03 March 2011

Book Review: Douwe Draaisma: Disturbances of the Mind. Cambridge University Press. 2009

There are any number of eponyms in neurology and psychiatry. Sometimes they are named after great clinicians – Alzheimer, Parkinson, or Asperger – and sometimes they are named for philosophers like Charles Bonnet. Although the discovery of a nervous disease brought eponymous fame to some, Douwe Draaisma argues in his highly-readable and enjoyable Disturbances of the Mind that the most important thing is not the discovery of the disease but “what happens after a discovery”. For Draaisma eponyms appear almost as a medico-scientific graffiti put their by the descendants’ of discoverers. He observes:
Eponyms are at once accolade and arena. They are the site of maneuver and manipulation, where power and authority are at issue, where conflicts over what constitutes a scientific proof are settled, and where decisions are taken on matters of classification and categorization (8).
Disturbances of the Mind is consequently a very different kind of popular history of neurology and psychiatry. Whereas numerous popular histories describe the biographies of scientist-clinicians, (re)make medical curiosities out of strange nervous patients, or seek to inform readers about personhood and selfhood through the exploration of medical conditions, Draaisma studies the mystery of why a name should remain even as everything it represented changed with time. In many respects, Draaisma thus successfully moves his work between academic interests and popular ones. The result is both successful and enjoyable.

Readers familiar with neurology or neuroscience will not be surprised by the eponyms that appear in his book. Conditions like Parkinson’s, Alzheimer’s, Tourette syndrome, and Asperger syndrome are topics both easy to comprehend and of obvious popular interest. But other topics offer some surprises. His discussion of Korsakoff syndrome, for example, discusses the meaning of traces of memory in the darkness of memory loss. Or what Korsakoff described as the “unconscious sphere of psychological life” (166). Another example appears in the chapter on Capgras Syndrome. Here Draaisma, as he does in many chapters, talks about modern explanations for the condition. He writes that it seems that patients with this condition are given a glimpse into the “separate activities of the two brain hemispheres”. His discussions of Broca’s area, Brodmann’s areas, and Phineas Gage – the perhaps oddest choice – are equally compelling.

Draaisma observes that one of the interesting features of neurological and psychiatric diseases is that they often seem to flip between those specialist medical worlds. Sometimes psychiatrists appear more interested in the conditions; at other times the neurologists take over. Draaisma suggests that in part these phenomena are products of a cultural consciousness made over time. He comments:
Distance in time makes it easier to identify the shared convictions and prejudices of past generations. This holds true for historians of brain science and for brain scientists themselves…. With the passage of the time the perspectives of historians and scientists begin to converge. The absence of a temporal distance creates a deceptive transparency. The view held by prominent scientists in the 1960s that ‘refrigerator mother’ was responsible for her child’s autism is today recognizes as contestable, but how will later generations see the now widely held view that autistic children have ‘no theory of mind’ (351)?
What makes this book stand apart from many popular volumes like it, is Draaisma’s acceptance that disease is culturally embedded. For Draaisma nervous diseases are products of their times. Even as he attempts to represent the ‘biological realities’ of these diseases and syndromes, he remains firmly attached to the notion that they are socially constructed. It is this subtle awareness of the playfulness of the historical moment that makes this volume reach so many audiences. And it also explains why its a great and fun read.

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