February 1, 2016

Listening to Grass Grow (Not)

While mining our 40 year history, I was gratified to remember the many people who joined my effort. More recently, preparing for the annual submission of grant proposals to fund next summer’s 41st season, deeper mining revealed more interesting stuff. We clearly did not

rest our heads upon the grass
and listen to it grow.
—Splendor in the Grass (Pink Martini, not Wordsworth)

Among the ~1200 artists who appeared in over 700 Gretna concerts 37 have won Grammy Awards, countless more have been nominated, and five are MacArthur (“genius”) Fellows. Next year I may try to count the many winners of competitions, like the Cliburn, Leventritt, Young Concert Artists, Queen Elizabeth, and Tchaikovsky.

Not only did our musicians represent major orchestras in the US like the Metropolitan Opera, Chicago Symphony, Cleveland and Philadelphia Orchestras, others came from more than 20 countries abroad like China, Bulgaria, Russia, and Brazil. They have been soloists in Carnegie Hall, Lincoln and Kennedy Centers, Severance Hall, Hollywood Bowl and Walt Disney Concert Hall, and the Tanglewood, Blossom and Aspen Festivals. 

We offer great young performers before they become household names or win Grammys and iconic performers after they have, but not the growing fad of ‘recreative tributes.’ So we have heard the ‘real’ Dave Brubeck, Sonny Rollins, George Shearing, Cleo Laine, The Four Freshmen, The Modern Jazz Quartet, Stéphane Grappelli and Lionel Hampton. Pianist Leon Fleisher (July 1) was taught by a student of a teacher who was a student of a teacher who was taught by Beethoven.

We have commissioned and premiered dozens of new works. In many cases the composers, like David Baker, William Bolcom, Edgar Meyer and Allen Krantz, performed their own music. Dancers danced their own choreography and jazz singers sang their own songs. When Tierney Sutton sang songs of Joni Mitchell, she put her inimitable stamp on them as Joanna Pascale did for Paul McCartney’s songs.

It was fun looking back, but the challenges are in the future. In words of conductor Alan Gilbert, we must always try “to sharpen our sense of purpose and . . . justify our very existence.” How do we do that? By taking new paths, some of which may be dead ends, and trying new ways, not all of which will succeed. By keeping our eyes open for new ventures and connections. By infusing our organization with new people. And by listening to you.

January 25, 2016

More the Matter With Classical Music

Attention span is "the amount of concentrated time on a task without becoming distracted" and it can easily be measured under proper conditions. In a recent New York Times column Timothy Egan cites recent data: the average attention span (among Canadian subjects) has fallen to 8 seconds, down from 12 in the year 2000.

Imagine orchestra players distracted every eight seconds! Rehearsals and performances would be chaos. It’s harder to imagine a task requiring more intense and prolonged concentration than is demanded of an orchestra violinist. Developing the ability to maintain attention may underlie the benefits of learning to play an instrument in childhood. It’s almost certainly a skill ‘transferrable’ later to other endeavors, as is reading by children.

Listening to classical music does not require quite such a high degree of attention — it’s natural for your mind to wander during a movement of a symphony (not, we hope, to Donald Trump or ISIS) — but the music is composed to travel from a beginning to an end, a narrative, so to speak. That progression, sonata-allegro form only a simple example, is one of the main distinguishing characteristics of ‘classical’ music. It takes you on a musical journey with wonderful sensations and mental images along the way, one leading to another. You aren’t supposed to get off the train whenever you want.

I suppose digital generations can’t imagine not texting or checking email every eight seconds, so there’s little chance for them to withstand Schubert’s ‘heavenly length’ without the frequent breaks they are accustomed to in pop music concerts. Those resemble sports events more than the original concert invented in the 19th century. “Why can’t we talk to friends? Get a beer?” Maybe the reason pop music concerts are so ear-shatteringly loud is to keep the attention of the fans.

As for the claim that they have evolved a new ability to ‘multitask,’ Dan Levitin in The Organized Mind says that multitasking is a very good way to sabotage productivity, efficiency and accuracy.

December 31, 2015


According to John Eliot Gardiner in Bach: Music in the Castle of Heaven the "future preoccupations" of the young (~21 years of age) JS Bach and GF Handel, both members of the "Class of '85" (born, in Germany in 1685), were:

Bach: life, death, God and eternity

Handel: love, fury, loyalty and power  

I thought about my preoccupations at that age. Definitely life and love. Probably wisdom as wellNot power, fury, God, death or eternity.

December 10, 2015

Is Music the Ultimate Placebo?

by Carl Ellenberger, MD

What theory explains why homo sapiens, almost alone among species (excepting a few exotic birds on YouTube), have made music since the ‘origin’ of their species?

That is a common question and subject of books, periodically pondered and researched without definitive results. One intuitive answer is that music confers a selective (evolutionary) advantage onto those humans who make it or listen. Exactly what that advantage may be remains elusive. A few possibilities include:

1. Music is sexy and promotes procreation. Someone who can sing and dance might be a more attractive mate and produce more offspring.

2. Music enhances social cohesion that increases survival. A part of that is nurturing of infants and children. Lullabies may help motherly love keep infants alive.

3. Music can be learned easily by the young developing brain, as can all languages, before the brain can handle more complex tasks, like philosophy and physics. It exercises the brain early (in 'pre-school') to develop certain abilities and skills when it is most receptive (plastic), gaining capacities that peers, coming later to education, may never acquire. "Perfect pitch" is a trivial example. (A corollary: so deeply hardwired into the brain these abilities remain through life and are the last to succumb to degenerative processes like Alzheimer's so they can be excavated and exploited in therapy.)

4. Music generates a true and salutary placebo response in the brain.
“Placebos are drugs, devices or other treatments that are physically and pharmacologically inert. Placebo interventions do not, by definition, have any direct therapeutic effects on the body. However, all treatments are delivered in a context that includes social and physical cues, verbal suggestions and treatment history. This context is actively interpreted by the brain can elicit expectations, memories and emotions….” * (my emphases)
Studies reliably show a success rate of around 30%, or higher, if the therapist is caring and convincing (the "context"). The context of acupuncture, for example, includes ritual, tradition ('proven over centuries'), positive expectations, value (it's not cheap), and perceived competence of a skilled practitioner exhaustively trained in an ‘ancient art.’ The needles don’t even have to puncture, just prick, so long as the patient experiences the context.

The placebo response is not a product of trickery or deception; it accompanies actual physiological/chemical changes in the brain, such as production of endorphins and dopamine, and changes in blood flow and connectivity, similar to changes evoked by other means like talk therapy, medications, and indeed, music. Wounds aren't healed, causes aren't eliminated and the effects are usually temporary, but patients come away feeling better -- as I do on the descending escalator in Disney Hall or walking home from the Gretna Playhouse after concerts.

The idea that music may generate something like a placebo response came to me as I read John Eliot Gardiner’s magnificent, Bach: Music in the Castle of Heaven. Monteverdi wrote L’Orfeo in 1607 during a time when “the emotional life of human beings was becoming a topic of the utmost fascination – with philosophers and playwrights trying to define the role of passions in human destiny, and with painters as varied as Velázquez, Caravaggio and Rembrandt all intent on portraying the inner life of men and women . . . . Monteverdi made the decisive creative leap – from a pastoral play, intended to be sung and not spoken throughout, to a musical-drama with emotions generated and intensified by music . . . ." (my emphasis)

This idea, however, may not support, at least in the views of some,** the theory that music indeed gives humans a selective adaptive advantage. We would probably be much the same humans without it, but it does give to life comfort and pleasure as does making and viewing art, burning fossil fuels, wearing fine clothes, and drinking a fine wine, all longstanding drives, not likely to disappear.

5. I should also mention another theory that musical sounds were homo sapiens' first language, carried over from pre-human ancestors, common to us and to those who now play in Bernie Krause's The Great Animal Orchestra. Providing better communication, spoken language prevailed many millennia ago and music, outmoded, became an unnecessary skill (or "frill") among humans, "auditory cheesecake," according to psychologist, Steven Pinker. I always wonder whether some of the sounds I hear coming from my grandson's earbuds are examples of the final throes of musics' extinction.

December 4, 2015

Flutes and Stethoscopes

by Carl Ellenberger, MD

Even as a physician and flutist, I was unaware of the same duality in the career of the young French doctor, René Laennec, inventor of the stethoscope.
In 1816, I was consulted by a young woman labouring under general symptoms of diseased heart, and in whose case percussion and the application of the hand were of little avail on account of the great degree of fatness. 
Such "percussion and the application of the hand," augmented by placing the ear directly on the chest, were used by Laennec's contemporaries to examine the heart. The fact that Laennec played the flute might account for the novel way he solved his problem.
I rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised and pleased, to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of the ear.
Eventually, he constructed other instruments out of various materials and called the technique, "mediate auscultation."
The most dense bodies do not, as might have been expected from analogy, furnish the best materials for these instruments.... Bodies of a moderate density, such as paper, the lighter kinds of wood, or Indian cane, are those which I always found preferable to others. A greater diameter renders its exact application to certain parts of the chest, impracticable; greater length renders its retention in exact apposition more difficult, and when shorter, it...frequently obliges [the doctor] to assume an inconvenient posture.... 
Flutes in Laennec's time were almost all made of wood. One might wonder whether Laennec as a flutist was especially able to evaluate sounds made by flow, of air through the flute and of blood through the heart. Laennec named his instrument, “stethoscope” (from the Greek stethos, chest or heart, and skopos, observer). Here is his drawing:

and an early model

and an early flute

Further reading: Edelman and Weber, Tenuous Tether, The New England Journal of Medicine, 373:2199, 2015. The authors lament the displacement of the stethoscope by modern techniques, like ultrasound, where the "mediate" part of the auscultation is a technician with a machine between the doctor and the patient. 

December 3, 2015

Musical Lives of Cells

Speaking of MacArthur ("genius") fellows, as I did in the Fall Newsletter -- we have had five on our stage, I came across a comment by a recent one, Dr. Lorenz Studer, Professor of Neuroscience at Weill-Corner Medical School and founding director of the Center for Stem Cell Biology at Memorial Sloan Kettering Cancer Center. He spoke about the process through which a stem cell becomes a nerve cell.

Normally, as a cell begins its journey from a fertilized egg to a young nerve cell -- that takes about eight weeks-- it is exposed to a number of molecular signaling pathways that essentially nudge the cell toward becoming a brain cell and not, for instance, a liver cell.
"A cell has to make a set of decisions to ultimately end up at a very specific fate. I compare it with playing a music piece. You can play jazz and get the liver [cell], or you can play classical and get something else. By now we can do that for about 40 cell types, and nearly all the time we can go from the stem cell to the young neural cell, then to a specialized subtype of nerve cell."
Of course, he doesn't actually expose developing cells to music, but the musical metaphor helps illustrate the complex process of cell development and how we can influence it. The metaphor can achieve reality during whole brain development in childhood when the brain cells are deciding how to fit in and what to do in their new universe inside your skull.

November 12, 2015

Orchestral Distress

Carl Ellenberger, MD

I suppose it is necessary to ask questions, as Peter Dobrin does,in this time of empty seats and unbalanced budgets. I had thought an orchestra's purpose was just to play music, but that was in an earlier time of sold-out subscriptions. Dobrin asks, "What is the job of this orchestra in this city in this day and age?" [re Philadelphia] His answer in part: "I'd get all the input I could and hold a public forum on the question...more money to program and market properly...." The orchestra awaits a consultant's report.

Dobrin sees the cause of the problem as “undercapitalization.” That prevents the orchestra from expanding and improving activities necessary to generate more revenue (and in Philadelphia from honoring salary commitments), a vicious cycle. This condition affects more than a few other orchestras and musical organizations (not including Gretna Music). 

It seems reasonable to link that condition to a general diminished interest in classical music among our society. Sure, there is enough violence and misery in the world to distract any sensible person these days, but I don't see many empty seats in the stands for the Fall sports lineup (based on what I see as I pass by ESPN on the cable dial and one actual physical presence at a Virginia Tech football game last month--with >60,000 others). 

Attempts to treat the problem that tend to be short term, focused on the music and its players, and often called "thinking out of the box," have brought limited success:

1) Changing the music to appeal to a broader audience. Most 'crossover' and 'pops' concerts are unfortunate examples of a quest for 'relevance' and 'accessibility.'

2) Changing the concert: shorter duration, less intimidating ritual and formality, 
better 'communication' 

3) Taking concerts to more venues, conventional and unconventional.
4) Seeking a 'new image' by 'creative marketing'
5) Going digital: streaming and filming 
6) Avoiding the word, "classical"
Despite these efforts the recent words of conductor Jed Gaylin remain, in general, true: 
"We need to figure out ways for the potency of great music to reach audiences that admittedly bond, socialize, recreate, and rejuvenate with technologies unforeseen in the era when the symphony orchestra was born." 2
When I see our musicians connect that "potency" with literally every member of our audience again and again each season, my first thought is always, "Why aren't more people here seeking this same amazing spiritual connection?" Tickets are affordable, walk-ups welcome, pre-requisites not necessary. Some people I'm talking about are sitting on porches just a few houses away -- in a Chautauqua!!!

I would argue that classical music and concerts are very healthy (and 'relevant'), in large part because increasing numbers of children all over the world manage to discover they want to play. The current abundance of good musicians, and resulting stiff competition, is why orchestras, and smaller ensembles, have been improving for decades, at least over my lifetime. 

I can only conclude that changes in the "wider cultural environment which surrounds classical music" 3 have not increased the number of listeners, and patrons, apace with the number of players. 

David J. Skorton, MD, cardiologist, and new Secretary of the Smithsonian, dug up what I think is one root of the problem: "As long as we consider the arts as a frill and as intrinsically less important than learning to code a computer, we're going to systematically disinvest. In school, when something's gotta go, it's art and music." (WSJ, Oct 24)  In contrast, investment in sports -- in schools and beyond -- seems to be increasing as we continue becoming a "shouting culture."4 

As in good medical practice, it's important to explore causes, including the environmental ones, before prescribing treatment. I buy tickets for the Cleveland Orchestra when I am East and LA Phil when West because I think they're worth $89 and $127 respectively. I don't similarly value mid-range seats for the Cleveland Browns ($269), but obviously not enough people's values align with mine. 

Why do I value an orchestra? The answer, I think, goes way back. My earliest memories include my mother playing the piano and my father blowing his old trumpet, both instruments untouched since their school years. Now it's clear; they resurrected those skills just for my (and my sister's) benefit! Neither played well but how was I to know? They also played records; my mother liked Somewhere Over the Rainbow, my father loved Schubert. Absent similar parental guidance you might find 3rd graders today blasting JZ's Big Pimpin out of their ear buds. Adult participation is clearly desireable.5

When I was in the third grade, after-school home piano lessons interrupted my play, but I learned, in 15 minutes of gently encouraged daily practice, how to make notes printed on pages into tunes, rhythm, and harmony, my first second language, easy to learn at age 8. After that math and Latin classes came easier. 

Using my new language skills, I could solo with the plastic 'flutophone' band by the end of the 4th grade. When I finally picked up a real flute, reading and figuring came easy and I enjoyed being excused from class to play in the small orchestra. In succeeding years the school bands were even more fun (except the marching part). The gentle parental encouragement became pride and admiration.

Sensitive developmental periods for the brain to acquire skills, like sensorimotor musical skills and aesthetic taste, come and go before age 9 or 10 (March 5, 2013). We have to learn certain skills while we can. If kids participate only in sports during those years, their future may take them in different directions, eventually to stadiums rather than concert halls. Though only a handful of my friends continued playing instruments after high school (more than continued football), enough of them learned to value the cost of symphony tickets and support their symphony. And sing in church.

My parents got as much of a thrill hearing me in school orchestras as other parents get from seeing their sons 'suit up' for the team. There is a risk, of course, that adults hearing only an average school ensemble will decide they don't like 'classical' because they have never heard it played well. But some parents clearly do get inspired; there are few performances more exciting than a really good orchestra of kids who amaze you by how well they play The Firebird.

Summer music camp at Interlochen brought me the confidence that I could compete successfully with good players and learn a large slice of the repertoire sealed my fate as a musician and lover of music.

In medical science single case studies like mine don't prove much but can be educational. I think my example may help explain why at least some of the symphony audience are in their seats, and suggest that the decline of music in schools is one reason for their dwindling numbers.

Imagine the impact of a good orchestral brass quintet or string quartet visiting a third grade classroom! Maybe not on all kids, but enough of them. Dobrin too advises the Philadelphians to conceive of 
"programs that reach every public school student, regularly, in a serious way."


1. Peter Dobrin: The Philadelphia Orchestra needs to rethink its future

2. Jed Gaylin: Being Relevant -- Who Cares?

3. Philip Clark: What’s wrong with the classical concert experience in the 21st century?
. . . And perhaps it’s the wider cultural environment which surrounds classical music that has a problem.

In a culture increasingly obsessed with ephemeral celebrity, fed by a spin drier of rehashed PR trivia presented as ‘news’, where sport is the new religion, where Saturday night fluff like Strictly Come Dancing is analysed seriously and given acres of press coverage, then a cultural landscape invested in supporting all that activity damn well ought to have a problem with classical music – with its difficultly, with its emotional ambiguity, with its allusiveness, with its celebration of individuality, with its refusal to conform, with its ability to move our emotions beyond something that can be controlled and manipulated into turning a profit.

. . . the real reasons that students quit is often beyond their own understanding.  It is up to teachers and parents to create “magical moments” during the year for students to want to continue on their instrument, especially during the early years of study, in order for the child to be successful and stay with their craft.

October 13, 2015

The Bard Comes to Reading

I attended a concert by Friends of Chamber Music in Reading PA. The artists were "The Bard Conservatory Ensemble."

The Conservatory is 10 years old and “guided by the principle that musicians should be broadly educated in the liberal arts and sciences to achieve their greatest potential. All undergraduates complete two degrees over a five-year period, a bachelor of music and a bachelor of arts in a field other than music."  I have always admired the President of Bard, Leon Botstein, the longest-serving college president (since age 28, now he nears 70), a renaissance man who is an inspiring scholar, educator, and esteemed orchestra conductor.

Robert Martin, the cellist in the ensemble (and 11-year veteran of the Sequoia Quartet), is Director of the conservatory, artistic director of the Bard Music Festival1 and Vice President for Academic Affairs of Bard College. He studied at the Curtis Institute with Leonard Rose and Orlando Cole and graduated from Haverford College. I knew Bob during the one year he was principal cellist of the New Haven Symphony while earning a Ph.D. at Yale, when I, a medical student, played in the orchestra. We both remember performing behind Van Cliburn, Perlman (age 17), Rubinstein (age 75), Rostropovich and many other superstars accessible to New Haven from New York. (My memory wants me to think I got perfectly all the flute licks in the Rococo Variations, but...)

The Reading concert was well-played by an ensemble that included two Bard faculty (Martin and Marka Gustavsson, viola) and 3 undergraduates: the pianist and two violinists. What a great opportunity for undergraduates to spend their Fall Break on tour with seasoned professionals! The ensemble could keep up with any of the ones at Curtis and many of those we have programmed over our 40 years.

The hall in Reading—“WCR Center for the Arts”—is a European-style chamber music hall downtown, converted from a decayed old building into what it is by $400,000 and a lot of "loving hands." It is rectangular in pale green pastel with 15 comfortable 9-chair rows on a wooden floor. A small proscenium and elevated stage at one end comfortably accommodated a piano quintet and could hold a Spohr Nonet without piano. A Strauss Serenade for 13 Winds might be a bit tight. The ceiling is flat and about 30 ft high. They have no special audio, video, or lighting—just like it would have been in Brahms' time. Only about 75 of the audience chairs were occupied for the Brahms Piano Quintet, Beethoven String Trio and a group of Bartok Violin Duets. 

I imagine a hall of wood with similar dimensions in the Gretna woods. There are lots of these at other summer festivals, called "sheds," "shells," etc. Climate control, offices, practice rooms, etc could be added in later stages, resources permitting.

My friend Tom Souders, a retired ophthalmologist, 'inherited' the “Friends” from his father who began it 63 years ago. Tom, a violinist, is now “Manager” and there is a board and an Executive Director, Shari Gleason-Mayrhofer2 and a website.3 

The parking situation was odd. When trying to shoe-horn into a short space on the street, I noticed a jolly toothless balded-headed individual leaning on the meter. He greeted me as I emerged from the car and assured me that parking on Sunday is free. (It would have been about $.75 on other days.) He delivered a short discourse on parking in Reading and, as I started away, politely asked if I could please spare $.75. I obliged and told him to take good care of my car as he started toward the next empty space on the block. A member of the audience recalled a similar experience in Senegal when he had to select from a crowd of children who competed to provide parking services.

1. The Bard Festival each summer "was created with the intention of finding ways to present the history of music in innovative ways to contemporary audiences. Each year the festival selects a single composer to be its main focus and presents performances in tandem with presentations on biographical details on the subject and links to the worlds of literature, painting, theater, philosophy, and politics that would have influenced the life and works of the featured composer." Bard Conservatory 

2. email Friends of Chamber Music

October 5, 2015

Mahler in Cleveland

by Carl Ellenberger, MD

The Cleveland Orchestra, Mahler 3, Severance Hall, Franz Welser-Möst: my equivalent to meeting the Pope. We drove 12 turnpike hours round trip through the margins of Hurricane Joaquin, and upon arrival in Cleveland endured 30-mph winds, arctic temperatures, and "Lot Full" parking. I recognized some of the potholes I learned to avoid when I lived there 30 years ago. 

Plunging into the traffic and crowds in University Circle I suspected that very few others were heading to Severance Hall for what I believed could be a concert of a lifetime. Most probably have never set foot in one of the world's greatest temples of music. Those suspicions were confirmed by the empty seats in every section of the hall. We easily obtained prime center seats in the third row of the dress circle for $89. 

The dark lobby spaces and narrow halls seemed old and a little shabby--the lower level a bit like the bowels of Penn Station--but better than Carnegie Hall. We wanted a glass of wine at a small booth before curtain time but the server had no cork screw. At least there were no long queues like there are in Walt Disney Hall. When we asked an elderly usher, still mystified by her bar-code scanner, for directions to the "Concert Preview," she directed us to the room where Renée Fleming was finishing a master class. We finally found the preview upstairs and eventually even a glass of wine.

When we finally entered the hall, it was indeed like walking through the pearly gates. It remains the most perfect concert hall I have ever been in, perfectly-sized, comfortable, with acoustics that seem to defy the laws of physics. In every seat you can hear every note perfectly balanced as if you were sitting on the conductor's podium. Only the sound of oboe players inserting earplugs before trombone eruptions failed to reach the audience. More than 200 performers didn't seem at all crowded.

Trombonist, Massimo La Rosa, was a star of the first movement. "Robust" would be an understatement. When he was acknowledged by conductor Welser-Möst during a long standing ovation, the cheers from the audience could have drowned out a stadium full of Browns fans after a touchdown. That's not to detract from the entirety of the performance, which was a magnificent and memorable experience--maybe "transformative" is the accolade du jour, and it must have been for some of the 50 members of the Children's Chorus. It was for me when I first heard this orchestra in this hall with George Szell as a child in the late 1940's. (Thanks, Mom and Dad.)

Kelley O'Connor's rich mellifluous, O Mensch! Gib acht! filled the hall and the orchestra playing would have brought Mahler to tears. I can't imagine even the most rabid tea-party congressman not being humbled--OK, maybe slightly moved--by such a powerful result of human collaboration. Too bad the Pope missed it.

After the concert, the Severance Restaurant provided a comfortable place to unwind and relax with a glass of Sancerre and a lovely charcuterie after 95 intense minutes of music. While some of the players were probably relaxing up the street in a Little Italy trattoria, we conversed at the bar with a close friend and student of John Mack, the orchestra's former principal oboist and Dean of Oboes in America. As I have been, Mack's friend was a neuroscience imager, albeit micro while I was macro. Go figure.

September 22, 2015

Truth about Vaccines

The candidates have done their best to spread fear and falsehood to serve small political gains, an unfortunate tactic that could eventually account for thousands of deaths.

The truth, written by Michael Specter in The New Yorker and bolstered by what little authority I have as a physician, thus might be worth repeating:
It is sad to have to write this, when it should be clear by now, but here it is: vaccines are the most successful medical intervention in the history of humanity. They have prevented millions of deaths. They are a triumph of human ingenuity and of our desire to alleviate suffering. 
There are not too many. They are not administered too soon. They do not cause autism or allergies or cancer. The only thing “too bunched up” about vaccines, as a matter of fact, are the falsehoods and deliberate misconceptions spread by demagogues and then endorsed by people like Carson and Paul, both of whom should—and almost certainly do—know better.

By the way, for anyone interested in autism, a common and misunderstood condition, NeuroTribes; the Legacy of Autism and the Future of Neurodiversity by Steve Silberman is fascinating reading.