“Monday Musings” for Monday June 26, 2017
Volume VII, No. 26/338
Brain and Behavior, Part IV
By Assad Meymandi, MD, PhD, DSc (Hon), DLFAPA*
(Editor’s Note: This is part IV of a four part series on Brain and Behaviour. In Part I, the general topography and physiology of the brain was discussed. In parts II and III, Memory and Post Traumatic Stress Disorder were explored. Today, Part IV, we are exploring the emergence of ‘Age of Mind’ by presenting the review of a book by Nobel Laureate American psychiatrist and Nobel Laureate Dr. Eric Kandel. Next week, in Part V, we will examine the issue of the holy marriage between psychoanalysis and neurosciences.)
IN SEARCH OF MEMORY
THE EMERGENCE OF A NEW SCIENCE OF MIND
By Eric R. Kandel, Psychiatrist
2000 Nobel Laureate for Physiology or Medicine
429 pages of text. 23 pages of glossary. 31 pages of notes and sources. 26 pages of index. Total: 510 pages.
W. Norton & Company, NY. London
Since Benjamin Rush, a framer of the US Constitution, and father of American psychiatry, there have been two psychiatrists who have won the Nobel Prize. The first winner was Julius Wagner-Jauregg, Psychiatrist (b. Wels 1857, d. Vienna 1940). He invented “Malaria-therapy” for the treatment of progressive paralysis, especially tertiary syphilis. He was awarded the Nobel Prize for Medicine in 1927. It took seventy three years before psychiatry had a second Nobel Prize winner. He is Eric R. Kandel, a University Professor at Columbia.
Dr. Kandel received his psychiatric training and training in psychoanalysis at Massachusetts General Hospital and McLean Hospital. Before entering medical school, he was interested in literature, the arts and humanities. He also found himself intrigued by the work of Freud and the relationship between neurology, biology, id, ego and superego, all components of Freudian theory of psychoanalysis. However, realizing that he needed to be a medical doctor to pursue his psychiatric ambitions he entered NY University Medical School where he received his MD. As a medical student and clinician, he became more interested in biology, physiology and cell, especially nerve cell (neuron), communication. Pun excused, he became more interested in “neuronics” rather than “neurotics.” His fifty years of work produced many books and seminal articles published in Journal of Nature and Science, reflecting his groundbreaking work on the cellular and molecular process of memory. This work ultimately earned him the Nobel Prize in Medicine or Physiology in 2000.
Reading this book is a sheer joy. Parts of it are heady and heavy neuroscience and neurobiology. But it is a page turner. Also, it is a kind of a book one wishes to re-read. The volume is autobiographical, weaving personal life experiences from childhood through student and professional life into a rich tapestry of words, syntax, and composition in an exquisitely readable and entertaining style. Dr. Kandel’s writing style is reminiscent of the writings of Freud. As I read and re-read parts of this enormously appealing book, through synesthesia, I kept hearing the complex and rich bouquets of baroque music of Bach and Telemann alternating with melodic symphonies of Haydn, Sibelius and the triumphant Mozart’s Jupiter Symphony in C major. While reading his words, I also saw a rich display of paintings of the masters, Michelangelo, Leonardo de Vinci and the smooth amorphous impressionist masters, like the work of Monet and Pissarro. It also reminded me of a recent symphony I heard conducted by Lorin Maazel. It has that characteristic Maazelian blend of incandescent colorings, unerring execution and cool brilliance.
The book starts when the author was nine, and a student at a neighborhood school in Vienna. Being Jewish, his parents, his brother, Ludwig (later Lewis), and he were expelled from his country by the Nazis. They came to America where Eric received a superb education in New York. In Vienna, his father had owned a small toy store. His mother was a stay at home Mom. At age 9, he recalls getting a shiny new battery operated toy car with a remote control from his father, which he brought to the United States. It is like “rosebud” and Hurst in the movie Citizen Kane. This illustrates the author’s understanding of object relation which is so important in psychiatry.
The science part of the book starts with Dr. Kandel’s introduction to the leading US biologist, University of Columbia’s Dr. Grundfest (Kandel later became Director of that laboratory). At that time Dr. Kandel developed techniques to micro puncture almost every cell of hippocampus, the seat of memory, as he put it “one neuron at a time.” He recorded the action potential of the cells and studied how the cells communicate with one another–how the messages (conversations) are transmitted from hippocampus to amygdala and other parts of the limbic system (thalamus, hypothalamus, mammary bodies, para-median gray and fornix). He identified the role of chemicals, the proteins and the cyclic AMP (cyclic adenosine-3’,5’- monophosphate) discovered earlier by another Nobel Prize winner, pediatrician Dr. Earl Sutherland of Vanderbilt, in cell transport.
The book is an elegant exposition of ethology, the study of animal behavior in its natural environment. It is also an in depth probe in molecular biology, the chemicals, proteins, neurotransmitters of memory, and the process of storage and recall of knowledge. It explains how the ionotropic receptors, the proteins that span the cell surface membrane and contain transmitter-binding sites and channels through which ions can pass and send messages to the next neuron.
This highly readable and delightful book also carries a compendium of people of note who have contributed to neurobiology and understanding of the central nervous system and how commands are generated by the cranial nerves and carried out by the peripheral network of neurons. The impressive pantheon starts with the work of Santiago Ramon Y Cajal, and Camillo Golgi to whom all of us were quickly exposed to in our first year of medical school. It continues to develop a rich anthology of all the names and a brief description of their contributions. Of course, the list starts with Aristotle. Here is an example of the author’s skillful writing bringing the ancient and the new together:
“Aristotle, and subsequently the British empiricist philosophers and many other thinkers, had proposed that learning and memory are somehow the result of mind’s ability to associate and form some lasting mental connection between two ideas and stimuli. With the discovery of NMDA (N-Methyl-D-Aspartate) receptor and long-term potentiation, neuroscientists had unearthed a molecular and cellular process that could well carry out this associative process.”
With clarity and eloquence, Dr. Kandel explains various forms of memory, such as habituation, sensitization, classical conditioning, short and long term, somatic, procedural, and verbal memory and the biological basis of individuality. He makes the reader feel a participant in the conversation between nerve cells.
We expect our educators from Kindergartens to Universities to teach their students the essentials in critical thinking. This is the ultimate goal of education. It is exciting to learn the molecular biology of critical thinking and memory. As one who has been doing book reviews for over 50 years, I have become accustomed to examine the down side of books reviewed. It is astounding that I can say nothing negative about this most impressive and seminal work. I recommend the book to all ages, even grammar school children. I plan to read parts of it to my grandchildren.
Finally, I believe people like Eric Kandel are saints. Eric is my kind of a saint. The kind of a saint who KNOWS, yet lets his knowledge get marinated in the elixir of spirit, faith and transcendence, giving it the lofty status of being in the presence of God and better yet, dining with God on an infinitely rich intellectual diet. And yes, Eric is a Jew, who escaped from the Nazi’s grip and emigrated to America, where he received the opportunity to learn, to study, to create knowledge and to earn a Nobel Prize. Like many of us who are Americans by choice and not by birth, Eric appreciates America’s rule of law, freedom of speech, worship and pursuit of one’s passions. Yes immigrants are blessed by America, and America is blessed for having so many living saints, like Nobel Laureate Eric R. Kandel, a psychiatrist for all ages.
*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.