'Tis the season. For reunions -- I'm attending my 50th Yale Medical School reunion this weekend. I would gladly go to medical school there again. It was where I developed a strong foundation for a medical and neuroscience career that included curiosity, a thirst for reading and writing, and a respect for listening, especially to patients.
And what other medical school would have allowed me to play rehearsals and concerts several nights every week for four years? Bach cantatas and chamber music at the Yale School of Music and orchestral music in the New Haven Symphony and several other nearby regional orchestras, some conducted by Leonard Bernstein's conducting fellows with soloists like Arthur Rubinstein, Benny Goodman, and Mstislav Rostropovich.
At the time I couldn't avoid anxiety over being distracted from my medical studies. Now I am convinced it was exactly what I should have done--for my sanity then and for my life afterwards. I hope music protected me from the dehumanization that medical schools (Yale excepted) are so good at instilling in students. Nowhere else could I have had a better medical education. Now retired from medicine, I can still play music.
'Tis the season also for Commencement speeches. A brilliant one at Washington University by the film maker, Ken Burns, is my favorite so far this year. "Wash U" is where cynicism set in after the Army and the Vietnam War interrupted my happy University of Virginia postgraduate education. Burns explains that feeling -- I still feel it -- and offers good therapy, such as replacing cynicism by its "old fashioned antidote, skepticism."
Excerpts from Burns' finale don't capture the full essence of the address:
Remember: Black lives matter. All lives matter.
Reject fundamentalism wherever it raises its ugly head. It's not civilized. Choose to live in the Bedford Falls of "It's a Wonderful Life," not its oppressive opposite, Pottersville...
Don't confuse monetary success with excellence. The poet Robert Penn Warren once warned me that "careerism is death"...
Listen to jazz. A lot. It is our music.
Read. The book is still the greatest manmade machine of all -- not the car, not the TV, not the computer or the smartphone.
Do not allow our social media to segregate us into ever smaller tribes and clans, fiercely and sometimes appropriately loyal to our group, but also capable of metastasizing into profound distrust of the other...
Convince your government that the real threat, as Lincoln knew, comes from within. Governments always forget that, too. Do not let your government outsource honesty, transparency or candor. Do not let your government outsource democracy...
Insist that we support science and the arts, especially the arts. They have nothing to do with the actual defense of the country -- they just make the country worth defending...
by Carl Ellenberger, MD
Who else would write this?
"It is the function of medication, or surgery, or appropriate physiological procedures, to rectify mechanism--the mechanism, the mechanisms, which are so deranged in these patients. It is the function of scientific medicine to rectify the 'It.' It is the function of art, of living contact, of existential medicine, to call upon the latent will, the agent, the 'I,' to call out its commanding and coordinating powers, so that it may regain its hegemony and rule once again--for the final rule, the ruler, is not a measuring rod or clock, but the rule and measure of the personal 'I.' These two forms of medicine must be joined, must co-inhere, as body and soul."
Like medical care, medical writing usually focuses on diseases: incidence, causes, manifestations -- "the mechanisms" -- and treatment. Oliver Sacks focuses instead on the stories of the victims of neurologic disease, on finding the "personal 'I.'" A pill or a shot or surgery may be necessary but rarely can totally heal. None of those methods can cure, for example, patients with MS, Alzheimer's, or Parkinson's, so knowing who they are can be important in helping them improve their time on earth. Alas, in my view, medicine has been heading mostly in the opposite direction during Dr. Sacks' and my careers, a reality that becomes evident soon after On The Move begins.
I admire Oliver Sacks, author of Awakenings, The Man Who Mistook his Wife for a Hat, Migraine, other books and articles in The New York Review of Books, Granta, The New Yorker, and The New York Times, where his recent Op-Ed (Feb 19) revealed his current battle with a lethal melanoma.
Throughout his career some of his colleagues, probably mostly those who practice, teach, or 'investigate' in conventional ways, have dismissed Dr. Sacks' voluminous, detailed, and often inspired descriptions of his selected patients or other "subjects" (including himself in disguise), gathered over many hours of intense and repeated observation, as little more than material for his many writings, well-crafted as they are, but don't offer much to his patients. Sacks has, however, more than anyone, revealed to the public what Neurologists do, or at least should do, in addition to adjusting 'the mechanism' by ordering MRI's and EEG's, and prescribing medication.
Sacks is an avid musician and probably plays Beethoven sonatas on the grand piano in his apartment. He's also a biker, lifter, hiker, swimmer, surfer, albeit a clumsy participant at best in most of these endeavors, according to his account. And he does't hesitate to reveal his own demons.
Here's one of his music-related stories:
A producer was filming, in their hospital, the patients with post-encephalitic Parkinsonism (an excerpt), the characters in Awakenings. (The book was also made into a longer film starring Robert Di Niro). He asked, "Where is Kitty?" the music therapist.
"It was quite unusual in those days to have a music therapist--the effects of music, if any, were considered no more than marginal--but Kitty...knew that patients of all sorts could respond strongly to music and that even the postencephalitics, although often incapable of initiating movements voluntarily, could respond to a beat involuntarily, as we all do."
David Leventhal of the Mark Morris Dance Company has taken that phenomenon to a new level; his efforts displayed in a new film, Capturing Grace, will soon be released. Then, in a footnote, Sacks relates:
"By 1978, Kitty had decided to retire; we thought she had reached the usual retirement age of sixty-five, but she was, we learned, in her nineties, though astonishingly youthful and vivacious (could music have kept her young?)"
Little 'hard' evidence could be mustered to answer that question, Dr. Sacks' neurology colleagues would hasten to assert. But they don't get it. In On the Move, an amazing story teller reveals his own amazing life.
