A Gifted Physician: Historical Erotica

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Robert B. Taylor, a distinguished leader in medical education and highly respected author of over 23 medical books. Each chapter presents a number of the fascinating tales of legendary medical innovators, diseases that changed history, insightful clinical sayings, famous persons and their illnesses, and epic blunders made by physicians and scientists. The book relates the stories in history to what clinicians do in practice today, and it highlights what all health professionals should know about the career path they have chosen.

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Front Matter Pages i-xv. Front Matter Pages Heroes in Medical History ab[Abstract. Pages Diseases That Changed History. Drugs and Other Remedies. Medical Words and Phrases. My final challenge was selecting a control group. After entertaining the possibility of choosing a homogeneous group whose work is not usually considered creative, such as lawyers, I decided that it would be best to examine a more varied group of people from a mixture of professions, such as administrators, accountants, and social workers.

I matched this control group with the writers according to age and educational level.


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By matching based on education, I hoped to match for IQ, which worked out well; both the test and the control groups had an average IQ of about If having a very high IQ was not what made these writers creative, then what was? As I began interviewing my subjects, I soon realized that I would not be confirming my schizophrenia hypothesis.

If I had paid more attention to Sylvia Plath and Robert Lowell, who both suffered from what we today call mood disorder, and less to James Joyce and Bertrand Russell, I might have foreseen this. One after another, my writer subjects came to my office and spent three or four hours pouring out the stories of their struggles with mood disorder—mostly depression, but occasionally bipolar disorder.

A full 80 percent of them had had some kind of mood disturbance at some time in their lives, compared with just 30 percent of the control group—only slightly less than an age-matched group in the general population. At first I had been surprised that nearly all the writers I approached would so eagerly agree to participate in a study with a young and unknown assistant professor—but I quickly came to understand why they were so interested in talking to a psychiatrist.

This is consistent with what some other studies have found. When the psychologist Kay Redfield Jamison looked at 47 famous writers and artists in Great Britain, she found that more than 38 percent had been treated for a mood disorder; the highest rates occurred among playwrights, and the second-highest among poets. When Joseph Schildkraut, a psychiatrist at Harvard Medical School, studied a group of 15 abstract-expressionist painters in the midth century, he found that half of them had some form of mental illness, mostly depression or bipolar disorder; nearly half of these artists failed to live past age While my workshop study answered some questions, it raised others.

Why does creativity run in families? What is it that gets transmitted? How much is due to nature and how much to nurture? Are writers especially prone to mood disorders because writing is an inherently lonely and introspective activity? What would I find if I studied a group of scientists instead? These questions percolated in my mind in the weeks, months, and eventually years after the study.

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As I focused my research on the neurobiology of severe mental illnesses, including schizophrenia and mood disorders, studying the nature of creativity—important as the topic was and is—seemed less pressing than searching for ways to alleviate the suffering of patients stricken with these dreadful and potentially lethal brain disorders. They know it, too: on a recent trip to London, I was proudly regaled with this information by several different taxi drivers.

Using another technique, functional magnetic resonance imaging fMRI , we can watch how the brain behaves when engaged in thought. Designing neuroimaging studies, however, is exceedingly tricky. Capturing human mental processes can be like capturing quicksilver. The brain has as many neurons as there are stars in the Milky Way, each connected to other neurons by billions of spines, which contain synapses that change continuously depending on what the neurons have recently learned. Capturing brain activity using imaging technology inevitably leads to oversimplifications, as sometimes evidenced by news reports that an investigator has found the location of something—love, guilt, decision making—in a single region of the brain.

Many forms of creativity, from writing a novel to discovering the structure of DNA, require this kind of ongoing, iterative process. With functional magnetic resonance imaging, the best we can do is capture brain activity during brief moments in time while subjects are performing some task. For instance, observing brain activity while test subjects look at photographs of their relatives can help answer the question of which parts of the brain people use when they recognize familiar faces.

Creativity, of course, cannot be distilled into a single mental process, and it cannot be captured in a snapshot—nor can people produce a creative insight or thought on demand. I spent many years thinking about how to design an imaging study that could identify the unique features of the creative brain. Some regions of the brain are highly specialized, receiving sensory information from our eyes, ears, skin, mouth, or nose, or controlling our movements. We call these regions the primary visual, auditory, sensory, and motor cortices.

They collect information from the world around us and execute our actions. But we would be helpless, and effectively nonhuman, if our brains consisted only of these regions. In fact, the most extensively developed regions in the human brain are known as association cortices. These regions help us interpret and make use of the specialized information collected by the primary visual, auditory, sensory, and motor regions.

For example, as you read these words on a page or a screen, they register as black lines on a white background in your primary visual cortex. To read, your brain, through miraculously complex processes that scientists are still figuring out, needs to forward those black letters on to association-cortex regions such as the angular gyrus, so that meaning is attached to them; and then on to language-association regions in the temporal lobes, so that the words are connected not only to one another but also to their associated memories and given richer meanings.

A neuroimaging study I conducted in using positron-emission tomography, or PET, scanning turned out to be unexpectedly useful in advancing my own understanding of association cortices and their role in the creative process. My team and I compared this with another system, that of semantic memory, which is a repository of general information and is not personal or time-linked.


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In this study, we divided episodic memory into two subtypes. We examined focused episodic memory by asking subjects to recall a specific event that had occurred in the past and to describe it with their eyes closed. And we examined a condition that we called random episodic silent thought, or REST : we asked subjects to lie quietly with their eyes closed, to relax, and to think about whatever came to mind. The acronym REST was intentionally ironic; we suspected that the association regions of the brain would actually be wildly active during this state.

This suspicion was based on what we had learned about free association from the psychoanalytic approach to understanding the mind. In the hands of Freud and other psychoanalysts, free association—spontaneously saying whatever comes to mind without censorship—became a window into understanding unconscious processes.

Based on my interviews with the creative subjects in my workshop study, and from additional conversations with artists, I knew that such unconscious processes are an important component of creativity. Samuel Taylor Coleridge once described how he composed an entire line poem about Kubla Khan while in an opiate-induced, dreamlike state, and began writing it down when he awoke; he said he then lost most of it when he got interrupted and called away on an errand—thus the finished poem he published was but a fragment of what originally came to him in his dreamlike state.

Based on all this, I surmised that observing which parts of the brain are most active during free association would give us clues about the neural basis of creativity. And what did we find? Sure enough, the association cortices were wildly active during REST. Once I arrived at this idea, the design for the imaging studies was obvious: I needed to compare the brains of highly creative people with those of control subjects as they engaged in tasks that activated their association cortices.

For years, I had been asking myself what might be special or unique about the brains of the workshop writers I had studied.

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In my own version of a eureka moment, the answer finally came to me: creative people are better at recognizing relationships, making associations and connections, and seeing things in an original way—seeing things that others cannot see. To test this capacity, I needed to study the regions of the brain that go crazy when you let your thoughts wander. I needed to target the association cortices. I was ready to design Creativity Study II. This time around, I wanted to examine a more diverse sample of creativity, from the sciences as well as the arts.

My motivations were partly selfish—I wanted the chance to discuss the creative process with people who might think and work differently, and I thought I could probably learn a lot by listening to just a few people from specific scientific fields. After all, each would be an individual jewel—a fascinating study on his or her own. My individual jewels so far include, among others, the filmmaker George Lucas, the mathematician and Fields Medalist William Thurston, the Pulitzer Prize—winning novelist Jane Smiley, and six Nobel laureates from the fields of chemistry, physics, and physiology or medicine.

Apart from stating their names, I do not have permission to reveal individual information about my subjects.

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And because the study is ongoing each subject can take as long as a year to recruit, making for slow progress , we do not yet have any definitive results—though we do have a good sense of the direction that things are taking.