Dr. Antonio Damasio is a renowned neuroscientist who directs the USC Brain and Creativity Institute. He was previously the Head of Neurology at the University of Iowa Hospitals and Clinics. His research focuses on the neurobiology of mind and behavior, emphasizing emotion, decision-making, memory, communication, and creativity. Dr. Damasio’s research helps describe the neurological origins of emotions and shows how emotions affect cognition and decision-making. Dr. Damasio is the 2010 winner of the Honda Prize, one of the most important international awards for scientific achievement.

In my continuing study of the brain, I left Self Comes to Mind refreshed with an intricate sense of biological treatment and yet deeply humanizing--real people with serious problems spring to life in the pages, but they are never reduced to their deficits. I found a thorough examination of interior life through lenses of research, medical cases, philosophical analysis, and unashamed introspection.

Publishers Weekly had this to say:

As he has done previously, USC neuroscientist Damasio (Descartes' Error) explores the process that leads to consciousness. And as he has also done previously, he alternates between some exquisite passages that represent the best popular science has to offer and some technical verbiage that few will be able to follow. He draws meaningful distinctions among points on the continuum from brain to mind, consciousness to self, constantly attempting to understand the evolutionary reasons why each arose and attempting to tie each to an underlying physical reality. Damasio goes to great lengths to explain that many species, such as social insects, have minds, but humans are distinguished by the "autobiographical self," which adds flexibility and creativity, and has led to the development of culture, a "radical novelty" in natural history. Damasio ends with a speculative chapter on the evolutionary process by which mind developed and then gave rise to self. In the Pleistocene, he suggests, humans developed emotive responses to shapes and sounds that helped lead to the development of the arts. Readers fascinated from both a philosophical and scientific perspective with the question of the relationships among brain, mind, and self will be rewarded for making the effort to follow Damasio's arguments.

Several interviews with Dr. Damasio can be viewed.  Several topics are available including:

How Memory Works

“Consciousness” is How We Know We Exist

How Our Brains Build Our Autobiographies

How Our Brains Feel Emotion

…and others.

I completed The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human by V.S. Ramachandran.   The preeminent neuroscientist V.S. Ramachandran has, without a doubt, raised the bar in this, his newest book, The Tell-Tale Brain. He states in the preface, "Readers who have assiduously followed my whole oeuvre over the years will recognize some of the case histories that I presented in my previous books, Phantoms in the Brain: Probing the Mysteries of the Human Mind and A Brief Tour of Human Consciousness: From Impostor Poodles to Purple Numbers. These same readers will be pleased to see that I have new things to say about even my earlier findings and observations. Brain science has advanced at an astonishing pace over the past fifteen years, lending fresh perspectives on - well, just about everything. After decades of floundering in the shadow of the "hard" sciences, the age of neuroscience has truly dawned, and this rapid progress has directed and enriched my own work." And what an enriching book this is!

     Ramachandran describes several neurological case studies that illustrate how people see, speak, conceive beauty and perceive themselves and their bodies in 3-D space. He explains the phenomenon of Phantom Limb Pain. He approaches the issues from evolutionary, philosophical, anatomical, psychological, and neurological perspectives.

Watch and hear Dr. Ramachadran describe how mirror neurons formed the foundation of civilization.

This is a non-fiction book about the travails of blood transfusion in the mid-1600s. The epilogue put the topic into perspective: how science and its discovery is historically taboo based on religion and other inhibitions of society and then, many times, transformed into well accepted practice.

In Catholic France transfusion experiments were shunned while in Protestant England experimentation was acceptable.  The times however were well before blood circulation or blood types were known.  Known science considered blood something akin to todays oil.  Science still considered the four humors, black bile, yellow bile, blood, and phlegm as determinative of a person's health and disposition.

The first transfusions were done with animals and then animal to human.  The cultural world views played a significant role in the toleration of medical research.  The French feared animal to human transfusions would create dog-headed men and the like.

In 2006 President George Bush in his State of the Union address warned against the travails of unrestrained medical research that could create atrocious creatures of animal and human substance.  However by 2006 medical science was using pig valves in humans.  The point is that the same fears and religious world views still influence the highest reaches of leadership that affect acceptable medical research.

I want to direct any one who is remotely interested in the cultural aspects of medical research hundreds of years ago and today to read this book.  I also want to direct anyone so interested to listen to my friend, Dr. Ginger Campbell, in her podcast interview of the author Holly Tucker.  This one hour interview expounds on the issues raised in the book and was a serious compliment.

Is Criminal behavior regulated by “free will?” Is free will something that is actually free at all? Neuroscientist, David Eagleman[1], recently published an article in The Atlantic, July/August 2011, The Brain on Trial.[2] He describes how the foundations of our criminal-justice system are beginning to crumble, and proposes a new way forward for law and order.

My interest in theological, philosophical, psychological and biological explanations ranging from the reason for suffering in this world and free will versus fate/destiny was discussed in my blog a few years back.

Can I freely choose to not eat chocolate cake? Can I freely invoke my long term understanding of the cake’s short term benefits versus its long term costs to overpower my short term understanding of my desire to eat it? Clearly the obesity crisis in our country and others would say ‘sometimes, but not most.’ Certainly eating chocolate cake is not a crime. But let’s apply the same ideas to crime and recidivism.

Neuroscientist, Wolf Singer argued that crime itself should be taken as evidence of brain abnormality, even if no abnormality can be found, and criminals treated as incapable of having acted otherwise.[3]

Conversely, at an Ethics and Public Policy Conference on Neuroscience and the Human Spirit,[4]  the question was asked: "Do . . . scientific advances challenge the first principles that the majority of our citizens believe provide the very foundation upon which our civilization rests—free will and the capacity to make moral choices? . . . Does [the] growing understanding of genetic and environmental influences on human behavior leave any room for free will?"

The conclusion advanced “accepting a compatibilist, naturalistic view of freedom and morality will unify our self-understanding. Since moral mechanisms have a clear social function that science can help us to understand and improve, no longer will morality have to seek shelter from science. We may not be free in the exceptional, ultimate sense we once supposed, but we are more than compensated by the pragmatic benefits that flow from recognizing our complete inclusion in the causal order. The "human spirit"—our dignity, freedom, and power—is not threatened by science, only shown its true home in the natural world.”

In his lengthy article, David Eagleman sets out court dramas of those recently brought to trial. Judges and juries compare, as they instruct and are instructed, to weigh their analysis against a “reasonable person” standard. Many times, we all engage in the blame game by asserting, “Well I would not have done that.” However that may be missing the point according to Eagleman. “Changes in the balance of brain chemistry, even small ones, can also cause large and unexpected changes in behavior [:]” Addictive personalities and gambling; Pedophiles and the desire to look at children. Also included are not just unacceptable behaviors but, as mentioned earlier, compulsive eating, excessive alcohol consumption, and hypersexuality, to name a few.

“The lesson from all these stories is the same: human behavior cannot be separated from human biology….Perhaps not everyone is equally “free” to make socially appropriate choices.” Do we really have free will to choose or is that really an illusion? Eagleman states “Many of us like to believe that all adults possess the same capacity to make sound choices. It’s a charitable idea, but demonstrably wrong. People’s brains are vastly different.”

Starting at birth we are the product of our parent’s genes. “When it comes to nature and nurture, the important point is that we choose neither one. We are each constructed from a genetic blueprint, and then born into a world of circumstance that we cannot control in our most-formative years….The unique patterns of neurobiology inside each of our heads cannot qualify as choices; these are the cards we are dealt.”

Turing to the legal system and courts, the standard applied assumes we are ‘practical reasoners’ which, in turn, presumes beings with free will. Eagleman uses the example of those inflicted with Tourette’s syndrome, who suffer from doing things they do not will to do: sticking out her tongue, voicing inappropriate language and others. The point is that a Tourette’s patient’s free will cannot over ride her sense of “free won’t.” Similarly, high-level behaviors can take place in the absence of free will.

“Historically, clinicians and lawyers have agreed on an intuitive distinction between neurological disorders (“brain problems”) and psychiatric disorders (“mind problems”). The two ends of the spectrum have been those whose brain injuries (e.g. Parkinson’s) who cannot help some of their behavior, while most others are simply thought of as freely choosing actors.

Therefore, prisons have, according to Eagleman, become de-facto mental-health-care institutions. Incarceration does little to rehabilitate those with mental illness and increases cases of recidivism.   Courts around the country and in Nevada have begun mental-health courts and drug courts based on better understanding of the problems of recidivism. 

Eagleman proposes a new approach. He posits the understanding that the brain “operates like a team of rivals, with different neural populations competing to control the single output channel of behavior.” Something he terms the ‘prefontal-workout.’ Essentially he is trying to defeat the short term brain circuits to overcome bad behavior. It is similar to bio-feedback of the 1970s. So when we see that delicious piece of chocolate cake, we can overcome the choice to eat it, which is essentially against our will. More importantly when one is faced with a socially unacceptable behavior, can he invoke a system to squelch the urge and make a better choice?

Eagleman concludes by saying that “neuroscience is beginning to touch on questions that were once only in the domain of philosophers and psychologists, questions about how people make decisions and the degree to which those decisions are truly ‘free.’ These are not idle questions. Ultimately, they will shape the future of legal theory and create a more biologically informed jurisprudence.”

David Eagleman’s article is available on The Atlantic's site and in print.

Gary Prowe of Gainesville, Florida has published a book entitled Successfully Surviving a Brain Injury: A Family Guidebook, From the Emergency Room to Selecting a Rehabilitation Facility.

Susan H. Connors, the president of the Brain Injury Association of America has written the foreword to this easy-to-read guidebook, which is intended for families in the first days, weeks, and months after a brain injury. The book covers the wide range of medical, financial, legal, insurance, family, and personal issues caregivers encounter following a brain injury.

Survivors of a brain injury learn much from this book and develop a greater appreciation of what their families went through in the early days of their recovery. You can read more about Successfully Surviving a Brain Injury: A Family Guidebook at www.BrainInjurySuccess.org.  You can also purchase a copy of the book at Amazon.

Info@BrainInjurySuccess.org

The topics covered in Brain Science Podcast vary and are very interesting.  Personally. I love to catch up by listening while on my elliptical machine in the morning.  There are over 4 years of podcasts sure to keep even the most ambitious listener busy for quite some time.

 I recently wrote to Dr. Campbell, conversation below, and sadly discovered that she is considering discontinuing the podcast after her summer break.  In other words she may or may not restart the podcast in September 2010.  Granted it is a large committment and amount of work.

I propose that anyone who enjoys learning about the brain write to Dr. Campbell by leaving a comment on the Brain Science Podcast.  Personally, I always appreciate comments to my posts and the back and forth discussion that follows.  I think hearing from interested listeners might prompt Dr. Campbell back to the mission she has been up to these past 4 years: educating folks.

I especially reach out to my clients to leave Dr. Campbell a comment after visiting her site.  Alternatively, if you are more comfortable with Facebook, leave a note at her Facebook site.

Here is the discussion I recently had with Dr. Campbell:

Tim,

Thank you so much for taking the time to write.

One topic that I have not yet had a chance to cover on the Brain Science Podcast is Head Trauma. This does not reflect a lack of interest on my part, but it is a result of two things. One is that since I have created the podcast for a general audience I only talk  specifically about medical issues once or twice a year. Secondly, I generally base episodes on books that are accessible to general audiences and I have yet to find a good book on Brain Trauma. This may reflect the fact that our scientific understanding is still fairly poor. Until a few decades ago patients with significant brain trauma (and spinal cord injury) usually died, so the field is relatively young.

After you have made it through the first year of episodes you will have a clearer idea of what I have in mind. Maybe then you might have some book suggestions.

Right now I am leaning toward continuing only my other podcast Books and Ideas, which would leave me the flexibility to consider brain-related topics whenever I want. But it is too early to make that decision.

Thank you so much for sharing my podcast with others. Even if I quit producing new shows after September, there will still be 70 episodes available, and I intend to leave these on-line as long as they remain accurate and relevant.

You mention that you disagree with my position on evolution and I am glad that this is not an obstacle to your enjoying the Brain Science Podcast. One current cultural trend that disturbs me is the idea people ought to agree about everything, and never listen to opposing viewpoints (let alone ideas from their opponents).

Since you are a lawyer, I am curious! Have you read John Stuart Mills book On LIberty?

Ginger

_____________________________

Dr. Campbell

Thank you for taking the time to respond. No I have not read the book On Liberty. I will look for it at the bookstore.

I understand your audience and desire to speak about the brain to a general audience. To a lesser extent, I occasionally post about human brain subjects that have nothing to do with TBI. Like I said, I am really fascinated with how the brain makes us who we are. I’ll explore neurophilosphy, religion and psychiatry, fiction (Crichton’s Terminal Man), Movies (The Lookout, The Soloist), Neuropsychology, Cognitive Neuroscience, Neuroeducation, http://brainandspine.titololawoffice.com/2008/06/articles/brainy-reviews/how-doctors-can-think-better/ .

I agree that healthy disagreement and the flow of ideas is vital. I look forward to working my way through the podcasts. There is no way I could get through reading all the books and I appreciate how you cover the content and describe the author.

 I posted on an interesting book entitled Another Day inThe Frontal Lobes, by Katrina Firlik. I was trying to review each chapter. Here is an example: http://brainandspine.titololawoffice.com/2007/11/articles/brainy-reviews/the-frontal-lobe-11/ If you link to my blog http://brainandspine.titololawoffice.com and click on Another Day inThe Frontal Lobes Reviews by Tim Titolo I have some other books I reviewed. I expect I will find some in your podcasts.

If it is OK, I intend to link to your site and podcast from my own blog. I really like the information. I had hoped we could list each other blogs on our sites. Yours is on mine. Check the right hand side of my blog (scroll down) to Links.

I am subscribed to your books and ideas blog/podcast although I have not visited it yet but will very soon. I love books. You are right about that blog giving you more freedom to explore brain books when they come up while still having the ability to explore multiple other areas of interest.

I see you are an emergency physician. Here is a problem worth considering. The care received in ERs for Brain injury or suspected brain injury is very poor. That is why, through the North American Brain Injury Society NABIS, we are advocating biomechanical professionals to be involved in ER care. Too often folks are sent home with complaints of headache or overwhelming pain from obvious injuries like fracture and lesions, and the brain injury (mild and moderate) diagnosis does not come for weeks and months. By then, the powers that be involved in damage control, defendants and insurance companies, deny causation etc. I simple CT or even more involved MRI routinely miss microscopic cellular injury, focal and diffuse.

I look forward to exploring the rest of the Brain Science Podcast and the Books and Ideas blog. Here is a link to books published by NABIS. http://www.braininjurybooks.com/  

Be Well and have a relaxing summer. (I love your dogs!)

Tim Titolo

Support the Brain Science Podcast.

A new book focuses on evaluating what is currently known about childhood TBI and the challenges faced by researchers and clinicians in this arena. The book is entitled "Pediatric Traumatic Brain Injury: New Frontiers in Clinical and Translational Research," edited by Vicki Anderson and Keith Owen Yeates and published by Cambridge University Press. 

The following is an Introduction I ran across:

Traumatic brain injury (TBI) is a major public health problem among children and
adolescents. Surveillance data reveal that 1 in every 20 emergency department presentations at pediatric hospitals is for a TBI, making TBI more common than burns or
poisonings. For children, such injuries represent a common interruption to normal
development, with population estimates ranging from 200 to over 500 per 100 000 a year,
and with well-established variations across age and gender (Crowe et al., in press; Langlois et al., 2006).

The majority of TBI in children and adolescents are mild, typically with few
long-term consequences; however, a significant proportion of children will suffer more
serious injuries and will experience a range of residual physical, cognitive, educational,
functional, and social and emotional consequences, requiring the lifelong involvement of
health professionals across a range of disciplines and leading to a significant social
and economic burden for the children’s families and for the community more broadly
(Cassidy et al., 2004).

This book, New Frontiers in Pediatric Traumatic Brain Injury, aims to evaluate what we
have learned about TBI in childhood to date and, perhaps more importantly, to articulate
the challenges we face and how we should go forward in the future. Over the past two or
three decades, researchers and clinicians working with children with TBI have become
aware that injuries to the developing brain cannot be understood or treated in exactly the
same manner as those occurring in adulthood. Although we may be guided by science and
practice in adult TBI, unique developmental and contextual issues need to be taken into
account at all stages of recovery and treatment in children. Thus, a separate knowledge base is needed for pediatric TBI. As a consequence, until recently our understanding of recovery and outcomes in pediatric TBI has lagged behind that for adults. This is changing. Research in pediatric TBI now has more solid foundations. A number of principles have been established, some consistent with the adult literature, such as the predictive value of injury severity (Anderson et al., 2004; Taylor et al., 2008).

Others are specific to early brain injury, such as the unique mechanics and characteristic pathology of inflicted injury in children (Coats & Margulies, 2006; Prange & Margulies, 2002), or reflect the importance of developmental and contextual factors, such as the age at injury, developmental stage of brain development, and functional maturation (Anderson et al., 2005; Taylor & Alden, 1997), the key role of the family, and implications of life tasks specific to children (Yeates et al., 1997). 

There are several diagnostic tests to assist physicians in detecting and treating back and neck conditions.

An interesting review entitled "Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain" (Van der Windt DAWM, et al. Cochrane Database of Systematic Reviews 2010) reveals that diagnosing back pain is not a simple matter. I read the findings.

While lower back pain ranks as a common cause of disability in the United States, determining what causes a person's back pain is often challenging. A new review on diagnosing back pain finds that no single diagnostic test is good at discriminating between patients who have a herniated disc and patients who do not.

Lawrence Kurz M.D., an orthopedic spinal surgeon at Beaumont Hospital in Royal Oak, Mich., agreed with the results of this review: No one test is specific and sensitive enough to be used as the sole guide for making an accurate diagnosis of disc herniation as the cause of sciatica.

Healthy discs are spongy cushions of cartilage that fill the spaces between vertebrae in the spine. They act as shock absorbers for the spine and allow flexibility. A herniated disc can occur when a disc incurs damage because of trauma or stress and bulges outside of its normal position to press on a nerve. This can result in pain that radiates down to the lower leg - also called sciatica.
 

In other conditions, including osteoporosis and similar aging disorders, bony structures could press on nerves, causing pain.

Representing injured people with back and neck pain complaints requries diverse diagnositic testing.  Insurance company representative all too often point to one test to either deny or rule out a condition.

Lawyers finding juries are more sympathetic during hard times

It’s a truism that juries, and hence insurance companies, become tight-fisted with damages arising from personal injury lawsuits during a recession, but that isn’t necessarily accurate when it comes to catastrophic injuries, such as traumatic brain damage. Some attorneys who handle such cases have found that if anything, the recession has encouraged them.

“The high-end cases are still high-end,” said Woodbury attorney William Harper, who recently settled two brain injury cases for the policy limits of $1 million. “The only reason they settled is that they were worth a lot more.”

Ever since the 1983 Supreme Court case of Short v. Dairyland, the law has been clear that an insurer can be liable for excess damages if the court finds a bad-faith failure to settle the case.

Defense attorneys agree that the economic climate has not diminished the value of brain-injury cases.

All personal injury cases with real objective damages that strike a chord with jurors still have the potential for high damage awards, according to defense attorney Mark G. Pryor of Minneapolis.

St. Paul defense attorney Terry Votel agreed, adding that catastrophic injuries are particularly invulnerable to the ups and downs of the economy.

There are several reasons the damages in brain injury cases remain high, attorneys say.

One is the skyrocketing costs of medical care. In fact, Harper said, the legal system’s method of awarding damages cannot keep up with the cost of lifelong medical care because jurors are instructed to reduce the verdict to a present value amount. But medical costs don’t “reduce,” Harper said.

Neither do the costs of caring for the injured person in the home. “My goal is always to bring the client home. That is a cost that should be borne by the (party found to have committed the tort),” said Anoka attorney Fred Soucie.

Another reason is that brain injury cases are readily demonstrable, both by medical evidence and through changes in the plaintiff’s behavior and moods. A traumatic brain injury will affect the person’s personality, judgment and concentration — which in turn affect the person’s ability to earn a living.

When the injury is catastrophic, the damages usually are self-evident. “I have had jaded insurance company lawyers say that the person has no pain and suffering because they are [so injured that they are] oblivious. That’s immoral and tactically stupid,” Soucie said. If jurors feel that the injured person is aware and suffering, they will punish the defense lawyer who appears callous in the extreme, he explained.

But even a “mild” injury can be proven, Soucie continued.  In fact, calling the injury “mild” can be a misnomer. Technically, the term “mild” is defined by the period of post-injury amnesia or loss of consciousness but the effects can be severe. The person may change dramatically, and friends, family and co-workers can explain the difference, he said.

Emotional value for juries

Additionally, the injuries are very compelling to jurors, Soucie said. “There’s always some juror skepticism but their hearts and minds are easily wrapped around these injuries,” he said.

The injuries are also capable of medical demonstration, said Minneapolis attorney Peter Riley, who recently settled a $3.4 million case involving multiple skull fractures among other injuries. Often the injury will show up as a bleed on a CAT scan or on an MRI, he said. “The defense [then] has a hard time saying the injury is due to something else,” Riley said.

Additionally, neuropsychometric testing can test for memory and brain functioning, showing exactly where the brain is damaged, and the test results can be matched to the patient’s symptoms, Riley said.

The neuropsychometric testing also can reveal any compensatory measures the brain has taken to make up for the injury, Riley said. In those cases, the jury has to be educated about the test results. If his recent case had called for it, Riley said he would have “backloaded” the plaintiff’s testimony by educating the jury beforehand so they would not have an opportunity to form an inaccurate opinion about the brain damage.

Not all head injuries are the result of trauma that reveals itself physically. Bloomington attorney Richard Ruohonen recently received a $128,000 verdict for a man who received an electric shock. The defendant, the city of Glencoe, had offered $50,000. The man was injured when he touched a pole the city had installed in his yard, but which was connected to a power line. He received five to 10 seconds of electric shock.

An electrical injury is more diffuse than an injury to a lobe of the brain, explained Ruohonen. His client’s injuries included loss of attention and concentration, memory impairment, pain and headaches. He also had a sleep disorder caused by injury to the brain stem, Ruohonen said.

This was a case of a skeptical insurance company. “They basically were saying it was all in his head,” Ruohonen said.

Actually, the case would have been more valuable but the client had a subsequent workers’ compensation injury to his neck. “That was the day the city got lucky,” Ruohonen said. The case might have been worth as much as $250,000 without the second injury, he explained. However, he is pleased with the result.

It would be speculating to say that the economy played role in the size of the verdict, Ruohonen said. It could also be that people in rural communicates are more conservative or that there were a lot of younger jurors (under age 35), he said.

The personal injury business can actually pick up during a recession, Ruohonen said. He noted that he is getting more calls from people whose injuries are two or three years old, and thinks perhaps they are now more hesitant to pursue their own claims. Besides, he added, “people down on their luck can be more sympathetic plaintiffs.”

And jurors don’t have a lot of sympathy for corporate or commercial defendants right now, he added.

“You’ve got a lot better chance if you’re going against corporations or insurance companies because people are upset with them. Those are great cases to try right now,” Ruohonen said.
 

Religion is one subject that many people around the world feel extremely passionate about, either feeling strongly in their belief of a certain religion, or being against religions generally or specifically. Other people do not engage with religion at all. These choices represent a part of who we are, and as such it is essential for psychiatrists to understand and be able to relate to their patients' decisions and beliefs in this area.

Religion and Psychiatry is recommended reading for residents in psychiatry, postgraduates in theology, psychology and psychology of religion, researchers in psychiatric epidemiology and trans-cultural psychiatry, as well as professionals in theology, psychiatry and psychology of religion.

Religion (and spirituality) is very much alive and shapes the cultural values and aspirations of psychiatrist and patient alike, as does the choice of not identifying with a particular faith.  Patients bring their beliefs and convictions into the doctor-patient relationship.  The challenge for mental health professionals, whatever their own world view, is to develop and refine their vocabularies such that they truly understand what is communicated to them by their patients.

"The boundary between religious belief and the practice of psychiatry is becoming increasingly porous," say the editors in the Preface to Religion and Psychiatry: Beyond Boundaries. "No longer can psychiatrists in a multi-faith, multi-cultural globalized world hide behind the dismissal of religious belief as pathological, or behind a biomedical scientism, as they are more frequently confronted by distressed patients for whom religious belief may determine their choice of symptoms and their compliance with treatment."

Published on behalf of the World Psychiatric Association, Religion and Psychiatry: Beyond Boundaries, addresses the impact that religion and spirituality have on shaping cultural values, as well as the choice of not identifying with a particular faith. With this book, Peter Verhagen and colleagues provide a framework to understand the importance of these factors in mental well-being, and how to develop and refine their vocabularies to ensure they truly understand what their patients are telling them.

This is the first time that so many psychiatrists, psychologists, and theologians from all parts of the world and from so many different religious and spiritual backgrounds have worked together to produce a book addressing these important issues.

The book discusses what religious traditions can learn from each other to assist the patient, as well as the neurological basis of religious experiences. It describes training programmes that successfully incorporate aspects of religion and demonstrates how different religious and spiritual traditions can be brought together to improve psychiatric training and daily practice.

In the Foreword to Religion and Psychiatry Mario Maj, President of the World Psychiatric Association, states "The WPA welcomes this comprehensive and multifaceted volume, produced by one of its most active Scientific Sectors, hoping that the effort will continue to clarify the issue and stimulate further reflection and research."
 

 Education and brain experts discuss their experiences, challenges, and potential next steps to allow for the crossover from classroom to lab and lab to classroom. The concerns and hopes of those working in the field are presented in a summary of the roundtable discussions that served as the centerpiece of the summit.

Neuroeducation: Learning, Arts, and the Brain is available free by written request on institutional letterhead. Please make certain your request contains a complete telephone number-including area code-and a full street address. Requests should be mailed or faxed to:

Johanna Goldberg
Dana Foundation
745 Fifth Avenue, Suite 900
New York, NY 10151
Fax: (212) 317-8721

You may also e-mail your request to: jgoldberg@dana.org. Please include your institutional and mailing information.

The book is available online at http://www.dana.org/news/publications/publication.aspx?id=23964.
 

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Motorcycle Accidents in Maryland: Avoiding Fatalities and Reducing ... By Lebowitz & Mzhen Motorcycle Accidents in Maryland: Avoiding Fatalities and Reducing Injuries from Car-Bike Crashes :: Maryland Motorcycle Accident Lawyer Blog. ... As a result, many motorcycle accidents have an especially high rate of injuries, including broken bones, spinal cord injuries, traumatic brain injuries, and other permanent injuries. Sadly, fatalities are very common when it comes to motorcycle accidents. Wearing a helmet is one of the best things a rider ... Search this Blog ... Maryland Motorcycle Accident Lawyer Blog - http://www.marylandmotorcycleaccidentlawyerblog.com/

SPINAL CORD INJURIES FROM CAR ACCIDENT « Haire Law Firm Blog By admin Below the point of injury, the spinal cord cannot send messages to the brain to control the operation of the body. Accidental spinal cord injuries result primarily from motor vehicle accidents all kinds, but can also occur in accidents ... Haire Law Firm Blog - http://hrj-law.com/blog/

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Recent Train Accident Devastates Southern California | Chicago ... By admin From January 2008 to March 2008, 4875 railroad accidents were reported, resulting in 309 fatalities and 3223 injuries. Â. The most common injuries stemming from train accidents include: · Brain trauma. · Spinal cord injuries. · Concussions ... It is important to consult an experienced personal injury lawyer if you have been involved in a train accident. Hiring a lawyer will ensure that your rights are protected and that you receive a fair settlement for your injuries. ... Chicago Injury Law Blog - http://www.chicago-injury-law-blog.com/

SPPS will publish cutting-edge, short reports of single studies, or very succinct reports of multiple studies. The journal's brief, to-the-point research articles will be of broad interest to both professional and lay audiences and will be written in a format accessible to a wide range of readers, including science writers for the popular press. It will feature a speedy review and publication process to allow groundbreaking research to be published quickly.

Source:
Jim Gilden
SAGE Publications
 

Schizophrenia is a serious and challenging medical illness, an illness that affects well over 2 million American adults, which is about 1 percent of the population age 18 and older.

Although it is often feared and misunderstood, schizophrenia is a treatable medical condition.

Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different from the brains of people without the illness.

Like many other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person's development.
Read More Here.     

This is a very welcome addition to the field of neuroscience literature and should be read by anyone involved in the care of persons with disorders of consciousness. The book starts with a thoughtful Preface by the editors, Dr. Laureys and Dr. Tononi, which is followed by yet another introspective commentary by Dr. Allan Hobson of Harvard Medical School in the form of a Prologue. The contributors to this text include some quickly recognizable names, including Drs. James Bernat, Antonio Damasio, Joseph Fins, Michael Gazzaniga, Adrian Owen, Joseph Giacino, Nicholas Schiff and Adam Zeman, among others.

Read the full review here.

The new book, Disconnected Kids: The Groundbreaking Brain Balance Program(TM) for Children with Autism, AD/HD, Dyslexia and Other Neurological Disorders, (Amazon.com: Disconnected Kids: The Groundbreaking Brain Balance ...) shows parents how to use this drug-free approach at home, with customizable exercises for physical, sensory, and academic performance, behavior modification strategies, information on foods to avoid, and a follow up program for lasting results.

Reviewed by Lloyd deMause

The revolution in neuroimaging techniques in the past two decades has produced such a new understanding of the effects of early experiences on the brain and the disorders from attachment deficiencies that are their result that psychologists-including psychotherapists and psychohistorians-simply cannot fully understand what the developmental causes of child abuse unless they keep up to date on what neuroscience has been discovering. If, for instance, you write about racism-from the Holocaust to Islamic terrorism-you cannot really understand what is happening unless you know early developmental problems affect the prefrontal cortex and later produce disabled medula (mirror neurons that enable one to empathize with others). Similarly, when you study group-fantasies of growing irrational fears of being attacked by other nations (who often have no designs at all on your nation), you really must understand how these fears (say, of Mother England about to pounce on you) were originally implanted in the amygdala, and unless you understand how kinds of experiences are making whole nations switch into these early amygdalan fear modules.

Restak provides an excellent summary of the basic advances in understanding neuropathology. I particularly learned a lot about what makes people-even groups-create in-group and out-group minds and feelings, which happens particularly before wars. That groups (tribes, states, ethnic groups, nations) carry over the fears they imprint from their parents to their later social lives is evident, particularly if their early attachments are insecure and they generate fears of being controlled by "enemies" (external and internal) should they try anything new and experience too much freedom in their adult lives. Studies are cited that scan the brains of hundreds of mothers interacting with their infants that show that the mothers who are postpartum depressed or otherwise were not adept at reading their infant's needs produce older children who have crippled prefrontal lobes and therefore are behind others in language and play skills by age two. It simply helps one to think this way about political events: "You remember quite vividly where you were on September 11, 2001, because the horrific events of that day aroused your emotions and activated your amygdala." And charts showing wars occurring during a nations' most fearful, most reactionary periods are actually amygdalan activation periods. Eliminating wars therefore must somehow affect this brain state.
 

How Doctors Think

I find the latest advances in legal thinking and the use of heuristics is also cutting edge thinking in medicine. 

The following is an interview printed in Medical Economics by Leslie Kane MACC of Dr. Groopman:

Kane: You described three heuristics that doctors typically use—"the three As," as you call them. What are they?

Groopman: The first is anchoring. We quickly latch onto what we think the diagnosis is, and selectively accept or ignore information that corresponds with what we expect to find. This influences the questions we choose to ask, and how we ask them. That, in turn, tends to focus patients' answers. So we're more likely to find what we've already decided we're looking for.

The second heuristic is availability. That's the tendency to judge the likelihood of a diagnosis based on how readily relevant examples come to mind. During a flu epidemic, for instance, if you see 15 people with the flu, when the 16th person comes in saying he feels clammy and has a bit of fever, you automatically assume it's the flu. But it might be something else entirely.

Or if you've had a very dramatic case—which all doctors do—it imprints on your mind. When you see patients with similar physical findings, you superimpose that prior dramatic case on the one in front of you.

The third heuristic is attribution. We all hold stereotypes in our mind and are very quick to attribute complaints to a larger stereotype. If a patient is slovenly, hasn't shaved, has rum on his breath, and has an enlarged liver, he becomes alcoholic cirrhosis even if he says he doesn't drink much.

Kane: Doesn't everyone use heuristics to get through life? That's how people learn by experience, and make it through the day without having to evaluate every occurrence from scratch. How are doctors supposed to turn off these very human thinking mechanisms?

Groopman: You're correct. These kinds of mental shortcuts are wired in our brains. Physicians in particular invoke heuristics because we're working under conditions of time pressure and uncertainty, with limited data.

Kane: Given that heuristics are hard-wired, how can doctors overcome them?

Groopman: We need to remember that the three heuristics I mentioned are all traps. So you need to do metacognition—think about your thinking. To do that, ask yourself some simple questions when evaluating patients: "What else could it be?" Or "Am I being too quick to lump it all together?" Or "Can two things be going on at once?" Because maybe the person does drink, but that doesn't mean there can't be another problem that accounts for his enlarged liver.

These are the kinds of questions that when we were residents, we asked our attendings or the attending physicians asked us. But now that we're in practice, it becomes harder to ask these questions because we're working within our own heads.

Kane: With today's shorter patient visits, pay for performance, and evidence-based medicine, doctors are encouraged to use algorithms and decision trees to diagnose. The system doesn't encourage doctors to take more time for open-ended thinking. How can doctors find the time to think more and still make a good living?

Groopman: The system has gone headlong into checking off the boxes and following all the outcomes and decision trees. I believe medicine is still something that requires an understanding of the individual.

I've spent years in research for evidence-based medicine, and I'm very aware of the limits and deficiencies of how those data are used. They reflect a very, very cherry-picked group of patients. They use patients who aren't on seven medications, and they come up with statistical averages. How closely does the patient in your office correspond with the data-based medicine? Are you supposed to say to your patient, "Please leave my office, you don't fit the data"?

Kane: It sounds like there isn't really an answer to the situation. Hearing from doctors who are struggling with diminished reimbursements, I get the impression that the public expects doctors to be more altruistic than other human beings and not care about the financial end.

Groopman: I think this is a caring profession; it still attracts people who want to do good and people who are altruistic and dedicated. But that doesn't mean you shouldn't make a living. Being a doctor doesn't mean you're required to be a monk and give up the world. Physicians are being pushed to work ever harder, while at the same time the system is changing in ways that prevent profit from going to the people who do the work.

Kane: Any other wisdom or advice you'd give doctors?

Groopman: Learning how doctors think has helped me give better care, and has prevented me from making the kinds of mistakes I made in the past. I feel it has restored to me some degree of control because I know my mind better. And that control enables me to more effectively buck the system.

Groopman brings up important information about tuning into your own thinking. Doing so takes some attention and practice; and because thinking short-cuts are so human, it may be a challenge. But doctors have never been ones to take the easy path, especially when an activity can sharpen their expertise and enhance their patients' lives.

Groopman holds the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School and is Chief of Experimental Medicine at the Beth Israel Deaconess Medical Center. His earlier books include The Measure of Our Days (1997), which explores the spiritual lives of patients with serious illness; Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine (2000); and The Anatomy of Hope: How People Prevail in the Face of Illness (2005). He is also a staff writer at The New Yorker.