I just finished reading The Center Cannot Hold, a new memior by Professor Elyn Saks of USC. Saks begins her first-person account of schizophrenia by chronicling her life as an undergraduate philosophy major, her time at Oxford as a Marshall Scholar, and her subsequent hospitalization at a British mental institution. Eventually Saks returned to the Unites States and began law school at Yale. There she had a second psychotic break that led to another hospitalization. Saks draws a stark contrast between the British hands-off approach to mental illness and the American system of restraints and punishment. This contrast inspired much of her scholarly work, which has focused on the legality of coercion in psychiatric treatment.
Saks’ success is remarkable in light of the fact that only about 10% of schizophrenic individuals have steady jobs. Saks has not only remained employed, but she has also become a leader in her field and a role model to many who suffer from mental illness. In fact, she credits her career as an enormous source of strength during the most turbulent periods of her life. Saks goes into more detail, and reads several excerpts from her book, in this video:
The Chronicle of Higher Education’s fantastic blog, Arts and Letters Daily links to reviews of two recent books: Making up the Mind: How the Brain Creates our Mental World by Chris Frith and How Doctors Think by Jerome Groopman. Both books receive harsh criticism, but ironically, neither review deters me from going to Barnes and Noble and buying them.
The first review dives into the ongoing debate about free will and the brain. Stuart Derbyshire, director of pain research at the Birmingham University Imaging Centre, argues that Frith has unrealistic expectations about the role that neuroscience can play in answering our most fundamental existential questions:
The fundamental mistake that Frith makes – and this is a common error – is to believe that agency or free will are products only of the human brain. The brain is necessary but it is not sufficient, and chasing agency into the brain will only yield disappointment or, in this case, a sense that agency is illusory. If agency is not merely a product of ordinary brains, then it follows that abnormal brains might not be the whole or only answer when there are psychiatric problems and delusions of agency such as in schizophrenia.
The second review applauds Groopman for recognizing the damaging role that bias and simplistic heuristics play in diagnosing disease, but chides him for offering no better alternative than clinical intuition. Instead, reviewer Charles Lambdin contends that evidence-based medicine is usually the best way to avoid mistakes. Furthermore, he attacks Groopman’s unscientific approach:
One would hope that a book entitled How Doctors Think would be about just that, how doctors make diagnoses, a topic on which much scientific research has been done. Unfortunately, Groopman by-and-large ignores this research, instead giving us a long collection of anecdotes wherein his doctor friends tell us how they think. And this is the book’s main failing, for if you were to write a book purporting to examine how some group of people thinks, you would have to do more than simply ask some of them.
Like I said, both books still sound like good reads.