Meet­ing of minds

Mar­jorie Bren­nan talks to neu­rol­o­gist Dr Suzanne O’Sul­li­van who says the brain con­tin­ues to be a mys­tery de­spite med­i­cal ad­vances in the field of imag­ing

Irish Examiner - Feelgood - - Feature - Brain­storm: De­tec­tive ■ Sto­ries from the World of Neu­rol­ogy, pub­lished by Chatto & Win­dus, is out now.

SUZANNE O’Sul­li­van has seen and treated thou­sands of pa­tients in her 20 years as a neu­rol­o­gist, but for her, the brain is still a mys­te­ri­ous en­tity, her job like a never-end­ing jig­saw puz­zle in which she doesn’t have all the pieces. Hence the ti­tle of her lat­est

book, Brain­storm: De­tec­tive Sto­ries from the World of

Neu­rol­ogy. Like her pre­vi­ous book, It’s All In Your

Head, which won the pres­ti­gious Well­come Prize, Brain­storm fea­tures some of the most chal­leng­ing and bizarre cases which O’Sul­li­van has dealt with, from a man who sees car­toon char­ac­ters to a woman who plays an imag­i­nary trum­pet. Along the way, she works out life-chang­ing di­ag­noses from the slight­est of clues.

“When it comes to un­der­stand­ing how the brain works, we are still at the very be­gin­ning of just try­ing to un­der­stand the nor­mal things the brain can do,” she says. “It’s only in the 21st cen­tury that we have even have any idea at all of how we can store mem­o­ries, for ex­am­ple. When we haven’t re­ally un­picked the nor­mal func­tions, that means we still have a great deal of dif­fi­culty ex­plain­ing the strange things that hap­pen when a brain is diseased.”

O’Sul­li­van, who is orig­i­nally from Shankill, Co Dublin, stud­ied at Trin­ity Col­lege, and is now one of the top neu­rol­o­gists in Bri­tain, spe­cial­is­ing in epilepsy at the Na­tional Hos­pi­tal for Neu­rol­ogy and Neu­ro­surgery in London. In the book, she de­scribes the brain as a “de­vi­ous” or­gan. It sounds like an al­most ad­ver­sar­ial re­la­tion­ship, I sug­gest.

“That’s a re­ally good way of putting it ac­tu­ally….it’s more of a re­la­tion­ship where I am con­stantly sur­prised and in awe of what I’m encountering. I think I’ve seen ev­ery­thing and then one morn­ing I come in and some­thing has hap­pened that I’ve never seen be­fore. I do think it’s like de­tec­tive work be­cause ev­ery­thing un­folds very slowly.

“Some­one comes in with one odd thing and you can’t quite un­der­stand it, you do a test, you get an­other bit of the jig­saw, you meet them again, and they tell you some­thing else, you get an­other bit.”

How­ever, O’Sul­li­van says while get­ting a di­ag­no­sis in it­self is an achieve­ment, the next chal­lenge is one that of­ten can’t be over­come.

“When we get to the next stage, which is try­ing to make some­body bet­ter, science just isn’t there yet...even when I fig­ure it out, there is no magic so­lu­tion.”

While there have been sig­nif­i­cant break­throughs in terms of imag­ing the brain, there are lim­i­ta­tions when it comes to treat­ment, says O’Sul­li­van.

“Tech­nol­ogy has been good at un­pick­ing the brain’s ba­sic pro­cesses. I think that has led peo­ple to be­lieve that MRI scans have been the an­swer to ev­ery­thing. But when it comes to ac­tu­ally help­ing us treat brain dis­eases, it re­ally hasn’t helped at all. All we are do­ing at the mo­ment is pro­duc­ing more and more so­phis­ti­cated ways of see­ing the healthy brain.

“Ob­vi­ously, tech­nol­ogy is bril­liant for surgery but for med­i­cal dis­eases like mul­ti­ple scle­ro­sis or mo­tor neu­rone dis­ease, we can do scans on peo­ple but we can’t make those things bet­ter. It’s bril­liant but there’s a long way to go.”

O’Sul­li­van says she is hope­ful about the po­ten­tial of ge­netic ma­nip­u­la­tion but doesn’t see a cure for dis­eases such as Hunt­ing­ton’s or Parkin­son’s in the fore­see­able fu­ture.

“If ev­ery­thing keeps go­ing at the present rate, it won’t be in my life­time un­less some­thing mirac­u­lous hap­pens. All you need is that one an­tibi­otic mo­ment — I could be wrong, I hope I’m not — where some­one spills some­thing on some­thing else and sud­denly you’ve in­vented some­thing brand new. I’d be very hope­ful that dis­eases with more of a ge­netic ba­sis, that we’ll be able to ma­nip­u­late those in the near fu­ture. I think surgery is go­ing to im­prove ex­po­nen­tially as well.”

There is still a stigma sur­round­ing epilepsy, a con­di­tion that af­fects 36,000 peo­ple in Ire­land. Her pa­tients are of­ten dis­crimi- nated against and also have to deal with other peo­ple’s fears around seizures.

“Peo­ple with epilepsy are not a dan­ger to any­body…no one would look at an asthma at­tack and think it was de­lib­er­ate or part of your per­son­al­ity. But as soon as you see some­thing com­ing from the brain, peo­ple have dif­fi­culty ex­tri­cat­ing it from some­one’s per­son­al­ity.”

How­ever, O’Sul­li­van says that writ­ing the book also gave her an ap­pre­ci­a­tion of the kind­ness of­ten shown to­wards peo­ple with epilepsy. She says her pa­tients also ap­pre­ci­ated be­ing given a pub­lic voice which they are of­ten de­nied. “I re­alised how many pos­i­tive sto­ries peo­ple had to tell about how they were treated by the gen­eral pub­lic. It is my job as a doc­tor to go down that neg­a­tive route of dis­cov­er­ing aw­ful things, but in writ­ing the book, I had to think more about the whole pic­ture. It al­lowed me to see things dif­fer­ently and my pa­tients are so thrilled to have their sto­ries told.”

While med­i­cal writ­ing has be­come an in­creas­ingly pop­u­lar genre of lit­er­a­ture in re­cent years, for O’Sul­li­van, the orig­i­nal and the best is still Oliver Sacks, who wrote The Man Who Mis­took His Wife for a Hat. “I don’t think there is a neu­rol­o­gist in the world who hasn’t read his work and ad­mired it,” she says. She also cites the neu­ropsy­chol­o­gist Paul Broks, au­thor of Into The Silent Land, a “stun­ning” book. “Of course, some­one like Atul Gawande as well… I love that sort of stuff which wan­ders be­tween med­i­cal writ­ing and phi­los­o­phy. Those three writ­ers, in par­tic­u­lar, take it to an­other level.”

She has al­ways loved read­ing and writ­ing and cites the Ir­ish ed­u­ca­tional sys­tem as be­ing in­stru­men­tal in giv­ing her an ap­pre­ci­a­tion of the arts and science, of­ten seen as ex­clu­sive of each other.

“When I got to Leav­ing Cert, I was do­ing honours English and honours bi­ol­ogy and physics. I was able to be broadly ed­u­cated right to the point of start­ing uni­ver­sity which meant I re­tained a love for read­ing which stayed with me. I en­joyed both... we shouldn’t be forc­ing chil­dren into one box or the other. I think if you want to be a writer, you have to be a reader.”

She nur­tures her writ­ing tal­ents. Af­ter she won the Well­come Prize, O’Sul­li­van went back to study cre­ative writ­ing, gain­ing a mas­ters from Birk­beck Col­lege. “That was like a lit­tle present to my­self,” she says. “I did it slightly back­wards, I did the MA af­ter the book. I re­ally en­joyed writ­ing the book and I wanted to op­ti­mise that ex­pe­ri­ence. Also, I en­tered med­i­cal school when I was 17. Af­ter I wrote the first book, I de­cided to take a year off and have at least one year of my life that wasn’t fully ded­i­cated to medicine.”

She has just started her third book, about cul­ture­bound syn­dromes [also known as folk ill­ness]. “It’s about groups of peo­ple around the world who get have re­ally strange med­i­cal con­di­tions that are spe­cific to their com­mu­nity. There is one in Swe­den called res­ig­na­tion syn­drome, where chil­dren, who are all asy­lum seek­ers from Rus­sian fam­i­lies, when they’re faced with de­por­ta­tion they lapse into co­mas for weeks, months, years at a time. It’s like they le­git­imise a way of ex­press­ing their dis­tress with phys­i­cal symp­toms and it’s dif­fer­ent in ev­ery cul­ture.”

The ex­cite­ment in her voice at new cases to be in­ves­ti­gated and dis­cov­er­ies made is pal­pa­ble. I imag­ine her pa­tients con­sider them­selves lucky to have such a sleuth on their side.

Newspapers in English

Newspapers from Ireland

© PressReader. All rights reserved.