Joseph Buford Pennybacker was born in Somerset, Kentucky, on 23 August 1907, the only son of Claude Pennybacker, a train dispatcher. His early education was at Knoxville High School, Tennessee, before entering the University of Tennessee, graduating BA in 1926 (summa cum laude). He followed the earlier colonial tradition of going from the American south to study medicine in Edinburgh, graduating with honours in 1930 and being awarded the Allen Prize in surgery. He had a short period in general practice before being appointed house physician at Edinburgh Royal Infirmary and later house surgeon to Sir John Fraser. He decided to pursue a career in surgery and took an appointment as resident surgical officer at Grimsby and District Hospital, passing the FRCS in 1934 and subsequently being resident medical officer to the National Hospital for Nervous Diseases, Queen Square, where he acquired considerable neurological diagnostic skills. He then decided on a career in neurosurgery and was appointed first assistant to Hugh Cairns at the London Hospital in 1935, subsequently moving to Oxford two years later when Cairns was appointed first Nuffield Professor of Surgery. During the war years he was appointed honorary consultant to the Military Hospital for Head Injuries at Oxford, took the MD degree in 1941 and when Cairns was occupied with military duties Pennybacker ensured the efficient running of the professorial department's neurosurgical service. After Sir Hugh Cairns' death in 1952 he was appointed director of the new, separate department of neurosurgery at the Radcliffe Infirmary and remained there until his retirement in 1971. After some years in Oxford he became a naturalised British Citizen. During his tenure of the post of director of his department he attracted many visitors who were impressed with his diagnostic skills and his ability to perform neuro-surgical operations with greater speed than had hitherto been considered possible. He was able to complete a prodigious amount of work and made valuable contributions to invertebral disc surgery. He encouraged junior staff to publish professional papers. A special interest was the Society of British Neurological Surgeons which he served as treasurer and secretary although he declined the offer of presidency. He was consultant adviser in neurosurgery to the Ministry of Health and in later years undertook much administrative and committee work. He was awarded the Cross of the Royal Order of George I of Greece in 1966 and Commander of the Order of the British Empire a year later. In 1941 he married Dr Winifrid Dean MB, ChB Manchester, DA, and they had one son. He retired from hospital practice a year early in 1971 and went to live in Tighnabruaich, Argyllshire where he pursued his hobbies of gardening and photography. His wife died in 1980 and he died suddenly on 27 March 1983 aged 75.