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BRAINSPOTTING: Adventures in Neurology
As a trainee doctor, Andrew Lees was enthralled by his esteemed neurologists who combined the precision of mathematicians, the scrupulosity of entomologists and the solemnity of undertakers in their diagnoses and treatments. For them, there was no such thing as an unexplained symptom or psychosomatic problem – no difficult cases, only interesting ones – and it was only a matter of time before all disorders of the brain would be understood in terms of anatomical electrical and chemical connections.
Today, this kind of ‘holistic neurology’ is on the brink of extinction as a slavish adherence to protocols and algorithms – plus a worship of machines – runs the risk of destroying the key foundational clinical skills of listening, observation and imagination that have been at the heart of the discipline for over 150 years. In this series of brilliant, insightful and autobiographical essays, Andrew Lees takes us on a kind of Sherlock Holmes tour of neurology, giving the reader insight into – and defending – the deep analytical tools that the best neurologists still rely on to diagnose to heal minds and to fix brains.
Today, this kind of ‘holistic neurology’ is on the brink of extinction as a slavish adherence to protocols and algorithms – plus a worship of machines – runs the risk of destroying the key foundational clinical skills of listening, observation and imagination that have been at the heart of the discipline for over 150 years. In this series of brilliant, insightful and autobiographical essays, Andrew Lees takes us on a kind of Sherlock Holmes tour of neurology, giving the reader insight into – and defending – the deep analytical tools that the best neurologists still rely on to diagnose to heal minds and to fix brains.
137 pages, Kindle Edition
Published March 22, 2022
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Displaying 1 - 21 of 21 reviews
July 21, 2022
The book had its moments, and the author seems like an affable chap I'd like to have a drink with in a pub and hear his stories. In the book there weren't that many stories that were interesting and I didn't really learn anything. I read non-fiction for enjoyment and it was quite enjoyable, and to learn something. I can't say I learned anything much, so a 3.5 star. However, the author did learn an excellent lesson when he was learning about diabetes,
I wasn't really fascinated by the initial preface and chapters on growing up as a bird-watching fanatic, until I came to this line, "My mother, who sometimes used birds to tell fortunes..." then I was! But nothing further was said about his fortune-teller mother, so it was kind of clickbait to keep me reading.
Getting on to the chapters of training and being a neurologist were better, but there is a great deal of history that is repeated in lots of books on neurology and I found that really boring, but if you are new to this genre, you may find it fascinating as I did first time round. I realise that popular science authors never know if their readers have any background in the subject and the default is always to assume that they don't, that this is the very first book in the genre they have ever read so all the history that can be fitted in, is.
The writing is meticulous, detailed and the author could probably write brilliant text books, but he didn't connect with me at all. His patients are just symptoms and diseases, the opposite of Oliver Sacks and Harold Klawans who wrote about people with issues that needed investigating and finding solutions for together. If signs and symptoms and a memoir are more your thing, you might enjoy this book a lot more than I did.
[t]he senior registrar decided to teach us about diabetes mellitus. He began by saying that the word ‘diabetes’ was Greek for ‘siphon’ but that the Romans had added the Latin word ‘mellitus’ for ‘sweet’ because they had observed that bees were strongly attracted to the urine of its thirsty victims.In a speciality where observation and measurement are all, that was a very clever way of teaching them. And they deserved to suck someone else's urine for not being observant!
He then went into the sluice room, came out with a sample, and proceeded to dip his finger into the yellow-coloured excretion before sucking it and suggesting, by his facial expression, that it tasted sweet. He then asked us all to do the same. After we had tasted the urine he looked at us triumphantly and said: ‘Today you have learned an important clinical lesson. None of you noticed that I dipped my middle finger into the urine but licked my index finger.
I wasn't really fascinated by the initial preface and chapters on growing up as a bird-watching fanatic, until I came to this line, "My mother, who sometimes used birds to tell fortunes..." then I was! But nothing further was said about his fortune-teller mother, so it was kind of clickbait to keep me reading.
Getting on to the chapters of training and being a neurologist were better, but there is a great deal of history that is repeated in lots of books on neurology and I found that really boring, but if you are new to this genre, you may find it fascinating as I did first time round. I realise that popular science authors never know if their readers have any background in the subject and the default is always to assume that they don't, that this is the very first book in the genre they have ever read so all the history that can be fitted in, is.
The writing is meticulous, detailed and the author could probably write brilliant text books, but he didn't connect with me at all. His patients are just symptoms and diseases, the opposite of Oliver Sacks and Harold Klawans who wrote about people with issues that needed investigating and finding solutions for together. If signs and symptoms and a memoir are more your thing, you might enjoy this book a lot more than I did.
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January 8, 2024Interesting that A.J. Lees, a neurologist, doesn't need to trumpet his medical degrees or titles on the book's cover.
Nope. Just A.J. Lee, is all. Old school. A listener with his patients. An observer on a par with Sherlock Holmes (a medical enthusiast himself). Someone who only orders necessary tests, doesn't rule out a disease if one of the key symptoms is missing, knows the power of touch and voice during an examination first to learn from the body by its reactions and second to reassure the patient who, no doubt, is there due to his or her dire health condition.
All good, all there in this book. With it, you get a British POV history of neurology along with background on some of the historical giants in the field (not just from England), what they accomplished, and how they accomplished it.
Are there model cases? Of course, but no so many that folks with symptoms of unknown provenance might expect to find answers to their own questions.
Still, interesting. The hell that some bodies go through, I mean, when their neurological system turns traitor by going haywire. And hunting down the culprit (Sherlock Holmes-like) is no easy job, either. Some you win, some you lose. Some you save, some you don't. Some survive or die despite you, and some survive (but hopefully don't die) because of you. And so on.
A few quotes for the tone of Lees' voice:
“Private hospitals are there to generate income and all the rhetoric of quality, safety and patient satisfaction is in truth no more than a public relations exercise.”
“Most of the deans and directors of neurological institutes and heads of department are now divorced almost entirely from clinical practice. They are obliged to spend most of their time in administration signing forms and sitting on committees.”
“While medical technology has greatly enhanced the ability to diagnose and treat disease it has also encouraged a mental laziness in some doctors.”
“Included within the sixty Sherlock Holmes adventures are references to sixty-eight diseases, thirty-two medical terms, thirty-eight doctors, twenty-two drugs, twelve medical specialties, six hospitals and even three medical journals and two medical schools.”
In the end, you get a sense of what it's like to have a doctor passionate about his field and his patients (who are people, not numbers). Everyone should have a doctor like this, but not everyone does, sadly.
Nope. Just A.J. Lee, is all. Old school. A listener with his patients. An observer on a par with Sherlock Holmes (a medical enthusiast himself). Someone who only orders necessary tests, doesn't rule out a disease if one of the key symptoms is missing, knows the power of touch and voice during an examination first to learn from the body by its reactions and second to reassure the patient who, no doubt, is there due to his or her dire health condition.
All good, all there in this book. With it, you get a British POV history of neurology along with background on some of the historical giants in the field (not just from England), what they accomplished, and how they accomplished it.
Are there model cases? Of course, but no so many that folks with symptoms of unknown provenance might expect to find answers to their own questions.
Still, interesting. The hell that some bodies go through, I mean, when their neurological system turns traitor by going haywire. And hunting down the culprit (Sherlock Holmes-like) is no easy job, either. Some you win, some you lose. Some you save, some you don't. Some survive or die despite you, and some survive (but hopefully don't die) because of you. And so on.
A few quotes for the tone of Lees' voice:
“Private hospitals are there to generate income and all the rhetoric of quality, safety and patient satisfaction is in truth no more than a public relations exercise.”
“Most of the deans and directors of neurological institutes and heads of department are now divorced almost entirely from clinical practice. They are obliged to spend most of their time in administration signing forms and sitting on committees.”
“While medical technology has greatly enhanced the ability to diagnose and treat disease it has also encouraged a mental laziness in some doctors.”
“Included within the sixty Sherlock Holmes adventures are references to sixty-eight diseases, thirty-two medical terms, thirty-eight doctors, twenty-two drugs, twelve medical specialties, six hospitals and even three medical journals and two medical schools.”
In the end, you get a sense of what it's like to have a doctor passionate about his field and his patients (who are people, not numbers). Everyone should have a doctor like this, but not everyone does, sadly.
March 30, 2022
Dr Andrew Lees is a professor of neurology at the National Hospital in London and a world-renowned Parkinson’s disease researcher. The essays in this short autobiographical volume emphasize the importance of listening and noticing. The opening piece, in fact, is about birdwatching, a boyhood hobby that first helped him develop this observational ability. In further chapters he looks back to his medical education and early practice in London’s East End and in Paris in the 1960s and 1970s. He profiles the hospitals he has known over the last five decades, and the neurologists who paved the way for the modern science, such as Jean-Martin Charcot and François Lhermitte.
The professors whose lessons have most stuck with him are those who insisted on weaving patient histories and symptoms into a story. Lees likens the neurologist’s work to Sherlock Holmes’s deductions – even the smallest signs can mean so much. Indeed, Arthur Conan Doyle, himself a doctor, is known to have modelled Holmes on Joseph Bell, a Scottish surgeon. I particularly liked the essay “The Lost Soul of Neurology,” about science versus spirituality. As a whole, this didn’t particularly stand out for me compared to many of my other medical reads, but I’d still liken it to the works of Gavin Francis and Henry Marsh.
Originally published on my blog, Bookish Beck.
The professors whose lessons have most stuck with him are those who insisted on weaving patient histories and symptoms into a story. Lees likens the neurologist’s work to Sherlock Holmes’s deductions – even the smallest signs can mean so much. Indeed, Arthur Conan Doyle, himself a doctor, is known to have modelled Holmes on Joseph Bell, a Scottish surgeon. I particularly liked the essay “The Lost Soul of Neurology,” about science versus spirituality. As a whole, this didn’t particularly stand out for me compared to many of my other medical reads, but I’d still liken it to the works of Gavin Francis and Henry Marsh.
Originally published on my blog, Bookish Beck.
April 27, 2022
A distinguished and compassionate neurologist explores how his field has changed over the past 50 some years, for better and for worse, and how to care for people with brain diseases that “can humiliate in a way that cancer or heart disease never do.”
Here are just two of the particularly lyrical passages that struck me:
“Soulful neurology insists that mistakes in medicine are inevitable, but when they are admitted and taken to heart become future friendly.”
“Memories are random and volatile and defy logic. They are made in the dendritic canopy and paper and disappear as they wish. Some memories exist like delicately folded magic carpets; others lie covered in dust and forgotten in the kasbahs of the mind. Four years ago, I eventually succeeded in loosening the lid of a canister stored in my hippocampus which held a preserved engram of an undisturbed faraway time.”
Here are just two of the particularly lyrical passages that struck me:
“Soulful neurology insists that mistakes in medicine are inevitable, but when they are admitted and taken to heart become future friendly.”
“Memories are random and volatile and defy logic. They are made in the dendritic canopy and paper and disappear as they wish. Some memories exist like delicately folded magic carpets; others lie covered in dust and forgotten in the kasbahs of the mind. Four years ago, I eventually succeeded in loosening the lid of a canister stored in my hippocampus which held a preserved engram of an undisturbed faraway time.”
July 12, 2022
If you enjoy reading memoirs by neurologists who are passionate about their jobs, then you'll like this one. Oliver sacks really set the gold standard and his shadow always casts its presence upon this whole genre. Lees is a very insightful physician with an appreciation for his craft. He seems to have a good command of its history and splices bits and pieces of its history- especially with relationship to the famous historical hospital 'Queens square'. A hospital famous as arguably the place where British neurology and some would venture to say, modern systematic neurology started with John Hughlings Jackson.
I enjoyed reading this. It is written by one of those classical neurologists. They strived for observational diagnosis based on careful induction of the patient's minutia of behaviors over the modern array of tests and scanners used for diagnostics.
I enjoyed reading this. It is written by one of those classical neurologists. They strived for observational diagnosis based on careful induction of the patient's minutia of behaviors over the modern array of tests and scanners used for diagnostics.
April 7, 2022
As a neurologist I always like to learn from the experience of colleagues and this book by Andrew ,, Lee's about his training over 40 years ago contains many interesting insights into the history of neurology and the challenges of the job.
October 23, 2022
Brainspotting, the experience of a great clinician neurologist
Nowadays, machines do such extensive work that we have become dependent on them. But not all fields are suitable for machines instead of human beings. Neurology is one of these fields. Of course, machines are of great aid. We have CTs, MRIs, EEGs, SPECTs, and PETs, but, despite what may seem, these complicated devices do not usually make the correct diagnosis on their own. The clinician is still indispensable. The clinician’s role in Neurology is the topic in the book Brainspotting. Andrew Lees is a neurologist who developed most of his work at Queen Square, the temple of British Neurology, and one of the world's references on the subject. In this book, he tells how he became a neurologist. He thinks his interest in classifying birds since he was young was vital in choosing his speciality. The author considered that an orderly mind is crucial both for birds and Neurology. He emphasises the importance of his staying, as a young Neurologist, in Paris. He describes in great detail his mentors’ skills as clinicians and how he could apprehend the best of each one, always following a careful clinical method. The last part is a plea for the clinician’s crucial role in current Neurology, being lab tests significant help, but a help. He illustrates this with an example of a patient with a tension headache and a myriad of useless lab tests. He does not forget to highlight the importance of a neurologist having research skills like his admired Sherlock Holmes. He sets an example of a former rugby player with progressive supranuclear palsy and a thorough investigation on his part, not only medical. In brief, a very recommendable reading for any neurologist, particularly the younger ones, to remind them of the fundamental clinical method.
Nowadays, machines do such extensive work that we have become dependent on them. But not all fields are suitable for machines instead of human beings. Neurology is one of these fields. Of course, machines are of great aid. We have CTs, MRIs, EEGs, SPECTs, and PETs, but, despite what may seem, these complicated devices do not usually make the correct diagnosis on their own. The clinician is still indispensable. The clinician’s role in Neurology is the topic in the book Brainspotting. Andrew Lees is a neurologist who developed most of his work at Queen Square, the temple of British Neurology, and one of the world's references on the subject. In this book, he tells how he became a neurologist. He thinks his interest in classifying birds since he was young was vital in choosing his speciality. The author considered that an orderly mind is crucial both for birds and Neurology. He emphasises the importance of his staying, as a young Neurologist, in Paris. He describes in great detail his mentors’ skills as clinicians and how he could apprehend the best of each one, always following a careful clinical method. The last part is a plea for the clinician’s crucial role in current Neurology, being lab tests significant help, but a help. He illustrates this with an example of a patient with a tension headache and a myriad of useless lab tests. He does not forget to highlight the importance of a neurologist having research skills like his admired Sherlock Holmes. He sets an example of a former rugby player with progressive supranuclear palsy and a thorough investigation on his part, not only medical. In brief, a very recommendable reading for any neurologist, particularly the younger ones, to remind them of the fundamental clinical method.
June 8, 2022
A five star read with an important message
This is beautifully written collection of essays oozing humanity and wisdom on every page. It should be essential reading for the aspiring doctor especially those pursuing a career in neurology. Its reflective readable literary style however makes it a great read for a much wider audience; indeed anyone interested in the complexity of how the brain works and the detective work involved in identifying causes when things go wrong. The importance of watching and listening form the author’s key message as he charts his own adventures as a neurologist from student to professor. We read about him honing skills as a child bird watching and then follow his career as he learns from his mentors, heroes, literature and above all from his patients. Lee’s description of the surface of the brain with “its coralline ridges and intertidal folds resembled a marshy delta viewed from the sky” is just one memorable example of his rich prose.
This book deserves a wide readership with its central message that the uniquely human skills of observation and common sense are as important now in clinical medicine as they ever were especially where technical advances such as scanning are in danger of replacing them.
This is beautifully written collection of essays oozing humanity and wisdom on every page. It should be essential reading for the aspiring doctor especially those pursuing a career in neurology. Its reflective readable literary style however makes it a great read for a much wider audience; indeed anyone interested in the complexity of how the brain works and the detective work involved in identifying causes when things go wrong. The importance of watching and listening form the author’s key message as he charts his own adventures as a neurologist from student to professor. We read about him honing skills as a child bird watching and then follow his career as he learns from his mentors, heroes, literature and above all from his patients. Lee’s description of the surface of the brain with “its coralline ridges and intertidal folds resembled a marshy delta viewed from the sky” is just one memorable example of his rich prose.
This book deserves a wide readership with its central message that the uniquely human skills of observation and common sense are as important now in clinical medicine as they ever were especially where technical advances such as scanning are in danger of replacing them.
April 26, 2022
The human brain is an intrinsically interesting topic, but since being diagnosed with Multiple Sclerosis 15 years ago understanding my brain and nervous system has taken on a whole new importance. So when I saw this new book from Notting Hills Edition I was immediately drawn to it and had to read it. And Brainspotting did not disappoint! I found each essay incredibly interesting, and A. J. Lees writing was a delight to read. His personal stories and experiences interwoven with historical figures whose discoveries and insights have been instrumental in making neurology what it is today meant that there was never a dull moment. His use of literary references, such as Sherlock Holmes, added another layer of enjoyment, as well as underpinning points in his essays. Although neurology is in many ways an intense and complicated area, Brainspotting makes it very accessible for the lay person, and I cannot recommend it highly enough, regardless of whether or not your life has been impacted by a neurological condition.
February 4, 2023
this was so rambly holy fuck; the fact that this is rated 4.12/5 on goodreads ELUDES me. i don't know if i'm being generous with 3/5 stars. this almost reads like a personal statement (albeit a vvvvv long winded one) (i.e. when i was young or during med school, x/y were crucial to honing my success as a neurologist), followed by long ramblings about neuro history (which is a hit or miss ... while mostly a miss, i do love a mention of mcgill here and there), and only the last few pages of each chapter dedicated to his patients. i think ramachandran and sacks do much better in engaging the reader - i.e. showing them the science and art (read: wackiness) that neuro can be. going to read sacks in its entirety next eee tb to psyc 410!!
i only held out as long as i did bc i hold the barbican bookstore in very high regard. perhaps this would be a good read for a very niche sector of its market: retired neurologists who want to remininsce on their career and are familiar with the personal connections to neuro, the history, patient experiences. the most interesting point lees makes is a take on ML/neuro we probably don't hear a lot on: that the essence of neurology is being eroded by the medical industry's slavish adherence to the protocol that comes with running scans on fancy new tech. when is a scan *really* necessary? what are you looking for when you order a scan?? what can you deduce from the scan without a "control" scan?? altho brain scans have had the most positive impact on neuro, he discusses how clinical neurophysiology tech is more helpful in actually identifying the "bug" within the nervous system (so to speak) and complements the "traditional" approach to medicine - i.e. actually listening to your patient + using their experience to reach a diagnosis!!! this was really sad to read but i don't doubt it at all:
“I have found that the more machinery I have at my disposal the greater the demands have become on my clinical judgement.”
theres so much talk these days about how "working with AIs/fancy tech" are the skill of the future, but it seems like when *not* to use it (and knowing how to justify this to your superiors!!!) is just as important. in the earlier chapters of the book, lees also talks about how the etiology of a condition varies vastly among different people at different stages of their lives, and it kinda reminds me of the humanities vs data science way of doing research: do you do a EDA and narrow down based on interesting trends or do you formulate questions and then research? how do we use data sci tools while not superimposing its methodology on established disciplines?
i only held out as long as i did bc i hold the barbican bookstore in very high regard. perhaps this would be a good read for a very niche sector of its market: retired neurologists who want to remininsce on their career and are familiar with the personal connections to neuro, the history, patient experiences. the most interesting point lees makes is a take on ML/neuro we probably don't hear a lot on: that the essence of neurology is being eroded by the medical industry's slavish adherence to the protocol that comes with running scans on fancy new tech. when is a scan *really* necessary? what are you looking for when you order a scan?? what can you deduce from the scan without a "control" scan?? altho brain scans have had the most positive impact on neuro, he discusses how clinical neurophysiology tech is more helpful in actually identifying the "bug" within the nervous system (so to speak) and complements the "traditional" approach to medicine - i.e. actually listening to your patient + using their experience to reach a diagnosis!!! this was really sad to read but i don't doubt it at all:
“I have found that the more machinery I have at my disposal the greater the demands have become on my clinical judgement.”
theres so much talk these days about how "working with AIs/fancy tech" are the skill of the future, but it seems like when *not* to use it (and knowing how to justify this to your superiors!!!) is just as important. in the earlier chapters of the book, lees also talks about how the etiology of a condition varies vastly among different people at different stages of their lives, and it kinda reminds me of the humanities vs data science way of doing research: do you do a EDA and narrow down based on interesting trends or do you formulate questions and then research? how do we use data sci tools while not superimposing its methodology on established disciplines?
June 16, 2022
Brainspotting is a unique book in which the author reflects on how his childhood passion for birdwatching enriched his medical training in London and Paris and what modern neurology can learn from its low-tech past.
Lees opens with a quote from Sherlock Holmes stating that “life is infinitely stranger than anything which the mind of man could invent.” A little later he quotes his own father who in reference to birdwatching reminded him one day that “birds don't read bird books”.
These two ideas reveal one of the main concerns of the book, namely how important it is for medical thinkers to retain the ability to look at things afresh, unhampered by received wisdom, remaining open to both anomalies and novel clues. The safe practice of medicine at scale requires bureaucratic box ticking but this should not come at the price of turning doctors into sleepwalking slaves of protocol.
Lees warns against the temptation to focus on numbers, brain scans and test results at the expense of knowing nothing of patients’ lives and thereby missing what is really in front of you. In contrast, he recalls a time when clinicians had to rely on broad observational skills, detective like reasoning and artful interactions with patients in order to diagnose and treat.
Indeed, the rich nonlinear prose of Brainspotting, where the fictional, personal and professional interact is itself an antidote to lazy consensus. Linking the lessons learned from ornithology to later success with neurological examination, it shuffles through anecdotes from the history of the field, cinematic personal memories of hospitals and staff, existential reflections and continually stresses the importance of the accidental - such as how nostalgia for 1950s rugby league helped resolve a medical mystery decades later. In this way it is a triumphant proof of Lees stated desire to “to crawl through gaps in the barbed wire fence that divides art from science’
The importance of retaining this sense of wonder and enthusiasm for the beautiful enigmas of both the natural world and the human condition, be it in a healthy or diseased state, is the essence of soulful neurology.
April 18, 2023
My sister’s husband is named Dalton. He has red/green colorblindness. Reading A.J. Lees’ book I was surprised to learn (among other things) that another name for red/green colorblindness is “Daltonism,” after English chemist John Dalton (1766-1844). I shared this with my brother-in-law, who had never heard it before, nor were his parents in a position to have known it – and, anyway, he’d already been given his name before his colorblindness was apparent.
I can’t help thinking that – somehow – coincidences like this prove the existence of dragons and unicorns and moderate politics.
Lees is a professor of neurology in the UK and the author of several books. In the present title he remembers his medical training, the traditions and historical figures of his discipline, and some of his personal experiences in treating patients. The best chapters, I think, are those in which he describes the art of observation – not only of patients in the clinic but of strangers on the subway and of birds in the field (birdwatching is a hobby but also a challenge for Lees, who himself suffers from Daltonism). He draws a line from the early history of neurology to Conan Doyle’s Sherlock Holmes.
Lees’ prose is clear and measured, but he sometimes risks dullness. The first and last few chapters are the best. Once or twice he even gives himself over to fancy:
“Outside my office were white buckets containing formalin-fixed brains waiting to be cut and prepared for histological examination. Sometimes in the early evening sitting alone at my desk after the laboratory staff had gone home, I could hear the hum of their afterlife. I sensed cities chained by the rust of habit; I pictured lives submerged in symbolism, culture and myth, and the skeletons of ancient trees concealed below grey membranes. I mapped vestigial flight paths and sea lanes that were crowded with desires, hopes and fears; I wanted to know what no longer was and that which had passed but was still alive.”
I can’t help thinking that – somehow – coincidences like this prove the existence of dragons and unicorns and moderate politics.
Lees is a professor of neurology in the UK and the author of several books. In the present title he remembers his medical training, the traditions and historical figures of his discipline, and some of his personal experiences in treating patients. The best chapters, I think, are those in which he describes the art of observation – not only of patients in the clinic but of strangers on the subway and of birds in the field (birdwatching is a hobby but also a challenge for Lees, who himself suffers from Daltonism). He draws a line from the early history of neurology to Conan Doyle’s Sherlock Holmes.
Lees’ prose is clear and measured, but he sometimes risks dullness. The first and last few chapters are the best. Once or twice he even gives himself over to fancy:
“Outside my office were white buckets containing formalin-fixed brains waiting to be cut and prepared for histological examination. Sometimes in the early evening sitting alone at my desk after the laboratory staff had gone home, I could hear the hum of their afterlife. I sensed cities chained by the rust of habit; I pictured lives submerged in symbolism, culture and myth, and the skeletons of ancient trees concealed below grey membranes. I mapped vestigial flight paths and sea lanes that were crowded with desires, hopes and fears; I wanted to know what no longer was and that which had passed but was still alive.”
May 9, 2022
If you loved Henry Marsh's book "Do no harm", then this is a must read. In many ways this book is far better, in my opinion, as it really gets into the soul of being a neurologist, Prof. Lees' own specialty, and this is just as true for other specialties in Medicine. Through the autobiography of his own career, Andrew Lees takes us through his many travels and experiences as a medical detective trying to solve the diagnostic conundrums he faces but never losing sight of the human being behind the symptoms and signs. I found a short paragraph he wrote abut the importance of touch in the medical consultation really deeply moving. I wish all medical students would read this and think about what it means in their training. In this day of sophisticated neuroimaging and investigations it is easy to lose sight of the "ghost in the machine" and I loved his reconstruction of an anonymous patient's life simply by looking at their donated brain which showed the classic neuropathology of Richardson's syndrome.
As well as presenting wonderful case studies, the book is a fascinating read on the history of Neurology from Charcot to the bastions of UK neurology taking in Conan Doyle and the cold logic and keen observational skills of Sherlock Holmes along the way.
Whilst I am a fan of e-books especially when travelling I must really commend this beautifully produced small hardback edition, which feels and smells of how books should. It is a joy to own and easy to carry with you (dare I say in a white coat when they still existed). For no extra cost, you can even request a personal signature from the author! What can be better.
If you enjoy simply sitting in your favourite armchair, or in my case on long train rides, you will be hugely rewarded by reading this book, be you doctor, student, patient or just a human being. It deserves to sell many copies.
As well as presenting wonderful case studies, the book is a fascinating read on the history of Neurology from Charcot to the bastions of UK neurology taking in Conan Doyle and the cold logic and keen observational skills of Sherlock Holmes along the way.
Whilst I am a fan of e-books especially when travelling I must really commend this beautifully produced small hardback edition, which feels and smells of how books should. It is a joy to own and easy to carry with you (dare I say in a white coat when they still existed). For no extra cost, you can even request a personal signature from the author! What can be better.
If you enjoy simply sitting in your favourite armchair, or in my case on long train rides, you will be hugely rewarded by reading this book, be you doctor, student, patient or just a human being. It deserves to sell many copies.
August 12, 2022
Solidly okay. I certainly sympathize with the author’s insistence of the validity and insight provided by a well-performed neuro exam. I was delighted by the opening chapter’s rhapsodizing on the parallels between Dr Lees’ early enthusiasm for birdwatching and the way that this enthusiasm anticipated his enthusiasm for neurology. In spite of my wanting it to, the rest of the book failed to make much of an impact. The final chapter which attempted to summarize the author’s objections to contemporary neurology, specifically the shotgun approach to neuro imaging as a replacement for a careful exam which…okay. Are CT scans and MRIs over-ordered? Of course. Are they utterly crucial in neurological emergencies in a way that renders the neuro exam if not superfluous at least secondary? Absolutely. I feel like Dr Lees misses something of the richness of contemporary neurology in his dismissal.
May 25, 2022
In the history of painting, to be a master of abstract technique required a perfect management of proportion and perspective. The Davinci´s Divine Proportion or ¨Aureous Number¨ This book is about it. It’s about the search for the ¨Aureous Number¨ of Neurology through a life. Its about how the high-end level or scientific precision finds the exact balance with the human, pious observation. A human facing a human based in a humble listening of the patients, the masters, and the literature. This is the “camino” of A. J Lees from being a medical student to being a greater Neurologist. Highly recommended not only for Neurologist but anyone who wants to become wise through the practice. Now in the bookshelf of my personal library next to Dear Glorious Physician.
July 7, 2022
Hélio Teive.
Professor Andrew Lees' new book, Brainspotting: Adventures in Neurology, has fascinating features reflecting the author's immense savoir faire in the art of evaluating patients with neurological diseases. The style is very reminiscent of the famous British writer, Graham Greene!
Professor Andrew Lees' new book, Brainspotting: Adventures in Neurology, has fascinating features reflecting the author's immense savoir faire in the art of evaluating patients with neurological diseases. The style is very reminiscent of the famous British writer, Graham Greene!
July 11, 2022
This wonderful memoir by Professor Andrew Lees, one of the most preeminent of British neurologists, should be read by every neurologist in training at least once and then again at regular intervals throughout his or her career.
May 11, 2023
A short book, i read it on a 90 minute flight.
More of a memoir, compared to the neuro-anthropology like Oliver Sacks. Filled with many little gems of neurology 💎 and British history of medicine.
Could use footnotes to extend discussion without breaking flow or references/citations.
More of a memoir, compared to the neuro-anthropology like Oliver Sacks. Filled with many little gems of neurology 💎 and British history of medicine.
Could use footnotes to extend discussion without breaking flow or references/citations.
November 27, 2025
Describe de forma autobiográfica su recorrido y aprendizaje en la neurología. Su prosa descriptiva permite acompañarlo en su devenir europeo y entender como sus lecturas lo forjaron de una mezcla apasionante entre Sherlock Holmes y mi otro héroe Gowers.
May 27, 2022
Andrew is a friend so this may be biased. I’m not a neurologist but this didn’t make the book less enjoyable. He has an easy style which explains more of the complicated tales. Fascinating stuff.
September 23, 2025
A nice depiction of lamenting the age old clinical neurologist, one that will surely not exist in the near future
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