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“Call Me Ishmael”: In the Realm of Outliers
Editor’s Letter
“Call Me Ishmael”: In the Realm of Outliers
H
erman Melville, in his monumental American novel, opens the narrative with the line “Call me Ishmael,” developing the character of the protagonist—an individual who separates himself from the land to enter the unique environment of the sea—an act of both escape and rejuvenation. Ishmael was, of course, the Old Testament’s son of Abraham who was cast out after the birth of his halfbrother, Issac, banished to the desert only to later experience immense success and have dramatic historical impact and relevance. A complicated individual, Ishmael has come to connote the castaway, the outlier, the outcast, the heretic, and the unfortunate. The character of Ishmael holds a prominent place in not only Christianity but also Judaism and Islam. His rudimentary life course serves as a model that is recapitulated with great frequency in history.
“establishment” has emerged. Upon examination, it is apparent that the culture of neurosurgery is grounded in this establishment—in many ways laudable and offering a stable grounding that demands protection and cultivation. We see this in clinical practice, research, and our societies. Established paths and practice exist that provide stability and comfort for those involved (1). It can be suggested, however, that the modus operandi may create intellectual lethargy and frequent stagnation. The realm of the novel, the innovator, and the outlier from the conventional are then seen as a threat to what is perceived as a sense of order, the status quo, patterns of thinking, and, for some, their pathways or offices of “earned” entitlement. A healthy establishment is characterized by continuous meaning full evolution and renewal to achieve progress and freshness based on factors both internal and external. It is clearly apparent from examination of history that in all areas of endeavor, the new, the progressive, and the evolutionary more often than not come from the outliers, and that it is they who convey the needed fresh perspectives and actions. The establishment is frequently prone to stagnation and elements of lethargy.
Vincent Willem van Gogh (1853e1890), the Dutch painter, is arguably the Established practices and organizations Western world’s most popular and ultiprovide us with stability, but new ideas and mately successful artist (2). His work, the truly revolutionary and progressive are renowned for its vivid color, rough frequently born in the periphery. These new beauty, and emotional honesty, has had ideas should be recognized as potentially immense influence on those who folbeneficial and actively fostered in a positive lowed him. Van Gogh died at the age of way, with no effort to subvert or control to 37, leaving an immense catalogue of oil The Zouave, June 1888. Courtesy: Van Gogh Museum, Amsterdam, preserve what is viewed as established and painting, the majority of which had been The Netherlands. mainstream. The established foundations produced only during the last 2 years of require vigilant introspection and benign regular self-assessment. his life. Van Gogh’s circuitous and painful pathway to the ultimate Fertile ideas, irrespective of the source, must be cultivated, honestly unique expression of genius is legendary. A cyclical pattern of failure assessed, and, if required, supported and developed with vigor! and escalating seclusion were catalyzed by failed relationships and rejections, including a vocational effort within the clergy. Although an accomplished sketcher, he was introduced to oils only 8 years before his death. The artist then persisted through a painful and stormy evolution to the development of his ultimate expression in the final 2 years of his life, an expression that was both prolific and Michael L. J. Apuzzo, monumental—a conveyance of emotion that penetrated the REFERENCES superficial and acted as a true trailblazer for the modern. In spite of his eventual importance, during his lifetime he remained a largely 1. Apuzzo MLJ: Individualism and collectivism in the realm of neurosurgery. World peripheral figure who was, fundamentally, marginalized by the Paris Neurosurgery 78:555, 2012, 2012. art establishment. Modern neurosurgery is in essence a young surgical specialty, but it has gone through significant maturation during the past 30 years. During this time and in keeping with this evolution, an
WORLD NEUROSURGERY 80 [6]: 675, DECEMBER 2013
2. Salcman M: Self-portrait in a felt hat (1886-1887) by Vincent van Gogh (1853e1890). World Neurosurgery 80, 2013.
1878-8750/$ - see front matter ª 2013 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.wneu.2013.10.024
www.WORLDNEUROSURGERY.org
675
“Call Me Ishmael”: In the Realm of Outliers
H
erman Melville, in his monumental American novel, opens the narrative with the line “Call me Ishmael,” developing the character of the protagonist—an individual who separates himself from the land to enter the unique environment of the sea—an act of both escape and rejuvenation. Ishmael was, of course, the Old Testament’s son of Abraham who was cast out after the birth of his halfbrother, Issac, banished to the desert only to later experience immense success and have dramatic historical impact and relevance. A complicated individual, Ishmael has come to connote the castaway, the outlier, the outcast, the heretic, and the unfortunate. The character of Ishmael holds a prominent place in not only Christianity but also Judaism and Islam. His rudimentary life course serves as a model that is recapitulated with great frequency in history.
“establishment” has emerged. Upon examination, it is apparent that the culture of neurosurgery is grounded in this establishment—in many ways laudable and offering a stable grounding that demands protection and cultivation. We see this in clinical practice, research, and our societies. Established paths and practice exist that provide stability and comfort for those involved (1). It can be suggested, however, that the modus operandi may create intellectual lethargy and frequent stagnation. The realm of the novel, the innovator, and the outlier from the conventional are then seen as a threat to what is perceived as a sense of order, the status quo, patterns of thinking, and, for some, their pathways or offices of “earned” entitlement. A healthy establishment is characterized by continuous meaning full evolution and renewal to achieve progress and freshness based on factors both internal and external. It is clearly apparent from examination of history that in all areas of endeavor, the new, the progressive, and the evolutionary more often than not come from the outliers, and that it is they who convey the needed fresh perspectives and actions. The establishment is frequently prone to stagnation and elements of lethargy.
Vincent Willem van Gogh (1853e1890), the Dutch painter, is arguably the Established practices and organizations Western world’s most popular and ultiprovide us with stability, but new ideas and mately successful artist (2). His work, the truly revolutionary and progressive are renowned for its vivid color, rough frequently born in the periphery. These new beauty, and emotional honesty, has had ideas should be recognized as potentially immense influence on those who folbeneficial and actively fostered in a positive lowed him. Van Gogh died at the age of way, with no effort to subvert or control to 37, leaving an immense catalogue of oil The Zouave, June 1888. Courtesy: Van Gogh Museum, Amsterdam, preserve what is viewed as established and painting, the majority of which had been The Netherlands. mainstream. The established foundations produced only during the last 2 years of require vigilant introspection and benign regular self-assessment. his life. Van Gogh’s circuitous and painful pathway to the ultimate Fertile ideas, irrespective of the source, must be cultivated, honestly unique expression of genius is legendary. A cyclical pattern of failure assessed, and, if required, supported and developed with vigor! and escalating seclusion were catalyzed by failed relationships and rejections, including a vocational effort within the clergy. Although an accomplished sketcher, he was introduced to oils only 8 years before his death. The artist then persisted through a painful and stormy evolution to the development of his ultimate expression in the final 2 years of his life, an expression that was both prolific and Michael L. J. Apuzzo, monumental—a conveyance of emotion that penetrated the REFERENCES superficial and acted as a true trailblazer for the modern. In spite of his eventual importance, during his lifetime he remained a largely 1. Apuzzo MLJ: Individualism and collectivism in the realm of neurosurgery. World peripheral figure who was, fundamentally, marginalized by the Paris Neurosurgery 78:555, 2012, 2012. art establishment. Modern neurosurgery is in essence a young surgical specialty, but it has gone through significant maturation during the past 30 years. During this time and in keeping with this evolution, an
WORLD NEUROSURGERY 80 [6]: 675, DECEMBER 2013
2. Salcman M: Self-portrait in a felt hat (1886-1887) by Vincent van Gogh (1853e1890). World Neurosurgery 80, 2013.
1878-8750/$ - see front matter ª 2013 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.wneu.2013.10.024
www.WORLDNEUROSURGERY.org
675