Stoner – A Personal Review

 

Several months ago, I read a review of the 1965 Pulitzer Prize winning novel – Stoner by John Williams.  The plot was described as life story of a man who goes from farm life to college to get an agricultural degree but gets sidetracked and ends of being a college English professor instead.  That seemed very similar to what happened to me so I was interested in two things – were there any parallels – psychological or otherwise and were there any examples of stream of consciousness prose?  Stream of consciousness is one of my literary and psychiatric interests.  I was not disappointed. 

For comparison, I went to college because I had a football scholarship. I did not apply to several colleges – I only went to one because of the scholarship and my vague goals of teaching physical education and possibly coaching.  I developed a serious case of appendicitis and sepsis so football was not a possibility. A series of events followed that involved the many of the faculty of that college that resulted in me graduating as a chemistry biology major and eventually going on to medical school.  None of that was planned by me and in retrospect it seems like I was swept along by the enthusiasm and concerns of my professors.  I don’t think that would have been possible at any other place than the small liberal arts college that I attended. I know several others who had similar experiences there and went on to highly successful professional careers. Ironically, when our small college closed two years ago, it left behind a tragic void—all the unrealized potential of the students who will never get to attend.

William Stoner was born as an only child and raised on a farm in late 19th century Missouri.  As the story begins, we hear about the rigors of farm life and the stoic approach taken in his family of origin. His father talks with him about a new agriculture degree available at the College of Agriculture at the University of Missouri in Columbia.  He explains the crop yields are low and more scientific methods may improve the yield and sustainability of their farm.  Stoner accepts his father’s suggestion and arrangements to live on his mother’s cousins farm where he can work for room and board while paying for tuition. He expects to complete his degree and return to the farm.

From the outset he is described as tall, thin, awkward, and having a stooped posture from all of the hard physical labor on the farm. From the outset Williams describes him as an unremarkable and not memorable man.  His physical labor is only slightly diminished with his initial living arrangements.  His first year in school was routine.  In the second year he had a life changing event. 

He was taking a required survey of English literature from Prof. Archer Sloan.  Sloan was described as being disliked by most of his students because of his detached teaching style as if he knew he was unable to convey all that he knew about literature to the students.  Stoner notices he was getting frequent images of Sloan and his speech patterns away from the classroom and engaged in other activities.  He had initial difficulty with the class.  One day in class Sloan asks about Shakespeare’s Seventy-Third Sonnet – specifically what does it mean?  He calls on two students and after giving an elaborate introduction of the poem calls on Stoner.  Stoner is unable to answer and the class is dismissed.  With no explanation we learn in the next semester that he dropped his science courses and added history, philosophy, and English literature.  The process suggested to me that he identified with Prof. Sloan at some level. 

The next two years he was immersed in study and experienced a change in his experience of reality. In his fourth year, he has a more cordial meeting with Sloan who asks him about his plans and then announces that he is going to be a teacher. They outline a plan to get him on a path to his master’s degree and then his PhD. At this critical point, Sloan possesses a clearer vision of Stoner's path than Stoner himself does.  When Stoner asks for clarification of his certainty, Sloan replies “You are in love, it’s as simple as that.” Referring to Stoner’s love of the subject material.

All of this happens in the first chapter that ends with Stoner explaining to his parents that he will not be returning home after graduation.  They are shocked but deal with it in the expected quite desperation of deeply disappointed parents who never express much emotion. Williams describes these scenes perfectly in third person narrative.     

The next chapters follow the course of Stoner’s life and relationships.  His erratic marriage to Edith and his personal relationship to their daughter Grace.  Edith is described as a thin attractive women shaped by her privileged upbringing to expect that she will be taken care of.  She has no interest in academics and her attachment to Stoner fluctuates significantly over the course of the book. At times Stoner had to care for the home and their young daughter when Edith was withdrawn and isolative.  They eventually come to an equilibrium where she is concerned but at a considerable distance. 

He has two close friends that are described more as acquaintances.  One of them eventually becomes a Dean at the University and offers him some cover from the department head who is his arch enemy and would fire him if possible. An affair with a younger instructor that eventually leads to scrutiny and pressure that causes her to leave and move to another college. The effects of two world wars and various health crises are described.  One of his two friends is killed in WWII almost immediately. As time passes, Stoner is becoming more of an academic and a better teacher.

Stoner’s relationship to his daughter Grace becomes a central part of the book. During the time when he is caring for the home while Edith is isolated and seemingly ill, he is also responsible for taking care of Grace.  He alters his work and preparation schedule so that he can do more of it at home and watches her at the same time. He sets up his study to accommodate her and she draws while he is working on his courses. Edith eventually takes a more active role in Grace’s life, bans her from Stoner’s study and fills her schedule with social activities.  She becomes a frail and anxious person like Edith, hardly talking with Stoner.  She ultimately becomes a more tragic figure after losing her husband in the war.  She returns home visit him at one point and although she has developed a problem with alcohol – Stoner thinks he is glad that she has alcohol to comfort herself.

The main characters outside the family in this novel include Katherine Driscoll – a young instructor in Stoner’s department and Hollis Lomax the head of the department.  We see Lomax become Stoner’s arch nemesis early in the plot when they disagree on the promotion of a graduate student.  During an oral examination, Stoner demonstrates that the student lacks the basic knowledge base to continue in the graduate program but Lomax disagrees.  After Stoner refuses to compromise, Lomax increases his teaching burden of lower-level courses, refuses to promote him even though Stoner has tenure and is a well-liked and productive teacher.  The conflict becomes more heated when the affair between Stoner and Katherine Driscoll becomes widely known and Lomax threatens to fire her. Both Lomax and Stoner are communicating through surrogates at that point.

Katherine Driscoll and Stoner have an intense intimate relationship. Stoner if fulfilled by the relationship and it causes his to examine his thoughts about love over the course of his lifetime.  When the relationship becomes more known – it leads to the inevitable ultimatum from Lomax and societal pressure to end it.  In Katherine Driscoll’s interest she decides to move to another school and is eventually successful there and published a book that Stoner reads.  He notices that it is dedicated anonymously to him.

I will not discuss the ending except to say that it continues the main themes of the book.  Many reviewers suggest this book is about an average man living an average life.  They suggest it is a celebration of that averageness.  I see it somewhat differently.  Just living anywhere requires a tremendous sustained effort.  Many force that thought out of their awareness every day as they go to work and either do a job they do not like or as in Stoner’s case – work a job they but suffer because their manager is not a reasonable person.  In those cases, most people do not rebel and lash out but put their shoulder to the wheel and keep pushing ahead no matter what.  Stoner’s life was permanently altered by his love of literature.  He becomes a devoted teacher protecting the integrity of his discipline.  When pressured he retreats into this work with stoic discipline and dedication.

I had the random thought last week that nearly all of the professors who taught me in college and medical school are dead.  They were all dedicated scholars but none of them were famous.  I was profoundly saddened by that thought. All of that work and dedication – to be celebrated by a few grateful students in relative anonymity. Getting back to the questions posed at the outset of this post – yes - I think this story reflects some of my experience in college and how it changed my life.  And – yes - there is some stream-of-consciousness writing – but not much. Williams writes a precise and almost perfect third person narrative about William Stoner.  He describes an episode of delirium near the end of the book that is very good and relies on elements of stream of consciousness.  The Shakespeare Sonnett epiphany in class that changed Stoner’s life trajectory was another brief example:

“…He looked away from Sloane about the room. Light slanted from the windows and settled upon the faces of his fellow students, so that the illumination seemed to come from within them and go out against a dimness; a student blinked, and a thin shadow fell upon a cheek whose down had caught the sunlight. Stoner became aware that his fingers were unclenching their hard grip on his desk-top. He turned his hands about under his gaze, marveling at their brownness, at the intricate way the nails fit into his blunt finger-ends; he thought he could feel the blood flowing invisibly through the tiny veins and arteries, throbbing delicately and precariously from his fingertips through his body.” (p. 13)

Many critics write about Stoner as an existentialist novel.  Whenever I think of existentialism I reflect on Yalom’s dimensions of death anxiety, freedom, isolation, and meaninglessness. Those themes apply not only to Stoner but several other characters in the plot line.   In Stoner’s case his isolation within his own marriage is an extension of the emotional isolation he had growing up with distant parents.  He carves out an existence within his that home as Edith isolates herself and removes Grace from his influence.  Although Stoner seems to live a life of tolerance and passive acceptance of his predicament – his life trajectory is altered by radical freedom of choice when he chooses to abandon farm life in favor of academia, refuses to pass an incompetent student over his department head’s strong objection, and elects to end his affair with Katherine Driscoll rather than ruin her career.  Although more implicit at no point did, he consider divorcing his emotionally estranged wife. 

In terms of meaningfulness, Stoner treats scholarship and teaching as an intrinsic good and an organizing factor in his life. He recognizes that his contributions to his field are modest.  His only book was a monograph from his doctoral thesis that was not widely read and did not bring him any fame.  In the final analysis, it was proof he had lived a life faithful to his goal of scholarship. 

Stoner’s sophomore epiphany can also be seen in psychodynamic terms.  Identification occurs when an individual unconsciously adopts the traits, values, or posture of an admired figure, incorporating them into their own ego ideal.  He does not want to just learn from Stone – he wants to be like him.  He introjects Sloan’s love of literature, institutionalized approach to university life, and self-discipline.  Any identification with his father and farm life are gone at that point.  In this type of identification, it does not stop with introjection it also requires generativity consistent with the identification and Stoner does that throughout his teaching career.

In reading a book like Stoner, it may be temping to think “I am Stoner.” Or “We are all Stoner” because of some of the common elements.  As I mentioned at the outset, my trajectory was very similar to Stoner and as an old many who teaches psychodynamics – I have attributed it to identifying with many of my undergraduate and medical school professors.  In most of those cases I worked with them intensely for 3 or 4 months and never saw them again.  The identification in my case opened up a world of possibilities that I could not have imagined.  But Williams’ novel points out all of the nuances in a life beyond what you do or do not imagine for yourself and who you identify with.  The interactions between Stoner and all of the important people in his life – especially the emotional tone cannot be predicted and there are rarely any good resolutions. There are too many permutations of what can happen in any life to say you would probably react like Stoner.  In the end, Stoner achieves hard-won satisfaction with his life despite multiple failures because he can claim it as his own.

 

George Dawson, MD, DFAPA

 

Supplementary 1:  Even though I did not come right out and say it – I highly recommend this book.  Reading it is without a doubt more enjoyable than reading my obsessive review.  I have not encountered a novel written like this before and it is very unique.  All of Stoner’s 60+ years are packed into 278 pages and Williams keeps it moving right along.  The description of characters who are emotionally unexpressive or unpredictable expressive is first rate.  Anyone involved in academic or medical administration politics will relate immediately to the type of conflict Stoner has with his department head.

Supplementary 2:   Physicians may find this novel particularly interesting.  Stoner’s monastic academic career resembles the career of most physicians. Lifelong study without acclaim and the only reward being the knowledge that you are doing an adequate job.  The field has to be approached with the same level of integrity that Stoner approaches English literature.  The impact on the family is high even though in Stoner’s case – his wife had a large role in that.     

 

 

 

The Consolations of the Forest – Alone In A Cabin on the Siberian Taiga

 

I thought I would review a book sent to me by a friend who I emailed about the concept of suffering. At issue was whether suffering was useful or not. That issue was used as a social media cudgel against psychiatrists – specifically that psychiatrists are trained to alleviate suffering but if they did not people would benefit from it instead. That is obviously an overly simplistic argument by a person who does not know very much about psychiatric practice.  I don’t want to get too far afield from the actual book.

The author is Sylvain Tesson who is generally described as a world adventurer who writes about those adventures. He wrote this book over the course of 6 months living in relative isolation on the shores of Lake Baikal in Siberia when he was 39 years old.  He is currently 51.

Lake Baikal is in the Southern region of Siberia and it is the world’s oldest and deepest freshwater lake. Irkutsk – the 25^th largest city in Russia in on the main outflow river from the lake – the Angara River about 45 miles from the lake. Irkutsk has a population of about 600,000 people and is probably best known to people of my generation from the board game Risk where it is a separate region rather than a city.  After reading the book I did research Tesson’s academic background and he has a degree in geopolitics. He is obviously well read and provides many of those references in the text.

Tesson’s previous exposure to Lake Baikal led to his interest in a more prolonged stay at a rough time of the year.  He documents what occurred along with his associations in diary form beginning on February 14 when he arrives on the lakeshore and ending on July 28 as a boat sent to pick him up is coming in from the horizon. He describes his motivation for this adventure in the introductory chapter. The climate in that area is temperate and comparable to Canada and the upper Midwestern states in the US.  He stayed during winter and spring and temperature ranges from -20 F to above freezing. He did this with the intention that living as a hermit would lead to desired changes – while documenting the day-to-day effects of the climate, changes in the ecosystem, occasional social contacts, his hiking and outdoor adventures, and the necessary work to maintain himself. It is presented mostly as a document of what he experienced and the associations (both autobiographical and literary) that he has with those experiences. At no point was this an argument that we can all be saved by living the life of a hermit.  It is more of a document about a part of that experience and what others have said about it.

He was well supplied for this adventure including 6 months of food and solar panels for recharging batteries and a satellite phone. Despite the relative isolation he describes plenty of traffic on both the frozen and thawed lake providing visitors and, in some cases, additional supplies. There was abundant wild life but he did not have a firearm apart from a flare gun for scaring off bears. His main protein source was fish from the lake.  He did not hunt any mammals or birds.  He had 67 books that were compromised mainly of humanities titles, but also some fiction and descriptions of surviving winter in Siberia. 

He described high levels of activity across terrain elevations and temperature ranges.  Much of the terrain was difficult to navigate because of the presence of underbrush, deep snow, and dwarf pines.  Tesson was undeterred by temperatures in the – 27F range.  He makes detailed observations and descriptions of the nature and scenery.  On some days he is trekking 10 miles to get to a fishing site, on others he is going 80 miles on a 6-day round trip.  He acknowledges that his levels of physical exertion and the resulting pain and exhaustion are high at times.     

What is it about hermitism that is life changing?  Tesson believes it is silence against a background of the splendor of nature existing forever in an idyllic setting. One of his last observations:

“It is good to know that out there in a forest in the world there is a cabin where something is possible, something fairly close to the sheer happiness of being alive.” (p. 232).

It seems apparent that he knew this all along and had to prove it to himself.  Full circle back to the theme of suffering.  Tesson suffered but that he tolerated it to attain a goal. At any point he could have called the nearest neighbor, called it off, and gone home.  The suffering is over at that point.  That is no equivalent to the suffering that accompanies medical problems that can seem random and senseless.  In many cases – people are expected to expend energy and tolerate suffering not toward any higher goal or advantage but because there are no effective treatments or they can’t access them.  It is also not the same as acute and unpredictable stress like an accident or natural catastrophe.

Despite seeing his hermitage as transformative he is circumspect about the experience.  He quotes Aldo Leopold that “hermitism is elitism”.  It is not a solution to the ecological problems of modern-day life because any mass exodus to the wild would destroy the forests. In fact he talks about how some of that had been done.

There is no description of the potential limitations of hermit life.  As a physician – medical emergencies and access to care is at the top of that list. To an extent that is age dependent but even a healthy 30-year-old can come down with acute appendicitis or break a bone.  He is very conscious about dying of exposure and guards against that.

In writing about the advantages – he does not consider alternatives.  For example, I was born and raised on the shore of one of the largest freshwater lakes in the world and could experience much of what Tesson experiences by walking 6 blocks to the lake.  There were no bears but plenty of fishing, ice transitions, and winter sports every year.  And all of that occurred in a town of 8,000 people and homes full of modern conveniences.  The largest close city was Duluth about 70 miles away with a population of 100,000.

A secondary observation is that the hermit in the woods is a more honorable position to be in because there is a smaller carbon footprint.  The hermit only uses the resources they need and does not squander energy or material goods.

One of the thought experiments prompted by Tesson’s hermetism is the characteristics of a transformative environment.  Each of us can probably think back to several of the environments in our life and not have to think too much about the impact it had on us.  Taking the histories of thousands of people illustrates how varied those environments are and how varied the responses can be to environments that are qualitatively similar. I spent a week hiking through Glacier National Park with a friend of mine when I was in my 20s. The scenery was magnificent and it was rigorous hiking at altitude (5393 ft). It was also populated by grizzly bears and you could always see them at a distance. There were bear warnings every day and we took them seriously. My friend thought I was too serious about it until we encountered a ranger in a fern filled valley loudly banging a shovel and his hard hat together to “warn the bears”. The effect it had on me was “great place to visit but I don’t want to live there.”

As a physician – the training and work environments are striking. Medical school was probably the most.  Going from the lecture hall to seeing people dying in front of you to being responsible for preventing those deaths probably had the most impact on me than anything. That is probably the closest I can come to an environment that Tesson describes as “changed myself completely.”  It was my equivalent of the Russian taiga.

It also raises the question of what is suffering and these days – what is trauma? There are a lot of variables. One of the critical dimensions seems to be voluntariness – whether people choose to suffer or not.  If they do – is there enough information ahead of time for true consent?  In this context – there is knowledge about what to expect and probably some experience in tolerating the environment. The example I am most familiar with is athletes where painful effort is required and career ending injuries are always possible. Tesson’s hermetism seems to fit this model compared with unexpected serious illness or injury.  The latter can also be life changing in unpredictable ways but it is not possible to predict whether the individual would consider the event a net positive or negative.

A second consideration is what increases our tolerance or in the more popular vernacular - resilience to the stress. In Tesson’s case he seems to attribute much to solace, silence, freedom, and the beauty of nature as a counterpoint to the noise, artificiality, regimentation, and excesses of modern life.  There are Darwinian considerations that he does not cover – primarily that many people in populations everywhere could not survive in such an environment.

Thirdly, people often view trying times much more positively in retrospect. I think back to another experience in my 20s – climbing Mt. Kenya with a coworker and friend. We were both habituated to 5,000 feet and ran regularly at that altitude. I have a single grainy photo of me climbing the scree at about 12,000 feet. We were poorly prepared and knew very little about mountaineering. The first night we stayed in a hut at about 10,000 feet and I had altitude sickness. That night hyraxes – small rodent like mammals weighing 4-10 pounds scurried about the hut running over us as we tried to sleep. I was able to recover the next day and continue the ascent but at the time it was a miserable experience and I could not wait to get off that mountain.  I recalled a quote from Pirsig that Zen happens in the valleys and not on the mountaintops.  In retrospect – I really like that old picture.  But at the time I was not sure I was going to make it.

Tesson’s literary and social observations are as interesting as his social and ecological ones.  I was interested in his take on DH Lawrence’ Lady Chatterley’s Lover. I have not read the book since college. It was widely considered to be an advance in explicit sexuality and was high controversial in the early 20^th century.  It was banned as obscenity in several countries including the US. Some opinions focused more on sexual life as being part of the larger life picture.  Tesson describes it more of a “requiem for wounded nature.”  He focuses on the effect of mining and the industrial revolution on the landscape and how the main protagonist describes the adverse effects on the environment and the human spirit. (p.89).

Boredom was always an interesting topic to me as a psychiatrist. No matter where I am it seems to be a completely alien feeling. I can’t recall ever being bored. Tesson comments that he was warned that boredom might not only get the best of him in solitude but that boredom can kill. (p. 79).  He did not take the warning seriously.  He discusses why the solitary man must be a virtuous man.  He describes a “double penance”  that can occur and quotes Rosseau: “The civil man desires the approval of others, the solitary man must of necessity be content with himself, or his life is unbearable. And so, the latter is forced to be virtuous.”  The double penance occurs at both levels.  Contemporary theory just focusing on the cognitive aspects of boredom suggest that spontaneous thought is a factor and, in that department, Tesson never seem to be lacking.

Should you read this book?  If you have read any of my past book reviews, I try to make things as conditional as possible. I recently read a paper on how many people read books after they graduate from high school or college.  It is a surprisingly low percentage and the same survey looked at how many people read assigned texts in college and that percentage was far below expected. This book is logistically straightforward to read. It is arranged in diary form. Some days are described in a paragraph and the more detailed days takes several pages. It can be read by dates or months. It is a unique book that ties in life in the wilderness with literary references.  Some of the books referenced you may have read.  The others are interesting enough to investigate. Following Tesson’s lead – I like the idea that there are people living successfully in the Russian taiga and that he wrote about his adventure and philosophy.  It is good to know how one man experienced personal growth and the sheer happiness of being alive in such a setting.

George Dawson, MD, DFAPA

 

Supplemental:  I also want to credit the translator of this book from French – Linda Coverdale, PhD. There is a 7-page addendum - Translators Notes – that adds significant details about geology and the history of the area as well as literary references.

 

Reference:

1:  Tesson S.  The Consolations of the Forest – Alone In A Cabin on the Siberian Taiga.  Rizzoli International Publications, Inc. New York; 2014.

Koch's Book On Consciousness

I was pleasantly surprised to find this book.  I have been following the work of Guilio Tononi for some time and that involves reading articles co-authored by Christof Koch as one his main collaborators.  There also have several excellent videos available on YouTube where they discuss consciousness and Integrated Information Theory (IIT) of consciousness.  In this book we learn about Koch's personal and professional trajectory in the field and several of his influences.  He is currently the President and Chief Scientific Officer of the Allen Institute for Brain Science and a Professor of Biology and Engineering at Caltech.  His academic credentials are available at the link to his web page and they are reviewed in this book as a backdrop to how he came to the field of consciousness studies.     

The layout of the book is 10 chapters over 166 pages.  It is well written in that it contains technical terms but they are well explained for the novice.  On the other hand there are also higher level concepts pertaining to consciousness that will probably not be obvious to many readers that are well explained and worthwhile reading for anyone who is not an expert in the field.  The text reminds me of a slim guide to neuropathology that one of my med school professors claimed was the only book he studied to pass his subspecialty boards exams.  In other words, the more you bring to a book like this, the more you may take away.  At the same time it is interesting reading for a novice.   

A typical chapter is organized around clinical and scientific observations, associated philosophy and the personal experience and meaning to the author.  I thought about characterizing the writing as a very good blog, but this writing by one of the top neuroscientists of our time is several levels above that.  Koch writes from the perspective of admiration of some of the best scientists in the world when it is clear that he is among them.  He adds a unique perspective referencing his training, his family and social life, and the relationships he has with colleagues and mentors.  In the final chapter he describes how his career and experience has impacted on his belief system and personal philosophy.

I will touch on a couple of examples of what he covers and the relevance to consciousness.  Chapter 5: Consciousness in the Clinic is a chapter that is most accessible to clinicians specializing in the brain.  He briefly summarizes achromatopsia and prosopagnosia or face-blindness.  He discusses prosopagnosia from the perspective of clinical findings and associated disability, but also consciousness.  For example, patients with this lesion do not recognize faces but they do have autonomic responses (galvanic skin resistance) when viewing faces that they know (family or famous people) relative to unknown people.  This is evidence of processing that occurs at an unconscious level that he develops in a subsequent chapter.  He describes the Capgras delusion - as the "flip-side" of prosopagnosia in that they face is recognized but the patient believes the original person has been replaced by an impostor.  In this case the expected increase in galvanic skin resistant is lacking because there is no autonomic response to unconscious processing.

In the same chapter he details the problem of patients in a coma,  persistent vegetative state (PVS) and minimally conscious state (MCS) and how some new developments in consciousness theory and testing may be useful. From a consciousness perspective coma represent and absence of consciousness - no arousals and no sleep transitions.  Persistent vegetative state result in some arousals and sleep-awake transitions.  In the minimally conscious state there are awakenings and purposeful movements. The minimally conscious person may be able to communicate during the brief arousals.  At the clinical level being able to distinguish between the persistent vegetative state and the minimally conscious state is important from both a clinical and medico-legal perspective. He discusses the use of fMRI in the case of apparently unresponsive patients who are able to follow direction to think about very specific tasks and produce the same brain pattern of activation seen in controls.  In a subsequent chapter Tononi and Massimini use transcranial magnetic stimulation (TMS) and electroencephalography (EEG) for the same purpose.  This technique is considered proof of IIT as well as a clinical test to differentiate PVS from a minimally conscious state.  In normal awake volunteers the TMS impulse results in brief but clear pattern of reverberating activation that spreads from the original stimulation site to surrounding frontal and parietal cortex.  The pattern can be viewed in this online paper (see figure 1).  In the patient who is in non-REM sleep there is no cortical spread from this impulse and the total impulse duration is less, illustrating a lack of cortical integration required for a conscious state.  When applied to PVS versus MCS patients, the MCS patients show the expected TMS/EEG response that would be seen in conscious patients.  The PVS patients do not.  He describes the TMS/EEG method as a "crude consciousness meter" but obviously one that probably has a lot more potential than traditional clinical methods.

There are many other clinical, philosophical and scientific issues relevant to consciousness that are discussed in this book that I won't go into.  I will touch on a recurring theme in the book that gets back to the title and that is science and reductionism.  Philosophical perspectives are covered as well as the idea that the origin of consciousness may not be knowable by scientific methods. Koch's opinion is that most everything is knowable by science and that science generally has a better track record of determining what is knowable.  That is certainly my bias and I am on record as being an unapologetic reductionist rather than a romantic one.                           

This is a book that should be read by psychiatrists and residents.  These concepts will hopefully be some of the the mainstays of 21st century psychiatry.  It can be read at several levels.  I was interested in the development of Koch's ideas about consciousness.  I wanted to learn about his relationship with collaborators.  I was pleasantly surprised to learn that we had similar thoughts about popular media, philosophy, and and psychodynamic psychiatry.  I have had career long involvement in neuropsychiatry and behavioral neurology so the description of cortical localization and clinical syndromes was second nature to me.  But even against that background, he makes it very clear where consciousness comes in to play.  One of my concerns about psychiatric training is that there is not enough emphasis on neuroscience and consciousness.  Condensed into this small book there are number of jumping off points.  Each chapter has a collection of annotations and there is a list of about 100 scientific references at the end.  It may take some work, but this book is a brief syllabus on how to get up to speed in this important area and greatly extend your knowledge of how the brain works.


George Dawson, MD, DFAPA


Reference:

Christof Koch.  Consciousness: Confessions of a Romantic Reductionist.  First MIT Press Paperback.  Cambridge, Massachusetts, 2017.  Copyright 2012.   

Attribution:

Figure 1 above used with permission of the publisher.  The complete reference is:

1:  Massimini M, Ferrarelli F, Sarasso S, Tononi G. Cortical mechanisms of loss of consciousness: insight from TMS/EEG studies. Arch Ital Biol. 2012 Jun-Sep;150(2-3):44-55. doi: 10.4449/aib.v150i2.1361. Review. PubMed PMID: 23165870.  Open Access Free Text.