uary 2023 ).
I had attended the post-mortem examination of JP ’ s brain in May 1977 . JP ’ s mother had contacted Ackerly after her son ’ s death and asked for the brain to be examined . The body had already been embalmed and dressed for the funeral . The Chief Resident in Pathology , Dr . Sam Smith , incidentally a childhood friend of mine , was sent to the funeral home to remove the brain . Dr . Smith told me that there were medical photographers present to record the event , fortunately .
A few days later neuropathologist Dr . Ryland Byrd conducted an external examination of the brain followed by coronal sections through the brain . There was still and videotape imaging of the procedure ; Dr . Byrd also had a small voice recorder operating , which was his standard procedure . In attendance , other than Dr . Byrd and myself , were Dr . Spafford Ackerly and his grandson William Spafford Smock ( Bill Smock , MD , is now Police Surgeon for the LMPD ). There were also a few other staff and residents , including Dr . Dan Tucker from psychiatry , who had treated JP most recently .
Ryland Byrd was an extremely careful examiner and recorder of his brain cutting sessions . However , no written record of this historic event has ever been found , despite monumental efforts by Dr . Benjamin and others .
In 1978 , about a year after JP ’ s death , Dr . Christine Adams , a Louisville psychiatry resident at the time , presented a paper including a videotape interview with JP , at the American Psychiatric Association Annual meeting . “ Timelessness and Forgetting in Frontal Lobe Defect ” included segments with Ackerly and JP reminiscing about their long association . Dr . Adams , now in practice in Louisville , had known JP in the last months of his life , and Ackerly had given her copies of papers , photographs and videos about the now deceased patient . When Shel found out about this collection of materials he decided to come to Louisville and examine them with Dr . Adams .
It became apparent that Shel was going to research the case of JP very thoroughly , so there were more trips to be made . Internet and email can be very helpful tools in such detective work , but there is no substitute for direct , face-to-face investigation . Louisville being the small city or big town that it is , helps in ways that might not be possible in very large metro areas . Continuity in the medical profession over three generations of Ackerly ’ s family , was a start .
Spafford Ackerly , MD , came to Louisville in 1932 , after graduating from Yale in 1925 , with various appointments in New York , Europe and state-run hospitals in Massachusetts . On his initial UofL faculty record form , beneath his Wesleyan University graduation in 1921 , is the terse entry : 1914-1916 ( war ). Shot in the trenches , he lay under the dead body of a close friend and witnessed a German pass over them dismissively . His thigh wound was tended to but never completely healed - chronic osteomyelitis . One of his happiest days was a morning when Sir William Osler , on ward rounds , briefly examined him and pronounced that he would not need an amputation .
In preparing my original Frontal Lobe Guys talk , I got to know Spaff ’ s daughter Carita Warner . Her son , Bill Smock , was the uncomfortable looking teenager whom I had first encountered at the brain cutting for JP . Spaff ’ s relationship with JP was not an arm ’ s length one . JP was a not infrequent visitor to the Ackerly house ; in fact , he proposed marriage to Carita when she was about 13 ( he was in his 30s ). Ackerly was frequently called upon to explain JP ’ s unusual behavior to police and judges after the latter ’ s being apprehended . The fascinating details of JP ’ s psychosocial abnormalities can be found in the recently published article in Cortex .
Having identified the Louisville players who knew something of JP , Shel felt that a conference among his Massachusetts experts and the local contributors was necessary .
In June 2017 Dr . David Casey , Innominate Society member and Psychiatry chief , offered the use of his facilities for a meeting to sort through what had been learned . In addition to Dr . Benjamin ’ s Massachusetts team , Dr . Adams , Dr . Smock and his mother , and myself convened in a large conference room for discussion and display of photographs and videos . The late Dr . Stuart Urbach , who had been a medical student here in the 1940s , joined the discussion group with his perspective from that much earlier time .
Some of the most moving memories I have of the meeting were hearing JP speak , sing and seeing him move around . This was a human being , not a freak from a side show . The interaction between JP and Spaff was particularly warm .
In preparing for the meeting , Shel had toured the areas where JP had lived , and gone to ( numerous ) schools . He had seen where his father had sold cars . JP was mesmerized by automobiles , and his father sold nicer touring cars , such as Austins and Durants . Unfortunately , this passion caused many problems , as JP early on learned how to drive cars and would drive away with any vehicle that had the keys in the ignition , frequently driving in a straight line until he ran out of gas . One of his thefts was an ambulance , which he drove all the way to Kansas .
Certainly , one of the biggest tragedies to hit Louisville during my life was the 1974 tornado . The house that JP and his mother shared , I believe in the Highlands , was destroyed , and this prompted their move to a nursing home . The ever-boastful JP insisted that he owned the facility . His behavior deteriorated ; he suffered a fall with broken bones . He developed urinary incontinence . He became aggressive and abusive to staff , which required his being restrained to his bed . When Spaff and Bill Smock visited him in 1976 , they were struck by the violence of his outbursts .
JP was transferred from the nursing home to the hospital in January 1977 , in an effort to find an organic cause for his deteriorating and increasingly violent behavior . An early EMI CT scan showed hydrocephalus , which had not been evident on two pneumoen-
( continued on page 28 ) March 2023 27