Abstract
Nancy C. Andreasen first came to Australia in 1985, as an invited speaker at an annual College conference in Hobart. She brought with her some copies of The broken brain which had been published the year before. In that book Andreasen opined that psychiatry was realigning itself with the biological traditions of medicine, moving from the ‘troubled mind’ to the ‘broken brain’, and closed with hope for a social revolution in the public perception of mental illness. Brave new brain comes nearly two decades later. Rave reviews on the back cover from the Washington Post, Science and Nature, leave little to be said.
It is not unreasonable to consider Brave new brain, as an update. Andreasen deftly describes recent advances in molecular biology (the mapping of the human genome and current knowledge of genetics of mental disorders) and advances in brain imaging. She explains that we live in an era when these two knowledge bases ‘will meet and mingle’. We look forward to the final volume, hopefully The idiot's guide to the prevention and treatment of psychiatric disorders.
Brave new brain was written for the general reader but the writer admits that they ‘may find some sections tough going’. She encourages skimming and dipping in and out of more technical sections.
Andreasen, formerly a professor of English, is not afraid of flair, colloquialisms or humour. She describes the journey of germ cells from the middle of the brain to their destination as ‘more magical and mysterious than the seasonal flights of birds’. Pertaining to the effect of the environment she states: ‘Genes are not rigid autocrats that dictate our destiny’. She describes the original Watson and Crick paper as ‘one of the great head-turners in the history of science’. She goes on: ‘If the amount of numerical data in a regular structural MR scan is mind-numbing, fMR may induce a near-comatose state’.
Brave new brain is a godsend for students of psychiatry, both undergraduate and postgraduate, not to mention psychiatrists who have trouble keeping up with new techniques. Andreasen explains ‘lod’, ‘endophenotype’, ‘functional genomics’ and the distinction between the memory of the amygdala and that of the hippocampus. She discusses the probable role of the cerebellum in mental disorders, a field she herself has been promoting. She is critical of the economic forces which are reshaping medicine, where primacy of care is replaced by the financial ‘bottom line’.
Brave new brain is a magnificent (the only extolment absent from the back cover) addition to the field of psychiatry and is recommended to the general reader, the student of psychiatry and all libraries.