The Tale of the Dueling Neurosurgeons by Sam Kean
Science has always had a back-and-forth, give-and-take dynamic. Accordingly, the history of neuroscience is rife with competing ideas and evolving theories, with scientists continually building on each others’ work. Author Sam Kean illustrates this in his most recent romp through history, The Tale of the Dueling Neurosurgeons.
(The title comes from an incident in the mid-1500s in which Henri II of France suffered a mortal wound in a joust. The royal surgeon Ambroise Paré “jousted” in the operating room with anatomist Andreas Vesalius as the two determined how to treat the dying king.)
The book, published this May, sketches entertaining and all-too-human accounts of the men and women who built the foundation of neuroscience, cognitive psychology, and mind-body philosophy. In presenting what he calls a “natural history of the brain,” Kean claims that the reader’s knowledge of neuroscience’s classic characters is “probably wrong,” and intends to set us straight. He suggests that studying brain damage is the “best way” to understand the brain, saying that brain-scanning techniques are “often overhyped.” Making inferences based on what scientists would call lesion studies is actually weakened by the nonspecificity of most injuries, however. In reality, stories of people whose brains have betrayed them make for a far more interesting book than “a litany of one damn brain-scan study after another,” as Kean remarks. The reason for presenting information in narrative form is itself related to the study of the mind and brain: stories are easy to remember. And the story of neuroscience, as told rather conversationally by Sam Kean, is one of dramatic twists of fate, Eureka! moments, and rich details dug up from the annals of history.
The first few sections read like a Psych 101 textbook, with simple line drawings and brief descriptions of brain structures and their known roles. While he acknowledges the oversimplification of these categories, Kean presents the brain as three parts: the reptile brain, including the brainstem and cerebellum (“a wrinkly bulb on the brain’s derrière”); the mammal brain containing the limbic system; and the primate brain of the frontal, occipital, parietal, and temporal lobes.
After outlining the gross anatomy, the book moves on to neurotransmitters and electrical impulses that enable the brain; the brain’s relationship with the body; delusions; and finally — throwing a few bones to the philosophically-minded readers — consciousness, including memory, language, and the human “sense of self.“
Every chapter features at least one victim of botched surgery, a horrific accident, strokes, disease, or seizures, interwoven with the stories of relevant brain research and contemporary scientists. There’s the rotten brain of President Garfield’s assassin and Edward Charles Spitzka’s intuition that chemical disturbances in the brain could affect its function. There’s the world traveler and echolocator James Holman, blind as a bat, and Paul Bach-y-Rita who said, “We don’t see with the eyes. We see with the brain.” There are the synesthetes who perceive the texture of orange as shocking and Albert Hoffman’s synesthesia-inducing experiments with LSD. There’s the giant John Turner and the farmer with pituitary gland problems, and the neurosurgeon Harvey Cushing who did pioneering work on hormones. There’s the literally fearless S.M. and Papez’ study of the limbic system, which is the brain’s emotional center. The list goes on, and includes classic cases like H.M. and Phineas Gage.
In the well-known tale dating from the 1840s, the railroad foreman Phineas Gage had a meter-long tamping rod blasted through his skull. He’s famous because he survived the accident, living a dozen more years. And although he retained his senses, reflexes, language, and memory, his personality changed; he made whimsical decisions and acted on his desires without regard to others. The rest of the story, however, has been warped by rumors, and Kean uses the story as a launching pad to discuss consciousness.
Two of the most captivating stories involve complex characters.
The first is Weir Mitchell, who studied Civil War amputees and their phantom limbs. Mitchell accomplished ground-breaking work on phantom sensation, not to mention sleep paralysis and object blindness. Yet, his “rest cure” for psychological problems inspired Charlotte Perkins Gilman to write her classic short story “The Yellow Wallpaper” about a woman who goes insane when kept from writing.
The second is D. Carleton Gajdusek, an intrepid anthropologist-doctor who discovered the mode of transmission of the deadly Papua New Guinean disease kuru. While Gajdusek provided some of the first evidence of slow viruses through his meticulous studies of kuru, he also allegedly molested the young Papuan boys who accompanied his research efforts.
With these two, the author makes us realize that even world-class scientists are fallible human beings.
The Final Frontier
Throughout the centuries, scientists have faced and overcome questions about the function of the brain, but the final frontier for scientists and philosophers alike is the question of how the material brain enables an immaterial mind. Perhaps, the author suggests, consciousness is not localized in the physical stuff of the brain, but emerges from a process involving the entire brain. We may always debate the topic of consciousness, that old mind-body conundrum, but for now it’s enough to enjoy the stories of how far we’ve come — stories that will, as Kean hopes, “enrich our understanding of the human condition.”