grunion
23rd July 2007, 03:14 PM
Growing up in the Bronx in the 1960s, my formal science education at elementary school P.S. 96 consisted of times when Mrs. Schnurr, who seemed rather ancient to our first-through-sixth-grade selves, would visit our classroom with her rolling cart and walk us through the bean seed dissections, celery-in-colored-water demonstrations, and baking soda/vinegar volcanoes that the Board Of Education deemed a fit body of science knowledge for young citizens to master.
<O:p</O:p
More fascinated, as I was, by the way the flab rippled under her arms when she shook the jars than by the actual experiments themselves, I was not prone to remembering the details. There’s no doubt, however, that sitting through six years of her one-hour weekly sessions she was subtly inculcating my baseball-and-Batman addled brain with The Method. Regardless of the topic the steps were repeated every single time – make observations, make guesses as to why, devise controlled experiments to test the guesses, eliminate plausible alternatives, draw conclusions. It was a logical, elegant and bullet proof way to learn things of which one could accept as true, at least until demonstrated otherwise.
<O:p</O:p
I clearly recall a 5<SUP>th</SUP> Grade unit she led on Human Anatomy. She would describe the role and structure of each of the major systems and organs of the body. It closed with a description of the central nervous system and the brain, differentiating between its autonomic and somatic functions (which she taught as “voluntary” and “involuntary”). It was a topic that our class was most engaged on – finally, we would learn of the mysteries of the most mysterious organ of all, the brain – but was shown to be a very unsatisfying lesson based upon the questions we shot at her afterwards. “But Mrs. Schnurr,” we implored, “how does the brain think? How does it learn? How does it understand?” She had adequately described the brain’s importance to us as organisms, but we wanted to understand how the brain made us human. Alas, her answer was unsatisfying, but it was the best she could do. “These questions, my children, are beyond the realm of science. Scientists indeed wonder the same things that you do. But the answers cannot be known.”
<O:p</O:p
A haunting answer indeed, the concept that something so important is “unknowable.” But interestingly, just three blocks to the west of that classroom stood Beth Abraham Hospital, where an English neurologist named Oliver Sacks was wrestling with those very same unknowables, and struggling for a tether into that knowledge to solve real peoples’ problems. This was where Dr. Sacks performed his experiments with the drug L-dopa, which he used to bring victims of the “Sleepy Sickness” pandemic of the 1920s out of their catatonic state for the first time in 40 years. He wrote Awakenings in 1973 in which he chronicled his experiences with those patients, and provided a new genre – medical literature in which the Observer is not a disinterested, objective documentarian listing symptoms and test results but is a character in the story of diagnosis and treatment. By allowing himself to feel compassion for his patients, he is able to gain special insight into their problems. He is able to, heaven forbid, identify with what others might see as deranged personalities, to find commonality with them, and, being the gifted writer that he is, allow his readers to also share a sense of what certain neurological disorders must be like.
<O:p</O:p
In The Man Who Mistook His Wife For A Hat and Other Clinical Tales, Dr. Sacks applies his knowledge, his insight and his craft to 24 fascinating neurological cases he treated during the 1970s and 80s at Beth Abraham and at the Einstein College of Medicine, the great teaching hospital about six blocks to the north of my elementary school.. In this book, Sacks is especially drawn to (and at his best when he discusses) disorders of the right hemisphere, cases in which tumors, accidents, drug interactions or other aberrations led to syndromes that impact the “personalistic” or “romantic” aspects of the brain function, and the fascinating (and often heartbreaking) ways in which those syndromes affect the perception, memory, personality and behavior of their victims.
<O:p</O:p
For example, we meet people that seem eminently likeable from moment-to-moment but with such severe and unusual memory disorders that attempting to sustain a conversation with them would be insufferably uncomfortable, as they are forced to recreate their perception of the scene and its context several times a minute.
<O:p</O:p
We gain a sense of what it must be like to have Tourette’s. We gain an appreciation for the experiences of “Rain Man” types who can calculate any calendar date within 40,000 years but can barely function on any social level – not through the “side show” treatment of the tabloid news but by somehow gaining empathy with them, with Dr. Sacks as our guide.
<O:p</O:p
We learn of hidden senses that we intuitively possess but never even think about, only gaining an understanding of them by learning of people who have lost the use of these senses. We meet a woman who awoke one day to no longer have a sense of being in control of her body, or of even having a body. We observe, through Sacks’ observant eyes, a roomful of patients who lack the ability to understand the meaning of the spoken word but can successfully engage in conversation by placing the speaker in visual context (and the hysterical reaction they have to a televised Presidential address.)
<O:p</O:p
And in the title story we get to befriend a man with a perception disorder so profound that he indeed does mistake his wife for a hat, but we are able to understand and forgive him that idiosyncracy, with gratitude for sharing it with Dr. Sacks, and by extension with us.
<O:p</O:p
Throughout the book, I constantly had to remind myself that here was a man who was not only tasked with identifying the problems at hand and using them to learn about how the brain works, but had real people before him that were coming to him for help. In only a few of the cases does Sacks go into any real detail about treatment; in most of these, treatment is understood to be futile but we feel grateful for the patient’s willingness to be examined.
<O:p</O:p
As it is largely a collection of previously published material, one shortcoming of the book is its unevenness. Some of the articles, likely written with a medical audience in mind, are brief and more clinical and disinterested than others. Some include extensive reviews of the medical literature, and give us an appreciation for the studies of the Russian neurologist R. A. Luria and others.
<O:p</O:p
So we still don’t get an answer to the fundamental questions asked by my 5<SUP>th</SUP> grade class. We do not leave with a mechanistic understanding of perception and memory. But we do indeed feel confident that just because something isn’t “known” doesn’t make it “unknowable,” and we are ultimately left with an even greater sense of awe of the workings of the human brain than when we began.
<O:p</O:p
More fascinated, as I was, by the way the flab rippled under her arms when she shook the jars than by the actual experiments themselves, I was not prone to remembering the details. There’s no doubt, however, that sitting through six years of her one-hour weekly sessions she was subtly inculcating my baseball-and-Batman addled brain with The Method. Regardless of the topic the steps were repeated every single time – make observations, make guesses as to why, devise controlled experiments to test the guesses, eliminate plausible alternatives, draw conclusions. It was a logical, elegant and bullet proof way to learn things of which one could accept as true, at least until demonstrated otherwise.
<O:p</O:p
I clearly recall a 5<SUP>th</SUP> Grade unit she led on Human Anatomy. She would describe the role and structure of each of the major systems and organs of the body. It closed with a description of the central nervous system and the brain, differentiating between its autonomic and somatic functions (which she taught as “voluntary” and “involuntary”). It was a topic that our class was most engaged on – finally, we would learn of the mysteries of the most mysterious organ of all, the brain – but was shown to be a very unsatisfying lesson based upon the questions we shot at her afterwards. “But Mrs. Schnurr,” we implored, “how does the brain think? How does it learn? How does it understand?” She had adequately described the brain’s importance to us as organisms, but we wanted to understand how the brain made us human. Alas, her answer was unsatisfying, but it was the best she could do. “These questions, my children, are beyond the realm of science. Scientists indeed wonder the same things that you do. But the answers cannot be known.”
<O:p</O:p
A haunting answer indeed, the concept that something so important is “unknowable.” But interestingly, just three blocks to the west of that classroom stood Beth Abraham Hospital, where an English neurologist named Oliver Sacks was wrestling with those very same unknowables, and struggling for a tether into that knowledge to solve real peoples’ problems. This was where Dr. Sacks performed his experiments with the drug L-dopa, which he used to bring victims of the “Sleepy Sickness” pandemic of the 1920s out of their catatonic state for the first time in 40 years. He wrote Awakenings in 1973 in which he chronicled his experiences with those patients, and provided a new genre – medical literature in which the Observer is not a disinterested, objective documentarian listing symptoms and test results but is a character in the story of diagnosis and treatment. By allowing himself to feel compassion for his patients, he is able to gain special insight into their problems. He is able to, heaven forbid, identify with what others might see as deranged personalities, to find commonality with them, and, being the gifted writer that he is, allow his readers to also share a sense of what certain neurological disorders must be like.
<O:p</O:p
In The Man Who Mistook His Wife For A Hat and Other Clinical Tales, Dr. Sacks applies his knowledge, his insight and his craft to 24 fascinating neurological cases he treated during the 1970s and 80s at Beth Abraham and at the Einstein College of Medicine, the great teaching hospital about six blocks to the north of my elementary school.. In this book, Sacks is especially drawn to (and at his best when he discusses) disorders of the right hemisphere, cases in which tumors, accidents, drug interactions or other aberrations led to syndromes that impact the “personalistic” or “romantic” aspects of the brain function, and the fascinating (and often heartbreaking) ways in which those syndromes affect the perception, memory, personality and behavior of their victims.
<O:p</O:p
For example, we meet people that seem eminently likeable from moment-to-moment but with such severe and unusual memory disorders that attempting to sustain a conversation with them would be insufferably uncomfortable, as they are forced to recreate their perception of the scene and its context several times a minute.
<O:p</O:p
We gain a sense of what it must be like to have Tourette’s. We gain an appreciation for the experiences of “Rain Man” types who can calculate any calendar date within 40,000 years but can barely function on any social level – not through the “side show” treatment of the tabloid news but by somehow gaining empathy with them, with Dr. Sacks as our guide.
<O:p</O:p
We learn of hidden senses that we intuitively possess but never even think about, only gaining an understanding of them by learning of people who have lost the use of these senses. We meet a woman who awoke one day to no longer have a sense of being in control of her body, or of even having a body. We observe, through Sacks’ observant eyes, a roomful of patients who lack the ability to understand the meaning of the spoken word but can successfully engage in conversation by placing the speaker in visual context (and the hysterical reaction they have to a televised Presidential address.)
<O:p</O:p
And in the title story we get to befriend a man with a perception disorder so profound that he indeed does mistake his wife for a hat, but we are able to understand and forgive him that idiosyncracy, with gratitude for sharing it with Dr. Sacks, and by extension with us.
<O:p</O:p
Throughout the book, I constantly had to remind myself that here was a man who was not only tasked with identifying the problems at hand and using them to learn about how the brain works, but had real people before him that were coming to him for help. In only a few of the cases does Sacks go into any real detail about treatment; in most of these, treatment is understood to be futile but we feel grateful for the patient’s willingness to be examined.
<O:p</O:p
As it is largely a collection of previously published material, one shortcoming of the book is its unevenness. Some of the articles, likely written with a medical audience in mind, are brief and more clinical and disinterested than others. Some include extensive reviews of the medical literature, and give us an appreciation for the studies of the Russian neurologist R. A. Luria and others.
<O:p</O:p
So we still don’t get an answer to the fundamental questions asked by my 5<SUP>th</SUP> grade class. We do not leave with a mechanistic understanding of perception and memory. But we do indeed feel confident that just because something isn’t “known” doesn’t make it “unknowable,” and we are ultimately left with an even greater sense of awe of the workings of the human brain than when we began.