Monday, May 26, 2014

Discovery ("The Tale of the Dueling Neurosurgeons" by Sam Kean)

Two of the most interesting, engaging, and informative science books I've ever read were published in the last five years and written by the same person:  Sam Kean. The first of these books, The Disappearing Spoon, is a history of the varied elements that make up the Periodic Table, which hangs in every American science classroom and is almost Borgesian in its functionality as both a serious emblem of scientific discovery and a series of 118 doorways that open to reveal 118 separate stories. Kean's second book, The Violinist's Thumb, was a similarly anthological collection of "lost tales," each demonstrating the ways in which our genes have made us into the people we are today. What makes both books so successful, not just as narrative pieces but also works of enlightenment, is Kean's unyielding belief in the people behind these stories. Rather than numb his readers with facts, figures, dates, and academic jargon, Kean distills the most important discoveries of our lifetime--not to mention the last few centuries--into stories of love, death, obsession, resilience, success, failure, and redemption. In some instances, his subjects are unlikely heroes; in others, their genius is tempered by arrogance, jealousy, or even bigotry. But they are human, and the very same men and women who discovered the microscopic bits that make up our universe, our world, and ourselves--the billions of tiny puzzle-pieces that fit together with such impossible precision to make the Everything around and inside us--also allow us to discover them through their work. And in Kean's mind, these two otherwise isolated bodies--the scientist and their science--are inextricably linked and, without one another, incomplete.

With The Tale of the Dueling Neurosurgeons, Kean has taken on another difficult and long mysterious subject, the human brain...or, as he himself writes, the "electrified tapioca" nestled so precariously in the thick lockbox of bone atop our necks. It is the most important organ we possess--the Everest in the atlas of our bodies--and it is unique among the brains of all other creatures in that it is aware of itself, its functions, and its limitations. The human mind questions the universe and our place in it, ponders the existence of a Higher Power (or lack thereof), debates existential quandaries that are forever unsolvable, and struggles with emotions that even its millions of firing neurons cannot understand, though it expends quite a lot of its energy in pursuit of an answer all the same. And yet, for all its powers, we know so little about it that conflicts and disagreements among the most eminent of experts rage to this day, despite centuries of study. Even with the advent of advanced technology, those three gelatinous pounds remain mystifying, and ironically so:  the very organ we use to decode the world around us is incapable of decoding itself.

It's in this rich, frustrating, and seemingly fruitless pursuit that Kean finds his stories. Much like his previous books, an outwardly simple scientific task--a cataloging of the world's elements, an analysis of human genetics, and now a study of the human brain--becomes a monumental exercise in patience, dedication, endurance and, frequently, pure dumb luck. The two most unforgettable stories--and for completely different reasons--involve scientists who found themselves in tropical locations thousands of miles from home. The first is story of Carleton Gajdusek, a bombastic and headstrong man who took up residence in the Southern Pacific to study kuru, a degenerative neurological disorder that was devastating an isolated tribe in New Guinea. Earning the trust of the locals, he was able to gather brain and tissue samples from their dead, which he then had to ship back to laboratories throughout the world without a reliable postal service or the assistance of refrigerated transport; by the time he returned stateside, he had gathered enough raw data and materials to diagnose the cause of the tribe's problems. Unfortunately, his return--with quite a few of the island's boys over a number of years--also marked the end of his career, as his sexual predilection for those same boys became known. Gajdusek would die in exile after spending a year in prison, his legacy ruined--a Nobel Prize forgotten--and his otherwise monumental research forever tarnished by his actions. Similarly, the disease he had dedicated much of his life to unraveling and even curing, known as the "laughing disease," ended on its own when the locals stopped consuming the brains of their recently deceased tribespeople.

The second story concerns two British soldiers during World War II who also happened to be doctors. Captured by Japanese soldiers and mercilessly starved, they watched as their fellow POWs fell victim to an epidemic of beriberi, which they documented in great detail for months on end but were unable to stop. When it became clear that their research would be confiscated and likely destroyed by their captors, the two men sealed their papers in a tin and buried everything, unsure if they would even survive to see their hypotheses tested. Luckily, both of them did, and their research was retrieved with literally minutes to spare.*

In both instances, the scientists involved found themselves in extreme conditions, noticed a devastating health problem, and used whatever they had on hand--makeshift surgical instruments, a cooler, scraps of paper, a tin, and their knowledge of the human body--to work towards a solution, not just to save lives, but to advance science itself. Many of the other stories featured in Kean's book work the same way. In one chapter, a famous neurosurgeon bribes a priest so that his assistant can cut out the glands of a dead man hours before he is to be buried; described as "an illiterate wagon-driver," the man--John Turner--suffered from giantism, and the neurosurgeon is certain the cause is located in his glands. But as the assistant finishes removing the pituitary, the deceased's family breaks down the funeral-parlor door, forcing the young assistant to flee into a waiting taxicab. In another, an epileptic known only as H.M. has pieces of his brain sucked out with a tube; the procedure cures him of almost all seizures but leaves him with almost no memories. In fact, his brain becomes such a mysterious and important part of neuroscience that, after he passes away at age 82, it is removed from his skull, frozen, sliced into more than two thousand micro-thin slices, and scanned at extreme magnification for digital study.

I write of these men and their patients in present tense, not only because they are the subjects of narrative nonfiction, but because their work--or, conversely, their ailments--are with us today. They inform modern science in ways that theories, anecdotal tales, and small-animal experimentation never could. Which is the tragedy that underlies much of Kean's book:  in order for us to understand the brain as much as we do today, many people--men, women, and children equally--had to suffer. Some of them were unfazed by their ordeals, or they learned to live with what had happened to them, but most experienced pain and misery, if not total loss of life, and because of their own bodies no less. When neurosurgeons today speak of the advancements that have been made and the knowledge that has been gained, they speak of countless patients--dozens, maybe even hundreds of ordinary people--whose lives were unexpectedly interrupted, their bodies and minds forever unfixable. The pursuit of knowledge often claims its fair share of victims--Marie Curie is perhaps the most recognized example of this--but very few areas of science have claimed more than neurosurgery. And still, despite all this, we know very little. Those who taught us through their suffering did so in the beach-waters of an ocean that, even today, seems unimaginable in its breadth and depth. The horizon, unfortunately, is so very far away.

*One of the men--Hugh de Wardener--lived long enough to be interviewed by Kean himself for this book. De Wardener passed away in late 2013 at the age of 97.