The first brain surgeon in the US (1837–1932). FDR sought his expertise after his paralytic illness struck, and Keen went on to closely tend to six presidents. TLS signed “W. W. Keen,” three sides of two pages, 8.5 x 10.5, 1729 Chestnut St., Philadelphia letterhead, May 19, 1898. Keen writes to his daughter Margaret, in part: “I was really a good deal disturbed yesterday when I got home and found your letter awaiting me. I had no idea that you were sick….I wish you would be perfectly frank in all such cases and let me know when you are not well, so that I can feel confident that I shall be really posted as to your condition…I hardly thought you would read the lecture, as it was so technical…If I had been writing for the general public I should have used different terms. In one of my lectures I said that I feared they would think that the course was all ‘gas’…As to Miss Kreh getting well when I didn’t do anything, I confess I don’t understand it any more than you do, but it is a fact that they do get well so frequently after simply opening the abdomen. The opening in Senn’s method of gastrostomy is a the apex of the pyramid…” In fine condition, with intersecting folds, one passing through a single letter of the signature, and some light creasing and mild overall toning. RRAuction COA.