We Are Our Brains

by D. F. Swaab

  That is indeed the question. People who are tried for crimes are sometimes acquitted on the grounds that they had clearly been asleep when they broke the law. Some people can indeed perform very complex actions while asleep without being the least aware of it. In 90 percent of cases these are men, and these events occur in a transitional stage between REM sleep and other forms of sleep. Such actions, like sleepwalking, are completely automatic. People have been accused of robbery, rape, and attempted murder while asleep, and some have even been thought to commit suicide, though such deaths could also simply be attributed to accidents while sleepwalking. Those affected sometimes have brain disorders like narcolepsy or Parkinson’s disease, but in many cases there’s absolutely no neurological or psychiatric abnormality. Events of this kind can be induced by fever, alcohol, lack of sleep, stress, or medication. Some sleepwalkers who are extremely mild and amiable when awake are shockingly violent when asleep.

  In 1987 Kenneth Parks drove fourteen miles while asleep and battered his mother-in-law to death. He woke up just as he was about to kill his father-in-law and gave himself up to the police. He was subsequently acquitted. Julius Lowe was a frequent sleepwalker, and during one of these episodes he killed his eighty-two-year-old father, to whom he was extremely attached. A man by the name of Butler shot his wife dead while in a sleep-confused state; he was later found guilty, however. While on vacation in 2008, a fifty-nine-year-old Briton called Brian Thomas strangled his wife, to whom he had been married for forty years. He told the court that he had been dreaming that he was fighting with a robber who had broken into their caravan. Thomas had suffered from sleep disorders, including sleepwalking and insomnia, from an early age. He was taking medication for this condition, but a side effect was that he became impotent. Since he and his wife were going on vacation and wanted to be “intimate,” he had briefly stopped taking his pills. The case against him was dropped when the judge ruled that he couldn’t be held responsible for this tragedy on account of his sleep disorders.

  A total of sixty-eight such murders by sleepwalkers have now been recorded. To prove that you carried out a crime while asleep, you need to undergo a battery of sleep studies by highly qualified experts and to have an excellent lawyer. But given the obvious impossibility of proving beyond a doubt that a crime was committed while the perpetrator was actually fast asleep, courts are mostly reluctant to acquit such individuals. And you can hardly blame them.

  9

  Autism

  DANIEL TAMMET, AN AUTISTIC SAVANT

  “So what are you painting?” I inquired with interest.

  “The number pi,” he replied.

  Daniel Tammet has Asperger’s syndrome, a form of high-functioning autism, and is also a savant: He possesses undreamed-of numerical and linguistic abilities. In 2004, he set a European record by reciting pi from memory to 22,514 decimal places in five hours and nine minutes without making a single mistake. It had taken him three months to learn. People with autism often have synesthesia, a condition in which sensory and cognitive pathways are interlinked, causing letters or numbers to be perceived as colored. Tammet sees Wednesday, the day on which he was born (January 31, 1979), as blue, hence the title of his book: Born on a Blue Day. He sees numbers not only in color but also in different shapes and sizes, and he can identify every prime number under 9,973 by its crystalline sparkle.

  I spent a few days with Tammet when the Dutch translation of his book came out. He told me proudly that he had started to paint. “So what are you painting?” I inquired with interest. “The number pi,” he replied. He sees number series like the decimals of the number pi as mountain landscapes consisting of series of differently colored numbers. Synesthetes have unusually strong connections between the various areas of the cerebral cortex. As a result, the visual cortex, which normally occupies itself only with the sense of sight, receives extra information about calculation going on in other areas of the brain. Complex calculations suddenly become easy when they are translated into images. But Tammet also has extraordinary linguistic abilities, being able to learn a new language in a single week, even one as difficult as Icelandic. That’s an unusual combination, but what makes Tammet unique as a savant are his well-developed social skills, which tend to be lacking in autistic savants. These skills enable him to convey very movingly in his book how lonely he was as a child, how desperately he wanted to have friends and yet was isolated by his differentness. He also speaks of the many phobias that he combated as a child by thinking of numbers, which he regarded as his only true friends, and of his obsessive need for order and regularity, which has stayed with him ever since. Every day he eats exactly forty-five grams of porridge for breakfast and drinks a cup of tea at exactly the same time; strict regimes of this kind counteract his anxiety. These characteristics, so typical of Asperger’s, have never before been communicated so eloquently. What makes his book fascinating is the personal, poignant account of what a child with these gifts lacks, how problematic Tammet’s development was, and how he succeeded, step by step, in overcoming his social deficiencies to become a completely independent adult. Tammet earns his living by giving online language courses—online communication being much easier for individuals with autism to deal with than face-to-face conversations.

  Over twenty years ago, Dustin Hoffman movingly portrayed the challenges of living with autism in the film Rain Man, inspired by the savant Kim Peek. Daniel Tammet regarded his meeting with fellow savant Peek as a highlight of his life. On the way to his meeting with him, which was featured on a BBC documentary, Daniel tried, like Rain Man, to earn money by counting cards in Las Vegas. The experiment failed; he lost heavily. Then he decided to use his intuition instead. That worked perfectly, and he won over and over again. Since then, Daniel Tammet has been known as “Brain Man,” which certainly does justice to his phenomenal cognitive capacities but ignores his most special achievement, which was the insight and courage he displayed in overcoming his many handicaps and becoming a socially competent, extraordinarily sympathetic savant.

  When you read Tammet’s book you’re constantly confronted with the blurry boundaries between what is considered normal and what is classified as a psychiatric problem, and you find yourself wondering how different savants are from people regarded as geniuses in the days before the labels savant or Asperger’s had been invented. As a boy, Picasso struggled with reading, writing, and arithmetic. Einstein was slow to talk and would apply picture thinking to complex problems in the field of physics. The dividing line between psychiatric disorders and great gifts is often a very narrow one and strongly depends on how someone is viewed by their surroundings.

  AUTISM, A DEVELOPMENTAL DISORDER

  Autism has only fairly recently been classified as a developmental brain disorder originating in the womb.

  Autism is marked by severely disrupted social skills and a very confined repertoire of activities and interests. It was first described in 1943 by Leo Kanner in Baltimore and in 1944 by Hans Asperger in Vienna, who both used the same term independently of one another. However, there were great differences between the two descriptions. The children whom Kanner described scarcely spoke, were mentally subnormal, and displayed symptoms that were mostly neurological. The children Asperger described as Intelligenzautomaten (intelligence machines) had a precocious grasp of language, could talk about their experiences and feelings, and were normally abled. Asperger’s publications made little impact until 1981, when it was suggested that people of normal intelligence with autism be designated as suffering from Asperger’s syndrome.

  Brain development in autism is atypical. Between the ages of two and four there is too much brain volume, delaying growth in some areas and prematurely terminating it in others. The main cause of autism is genetic. Daniel Tammet has a younger brother, Steven, who also has Asperger’s. (He has an encyclopedic knowledge of the band the Red Hot Chili Peppers.) Their father was frequently admitted to psychiatric clinics. Tammet’s grandfather had epilepsy and was so i
ll that his wife was advised by a psychiatrist to divorce him. Paternal age plays a role in autism, too: The syndrome occurs ten times more frequently in people born to fathers in their fifties than in those whose fathers were in their twenties when they were conceived. In addition, the likelihood of autism increases if a child acquires metabolic disorders or infections in the womb, has an older father or mother, or is deprived of oxygen at birth.

  The symptoms of autism appear early, around the age of three. Children with autism don’t make contact with others and have motor problems due to a developmental disorder of the cerebellum. They are clumsy and display stereotypical autistic behavior, like flapping their hands or walking on tiptoe. Daniel Tammet writes how very much he wanted to have friends but how impossible this was because he was “different.” Both he and Temple Grandin, a professor of animal science with autism, invented friends to compensate for their lack of company. Team sports are hugely problematic for people with autism. Daniel hated soccer and rugby, as he was always being picked last for the team. But he was good at trampolining and chess. He was taught chess by his father at the age of thirteen, beating him in his very first game.

  People with autism have trouble interpreting emotion and empathy. They don’t understand why another child is crying. According to Temple Grandin, her emotional circuitry had simply been disconnected. Indeed, disorders are now being found in the social brains of people with autism, in which the chemical messengers vasopressin and oxytocin play a crucial role. Individuals with autism also tend to shy away from bodily contact, even though they may feel a need for it. Temple Grandin, who invented veterinary machinery, found a professional solution for this problem. She constructed a “hug machine” in which she could lie, with the sides (controlled by air pressure) squeezing against her. People with autism can also be oversensitive to certain sounds. Tammet describes how the sound of cleaning his teeth drove him mad as a child, making him stuff cotton in his ears. (He told me that this troubles him much less now that he has an electric toothbrush.) Sometimes people with autism will concentrate so hard on an idea or task that they can’t hear what is being said to them. Tammet tells the story of how he didn’t hear the voice of the mayor calling him forward to receive an award because he was concentrating so hard on counting the number of links in the latter’s chain of office.

  Autism has only fairly recently been classified as a developmental brain disorder. Thirty years ago I remember the parents of a child who had been “different” right from the start being told, after lengthy tests by psychiatrists and psychologists, not just that the diagnosis was autism but also that their method of upbringing was to blame. That was the fault of Kanner, who devised the theory of “refrigerator mothers,” maintaining that autism was a response to a lack of close maternal contact. In 1960 he went so far as to claim that the mothers of autistic children “had just happened to defrost enough to produce a child.” How many parents’ lives were made undeservedly wretched by this ludicrous notion?

  SAVANTS

  It isn’t uncommon for individuals with autism to have a unique talent, but only in exceptional cases are they as multitalented as Daniel Tammet.

  One in ten children with an autistic spectrum disorder has savant qualities, usually a talent that contrasts sharply with the mental disability and handicaps they may also have. However, few of these gifted children become truly creative as adults, either because of the kind of talent that they possess or because of their personality. Half of savants have an autistic spectrum disorder, and the other half have brain damage or a brain disease.

  A savant’s talent can be very limited. Twins George and Charles, though unable to count, were calendar calculators: They automatically “knew” on what day a date fell in a particular year. Savants are able to make unconscious use of algorithms. But not all known stories about the gifts of savants are reliable. In his book The Man Who Mistook His Wife for a Hat, Oliver Sacks describes autistic twins who, when they saw the contents of a box of matches fall on the floor, immediately both cried out “111!” They also saw that the figure 111 was composed of three times the prime number 37. By the time Rain Man was made, this number (using toothpicks instead of matches) had grown to 246. Four remained behind in the box. Daniel Tammet doesn’t believe this story. According to him, no one, not even Kim Peek, could identify the exact number, if only because the matches at the bottom of the pile would be hidden from sight. The above-mentioned twins had an IQ of 60 and were unable to do even simple sums. Sacks describes how the two would exchange prime numbers. When he took along a book of prime numbers and joined in the game, the twins were delighted. But after a while, they continued with twelve-digit prime numbers, whereas Sacks’s book stopped after ten digits. Again, Tammett voiced his doubts. He didn’t think that anyone knew of such a book, and when Sacks was recently asked its title, he answered that it had disappeared!

  The term idiot savant is used to describe the combination of an exceptional gift and low IQ (30 to 70). It was coined in 1887 by John Langdon Down (the British doctor who gave his name to Down syndrome), who went on to say that he had never met a female idiot savant. They do exist (see for instance Nadia in later in this chapter), but they are greatly outnumbered by boys.

  Leslie Lemke, who was born prematurely, spastic, blind, and with an abnormal left prefrontal cortex, is an idiot savant with unusual musical capabilities. At the age of seven, his mother let him feel the keys of the piano. A year later he was able to play six instruments. When he was fourteen he played Tchaikovsky’s first piano concerto flawlessly after hearing it just once on television. He is famous for his ability to improvise. After hearing a piece of music by a particular composer only once, he can effortlessly improvise in the same style. He gives classical concerts, but is mentally retarded, with an IQ of 58.

  It’s not uncommon for autistic individuals to have a talent, but only in exceptional cases are they as multitalented as Daniel Tammet. These talents are largely possessed by boys and lie in the field of art, music, calendar calculation, and almost instantaneous mental calculation. They almost always go hand in hand with a remarkable memory. A Japanese savant who went on a journey of several months was afterward able to make very detailed drawings of the things he’d seen on his trip. Savants appear to store all the information that enters their short-term memory in their long-term memory, too. They can remember vast quantities of trivial facts, like license plates and railway timetables; it’s as if they are unable to forget information. But Tammet said that he would now no longer be able to recite that long series of pi decimals; he would need to practice them again.

  But remarkable memory isn’t in itself enough to account for the savant syndrome. These individuals possess genuine talent, too. Stephen Wiltshire was an autistic boy with a verbal IQ of 52. He was known for his “London alphabet,” a series of pictures showing landmark structures in London, drawn at the age of ten. He went on to draw in New York, Venice, Amsterdam, Moscow, and Leningrad. After a forty-five-minute helicopter flight above Rome, he produced a six-foot drawing showing every house, window, and pillar in the city with photographic precision. He has sometimes been compared to a printer because of the automatic way he draws. Artistic savants always have a strong preference for a particular subject and a particular technique. It’s striking that they almost never draw people; the social brain is their Achilles’ heel.

  BRAINS OF SAVANTS

  Brain damage at an early age appears to foster the development of savant qualities, because at that stage the brain is still fully able to make new connections with other structures.

  There are various theories about the neurobiological background of the savant syndrome. The exceptional gifts associated with it almost never develop unless there’s brain damage, especially on the left side of the brain. It’s thought that the brain damage allows links with other brain structures to be reinforced, enhancing the functioning of the visual cortex. Indeed, there are many examples supporting this theory. The left side of Kim Pee
k’s brain was damaged, and there was no connection between the right and left hemispheres. Peek was able to read two pages simultaneously, using both eyes separately, at lightning speed. He read nine thousand books about the history of the United States and knew them all from memory. But he couldn’t look after himself, relying on constant help from his father.

  Epilepsy is often associated with autism. Daniel Tammet had his first serious epileptic seizure at the age of four and was treated effectively for three years with Valium. He suffered from temporal lobe epilepsy on the left side, which could explain his compulsive writing around the age of seven and his subsequent religious feelings (see chapter 15). Damage to the left side of the brain might cause right-side compensation and thus promote numerical skills, but the left side of Tammet’s brain shows no trace of damage. Indeed, he’s also a linguistic genius.

  One theory is that everyone possesses potential savant talents localized in the “lower” regions below the cerebral cortex that are suppressed by “higher” processes. The psychiatrist Darold Treffert has dubbed this the “little Rainman” that each of us possesses. The idea is that these hidden talents can only be expressed by switching off the part of the brain that controls higher functions. Cases have indeed been known of people developing savant-like qualities due to a form of dementia that starts in the left frontal region. Some start to paint compulsively, for instance. These outbursts of creativity go hand in hand with a loss of language and social skills. In such cases, brain activity is concentrated in the rearmost region on the right, the visual cortex. When magnetic stimulation is used to disable the left frontotemporal region temporarily in healthy subjects, some improve at tasks like drawing, math, and calendar calculation. However, these improvements are modest, and no exceptional artistic feats have been seen. So the notion of a universal “little Rainman” doesn’t satisfactorily explain the syndrome and moreover doesn’t take into account its genetic component.