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Media Watch
Media watch Brain-Wise: Studies in Neurophilosophy Patricia Smith Churchland MIT press, 2003 £16·50, 470 pp ISBN 0 262 53200 X
Learning how the neuromuscular junction works was interesting I suppose, but the lectures on neurophilosophy were the ones that really caught my interest as an undergraduate. For 3 years I had been immersed in the minutiae of physiology, biochemistry, and pharmacology—cell membranes, action potentials and the like—but at no point, until that excellent lecture series, had anyone challenged me to ask questions like: Do I have free will? Is religion merely a product of the brain? And, what is it like to be a bat? Big questions indeed, but most importantly ones that scientists were beginning to test empirically. Patricia Smith Churchland’s Neurophilosophy, first published in 1986, introduced neuroscience to philosophers and philosophy to neuroscientists and was gripping reading. Now, nearly 20 years later, Churchland has written a sequel, Brain-Wise: Studies in Neurophilosophy, which aims to be an introductory textbook to philosophers interested in tackling the big problems—such as consciousness, free will, and the self. However, this book will also appeal to scientists and
Shared Care for Neurology Shevlin B, Misulis KE, Samuels MA Martin Dunitz, 2002 £24·95, 272 pp ISBN 1 84184 160 9
This excellent addition to the Shared Care series fills an important gap in the medical literature. It is aimed at general practitioners with an interest in neurology, or those who would like to update their knowledge, but its scope is such that it will also be of use to medical students, senior house officers, and registrars in the clinical neurosciences, and other health-care professionals. Shared Care for Neurology provides a very informative overview, particularly in relation to symptomatology and diagnosis. It covers the salient points in history and examination and outlines the common neurological problems faced in primary care—including headache, dizziness, weakness, pain, epilepsy, stroke, dementia, and movement disorders. These are illuminated by case studies and sections called “pearls” and “when to refer”. A comprehensive appendix has sections on “what can be expected?” and “what can I do?” as well as targeted questionnaires for common complaints and weblinks. Many family practictioners are underequipped to deal with common neurological complaints and diseases effectively. Furthermore, nervous-system disorders are often thought of as difficult or impossible to understand and treat. Shevlin, Misulis, and Samuels have achieved a remarkable feat by bringing exciting new research into the
448
clinicians who want to get a handle on how philosophers such as Churchland are approaching these Big Questions in light of the many developments in neuroscience that have occurred in the past two decades. Churchland has a pragmatic view of the mind–brain problem that will immediately ingratiate her in the eyes of most scientist readers. For example, she believes that consciousness is based on neuronal mechanisms that should be made understandable by well constructed experiments. She casts aside the notion proposed by some philosophers that the brain is so complex that we will never be able to understand it, no matter how much we study it. One of the strengths of the book is that Churchland discusses the arguments for and against many neurophilosophical theories and then draws her own conclusions, leaving the reader to make up his or her own mind. This didactic approach works well. The book, though well written, could have been edited better for meaning. The following excerpt, which appeared on page 5, did not bode well for the rest of the book, “… a pivotal concept whose clarity is no luxury as we begin to assay the integration of hitherto separated domains”. Thankfully, this was the worst example in the 471 pages. My other gripe is that Churchland uses italics to emphasise meaning up to 20 times each page. Unfortunately, this really annoying feature cast a dark cloud on my enjoyment of what is an otherwise excellent book. James Butcher
family practitioner’s surgery. Parkinson’s disease, stroke, headache, multiple sclerosis, and epilepsy are all treatable and even refractory degenerative processes such as Alzheimers’ and motor-neuron diseases are slowly yielding to molecular biology, genetics, and immunology, with various treatments now approved or in development. Superimposed on this is the recognition that there are not enough neurologists to provide ongoing care to all neurology patients; as the population ages, this problem will intensify. It is, without doubt, in the patients’ best interest to be managed by a well informed generalist in partnership with a neurologist to give state-of-the-art care in a cost-effective way. Written by a highly enthusiastic and experienced family practitioner and two neurology professors, this timely publication (which instantly makes you feel it should have been written before) provides practical solutions and spans the gap between generalist and specialist. It is both traditional and advanced in its outlook and is punctuated by stunning pieces of detail that will be new to many readers—eg, the succinct descriptions of the HallpikeNylen-Barany manoeuvre, the use of stereotactic radiosurgery for trigeminal neuralgia, and the giving of eponymous syndrome names (which adds historical interest). The level of clarity throughout reflects the hard work that must have gone into this publication. It will help many family practitioners to manage and communicate with their patients more effectively and I am personally grateful for a neurology text which does not leave me with headache, dizziness, fatigue, and memory loss. Jon Sen
THE LANCET Neurology Vol 2 July 2003
http://neurology.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Learning how the neuromuscular junction works was interesting I suppose, but the lectures on neurophilosophy were the ones that really caught my interest as an undergraduate. For 3 years I had been immersed in the minutiae of physiology, biochemistry, and pharmacology—cell membranes, action potentials and the like—but at no point, until that excellent lecture series, had anyone challenged me to ask questions like: Do I have free will? Is religion merely a product of the brain? And, what is it like to be a bat? Big questions indeed, but most importantly ones that scientists were beginning to test empirically. Patricia Smith Churchland’s Neurophilosophy, first published in 1986, introduced neuroscience to philosophers and philosophy to neuroscientists and was gripping reading. Now, nearly 20 years later, Churchland has written a sequel, Brain-Wise: Studies in Neurophilosophy, which aims to be an introductory textbook to philosophers interested in tackling the big problems—such as consciousness, free will, and the self. However, this book will also appeal to scientists and
Shared Care for Neurology Shevlin B, Misulis KE, Samuels MA Martin Dunitz, 2002 £24·95, 272 pp ISBN 1 84184 160 9
This excellent addition to the Shared Care series fills an important gap in the medical literature. It is aimed at general practitioners with an interest in neurology, or those who would like to update their knowledge, but its scope is such that it will also be of use to medical students, senior house officers, and registrars in the clinical neurosciences, and other health-care professionals. Shared Care for Neurology provides a very informative overview, particularly in relation to symptomatology and diagnosis. It covers the salient points in history and examination and outlines the common neurological problems faced in primary care—including headache, dizziness, weakness, pain, epilepsy, stroke, dementia, and movement disorders. These are illuminated by case studies and sections called “pearls” and “when to refer”. A comprehensive appendix has sections on “what can be expected?” and “what can I do?” as well as targeted questionnaires for common complaints and weblinks. Many family practictioners are underequipped to deal with common neurological complaints and diseases effectively. Furthermore, nervous-system disorders are often thought of as difficult or impossible to understand and treat. Shevlin, Misulis, and Samuels have achieved a remarkable feat by bringing exciting new research into the
448
clinicians who want to get a handle on how philosophers such as Churchland are approaching these Big Questions in light of the many developments in neuroscience that have occurred in the past two decades. Churchland has a pragmatic view of the mind–brain problem that will immediately ingratiate her in the eyes of most scientist readers. For example, she believes that consciousness is based on neuronal mechanisms that should be made understandable by well constructed experiments. She casts aside the notion proposed by some philosophers that the brain is so complex that we will never be able to understand it, no matter how much we study it. One of the strengths of the book is that Churchland discusses the arguments for and against many neurophilosophical theories and then draws her own conclusions, leaving the reader to make up his or her own mind. This didactic approach works well. The book, though well written, could have been edited better for meaning. The following excerpt, which appeared on page 5, did not bode well for the rest of the book, “… a pivotal concept whose clarity is no luxury as we begin to assay the integration of hitherto separated domains”. Thankfully, this was the worst example in the 471 pages. My other gripe is that Churchland uses italics to emphasise meaning up to 20 times each page. Unfortunately, this really annoying feature cast a dark cloud on my enjoyment of what is an otherwise excellent book. James Butcher
family practitioner’s surgery. Parkinson’s disease, stroke, headache, multiple sclerosis, and epilepsy are all treatable and even refractory degenerative processes such as Alzheimers’ and motor-neuron diseases are slowly yielding to molecular biology, genetics, and immunology, with various treatments now approved or in development. Superimposed on this is the recognition that there are not enough neurologists to provide ongoing care to all neurology patients; as the population ages, this problem will intensify. It is, without doubt, in the patients’ best interest to be managed by a well informed generalist in partnership with a neurologist to give state-of-the-art care in a cost-effective way. Written by a highly enthusiastic and experienced family practitioner and two neurology professors, this timely publication (which instantly makes you feel it should have been written before) provides practical solutions and spans the gap between generalist and specialist. It is both traditional and advanced in its outlook and is punctuated by stunning pieces of detail that will be new to many readers—eg, the succinct descriptions of the HallpikeNylen-Barany manoeuvre, the use of stereotactic radiosurgery for trigeminal neuralgia, and the giving of eponymous syndrome names (which adds historical interest). The level of clarity throughout reflects the hard work that must have gone into this publication. It will help many family practitioners to manage and communicate with their patients more effectively and I am personally grateful for a neurology text which does not leave me with headache, dizziness, fatigue, and memory loss. Jon Sen
THE LANCET Neurology Vol 2 July 2003
http://neurology.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.