The Tale of Dueling Neurosurgeons

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thetaleoftheduelingneurosurgeonsKasey Hemington | IMS Magazine

Author: Sam Kean

Reviewed by: Jabir Mohamed

In The Tale of the Dueling Neurosurgeons, Sam Kean traces the origins of modern neuroscience through stories of brain injury and recovery. Celebrated figures from the annals of medical history come alive as Kean describes their courageous desperation to advance our understanding of the brain. Despite the emphasis on neuroscience history, reflecting the author’s intended focus, the book presents a fundamental look at how the brain works. The result is a pleasant read for all those studying, or simply interested, in neuroscience.

The 12 chapters of The Tale of the Dueling Neurosurgeons are arranged in five sections. The book’s first section, “Gross Anatomy,” provides a general layout of the brain and skull. One of the virtues of this section is the lucid and comprehensive coverage of King Henri II’s fatal head injury despite the best efforts of his physicians, Ambroise Paré and Andreas Vesalius.

Basic neurobiology is discussed in the next section, “Cells, Senses, Circuits.” The contributions of Cajal (and Golgi) on the neuron doctrine, Loewi on chemical transmitters, and Hubel and Wiesel on vision neuroscience are covered in detail. Notable examples include the 3009th neuron that made Hubel and Wiesel rejoice in their laboratory basement, or the unusual incident when Nobel Prize winner, Loewi, was permitted to enter the United States only after he had persuaded an immigration official to read about him in Who’s Who.

With these foundations in place, Kean takes us through the brain’s major structures and systems in the book’s third section, “Body and Brain.” In my opinion, the two most provocative stories are recounted in this section and are reason enough to read the book. The first story is of Carleton Gajdusek, a brilliant yet deeply flawed clinician-scientist who settled in Papa New Guinea to study kuru, a degenerative neurological disease that was devastating the Fore tribe. The second story concerns the pituitary work of neurosurgeon Harvey Cushing, who visited giants and dwarfs across the east coasts to illuminate how the brain’s glands work (or fail to).

The fourth section, “Beliefs and Delusions” provides incisive analyses of several psychiatric and neurological conditions. The first chapter describes epilepsy neurosurgeon Wilder Penfield’s fight to save the life of his sister, Ruth, who suffered from uncontrollable seizures. The experience had a profound effect on Penfield, who later founded the Montreal Neurological Institute, a center of excellence—then and now—for brain treatment and research. The remaining chapters explore two particularly peculiar delusions—the belief that your relatives have been replaced by impostors (Capgras delusions) and the belief that you have died (Cotard delusions).

Kean devotes the final section to the most enigmatic concept of neuroscience, “Consciousness”. While the liveliest topic, this section lacks the thoroughness found in other sections. The behavioural changes of Phineas Gage, the aphasia of M. Leborgne (“Tan”), the amnesia of HM, though extensively covered, are not tied together to establish a coherent examination of consciousness. Readers must draw their own conclusions based on these wonderful sets of stories.

Case studies have had a significant impact on the field of neurology. In this respect, Kean has done an excellent job of bringing together the most influential cases for this book. In general, the book is well laid out and clearly organized. Figures are carefully chosen to illustrate specific points and references are extensive and up-to-date. I highly recommend The Tale of the Dueling Neurosurgeons as a historical introduction to the field of neuroscience for students enrolled in neuroscience, but also for interested readers from other disciplines.