Australasian Science: Australia's authority on science since 1938

Books: We Write, Read, Love, Need Them

By John L. Bradshaw

Why write books? For some, it's a need — to find out what we think, and get the record down for all of history to see. And in science, there's the need to update what's known, something Emeritus Professor John Bradshaw has done.

It’s a bit like Christmas, the arrival and opening of that box from the publishers containing samples, examples, of the first print run of your magnum opus, your book, no matter whether it is the first ever or the latest in a long line. You, and maybe co-authors, will have exuded, expended, the proverbial blood, sweat and tears. So it was, arriving in late December 2016 and suitably synchronous with general celebrations, that our Developmental Disorders of the Brain was born into a wider world. Parturient montes, nascetur ridiculus mus: The mountains will labour – and a silly little mouse will be born (the ancient Roman poet Horace, on authorship). We hope not, maybe an elephantulus, a tiny elephant at 377 pages, hard and soft back, with an electronic version.

Supposedly ‘born’ in the year 2017, its conception and prior genome, as it were, extended surprisingly far back in time. In 1995, my then graduate student, now Professor Jason Mattingley, and I published Clinical Neuropsychology, Behavioral and Brain Sciences. This volume, whose translation into Serbo-Croat, of all languages, was to prove stillborn due to the Croatian war, dealt largely, but not exclusively, and certainly not comprehensively, with degenerative disorders which can plague our later lives. A book in the neurosciences is obsolete and out of date even before it hits the bookshops, so fast is that discipline advancing; possibly, with electronic versions, one can update or at least annotate new findings or opinions as they arise. As it happened, 1995 also marked a turning point with an emerging interest in the neurodevelopmental disorders, which disrupt the thoughts, consciousness, will and maybe even the very existences of the young.

I had, in 1997, authored a book on human evolution, a field unfolding even faster than neuroscience. It had fared well, with good sales and translations into French and Italian, though one rarely waxes wealthy on scientific tomes – an anecdotal exception being a timely and unique publication of a handbook on the laboratory rat, supposedly making its author millions. So I again chose to publish Developmental Disorders of the Frontostriatal System with the same publishers, concentrating on the basal ganglia and associated frontostriatal structures and mechanisms; they mediate what the great Russian neurologist Alexandr Romanovich Luria insightfully labelled in his magisterial work of that title The Higher Cortical Functions in Man. It was OK to be sexist in titling in those days. As my Developmental Disorders of the Frontostriatal System, published in 2001, apparently was still selling well after some 14 years, I was then approached to prepare a second edition.

It is always nice to see your effort in print, even though scientific works generally bring more kudos than cash. Royalties from a good title, a good contract, good marketing, a well-chosen target audience and good sales by the publisher will usually provide at most a little icing upon the domestic cake. And publishing your empirical findings or writing a review or meta-analysis of a field is of course far better for your grant or career prospects than for your bank balance. However some 10 years ago I received an unusual email, from a dodgy-sounding British outfit calling itself the Authors’ Licensing and Collecting Society; they informed me they were holding a fair sum of money in my name, and if I would pay some 10 pounds UK annual membership and handling fee, they would pay what was owing into my nominated account; a scam, for sure! However my curiosity was piqued, and I Googled it; it had a very respectable London address, and the requested sum would not break the bank, so I obliged, taking certain additional security precautions. So far I have received over 18,000 pounds, from a twice-yearly distribution composed of multitudes of small payments or reimbursements for the reproduction and “secondary use” in Universities, research institutions, hospitals, museums and the like, of copyright materials which I have published in books and journals. I have a Dickensian image of lots of wizened little men (sexist again?) carefully totting up, in huge ledgers, countless small sums. But I cannot speak too highly of that wonderful organisation, ALCS.

Science nowadays moves inexorably forward ever faster, and possessed of a rocking chair, originally bought for my then breast-feeding daughter, I wondered, in my mid 70s, whether I had the will, way or wherewithal to undertake a revision, to comprehend and assemble, into a meaningful, coherent, constructive and instructive whole, all the complexities of recent discoveries and publications, to say nothing of newly minted maladies. It is not to say that in the neurosciences new disorders are nowadays often popping up; rather, pre-existing neuropsychiatric disorders are now being properly described and categorised, sometimes for the first time, to become appropriately recognised as party to the pantheon of DSM-5, the nearest thing in diagnostic psychiatry to the gold-standard recognition of, for example, a blood test for thalassemia.

So, how might I accept the publisher’s invitation to generate a second edition, without crucifying my so-called sunset years? I decided to invite the participation of two of my old graduate students, to farm out, as discrete disorders and chapters, the material to trusted students, colleagues and collaborators, with empirical or clinical expertise in the relevant disorder. We also decided to add frontocerebellar disorders to the original frontostriatal.

This expansion was far from gratuitous. The two systems largely control much of the automaticity of thought and action. Crudely and simplistically, while the former structure largely mediates the initiation and orderly sequencing of thought and action, the latter plays a key role in fine tuning target or end-point accuracy.

We can create a 3-dimensional object either by incrementally adding further layers or pieces, as with a clay model, or alternatively, if sculpting a figure from marble, by subtracting unwanted material until the intended end product slowly emerges. The brain develops along both such lines, adding new neurons, connections or circuits, or, typically later in development, culling superfluous elements by programmed apoptosis or trimming. Both processes act to fine tune the system, and both at various times may go awry. Unwanted circuits may also be silenced throughout life by epigenetic or environmental processes, or new ones enabled, maybe at an ever reducing rate, as a consequence of experiences or environmental demands. Nature may initially control the gross development of the general architecture, while environment may continuously modify the ‘end’ product, in entirely idiosyncratic fashion, different in and peculiar to each individual throughout life. Psychiatric illness can therefore stem from delayed or maldevelopment of structure or function, but also from changing societal expectations or norms. A crime in one society may be seen as normal or even desirable in another. So why do these putative disorders, often with strong genetic links and seen as disadvantageous, commonly persist in the genome, rather than be selected out? Maybe in ‘low doses’, or when manifesting in close relatives, they have certain adaptive advantages. Thus in some ways ADHD may benefit explorers or soldiers to maintain hair-trigger vigilance; focused obsessionality in autism or Asperger’s may advantage the meticulous scientist or forensic pathologist; some paranoia may be of use to spies or diplomats, and it may be no accident that artistic creativity may associate with depression. Or is it simply that in a system as genetically and structurally complex as the human brain, there are certain weak regions or fracture zones, where recurrent failures may be expected? Indeed rather than a tendency to inherit a particular disorder, it often seems that what is inherited is a tendency to inherit any one (or more) of quite a range of such disorders, with particular adventitious stressors maybe determining which one may actually manifest. Moreover the actual boundaries between pathology and normality may be unclear, with a graded spectrum in between; and comorbidity of two or more disorders is common, with the boundaries between disorders often fuzzy. Examples include the boundaries between autism and ADHD, or schizophrenia, or obsessive compulsive disorder. Moreover diagnostic, prognostic and treatment considerations are not always compatible in defining, describing or managing an apparent dysfunction, which may have more than one single cause, genetically, structurally and biochemically, and may thus manifest as a final common path from various possible origins. Conversely, a single genetic, structural or biochemical anomaly may have different clinical manifestations in different individuals, perhaps due to varying environmental influences. It is only where the genetics are straightforward, as in Williams syndrome and Friedreich ataxia, that the presentation and course of the disorder is ever even comparatively invariant.

But are books themselves now passé in this modern digital age – and I am not just talking about E-books on tablets, or resources such as Wikipedia, or even the electronic version of our new book. Our books, and doubtless many others like them, are aimed at diverse audiences and users, from students to clinicians, lecturers, parents and carers. People still seem to want a dedicated and portable account of what concerns them, and just as the advent of TV failed to kill the cinemas, and bookshops are still booming despite the electronic media, it looks as if we shall continue to value the printed word as a handy medium. Indeed, many electronic journals are still supplemented by hard copies. There is in fact a good case for an electronic analogue or accompaniment to the text book, which can be updated with the advent of new information, so that it is always state of the art. But then there is the thorny question of quality control, as Wikipedia is finding. It is an arduous job vetting, inserting, deleting and replacing, without destroying the coherent unity of the original.

Multiple audiences are by their very nature difficult to accommodate – in our present case, parents and carers probably need less complexity and detail; clinicians may want more than students.... That might be where the electronic version comes in, or rather maybe versions, each of which is perhaps tailor made for a particular audience. In any case, science is just another word (scientia, in Latin) for knowledge. And knowledge is useless unless it can be promulgated and adapted for an appropriate audience. Indeed, science is largely funded through the public purse, and all scientists have a real obligation and duty to communicate their findings, and their relevance, to wider issues (public health, ecology, climate change, defence, communication systems, education, transport, waste disposal, new materials....). Otherwise there is a real case to terminate funding. But equally, there is an overwhelming case for properly supporting young scientists, far better than at present. We are graduating doctorates in unprecedented numbers; and in unprecedented numbers after a couple of years, with the ever worsening job market, career prospects and funding shortfalls and terminations, they are leaving us for pastures greener, easier and new. In your mid twenties, you need some security of funding and job tenure, with career prospects to accommodate the personal burdens of marriage, housing, child rearing, and eventual old age. We are haemorrhaging our heirs, and our society will suffer, as indeed was forcefully observed by a recent Australian of the Year.

In any case, as old Thucydides commented millennia ago, a good book is a ktema eis aei, a possession for ever.

Oh, and PS: I am now under contract for a memoir; books beget books beget books.

John L. Bradshaw is Emeritus Professor (Neuropsychology) at Monash University. This article was originally broadcast on the Radio National program Ockham's Razor.