by Assad Meymandi, MD, PhD, DLFAPA
Dr. Meymandi is in private practice as a psychiatrist and neurologist and serves as an adjunct professor of psychiatry at the University of North Carolina at Chapel Hill. He is a noted physician, editor, and philanthropist who frequently speaks and writes on diverse topics that relate to his interests in medicine, the arts, religion, and philanthropy. He lives in Raleigh with his wife Emily.
Psychiatry (Edgemont) 2009;6(11):48-50
Since Benjamin Rush, a framer of the United States Constitution and father of American psychiatry, there have been two psychiatrists who have won the Nobel Prize. The first winner was Julius Wagner-Jauregg, psychiatrist (b. Wels, Austria 1857, d. Vienna, Austria 1940). He invented “malaria therapy” for the treatment of progressive paralysis, especially tertiary syphilis. He was awarded the Nobel Prize for Medicine in 1927.
Seventy-three years passed before the field of psychiatry had a second Nobel Prize winner. Eric R. Kandel, a university professor at Columbia University in New York was awarded the 2000 Nobel Prize in Medicine or Physiology.
Dr. Kandel received his psychiatric and psychoanalytic training at Massachusetts General Hospital and McLean Hospital in Boston, Massachusetts. Before entering medical school, he was interested in literature, the arts, and humanities. He also found himself intrigued by the work of Freud and the relationship between neurology, biology, id, ego, and superego, all components of Freudian theory of psychoanalysis. However, realizing that he needed to be a medical doctor to pursue his psychiatric ambitions, he entered New York University Medical School where he received his MD. As a medical student and clinician, he became more interested in biology and physiology and cell (especially nerve cell [neuron]) communication. Pun excused, he became more interested in “neuronics” rather then “neurotics.” His 50 years of work produced many books and seminal articles published in Journal of Nature and Science, reflecting his groundbreaking work on the cellular and molecular process of memory. This work is what ultimately earned him the Nobel Prize in 2000.
Recently, I read Kandel’s book, In Search of Memory: The Emergence of a New Science of Mind (W. W. Norton & Company, New York and London, 2006). I found this book to be a sheer joy. Parts of it are heady and heavy in neuroscience and neurobiology, but it is a page turner. Also, it is the kind of a book one wishes to re-read. The volume is autobiographical, weaving personal life experiences from childhood through student and professional life into a rich tapestry of words, syntax, and composition in an exquisitely readable and entertaining style, reminiscent of the writings of Freud.
As I read and re-read parts of this enormously appealing book, through synesthesia, I heard the complex and rich bouquets of baroque music of Bach and Telemann alternating with melodic symphonies of Haydn, Sibelius, and the triumphant Mozart’s Jupiter Symphony in C major. I also saw a rich display of paintings of the masters: Michelangelo, Leonardo de Vinci, Monet, and Pissarro. Dr. Kandel’s words reminded me of a recent symphony I heard conducted by Lorin Maazel. It had a characteristic Maazelian blend of incandescent colorings, unerring execution, and cool brilliance.
The book starts when the author was nine and a student at a neighborhood school in Vienna, Austria. Being Jewish, his parents, his brother Ludwig (later Lewis), and he were expelled from his country by the Nazis. They came to America where Dr. Kandel received a superb education in New York. In Vienna, his father had owned a small toy store. His mother was a stay-at-home mom. At age 9, he recalls getting a shiny new battery-operated toy car with a remote control from his father, which he brought to the United States. It is like “Rosebud” and Hurst in the movie “Citizen Kane.” This illustrates the author’s understanding of object relation, which is so important in psychiatry.
The science part of the book starts with Dr. Kandel’s introduction to the leading United States biologist, University of Columbia’s Dr. Grundfest (Kandel later became director of that laboratory). At that time, Dr. Kandel developed techniques to micropuncture almost every cell of the hippocampus, the seat of memory, as he put it “one neuron at a time.” He recorded the action potential of the cells and studied how the cells communicate with one another—how the messages (conversations) are transmitted from hippocampus to amygdala and other parts of the limbic system (thalamus, hypothalamus, mammary bodies, para-median gray, and fornix). He identified the role of chemicals, the proteins, and the cyclic AMP (cyclic adenosine-3’,5’- monophosphate) discovered earlier by another Nobel Prize winner, pediatrician Dr. Earl Sutherland of Vanderbilt, in cell transport.
The book is an elegant exposition of ethology—the study of animal behavior in its natural environment. It is also a probe in molecular biology, the chemicals, proteins, neurotransmitters of memory, and the process of storage and recall of knowledge. It explains ionotropic receptors, the proteins that span the cell surface membrane and contain transmitter-binding sites and channels through which ions can pass and send messages to the next neuron.
This highly readable and delightful book also carries a compendium of people of note who have contributed to neurobiology and understanding of the central nervous system and how commands are generated by the cranial nerves and carried out by the peripheral network of neurons. The impressive pantheon starts with the work of Santiago Ramon Y Cajal and Camillo Golgi, to whom all of us were quickly exposed in our first year of medical school. It continues to develop a rich anthology of all the names and a brief description of their contributions. Of course, the list starts with Aristotle. Here is an example of the author’s skillful writing bringing the ancient and the new together:
“Aristotle, and subsequently the British empiricist philosophers and many other thinkers, had proposed that learning and memory are somehow the result of the mind’s ability to associate and form some lasting mental connection between two ideas and stimuli. With the discovery of NMDA (N-Methyl-D-Aspartate) receptor and long-term potentiation, neuroscientists had unearthed a molecular and cellular process that could well carry out this associative process.”
With clarity and eloquence, Dr. Kandel explains various forms of memory, such as habituation; sensitization; classical conditioning; short- and long-term, somatic, procedural, and verbal memory; and the biological basis of individuality. He makes the reader feel like a participant in the conversation between nerve cells.
We expect our educators, from kindergarten to university, to teach our children the essentials in critical thinking. This is the ultimate goal of education. It is exciting to learn the molecular biology of critical thinking and memory.
As one who has been doing book reviews for more than 40 years, I have become accustomed to examining the down side of books reviewed. It is astounding that I can say nothing negative about this most impressive and seminal work. I recommend the book to all ages, even grammar school children. I plan to read parts of it to my grandchildren.
Finally, I believe people like Dr. Kandel are saints. Dr. Kandel is my kind of a saint—the kind of a saint who KNOWS, yet lets his knowledge get marinated in the elixir of spirit, faith, and transcendence, giving it the lofty status of being in the presence of God and better yet, dining with God on an infinitely rich, intellectual diet. Dr. Kandel is a Jew who escaped from the Nazis’ grip and immigrated to America, where he received the opportunity to learn, study, create knowledge, and earn a Nobel Prize. Like many of us who are Americans by choice and not by birth, Dr. Kandel appreciates America’s rule of law and freedom of speech, worship, and pursuit of one’s passions. Immigrants are blessed by America, and America is blessed for having so many living saints like Nobel Laureate Eric R. Kandel, a psychiatrist for all ages.
