Oliver Sacks - 15/12/1997

él es que pensó nunca Tama Dwayne Dwayne say que tenia pursuer do centro de vivre esta noche stall doto Oliver Sacks who neurologist a komodo intend amento sobriquet doin say you care normally da de gálvez accent-less auteur Tencent a quatrain z Villanova rocky on the professor genealogy at clinica nice College medicine Albert Einstein Olivia Brazil on Sasori taboo Devo Alito's de Auto Nico's Angela knowledge economy on Tripoli ma comunidade ons pursuing Capades Rivera schools coos OH - sadly visual basic see a few public are do Brasil might wanna see doodle is a temple despair attack includes a video region film it home mais non I study interpreted Robert DeNiro in Harvey Williams EMI so men's appropri storage always sucks in studio soda multi-part song le travail glioma Clinic in Ohio akan group of patients offloaded residue so no extra Bonilla Nardo moon drea us PDS a polemical you Salomon lava Drogo meadow conseguir aerospace en su estado Gillette Isaiah sutras ellos para más per toda vida normal maha prasat yeau mice for sequence personal involvement Posada medical coding error VAR e platinum se volvió gente que lleva investigation biographical ado si yeah human is Azam de práctica medica estas simple present a nasi des des neurologist a high-density del caño more compassion universe sooner hola hermano parent revista you met Oliver Sacks nessuno he knows confidence Elena cat doctor incommunicado semiotic Apella Pookie San Paulo critically desuka Dona Dona estado de Sao Paulo de programa metropolis ikeda eriko to de novo by telugu new doctor in ciencia de comunicaciones dodgy vivid building Kirito da fak u da de de comunicación de aqui aqui sample reporter Ricardo Bonalu need a for example a Monica Teixeira k-directorate programa sebt reporter who Jonah lista Lian Selva mr. Thomas it is clear especially in Saudi pública yo professor in Jerusalem George Pegula Hospital Albert Einstein Rada TV transmitting heat Nacional para todos ustedes Brasil Gomez program of agravado Washington is made was a non polar opposite giunta's aqui para nós and Chris Dodd dr. Oliver Sacks von euch total air sacs Milligan pursue President Aquino nos programa Luther Sachs short scribbled liver so be addressable so on livers of in shock a occur only become unidades un problemas ESO la voz your s : will be here to the studio s Kaleo Bichette don't even I feel they choose me I don't know that I choose them a doctor's life is full of chances and unexpected muscles I hear things but recently my interest has especially been not just in individuals but in communities where an unusual disorder is rampant but there have been a really a series of accidents and nothing very systematic in my choice of themes total sacks assure them represented as a stupid magic with discrete auras in the enormous como check of calm William Carlos Williams como de barajas Aquino Brazil my synthesis mosquito is a lahar Figueiredo neurologist a mere per volt AC he'll be assumed associa cells in three neurology literature a neo-pagan to his particular arrangement Sinan yes professor genealogist Marzuki and neurology ahiki in jagneauxs caused by probably data meant because jack nauseous propecia vuela Boris own intellectual Keyshia album winter's voluminous area daddy's first I think you were being very modest and admitting yourself from the list of doctor writers check off of course sometimes used to say that literature is my mistress and medicine is my lawful wedded wife and to feel that there was a division in him between the writing part and the doctor part where's with myself I feel there's no such division and in a way although I've had a range of subjects the subjects for me have always been clinical I have no writing which are separated for my from my clinical work although as you say neurology may be short on therapy I think it is long or narrative I think that many patients with neurological problems have extraordinary and involved stories to tell about the worlds which they have been thrust into and so in a way it seems to me a very natural subject which calls out ones ones desire to communicate their experiences into the tell stories so sleeves podracing Tata Young momiji Dada pequeñas Pharisee aunty normally dodgy yeah normally dodge beyond atado Brasileiro kg ski introduce a go contain world wahay and numa alleged adult on akuze yellow diamond so level King the chorus air nor mouth there is a story by HD wells which are set in Brazil and where this proverb is quoted where a sighted man finds his way into a community of blind people and he thinks he is going to be king and but and that they are very defective but when nightfall comes of course there no lights he stumbles over things and then they start thinking he is defective and also subject to strange hallucinations caused by these pathologies in his face which he calls eyes and finally he falls in love with a girl in the village but the elders decide they will only permit him to marry if he consents to the removal of his eyes so that he can be normal like the rest of them I think the story brings out that normality to some extent is a matter of social judgment and an context an opinion but obviously only to some extent now this story was very much in my mind when I visited the island of the colorblind where a large number of people have no conception of color I think to some extent they thought of us Kara normals as preoccupied by color as as obsessed with something non-existent or probably trivial the I think one has to distinguish a medical frame of reference from an ethnic frame of reference one can say in medical terms that these people have no cones in their eye that vital visual receptors are missing and of course they are abnormal but they themselves construct worlds with what they have they are the center of their own worlds and they do not have a feeling of being defective in their own terms they are normal and so I think one always needs these these two frames of reference King aloo it came nowhere nowadays implicado cookies was sleeping sobbing mustard Sociedad zuman so complete a Lucas T for music r zu zu fume memory quality passed on a premiere again Hangzhou he the repaint she was local zuma-zuma sign that he disappeared Sabina Kelly moment or a boon to my sad you with my SingStar to Saluki Part C particle Academy if you see an attack upon Telugu remote constants also co-author me okay the D Finch map is swap probably and Luca was Montessori Kapoor tell me remain with the interval this is certainly a matter of phone of continued argument with people like Lang and especially Thomas s on one side talking about the myth of mental illness on the one hand I think there is clearly a biological and neurological disposition to to manic depressive disorder or schizophrenia to use some of our medical names but equally I think the the shaping of these biological conditions depends very much on the personality on context and they may also be seen as attempts to redefine purpose and meaning in one's life so they are exist tential adventures on the one hand and biological illnesses on the other and it's it's it's complex and i i've known a number of people who have very much regretted having been given tranquilizers and treated and not being able to explore a psychosis in its own terms i I don't know where where I am I stand here our valet zone jompa said yo ma stenosis vidoes a sarcoma estrella young respect fundamental notatum antenna condescending cars cerca de tocqueville ozone technological NK Mo's d que NOS quedamos therapeutics commendation surface energy patina do futuro mode are completamente Seguros Jana Mentos as the conclusive pika methi bhujia demise important iki evolution Ament job service owing to match capacity um well until relatively recently of course diagnosis in neurology and neurosurgery depended very much on the diagnostic skill and experience of the clinician and neurologists were known above all par excellence as diagnosticians now as you say much of this role can be taken over and usurped by brain imaging and other forms of technology and I certainly know some colleagues who feel they may be out of look that they may no longer have a a role to fill no I I am very true technology myself it would be mer to be otherwise but I'm also very conscious of that it can encroach or may appear to encroach on on the doctors role or the human role but I don't really think it does because I think that the the diagnosis is only am establishing the diagnosis is only a part and a small part of the total relationship of doctor and patient and there all sorts of questions of judgment and feeling which will still be there I think that technology somehow has to be incorporated into the relation Martin Buber used to say we must humanize technology before it dehumanizes us and I think this is this is a very present problem right now for us so leave a comment luc besson little Sachs the factory Tomoko Harry Potter's approximately aqui básicamente all a person Thomas opportunity Romans Don jagneauxs Chrissy satisfies means no one spoke whiskey Tarkenton Kasich Athenians Ellen way of Paris oh now Alan ten days energy from Jesse and jagneauxs cada una palabra de Kasich episode atrazine in Contra Amador so so much half the program so no sales compass so soon reg1 ceremonial feeders and clinical exam I'm not sure how it is in Brazil but certainly it sounds as if maybe a situation similar to the states where where there is a diagnostic Bible called the diagnostic Statistical Manual and here every diagnosis is arrived at by a handful of criteria of symptoms the I mean you are deepening the question which which your colleague brought up and this is that a diagnosis is not enough one has to think in terms of the process which is going on and and its impact on the person's life and I'm very struck having worked for many years at psychiatric hospitals as well as as neurological and geriatric hospitals that sometimes the old charts from the 1920s or 1930s are much richer in clinical and human terms than the present ones which may list a few symptoms and give a diagnosis and tell one nothing I I think there are many dangers in this not least the fact that that information is a great casualty I think it takes many many hours of listening and attending and thinking to get any idea of what is going on on a person in their life you may be able to make a technical diagnosis in two seconds I can look at someone a mile away and say that parkinsonian but that's only the beginning I don't even need a cat scan doctor sax mr. Shido to ignore school sewer is gravy another presenta science Fatah's as lives do neurologists who sue alexander Lauria alexander from nvidia q su propio the ng umaga Monica alcohol Gloria Hickey taqueria TT residue inventor open air o escritorio general hormones in neurology in town circle Acharya nest nest this general you know pebble Thalia nausea instruments in neurological tambay instrument au g de agosto Equus - no sabemos tsuki illiterate - de gallo mass keep going asiye creek listen tom walker go to the garlic are you an engine kicks or asakujaku no squad gentle practice so acute and generous girl okay sir judge ignores ah you've asked a lot of questions between let me think here um now louia himself the the great russian neuropsychologist too over these terms of regarding the classical scholar and the romantic scholar the classical scholar who is a meticulous analyst and examines all the details and the romantic scholar who puts it all together for him romantic science and romantic neurology consisted in trying to give a portrait of a person's mind and life and behavior as a whole but he also says in his autobiography that he was divided from the very start regarding the strengths and weaknesses of two complementary approaches one of these he calls nomothetic and the nomothetic approach is diagnostic it looks for a genus of disease and the other is IDEO crap IDEO graphic which is concerned with presenting a unique individual now in fact in his two novel like books which he only published in his sixties the man with a shattered world and the mind of an eminent incidentally Peter book is making a film of the mind of an ominous T in fact one finds an alternation between these two approaches I read the first ten pages of the mind of an eminent thinking it was a novel actually thinking it was a M it reminded me very much of Boris short story fumed the memorials and then there were technical details Numa thetic details which made me realize that it was a study as you say the the romantic part will make such studies sympathetic to artists which is why why Peter Brooks say has been interested in making a film of the mind of an analyst and perhaps why his he's made a play from some of my own work on the other hand the the details must also be put in and it is very very difficult and whether it's in principle possible I don't know no this is discussed in very general terms by by the philosopher Hume when he compares the artist with the anatomist and Hume says that the but whom insists that an anatomical analytical knowledge is essential to being an artist I what uses a diagnosis to a patient it may give the patient some sort of anchor I think some patients certainly want to have a clear grasp of what processes going on in them its nature its possibility is what may be done about it other others may not want to know virus disguises casino gelatin devezin cuando parece a tendency to pop a therapeutic og fallacy mundo de la zona mentos entry arch ECAC sera que nos podemos pensar que sigue la zona Mentos Gomez and Oh Cerebus well I'm not quite sure how to approach an answer let me first think back to my awakenings patients who even before they had been given l-dopa would sometimes respond to music in a remarkable way these people were often frozen and unable to move or speak but sometimes a person who couldn't walk / dance someone who couldn't speak could sing and music words would liberate them for a little while there are many other sorts of role which music can play with with neurological patients but we of course we we all respond to music one of the things which interests me and which is hotly under investigation at the moment is what parts of the brain become active in the response to music and in different sorts of music are the separate parts of the brain which respond to pitch to rhythm to Tamara it's known that an Lauria described how lesions on one side in imminent conductors how lesions on the left side of the brain might sometimes remove the ability to analyze music might remove some of musical intelligence but allow full emotional response whereas lesions on the other side might allow full emotional response but there's no one the wrong way around and the and one knows for example that naive listeners so-called listen mostly with the right half of the brain and as they become more sophisticated the left and linguistic half one also knows that there's an interesting condition called Williams syndrome and that this is not Robin Williams it's another Williams aye it's rather way only about one person in thirty thousand hazard but children and adults with Williams syndrome as well as being very precocious verbally and socially are those precocious musically although very defective in many other ways they can't tie a shoelace they can't cross the road and one knows of them that the entire auditory system from the primary auditory cortex right up to parts of the temporal lobe are enlarged and other parts of the brain are smaller the it's such a no I am but I I'm sure sort of the sort of thinking which which is central to art and also which is central to science must originate in the blame one knows that narrative the power to give narratives develops very early incidentally it has very high in people with Williams syndrome and I think narratives are one of the first forms of art the ability to understand paradigms or theories comes later I'm sorry I've got myself at well labyrinth this judge sees a body dodgy mangy materia attack upon to stratum into the todo es mejor de novo genome to influence my espresso Chivas don't read so now in true care materia you kiss a year a mange calles Amakusa me to complicado you see deafening here Youkilis opinion Sabri super key is aesthetically foremost rock Egidio English Romantic for language without recursion English what's mind it doesn't matter what's mirror it doesn't mind como se facilitate an immense luma pursuer Oh mismo tiempo tratan de materia autonomous instance a chemical siripu civil traffic Susan problems neurons whose name appears pings and robot Bill King boots assume a substantially new doesn't report a meal to the other and well I think you've reversed the deepest question of all and the the separation has been strong since since Descartes who thought in terms of two principles and an immaterial raised Kaja turns the mind and and a spatially extended mindless body the which which moved automatically and had a reflexes he he regarded dogs as automata I don't think he could have had a dog because a dog clearly has a spirit of personality Lucas or some complete immune to do see God oma a pebble toe you can poke my spiritual leaders of geography eventually think those the titushki short answer would you saw their feed in general or justice so pious or mine for whom there was no role of justice okay Marcus a harsh music but in Japan Giotto critics also freely Shakira's yeah they're good they're called SS those quizzes they've over neurology or porous do is going to deliver a novella here well I think they both had an influence I should say that though my parents both trained in neurology neither them stayed in neurology actually they couldn't stand it and my father became a general physician and my mother became a general surgeon I myself like my mother and others my family certainly had migraines from a very early age and not just the headache part but the visual part in which one might go blind to one side will lose the sense of color and these both fighting and fascinated me and I think showed me very early that the world has not given to one except by grace of our brain which which works normally I think it's probably no coincidence that my first clinical work and book was on migraine although the dealt much more with the thousand patients I'd seen however I will not divulge the identity of case number 75 sex not sporting sentiment for King is due to heat and Rosalind but hello my auto dolly Dodge to be mrs. Colossus Alma associates a mood for entry doing itself paramedic para neurologist every sister school year uma definition yourself a procedure subject itself is sure Scalia woman they are do anyone any societies I'm not entirely sure that I I follow you I wanna secede IgG is cornea n3 Kiki ourselves protracted itself I think that the self is not something which which exists in vacuo like the Cartesian self like the cogito ergo sum I don't think you can know yourself from cogitating I think you know yourself in relation to a another person and you might say mo ergo sum or something like this so I think the self of both the physician and the patient developed together and they develop in interaction and and it's the nature of this interaction and this intersubjectivity to use the jargon which to some extent defines what aspects of self are are active in both and perhaps active in a collaborative and positive way and perhaps that's the negative way so sacks as follows improve our pork especially stimulus Bozek ice Machiavelli Madeleine G McGowan Cassidy percents spirited Zi mo music eyes this one oh gee O'Donovan see palomito concetto de neuroplasticity syria capacidad e OD face - Torah sounds - two days no no nice Oh an indica pathology achieve our hardest Christopher's in theory community adore messiness commercials is a new Placid an EMR someone has observe a sois todos of a year use death to establish these teams inhale our San Jose so talented na Ltd macaroon at immunity Buddha Kumu stimuli society escape she puja so put the refers they said you must sound for example como música muscle socio some beauty mechanism cheap would you say to Moodle saleable I think there's been a profound change of course which were all very aware of in the last 10 years allowing how much plasticity that may be in in the nervous system certainly in my training days we used to use terms like pre dedicated for parts of the brain it was understood for example the part of the temporal lobe were dedicated or committed to to auditory processing but it's um it's come up very clearly I think it's a beautiful example of our cerebral plasticity with regard to people born death who use sign language one has very nice physiological evidence that the auditory cortex has been given another function that's been reallocated for visual processing I think this is sort of very spectacular I think one I think the degree of recovery and rehabilitation which may be possible after a stroke or after the resection of a tumor would not be possible without tissue new tissue taking over some of the lost functions although clearly there's a limit to which this can occur the you are generalizing here in terms of learning and clearly all learning involves changes in the brain and learning is possible to one's death I know I've had a little example of this myself because recently I've been going to a swimming guide because I wanted to to alter my swimming and that some is interesting learning a new motor skill in one seventh decade it's not as easy as in your first or second decade but you can do it and I'm sure that if one has or had sufficiently sensitive brain imaging you know one could see some of the changes which which had occurred within limits experience constantly molds the brain and and so the the brain is as much a reflection of of experience as it as a predetermined that I mean for this reason all our brains become personal you could have a heart transplant you have a liver transplant there may be some problems with rejection there is a certain immunological identity in the heart of the liver but there's no personal identity on the other hand I don't think you could have a brain transplant because your brain is yours and your brain is you and here we're coming back to the duality in cuy Freud enters Marissa's Couture esto se llaman majeeda Hetty Rondo the Friday discussion sobre prices el stereos daily respond DoCoMo literate problem enter plain resin of libro reduce dr. Lucas Chivas census on daily lives Ephesians resentment Scriven McKenna can attest Oprah New Yorker Chianti steamy Mario's quasi literary Meadows Cersei sent me grando para literature escrito senso-ji Hamza Cindy skoland do sales team as originals so vanilla regime its inner parama purification the a curious way of in a way of criticizing or perhaps less valuing for its sounds would be to say here's here's a writer and this is something which he which he sometimes said of himself no I agree he is a splendid writer and the seductive quality of his writing and the way in which in imagination he anticipates various objections is and I think the sheer beauty of a narrative sometimes carries one along the for myself although I may have some excursions of one sort and another into non neurological realms and there are some botanical excursions in my new book and there was a swimming excursion and the new yorker thinking if that's the way you're you're referring to but but for me these are excursions and and since you talk about self I think my central self or central identity does have to do with being with patients and and being a neurologist my if I have an X book I could never never really anticipate I think my next book will be on on Aging and this is going to involve amongst other things a very close look at things like Alzheimer's disease and it's what goes on in the brain and has impact on the person the family the community so I I don't think I am in flight from the phone - lunacy dr. Nichols he is not as jihad apparent in Morris as not as the union live apart the sobre la susa's my cigars you know spies copper s mu deliverable to nefarious toilet around who kills with coq10 to the solution in school even koala sinuses today well you're right footnotes are are very important to me and I I have to say my my publishers will not like this that in the last two weeks I've added another 15 footnotes to forget the future editions and the it seems to me that on the one hand one needs I think to have a relatively straightforward narrative or argument it must be tight it must be coherent it mustn't be diverted too much but on the other hand different points in the narrative or the argument may give rise to reflections may may make the mind meditate on other things and the sort of the side trips of the mind the excursions become the footnotes I if if I didn't have footnotes I think the book would meander like the Amazon although it would finally get to its destination like the Amazon but the but but I love footnotes and since you were talking about autobiographic things my some of my earliest experiences were seeing my father read the Talmud and in the Talmud the central script has commentaries and commentaries on commentaries and the idea of this sort of sort of delights me a friend of mine in fact said I suffered from comment area although I don't know that this word will translate into Portuguese little sacs Sharath sit down your mother's davis QV sure do sit down changes social and other one como the range offense at door - okay so icky tensed Desmond etiologic a circus or who make our concepts on auto stocks gee kweku Shari's concern basic arrangement concern be else agro manures he also Gisela concert of respondent promote released so cerebral for say they also know sulfide Tomo Jassi as it's part of your mouth so sort of here Mikey a also will second Lucas yoga also second exclusive amazing keep while only me to geez well first not just ones vein but one's body so for example the stomachache somewhere Wittgenstein says that the the human body is the best expression of the human soul the I used to be tormented by dualisms of one sort and another for many years I know that when I thought very much in computational terms I used to say well okay this there's the hardware and the software but but there's also me and this was a sort of version of of what are sometimes called the ghost and the Machine and but clearly the brain if one insists on calling at a machine is not like any man-made machine or any other machine in the universe and precisely because it it is so plastic and it it becomes individual now Adelman is a great neurobiologist who got a Nobel Prize when he was a young man for his work on the immune system and for defining the notion of immune identity how the immune system recognizes self and not self and we spoke earlier about heart transplants liver transplants and these these are questions are immune identity now in the last 15 years Adelman has turned his attention to the brain and the question of personal identity and he has brought together a very complex multi-leveled theory which which I really couldn't couldn't attempt to to condense which at least provides a possible way in which experiences will shape the brain categories will arise and be further categorized from percepts to concepts and the mind and the personality may be then then embodied in the brain to protect our case against them what mode are said because in the West O'ahu deceive us all new to dismiss or keep our DeFazio portamento más pequeñas KCMO comportamiento podgy the vedas in Kodama format for solomon the same um well absolutely this is this is always this sort of the nature-nurture now um no one is more conscious of the details of neural anatomy and physiology and chemistry and genetics and embryology and evolution than the Adelman he gets furious at people who who think in terms of quantum consciousness and don't know enough about the brain and yet he makes a point that say even in identical twins the details of neuronal circuitry will already be different at birth because it's not just genetic determination but the migration and death of nerve cells during pregnancy which will contribute this so already at birth people are disposed to interpreting to construct a world and to construct their perceptions in different ways and they go from here obviously the sense of biological constraints are always there one is not free to become anyone one is not free to become a Mozart all the neuroplasticity in the world won't help him become a Mozart you have to have the right you have to be born with the right nervous system to become a Mozart though being born with the right nervous system is probably not enough you may need the right opportunity isn't training and encouragement and everything else so I think Adelman has simply helped one refine some of the the eternal the sort of notions of nature and nurture those cells Leo speak a bit insecure el mágico so jetties emerge cookie know I've been a strata but since no the large coos come come vehicle but since the ostriches at my request is present neurological village Tammy no no fume you tempted spatter who keeps her rationed at all consume to the distinction magic New Moon's Germany Ruggiero notice pallavas so dashiki no system at all just in semantics you'd be were on a mile passers-by uses our God but match with first mention a couple sofas I think my way of practicing medicine is in a way old-fashioned and in the traditional way and I think it it needs to continue and medical systems have to allow it somehow otherwise there will be and one sees to some extent there has been a severe sort of breakdown of relationships between doctors and patients patients will feel that they are not being paid attention to that they are treated as objects doctors may feel that they are being treated as objects as diagnostic machines and and the whole my father who practiced medicine almost till till he was 94 he always used to say medicine as fun it's a great fun and he enjoyed medicine and I think that the fun and joy as well as the is is a risk and but how fullness of relationship can be can be kept and face of all sorts of economic restraints and and technical changes I you know is a huge subject but it must be kept dr. Sachs in careful on books oblivious to appear appear nakusoo rose oprah sequoia a new momento de cooper assume no great momentum are cookie el Tambor momento de grenoble is a little humorous Ratna piece in the post phenomenology Fantasma the permanent called fantastic interest critique e hecka para Mikkel momentum música de perma Tomczyk you poke the music in went to fat Estella Pacheco my snow Nigella some contrarian recupera song the music at is ice time Trista Caden to the core he yes a musical the poisonous bleak intimacy chief whose duffle solamente do Systema nervo Superferry camuto important want to sustain maneuver central the yoga status of explication book Milan yes Tom musica the parents um well first of all I need to say that although in the preface to that book a leg to stand on I call it a neurological novel it was not fiction and that would be indiscreet to show you the scar although I must say I have an impulse to do so the one certainly sees rhythm and grace in in in the movements of animals in my biology days I was fascinated by animal movement and the patterns of movement and and I still am the Harvey who described the circulation of the blood also wrote another book on animal movement although in a strange way this wasn't published or three centuries after his death in the first half of the book he had gone to Galileo's lectures in Padua when he was a young man and he attempted the Galilee and analysis in terms of a mechanical analysis of movement in terms of inertia and momentum in the second half of the book he he said that this was not enough and he spoke of the grace and rhythm of movement and he spoke of movement as the silent music of the body the this grace of movement is is unconscious I think if one becomes self-conscious one tends to become awkward and clumsy and and and manner istic it's it's unconscious it can be knocked out by various diseases for example with in parkinsonism movements can become wooden and and an almost robotic and instead of having a graceful rhythm there can be a sort of festive a stutter I had one patient a music teacher who said that she had been unmusical by parkinsonism and that she needed music either the playing of music or the imagination of music to enable her to to move I mean this is a metaphor although since you mentioned lawyer' lawyer' often speaks of kinetic melody in in these terms and one also wants to speak about the orchestration of movement and the harmony of movement when I wrote about a a surgeon who had had Tourette's syndrome with the sudden violent convulsive movements I couldn't imagine you know what sort of life he had and when he told me he was a surgeon I was incredulous and sort of said you know you had sort of cut the aorta and to what one saw when he was operating was that everything was orchestrated and focused and one one really had a feeling of a a musical organization sort of dominating the motor system and dominating the attend actually I forgotten there was no question I you my struggle were not dancers Kishore consciously then we started Russia Anka chasing me to head total stars only went to the style of Suez II there was a continuous pre mirrors lessons at responder condo I'm Alan so icky so lyrical overall akiko fujita Samuel a constructor of King yoky gotta be a political tour today Dickinson stories to show that the suspicious open serious and stories to shore and TV TV has paid to temp we in education we are more rational proper Oviatt over there for 40 minds in contortion were afraid this personage exudes quite squalor 7kc lucky my stock was working 12 surmise see then she cold came so my goes to they all enchanted me the most at when I'm attending to a person I'm thinking about them they seem the most interesting in the world and it's some I feel similar say with all some of my students if I'm asked which you know which is my favorite student they've all be my favorite students fear so I so I'm not I'm not sure that I can really really select but I I think among people I've seen recently I have been very deeply moved by Temple Grandin the remarkable autistic woman who is a professor of of animal psychology and arrests such a deep grasp on our a passionate sympathy for for the feelings and the thoughts of cattle but as so puzzled by human behavior although she always says she she she studying us very closely which is why she calls herself an anthropologist on Mars but in a way so much is missing for her and yet she is searching for meaning and satisfaction and love and work as as we all need I think I've been especially moved by her but I'm especially moved by everyone I see certainly by everyone I write about dr. Sachs and you know mommy did nummies Molina desappear Volta so Steve's own bestsellers wounded or killed Shana Shakya tried turned to the tourists are letting leave those so Bri syndromes advances meant eyes or neurological the amido G their humid as a single mothers dresses ome speci G preserved Okuma Morrison didn't tear s advance important to Lando libros existing with the sweet mustard well um well I think these feelings may enter and be stronger and some people but I'm sure they are not the main attractions I don't think these are very sort of attracting I'm first I think um I think there is a great wave of interest now in the brain of the mind as as there's a great wave of interest and you know at the other extreme in cosmology and the new physics and people interested in the birth of the universe the Big Bang but they're also interested in this three-pound universe which which is the brain and which is which is us and so at one level I think my narratives musings sort of pondering the relation of brain to mind and brain to identity interest secondly I think my stories are not just stories of disease and and fear of disease and gratitude that one doesn't have them I think they're stories of struggle of negotiation sometime of survival sometimes of transcendence and and I think the the idea of battling with the disease or living with it or even in a strange way turning it to creative use or finding some advantage in it but not in a perverse way I think I think all this can be reassuring so I mean I think of many of my patients as here it was not as pitiful but as warriors and as heroes and and Luria often does the same and many patients do the same thirdly and then I'll stop because I know thirdly I think that perhaps in in this region which is a fearful region a human voice is somehow we are showing and this is not sort of the the cold voice of the doctor giving the statistics for Alzheimer's disease but but but another sort of voice which which somehow may make the reality more more bearable as well as more intelligible but I I don't know Corleone complements in some Scalia pedasi medicine apply clinica and Kim in numerous ways to sure no puja a oh furgus a accordance quake ashore along the todo su experiencia con man kuku mathur perspectiva geo view percentage diary vlookups enforcer customized all dragon newsmen who make you surely do construing potential jurors of the immense problems whose meta-genome a chip see propolis Salah al Mustafa promesa Naidu's magic a despotic forgotten I ask you sir she doesn't owe me toss wins can contrive um well I think this is a reason why both of my parents as I said clerk neurology and couldn't stand it because um if you are a surgeon um you may achieve an important change straightaway we'll see what you've done the workers before you and and and if you're a general physician you save someone's life you treat an attack of asthma or whatever and as you say much of Neurology many newer is deals with incorrigible or seemingly incorrigible disease and damage now the awakenings situation was a was a rare exception and sometimes other patients would come up with with multiple sclerosis and and with strokes and with other problems and say I wish I had sleeping sickness you know I wish I had partners then you could do something about it but and one of the other things I described in my new book there's the island of the colorblind but I also speak of the island of cycads where which has Guam and these primitive trees grow all over the island but there's also a strange terrible disease on the island which has really a progressive fatal disease of the nervous system which has some similarities to the the post encephalitic disease and maybe due to eating the trees but I my colleague whom I went round with we did house calls sometimes I would see him weeping at his impotence he never he didn't show it directly but the I think that if you know the therapeutic desire was an exclusive on overwhelming element in me I couldn't bear urology but since the desire to understand and curiosity is at least a strong this makes it more tolerable but but you mustn't suppose that I am you know I wouldn't want to see things different and I'm very excited like all my colleagues that some of the advances were seeing now some of which depend on neural plasticity or neural transplants the finding of nerve growth factors and and continually more refined knowledge I think more and more look 10 years ago it was never thought that you could have any regeneration of the nervous system and now we we know there can be some and and people also one could also have neuroprotective medications and the I don't become too depressed by the implacable nature sometimes of neurological disease on my own therapeutic impotence what does upset me and profoundly are questions of mistreatment seeing people not cared for seeing negligence seeing cruelty seeing indignity and and and and this is very different because because here one is not dealing with with with an aim or nature but with with among human beings attentively police permission was granted centers of burns in cidades comes on power for example Chris Amer to G do a Stockholm Syndrome panic a policeman scarcely the present al maseeh Tama prozac for exemplary concept abhava karati am observes a mood stems are Christ Muslims no good laissez-moi lava pit amiable deciduous as neurologically they near modern advances there are no actors Houdini's disease see I certainly think that some stress in modern life and modern cities whether it's greater than it's ever been I don't know I'm sure it takes different different forms and and in the city of thirty million there are great many forms that can take the I some of us I think has to do with physical in a way partly physical problems like like congestion we all need space animals need space if you have thirty million people in one place you're on top of each other we are very crowded here traffic jams are particularly intolerable you can't get away from people noise and smell are all around you people don't have gardens this is very much the case in New York which is a city of apartments I think one has to have contact with nature one way or another I think that the number of meaningful I think meaning and work may may get less the artisan is disappearing we've said earlier the the pleasure and meaning of Medicine of being a doctor itself come can be threatened what else is happening well as they say no to quote Nietzsche God is dead or the forms of spiritual security and comfort and Dogma are under attack and and and can't and can't fortify many people as before and we we break down in in in different ways the as a doctor my first work was with patients with migraine now migraine is a neurological disorder a physiological disorder the disposition to it is probably genetic but the pressure to have attacks may depend very much on the pattern of people's lives and I feel in a way that that I partly got a picture of the stresses of life in New York through the pattern of my patients migraines I you know I'm so long windows I think it I think Nelson ethylene was the really fashionable Boonton actually helped me to thing is the clima catastrophically suggest no happiness it's just keep their system what you would yelling a crazy introduced a multi no second now Secotan even cannot do know since a mother myself he'll meet you myself asuma changing into courage or being to G do answers has attention to estrellas so the two dresses be enticed II the being a parallel American attested appears biological time it was a commutation Pitino he'll assume el papel that novice has been ties is so busy as Australia yeah dude that'll appear biological compared aku objected appear classic for Journal in the States at least the the pendulum has has swung strongly in both directions I think prior to 1960 there was a strong emphasis on psychoanalysis and counseling and then when some of the tranquilizers became available the movement has been very much more to a biological psychiatry I I think that both are needed in in many people although one might say that there are economic considerations which disposed to two using drugs if you can titrate to someone if you can get someone with with manic depressive disorder on the right dose of lithium then then perhaps you don't have to pay attention to them so much but I I think that with the common ah neuroses that counseling and therapeutic attention are relatively of more importance than drugs and in the in the psychosis drugs may be crucial but I I think there's a very very strong place for for for both and you know if I can mention for example because he himself has brought it out publicly Robert Hughes the Great Australian art critic who has recently brought out a wonderful book on on art and a wonderful television series but the pressure of this cause the sort of breakdown in him and made him drink heavily and so forth now he is written about this saying that drugs and psychoanalysis were of equal importance to him and that although the analysis would not have you know he needed drugs to become accessible to the analysis yet the analysis by tracing chains of vulnerability back to childhood as sort of was also crucial and so is so in general I would say I think I think a balance is needed and I think it's also needed in in neurology and in all of medicine dr. Sachs certain manifested interest pukani dodges a neurology a Paris intercept of individuals who cerebral individual quando who cemeteries vibe para comunidade as a neurology anthropological must podium spin sake which this tube is neurological something to rise well in a culture there may be some genetic disposition or some environmental threat as I described in my new book so on the island of the colorblind the normally extremely rare genetic condition of total colorblindness total daltonism equal Matassa one and fifty thousand and the general population the here this condition had become very common through intermarriage and isolation on the island of guam their suspicion of some physical environmental cause whether it is a a disease agent or the psychiatry is or whatever it is but i think this isn't your question no question as whether the thoughts of an individual or a culture can produce a neurological disease I I think not although this this may depend on how one defines disease but it may certainly shape the disease to some extent for example Tourette's syndrome which I'm very fond of and as you've seen and I find something liberating about the convulsive but in them I travelled with a friend with Tourette syndrome in many places over the world and it it was most easily accepted I should say in Holland and especially in Amsterdam wherever anything goes and but it was least tolerated in Japan and in particular I was struck by the fact that in Japan vocal Tourette's vocal outbursts are almost non-existent but perhaps motor turrets and sudden movements become exaggerated so I think here one has a cultural shaping interestingly a turlet like syndrome is endemic in some places in Indonesia and Malaya and is called Lata and the people with Lata have a special social role in the community they are regarded in a sense as as as innocence or fools who who are compelled to utter the truth in involuntary ejaculation so and those fair goodness oh my goodness that is equally pace or Jacksonville on the dam Scylla to health conscious circulatory loud bang from her fleece anxious tears in my eyes cuando está historian Amano pero no % o conscious part economic our own idea who any as a premier yes segunda hello song of a zoo taps he raises is a contest magenta belong tape 2 percent voted or chronic in que vas a technical many condos Iroquois animal farmer me to be known via como percent non poder me Laura my zealous purses tear us apart salacious races you seem Toma module Alicia cake about say important not part of segment de vida de passe um I had a little difficulty hearing some of the second question but let me first address the the the first question I think I wasn't particularly afraid either watching him operate with or watching him fly he did refer to himself as the world's only flying Torretta surgeon and he did to it a certain amount while he was flying if he would touch himself and touch the windscreen and at one time I did have a fantasy that he would he would try and touch the propeller of the plane or that he would he would spin the plane people with Tourette's often they fonder of spinning or do a somersault or since people with - it's like sometimes to play with boundary conditions I thought he he might go with him within sort of 2 foot of the mountain tops but if he did but I never doubted the sufficiency of control with with either now I'm afraid I didn't entirely Hidden Dragon Quest the second or similar case now she will show a kddeitrick as Jesus I'm undertaking some juice in Toma all human race demarcation season 420 nama not a sign no segmented Aveda there will serve to specific oh yes absolutely the I think I first felt this when I worked with patients with migraine when when as a well one couldn't dislodge the migraine without something else and hopefully something healthy to take its place I remember this occurred to me very strongly with one patient who you always used to have migraines on Sunday and then I gave him some medication and he was delighted the first Sunday the second Sunday he said he was bored he had nothing to do and the third Sunday he had an attack of asthma and when I offered to treat the asthma he then said do you think I need to be ill on Sundays but I think that when a symptom has been present for a long while it is bound to become part of one's life and can only be eased out rather gently I saw the sometimes with my awakenings patients I remember one man in particular in whom the l-dopa didn't seem to work and and then he said that he was afraid to show me how improved he was in case it belongs on him I am a case which struck me very very strongly which I described an anthropologist on Mars is of the blind man a man blind from birth who was persuaded in middle life to have surgery and restoration of vision this it was thought that this would be a wonderful gift and open his life but in fact although he could see everything he had the greatest difficulty interpreting the world you don't just see you you have to learn to see and the visual parts of the brain just hadn't developed in this man and he was thrown into a state of confusion and and and panic and in a sense we had not we had taken away his equilibrium and taken away his blindness so I think now obviously in an acute case I will act as quickly as the next man I once did and played my surgical technique wasn't very good and I used a carving knife I once did a crude track yata me on someone at a dinner table though he was in an epileptic attack he had he had a Spears got a chicken leg down his trachea and couldn't do this the only way to save his life was to do a tracheotomy and I did it right then and there I will act acutely when need be but in general I think one has to consider very carefully the equilibrium or the economy of patients and and the fact that sometimes one can't change straight away and even if a medical or surgical change can occur can be made straight away adaptation is slow falen poco de - whapa syllabic ong todo todo hasta appears vivica's non-functional mess therapeutic for contra de piel appropriate achieved new tato Depot associate SEO commentary Dukey a medicine or neurology Asteria mundo preocupada common defect illusion equal todavía se preocupe Armas common AHA Toro Jie a Nintendo Nagato Giacomo osawa choice as grand a las Tres culturas Yasuo Achieva COMESA cuando contra astrology hey Becca recommends cantando de pasión rebecca de l'eau s'il vous Roussel Jose Peraza twice as Rose rose Velas key observation DiMaggio Apostolou re per se que hora de pacientes ENT coma Plaxico glorious gravis estava nu ma IEI integration kuta yoga seryozha fashion pocus Aubry and Maharaja in the case of this young woman who was quite severely the but emotionally rich and healthy and well-developed there wasn't that much one could do medically or surgically it was very striking to see how ritual and symbol and and drama made sense to her and and how being part of a dramatic and impacting and performing roles gave her some identity in a way you were asking earlier about selves and identity and to some extent actors are given the identity of their roles and it was remarkable to see how this woman could act or philia and in a way expand in two realms and roles which would have seemed impossible although I think we all do this in relation to art and I think art has this one of the functions of art is its possibility to enlarge consciousness and they in a in a radical way I mean none of us can compose like Mozart but perhaps we can all appreciate him and be be elevated and expanded to to some extent I and I spoke a little bit earlier about the power of narrative of telling stories and following stories say developing and children much earlier than the ability to sort of read Euclid although maybe with a Bertrand Russell at first it was the other way around and I think one sees in a way the converse of this sometimes in intellectual decline and Alzheimer's disease where certain formal sorts of thinking may become difficult but storytelling and acting and musical performance may it may still be be very well preserved the but in general I think with everyone and Louie I used to stress this very very much it's it's not just a question of looking at the disease or the defect but also looking at what is strong so louia and Vygotsky especially spoke with us with regard to to deaf children they said ok so their death there's not that much you can do in auditory terms but but use their vision and and you know my my own book on deaf people is very much about about vision and it's not about the lack of hearing so much as the height and a vision and the way in which a visual language and a culture become possible dr. sacks every afternoon Tata face shaitaan seen creep and intoxicate sergey's Caserta paints and risk living disability and also in Venice near to soba Vegas USA Bay Shore Awami we - Observatory certain nature observe what rock they are longer da da vida Tour de Nesle surgery to subside with time various end oh he's a rock you kiss kuitar selfish or willfully cementery stylist another service Jurgis you are going to also tell tell tell yourself yes I'm very conscious all too conscious of cerebral aging in some ways I I hope that's not cerebral disease but I I find that certain forms of recall or his access become more difficult proper names escape they sometimes and and and and and embarrassingly they haven't been lost because usually they will they will come back and to some extent I have to make a memory of paper as a substitute now I I don't think if I have insight I don't know I don't think the general intelligence has been badly impaired so far no I mean loss of recent memory can be very specific it was recorded of the 85 year old Newton but he couldn't remember the beginning of any sentence he had started another thought almost single-handed he was able to complete the Principia and unshaken of nada Nostradamus it was made by the proposed the people to the mon coeur de mosquito Brazil from a do now so hot breeze tomorrow so evident at kcon salut le da da la vez religious even ISM with surgery a mere supersonic I I think some way to be regardless of President Aquino that in a sandwich it would study at the garden see an awesome one card in previous table Doris I got this in a certain circles nature which was in point but span program named Barabbas a cover the riverboat anaplasma segunda Phillip pom-pom nature's very Mia Donatella my boy Sam earning my bone which proves it

Channel: Roda Viva

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Keywords: tv cultura, roda viva, entrevista, oliver sacks, medicina

Id: 6bidu-JQIDE

Length: 89min 57sec (5397 seconds)

Published: Wed Dec 08 2010