From school shootings to everyday counter-terrorism

CC Licensed Image from Secretive Ireland. Click for source.Mother Jones has a fascinating article on how America is attempting to stop school shootings by using community detection and behavioural intervention programmes for people identified as potential killers – before a crime has ever been committed.

It is a gripping read in itself but it is also interesting because it describes an approach that is now been rolled out to millions as part of community counter-terrorism strategies across the world, which puts a psychological model of mass-violence perpetration at its core.

The Mother Jones article describes a threat assessment model for school shootings that sits at an evolutionary mid-point: first developed to protect the US President, then to preventing school shootings, and now as mass deployment domestic counter-terrorism programmes.

You can see exactly this in the UK Government’s Prevent programme (part of the wider CONTEST counter-terrorism strategy). Many people will recognise this in the UK because if you work for a public body, like a school or the health service, you will have been trained in it.

The idea behind Prevent is that workers are trained to be alert to signs of radicalisation and extremism and can pass on potential cases to a multi-disciplinary panel, made up of social workers, mental health specialists, staff members and the police, who analyse the case in more detail and get more information as it’s needed.

If they decide the person is vulnerable to becoming dangerously radicalised or violent, they refer the case on the Channel programme, which aims to manage the risk by a combination of support from social services and heightened monitoring by security services.

A central concept is that the person may be made vulnerable to extremism due to unmet needs (poor mental health, housing, lack of opportunity, poor social support, spiritual emptiness, social conflict) which may convert into real world violence when mixed with certain ideologies or beliefs about the world that they are recruited into, or persuaded by, and so violence prevention includes both a needs-based and a threat-based approach.

This approach came from work by the US Secret Service in the 1990s, who were mainly concerned with protecting key government officials, and it was a radical departure from the idea that threat management was about physical security.

They began to try and understand why people might want to attempt to kill important officials and worked on figuring out how to identify risks and intervene before violence was ever used.

The Mother Jones article also mentions the LAPD Threat Management Unit (LAPDTMU) which was formed to deal with cases of violent stalking of celebrities, and the FBI had been developing a data-driven approach since the National Center for the Analysis of Violent Crime (NCAVC) launched in 1985.

By the time the Secret Service founded the National Threat Assessment Center in 1998, the approach was well established. When the Columbine massacre occurred the following year, the same thinking was applied to school shootings.

After Columbine, reports were produced by both the FBI (pdf) and the Secret Service (pdf) which outline some of the evolution of this approach and how it applies to preventing school shootings. The Mother Jones article illustrates what this looks like, more than 15 years later, as shootings are now more common and often directly inspired by Columbine or other more recent attacks.

It’s harder to find anything written on the formal design of the UK Goverment’s Prevent and Channel programmes but the approach is clearly taken from the work in the United States.

The difference is that it has been deployed on a mass scale. Literally, millions of public workers have been trained in Prevent, and Channel programmes exist all over the country to receive and evaluate referrals.

It may be one of the largest psychological interventions ever deployed.

Link to Mother Jones article on preventing the next mass shooting.

The echoes of the Prozac revolution

The Lancet Psychiatry has a fantastic article giving a much needed cultural retrospective on the wave of antidepressants like Prozac – which first made us worry we would no longer be our true selves through ‘cosmetic pharmacology,’ to the dawning realisation that they are unreliably useful but side-effect-ridden tools that can help manage difficult moods.

From their first appearance in the late 1980s until recently, SSRIs were an A-list topic of debate in the culture wars, and the rhetoric, whether pro or con, was red hot. Antidepressants were going to heal, or destroy, the world as we knew it.

Those discussions now feel dated. While antidepressants themselves are here to stay, they just don’t pulse with meaning the way they once did. Like the automobile or the telephone before them, SSRIs are a one-time miracle technology that have since become a familiar—even frumpy—part of the furniture of modern life.

At some point recently, they’ve slid into the final act of Mickey Smith’s wonder-drug drama. And in the aftermath of that change, many of the things that people used to say about them have come to sound completely absurd.

It’s a wonderful piece that perfectly captures the current place of antidepressants in modern society.

It’s by author Katherine Sharpe who wrote the highly acclaimed book Coming of Age on Zoloft which I haven’t read but have just ordered.

Link to ‘The silence of prozac’ in The Lancet Psychiatry.

Spike activity 09-10-2015

Quick links from the past week in mind and brain news:

How much can you really learn while you’re asleep? Interesting piece that looks at what the research genuinely tells us in The Guardian.

Comedian John Oliver takes on mental health in America with a segment which is both funny and sharp.

Neuroecology has an excellent post looking at the latest mega-paper from the Blue Brain Project.

There’s a good piece on how cognitive biases affect the practice of doing scientific research in Nature. Thankfully, my training has made me immune to these effects, unlike my colleagues.

Braindecoder has some striking artistic renditions of neuroanatomy from artist Greg Dunn.

Is a Liberal Bias Hurting Social Psychology? Excellent piece in Pacific Standard.

BBC News has a good piece on the evidence behind the school shooting ‘contagion’ effect.

“A tumor stole every memory I had. This is what happened when it all came back.” Great piece in Quartz. Don’t get distracted by the inaccurate use of the term dementia. Recommended.

Statistical fallacy impairs post-publication mood

banksyNo scientific paper is perfect, but a recent result on the affect of mood on colour perception is getting a particularly rough ride post-publication. Thorstenson and colleagues published their paper this summer in Psychological Science, claiming that people who were sad had impaired colour perception along the blue-yellow colour axis but not along the red-green colour axis. Pubpeer – a site where scholars can anonymously discuss papers after publication – has a critique of the paper, which observes that the paper commits a known flaw in its analysis.

The flaw, anonymous comments suggest, is that a difference between the two types of colour perception is claimed, but this isn’t actually tested by the paper – instead it shows that mood significantly affects blue-yellow perception, but does not significantly affect red-green perception. If there is enough evidence that one effect is significant, but not enough evidence for the second being significant, that doesn’t mean that the two effects are different from each other. Analogously, if you can prove that one suspect was present at a crime scene, but can’t prove the other was, that doesn’t mean that you have proved that the two suspects were in different places.

This mistake in analysis  – which is far from unique to this paper – is discussed in a classic 2011 paper by Nieuwenhuis and colleagues: Erroneous analyses of interactions in neuroscience: a problem of significance. At the time of writing the sentiment on Pubpeer is that the paper should be retracted – in effect striking it from the scientific record.

With commentary like this, you can see why Pubpeer has previously been the target of legal action by aggrieved researchers who feel the site unfairly maligns their work.

(h/t to Daniël Lakens and jjodx on twitter)

Spike activity 02-10-2015

Quick links from the past week in mind and brain news:

The madness of Charlie Brown. The Lancet has a wonderful article on Lucy, Charlie Brown’s local psychiatrist.

The Atlantic has an excellent piece on new research showing neurons have different genomes.

Mexico’s 13-year-old psychologist is amazing, reports USA Today. Sí, es.

PLOS Neuro has an excellent in-depth piece about the neuroscience of sleep deprivation.

Boring cityscapes increase sadness, addiction and disease-related stress. Is urban design a matter of public health? asks Aeon.

The Wall Street Journal on why a new paper may show that the ‘hot hand’ effect in basketball may be real after all.

Pioneering dubstep DJ and producer Benga was diagnosed with bipolar disorder and schizophrenia last year. He speaks to The Guardian on mental health and his comeback.

The Psychologist has an excellent piece on whether the media be restricted in their reporting of mass shootings to prevent copycat killings.

There’s a good piece in Nature about the state of connectome research in neuroscience.

The Quiet Room

This month’s British Journal of Psychiatry has a brief but fascinating article about a 1979 Marvel comic featuring and written by rock legend Alice Cooper which depicts his real-life admission to a psychiatric ward.

The comic was timed to coincide with the release of his concept album From The Inside which describes his experiences as a psychiatric patient being treated for severe alcoholism and depression.

He was there for 3 months and in the comic he depicts the patients, doctors and nurses he met during his admission. Alice has often commented in interviews that treatment in hospital and recovering from his substance misuse saved his life, when many similar artists at that time, such as Jim Morrison and Janis Joplin, were not as fortunate, succumbing to their addictions. The lead single from the album was ‘How You Gonna See Me Now’, a song describing the anxiety the singer felt coming back home to his wife after his stay in hospital and facing the stigma of being treated for his mental illness. It went on to become a well-known successful ballad. The comic can still be found in comic shops or through online auction sites.


Link to brief British Journal of Psychiatry article.

How the magic of cinema unlocked one man’s coma-bound world

Image from NIH. Click for source.An Alfred Hitchcock film helped to prove one patient had been conscious while in a coma-like state for 16 years. The discovery shows that neuroscience may still have lots to learn from the ancient art of storytelling, says Tom Stafford.

If brain injury steals your consciousness then you are in a coma: we all know that. What is less well known is that there exist neighbouring states to the coma, in which victims keep their eyes open, but show no signs of consciousness. The vegetative state, or ‘unresponsive wakefulness syndrome’, is one in which the patient may appear to be awake, and even goes to sleep at times, but otherwise shows no reaction to the world. Patients who do inconsistently respond, such as by flinching when their name is called, or following a bright object with their eyes, are classified as in a ‘minimally conscious state’. Both categories of patients show no signs of deliberate actions, or sustained reaction to the environment, and until recently there was no way for anyone to discern their true, inner, level of consciousness.

The fear is that, like the ‘locked-in syndrome’ that can occur after strokes, these patients may be conscious, but are just unable to show it. The opposite possibility is that these patients are as unconscious as someone in the deepest coma, with only circuitry peripheral to consciousness keeping their eyes open and producing minimal responses automatically.

In the last 10 years, research spearheaded by cognitive neuroscientist Adrian Owen has transformed our understanding of these shadowlands of consciousness. There is now evidence, obtained using brain scans, that some patients (around one in five) in these ‘wakeful coma’ states have conscious awareness. If asked to imagine playing tennis, the brain areas specifically controlling movement become active. If asked to imagine finding their way around their house, the brain regions involved in navigation become active. Using these signals a small minority of patients have even communicated with the outside world, with the brain scanner helping observers to mind-read their answers to questions.

The practical and ethical implications of these findings are huge, not least for the treatment of the hundreds of thousands of people who are in hospitals around the world in these conditions right now.

But the meaning of the research is still hotly debated. One issue is that the mind reading uses neural responses to questions or commands, and careful controls are needed to ensure that their patients’ brains aren’t just responding automatically without any actual conscious involvement. A second issue, and one that cannot be controlled away, is that the method used may tell us that these patients are capable of responding, but it doesn’t tell us much about the quality of conscious experience they are having. How alert, aware and focused they are is hard to discern.

In a relatively new study, a post-doctoral fellow at Owen’s lab, Lorina Naci, has used cinema to show just how sophisticated conscious awareness can be in a ‘minimally conscious’ patient.

The trick they used involved an 8 minute edit of “Bang! You’re dead”, a 1961 episode of “Alfred Hitchcock Presents”. In the film, a young boy with a toy gun obsession wanders around aiming and firing at people. Unbeknownst to him, and the adults he aims at, on this day he has found a real gun and it has a live bullet in the chamber.

The film works because of this hidden knowledge we, the viewers, have. Knowing about the bullet, a small boy’s mundane antics become high drama, as he unwittingly involves unsuspecting people in round after deadly round of Russian roulette.

Naci showed the film to healthy participants. To a separate group she showed a scrambled version involving rearranged one-second segments. This ‘control’ version was important because it contained many of the same features as the original; the same visual patterns, the same objects, the same actions. But it lacked the crucial narrative coherence – the knowledge of the bullet – which generated the suspense.

Using brain scanning, and the comparison of the two versions of the film, Naci and colleagues were able to show that the unscrambled, suspenseful version activated nearly every part of the cortex. Everything from primary sensory areas, to motor areas, to areas involved in memory and anticipation were engaged (as you might hope from a film from one of the masters of storytelling). The researchers were particularly interested in a network of activity that rose and fell in synchrony across ‘executive’ areas of the brain – those known to be involved in planning, anticipation, and integrating information from different sources. This network, they found, responded to the moments of highest suspense in the film; the moments when the boy was about to fire, for example. These were the moments you could only find so dramatic if you were following the plot.

Next the researchers showed the film to two patients in wakeful comas. In one, the auditory cortex became activated, but nothing beyond this primary sensory region. Their brain was responding to sounds, perhaps automatically, but there was no evidence of more complex processing. But in a second patient, who had been hospitalised and non-responsive for 16 years, his brain response matched those of the healthy controls who’d seen the film. Like them, activity across the cortex rose and fell with the action of the film, indicating an inner consciousness rich enough to follow the plot.

The astounding result should make us think carefully about how we treat such patients and marks an advance on the arsenal of techniques we can use to connect to the inner lives of non-responsive patients. It also shows how cognitive neuroscience can benefit from the use of more complex stimuli, such as movies, rather than the typically boring visual patterns and simple button-press responses that scientists usually use to probe the mysteries of the brain.

The genius of this research is that to test for the rich consciousness of the patient who appears unresponsive you need to use rich stimuli. The Hitchcock film was perfect because of its ability to create drama by what we believe and expect not because of what we merely see.

My BBC Future column from last week. The original is here. The original paper is: Naci, L., Cusack, R., Anello, M., Owen, A. M. A common neural code for similar conscious experiences in different individuals. PNAS. 2014;111(39):14277–82.

Spike activity 25-09-2015

Quick links from the past week in mind and brain news:

Science has a fascinating piece on how cultures developed words for numbers – many languages don’t have words for numbers above five.

The majority illusion. The social illusion covered by Tech Review where something can seem socially common despite being rare in the overall group.

Wired has a thought-provoking piece on the potential role of the internet in hastening the demise of dying languages.

Researchers who reported a study on how oxytocin increases trust try and fail to replicate their own results. Good coverage from Neuroskeptic.

The LA Times has a good piece in light of the Hajj disaster that dispels some crowd behaviour myths.

There’s a brilliant piece from boxer Jerome Wilson on what it’s like to recover from a serious brain trauma in The Telegraph. Really, it’s great, go and read it.

The Guardian covers the news that a man completes a 3.5-metre course thanks to computer system that reroutes signals from his brain to electrodes on his knees.

DeepMind’s AI can now beat humans at 31 Atari 2600 arcade games, reports TechRepublic. Still thinks ET was rubbish.

Pacific Standard has a fascinating piece on how our understanding of Neanderthals has dramatically and rapidly shifted.

Guy puts cameras in his home to record every second of his new baby’s life to record his exposure to language and work out how new words emerge. Great study and findings covered in Science News.

AlterNet has a good piece critiquing the concept of ‘sex addiction‘.

A museum of many minds

I spent a very long time in the old Bethlem museum, owing to the fact that there’s little else to do when you live at one of the world’s oldest psychiatric hospitals.

The Bethlem Royal Hospital, or Bedlam as it’s been known in centuries past, has moved many times over its lifetime, but it’s now located in one of London’s comfortable, sleepy suburbs. Unfortunately, there is very, and I mean, very little to do there on weekends.

The museum was occasionally open on Saturdays, and during the six months I lived at the hospital, I visited. Repeatedly, as it turned out.

But for an institution that was founded in 1247, that has been a central character in London’s history and formative in our understanding and misunderstanding of madness, the museum was surprisingly crap.

It lived in a small, bleak portakabin in the corner of the grounds. You would walk in, stare at a few tiny walls of exhibits and then chat to the curator, who would be so bereft of visitors that it would be like a turning on a ‘history of the Bethlem’ fire hose for a few minutes before you left them to solemnly contemplate the archives once more.

But after years of neglect, the portamusem has been replaced by the Museum of the Mind in the Bethlem Royal Hospital’s central building. To get an idea of how much the new museum is being valued, they kicked the hospital bosses out to make space for it.

Apart from the museum space, it also has two galleries. One dedicated to work from current patients and another that has guest exhibitions. It also does talks from historians and art workshops – on everything from art techniques to building websites. You can even buy Bedlam mugs and pencils in the museum shop – for reasons I’m not entirely sure of.

The museum itself is beautifully put together and is entirely focused on tackling the most contentious issues in mental health. Here’s a quote, painted in large letters on one of the walls:

“The words of psychiatry are often unjust stewards, sorry guardians of meaning, workers of deception.”

The quote, quite profound in itself, doesn’t have the same impact until you understand that it’s from Aubrey Lewis the ‘father of British psychiatry’ and one of the most important people in the history of the profession.

And it is this rather confrontational approach to psychiatry’s assumptions, now and in the past, which permeates the museum.

Many of these challenges come from the voices of patients themselves, either contemporary or historical, and the testimonies to medically-induced suffering sit alongside the testimonies to its value as a remedy to mental distress.

For those looking for something of the London gothic, there are strait-jackets, manacles, and panels from a genuine padded cell from an old asylum, but it’s hardly the gaudy tourism of the London Dungeon – not least because the framing is quite different – the question of what it means to be humane in treating people with mental health difficulties is a central theme.

This approach also means artwork from patients, some of whom have been the country’s most distinguished artists in their own right, is integral to the design of the museum.

While you’re visiting, by the way, have a walk through the hospital grounds. They’re open to the public, extensive and beautiful. Locals walk their dogs there and come in the use the swimming pool. It’s quite different from how many people imagine a psychiatric hospital to be (and it has to be said, quite different from how many other psychiatric hospitals are).

And before you leave the museum, don’t miss the guest book. I’ve visited twice but the comments and art in the guestbook have been one of the highlights.

Link to the Museum of the Mind website.

Disclaimer: I still work for the NHS Trust which is responsible for the museum and occasionally still work at the Bethlem. However, I have since moved out to less salubrious accommodation in South London’s out-of-control rental market. Do note, however, that the Bethlem is genuinely out of the way in suburban London. It takes a while to get there and there is still nothing else to do there on weekends.

Spike activity 18-09-2015

Quick links from the past week in mind and brain news:

GlaxoSmithKline straight-up lied about teen suicide attempts in a trial that was used to convince regulators that Paxil was safe for kids. In-depth from the BMJ. Good summary from The Atlantic.

The New York Times on basically the same shit from Johnson & Johnson over Risperdal. Jaw-dropping punchline: the profits were worth more than any financial blow-back in fines and law suits.

Fascinating article on how the ability to deceive is being built into AI and robot interactions from Fusion. To the bunkers!

The Whitehouse, yes, President Obama, issues an executive order requiring all government services to use behavioural science nudges ‘to Better Serve the American People’. “Your neighbours believe that we have always been at war with Eastasia…”

The neuroscience of Donald Trump. I SHIT YOU NOT. A Salon piece that should be a warning to everyone not to write neuroscience articles while high on butane.

The head of the world’s biggest mental health science organisation, the NIMH, is leaving to join Google. Will be deleting YouTube videos that mention the DSM.

Wired reports on a new campaign to ban sex robots. It’s the date-that-drags-on robots I want to see the back of.

The big review paper on the lack of political diversity in social psychology is finally out. Heterodox Academy has links to the full text.

MyCentralJersey reports on Jason Lunden, an autistic neuroscientist who researches the neuroscience of autism.

There’s a brilliant piece in The Psychologist about Geel in Belgium, where for 700 years boarders with learning disabilities and mental health problems have lived with residents.

Your ears emit sounds

There’s a fascinating article on the evolution of hearing in The Scientist that also contains an interesting gem – your ears produce sounds as well as perceiving them.

In addition to amplifying hair-cell activity, these active mechanisms manifest as spontaneous movements of the hearing organ, oscillating even in the absence of sound stimuli. Such spontaneous movements actually produce sound that is emitted through the middle ear to the outside world and can be measured in the ear canal.

I wondered whether this only applied to non-human animals – it’s not clear from the text – but a brief search brings up various studies on spontaneous otoacoustic emissions in humans. For example:

Spontaneous otoacoustic emissions were evaluated in 36 female and 40 male subjects. In agreement with the results of previous surveys, emissions were found to be more prevalent in female subjects and there was a tendency for the male subjects to have fewer emissions in their left ears.

It also turns out that spontaneous otoacoustic emissions are used to test hearing in newborn babies.

It’s an interesting problem, because normally hearing is tested by giving people tests where they are played various sounds or silence at certain time points and they have to signal whether they think they heard the sound, and correct decisions are counted.

This clearly doesn’t work with babies but one way of testing hearing is by measuring the response of nerve signals that connect to the auditory brain stem.

This training video shows how it’s done but in the last section there’s a test which relies directly on detecting the ‘echoes’ created by otoacoustic emission when a tone is played directly into the ear.


Link to The Scientist article on the evolution of hearing.

Spike activity 11-09-2015

Quick links from the past week in mind and brain news:

Mental illness throughout the animal kingdom. Interesting piece from BBC Earth.

The Guardian has an excellent in-depth article on scorpion venom as a way of identifying brain tumours during neurosurgery.

There’s an excellent piece on the history of using deception in psychology studies over at Aeon.

The Covnersation has an excellent piece on how so much talk about ‘the brain’ in education is meaningless.

Psychology Should Aim For 100% Reproducibility. Some Grade A trolling from Neuroskeptic.

Robohub has an interesting piece on ‘morphological computation’ and the hidden superpower of soft-bodied robots.

Yet another ancient human / hominin species is discovered. Great coverage from The Atlantic. So where’d all our cousins go?

Twelve minutes of consciousness

The Economist has an excellent video on consciousness, what it is, why and how it evolved.

The science section of The Economist has long had some of the best science reporting in the mainstream press and this video is a fantastic introduction to the science of consciousness.

It’s 12 minutes long and it’s worth every second of your time.

Images of ultra-thin models need your attention to make you feel bad

I have a guest post over at the BPS Research Digest, covering research on the psychological effects of pictures of ultra-thin fashion models.

A crucial question is whether the effect of these thin-ideal images is automatic. Does the comparison to the models, which is thought to be the key driver in their negative effects, happen without our intention, attention or both? Knowing the answer will tell us just how much power these images have, and also how best we might protect ourselves from them.

It’s a great study from the lab of Stephen Want (Ryerson University). For the full details of the research, head over: Images of ultra-thin models need your attention to make you feel bad

Update: Download the preprint of the paper, and the original data here

Spike activity 04-09-2015

Quick links from the past week in mind and brain news:

Go get your gramophonic digital podcast player and listen to this amazing BBC Radio 4 programme on how the social discussion of dreams has changed through history.

The Atlantic on what Google’s trippy neural network-generated images tell us about the human mind.

Ignore the fact that this is yet another article on mental health that says this particular condition is much more common than you think, and you’ll find an interesting piece on depersonalisation in The Guardian.

Nature has a tribute and article collection in memory of Oliver Sacks.

Architecture’s brief love affair with psychology is overdue a revival. Good piece in The Conversation.

The New York Review of Books has Oliver Sacks’s last piece on Klüver-Bucy syndrome, the temporal lobes and unruly urges.

One of the great debates in neuroscience: are all neurodegenerative diseases caused by prions? Interesting post from Brainblogger.

Oliver Sacks has left the building

CC Licensed Photo from Wikipedia. Click for source.Neurologist and author Oliver Sacks has died at the age of 82.

It’s hard to fully comprehend the enormous impact of Oliver Sacks on the public’s understanding of the brain, its disorders and our diversity as humans.

Sacks wrote what he called ‘romantic science’. Not romantic in the sense of romantic love, but romantic in the sense of the romantic poets, who used narrative to describe the subtleties of human nature, often in contrast to the enlightenment values of quantification and rationalism.

In this light, romantic science would seem to be a contradiction, but Sacks used narrative and science not as opponents, but as complementary partners to illustrate new forms of human nature that many found hard to see: in people with brain injury, in alterations or differences in experience and behaviour, or in seemingly minor changes in perception that had striking implications.

Sacks was not the originator of this form of writing, nor did he claim to be. He drew his inspiration from the great neuropsychologist Alexander Luria but while Luria’s cases were known to a select group of specialists, Sacks wrote for the general public, and opened up neurology to the everyday world.

Despite Sacks’s popularity now, he had a slow start, with his first book Migraine not raising much interest either with his medical colleagues or the reading public. Not least, perhaps, because compared to his later works, it struggled to throw off some of the technical writing habits of academic medicine.

It wasn’t until his 1973 book Awakenings that he became recognised both as a remarkable writer and a remarkable neurologist, as the book recounted his experience with seemingly paralysed patients from the 1920s encephalitis lethargica epidemic and their remarkable awakening and gradual decline during a period of treatment with L-DOPA.

The book was scientifically important, humanely written, but most importantly, beautiful, as he captured his relationship with the many patients who experienced both a physical and a psychological awakening after being neurologically trapped for decades.

It was made into a now rarely seen documentary for Yorkshire Television which was eventually picked up by Hollywood and made into the movie starring Robin Williams and Robert De Niro.

But it was The Man Who Mistook His Wife for a Hat that became his signature book. It was a series of case studies, that wouldn’t seem particularly unusual to most neurologists, but which astounded the general public.

A sailor whose amnesia leads him to think he is constantly living in 1945, a woman who loses her ability to know where her limbs are, and a man with agnosia who despite normal vision can’t recognise objects and so mistook his wife’s head for a hat.

His follow-up book An Anthropologist on Mars continued in a similar vein and made for equally gripping reading.

Not all his books were great writing, however. The Island of the Colorblind was slow and technical while Sacks’s account of how his damaged leg, A Leg to Stand On, included conclusions about the nature of illness that were more abstract than most could relate to.

But his later books saw a remarkable flowering of diverse interest and mature writing. Music, imagery, hallucinations and their astounding relationship with the brain and experience were the basis of three books that showed Sacks at his best.

And slowly during these later books, we got glimpses of the man himself. He revealed in Hallucinations that he had taken hallucinogens in his younger years and that the case of medical student Stephen D in The Man Who Mistook His Wife for a Hat – who developed a remarkable sense of smell after a night on speed, cocaine, and PCP – was, in fact, an autobiographical account.

His final book, On the Move, was the most honest, as he revealed he was gay, shy, and in his younger years, devastatingly handsome but somewhat troubled. A long way from the typical portrayal of the grey-bearded, kind but eccentric neurologist.

On a personal note, I have a particular debt of thanks to Dr Sacks. When I was an uninspired psychology undergraduate, I was handed a copy of The Man Who Mistook His Wife for a Hat which immediately convinced me to become a neuropsychologist.

Years later, I went to see him talk in London following the publication of Musicophilia. I took along my original copy of The Man Who Mistook His Wife for a Hat, hoping to surprise him with the news that he was responsible for my career in brain science.

As the talk started, the host mentioned that ‘it was likely that many of us became neuroscientists because we read Oliver Sacks when we started out’. To my secret disappointment, about half the lecture hall vigorously nodded in response.

The reality is that Sacks’s role in my career was neither surprising nor particularly special. He inspired a generation of neuroscientists to see brain science as a gateway to our common humanity and humanity as central to the scientific study of the brain.

Link to The New York Times obituary for Oliver Sacks.


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