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The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human

The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human - V.S. Ramachandran I don't really know all that much about neuroscience or the field in general, so please take this review with a grain of salt.

I have to say that I was pretty disappointed by The Tell-Tale Brain, which billed itself to be an overview tour of the brain and how it is used to delineate our sense of self. This is primarily achieved by examining brain-based maladies with the thinking that really outlandish and odd neurological conditions can highlight what different parts of the brain are responsible for and how they might work together. This is a sound, logical approach, and some of the conditions hinted at in the introduction were so bizarre that I was readying myself for a wild ride. For the most part, the informational content of the book is sound. Ramachandran is a leader in the field of neuroscience, a giant among his peers and worthy of a lot of the praise he receives for the therapies and intuitions he's developed over the years diagnosing and treating neurological conditions using a Sherlock Holmesian approach. Unfortunately, it seems that a lot of that praise has gone to Dr. Ramachandran's head and he feels compelled to constantly insert his self into the tale in ways that I personally found obtrusive and distracting. I'm willing to concede that maybe I was being really picky and finicky, or that maybe the thought of my vacation's imminent end distracted my with upcoming responsibilities while reading through the book preventing immersion and heightening my focus on words and phrases that jarred. In fact, I'm hoping someone I know will read this and give a second opinion to either tell me I'm crazy or if there's really something there and I'm not just imagining things.

Anyway, there were several things that bothered me about this book as a scientific work, even one designed for popular audiences and most of these problems are stylistic. Each chapter is divided into a different aspect of brain function and follows a general problem of examining curious cases of neurological maladies and what it reveals about how our brains work within that process. There are chapters relating to vision and perception, feeling, and consciousness. The approach and format work well and provide interesting stories and one would expect that most of these stories would be from personal experience. Ramachandran gives the impression in almost every single chapter and disease that he was absolutely instrumental in the diagnosis and development of treatment. The general pattern of disease/revelation is followed by a not-so-subtle pattern of "And that led me to propose in 199X, blah blah blah, which was later confirmed by so-and-so and is now the standard treatment in dealing with blah blah blah disease...." This latter habit casts the rest of the work in a very poor light to me. It shifts the focus of the book from the evolutionary and functional development of the brain to the achievements of Dr. Ramachandran the Great and Magnificent (and by the way, here's some stuff about the brain that I figured out to sate your curiosity). Am I being unfair? Maybe. Ramachandran is a very well-respected neurologist and a lot of the works he congratulates himself for have been professionally published and reviewed. In short, he deserves the praise - but doing so yourself is really distracting. Perhaps I'm especially cognizant of this self-congratulation because of the volume of scientific memoirs and pop-sci books I consume. True, I usually stick to the physical sciences, but earlier this year I did read The Emperor of All Maladies by Siddhartha Mukherjee and the experience was very different. In Emperor, Mukherjee used case studies to give a personal context to the disease being studied, to bring the science and history of cancer to life. There's a reverence when dealing with the patients that seems befitting and less like they're being used by the author. Dr. Ramachandran seems to do quite the reverse. At times, it feels like his list of patients are rungs on the ladder of achievement and excuses for self-congratulation and personal aggrandizements. Again, Dr. Ramachandran is indeed a renowned neuroscientist with plenty of professional publications and treatment methods ascribed to his name. He has earned bragging rights, but there are whole chapters of this book where he comes across as narcissistic. I've also read Einstein and Feynman in their own words, pivotal figures in the development of physics and wonderful people to boot. Their works are personal yet filled with humility and almost never bespeak their personal achievements. If you didn't know what they achieved before picking up their autobiographies, you wouldn't really have any idea about them after, even when they were talking about developments in their respective fields to lay audiences. Ramachandran's style was just a major turn-off to me.

The second major problem I had was probably more the fault of the editors of the work. Ramachandran has a rather annoying habit of giving asides that come across as flippant or pedantic. He includes references to other fields and terminology or to literary works not because they elucidate some principle he's discussing, but because it makes him look smart. Or at least that's the way I read it. Here's an example:

"Note that the fusiform area itself mainly performs a dry classification of objects: It discriminates Ps from Qs, hawks from handsaws, and Joe from Jane, but it does not assign significance to any of them. Its role is analogous to that of a shell collector (conchologist) or a butterfly collector (lepidopterist), who classifies and labels hundreds of specimens into discrete nonoverlapping conceptual bins without necessarily knowing (or caring) anything else about them."

Again, call me picky. Both of these are good analogies, however it seems redundant and almsot braggadocious (boastful) to give the jargon once you've already made the point. Either use conchologist and lepidopterist and expect your audience to know what you mean or just stick with shell collector and butterfly collector and move on. Doing otherwise makes it appear that you're showing off your fancy lexicon like you're trying out for Jeopardy or something. One instance may be forgiven, but the redundant use of these parentheticals continues throughout the work. As an editor, I'd have eliminated them.

The last problem I had (again, stylistically) was the inclusion of dialogue in significant portions of the book. Certainly, science writers make use of occasional bits of dialogue and quotation in their works, Mukherjee does this in Emperor of all Maladies, but these instances are usually well-contained and brief or are extracted from recordings or interviews. Ramachandran seems to re-invent whole passages of conversations from 15 years ago right down to the jokes he used and the responses he's gotten. Either his memory is incredible or he's just making them up to suit the point he's trying to make, usually points that are already well-made by their invocation in the narrative. The following example was from the early part of the chapter on synesthesia:

Certain otherwise normal people claim they see sounds, or that certain numbers always evoke certain colors,” we told the class. “If any one of you experiences this, please raise your hands.”
To our disappointment, not a single hand went up. But later that day, as I was chatting with Ed in my office, two students knocked on the door. One of them, Susan, had striking blue eyes, streaks of red dye in her blonde ringlets, a silver ring in her belly button and an enormous skateboard. She said to us, “I’m one of those people you talked about in class, Dr. Ramachandran. I didn’t raise my hand because I didn’t want people to think I was weird or something. I didn’t even know that there were others like me or that the condition had a name."
Ed and I looked at each other, pleasantly surprised. We asked the other student to come back later, and waved Susan into a chair. She leaned the skateboard against the wall and sat down.
“How long have you experienced this?” I asked.
“Oh, from early childhood. But I didn’t really pay much attention to it at that time, I suppose. But then it gradually dawned on me that it was really odd, and I didn’t discuss it with anyone…I didn’t want people thinking I was crazy or something. Until you mentioned it in class, I didn’t know that it had a name. What did you call it, syn…es…something that rhymes with anesthesia?”
“It’s called synesthesia,” I said. “Susan, I want you to describe your experiences to me in detail. Our lab has a special interest in it. What exactly do you experience?”
“When I see certain numbers, I always see specific colors. The number 5 is always a specific shade of dull red, 3 is blue, 7 is bright blood red, 8 is yellow, and 9 is chartreuse.”
I grabbed a felt pen and pad that were on the table and drew a big 7.
“What do you see?”
“Well, it’s not a very clean 7. But it looks red…I told you that.”
“Now I want you to think carefully before you answer this question. Do you actually see the red? Or does it just make you think of red or make you visualize red…like a memory image. For example, when I hear the word ‘Cinderella,’ I think of a young girl or of pumpkins or coaches. Is it like that? Or do you literally see the color?”
“That’s a tough one. It’s something I have often asked myself. I guess I do really see it. That number you drew looks distinctly red to me. But I can also see that it’s really black—or I should say, I know it’s black. So in some sense it is a memory image of sorts…I must be seeing it in my mind’s eye or something. But it certainly doesn’t feel like that. It feels like I am actually seeing it. It’s very hard to describe, Doctor.”
“You are doing very well, Susan. You are a good observer and that makes everything you say valuable.”

The dialogue to me is just a huge distraction and deviation from the otherwise scientific tone of the work in general and don't do well to personalize the condition (as I'm sure was the intention) - especially that bit about Susan mispronouncing synesthesia.

To sum up, The Tell Tale Brain does contain some really good information and the sections where the information is presented without commentary work really well. I liked the detective-like approach to making inferences and assumptions about how the brain functions and I liked Ramachandran's overall approach toward psychology, Freudian psychology specifically, and his attempt to enhance those fields with a brain-based physiological understanding of certain common disorders like anxiety and depersonalization. I also liked that he made it a point to highlight areas for future research and to make clear to the reader when he was straying into the realms of speculation. Overall, there were just too many narrative and stylistic distractions for me to fully appreciate the science going on here. If you're interested in neuroscience, I have no alternatives to suggest since I'm rather new to the field myself, but give it a shot anyway. It's comprehensive and maybe I am just crazy. Let me know.