Two weird things happened while I was reading this book. I had been having some bad insomnia, so I took a little something-something to help get to sl...moreTwo weird things happened while I was reading this book. I had been having some bad insomnia, so I took a little something-something to help get to sleep. Before it kicked in I was reading this book, and it looked like the background of my Kindle Paperwhite had clouds floating around behind the text. Conversation with my husband:
Me:"There's clouds floating around the background of my Kindle." Husband:"Sounds kind of pretty." Me:"I guess." Me:"But I'm trying to read."
The second weird thing is that I ended up with a freak infection in my arm, which caused some awful fevers. I paid close attention, and yup, got some fever-induced hallucinations. Specifically, when I closed my eyes, it was gray with what looked like b&w christmas ornaments raining down on me.
Fantastic. I would have loved to read more scientific details of the biological theories of the various types of hallucinations. There was some of this, but I wanted more.
By far the best part of the book was Sacks discussing his prolific drug use. He's pretty awesome.(less)
Prion diseases are freaky! That little bits of proteins could mis-fold, and that topological change could decimate a brain is just bizarre. One of the...morePrion diseases are freaky! That little bits of proteins could mis-fold, and that topological change could decimate a brain is just bizarre. One of the facts I was most surprised by is that prion diseases have three methods of infection: genetic, direct contact (i.e. eating or touching infected tissue), and spontaneous (i.e. a protein accidentally misfolds in the body). No other disease vector can spread via all three methods like prions. They are freaky disease superstars!
The Italian family in the title is beset with FFI, fatal familial insomnia, an inherited/genetic prion disease. It's sufferers tend to develop symptoms in middle-age (usually), and die fairly quickly. It's grim: their pupils turn into pin-pricks, they start sweating profusely, and they become unable to achieve any type of restful sleep. Eventually they lose all control, go into mad fits, finally fall into a coma and die. All the while their mind is intact.
The family's biography is only a frame for the rest of the book. In order to explain FFI and how difficult it was to diagnose as a prion disease, you have to understand the history of prion diseases, and the history of the field. Max delves into scrapie, kuru, GSS, CJD, BSE, and other known prion diseases. In some ways, the story of the researchers trying to pin-down this new class of illness was more fascinating than the family that couldn't sleep. There are huge egos, government cover-ups, and other non-science dramas that affect the lives of many people.
I really, really enjoyed this book - Max sets up the story in an extremely engaging way. It reads like a medical thriller - like something out of that TV show Mystery Diagnosis, but on steroids. There are twists and turns to the diagnosis, and a whole lotta shock factor.
And yet I had to dock it a star. I thought there were two questions not just left unanswered, but totally unaddressed. 1) How does a genetic version of a prion disease, like FFI, not cause symptoms until middle-age? Is the disease building up slowly over time, or does something later set it off? 2) How does a simple mis-folding of a protein lead to a swiss-cheese brain? How do you connect the dots from misfolding to erosion of brain tissue and development of plaques.
There's a good chance that there aren't satisfactory answers to either of those questions, but I was hoping Max would at least acknowledge or address them. He certainly didn't shy away from other more technical discussions.
I had just finished the chapters on Mad Cow/BSE/CJD and Max goes into detail about the state of affairs today. Spoiler: it's not good at all, particularly the government's reluctance in the US. British beef is safer than US beef. Scary. My husband and I had already planned on eating beef for dinner - we had some leftover steaks that needed finishing. It certainly gave me pause. I don't eat a whole lot of beef as it is, but I might try to cut back a little more. Prions are just that freaky.(less)
I'm not sure if it's just Mark Vonnegut's style, or if this indicative of someone living with mental illness, but the writing h...moreA book with no segues.
I'm not sure if it's just Mark Vonnegut's style, or if this indicative of someone living with mental illness, but the writing had this staccato quality. Ideas jumped from one paragraph to the next. There would be sentences in the middle of paragraphs that didn't seem to connect to much around it.
It's kind of like the old-timey comedians whose routines were: Set-up, Punchline, Laughter...Set-up, Punchline, Laughter... lather, rinse, repeat. Except this book isn't exactly funny. It was small anecdote, pithy sentence, small anecdote. All this is wrapped up in chapters that revolve around an event or idea.
That's not to say that there aren't great, quotable sentences in the book. I was just hoping for more of a narrative to the musings.
I'm always interested in diseases of the brain, insights into how that lump of gray matter functions, and particularly stories of how it can all go wrong. Things have gone wrong in Mark Vonnegut's brain - he's a highly intelligent guy who also happens to have bipolar disorder. He's suffered several major breakdowns, although not for years, and he also grew up in a weird, somewhat abusive family. And yet he's been able to become a practicing pediatrician, have a family, recover from alcoholism.
It's that recovery and coping I was most curious to read about. You do get a few insights into the doctor's life and coping mechanisms. Unfortunately, you also get long, multiple rants about the poor state of the US healthcare system, particularly insurance companies. You're preaching to the choir, Mark.
Funnily, those medical rants were the most coherent and well-strung together parts of the book.(less)
Mind's Eye is classic Sacks. It's a collection of essays with a focus on case studies. This time they were loosely based around the theme of the Mind'...moreMind's Eye is classic Sacks. It's a collection of essays with a focus on case studies. This time they were loosely based around the theme of the Mind's Eye - or how our perceptions of the world translate to imagery in the mind. As usual, he looks at people who have some sort of injury, illness or deficit to tell us about the normal functioning processes.
Sacks has never shied away from including his own illnesses and problems in his books. (To wit: A Leg to Stand On and Migraine.) This time felt brutally personal as he shared both his life-long problem with prosopagnosia (face blindness), and his recent battle with a melanoma tumor on his retina. The latter altered then robbed him of his sight, and we see the normally upbeat the resilient doctor become alarmed, depressed, anxious and doubting. His Melanoma Diary is included verbatim, describing his thoughts as his vision changed day-to-day through the cancer treatments.
The last chapter, which was also titled "Mind's Eye", is very detailed, filled with citations, and had more of a scholarly and philosophical tone than the other case-study/memoir chapters. However, it really brought together the deeper themes in the book: the difference between perception and mental imagery. I suspect this chapter has been published elsewhere before inclusion in the book.
One of the best things I took away from the book is the difference between people who are strong visual imagers and people who do a more abstract type of mental imagery. In that last chapter, he discusses quite a few cases of blind people who have either maintained a very strong sense of visual imagery despite their deficits. He contrasts those with cases where the blind person has completely shifted their mental imagery towards aural, texture, and more abstract imagery. (It turns out Sacks admits he has almost no capabilities to pull up mental visual images, and he attributes some of this to his prosopagnosia.)
It took me a long time to think about the differences, but I think there are strong parallels with my fellow physicists. At work, I have always been a very strong visual, "graph it" person -- I think best about a physical relationship or concept if I can imagine the graph or other physical representation. My husband, at the other extreme, likes to think much more abstractly in equations, and rarely graphs things in his head. As I've chatted with other folks over the years, physicists tend to fall into one or the other category - and I think this is what Sacks is talking about in the last chapter. (less)
Randy O. Frost and Gail Steketee's Stuff: Compulsive Hoarding and the Meaning of Things is an Oliver Sacks-style series of...moreSaw a review at BoingBoing.
Randy O. Frost and Gail Steketee's Stuff: Compulsive Hoarding and the Meaning of Things is an Oliver Sacks-style series of case-histories of people who suffer from a compulsion that causes them to fill up their living spaces with all manner of junk. The cases are very wide ranging, from people who literally hoard garbage and live in places that are carpeted with vermin and roaches to millionaires who fill a series of posh hotel suites with mountains of fine art and jewels that accumulate layers of dust. All have been Frost and Steketee's patients at their hoarding clinic, where they have pioneered a series of protocols that have had limited success in treating hoarding.(less)