side of him that could not easily accept success. When things were going well, he could become quite depressed and worried and, if asked why, would reply “they can’t stay this way, things are too good.” He was a man who deserved things to be too good!

Luis wife Tina (Lydia) and children Andrew, Edward, and Henry and grandchildren were the jewels in Luis’ life although they, like all our wives and children, often had to take second place to other people’s children, our patients. As we miss Luis, we must remember how much greater their loss is. I hope this reflection of we, his colleagues and trainees, will express to Luis’ family the love and admiration we had for him and his impact on the world he lived in. We thank them for the loan of Luis Schut.