Summary:

Eric Kandel, the 2000 Nobel Prize winner in Physiology or Medicine, has an abiding interest in art for its own sake, and also in how art can inform his primary work in brain science, especially as both art and science can be understood through reductionism.

My central premise is that although the reductionist approaches of scientists and artists are not identical in their aims—scientists use reductionism to solve the complex problem and artists use it to elicit a new perceptual and emotional response in the beholder—they are analogous (p. 6).  

Kandel’s aim, however, is more than just explaining how reductionism is used in brain science and in modern art. He is also out to show in a larger sense how science and the arts, which now exist as “two cultures,” are more alike than not. 

My purpose in this book is to highlight one way of closing the chasm by focusing on a common point at which the two cultures can meet and influence each other—in modern brain science and in modern art. Both brain science and abstract art address, in direct and compelling fashion, questions and goals that are central to humanistic thought. In this pursuit they share, to a surprising degree, common methodologies (p. 3).   

This slim volume comprises four parts amply supplied with schematics of brain structures and nerve tracts, and with reproductions of modern art works. The two middle parts are concerned with how reductionism applies to brain science and to art, respectively. The introduction places the topic within the context of the two-culture divide. The final part argues that art reduced to a set of core elements (e.g., form, line, color, and light) can add to the understanding of how the brain works, just as brain science reduced to a set of core elements (e.g., top down and bottom up processing of images) can add to the understanding of how art can be perceived and used to evoke certain responses.      

Bottom up processing refers to “universal rules that are largely built into the brain at birth by biological evolution and enable us to extract key elements of images in the physical world, such as contours, intersections, and the crossings of lines and junctions” (p. 22) This inborn circuitry is all that is needed for perceiving figurative art, and as a result produces uniform perceptions among viewers. Top down processing refers to the information the brain needs to perceive images when bottom up processing is insufficient, like in the case of abstract painting. It “incorporates the information our brain receives from the external world with knowledge based on learning from earlier experiences and hypotheses testing.” This includes “people we have seen and known, environments we have been in, as well as memories of other works of art we have encountered” (p. 23). Top down processing thus brings the viewer into the creative process and results in differences in perceptions among individuals of a particular work of art.  

In Kandel’s and many others’ telling, modern art was the response to the advent and expanding use of photography. No longer was figurative painting needed to render life as it is. Artists became free to explore and experiment with other ways to generate perceptions of life. Starting with impressionism and progressing through abstract expressionism and pop art, Kandel describes how painters in particular reduced their art to form, line, color, and light. They invited—demanded—that viewers participate in creating what they perceive. Brain science was able to use these elements also to map places in the brain where this processing takes place and to associate these elements with the different responses they produce. To illustrate these concepts, Kandel features the works of Turner, Monet, Kandinsky, Mondrian, de Kooning, Pollock, Rothko, Morris, and Warhol among others.  

In the end, Kandel is asserting—hoping—that reductionism in art will serve brain science because it will show “how we process unconscious and conscious perception, emotion, and empathy.” (p. 188). And, that reductionism in brain science will help artists “enhance traditional introspection with the knowledge of how some aspects of our mind work” (p. 189).

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In Karel Schoeman’s novel, Another Country, Versluis, an affluent and educated Dutchman diagnosed with tuberculosis, immigrates to Bloemfontein, South Africa, to convalesce. Bloemfontein in the 1870s, located within the remote interior of the Free State, is little more than a dusty outpost populated by first- and second-generation German, Dutch, and English inhabitants. As the novel quietly unfolds, Versluis’s tenuous recovery, and subsequent regression, are punctuated by his observations of the community’s struggle to both preserve and break from European culture to form a distinct South African identity.   Whereas Versluis cherishes his familiar Dutch customs and courtesies, here, in Bloemfontein, he must adapt to the community’s irregularities and gaucheries. Nevertheless, he is regularly astonished by the town’s culture of insouciance—a lack of punctuality, etiquette, and municipal orderliness; its sometimes frowzy fashions; disregard for conservatism; and ease among poverty, violence, and isolation. His observations, however, are not the mordancies of a snobbish European, but a wrestling with his sense of profound alienation as a precariously ill man living abroad in a strange country.   Informed that his case is terminal, Versluis resigns himself to the inescapable state of his life. With fresh sensibility, he embraces life in Bloemfontein, becoming more receptive to its people and daily life. Particularly, for Versluis, the veld—with its rocks, dust, succulents, and solitude—takes on a potent and portentous symbolism, as an immutable and implacable presence (and emptiness), much akin to the illness that is killing him. Within this ponderous flux of change, of a gradually evolving Africa, Versluis peacefully comes to terms with his imminent death.

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This engaging memoir describes Pearson's medical training at the University of Texas Medical Branch (UTMB) on Galveston Island from 2009 to 2016. During these years her personal values become clear, and she finds fault in her training, in medicine as practiced in Texas, and even in her own errors in treating patients.

Having left a graduate writing program, Pearson took a "postbac," a year of pre-med courses in Portland, Oregon. She interviewed at medical schools "all over the country" and writes satirically about them; she concludes "nothing out of Texas felt quite right," having lived there and done her undergraduate work at University of Texas at Austin. She's a Spanish speaker with a working-class background. When her classmates provide the annual “white-trash”-themed party, she wonders, “do I go as myself?” (p. 21).

Pearson's education continues on three tracks: the formal UTMB courses in medicine, a simultaneous Ph.D. program at the Institute for the Medical Humanities at the University of Texas, and her volunteer work at the St. Vincent's Student Run Free Clinic. The Ph.D. program is off-stage, not mentioned, but the St. Vincent's Clinic becomes pivotal to her development as a doctor and a moral person.

As for medical school, she finds the relentless "truths of biochemistry and anatomy" so reductive that the suffering of people and surrounding politics seem "not to matter at all" (p. 70). Among the politics are: the lack of safety nets for poor people, the use of uninsured (including prisoners) for students to practice on, failures to extend Medicare, pollution (notably from the oil industry), losses of charitable care, and income disparities that include crushing poverty for many. Something of a rebel, she writes that medical school "felt like junior high" (p. 44). She does enjoy the "clinical encounters" with real patients.

St. Vincent's, by contrast, was “a relief.” Her pages sparkle with her conversation with clinic patients, some homeless, all poor, and all suffering. She reports--confesses, she even says--her errors that had consequences for patients. She writes that errors are an unavoidable part of medical education, but that it's wrong that they should routinely happen to the poorest members of society.  

Chapter 8 discusses depression, which she felt after the second year. She writes about high rates of suicide among medical students and doctors; indeed a close friend killed himself during the "post-doc" year. Because some states require doctors to report psychiatric care, some doctors avoid such care. This consequence “drives a suicide-prone population away from the help we may need" (p.92).

The last two years are the rotations through specialties: surgery, dermatology, trauma, rural medicine, neurology, internal medicine, and so on. These are clearly and insightfully described. In one case (internal medicine), she allows the reader to see the irony of a doctor providing hair removal by laser, diet foods, and Botox treatment for wrinkles, “a pure luxury transaction” (p. 183).

Pearson describes the storms, hurricanes, and floods that hit Galveston Island, also the pollution from the oil industry that causes a “cancer belt” along the Louisiana and Mississippi coasts (p. 104). At last she finishes her program, understanding that her identity is simultaneously a person, a physician, and a writer (p. 248). 

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This Way Madness Lies was published in partnership with London’s Wellcome Collection for the exhibition “Bedlam: The Asylum and Beyond,” which ran from September 2016 - January 2017 and was curated by Mike Jay and Bárbara Rodriguez Muñoz. It is a book that was meant to accompany the exhibition, yet which, by virtue of the substantial text and reproductions, can stand alone.  

The book traces the history of treatment of the mentally ill by following the colorful story of Bethlem Royal Hospital from its antecedents in the Middle Ages up to the present.  Its sway over the public imagination evidenced by its appearance in everything from Jacobean Drama to “Sweeney Todd,” Bedlam has truly attained archetypal status.  An archetype, yet also a real functioning hospital.  Sections of the book entitled “Madhouse,” Lunatic Asylum,” and “Mental Hospital” chronicle the facilities designed respectively during the 17th/18th, 19th, and 20th centuries, and explain how they reflect changing notions of madness in each era.   

The first structure was visually grand but lacked a foundation, a metaphor for what was going on inside: “a façade of care concealing a black hole of neglect” (p. 39).  It became a tourist attraction along the lines of the zoo, with nothing preventing the public from gawking at and taunting the inmates.  While its replacement gave the impression of being more functional, conditions proved equally squalid.  On the other hand, 19th-century Europe and the United States saw asylum reforms, as well as the medicalization of madness as an “illness” and the ascent of psychiatry as a branch of medicine.  Finally, in 1930, the buildings still in use in Monks Orchard, a suburb of London, were constructed.

By contrast, we learn about treatments elsewhere, most notably Geel, Belgium.  There, for centuries, as an alternative to being warehoused in psychiatric hospitals, the mentally ill have been successfully boarding with townspeople.   

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Set in the loosely fictionalized Jamaican town of Augustown (“loosely,” as it bears a strong resemblance to August Town, which was absorbed over time into the expansion of Kingston), the novel spans three generations of a single family.  The novel moves back and forth easily through different moments in time, from the birth of Rastafariansim in 1920 under British colonional rule, through the post-colonial division of the island and its citizens into turbulent threads, to the present day of 1982, where the same tensions run strong as ever.  

Ostensibly a family novel, the story centers on Ma Taffy, her niece Gina, and Gina’s son Kaia, and it boils down to several key moments in their lives.  But these moments are brief in the overall bulk of the novel, the majority of which is devoted to the fleshing out of the world that permits – and, as we ultimately realize, requires – that such moments come to pass.  There is the miracle of the preacher Alexander Bedward, who, as seen through the eyes of Ma Taffy, could have literally floated up to the Heavens; the comically doomed marriage and foiled aspirations of schoolteacher Emanuel Saint-Josephs; the errand run by Soft-Paw, a young gang member; the second chance that comes before the well-to-do Claudia Garrick; the friendship of Clarky and Bongo Moody, and their run-ins with the police.  As Miller moves between these characters, the forces pushing Ma Taffy, Gina, and Kaia to their conclusion become clearer and harder to resist.  

Despite the complexity of the novel’s structure, Miller easily weaves all of the component parts together.  The result is absorbing and affecting, a novel that is as much a family drama as it is an exploration of the legacy of colonialism, religion, class conflict, and violence.

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The exhausted narrator has just undergone 3 vessel coronary artery bypass graft (CABG) surgery. While grateful for surviving his "cabbage" operation, he is acutely aware how different he seems from his previous self. He gets a roommate sent from The Scrubs, a prison facility located next to the hospital, who has been jailed for grievous bodily harm with a sentence of 8 years. Now the prisoner is pretending to have a heart attack, hoping doctors will keep him for a few days for tests.

The two men exchange information and banter. The convict wants details about what it feels like to have a heart attack. The narrator wants to know what it's like to be in prison (The answer is "Boring."). They pass time imagining they are vacationing on a Mediterranean beach. The criminal has a knack for making his roomie laugh - a welcome, but painful sensation after open-heart surgery.

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In this wonderful short story, author Jeanette Brown describes a woman’s first visit to an alternative medicine healer. The woman has a persistent cough. Unhappy with the "five seconds per visit your doctor lavishes on you after your two-hour wait in his sterile lobby," she has taken her yoga instructor’s advice and made an appointment with a tall, olive-skinned man whose voice is "low and soothing" and whose manner is slow, relaxed, and personal.The woman, whom the healer diagnoses as "the roadrunner, a busy fidgety type," alternates between interest, skepticism and dismay. She cracks jokes; he doesn’t laugh. He recommends diet, exercise, no caffeine, and colon cleansing. She mentally rolls her eyes until, his hands massaging her foot, she feels her stomach lurch, a twinge in her armpit and begins to think of her body as "a human pinball machine." Whenever her self-defensive, rational, traditional beliefs almost propel her off the exam table and into her clothes, the healer "nails" her, reading her personality and her lifestyle exactly.Well into the visit, she realizes she hasn’t coughed once. Then, when she’s the most relaxed, incense wafting, his hands kneading all tensions from her back, her mind registering "this is bliss," her esophagus becomes blocked. Sitting up, she coughs, and the healer confronts her. "You have something to say," he insists, and she counters with "You expect me to believe all this mumbo-jumbo?" He tells her she swallows her feelings, and when she coughs again a "feather? A butterfly?" escapes from her mouth and disappears.When the healer pats her back and asks her to cough once more, she can’t. Taking her hands, he declares her "cured." At the story’s end, still not quite able to admit that this strange physician has helped her, yet knowing that he has, the woman struggles to count out his fifty dollar fee, finally dropping a handful of bills onto his bench, "hoping he won’t be offended by a tip."

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Subtitled "A Memoir of Mental Interiors," this book is both an exploration of self and a search for reasons that led to the suicide of the author's friend, Henry, when both were of college age. But there is more. As the memoir unfolds, we learn that since childhood, the author experienced episodes of inexplicable, preoccupying, repetitive thoughts and behavior patterns--much later diagnosed as obsessive compulsive disorder (OCD). And finally, Barber discusses being drawn to work with mentally retarded people in a group home, and the mentally ill homeless at Bellevue Hospital in New York City.Growing up in an intellectual New England family with a tradition of sending its sons to Andover (a prestigious prep school) and Harvard, Barber was expected to continue the tradition, and so he did. At Harvard, however, Barber found himself disintegrating into obsessive thinking, unable to concentrate, near suicidal. He withdrew from Harvard, went back to his small town, hung out with his friends Henry and Nick, washed dishes in a local restaurant, took courses at the local college. Obsessive thinking continued to torment him.In desperation, he dropped out of college again, quickly finding a position as a "childcare worker" in a local group home. The author believes this step was the turning point that led eventually to effective treatment of his OCD (psychotherapy and Prozac), completion of his education, a fulfilling "career" in mental health recovery, and a happy family life. He is currently an associate of the Yale Program for Recovery and Community Health at Yale University School of Medicine.

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This anthology of poems, short stories, and essays derives from the literary magazine, Bellevue Literary Review, which began publication in 2001. The editor of the magazine and her staff have selected what they consider to be the best literary pieces from the Review's first 6-7 years of publication. Like its parent magazine, the anthology focuses on work that addresses the illness experience, health, healing, and the experiences of health care professionals and other caregivers. The anthology is divided into three parts, each of which has several subsections. Part I, "Initiation," looks at patients' introduction to illness and introduction of doctors to medical education and medical practice. Part II, "Conflict: Grappling with Illness," divides into sections on disability, coping, madness, connections, and family. Part III: "Denouement," addresses mortality, death, loss, and aftermath.

Among the 81 authors represented, seven are physicians, and another half dozen or so are in other caregiving professions such as nursing, social work, counseling. Some writers are well recognized in the literary world (for example James Tate, Amy Hempel, Alicia Ostriker, Rachel Hadas, Sharon Olds, Philip Levine, Floyd Skloot, Julia Alvarez, David Lehman, Rafael Campo, and Abraham Verghese -- the latter two are physicians); most of the less well-known others have published in a variety of venues.

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The idea for her second novel came to Sarah Perry in a flash (Ref. 1) as her husband was telling her about the 1699 sighting of a serpent or dragon in Henham, a village slightly to the northwest of the town of Essex, where Ms.Perry was born in 1979. The late 19th century events of the novel occur primarily in Aldwinter, a fictional fishing village on the Blackwater estuary.  Divided into 4 books (with titles derived from a 1669 pamphlet on the Serpent), each with subdivisions by month, further subdivided into chapters, the story takes place over 11 calendar months, from New Year's Eve to November, 1892. Although the story does not feel complicated and should not be difficult to describe in a synopsis, it is a tribute to the novelist's Dickensian talents  that in fact it is somewhat complex, involving four couples and their various children and friends and their increasingly intricate relationships, all revolving around the palpable feeling in Aldwinter that the famous Essex Serpent has returned, resurfaced, or decided to re-animate all the lives therein. The protagonist is Cora Seaborne,  a recently widowed free-thinker, adept in biology and natural sciences, and mother of an adolescent boy, Francis, who would nowadays probably receive the label "autistic." After the death of her abusive husband from oropharyngeal cancer, Cora becomes emotionally involved with Luke Garrett, the treating surgeon, an idiosyncratic, brilliant man, who has a bosom buddy, George Spencer (simply called "Spencer"), a very wealthy former medical school classmate. With an introduction from her friends Charles and Katherine Ambrose, Cora and Martha - her intimate companion - visit William (often referred to as just "Will") and his wife Stella Ransome in Aldwinter, where Will is the parish minister and father to three children. The eldest is Joanna, a precocious adolescent girl one imagines, alongside a younger Cora, as a younger version of this novel's author, who describes herself as vibrantly curious of all her surroundings while growing up in Essex as a young girl. (Ref. 2)

With the arrival of Cora and Martha in Aldwinter, the narrative begins in earnest with the development of the mounting anxiety over the mysterious events (a missing boat, unexplained drownings) attributed to possibly a resurgent Essex Serpent besetting Aldwinter; Luke's miraculous operation saving a man named Edward Burton from a knife wound to the heart; the increasingly romantic relationship between Cora and Will, to Luke's dismay; Stella's rapidly progressive pulmonary tuberculosis; the disappearance of Naomi Banks, a friend of Joanna; and an attack on Luke by the same man who had knifed Edward Burton. By novel's end, without spoiling the plot, most loose ends have been cauterized, left more neatly dangling or deftly retied.  

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