Charles Wilson, Top Brain Surgeon and Researcher, Dies at 88

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 O.K.,” Dr. Mitchel Berger, a former resident who is chairman of U.C.S.F.’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.)

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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 U.C.S.F. 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,” Dr. 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,” Mr. Gladwell wrote, “except that in this case, the windshield was a surgical field one 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 Dr. Wilson saw bleeding from one side of the gland, he realized that he had not gotten all of the tumor. He found it and removed it. The surgery took only 25 minutes.

Dr. Wilson performed the surgery more than 3,300 times.

He told Mr. Gladwell that 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 Mr. 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, Mo., 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.

Charles, though slightly built, was a three-sport athlete in high school and received academic and football scholarships to Tulane University, where he played running back as a freshman. But he went no further in football because of an ankle injury. He eventually turned to running marathons.

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A skilled pianist, he also played Dixieland jazz at a French Quarter nightclub during his college years in New Orleans.

Dr. 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), Dr. 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 U.C.S.F. in 1968 as chairman of its neurology division and soon expanded the brain tumor research he had begun in Kentucky.

“He was a visionary in how he built a multidisciplinary approach to studying brain cancer, linking basic science and clinical research together,” Dr. Susan Chang, director of the division of neuro-oncology at U.C.S.F., said in an interview. “He was able to set up an infrastructure to test new therapies on tumors and spare patients the side effects of treatments.”

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 co-founded 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 is survived by 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.

In 1994, in a speech to a medical conference, he offered his thoughts on how patients can better cope with a brain tumor. They cannot control the diagnosis, he said, and suggested that they face their mortality.

“Life can be beautiful,” he said, as he approached his 65th birthday, “but it is certainly not forever. A part of the end of life is dying, and it’s O.K. to think about it; it’s O.K. to wonder about it, but it’s not O.K. not to think about it.”

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