Curriculum Vital

When 'to pick someone's brains' has a new meaning
Conversations with Neil's Brain: The Neural Nature of Thought and Language
By William H. Calvin and George Ojemann

I like to think of myself as a brave person. When I was three I went down the death slide all by myself. When I was 14, I free-wheeled down a Cretan mountain. Two years later, I had my tongue tie removed without any kind of analgesia. However, you have to draw the line somewhere. In my case, I think my line would be drawn some place before the point of having open brain surgery whilst conscious.

Neil has suffered from epilepsy since he fractured his skull on his steering wheel during a road accident 15 years ago. Epilepsy, a fairly common condition, affects the brain and causes repeated seizures. Patients are usually treated with anticonvulsant drugs. However, as William H. Calvin writes in Conversations with Neil's Brain, these are ineffective in approximately one quarter of sufferers. As Neil's seizures are not treatable by anticonvulsants, he has opted for open brain surgery. In the operation, George Ojemann, the neurosurgeon, will remove a small portion of Neil's temporal lobe, the portion associated with his seizures. In order to ensure that the part of the brain being removed will have no significant impact on the patient's overall cognitive function, the patient must be awake during the procedure. Conversations with Neil's Brain is told in the voice of William Calvin, a neurophysiologist who has come to assist with the operation.

You seldom get a chance to see a real human brain - at least, not while its language cortex is holding a conversation with you. And somehow remembering words, piecing them together into a sentence, picking and choosing which sentence to speak out loud and which to leave on the subconscious to gestate a little longer. A unique person emerges from all that - Neil in this case.

Conversation with Neil's Brain is an interesting combination of fact and fiction. Ojemann and Calvin are real people. The book discusses a range of accounts of operations that actually happened, as well as a substantial amount of information about the anatomy and mechanisms  of the brain which are very much true. Neil, though, is a fictional character. The events that are documented in the book by both Calvin and Ojemann are actually a compilation of accounts of various operations on the brain that have taken place (that's right - there's more than one person on the planet who has been willing to have brain surgery without general anaesthesia). This is made apparent in the postscript: "A great many patients are represented in this book, usually through a question they asked or a concern they expressed." They go on to describe the book as, "a personal selection' [which] was considerably biased by the problems of constructing a story for general readers."

Neil is a believable character, with a considerable amount of insight into his condition as well as an interest in what is going on around him. Admittedly, he does seem surprisingly calm - which is far from what I would be in this situation. (Having read quite a bit on the brain myself, I know there is an awful lot of important stuff around the temporal lobe which I really wouldn't want to lose, such as my ability to recognise elephants, of which more later). Throughout the surgery, Neil asks many intelligent questions, which, as mentioned in the postscript, are actually a selection of questions that Ojemann has been asked during similar operations. It is useful to have the patient's voice represented as it gives the reader someone to identify with (ie someone with an interest in but by no means an expert on everything neurological). I believe that it is this unusual narrative style which makes a book about the anatomy of the brain so accessible to the average person.

Of course, writing a book about neurosurgery that is intended to be read by the general public is always going to be a challenge. Indeed, there are parts of the book which do require a a bit of re-reading in order to understand them properly. However, the first chapter is very successful in drawing the reader in. As with many pieces of fiction, Calvin creates intrigue by setting the scene, gradually building up the picture so the reader can create a vivid image in their mind (or the mental workspace - a widespread connection of neurons, as Calvin may call it). In this instance, rather than being a haunted woods or evil dungeon, the scene is an operating room, and, like any book which starts with a man about to undergo open brain surgery whilst conscious, is sure to get the reader wanting to read on.

Before launching straight into complicated neurospeak, Calvin eases the reader in by showing how certain areas of the brain control the senses and movements of the limbs. He does this by using the (slightly eery) example of when the 'hand area' of Neil's somatosensory cortex is stimulated:

George lowers the two silver wires until they gently touch the exposed  cortical surface, and then lifts them again. "Feel anything?"

"Hey! Someone touched my hand!" Neil volunteers. Neither the anaesthesiologists nor I had come anywhere close to Neil's hand.

"Which hand?" Asks George

"My right one, sort of like someone brushed the back of it. It's still tingling a little."

The right hand reports to the left side of the brain, and George evidently has located the hand area of somatosensory cortex with the stimulator.

The idea that the somatosentory cortex comprises of a patch for each part of the body is one of the simpler concepts that Calvin explains in his book. In contrast, the more complicated aspects of the human brain, such as language, memory and consciousness, require multiple chapters. For example, in the chapter 'Seeing the Brain Speak', Calvin alludes to the great number of different brain parts involved when we see a picture of an elephant and recognise it as such. We do not have a specific area of the brain that is devoted to recognising elephants (we would need a separate brain entirely just to recall the story of Noah's Ark). Instead, what enables us to recognise "that large grey thing with tusks and a trunk" as an elephant is a kind of collaboration between several different parts of the brain that specialise in naming, memory and language.

The field of neuroscience (the study of  the development, structure, function and effects of the nervous system) and the field of psychology (the science of the mind and behaviour) are clearly interconnected. Having said this, books about the brain tend to focus on one or the other. In The Mind's Eye, by Oliver Sacks, the author focuses more on psychology. Conversations with Neil's Brain, on the other hand, clearly comes from a more neuro-scientific perspective (which can only be expected, as it was written by a neurosurgeon and a neurophysioigist). This does make the book, at times, difficult for a non specialist to understand. The average non-neuroscientist is not that well acquainted with Broca's area and Wernicke's area - and Calvin tends to mention both casually, as if expecting the reader to go "Ah, Broca's area - I know it well!" Perhaps this book isn't the best choice for someone looking for some easy holiday reading (to be honest, unless you are a neuroscientist, any book abut the brain is an odd choice of holiday reading). But I would certainly recommend it to anyone hoping to study a degree in neuroscience, physiology, or just someone who wants a better understanding of the unbelievably complex set of mechanisms that enables us to think, feel, remember and imagine (and a whole lot of other verbs that I would list were my temporal lobe not getting tired).