Showing 1 - 3 of 3 annotations tagged with the keyword "Neuroscience"

Bewilderment

Powers, Richard

Last Updated: Dec-20-2021
Annotated by:
Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Science is a fundamental part of modern reality. It is used to explain the workings of the world around us and is instrumental in making that world a more hospitable place to live in. There are those who assert that there is a fundamental conflict between science and religion. They advocate considering science and religion as parallel but not intersecting ways to understand the place and purpose of human beings. What about science and art?  Or science and literature? Can they peacefully co-exist? Richard Powers is an author who has dedicated his literary career life to the proposition that they can.

In his latest book, Bewilderment, he examines the question whether neurobiology can help people achieve empathy, potentially even merge with another person. Theo is an astrobiologist, someone whose job is to explore the conditions on the many planets in the universe and to determine if they are able to support any form of life, but especially human life. The underlying premise is that there are bacteria, fungi, and animals that can live under very extreme circumstances on Earth. So even if other planets have different atmospheres, ambient temperature, water, or chemical elements, Earth should not be the only planet with life.

Theo’s wife, Alyssa, has recently died in a car accident and he is still grieving the loss. She was pregnant at the time, and the accident occurred when she lost control of her car when trying not to run over an animal on the road (more on this in a minute).  Theo has one son, Robin, who is very bright but on the autism spectrum with significant anger issues. The father and son are fiercely connected and share their lives; the early part of the book beautifully describes a camping trip that they take together. But Theo has his hands full with Robin. In order to avoid medicating his son, Theo enrolls him in an experimental program, Decoded Neurofeedback  (abbreviated DecNef, like any DARPA-sounding program). The experimental study will enable Robin to control his emotions better. This would be accomplished by capturing his mother’s brain waves in a functional magnetic resonance imaging (fMRI) scanner. The pattern of her neural activity, which reflected her intense love of animals and nature, would provide a template that could be channeled into her son using feedback methods. The objective of the experiment  is to convert Robin into a more sensitive child who is more attuned to the world around him. Robin is remarkably responsive to the sessions, more so than any other participant, and he becomes someone who has the same warmth and protective feelings towards animals and the environment as his mother. But funding for the project is terminated, Robin’s fMRI sessions stop, and he gradually reverts back to the child he was. There is a final twist. But I leave that to those who are motivated by this annotation to read the book.

View full annotation

Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In a 1976 Archives of Neurology essay, the neurologist Robert Katzman successfully argued for relabeling “senility” as “Alzheimer’s disease.” He urged rejecting various forms of dementia and senility as common consequences of aging, and accepting them as a disease requiring all the attention any other important disease deserves. Now medicine and society had a problem—"The Problem of Dementia,” the famed physician Lewis Thomas called it in a 1981 essay published by the popular magazine Discover, and he noted that, suddenly, “a disease of the century” had arisen (p. 3).

Forty years on, Jason Karlawish thinks there is still a problem, but in keeping with Katzman’s call, he refers to “The Problem with Alzheimer’s.” Based on the history he covers and the experiences he shares in this book, nothing of much significance has occurred since “The Problem of Dementia” became the “The Problem of Alzheimer’s.”

Karlawish is a physician who cares for people with Alzheimer’s and a researcher delving into “issues at the intersections of care, ethics, and policy” (p. 5).  He draws on his experiences in this book, which he describes as “the story of how once upon a time, Alzheimer’s disease was a rare disease, and then it became common, and then it turned into a crisis.” Karlawish wants to answer why during the time between Thomas’ essay and the year 2010, “nothing really changed,” and how that could be the case in “the richest and most powerful nation.” (p. 6) He tells this story in four parts.

The first part concentrates on efforts clinicians and researchers were making following Thomas’ call to distinguish Alzheimer’s disease from normal aging, other dementia types (e.g., frontotemporal, Lewy body), and precursor syndromes (e.g., minimal cognitive impairment). They were looking for definitive clinical patterns, imaging studies, diagnostic tests, and pathologic markers for the disease. 

In the second part, Karlawish goes back in time to when Alois Alzheimer first found what are known today as “plaques” in the brain of a patient who had an early onset of severe, progressive dementia. He traces the attention this finding drew to eventual advances in imaging and biochemistry aimed at diagnosis. Karlawish also covers how a cascade of events over the decades following Alois Alzheimer’s finding disrupted the pursuit of a pathophysiological basis for dementia. These events included the rise and dominance of Freudian psychology; followed by two world wars; the cold war; the overshadowing of AIDS; Medicare political and funding constraints; tussles among patient advocacy groups; loss of asylums where care and research had coexisted; clinical failure of the first drug; and the continued debate over whether dementia is a consequence of aging or is a disease. 

Karlawish moves on in the third and fourth parts to cover what “we will have to learn to live with the disease so as to improve the lives of persons...to provide the care they need to live well at home...and repair the broken system” (p. 171). Success in his view requires integrated biological, psychological, and social components. He reports the progress on each of these three fronts: some failed approaches continue to fail (such as drugs targeting amyloid); some psychological interventions show promise (though at times causing moral tension); some of the social configurations engineered for Alzheimer’s patients, families, caregivers, and society have produced triumphs and some disasters. He has much to say about why and how this search must go on, but with some much-needed course corrections. 

View full annotation

Transcendent Kingdom

Gyasi, Yaa

Last Updated: Jun-07-2021
Annotated by:
Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Can scientists be religious? Is Religion or Science best able to deal with the psychological problems that can arise over a lifetime? Yaa Gyasi’s powerful new book, Transcendent Kingdom, aims to answer these perennial questions. Gifty, the precocious daughter of two Ghanaian immigrants, is the narrator and the main character in this novel. She grows up in Huntsville, Alabama where her parents settled after moving to the United States. Her mother works as home health aide and her father is a manual laborer. Gifty’s older brother, Nana, is a talented athlete who excels in basketball and becomes the leading scorer and star of his high school team. Religion is a key element in the mother’s worldview, and she impresses this on Gifty.  The mother and daughter attend an evangelical church, and both are convinced that they can feel the presence of God, that he speaks to them, and helps guide their life. The father, called the Chin Chin Man, becomes homesick for Ghana and leaves the family to return his birthplace.

With the nuclear family reduced to three and her mother overworking to earn enough to care for her children, young Gifty assumes major responsibility for her older brother, Nana. He suffers an ankle injury during a basketball game. Unfortunately, playing out a common script, he is given a prescription for oxycodone to control the pain. The prescription is renewed and Nana, like so many others in similar situations, becomes addicted and ultimately succumbs to a heroin overdose. The family is now a twosome. In parallel with the family saga, Gifty is a graduate student in neuroscience at Stanford after a successful college career at Harvard. Her mother moves in with her because of extreme depression. Gifty is working on mice using state-of-the-art methods to map the neural pathways that control reward-seeking behavior.  Her research effort is motivated by an attempt to understand her mother, who has almost no reward- seeking behavior due to her depression, and her brother who could not suppress his reward-seeking activity. The story is filled with emotionally wrenching episodes that fill in the details of the main characters. The ending is surprising but provides a satisfying resolution to Gifty‘s approach to life and her challenges with her family members’ experience with overwhelming psychiatric disease.

View full annotation