Tag Archives: Medicine

CLARITY, ENLIGHTENMENT, EDUCATION

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

Your Best Brain Written by: John J. Medina

Published by: The Great Courses

JOHN J. MEDINA (AUTHOR, DEVELOPMENTAL MOLECULAR BIOLOGIST, PROFESSOR AT UNIV. OF WASH. SCHOOL OF MEDICINE)

At times, “The Great Courses” misses targets for clarity, enlightenment, and education.  However, Professor Medina hits every mark with understandable examples, utilitarian insight, and erudition. Though undoubtedly capable of mystifying layman with science jargon, Medina captures the complexity of what is presently known about consciousness and the mind with examples of well-known movies, television serials, commercials, and jokes.  His self-effacing delivery makes every lecture entertaining, enlightening, and educational.

CHARLES DARWIN (1809-1882, Explorer, Author of “The Origin of Species”, the seminal work on the evolution of humankind.)

Charles Darwin is Medina’s guide for explaining ascendance of the world’s greatest predator.  Brains make humans the dominant animal of life’s kingdom.  Medina notes how human brains evolve to outwit other predators in this biosphere.  A principal construct of that wit is homo sapiens’ ability to communicate among themselves.  With communication, humankind constructs a future out of the past and present. Humans evolve beyond instinct to not only survive but dominate the animal kingdom.

HUMAN COMMUNICATION (With communication, humankind constructs a future out of the past and present. Humans evolve beyond instinct to not only survive but dominate the animal kingdom.)
ENDORPHINS ARE CHEMICALS IN THE BRAIN THAT FUNCTION AS NEUROTRANSMITTERS

Though Medina answers many questions about the mind, he acknowledges mysteries that remain about consciousness.  There is no identifiable element that constitutes consciousness.  He explodes myths of right brain-left brain thinking, nature vs. nurture conception, intelligence testing and its validity, and the component nature of brains and their chemical and physical interconnections.  Medina goes on to explore deterioration and abatement of memory loss with age.

(Medina explains how unbelievably versatile the human brain is shown to be by the experience of people who have been severely injured.  Some recover many of the functions formally managed by parts of the brain that have been damaged.)

Medina explains how unbelievably versatile the human brain is shown to be by the experience of people who have been severely injured.  Some recover many of the functions formally managed by parts of the brain that have been damaged.  He notes that eyes do not see.  The brain is the functional source of sight.  He explains the miraculous feats of the brain that manipulate the scenes of life.  Medina explains the importance of sleep in maintaining and improving memory.

COMPONENT PARTS OF THOUGHT IN THE DECONSTRUCTION AND RECONSTRUCTION OF EVENTS.(Medina suggests every human event is taken apart and reassembled by the brain.)

One of many striking points made by Medina is the brain’s deconstruction of all visual events.  The brain reconstructs events to conform to an individual’s understanding of what happens.  Medina suggests every human event is taken apart and reassembled by the brain.  Our brains are not movie projectors.

(There is a risk to truth and justice.  It suggests a judicial recklessness in relying on eye witnesses to crime.  Further, it reinforces one’s opinion about the objectivity and malleability of history.)

What brain sight and memory imply is a risk to truth and justice. It suggests a judicial recklessness in relying on eye witnesses to crime. Further, it reinforces one’s opinion about the objectivity and malleability of history. It explains how remembrance of things past are affected by tellers of tales; let alone, present day interpretations of past events.

There are many interesting vignettes about the development and validity of IQ tests, savant memories, and the mechanical and chemical functions of the brain.  Medina ends with encouragement to exercise, socialize, and live in the present to maintain healthy brain function.  There is much to learn from Medina’s erudite lectures.

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MORALITY & REDEMPTION

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

QB VII

Written by: Leon Uris

Narrated by: John Lee

LEON URIS (1924-2003, AMERICAN AUTHOR)

In 1970, “QB VII” is acclaimed as a page turning best seller.  It is the story of a libel trial against an author for naming a knighted Lord as a Nazi collaborator.  Among other things, it is a parable about morality and redemption.  The books fame is enhanced by a mini-series aired on ABC in 1974.  The author, Leon Uris, had been sued for a similar libel accusation in his first best seller, “Exodus” (see Dering v. Uris).  The title, “QB VII”, is an allusion to Queens Bench VII.

HANNOVER-AHLEM JEWISH CONCENTRATION CAMP WWII

The story is about the trial of a Polish surgeon who runs a surgical department in a Polish concentration camp in 1943.  The story begins after the war with Dr. Adam Kelno being held in a British prison while Poland is requesting extradition of Kelno for medical experimentation and abuse of concentration camp prisoners.

Inmates of a German concentration camp in Sachsenhausen, near Berlin, stand in line during attendance check, on December 19, 1938. (AP Photo)

Kelno’s  principal accuser is Dr. Mark Tessler, a Jewish prisoner and fellow surgeon in the prison camp.  Tessler testifies that Dr. Kelno victimized concentration camp prisoners, particularly Jewish prisoners that are experimented on at the direction of SS leaders.  Kelno argues that Tessler is a liar.  No corroborating evidence (neither witnesses or records) is found to support Tessler’s accusations.

Uris prepares the reader/listener for the ending of the story by having one of the British interrogators suggest Dr. Kelno is hiding something.  However, after two years of imprisonment, the English courts deny Poland’s extradition request, and the doctor is released.

BORNEO SARAWAK NATIVE

Kelno fears for his life because of Poland’s aggressive extradition attempt, and Tessler’s damning testimony.  Kelno secretively flees with his family to Borneo to begin a practice treating local natives and colonial British overseers.  The natives resist his help because of their belief in witch doctor’ traditions of health care and medical treatment.  Over time, Dr. Kelno and his wife gain the confidence and appreciation of the natives.  Kelno reputation rises in the colonial medical administration of the region.

BRITISH COLONIALISM IN NORTHER BORNEO

Kelno’s stature grows to the point of being knighted by England for selfless service in the colony.  Kelno raises a son with his wife who becomes a favorite of local natives.  As Kelno’s reputation rises, he eventually returns to England to begin a practice in a small community near London.

Uris then introduces a new character, an unorthodox Jewish author who is a young successful writer and becomes a sought-after playwright for the movies.  However, this writer longs to return to writing and become a noted author of Jewish history.  After milking the movie industry with a work of pulp fiction, Abraham Cady dedicates time to researching and writing what becomes an acclaimed best seller titled “The Holocaust”.  This event sets the table for a libel case because it reveals Kelno’s role in a Polish concentration camp.  What makes Uris’s story revelatory is the complexity of guilt and redemption for unpunished crimes, and the tenuous nature of morality.

Half of Uris’s story builds Dr. Kelno into a legend.  Kelno provides selfless duty to his patients and the medical profession after the war.  He seeks no fame, none of the accouterments of wealth, raises one son and inspires his son’s best friend to become a doctor for the natives of Borneo; while later settling into a life of obscurity in a small English community.  In contrast, Abraham Cady uses his youth to perfect his writing skill, join the military as a WWII pilot, and marry a nurse who cares for him after a disastrous plane crash.  After recovery, Cady chooses to live the life of a profligate, cheating on his wife, and prostituting his skill as a playwright.

However, the writer in Cady reaches a point of self-awareness that compels him to author something important.  This point leads to the publication of “The Holocaust”.  From Cady’s research, the accusatory testimony of Dr. Mark Tessler is found and the book references Dr. Kelno and his role as the Polish concentration camp’s medical director.  Dr. Kelno’s son’s best friend convinces Kelno that he should sue for libel.  Kelno had been found not guilty of any misdeeds when Poland tried to extradite him from England after the war.  It seems he had been unfairly imprisoned for two years, investigated, and found innocent because of lack of corroborating evidence.

BRITISH COURT (The suit is drawn.  The case goes to the Queen’s Bench VII for trial.)

The suit is drawn.  Cady insists his research is accurate and refuses to retract his findings.  The case goes to the Queen’s Bench VII for trial.  This is thirty or more years after the war.  Cady is defended by one of the best lawyers in England with payment for services made by an English aristocrat (one of Cady’s lovers), and an obscurely identified Jewish interest group.

PENANCE (Doctors Without Borders)

The trial reveals Dr. Kelno’s guilt.  The complexity of the guilt is in Kelno’s penance by being a better person after the war.  It does not absolve his quilt but it makes him something less than a monster.  One is confronted with what he/she would do in a similar circumstance of war.  Would you say no to a supervisor that tells you to castrate someone if you believed you would be killed?  Stanley Milgram’s experiments show that normal human beings can be driven to kill other human beings for no other reason than their acceptance of someone else’s authority.

Kelno may have been an anti-Semite.  Poland is noted for anti-Semitism just as America is noted for Black discrimination.  Is Kelno less human because of his acculturation?  In a perfect world, yes, but who lives in a perfect world?  Kelno is despicable.  The Ku Klux Klan is despicable.  However, when any person is classified as something other than human, classifiers condemn themselves to inhumanity.

DISCRIMINATION (When any person is classified as something other than human, classifiers condemn themselves to inhumanity.)

There are so many questions raised by Uris’s story. How brave are you? Would you risk your life to save someone else’s life? Would you kill someone if you were told by the government it is your duty to kill another? Is their redemption in good works? A judge can sit in a chair and think what his/her answer should be, but any human in a circumstance of life or death can only answer the question with his/her action in the now. There are few winners in Uris’s story. There are many losers.

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DIETING AND THE BRAIN

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

Spark: The Revolutionary New Science of Exercise and the Brain

Written by: John J. Ratey, MD

Narrated by: Walter Dixon

JOHN RATEY (AUTHOR, MD)

Crash dieting and the brain compete for control of one’s established weight.  Per Doctor John Ratey, your first crash diet will undoubtedly help lose weight.  However, when weight is regained, the same diet will not be equally successful.

ENDORPHINS ARE CHEMICALS IN THE BRAIN THAT FUNCTION AS NUEROTRANSMITTERS

The brain automatically triggers weight conservation with a second crash diet because it signals body starvation.  The third, fourth; etc. crash diet will increasingly be unsuccessful.  Ratey’s point is that weight loss success requires cooperation from the brain.  Ratey suggests the key to that cooperation is exercise.

Ratey is not expecting everyone to become an athlete but that some exercise regimen, whether walking, biking, or climbing stairs will offer numerous benefits for weight maintenance, mental function, and psychological health.  Ratey does not discount the importance of a healthy diet but food binges, foggy thinking, and states of depression or anxiety can be scientifically ameliorated by exercise.  Ratey goes so far as to suggest exercise is medicine for health.

————————-WALKING, BIKING, CLIMBING STAIRS———————————————-
21ST CENTURY MODELS
LOUISE O’MURPHY – KING LOUIS’ MISTRESS 1751

An inference from Ratey’s research is that obsession with body image interferes with human health.  As history shows, the svelte image of modern models is a reversal of what was considered beauty in earlier centuries.  The substance of health is a combination of proper diet and exercise.  In most cases, Ratey implies body weight and health will stabilize with healthy eating and moderate exercise.  Ratey acknowledges genetics and medical maladies may interfere with that conclusion, but not change its efficacy when coordinated with medical consultation.

Part of one’s frustration with Ratey’s conclusion is dependence on what is called a proper diet.  It seems with each new study; some approved foods slip to the bottom of the “good food” pyramid, while some formerly “bad foods” move up the pyramid; i.e. chocolate for example.

PREGNANCY AND EXERCISE IN MODERN TIMES

The overriding value of Ratey’s book is the conclusion that exercise is a key to mood, memory, and learning.  Numerous control experiments support Ratey’s argument.  Exercise seems more for the brain than the body.  Every day should be an exercise day.  Ratey notes that pregnant women that exercise have been found to have healthier babies than those who, in earlier days, were counseled to rest and relax.

Exercise does not have to be a fixed regimen but walking rather than driving to the store, when close to home, is a beginning.  Replacing TV time with household chores is part of an exercise regimen. Keep moving.  Ratey suggests “Even 10 minutes of activity changes your brain.”

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HUMAN OPTIMISM

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

How to Create a Mind: The Secret of Human Thought Revealed

Written by: Ray Kurzweil

Narrated by: Christopher Lane

RAY KURZWEIL (AUTHOR,SCIENTIST,INVENTOR, DIRECTOR OF ENGINEERING AT GOOGLE)

The technological wizardry of Ray Kurzweil’s thoughts breed human optimism.  At times, “How to Create a Mind” seems like self-aggrandizement for Kurzweil’s beliefs.  Kurzweil believes artificial intelligence will expand the future of humankind.

TED BELL (AMERICAN AUTHOR)

On the one hand, listeners hope he is right; on the other, (paraphrasing Ted Bell) when artificial intelligence is applied to cyber warfare, it is a threat to everybody.

One is reminded of Kahneman and Tversky’s book, “Thinking Fast and Slow”, that implies human beings act more emotionally than logically.  If logic became a bigger part of human decision-making through A.I.’ enhancement, would humanity be better off?  Kurzweil implies the answer is yes.

Kurzweil argues that humanity is on the verge of an A.I.’ singularity.  Humanity’s existence will change with the physiological introduction of artificial intelligence into human beings.  Kurzweil argues the process has already begun with prosthesis being connected to the human nervous system, i.e. artificial human limbs that move at the order of thought.

RETIRED ARMY RANGER GETS FIRST PROSTHETIC LEG WITH ARTIFICIAL INTELLIGENCE 2006

He notes the expanded understanding of brain function offers knowledge of how human’s think at a physiological level.  The building blocks of human thought are being identified.  Kurzweil describes the building blocks of the mind as Lego pieces that can be assembled to create human thought.  With identification of the building blocks, a giant step toward reverse engineering the brain will be tantalizingly close.

DEEP BLUE (BEAT GARRY KASPAROV IN SIX GAME MATCH 1996)

Without question, computers think faster than human beings.  Kurzweil notes the creation of Deep Blue and its defeat of the best players of chess, and Watson’s defeat of the best players of Jeopardy as evidence of the superiority of AI to human intelligence. He questions those who argue Deep Blue and Watson are just programmed computers by humans.  Kurzweil argues that Deep Blue and Watson border the edge of consciousness by being self-taught with minimal programming from human beings.  He recounts the advances in medical treatment from computers designed to absorb all of the relevant literature on human disease to suggest effective treatment for ill patients.

————WATSON COMPUTER DEFEATS BEST JEOPARDY PLAYERS 2011————
GORDON MOORE (AMERICAN BUSINESSMAN, AUTHOR OF MOORE’S LAW

A part of Kurzweil’s cogency is reinforced by the geometric growth of technology from the diminishing Moore’s law (the belief that the number of transistors per square inch on integrated circuits doubles every year) to the age of quantum computing.  He argues that Moore’s law may become obsolete but new fields of computing miniaturization are opening as the law begins to fail.  With the advent of quantum computing, transistors for binary calculations based on transistors may become obsolete.  Kurzweil’s point is that linear thinking misleads those who think technology is either slowing down or failing to open new doors for humanity’s advance.

To Kurzweil, humanity’s future is rosy; not in the sense of their being a surcease of human pain and suffering, but in the sense of technological advance.  He suggests technology will continue to expand at a geometric rate to improve human health, reduce societal degradation, and assure human survival. Kurzweil sees a singularity that melds artificial intelligence with human DNA.  The combination, in Kurzweil’s opinion, provides a vehicle for humanity’s survival, exploration, and expansion.

So, “Don’t worry, be happy” as Bobby McFerrin said.  Or as Leo Tolstoy said, “If you want to be happy, be.”  As noted, Kurzweil’s thoughts breed human optimism.

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A NATURAL RESOURCE

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

Drinking Waterdrinking-water

Written by: James Salzman

Narrated by: Lee Hahn

JAMES SALZMAN (UCLA LAW PROFESSOR, RECEIVED DONALD BREN DISTINGUISHED PROFESSOR OF ENVIRONMENTAL LAW
JAMES SALZMAN (UCLA LAW PROFESSOR, RECEIVED DONALD BREN DISTINGUISHED PROFESSOR OF ENVIRONMENTAL LAW

James Salzman makes a case for “Drinking Water” as the 21st century’s most underappreciated and coveted natural resource.  Without food, you die in 3 weeks; without water, you die in 3 days.  Unlike food productivity, clean water technology lags behind human population.  The facts seem quite clear but solutions are elusive.

MEDIEVAL LEATHER WATER FLASK
MEDIEVAL LEATHER WATER FLASK

Salzman reflects on the ancient origin of bottled water.  While coveted in the past for religious and medicinal benefit, bottled water is ubiquitous today.  Contrary to many people’s understanding, public water systems are more stringently regulated for contamination than private water bottle distributors.

It is as unlikely to ingest known carcinogens from American public water as privately bottled water.  Salzman notes that neither distribution system guarantees non-carcinogenic water because no water source is perfectly pure.  But public water systems, particularly in the U. S., require frequent testing for quality and safety.  Public water systems regularly test water for known carcinogens, while private bottling systems are largely self-regulated.

perrierSalzman recounts a history of Perrier as a company that had to recall their product when it was initially suggested as a standard of measurement for the quality of an American city’s water system.  Perrier, when tested, was found to have unacceptable levels of arsenic in its bottled water.  Perrier corrected the problem but no one would have been the wiser without America’s mistake in suggesting and then testing Perrier as a standard for water quality.

Salzman explores terrorist threats to public water systems without being unduly hyperbolic.  There is potential for introduction of germs or other carcinogenic substances but water systems are either aggregated in defined spaces or drawn from aquifers that guarantee significant dilution before delivery to consumers.  These two conditions do not mean death cannot be a result of a terrorist act but mass murder from contamination is probabilistic, if not unlikely.

ALAFIA RIVER WATERSHED, SW FLORIDA
ALAFIA RIVER WATERSHED, SW FLORIDA

The more likely threat to a water system is pollution.  Salzman argues that runoff from industrialization and new technologies like fracking are a bigger threat to water source contamination than radicals’ sabotage.  However, even with intent or inadvertent contamination, Salzman suggests water treatment improvements can turn fouled water into drinking water.  The key is early detection, and immediate water service interruption, at least, until a technological fix can be executed.

UNTREATED INDUSTRIAL WASTE RELEASED IN SUDAN
UNTREATED INDUSTRIAL WASTE RELEASED IN SUDAN

Water, like food, is necessary for life’s sustenance.  Incidents involving American and Canadian natural water sources are given as examples of protectionist tendencies on the part of local populations.  Salzman tells the story of a mountain town in America where a bottle manufacturer (Nestle) offers to buy river water from the town. The price offered is pennies on the dollar for every bottle manufactured, and jobs for a town hurt by decline in the lumber industry.  The town rises up in arms at the low-ball offer and objects to an outsider’s virtual theft of the community’s natural resource.  A similar story is told of the Canadian government’s objection to use of Lake Superior’ water for desperate communities in undeveloped countries.  The private non-profit organization formed to suggest the plan is quashed by Canada’s objection to the use of Lake Superior’s water.lake-superior

MIDDLE EAST WATER CARRIER
MIDDLE EAST WATER CARRIER

Salzman catalogs the labor-laden plight of undeveloped or rapidly industrializing nation-states in their search for “clean” water.  Water pollution causes great hardship and death in third-world nations.  In many of these countries, there are no water lines within communities.  Every drop of water must be carried from its source to a family’s home for drinking, cooking, and bathing.  In many cases the source of water is not only distant, but polluted.  In a March 2010 “World Water Day” report, it is estimated that 2 million tons of sewage, industrial waste, and agricultural chemicals are discharged into the world’s water.

America is also threatened by what is happening in the undeveloped world.  The threat is both the same and different.  It is the same in that water is needed to live.  It is different in that the convenience established in the United States for water distribution and water treatment are compromised.  Without question, America is far ahead of most countries in water distribution, treatment, and quality control but the infrastructure, according to Salzman, is old, falling apart, and causing contamination because of waste infiltration near water resources (see Camp Lejeune, North Carolina) and public distribution system failures (see Flint, Michigan water crises).  The EPA estimates “…$335 billion is required to replace aging water infrastructure over the next 20 years.”

NEW YORK CITY WATER MAIN BREAK CAUSED BY CORROSION
NEW YORK CITY WATER MAIN BREAK CAUSED BY CORROSION

Salzman shows that solutions for these water crises are elusive and politically complicated.  Solutions range from desalinization of sea water to pushing icebergs to continental seaports.  There is the idea of treating sewage to provide “clean” drinking water.  There is the idea of mining water from asteroids or other planets.  There is utilizing better conservation measures.  There is the idea of privatizing water production to incentivize the business community to enter the water business.  There is the idea of raising prices for water to incentivize the consumer to be less wasteful.  There is technological improvement that removes carcinogens from accumulated rain water and contaminated aquifers.  Every solution has its drawbacks; most of which revolve around cost and fair distribution of this essential ingredient of life; i.e. water for human survival.

Solutions to the world water crises can only be implemented through politics and political will.  The question is–Are humans up to the task without resorting to their baser instincts; i.e. like war and a misunderstanding of Herbert Spenser’s interpretation of Darwin’s survival of the fittest?

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OLIVER SACKS

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

The Man Who Mistook His Wife for a Hat: and Other Clinical TalesThe Man Who Mistook His Wife for a Hat

Written by: Oliver Sacks

Narration by:  Jonathan Davis, Oliver Sacks

OLIVER SACKS (1933-2015, AUTHOR, BRITISH NEUROLOGIST)
OLIVER SACKS (1933-2015, AUTHOR, BRITISH NEUROLOGIST)

Neurological dysfunction is Oliver Sacks field of study and training.  The irony is that a tumor attacks his brain to end his life.  Of course, he was 82.  But somehow, a tumor attacking Sacks’ brain seems an unfair marker for his passing.  Sacks opens the eyes of many to the wholeness of being human when a neurological dysfunction changes their lives.  Sacks is the famous neurologist who wrote one book that becomes a movie and several that become best sellers.

Sacks is famous to some based on the movie “Awakenings” that recounts an experiment with L-dopa to treat catatonia; a symptom believed to be triggered by Parkinson’s.  Patients may spend years in a state of catatonia; i.e. a form of withdrawal from the world exhibited by a range of behaviors from mutism to verbal repetition.  Sacks wrote the book, “Awakenings” to tell of his experience in the summer of 1969 in a Bronx, New York hospital.  The success and failure of the L-dopa experiment became a life-long commitment by Sacks to appreciate the fullness of life for those afflicted by neurological disorders.  With the use of L-dopa, Sacks reawakens the minds and rational skills of patients that had been catatonic for years.  In their reawakening, Sacks found that catatonic patients have lives frozen in time. Their mind/body interactions became suspended in the eyes of society.  They were always human but they lost their humanness in neurological disorder.

“The Man Who Mistook His Wife for a Hat” is filled with stories of people with brain malfunctions that change theirs’s and other’s lives.  The underlying truth of each story is that symptoms of neurological disorder mask the wholeness of being human.  Sacks reveals that many people confuse what is seen with the completeness of an afflicted but whole human being.  Sacks first story is about an accomplished musician and teacher who appears increasingly forgetful.  He appears to forget people’s names.  He cannot identify objects that are given to him to examine.  He figuratively mistakes his wife for a hat.  Aside from these bizarre symptoms, Sacks notes the patient is highly intelligent and is known as a great teacher of music.

In examining “The Man Who Mistook His Wife for a Hat”, Sacks finds that the teacher’s mind works like a computer in that he sees the details of things without seeing the whole thing.  He forgets names until he hears their voice because he cannot recognize faces.  He can identify all the parts of a face but is unable to associate the face with a name.  When given a glove he examines its parts.  It has five pouches.  It is made of a soft material.  The pouches can hold things.  But, it is only discovered as a glove when given clues about its use.  Sacks’ first story becomes a metaphor for the wholeness of human beings that have neurological disorders.

The music teacher relies on sound and other cognitive senses to fully interpret and appropriately act in the world.  Sacks explains to the teacher’s wife that her husband’s neurological disorder is a part of who he is.  Sacks suggests the disorder may be ameliorated with drugs but an unintended consequence may be to destroy her husband’s extraordinary music and teaching ability.  In the years of this teacher’s life, he has unconsciously hidden a neurological dysfunction by using music as a method for organizing and routinizing his life.  His wife notes that he sings when he dresses himself with clothes carefully laid-out by his wife.  He uses the rhythm of the song to properly dress himself.

Sacks writes of several more patients that circle the same theme.  He notes that memory is a critical part of being human.  When memory is lost, humanness remains but personal understanding of oneself is changed.  Memory informs and affects action.  When memory disappears, time is disjointed and experience is lost.  On the one hand, lost memory makes one young again; on the other, friends are older than they should be and many things we know from experience are gone.

Sacks is saying never give up on patients with neurological disorders.  They are whole human beings.  The neurologist’s job, as with all who practice medicine, is “first, do no harm”.  “The Man Who Mistook His Wife for a Hat” illustrates how seriously Sacks took his calling.

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THE HARD WAY

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.com

Neuro Tribes: The Legacy of Autism and the Future of NeurodiversityNeuro Tribes

Written by: Steve Silberman

Narration by:  William Hughes

STEVE SILBERMAN (AMERICAN AUTHOR, CONTRIBUTOR TO WIRED MAGAZINE)
STEVE SILBERMAN (AMERICAN AUTHOR, CONTRIBUTOR TO WIRED MAGAZINE)

“Neuro Tribes” reminds one of the gambling phrase “the easy way and the hard way”.    On a Las Vegas craps table, rolling two die with the same number and repeating it is the hard way.  From Steve Silberman’s story, parents successfully raising a child with autism is like rolling the dice the hard way because the odds are stacked against them.  This may not be a great analogy but Silberman shows that parents have to work harder to understand and nurture a child who suffers from any one of the many variants of autism.

Silberman tends to name drop famous people who have never been diagnosed as autistic, but exhibit some of the characteristics of autism.  Silberman offers brief biographies of Henry Cavendish, Nikola Tesla, Paul Dirac, and others.

HENRY CAVENDISH (1731-1820, BRITISH NATURAL PHILOSOPHER, SCIENTIST, CHEMIST, AND PHYSICIST)
HENRY CAVENDISH (1731-1820, BRITISH NATURAL PHILOSOPHER, SCIENTIST, CHEMIST, AND PHYSICIST)
NIKOLA TESLA (1856-1943, SERBIAN AMERICAN INVENTOR, ELECTRICAL & MECHANICAL ENGINEER, PHYSICIST, FUTURIST)
NIKOLA TESLA (1856-1943, SERBIAN AMERICAN INVENTOR, ELECTRICAL & MECHANICAL ENGINEER, PHYSICIST, FUTURIST)
PAUL DIRAC AT THE TIME OF PULITZER PRIZE AWARD
PAUL DIRAC AT THE TIME OF PULITZER PRIZE AWARD (1902-1984, THEORETICAL PHYSICIST WHO MADE FUNDAMENTAL CONTRIBUTIONS TO QUANTUM MECHANICS)

Not every autistic person is a genius but Silberman’s point is that a person who may have social communication difficulties, obsessive/compulsive behaviors, or attention issues have become incredibly valuable to society.  These three men are characterized to have all of those symptoms.  To suggest autism implies worthlessness is a slippery slope toward abandonment, psychiatric incarceration, concentration camps, medical castration, and threatened individual or collective extermination.

Silberman recounts the history of  people who do not fit within social conventions.  In some well-known instances societal non-conformists are isolated, sterilized, and/or murdered.  They are classified as developmentally or intellectually inferior human beings to be eliminated by society for their aberrant physical abilities or mental faculties.  One may think this is a description of Hitler’s Germany but Silberman recounts the story of the U. S. Supreme Court’s ruling in Buck v. Bell.

OLIVER WENDELL HOLMES (1841-1935, JUSTICE OF THE SUPREME COURT 1902-1932)
OLIVER WENDELL HOLMES (1841-1935, JUSTICE OF THE SUPREME COURT 1902-1932)

In 1927, no less than a giant of the U. S. Supreme Court, Justice Oliver Wendell Homes Jr., writes the majority opinion that says compulsory sterilization of the intellectually disabled is not a violation of the Due Process clause of the 14th amendment.  Common sense, if not history, shows that intellectual ability, by any measure, is a small part of what a human being is or can be.  The very idea that there is a criterion that objectively measures intellectual capability is repugnant.  Mrs. Buck is involuntarily incarcerated and Mrs. Buck’s daughter is sterilized based on a 1924 Virginia law.  The United States reportedly sterilized 60,000 American men and women through the 1970 s (See January 2016 Newsweek report).

BUCK FAMILY (MOTHER AND DAUGHTER STERILIZED BY THE STATE)
BUCK FAMILY (MOTHER INVOLUNTARILY INCARCERATED, AND DAUGHTER STERILIZED BY THE STATE)

Silberman offers a short history of the growth of Eugenics.  The idea is that, like a patch of peas, human beings can be bred to eliminate any undesirable characteristics.  No civilizations’ hands seem clean.  Silberman reminds reader/listeners of the child euthanasia program in Germany and how a German family’s support of Hitler leads to a request that their child be euthanized because of physical deformity.  It is estimated that “…5,000 children were victims of this program” (see Wikipedia “Child euthanasia in Nazi Germany).

HANS ASPERGER (1906-1980, AUSTRIAN PEDIATRICIAN, MEDICAL THEORIST, AND MEDICAL PROFESSOR)
HANS ASPERGER (1906-1980, AUSTRIAN PEDIATRICIAN, MEDICAL THEORIST, AND MEDICAL PROFESSOR)

Silberman reports on the diagnostic discovery of autism by Hans Asperger in the 1940 s.  Asperger’s storied career includes association with the Nazi Party that is both reprehensible and insightful.  In defining autism, Asperger suggests children with autism are of little social value.  This categorization of human beings feeds Hitler’s extermination of handicapped and mentally challenged children and adults.  Despite this horrendous consequence, Asperger’s careful examination of autistic behavior provides insight to its symptoms and potential treatments.

Silberman notes Asperger’s prescient understanding of autistic children’s needs.  Autistic children need to be listened to and their behaviors analyzed to provide treatment that ameliorates social dysfunction.  Though Silberman does not mention the Montessori school of education, Asperger suggests that autistic children should be educated in ways that reinforce their natural interests.  Asperger, according to Silberman, had an uncanny knack of understanding what his patients were interested in and followed that lead to integrate them into society.

A part of Silberman’s story is about unscrupulous medical professionals that offer cures for autism that have nothing to do with science and everything to do with financial exploitation of parents that are overwhelmed by their child’s autism.  These “doctors” provide bogus treatments like blood chelation to remove impurities that are alleged to cause autism.  Silberman suggests there is no cure for autism.  There is only the promise of amelioration with the hard work and understanding of parents and caregivers who appreciate the value of human life.

For parents, the hard way involves toleration of symptoms of autism while reinforcing those behaviors that comport with the innate abilities of their children.  In the process of careful listening and observation, parents can reinforce socially acceptable behavior and diminish anti-social activity.

Silberman implies autistic human beings exist in every society.  Symptoms of hyperactivity, singular focus on particular subjects, poor communication skills, antisocial behavior, lack of interest in mutual achievements or interests, and a lack of empathy are symptoms that exist in most human beings, at some level.  Silberman implies it is a hard roll of the dice for parents with autistic children.  Their rewards can be monumentally greater but the odds are against autism’s cure.  Not every autistic child will be a Cavendish, Tesla, or Dirac but one can choose to believe every child is a gift to be treasured for whatever they become.

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