I also owe an intellectual debt to my brother V. S. Ravi, whose vast knowledge of English and Telugu literature (especially Shakespeare and Thyagaraja) is unsurpassed. When I had just entered medical school (premed), he would often read me passages from Shakespeare and Omar Khayyam’s Rubaiyat, which had a deep impact on my mental development. I remember hearing him quote Macbeth’s famous “sound and fury” soliloquy and thinking, “Wow, that pretty much says it all.” It impressed on me the importance of economy of expression, whether in literature or in science.
I thank Matthew Blakeslee, who did a superb job in helping edit the book. Over fifteen years ago, as my student, he also assisted me in constructing the very first crude but effective prototype of the “mirror box” which inspired the subsequent construction of elegant, ivory-inlaid mahogany ones at Oxford (and which are now available commercially, although I have no personal financial stake in them). Various drug companies and philanthropic organizations have distributed thousands of such boxes to war veterans from Iraq and amputees in Haiti.
I also owe a debt of gratitude to the many patients who cooperated with me over the years. Many of them were in depressing situations, obviously, but most of them were unselfishly willing to help advance basic science in whatever way they could. Without them this book could not have been written. Naturally, I care about protecting their privacy. In the interest of confidentiality, all names, dates, and places, and in some instances the circumstances surrounding the admission of the patient, have been disguised. The conversations with patients (such as those with language problems) are literal transcripts of videotapes, except in a few cases where I had to re-create our exchanges based on memory. In one case (“John,” in Chapter 2, who developed embolic stroke originating from veins around an inflamed appendix) I have described appendicitis as it usually presents itself since notes on this particular case were unavailable. And the conversation with this patient is an edited summary of the conversation as recounted by the physician who originally saw him. In all cases the key symptoms and signs and history that are relevant to the neurological aspect of patients’ problems are presented as accurately as possible. But other aspects have been changed—for example, a patient who is fifty rather than fifty-five may have had an embolism originating in the heart rather than leg—so that even a close friend or relative would be unable to recognize the patient from the description.
I turn now to thank friends and colleagues with whom I have had productive conversations over the years. I list them in alphabetical order: Krishnaswami Alladi, John Allman, Eric Altschuler, Stuart Anstis, Carrie Armel, Shai Azoulai, Horace Barlow, Mary Beebe, Roger Bingham, Colin Blakemore, Sandy Blakeslee, Geoff Boynton, Oliver Braddick, David Brang, Mike Calford, Fergus Campbell, Pat Cavanagh, Pat and Paul Churchland, Steve Cobb, Francis Crick, Tony and Hanna Damasio, Nikki de Saint Phalle, Anthony Deutsch, Diana Deutsch, Paul Drake, Gerry Edelman, Jeff Elman, Richard Friedberg, Sir Alan Gilchrist, Beatrice Golomb, Al Gore (the “real” president), Richard Gregory, Mushirul Hasan, Afrei Hesam, Bill Hirstein, Mikhenan (“Mikhey”) Horvath, Ed Hubbard, David Hubel, Nick Humphrey, Mike Hyson, Sudarshan Iyengar, Mumtaz Jahan, Jon Kaas, Eric Kandel, Dorothy Kleffner, E. S. Krishnamoorthy, Ranjit Kumar, Leah Levi, Steve Link, Rama Mani, Paul McGeoch, Don McLeod, Sarada Menon, Mike Merzenich, Ranjit Nair, Ken Nakayama, Lindsay Oberman, Ingrid Olson, Malini Parthasarathy, Hal Pashler, David Peterzell, Jack Pettigrew, Jaime Pineda, Dan Plummer, Alladi Prabhakar, David Presti, N. Ram and N. Ravi (editors of The Hindu), Alladi Ramakrishnan, V. Madhusudhan Rao, Sushila Ravindranath, Beatrice Ring, Bill Rosar, Oliver Sacks, Terry Sejnowski, Chetan Shah, Naidu (“Spencer”) Sitaram, John Smythies, Allan Snyder, Larry Squire, Krishnamoorthy Srinivas, A. V. Srinivasan, Krishnan Sriram, Subramaniam Sriram, Lance Stone, Somtow (“Cookie”) Sucharitkul, K. V. Thiruvengadam, Chris Tyler, Claude Valenti, Ajit Varki, Ananda Veerasurya, Nairobi Venkataraman, Alladi Venkatesh, T. R. Vidyasagar, David Whitteridge, Ben Williams, Lisa Williams, Chris Wills, Piotr Winkielman, and John Wixted.
Thanks to Elizabeth Seckel and Petra Ostermuencher for their help.
I also thank Diane, Mani, and Jaya, who are an endless source of delight and inspiration. The Nature paper they published with me on flounder camouflage made a huge splash in the ichthyology world.
Julia Kindy Langley kindled my passion for the science of art.
Last but not least, I am grateful to the National Institutes of Health for funding much of the research reported in the book, and to private donors and patrons: Abe Pollin, Herb Lurie, Dick Geckler, and Charlie Robins.
THE TELL-TALE BRAIN
INTRODUCTION
No Mere Ape
Now I am quite sure that if we had these three creatures fossilized or preserved in spirits for comparison and were quite unprejudiced judges, we should at once admit that there is very little greater interval as animals between the gorilla and the man than exists between the gorilla and the baboon.
—THOMAS HENRY HUXLEY,
lecturing at the Royal
Institution, London
“I know, my dear Watson, that you share my love of all that is bizarre and outside the conventions and humdrum routine of everyday life.”
—SHERLOCK HOLMES
IS MAN AN APE OR AN ANGEL (AS BENJAMIN DISRAELI ASKED IN A famous debate about Darwin’s theory of evolution)? Are we merely chimps with a software upgrade? Or are we in some true sense special, a species that transcends the mindless fluxions of chemistry and instinct? Many scientists, beginning with Darwin himself, have argued the former: that human mental abilities are merely elaborations of faculties that are ultimately of the same kind we see in other apes. This was a radical and controversial proposal in the nineteenth century—some people are still not over it—but ever since Darwin published his world-shattering treatise on the theory of evolution, the case for man’s primate origins has been bolstered a thousandfold. Today it is impossible to seriously refute this point: We are anatomically, neurologically, genetically, physiologically apes. Anyone who has ever been struck by the uncanny near-humanness of the great apes at the zoo has felt the truth of this.
I find it odd how some people are so ardently drawn to either-or dichotomies. “Are apes self-aware or are they automata?” “Is life meaningful or is it meaningless?” “Are humans ‘just’ animals or are we exalted?” As a scientist I am perfectly comfortable with settling on categorical conclusions—when it makes sense. But with many of these supposedly urgent metaphysical dilemmas, I must admit I don’t see the conflict. For instance, why can’t we be a branch of the animal kingdom and a wholly unique and gloriously novel phenomenon in the universe?
I also find it odd how people so often slip words like “merely” and “nothing but” into statements about our origins. Humans are apes. So too we are mammals. We are vertebrates. We are pulpy, throbbing colonies of tens of trillions of cells. We are all of these things, but we are not “merely” these things. And we are, in addition to all these things, something unique, something unprecedented, something transcendent. We are something truly new under the sun, with uncharted and perhaps limitless potential. We are the first and only species whose fate has rested in its own hands, and not just in the hands of chemistry and instinct. On the great Darwinian stage we call Earth, I would argue there has not been an upheaval as big as us since the origin of life itself. When I think about what we are and what we may yet achieve, I can’t see any place for snide little “merelies.”