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Journal of Cancer Research and Therapeutics, Vol. 7, No. 2, April-June, 2011, pp. 240-246 Book Review Neurological Disorders in Famous Artists - Part 1, 2 & 3 Varsha Dutta Clinical Neuropsychologist, ACRO- Department of Radiation Oncology, Dr. Balabhai Nanavati Hospital, S.V. Road, Vile Parle (W)Mumbai- 400 056, India
Code Number: cr11065 Art, History & Neurology "Stirring Dull Roots with Spring Rain" Part 1 Frontiers of Neurology and Neuroscience. Vol. 19 Editors: Julien Bogousslavsky and François Boller Publisher: Basel, Switzerland, Karger, 2005 Price: $99.75 Pages: 192 Introduction The connection between art and neurology is not difficult to see, but to pave the way from the perspective of the brain being its only origin of rapture is naïve. These three series of books on famous artists with neurological disorders does a bit more than just rove across the boundaries of art and neurology. It traipses and on its way finds its own depth, allowing everything to be roomed into its own neurological form and content. I was reminded of T.S. Eliot's "The Waste land," as I was trying to understand neurology's passionate concern with last century's art history and its intense desire to marry it to its 21 st century laden theories, "April is the cruelest month, breeding Lilacs out of the dead land, mixing Memory and desire, stirring Dull roots with spring rain." Eliot deliberately intonates memory's insufficient rationale of usurping a desire that could only be stale and bent by time, vehemently insisting on the callousness ("cruelest") of such "mixing." He appeals to memory′s innate nostalgia as it leans backwards to what is warped in time, whilst "desire" impels it to the present for its absolution, something that history craves for. Here "April is the cruelest month" because its fecundity stirs opposites in equanimous gusto ("birth, death and revival, memory and desire, dull roots with spring rain"). In this case, "Memory and desire" potentiates the need for reviving it in its fruitful time ("April, spring rain") by substantiating certain fragmented, systemic historic facts ("dull roots") and give it the much needed absolution and in doing so referees an unnatural contest of the un equals (fragmented, systemic historic facts and its revival). It is this tension of wanting to make history thrive as the absolute is where the trouble deepens. The predicament starts with the preface of the first book when the authors claim that "art originates in the brain" it puts itself in peril by accepting a epiphenomenalistic position by viewing the brain and its neuronal processes as the origin of all aspects of the conscious mind. With this it naturally obviates the causal link between the mind and physical reality (Jeffrey M. Schwartz & Sharon Begley, The Mind and the Brain,2002); as if one′ creative experience while being influenced by external factors were fed on by neuronal processes alone. This understanding of neurology and art is vague and makes its distance unbridgeable by simplifying the association of both to an all encompassing neuropsychological explanation alone. Between 21 st century modern neurological theories and its abstraction of art, the authors have managed to fit into it the practical utility of using a diagnostic criteria and affirming its existence in a strict neuropsychological sense. It is obvious that every clinician has encountered altered creative abilities in some form or the other in patients who have suffered acute or chronic neurological disorders. One way of looking at it is through the ambiguous idiom set by history on famous artists whose works were in some way affected by it, but by approximating ourselves to the analysis of their neurological dysfunction and quite frankly getting carried away by neurological patois alone scoffs us into accepting a retrospective diagnosis in the face of their timeless ingenuity. The first of the series house 18 artists, mostly European, portrayed through the lens of psychiatrists and neurologists, who have conspicuously presented the effects of neurological disease and their neuropsychological sequel from stroke, epilepsy, dementia, depression, trauma and tertiary neurosyphilis. Most of the accounts are elaborate and one can see how painstaking their efforts have been. The authors′ depiction of life and the works of most of the writers, poets, philosophers, painters, and musicians give us a good glimpse, and most of the medical facts seem to be collated well but one can see the problem of interpreting such facts through historic acquaintance only, thereby making it appear too trite. Among some prominent artists studied are Fyodor Dostoevsky, Gustav Flaubert, Guy de Maupassant, Friedrich Nietzsche, Maurice Ravel, Franz Josef Haydn, Robert Schumann, Vincent Van Gogh and Caspar David Friedrich. The structural vigor brought in by a few authors is worth the mention, like Julien Bogousslavsky′s forensic review of the little known poet Guillaume Apollinaire's cerebral trauma from a bullet injury in the First World War. Right from tracing the origins of the helmet hung for over 70 years and reinvestigating the impact of the forceful projectile on it and the skull, led to a convincing diagnosis of a subdural hematoma evinced also from the nurse′s documentation. The possibility of organic brain causality was well implied. The interpretation of the neuropsychological sequel that was to affect the poet′s mood and personality yet spare his cognitive strength were well located to the right lateral temporal lobe lesion rather than an earlier held belief of a psychological trauma rendered from the war as a residual gift [Figure - 1]. Another intriguing case was that of Carolus Horn, the German artist discussed by Konrad Maurer and David Prvulovic. This was a moving account of an artist's continuing effort with his paintings in the light of progressing Alzheimer's captured till the very last stages of the disease. An interesting aspect mentioned was color vision in AD. There was a shift in the artist's color preference, with an expanded use of dark colors especially from the blue range at the incipient stage of the disease. This was speculated to be because of his "depressive and dysphoric mood", but his later shift to a brighter range of yellow-orange simply because this ability was preserved over his ability to discern colors in the blue-green range was over simplistic and did little to substantiate their views, which clearly relegated the artist's own concerns [Figure - 2]. Paul Elie Gernez's aphasia did not come in the way of his artistic skills, however as observed by Francois Boller, his paintings had become less intense compared to his earlier works,"the almost oniric poetry found in some of his previous paintings was no longer apparent in his later works after the stroke," (Boller,2005) which was in sharp contrast to some of the art critics claim that Gernez had found a more profound way of expressing after the stroke. The ability to create is peculiar to every artist and the event of a neurological lesion affects each one differently, bringing about or perhaps even accentuating stylistic changes with the exception of untrained people being more vulnerable to impairment owing to a limited cortical representation of the same abilities. Since the last century much has been said and written about Vincent Van Gogh. In fact, most of the diagnoses (almost 30 from the last century according to the current authors, Carota, Laria, Berney and Bogousslavky) self styled on him were mulled over from the letters he wrote and his paintings. The exploration of his art and persona does little to configure the life of eccentric poetry he led, one that could find match with only his artistic fervor. Little can be ascertained from the many speculations held by a wide audience of medical scientists, and whatever has been said so far derides the basic essence of being in his art and to say that we can least of all derive meaning from his psychotic crisis, enunciated by his supposed bipolar disorder (probably affective or schizoaffective) does little to arrive at the alacrity and the plainness of truth found in his paintings [Figure - 3], [Figure - 4]. Deborah Hayden gives us a good historical perspective along with some interesting insights on the paretic prodrome of Nietzsche and Maupassant, just before the final onslaught of syphilis. The link between Nietzsche′s disease and his genius is no easy undertaking, there is no parallel in history with such a bent of belligerent intelligence tied at the same time to so much suffering. He has been ruthlessly misinterpreted right from the time history spilled over to its most sub-human form. As Camus had put it, "In the history of intelligence, Nietzsche's adventure had no equivalent: we shall never finish making reparation for the injustice done to him." "The life of which he spoke with such fear and trembling has been degraded to a sort of biology for domestic use." (Albert Camus, The Rebel, 1951) . Hayden mentions Freud who was himself considerably influenced by Nietzsche and saw the relevance of his condition and the effect it had on his life, "It is the loosening process resulting from paresis that gave him the capacity for the quite extraordinary achievement of seeing through all layers and recognizing the instincts at the very base……" In fact, Maupassant′s own reflection of his syphilis encounter some of his works even, and the popularly held 19 th century belief that "syphilis could take genius to new height" also finds mention by his biographer Sherard here. Erik Baeck′s chapter on Maurice Ravel does little to explain his progressing neurological illness in his later years which had finally snubbed his creativity. The categorical implication of Pick complex in the absence of an autopsy and the overture of surrender to his latent left hemispheric condition in his last compositions is overused, a fact agreed even by the author [Figure - 5]. Part 2 Frontiers of Neurology and Neuroscience. Vol. 22 Editors: Julien Bogousslavsky and Michael G. Hennerici Publisher: Basel, Switzerland, Karger, 2007 Price: $112 Pages : 240 The second volume of the series discuss various visual artists, poets, novelists, composers and film directors and in its attempt hurriedly tries to conjoin together certain neurological facts based loosely on the fact that their sole proprietors were extraordinarily gifted. Among them are Otto Dix, Lovis Corinth, Luchino Visconti, Federico Fellini, Willam de Kooning, Marcel Proust, Charles Baudelaire and Wolfgang Amadeus Mozart. Hansjörg Bäzner and Michael G. Hennerici provide a fresh and interesting outlook on the effects of right hemispheric stroke on 13 artists and their works. The authors throughout maintain an unobtrusive hindsight that appeals to the reader which is welcoming and at the same time avoids the tout speculation of a strict neuropsychological abstraction [Figure - 6]. A phenomenon quite rare and drawing a lot of intrigue these days is the eruption of creativity following a neurological event. Thomas Pollak, Catherine Mulvenna and Mark Lythgoe′s portrayal of the artist with a romantic nonchalance for societal norms is well understood and appreciated but that a certain mild frontal cortical dysfunction is a necessary prerequisite for artistic fervor is a tenacious assumption. The authors explicitly draw attention to its occurrence following frontotemporal dementia. The hemispheric localization of pathology is a strong contender for de novo artistic behavior but it clearly does not go very far when it comes to explaining the very seed of idea generation. So the authors go a bit further and attempt to link the source of this "idea generation" to a latent inhibition that is reduced and is usually known to fuel talent in artists, a belief borrowed from the psychological literature of creativity. This latent inhibition stems from the brain′s ability to "filter" from its conscious realm of awareness what it initially passed off as irrelevant. While latent inhibition is probably one of the factors associated with creative skills it does not necessitate a natural predilection toward a sudden emerging talent and much of what we know of de novo artistic emergence in a few people with brain lesions but not others is still a phenomenon under much speculation, one that should rely on the collation of diverse viewpoints instead of particular brain states to explain its outburst. A rather amusing and at times comical account has been provided by Sebastian Dieguez, Gil Assal, and Bogousslavsky on the aftermath of the right hemispheric stroke on Luchino Visconti and Federico Fellini. While Visconti showed no cognitive deficits and was able to direct two films, Fellini′s stroke would cause a mild unilateral extrapersonal neglect. The authors have thought it important to bring in profound neurological deftness toward their analysis of these two master craftsmen. The authors decided that there were indeed "no right hemispheric symptoms that could be detected" in Visconti's later works following his stroke. In fact they assert that "His last years are a vibrant lesson in resilience; it is almost as if the stroke was nothing but a mere obstacle in his career," this indomitable resilience on his part was seen as a possible sign of anosognosia when they mentioned that "After all, perhaps he somehow failed to entirely realize the severity of his condition." At the same breath however they also concede that the director "was also quite realistic" in his frame of mind and they somehow seem convinced that he did not have anosognosia after all only to contradict it later when they label both him and Fellini as "natural anosognosics." since their "neo-realistic origins" and their "leftist sensibilities" insulated them from acquiring it instead after their strokes. Fellini in his own terms has been quoted of being "a born liar," a term misinterpreted in the most pejorative sense. The life that he had been living and depicting through his cinema is a life that had accommodated itself to all the incoherence, stupidity and its absurdities, a life that simply could not be interpreted by mere autobiographical facts alone, it is that aspect of reality parading itself as life is what he did not care about (something evident even in his drawings 3-4 weeks after the stroke, Pg. 62-63) [Figure - 7], [Figure - 8]. This stubbornness was evident in both Visconti and Fellini, from the very beginning of their careers till the time they were afflicted by stroke. It was this stubbornness that made them throw away a subservient form of reality that many succumb to after a stroke. Much madness had been made out of Baudelaire's use of the now outmoded French expletive, Cré nom (closest counterpart in English: "Goddamn") a consequence of aphasia after his left hemispheric stroke. This was discussed in the earlier context of the often inciting language that was his poetry. The abstract expressionist Willam de Kooning even after being diagnosed with Alzheimer′s disease in 1989 continued to awe critics and audiences alike. Here he becomes the subject of a detailed cognitive analysis by Carlos Hugo Espinel. Espinel suggests a distinct neurocognitive syndrome, which he calls "Creating in the Midst of Dementia," to explain the intricacies of de Kooning's mind and how it operated despite the myriad limitations imposed by his condition [Figure - 9]. Espinel categorically states that it in the face of a defunct semantic memory, it was the preservation of the three other memory systems - working, procedural and episodic, that the artistic automacity in him survived. How he picked up a particular stimuli despite this lack of factual familiarity that was his art was explained by "the exposure to his own images from previous paintings which became the external stimuli, and served as the brain′s surrogate semantic memory", and in so doing was able to create in the midst of dementia! This overview of the artist's work lacks depth, is loosely collated and the cognitive analysis of memory systems seem miscomprehended. It is known that autobiographical memory of which episodic memory is one of its chief components is altered in AD and despite the ability to recall remote memories from the past, most of the details are semantic in nature and lack specific details. Most of the autonoetic consciousness, the ability to relive an event from the past in detail which Espinel claims were preserved in de Kooning, in AD is usually compromised. Leaving procedural memory, his suggestion of a preserved short term memory in de Kooning mediated by the prefrontal areas, ubiquitous to planning and reasoning appear too simplistic and far fetched. Olaf Blanke had in a previous chapter mentioned that de Kooning's stylistic changes in his art were noted by several critics, but there is much debate on whether the changes were brought in by the neuropsychological attributes of the disease, abstinence from a long history of alcoholism or just a natural evolution of his art. Lack of medical reports, coupled with the absence of MRI and neuropsychological information makes such retrospective analysis look pale and redundant. Part 3 Frontiers of Neurology and Neuroscience. Vol. 27 Editors: Julien Bougousslavsky, Michael G. Hennerici, Hansjorg Bazner, Claudio Basseti Publisher: Basel, Switzerland, Karger, 2010 Price: $123.00 Pages: 242 The third volume of the series opens with Leonardo da Vinci. Very little is known about da Vinci being a vegetarian and his diet has been discussed here at length as a possible risk for the stroke that rendered him a right hemiparesis. The authors (Ozturk, Altieri and Troisi) have compiled a series of cases that elucidate the link between elevated homocysteine levels in blood due to a deficient B 12 . One of the most common topics discussed in these series was syphilis. Like in the previous part of the series (Part 1) noted composers like Schumann, Wolf and Schubert ′s cases were all discussed here. While it has been suggested that Robert Schumann and Hugo Wolf′s condition progressed to general paresis, there′s speculation by the authors (Bazner & Hennerici) that Franz Schubert suffered from meningovascular syphilis. Schubert's physicians diagnosed it as nervenfieber, an unspecific term for fever and cerebral symptoms those days, which has been interpreted as meningovascular syphilis associated with the prodromal symptoms shown by the composer. Recorded excerpts from Schumann's stay at Endenich near Bonn find mention here. That all the three composers were aware of their condition and well understood the brief productive time they had left made these authors speculate that in all probability this is what must have led them to increasingly concentrate in their creative production. The view that the organic disruption of the neuronal networks and the limbic structures with its direct link to motivation was approached with mild caution. All authors even in the previous volumes (Guy de Maupassant & Friedrich Nietzsche) have tried to corroborate with the 19 th century belief that "the syphilitic condition takes the genius to a new height." The story on Clara Schumann is a moving one as it gives us a warm portrayal of her life and her continued success as a 19 th century concert pianist despite her chronic pain syndrome and a tumultuous personal life. The chapters surmise a detailed sketch of each and every artist and give us a glimpse on little known facts. Extensive consideration has been given to neurological diseases and its implications on the artist affected directly and sometimes even indirectly like in Egon Schiele. Schiele's art has been over speculated in the context of having a peculiar dystonia like quality by Frank Erbguth. Schiele apart from keeping in with the mood and the temperament of Vienna's art scene may have borrowed from neuropathology its dysmorphic contours as its doors opened to the "outside world" and quite successfully captured a young Vienna in its primordial state in conflict with itself [Figure - 10]. James tries fitting in Bela Bartok and Andy Warhol under the generous realm of autism spectrum disorders on the basis of loosely documented observations by critics and biographers. Their personalities became a subject of exhaustive scrutiny and too much was made out of their self imposed exile that supposedly limited them from wider social experiences. An interesting anecdote appears towards the chapter′s end when James quips the link between autism and art by Fitzgerald where "the autistic artist because of his rather diffuse identity, and diffuse psychological boundaries, works in an effort to sort out their confused identities." Elsewhere, Paul Wolf talks about opium use by composers, writers and poets and their work. The artists discussed are Hector Beriloz, Thomas De Quincy, Samuel Taylor Coleridge, John Keats and Jean Cocteau. This review could have done a little more than just talk about the famous artists and their opium use. The way in which opium use affects brain creativity could have been approached more acutely. Besides a few anecdotes on the artist's experimentation with opium little else was touched upon. The munificent progress in neurodiagnosis is making clinicians these days see more than what would normally be appreciated. Matthews dons a novel stance on the neurological diseases portrayed by Shakespeare in his plays and also in some instances talks of the physician′s presence. Since the last century, particularly from Freud′s time too much has been made out of King Lear. It appears improbable when every little phenomenon observed in King Lear is so convincingly attributed to a diagnosis of dementia with lewy bodies (DLB) [Figure - 11]. Overall, every author has contributed immensely to the neurological repertoire in the series. Most of the narratives provide interesting anecdotes on the lives of these artists and at times impinge on some little known historic facts. It is the persistent neurological tone that cannot be taken seriously. Most of the artists mentioned go through the ordeal of a rigorous interpretation, history has situated them in an ambiguous manner and to speak in strict neurocognitive parlance disparages meaning from art. After all, as Oscar Wilde puts it, "All art is at once surface and symbol. Those who go beneath the surface do so at their own peril. Those who read the symbol do so at their peril." Copyright 2011 - Journal of Cancer Research and Therapeutics The following images related to this document are available:Photo images[cr11065f15.jpg] [cr11065f3.jpg] [cr11065f7.jpg] [cr11065f5.jpg] [cr11065f11.jpg] [cr11065f14.jpg] [cr11065f2.jpg] [cr11065f1.jpg] [cr11065f12.jpg] [cr11065f13.jpg] [cr11065f9.jpg] [cr11065f10.jpg] [cr11065f8.jpg] [cr11065f6.jpg] [cr11065f4.jpg] |
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