S80 Chical
0 1992 I%wier
Science
Neurology ad Neurrmtrgeq Publishers
13.V. 1111 rights
94 (Suppl.) (1992) S8()- ~81 resclvcd
0303-8467/92/$05.00
CNN 00115
The neurologist as a true philosopher William Goody Old Sir&y, Brook, Godalming Surrey GLIB5LB (U.K.)
“When to the sessions of sweet silent thought I summon up remembrance of things past .....“. (Sonner~ William Shakespeare)
Summary This work is produced in the hope that the neurologist will learn to assert his commanding position (from the nature of his training and the special observations of human beings which his work is constantly providing) of that of the scientific philosopher. At present the discipline of neurology is toward divisive over-specialization, with a loss of that form of broader, even universal, vision of behaviour, of “living”, which our professional observations arc ever providing. Professor Dr. Bruyn may serve as an admirable model for us to emulate. As we contemplate the retirement of our colleagues and of ourselves, some of us already for beyond such a time and some scarcely aware of an inescapable happening at present so remote from themselves (as they suppose), we undertake to draw our neurologically-driven space-time vehicles alongside the highlighted vehicle of our friend who is approaching such a landmark, soon to be noted, celebrated, honoured. For a moment, for this moment, some of us may seem to superimpose our lifelines upon that of our friend, before our world-lines (rather than orbits, for WCare mortal) once more diverge into our own self-discriminating entities which are dictated, as the neurological philosopher suspects, by neuronal development, temporary stability and, inevitably, death. How may we relate the “Seven Ages of Man”, so well described by William Shakespeare in “As You Like It”, to inherited disease, birth injury, battle wounds of car crashes, the indulgences of prosperity, the anticlimax of retirement and (who knows when?) the appearance of the “lean and slippercd pantaloons, with spectacles on nose; and his big manly voice turning again towards childish treble pipes, and whistles in his sound”: and then “second childishness and mere oblivion, ... sans everything”? The clinical neurologist, aided ever more often by his tcchnological friends, is in an cspccially good position to explain to Shakespeare just what is happening. The pact thought it “a tale told by an idiot, full of sound and fury, signifying Correspondence 10:W. Goody, MD FRCP, Old Birtley, Brook, Godalming, Surrey GU8 SLB, Wormiey, U.K. Tel.: (0428) 682377.
nothing”. In the 375 years since Shakespeare died, we have better means of describing the mechanisms of life, even though we have gone only a very short distance along the way of curing the ills of living. Indeed we appear nowadays to be ignoring the principal problems of individual men and women while we provide resources for star wars, the visits of our vehicles to Mars, not to mention high technology warfare scattered over the whole world. It is perhaps too diflicult, too painful, to look deeply within ourselves; and so we turn to religions, philosophits, ideologies, sciences and technologies where all ills are externalized and attributed to anyone but ourselves. Those of us who believe that mechanisms of ncuronal development provide a language for a neurological philosophy arc in a position to make a new and perhaps more hopeful statement about human bchaviour and survival. It is time for us to show that our nervous activities, which we believe to be corrclatcd with a neuronal “machinery”, have the single purpose of enabling us to identify ourselves against all other backgrounds and other individuals. In language, so dcpcndent upon neuronal activity, our nervous systems cnablc us to have the concept of “I”. We may note that some 350 years ago Descartes declared “Cogito, ergo sum”, not “Cogitamus, ergo sumus”. We may bring Dcscartcs up to date by saying “Cogito, ergo estis”, that is to say, “Because I am able to think, therefort you come into existence”. And when we go to sleep, or sustain a head injury or end our own lives, everyone else disappears, as Housman tells us:
S81 llere
is a knife like other knives,
That cost me eighteen pence. 1 need but stick it in my heart And down will come the sky And earth’s foundations
will depart
And all you folk will die. (More Poems XXVI)
Neurological studies certainly tell us that each of us is separate, individual, personal, discrete. That is the principal function of nervous activity. WC can isolate our won collection of atoms, ceils, organs from all else we believe to exist. We are enabled to isolate ourselves from all others, who arc doing the same thing. We have to survive by overcoming all others. All that we perceive in what WC call “the world outside oursclvcs” has to be detected and then, as far as possible, convcrtcd to our sole purposes. So WC arc not part of some bcncvolent community, devised in antiquity, by a word (/qos), a noun which we use, each in his own language, to suggest the form of some super-human individual, such as “god”, God”; or of other nouns specifying non-human “gods”, “ but humanly-derived agents, such as “hcrcdity, evolution, providence”. On the contrary, we have achieved the complctc isolation of a separate entity. This achicvcmcnt is the triumph of nervous function, carrying with it the knowledge, the IIOUS, of having done so. If we accept simple neurological proposal, wc may positively accept the urgent clinical duty of propounding our own view of cosmology, thcrcby achieving “philosopher” status. To anyone who may point out that, in what some call “real” life, we seem to live in friendship at many diffcrcnt levels (perhaps writing retirement appreciations), cvcn at a time when wars and threats of wars have been overt and widespread as ever, we need to sugcst that it would bc wiser, more effective, if WC were to admit our ncurologitally-derived hostility as our primary driving instinct, and then, with better understanding, attempt some compromise with what our nervous systems identify as “other people”. It is through the CNS that we make the wonderful simplification, from our almost incalculable number of units, (organs, cells, atoms, sub-atomic particles) that “I” or, I suppose, “you” exist. We are aware that physicists keep finding, purely from neurological conceptualizing, ever a new “particle” or a new “galaxy” at a new degree of smallness or an even greater vastness of distance and time. Indeed, we owe the apparently abstruse notion for units in the realms of the outer univcrsc of the “light-
year” or the “parsec” to the space-scientists. represents 6 000 000 000 000 old-fashioned
A light-year milts. Bc-
twecn figures of lo”” and 10 ‘” wc find 10’. The neurologist will not be surprised to find these ligurcs for ourselves at the midpoint bctwecn these vast cxtrcmcs; for he is certain that the ideas, the figures, and cspccially the words of the scientist arc directly rclatcd to the amusing pastimes they have sclcctcd from their ccrcbra1 functions. Those of USC who spend our whole professional lives in studying higher ccrcbral functions have to accept rcsponsibility for expounding a philosophy for the common man, based upon our clinical findings rclatcd to the normal human being, and especially to the damaged human being. Only by an incrcascd dcgrce of human undcrstanding of the manner in which each of us constantly crcatcs his own univcrsc about him shall WC bc able gradually to improve relationships so as to avoid strife and to promote what wc call “progress”. If wc learn that WC‘arc obliged by our very form to prcscrvc oursclvcs only by agrcssion, then WC may have a chance of also devising some dcgrcc of harmony as well. Let us consider what Whitchcad wrote in his “772~ Co~zccp~ of h’ufurc” in 1920: We have found a strange footprint We have devised profound
on the shores of the unknoun.
theories. one after another.
to account
for its origin. At last wc have succccdcd in reconstructing creature that made the footprint.
the
And I,o! it is our own.
This statcmcnt was published 70 years ago. Few ncurologists have cvcr read thcsc words, because this is not the era of the complctc neurologist but of the ncurotcchnocrat, who promotes his career by the USC of any fashionable piccc of cquipmcnt dcviscd to screen him using his intcllcct in the manner which evolution has taken so long to achicvc in him. Gcorgc Bruyn, whom WC cclcbratc on this occasion, has been a man for all neurology - nearly 50 volumes of it: and wc hope that hc may now have more time to pcrsuadc friends, collcagucs, pupils to take the broad view of what neurology should bc. The neurologist has to proclaim himself as the lcadcr of a true philosophy, u.hich could assist the human organism to have a more enlightcncd view of what hc really is. This brief address of admiration, gratitude and affcction began with the lirst two lines of a sonnet by Shakcspcarc. It ends with the last two lines of the saw poem: “13~1 if the while 1 think on thee. dear friend. All losses are rcstorcd. and sorrows end.”
0 1992 I%wier
Science
Neurology ad Neurrmtrgeq Publishers
13.V. 1111 rights
94 (Suppl.) (1992) S8()- ~81 resclvcd
0303-8467/92/$05.00
CNN 00115
The neurologist as a true philosopher William Goody Old Sir&y, Brook, Godalming Surrey GLIB5LB (U.K.)
“When to the sessions of sweet silent thought I summon up remembrance of things past .....“. (Sonner~ William Shakespeare)
Summary This work is produced in the hope that the neurologist will learn to assert his commanding position (from the nature of his training and the special observations of human beings which his work is constantly providing) of that of the scientific philosopher. At present the discipline of neurology is toward divisive over-specialization, with a loss of that form of broader, even universal, vision of behaviour, of “living”, which our professional observations arc ever providing. Professor Dr. Bruyn may serve as an admirable model for us to emulate. As we contemplate the retirement of our colleagues and of ourselves, some of us already for beyond such a time and some scarcely aware of an inescapable happening at present so remote from themselves (as they suppose), we undertake to draw our neurologically-driven space-time vehicles alongside the highlighted vehicle of our friend who is approaching such a landmark, soon to be noted, celebrated, honoured. For a moment, for this moment, some of us may seem to superimpose our lifelines upon that of our friend, before our world-lines (rather than orbits, for WCare mortal) once more diverge into our own self-discriminating entities which are dictated, as the neurological philosopher suspects, by neuronal development, temporary stability and, inevitably, death. How may we relate the “Seven Ages of Man”, so well described by William Shakespeare in “As You Like It”, to inherited disease, birth injury, battle wounds of car crashes, the indulgences of prosperity, the anticlimax of retirement and (who knows when?) the appearance of the “lean and slippercd pantaloons, with spectacles on nose; and his big manly voice turning again towards childish treble pipes, and whistles in his sound”: and then “second childishness and mere oblivion, ... sans everything”? The clinical neurologist, aided ever more often by his tcchnological friends, is in an cspccially good position to explain to Shakespeare just what is happening. The pact thought it “a tale told by an idiot, full of sound and fury, signifying Correspondence 10:W. Goody, MD FRCP, Old Birtley, Brook, Godalming, Surrey GU8 SLB, Wormiey, U.K. Tel.: (0428) 682377.
nothing”. In the 375 years since Shakespeare died, we have better means of describing the mechanisms of life, even though we have gone only a very short distance along the way of curing the ills of living. Indeed we appear nowadays to be ignoring the principal problems of individual men and women while we provide resources for star wars, the visits of our vehicles to Mars, not to mention high technology warfare scattered over the whole world. It is perhaps too diflicult, too painful, to look deeply within ourselves; and so we turn to religions, philosophits, ideologies, sciences and technologies where all ills are externalized and attributed to anyone but ourselves. Those of us who believe that mechanisms of ncuronal development provide a language for a neurological philosophy arc in a position to make a new and perhaps more hopeful statement about human bchaviour and survival. It is time for us to show that our nervous activities, which we believe to be corrclatcd with a neuronal “machinery”, have the single purpose of enabling us to identify ourselves against all other backgrounds and other individuals. In language, so dcpcndent upon neuronal activity, our nervous systems cnablc us to have the concept of “I”. We may note that some 350 years ago Descartes declared “Cogito, ergo sum”, not “Cogitamus, ergo sumus”. We may bring Dcscartcs up to date by saying “Cogito, ergo estis”, that is to say, “Because I am able to think, therefort you come into existence”. And when we go to sleep, or sustain a head injury or end our own lives, everyone else disappears, as Housman tells us:
S81 llere
is a knife like other knives,
That cost me eighteen pence. 1 need but stick it in my heart And down will come the sky And earth’s foundations
will depart
And all you folk will die. (More Poems XXVI)
Neurological studies certainly tell us that each of us is separate, individual, personal, discrete. That is the principal function of nervous activity. WC can isolate our won collection of atoms, ceils, organs from all else we believe to exist. We are enabled to isolate ourselves from all others, who arc doing the same thing. We have to survive by overcoming all others. All that we perceive in what WC call “the world outside oursclvcs” has to be detected and then, as far as possible, convcrtcd to our sole purposes. So WC arc not part of some bcncvolent community, devised in antiquity, by a word (/qos), a noun which we use, each in his own language, to suggest the form of some super-human individual, such as “god”, God”; or of other nouns specifying non-human “gods”, “ but humanly-derived agents, such as “hcrcdity, evolution, providence”. On the contrary, we have achieved the complctc isolation of a separate entity. This achicvcmcnt is the triumph of nervous function, carrying with it the knowledge, the IIOUS, of having done so. If we accept simple neurological proposal, wc may positively accept the urgent clinical duty of propounding our own view of cosmology, thcrcby achieving “philosopher” status. To anyone who may point out that, in what some call “real” life, we seem to live in friendship at many diffcrcnt levels (perhaps writing retirement appreciations), cvcn at a time when wars and threats of wars have been overt and widespread as ever, we need to sugcst that it would bc wiser, more effective, if WC were to admit our ncurologitally-derived hostility as our primary driving instinct, and then, with better understanding, attempt some compromise with what our nervous systems identify as “other people”. It is through the CNS that we make the wonderful simplification, from our almost incalculable number of units, (organs, cells, atoms, sub-atomic particles) that “I” or, I suppose, “you” exist. We are aware that physicists keep finding, purely from neurological conceptualizing, ever a new “particle” or a new “galaxy” at a new degree of smallness or an even greater vastness of distance and time. Indeed, we owe the apparently abstruse notion for units in the realms of the outer univcrsc of the “light-
year” or the “parsec” to the space-scientists. represents 6 000 000 000 000 old-fashioned
A light-year milts. Bc-
twecn figures of lo”” and 10 ‘” wc find 10’. The neurologist will not be surprised to find these ligurcs for ourselves at the midpoint bctwecn these vast cxtrcmcs; for he is certain that the ideas, the figures, and cspccially the words of the scientist arc directly rclatcd to the amusing pastimes they have sclcctcd from their ccrcbra1 functions. Those of USC who spend our whole professional lives in studying higher ccrcbral functions have to accept rcsponsibility for expounding a philosophy for the common man, based upon our clinical findings rclatcd to the normal human being, and especially to the damaged human being. Only by an incrcascd dcgrce of human undcrstanding of the manner in which each of us constantly crcatcs his own univcrsc about him shall WC bc able gradually to improve relationships so as to avoid strife and to promote what wc call “progress”. If wc learn that WC‘arc obliged by our very form to prcscrvc oursclvcs only by agrcssion, then WC may have a chance of also devising some dcgrcc of harmony as well. Let us consider what Whitchcad wrote in his “772~ Co~zccp~ of h’ufurc” in 1920: We have found a strange footprint We have devised profound
on the shores of the unknoun.
theories. one after another.
to account
for its origin. At last wc have succccdcd in reconstructing creature that made the footprint.
the
And I,o! it is our own.
This statcmcnt was published 70 years ago. Few ncurologists have cvcr read thcsc words, because this is not the era of the complctc neurologist but of the ncurotcchnocrat, who promotes his career by the USC of any fashionable piccc of cquipmcnt dcviscd to screen him using his intcllcct in the manner which evolution has taken so long to achicvc in him. Gcorgc Bruyn, whom WC cclcbratc on this occasion, has been a man for all neurology - nearly 50 volumes of it: and wc hope that hc may now have more time to pcrsuadc friends, collcagucs, pupils to take the broad view of what neurology should bc. The neurologist has to proclaim himself as the lcadcr of a true philosophy, u.hich could assist the human organism to have a more enlightcncd view of what hc really is. This brief address of admiration, gratitude and affcction began with the lirst two lines of a sonnet by Shakcspcarc. It ends with the last two lines of the saw poem: “13~1 if the while 1 think on thee. dear friend. All losses are rcstorcd. and sorrows end.”
