One Book, Two Book...

Long-time readers of this blog may remember that at the start of my third year of medical school, I pledged to read one book a month until I graduated. I had just finished writing and defending my dissertation in the history of medicine, a process that involved much less reading than I would have liked, on the premise that I should not get hung up on what other scholars had written, would say what _I_ wanted to say, and could always incorporate secondary literature into the manuscript later. So I found to my dismay that I stopped reading nonfiction (I had largely given up fiction years before, except when Dear Husband and I read to each other on long car trips, or before bed).

Last summer, I began by filling a deficiency in my education, namely that I had read nothing about the Tuskegee syphilis experiments. I also indulged in a popular history of Jean Marie Charcot’s three most famous hysterics. And then Disciple I Bible study started. Disciple is a series of weekly readings, videos, and conversations created by the United Methodist publishing group, and I had long wanted to take the 32-week course, if only I could fit it into my busy schedule. Finally, I figured there was no time like the present, and gave up my quiet Sunday evenings to laughter, cheesy videos, and serious discussions about the historicity and spiritual truth of the Bible. I managed to keep up with the weekly readings through the first semester, but then Winter Break hit, and I fell entirely off the bandwagon. Between the pastor retiring and various Sunday-based holidays (Easter, the Super Bowl), the course stuttered to some kind of end in May.

Summertime meant the start of another medical year and renewed resolve to get back to reading. For my birthday, Dear Husband gave me a book he heard about on the radio: The Tale of the Dueling Neurosurgeons: The History of the Human Brain as Revealed by True Stories of Trauma, Madness, and Recovery, by Sam Kean. Since I was on the Neurology service for the month of August, it was a perfect fit.

Kean realized that the discipline of neurology thrives on patient narratives: when was the patient last normal? what happened when they fell down? what is wrong now? So he recounts how scientists have come to understand the functions of the brain through stories of historical patients. Neurology is also a diagnostic specialty par excellence: the presence of certain physical findings and absence of others suggests what precise part of the nervous system has been damaged. Neurologists love to sit around and talk about lesions. There is even an entire board game called The Lesion. Kean's Tale catalogues the localization of various brain functions, from spatial awareness (parietal lobe) to making new memories (hippocampus) to sense of touch (post-central gyrus). Consciousness, however, appears to be an additive property, the result of the collective functions of a variety of structures.

The text is engaging and easy to read. Each chapter begins with a rebus that spells out the topic (e.g. B + [image of rain] = brain) and is illustrated with photographs and charmingly simple line drawings depicting the thalamus or Broca's area. I did bristle slightly at Kean's characterization of the "dueling neurosurgeons" in the title. The two in question are Ambroise Pare and Andreas Vesalius, summoned in 1559 to tend to King Henri II of France, who had suffered a nasty closed head wound while jousting. The two actually worked quite well together, performing experiments with the heads of decapitated criminals to try to understand what had happened to the monarch's brain. The case was too serious to operate, so they settled for a post-mortem autopsy, which showed that Henri had suffered a coup-contrecoup injury, even though his opponent's lance had not penetrated his skull--he didn't even have a fracture. Kean weaves other famous patients and physicians--Woodrow Wilson, H.M., Phineas Gage, Santiago Ramon y Cajal, Wilder Penfield, Karl Wernicke--into a fascinating narrative that I can recommend to general readers and neurologists alike.