The Saad Truth with Dr. Saad - Neurologist Dr. Richard Cytowic - Your Stone Age Brain in the Screen Age (The Saad Truth with Dr. Saad_738)

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00:01:15.980 Hi, everybody. This is Gad Saad. For The Sad Truth, I've had many physicians lately on my show.

00:01:22.400 Add to that illustrious roster, I've got another physician, a neurologist, Dr. Richard Saitoic.

00:01:30.480 How did I do that? Was that okay?

00:01:32.280 That's perfect.

00:01:33.240 All right. Let me just mention a couple of things about you, Richard. You're a professor of neurology

00:01:39.000 at George Washington University, a pioneering researcher in synesthesia, which I'd love to

00:01:44.720 talk about that because that's one of those things that I first learned about when I read this guy's

00:01:49.840 work, Oliver Sacks. I recently bought his autobiography. I'm sure you've got great stories

00:01:54.160 about that. Your previous books include Synesthesia, The Man Who Tasted Shapes, The Neurological

00:02:02.320 Side of Neuropsychology, Wednesday is Indigo Blue, Discovering the Brain of Synesthesia, co-authored

00:02:09.600 with David Eagleman. And your latest book, I think out on October 1st, right? So about three weeks ago,

00:02:15.940 your stone age brain in the screen age. A lot of people are writing about some of the difficulties

00:02:21.660 we're facing with trying to pry away our children, let alone us, from all these technologies. So maybe

00:02:28.080 we, well, welcome, Richard. Maybe we could start with your latest book. Give us a quick summary of

00:02:33.560 its central thesis.

00:02:35.740 Well, I think what's going to surprise a lot of your listeners and viewers is that the brain

00:02:41.760 operates on a fixed bandwidth of energy and no amount of diet, exercise, supplements,

00:02:48.480 or Sudoku puzzles can increase that. So we're up against the brick wall. And yet people are forcing

00:02:55.700 themselves to multitask, to work on several screens at the same time, thinking that maybe just sheer

00:03:02.340 real power or a pot of coffee will get them through this. But I think everybody agrees that our attention

00:03:08.980 spans have gone to hell. And one of the reasons is that we're simply, our brains are simply exhausted,

00:03:15.340 we're asking it to do stuff that it cannot do. So we have to work within the limits that we have.

00:03:22.480 Now, was your idea, the impetus to write this book, was it in any way informed from your work as a

00:03:32.620 neurologist? Or it's just the fact that both of them in one form or another deal with the mind,

00:03:37.520 and therefore you went into it. What's the link between your work as a neurologist and this current

00:03:41.940 book?

00:03:42.920 Well, you know, most people don't think about the way they think or how they think. But for me,

00:03:47.780 it's my job. So a quick story is that my spouse and I were in New York, we're looking for an address,

00:03:55.600 and we just had track phones at the time. And we couldn't, the city is shut up on a grid,

00:04:01.220 for God's sakes, but we couldn't find this address. And all the phone books and public telephones

00:04:07.020 had been ripped out at the time. And so we looked at each other and said, we have got to get an

00:04:11.140 iPhone, if only for the maps. So we each got an iPhone. And after about the second day of fiddling

00:04:18.260 with it, I said, Oh, my God, no wonder these things are so addictive. It's like having a slot machine in

00:04:24.760 your hand. And there's no end in sight. And the quarters just keep coming. So that was the that was

00:04:32.220 the big insight is that yes, these are these devices are addictive, for very simple reasons. And they

00:04:39.020 are, they are a behavioral addiction. We're used to the physical ones like alcohol, drugs, things like

00:04:47.800 that. But then there's the behavioral addiction, such as overeating, gambling, compulsive sex,

00:04:55.120 shopping. And the endless scroll of the screen is, it feeds into this kind of behavioral addiction,

00:05:05.820 because when do you stop scrolling? You don't, there's no end in sight. So you just keep going

00:05:10.320 and going and going. And like a slot machine, I mean, you get a little hit, oh, that's interesting.

00:05:15.500 And you keep scrolling, maybe I'll get something better. Oh, I get a bigger hit. Yeah, at least keep

00:05:19.680 going. And you just keep going in in hopes of getting the jackpot, which never comes. So yeah,

00:05:26.980 right. Sorry, finish your point. So that's so that's one point. Another point is that the screens

00:05:31.820 act like secondhand smoke, so that anybody who's in the line of sight of a screen is going to be

00:05:38.000 distracted by it. We've all experienced this in waiting rooms and airport lounges. If there's a screen

00:05:45.500 on, it demands to be looked at, you cannot, it takes energy not to look at it. And so even not

00:05:52.720 looking at it is draining your your your limited supply supply of energy. Do you think that the

00:05:59.760 cat is out of the bag, and there's no going back? Or is there a way for us to set up some discipline

00:06:07.600 behavioral modifications that would allow us to temper our constant hit for the digital dopamine?

00:06:14.440 I think the first step is realizing that we're asking, we're looking at this situation the wrong

00:06:18.900 way. We're looking at it as this is a technological device. And therefore, the solution is going to be

00:06:26.080 technological. But what we should be looking at it is from the brain's perspective. What does it want? How is

00:06:34.640 it being overwhelmed? And how can we work within the natural limits that we have? I mean, we got we've

00:06:40.740 gotten along pretty well for 3 million years. And the iPhones, smartphones have been around for what 30

00:06:47.080 if that. So, you know, technology advances exponentially like a rocket ship. But we still

00:06:54.320 have the same Stone Age brain as our distant ancestors evolution. I see a picture of Darwin in

00:07:00.540 the background. Evolution does not, you know, not say, Oh, it's been 10 years, let's say we'll have a new

00:07:06.940 model, we'll have a new new model of the cortex. We don't have a new version, you know, like your

00:07:13.140 washing machine, you have a new one every 1015 years, the brain doesn't work that way. Evolution

00:07:19.160 just gives us what we have. And it works pretty good. We just have to be careful that we're we're not

00:07:27.280 overloading it. I mean, I love that the fact that, you know, in your title, you you reference our

00:07:33.380 evolutionary past, because you're correct. And that there here's the here's Darwin, my my own work,

00:07:40.560 my own academic work is at the intersection of evolutionary psychology and evolutionary biology,

00:07:45.600 and human behavior in general, but economic decision making and consumer decision making in

00:07:51.560 particular. And in my work, I argue that you can't fully understand human behavior,

00:07:55.980 behavior, and let alone consumer behavior, if you don't study the the underpinnings of our

00:08:01.320 biological heritage, what why do we consume the way that we do? And so much of it is unconscious,

00:08:06.160 you see, so much of it is unconscious, people think that they're rational beings in that that mean,

00:08:11.000 that's a joke. We're not rational at all, we're emotional through and through. And in terms of

00:08:16.200 behavioral economics, I mean, there are psychology knows pretty well why we do stupid things. And you 0.99

00:08:23.520 know, and the kind of biases that we have, and confirmation bias, expectation, etc. So we are our

00:08:32.560 thinking is inherently faulty, or at least it behaves in ways that don't make common sense. And so people

00:08:43.220 can go and push themselves off a cliff, if so to speak, unless they understand what they're up against,

00:08:51.540 unless they understand their own biases, for example, and that it's, you know, the iPhone is a fantastic

00:08:59.040 tool. I mean, it's better than Star Trek. It's certainly better than the Apollo computers. But it's

00:09:07.240 also a narcotizing agent. So you can have you can have the good, but you have to appreciate that unless

00:09:13.780 you're careful, you're going to get sucked in to the bad. Now you know that and I think the maxim is

00:09:20.600 physicians cannot heal by self or something to that effect the truism. So you know where I'm going

00:09:25.800 with this having now studied the ill effects of being addicted to technology. Does that mean that

00:09:33.480 you've been able to temper your own behavior or you're the pulmonologist who is smoking in the waiting

00:09:40.660 room? Well, yes, I have tempered my behavior. But I, you know, I realized that at any, any instant, I can be

00:09:52.700 sucked right back into the endless scroll. You know, I'm in the morning, I read the Wall Street Journal in the New

00:10:00.520 York Times, and the Washington Post on my iPad. And if, if I'm not careful, I'll just keep on going and going and

00:10:07.580 going. It's like, and so my, my Apple Watch dings is like, Oh, 6am time for breakfast, put this down.

00:10:13.300 Okay. So you have to discipline yourself and do certain things at certain times, because

00:10:20.040 there's no end to the news. You know, if something really important happens, I'll find out about it

00:10:26.380 eventually, or tomorrow when I read the paper, or when I read it in the evening at cocktail hour.

00:10:31.900 So, uh, I'm not missing anything. So I would argue, and I'm, I'm, I'm, I think that you probably

00:10:39.040 would agree with this. A lot of the behavioral modifications that we try to implement, say at

00:10:44.920 New Year's resolution, often they will fail because they don't have specificity to them. Right? So if I

00:10:51.240 say, uh, you know, I'd like to eat more health, you know, health, more healthily this year.

00:10:57.080 That means nothing. That's a vague promise. That means nothing. But if I say that when I'm going

00:11:02.940 to go to the club med in two weeks, even though it's all you can eat, I will never take more than

00:11:10.380 one plate of food. That is a specific rule by which I can abide. So maybe not maybe, but I would argue

00:11:19.600 that the exact same thing has to imply in terms of the digital appetite that we, you know, we, we

00:11:24.220 engage in, which is, you know, after six o'clock, I never checked my emails on the weekend without

00:11:29.300 that specificity, we're likely to get sucked in right into the, I know. I mean, I do. I check it.

00:11:34.500 I check my emails early in the morning and again, late in the afternoon and that's it. And if people

00:11:39.560 need to get hold of me, they will eventually, um, you know, when I was a, when I was a resident in

00:11:46.180 neurology, you know, we had beepers that we clipped to our belt and all that. And Oh, what a status

00:11:50.840 symbol that one was. Cause it's, Oh, you're important. Look how important I am. I have

00:11:56.180 to be reachable at any moment. There could be an emergency. Well, now of course, the luxury is

00:12:00.900 being unavailable. So it we've come full circle, right? You don't practice anymore, right? I don't

00:12:07.580 see patients anymore. I still, I still mentor medical students. Do you, I mean, do you miss it or

00:12:13.640 is this, Oh, thank God I got out of that job? No, because I basically, I went from, I just had

00:12:20.200 lunch with a psychiatrist friend of mine. And when I, when I stopped practice, he said,

00:12:24.020 Richard, you don't retire because you're always busy and you've just shifted your focus from

00:12:29.440 how to treat certain thing to writing about what is, what is the mind? What is the nature of

00:12:34.960 nervous tissue? Et cetera. So you're still solving problems and mentoring medical students,

00:12:41.460 we're still solving problems with them because this is all new to them. Right. So I don't miss

00:12:47.200 it. Uh, I'm still doing it. Uh, and basically as long as I'm awake, I'm working, my brain is

00:12:54.180 very active and I'm having thoughts and stuff. So that's beautiful. And I love it. I love it. I

00:12:59.960 really do. Uh, I was going to ask, I mean, I guess maybe this is the time since we're talking

00:13:04.520 about wearing different hats, uh, as I was preparing for our chats, I, you know, I, I will typically

00:13:09.760 look at a person's bio and something that struck me in your bio, Richard, is that you have an

00:13:15.500 MFA, a master's in fine arts, I think in creative writing, that really appeals to me because I'm

00:13:22.360 so, so in high school, I won the chemistry award and the history award, right? Right. And so I often

00:13:30.760 talk about interdisciplinary, I mean, my, my whole academic career.

00:13:33.760 How, how, how C.P. Snow would have admired you.

00:13:36.900 Uh, I don't know if you know the term consilience, right? Unity of knowledge.

00:13:41.920 Yes.

00:13:42.160 So maybe you could talk to us about how, you know, a neurologist is also an MFA because

00:13:48.720 that's, that speaks to my heart.

00:13:51.140 Well, my father was a physician and my mother was an artist. And back in the fifties and sixties,

00:13:59.320 the doctor's office and house were attached. So I would help my mother with squeeze this big two

00:14:07.660 pound tube of lead white Grumbacher on the, on the pallet and all that. And she'd mix it with

00:14:13.660 linseed oil and turpentine. And then when, when, and when she was done with the canvas, I would take

00:14:18.620 it down to the basement where they would dry, but the, the smells would then waft up into my father's

00:14:25.100 office and mix with an abyss medicinal smells that only the doctor's office had back then.

00:14:31.540 The distant, I don't know what it was. It's disinfected or something and all that.

00:14:35.720 So to me, and my, her father was a, was a horticulturist and my father's father was a technical

00:14:42.740 glass blower for RCA, but he made these beautiful Christmas ornaments and trees populated with different

00:14:51.840 colored birds. And I have get glass cufflinks that he made and all that. So to me, there's no difference

00:14:59.040 between art and science because I was, I had this mingling all my life. So it doesn't, it wasn't

00:15:06.740 strange for me to step from one to the other. And as far as writing I I've been writing since the seventh

00:15:13.900 grade. My teacher just praised out a impromptu essay that I wrote. I had forgotten the assignment

00:15:20.540 to do it in ahead of time. So I just did it right then and there. And I got an A plus and he read it.

00:15:26.000 This is great. And he told my mother at the PTA, he should go into journalism kind of thing. Anyway,

00:15:30.820 so I've written since the seventh grade for pay since my years at Duke. And then my first book was in

00:15:40.280 1989. And that was published by Springer Herlag. That was Synesthesia Union of the Senses. And Springer makes

00:15:48.540 beautiful books. They make books that aren't going to sell many copies, but they're, they're,

00:15:54.400 they're in mathematics and physics and all that, but they're, they're. This one is Springer.

00:15:59.240 Aha. The Darwin one is Springer. Yeah. Yeah. And they made beautiful, beautiful books. So that's

00:16:05.140 fine. And then after, you know, I wrote, I read, I don't know, six or seven books. And I wanted to

00:16:11.660 switch from, and I wrote a number of magazine pieces about teaching people how to die, students

00:16:18.540 how to deal with death, for example. And I thought, I really want to switch from pure science writing to

00:16:25.380 more literary kinds of nonfiction. And so I thought, oh, I'll go back to school. And American University

00:16:32.420 has a creative writing program. And I thought, well, they're never going to let me in. I'm too old and

00:16:37.540 all that. Well, I didn't realize that somebody like me was prized. And we had six of us who are

00:16:43.120 over the age of 50, they're called non-traditional students. We called ourselves old farts. And it was, 0.70

00:16:51.560 it was exciting being around all these creative people, young, young and 20 years old, and then the

00:16:57.820 faculty, well-established writers. It was very energizing. And I would do things like, I realized

00:17:08.280 how much I love to go to the library and just wander the stacks. And I hadn't done that in decades. It's

00:17:13.980 like, it's like being in a candy store.

00:17:16.820 Oh, I do that almost every day, Richard.

00:17:18.760 Yeah, it's, it's great.

00:17:21.040 So yeah, that's amazing. So okay, let's go. I just want to, I remember there's one term from your

00:17:27.180 latest book, let me mention it again, for people to go get it, your stone age brain in the screen

00:17:32.040 age. So there's one term, digital autism, I must admit, I haven't read the book yet, I plan to,

00:17:39.360 but that caught my eye, because I'm currently writing a book titled, suicidal empathy. And of

00:17:46.980 course, empathy is something or lack thereof, sometimes that you could see in autism. So I'm

00:17:51.700 familiar with some of that literature. But what does digital autism mean in the context of your

00:17:56.920 latest book?

00:17:57.500 It means that people exposed to heavy screen use, particularly young people, what they have

00:18:05.900 exposure does is it induces autistic like symptoms in otherwise normal individuals, they don't have

00:18:16.540 developmental autism, but they have autistic like symptoms. So the first thing is that reduced eye

00:18:23.080 contact, you call their name, you're lucky if you get a grunt out of them, they won't look up, reduce

00:18:29.820 socialization, reduce language, you know, and the thing is, is that if you and of course, if you try to

00:18:37.700 take the phone away from a from a kid, they, they, they have a meltdown there, you know, they, they have a

00:18:45.360 meltdown is what they have. And it's like, wow, tell me they're not addicted to this little device

00:18:52.600 here. But if you do take it away, and for only, I don't know, about two weeks or so, the symptoms go

00:18:59.160 away, which they never do in developmental autism. And this was first noticed in an orphanage in

00:19:06.560 Romania, where kids were exposed to TVs and screens all the all the all the time. And the doctors there

00:19:13.700 noticed these these autistic like symptoms, and remove the devices and noticed the dramatic

00:19:22.200 reversal of symptoms. And so there are there are deep boot camps that would go into for digital detox,

00:19:30.000 like Hillary cash's restart, for example, there's there's quite a few around the country now. And

00:19:35.640 basically, the kids get sent away to this camp, and they have no screens, no devices, no radios,

00:19:43.140 they just each other, and the counselors, and they have to talk to one another, they have to play with

00:19:49.980 each other, they have to engage over their meals. That in other words, they have to socialize, which is

00:19:58.240 something they haven't done in a long time, because they're so sucked into the screen here. And so

00:20:05.340 this, it has a caustic, it has a caustic effect.

00:20:08.640 Are you familiar with the recent book also by on the same topic by Jonathan Haidt, the anxious

00:20:16.760 generation, I think it deals with roughly the same types of issues.

00:20:20.180 I've not read it, but I, we corresponded sometime back, we're on the same wavelength, basically,

00:20:26.800 he's approaching it from a different angle than I am. Whereas I'm looking at it from the brain's point

00:20:32.620 of view, but pretty, pretty strictly. And not only just, you know, exposure to screens, but what

00:20:38.900 happens with with the lack of sleep, what happens with all this blue light that we're being exposed to,

00:20:44.020 etc. So there's quite a, and then what about the loss of cursive handwriting? How does that affect

00:20:51.220 thinking? So there's quite a lot of material in the book that I cover.

00:20:57.720 Here's a, here's a empirical question that maybe it's been addressed. And if it has, I'm sure you

00:21:02.900 probably have the answer. So I'm a voracious reader. But I found that even in for someone who,

00:21:10.020 I mean, I'm not a teenager, so my brain is not quite as malleable, I'm not quite as addicted

00:21:14.800 as some of the young folks. But I find sometimes that because I've been conditioned to also do the,

00:21:21.800 the scrolling for the next hit, that at times, I really have to work hard to not interrupt my

00:21:30.200 reading flow, because I've lost a bit of the ability to completely be immersed in the book.

00:21:36.140 So is there any research that links the amount of digital technology that I consume,

00:21:44.340 and my reading consumption?

00:21:48.060 I don't know if there's any qualitative, quantitative link that's been established. But the,

00:21:55.380 there is, there's a wonderful book called The Revenge of Analog. And it talks about people who write

00:22:02.260 in Molesky notebooks or sketch on inches paper, or talk about the finishability of a novel,

00:22:10.300 of the kind of pleasure you get from linear thinking, being able to follow a linear argument,

00:22:16.940 not just one screen pull at a time, not just a paragraph at a time, if you're lucky, because we don't

00:22:22.860 hardly get that much in these little dribs and drabs that we get online.

00:22:28.360 But to be able to follow a sustained argument is really flexing, building your cerebral muscles.

00:22:38.720 Yeah, beautiful. Okay, I want to go now, as promised, in the intro to synesthesia.

00:22:44.160 Yes.

00:22:44.500 Before we do that, so this is a, I think I read what I'm about to describe is called the President's

00:22:51.560 speech. It was one of the chapters in Oliver Sacks, the man who mistook his wife for a hat. And I've,

00:23:02.000 I've, are you familiar with that particular chapter? Do you know what I'm talking about?

00:23:05.240 No, I'm not.

00:23:05.860 So it, so at one point, Sacks, who was also a neurologist, was doing his rounds, and he passes

00:23:12.840 by a room, Richard, where the people who were in that room were all suffering from aphasia.

00:23:19.620 Mm-hmm.

00:23:20.440 But yet, they were looking at the screen, listening to some president, I can't remember

00:23:26.320 who the president would have been at the time, maybe Reagan. And even though they couldn't

00:23:30.680 understand the words that were being enunciated, they were all cracking up. And so that took

00:23:36.980 them about, why are they laughing? And apparently, the explanation he gave is that even though they

00:23:41.780 couldn't understand the words, they understood what seemed like some of the falsity in political

00:23:48.100 speech. And they were responding to those intonations. So having said, so that was the

00:23:53.180 first time that I kind of learned of the, these magical clinical tales that of course, you've

00:23:59.360 got a whole bunch of. So what is synesthesia? Because it seems like it's a complete science

00:24:04.660 fiction story from a script writer.

00:24:06.380 Well, synesthesia, and here's, here's the book here, right? The synesthesia, everybody knows

00:24:13.560 anesthesia, which is no sensation. So synesthesia means joined or coupled sensation. And there

00:24:20.360 are children born with two, three, or all five of their senses hooked together. So that my

00:24:25.580 voice, for example, is not only something that they hear, but they might also see it or taste

00:24:31.100 it or feel it as a physical touch. They assume everybody's like this, until they say something

00:24:36.780 innocuous. One seven year old told her best friend, Oh, my A is the most beautiful pink

00:24:42.500 I've ever seen. What does your A look like? And the girl looked at her and said, you're

00:24:46.640 weird, and never talked to her again. So they go from thinking everybody does it to I'm the

00:24:52.460 only one in the world. And, you know, at the beginning, when I did this, the first, I only

00:25:01.840 knew the word because I like words. And so I thought synesthesia, anesthesia, great, stick

00:25:06.660 it in the back of your head. And I had a new neighbor who taught lighting design at the School

00:25:12.040 of the Arts. And he invited me to dinner to meet some friends and then said, will be a few

00:25:16.240 more minutes, there aren't enough points on the chicken. Now his friends laughed and said,

00:25:21.620 Oh, Michael, what are you smoking? But he turned to me and said, Well, you're a neurologist,

00:25:25.680 maybe you'll understand. When I taste something, I feel it on my face and in my hands, a feeling

00:25:32.680 sweeps down my arm, and I feel weight, shape, texture, temperature as if I'm actually grasping

00:25:38.860 something. So I said, Oh, you have synesthesia. I was just trying to be polite. And he looked at

00:25:48.320 me and said, Do you mean there's a name for what I do? And then I thought, How could he

00:25:52.980 not know? And that's when the light bulb went off, like this could be something important.

00:25:58.420 Because here's this, this well known phenomenon that's been forgotten. And he doesn't know he

00:26:04.540 has it. So I told my my colleagues about him. And they said, Well, what is this CAT scan show?

00:26:09.760 And I said, No, no, no, you don't understand. He doesn't have a hole in his head. He has something

00:26:15.000 extra. And they looked at me like I was crazy and said, Oh, man, this is too weird,

00:26:20.800 to new age, you stay away from it, because it's going to ruin your career. So I don't know where

00:26:26.260 their careers went, but mine's doing fine. But as he says that with some gleeful,

00:26:32.740 for the first, for the first 15 years, I got these withering looks of this cannot possibly be a real

00:26:40.180 brain phenomenon. They're just making it up. They want attention. They're having residual

00:26:44.540 hallucinations from years of pot smoking and LSD, or maybe on and on and on and on everything they

00:26:50.580 came up with. And, you know, what they insisted on was were pictures of the brain, which we didn't

00:26:57.500 have at the time, really. And but eventually, because and what that's asking for, they want a third

00:27:04.600 person verification of a first person feeling. It's like, well, show me what it's like to be in

00:27:12.700 love on a brain scan. Okay, well, you sort of can, but it's like, you know, take the most

00:27:19.080 subjective thing and insist that you have an external operative definition of it. And that

00:27:24.700 just doesn't fly. But eventually, they got the pictures that they asked for, and they had to shut

00:27:30.400 up. And so now, of course, synesthesia is is very, very popular all around the world as young people

00:27:35.880 studying it, writing, doing their thesis on it, writing monographs and papers. There's conferences

00:27:43.900 all over the world. I just got invited to one in Spain, another one in Bern to give a keynote address,

00:27:50.680 et cetera. So but early on, it was like, these people are crazy. This can't be real. And of course, 0.51

00:27:57.360 what what synesthesia has done is cause a paradigm shift. Because we used to believe in modularity,

00:28:05.960 that every sense, every there was module for language for sensation for cap for calculation,

00:28:11.680 but just that the other. And by definition, there was no crossover between the two. Well,

00:28:16.940 synesthesia really sort of puts the kibosh on that idea. So it's synesthesia has caused a rethinking of

00:28:24.240 how we think the brain is organized. And we now know that there's cross it's not do do synesthetes

00:28:31.900 have crosstalk in their brain? Of course they do. But they have much more than the rest of us. And so

00:28:37.480 that's why I say that we are all synesthetic, except we're not consciously aware that we are.

00:28:42.480 Okay, a couple of questions. What percentage of the population has synesthesia?

00:28:47.340 Oh, 4% of 4% of the population, or one in 23 people inherit the gene for it. But because

00:28:54.020 it's not expressed with complete fidelity, a smaller number of one in 90 has some kind of overt

00:29:00.660 synesthesia.

00:29:02.320 Okay, now does the so I'm assuming that the condition implies that there are at least

00:29:08.980 an overlap between two sensations. But could it could it be that all of my five sensations are invoked

00:29:18.320 as I navigate the world? Or is there an upper limit? Is it there's never been a documented case with more

00:29:24.120 than three? How does that work?

00:29:25.420 Oh, yes, sure there has. Yes. The way I found out about synesthesia was by reading

00:29:30.460 A.R. Lurie's The Mind of a Mnemonist, which is about a memory expert who had a five fold synesthesia.

00:29:38.000 And the reason that he had such a limitless memory is he could add all these extra hooks that he could hang

00:29:43.120 things on. So yes, if you have one kind of synesthesia, you've got a 50% chance of having a second, third or fourth

00:29:49.640 kind. Wow.

00:29:50.580 So there are there are people who have multiple kinds of synesthesia. It's not unusual to have

00:29:57.100 four kinds or all five that they won't necessarily be the senses. For example, the personalization of

00:30:07.340 and genderization of graphemes, that is of numerous numerals and letters.

00:30:15.260 There's seeing time in three dimensions in space that encircles you. These are called number forms.

00:30:24.860 So people say, you know, where's seven? Well, seven is down here. It's brown and it's by my knee.

00:30:31.600 So and they have their then again, they have the it's like having a filofax or calendar that's

00:30:37.000 limitless. So they birthdays and certain appointments and things are colored in a certain

00:30:43.040 way in this spatial configuration that encircles the body. David Dickelman's done a lot of work

00:30:50.700 about a bit on number forms.

00:30:52.820 And it I mean, you mentioned just a few minutes ago about, you know, brain imaging and or you can't

00:30:58.080 quite see love and then you corrected yourself said, well, you can't. So does that mean that we can

00:31:03.120 see a signature of someone who has that condition, either through brain imaging or some other

00:31:10.300 neuroanatomical like, can I can I look at two brains and say, I can tell that this one has

00:31:17.480 synesthesia and this one doesn't or it's completely invisible to you?

00:31:21.080 Well, there's a cottage industry of functional MRI that looks at people who have, let's see,

00:31:27.460 you know, colored hearing, colored graphemes, different kinds, different kinds of musical

00:31:35.780 units, etc. And you can show that, in fact, if they say that when they listen to spoken

00:31:40.920 words, they see color. Indeed, the V4, the human color area does activate. So you can show

00:31:48.420 so but, you know, and it's interesting for a for us from a scientific perspective, but the mistake

00:31:58.740 is to point point and say there, there it is, you know, no, that's only one node in the distributed

00:32:04.820 system that that that accounts for synesthesia and synesthesia exists as the most active process in

00:32:13.940 this distributed system. So, you know, scans can only see a small part of the active brain.

00:32:21.540 Well, that's interesting that you say this, because so I've written two papers, academic

00:32:26.260 papers, Richard, where I was critiquing the neuroimaging paradigm. And in my argument, I

00:32:35.060 borrowed a term from one of my former professors in my PhD, who's a cognitive psychologist, I think he

00:32:41.200 called it the illusion of explanatory profundity. The idea is that, you know, if I see a bunch of

00:32:48.480 sciency looking brain images, it just it feels sciency. Now, in my view, and you're the neurologist,

00:32:56.100 so you'll tell me if I'm right or not. The brain imaging paradigm is great for diagnosis. You know,

00:33:04.020 here we are here, here's the tumor. It's not quite as good in inferring, you know, behavior and so

00:33:11.160 on where, you know, use the term cottage industry almost with some derision. Did I read that correctly,

00:33:17.720 that we are overselling how much explanatory profundity we're getting out of the neuroimaging

00:33:23.160 paradigm? Yes, I think so. Because I think that it's, it's, it's being misunderstood by the larger

00:33:29.840 population. I mean, that's that that's the real problem, is that they there's not an appreciation of

00:33:35.220 the limits of these techniques. When you're dealing with behavior, you've got the time factor,

00:33:44.220 and the scans, these scans take several minutes. And so, you know, they're not going to catch a

00:33:52.580 fleeting thought, because all that that you're thinking is too fast. And what are you thinking?

00:33:58.460 They used to be, well, I started, started with cerebral blood flow using radioactive xenon.

00:34:06.800 And it would be called the resting state. And we showed this hyperfrontal thing. Well,

00:34:14.140 of course, the frontal lobes are activated, because they're lying on this table with several thousand

00:34:19.420 volts going across their head in this motorcycle helmet that's modified with these scintillation

00:34:24.580 probes. And the doctors where there's telling them, relax, relax, relax. And so, of course,

00:34:31.060 so what's the resting state? Right? That's assuming that the brain is a tabula rasa? Well,

00:34:37.360 they could be thinking about their, their laundry list, their shopping, having sex, fantasizing,

00:34:45.100 you know, God knows what they're thinking about. It's not a resting state, their, their mind is very,

00:34:50.000 very active. So I think it's a misnomer to think that the thing that you're pointing to that's

00:34:56.500 activated is the only thing that's going on at the time. Right? And that's just not the case.

00:35:03.120 It may be a personal question. So my background is in psychology of decision making. That's what I did

00:35:08.800 my PhD on. I specifically, I studied how much information do we acquire before we stop acquiring

00:35:16.640 additional information and commit to a choice. So I studied those cognitive processes. So I'm very

00:35:20.980 much steeped in the behavioral decision theory and psychology of decision making literature and so on.

00:35:25.980 So as someone who studies decision making, I'm always interested when I have people on

00:35:29.980 to ask them, how did they make the choices that they made? So when you were deciding to specialize

00:35:35.200 in a particular medical, medical specialization, what do you remember, or was there a mechanism by which

00:35:42.700 you said neurology is for me, not internal medicine? Oh, neurology picked me. I hated it in

00:35:50.860 medical school. I hated neuroanatomy. We made all these drawings with colored pencils. And then the

00:35:56.360 next day, the professor came in with all the exceptions, and we had to tear that away and make

00:36:01.540 a new one and all. So just before a big exam, somebody we never saw, heard of before, came in with a 28

00:36:10.040 page handout, outlining quote, some of the highlights of the limbic system, the emotional

00:36:15.860 brain. Well, we threw a fit and marched into the dean's office saying, this is impossible. And then

00:36:23.560 trying to study that exam, I in a fit of peak, I threw my notes off the balcony of my apartment.

00:36:29.040 Well, obviously, I retrieved them. But then later on, in internal medicine, reading the section of

00:36:37.640 neurology and Harrison's internal medicine. I was late at night, 1am, I'm going to this laundry list

00:36:45.020 of unpronounceable diseases and all that. And I come across aphasia. And I think, oh, wow, this is

00:36:53.300 diabolical. You can move your mouth and tongue and make sounds, but you can't speak, or you can't

00:37:00.960 understand what's being said to you. I said, does that take away somebody's humanity? What's left?

00:37:07.000 Are they a ghost in the shell? And I laughed out loud, at which point I thought, oh, shit, 1.00

00:37:12.480 I'm supposed to hate this. So that was the moment that neurology picked me. And then when I rotated 0.99

00:37:18.160 through as a student, one of the professors, one afternoon, put his arm around me and say, you know,

00:37:24.340 Rick, you have a real knack for this. We're going to send you to a fellowship at Queen Square in London

00:37:29.720 after one of your clinical rotations. And that was that. It was decided for me. And of course,

00:37:36.340 when I got to London, which I loved already, but there you're at the center of English speaking

00:37:43.600 neurology. There's the amphitheater that the country where the CAT scan was invented, you had to wait a

00:37:51.640 week to get a CAT scan. So it was all hands on. It was very theatrical. Yeah, I remember in one

00:38:00.600 rounds, Brian McArdle of McArdle's disease was chastised. The resident said, well, let's get it.

00:38:07.920 We need to get an EMG. He said, what for? He said, well, to document the weakness. And the doctor said,

00:38:13.580 you just shown us that they're weak. You don't need to test. Only Americans do that. 0.99

00:38:20.780 Did you ever get a chance to meet or interact with Oliver Sacks?

00:38:26.300 We corresponded. We never met in person, but we corresponded.

00:38:31.120 Any fun stories that our viewers...

00:38:34.120 Well, people always, you know, people often ask

00:38:37.980 whether we were alike or not. Of course, we weren't alike at all.

00:38:42.060 Other than the fact, I guess they were both gay. There must be something about being gay and being 1.00

00:38:46.900 a neurologist that goes together. But, you know, Oliver was this like Talmudic kind of

00:38:53.500 approach to it. And I just have a different kind of approach.

00:38:57.660 Approach to being gay?

00:38:59.360 No, to being a neurologist. 0.97

00:39:02.200 Ah, okay. Because I wanted, I missed the part in the Talmud where you... Okay, I see.

00:39:07.360 Okay. So what are some of the next... I mean, I know now you're promoting your latest book,

00:39:15.600 but what are some projects that keep you up, excited about what the future holds?

00:39:22.400 You know, I always wake up with a sense of purpose. It's wonderful. It's great to be alive.

00:39:27.880 My next project is a suspense thriller called What She Saw. It involves murder. It involves

00:39:35.020 synesthesia. It involves poisoning.

00:39:37.500 It's a fiction book.

00:39:38.980 It's a... This is a fiction book. And I'm doing it in... With a collaborator,

00:39:43.060 one of my old MFA students. She's a little bit older than me.

00:39:46.500 Wow.

00:39:46.960 She's been a successful playwright. She's got a... Having a reading in London of her upcoming play.

00:39:54.700 So we're going to... On the 11th, I leave for the Virginia Center for Creative Arts, which is an artist colony,

00:40:02.640 three hours away in the foothills of the Appalachians. And so we're going to be working

00:40:06.740 there together for six weeks, working on this new project.

00:40:09.820 So you haven't struck a word yet.

00:40:12.620 Oh, we have. No, no, no. We... One afternoon in the Southampton Writers Conference, it was raining.

00:40:21.100 So we were standing under the eaves and after lunch, waiting for the showers to stop. And I had my

00:40:26.240 little recorder with me. So in an hour, we dictated this whole plot of this thing. And... But it sat for a

00:40:34.980 while because we were both busy with other things. And then just this past year, we started resuming

00:40:40.520 work on it. We've been Zooming sessions and getting a little preliminary work done so that by the time

00:40:47.060 we get to the artist colony, we'll be able to hit the ground running.

00:40:49.980 Well, I'm glad that you said that you're working on it because if you hadn't said that, then my next

00:40:53.920 question wouldn't make sense. What is the difference in your creative process? All of your previous

00:41:00.680 book have been nonfiction, correct? Yes. So is there a... I mean, yes, there's a difference in

00:41:07.160 that one is fiction, one is nonfiction. But in the generation of output, what would be some of the

00:41:14.960 key... Because for example, I've only written nonfiction books, right? So I don't know. I've

00:41:21.180 never... Even when I wrote as a kid, I would write about actual things. What is my position on the

00:41:29.020 death penalty, right? So I never created characters. I never generated a world that

00:41:35.260 didn't exist until I came along to build the characters. So from your view, having now engaged

00:41:41.760 both processes, what are some similarities and differences for aspiring authors?

00:41:45.900 Well, they're quite different, actually. And my agent said he's had a lot of his clients who have

00:41:54.920 gone, tried to write fiction, and they give up on it. It's just too hard. Well, the focus has got to be

00:42:01.860 on character. And as Aristotle says, a person's character is his desire. So that's the driving

00:42:10.600 force of what do people want? What are the obstacles in their way? And you can't have a lot of exposition.

00:42:19.020 You have to... It has to be dramatic. And so the arc is conflict and resolution and challenge.

00:42:32.860 Do you find it more daunting to write the fiction book? Because the other one,

00:42:37.580 you're protected by your expertise, right? I mean...

00:42:41.180 And I've done it... That's what I've done for decades is the nonfiction. And I wanted to get away from that.

00:42:46.220 Right. So even in your Stone Age brain, I start with a dramatic scenario of three million years ago

00:42:53.420 in some gorge where the sun comes up and the men come out and sniff the air and the women go off

00:42:59.980 marching to the tidal pool to collect snails and food and all that. And it illustrates some of the

00:43:07.020 things about the orienting reflex and some of the aspects of the Stone Age brain, and particularly about

00:43:13.180 the need for socialization because our early communities were only a couple dozen, two,

00:43:18.380 three dozen people, individuals together. And so everybody had to cooperate.

00:43:24.860 So the other thing about fiction is dialogue. You've got to have dialogue and then you have to know how to

00:43:33.020 write brief dialogue. You can't be long-winded. Mark Twain once said, I would have written you a shorter

00:43:42.140 letter, but I didn't have time.

00:43:45.980 Actually, it's...

00:43:47.340 So writing short and pithy and to the point.

00:43:50.460 As you're mentioning the importance of dialogue, I'm thinking about some of my favorite movies of

00:43:54.220 all time. Well, certainly my favorite movie of all time is 12 Angry Men, the original one,

00:43:58.540 that happens in one room.

00:44:00.460 The courtyard, right?

00:44:01.740 Right. And that movie can only work, right? I mean, there's no special effects and car chase

00:44:08.620 scenes, right? So the only thing that's gripping me are the words that are being exchanged within

00:44:13.660 that room. So it speaks to your point. Dialogue is everything. The other one that I was thinking

00:44:17.420 about, which I'm not sure, tell me if you've seen it, is Glengarry Glen Ross, which is...

00:44:24.140 Have you seen this?

00:44:25.020 It's been a long time since I've seen it, yes.

00:44:27.020 Well, incredibly powerful dialogue between a bunch of salespeople, real estate guys,

00:44:32.540 who are kind of conniving.

00:44:33.820 Grifters, yes.

00:44:34.940 Exactly. So, okay, last question, and then I'll let you go. This is one that has almost become

00:44:42.460 customary for me to ask at the end of the show, because in my last book on happiness,

00:44:47.100 I end the book with a section on regret. And you're going to be happy if hopefully at the end of your

00:44:54.700 life, you look back and you have few regrets. And before I cede the floor to you, let me give you

00:45:01.100 kind of the background. So one of my former professors, when I was a doctoral student,

00:45:04.940 his name is Thomas Gilovich.

00:45:06.700 Thomas Gilovich.

00:45:07.500 Oh, I know. I know his work.

00:45:10.060 Oh, you know his work. Okay. Specifically his regret work or his decision-making work or which work?

00:45:14.700 Oh, the earlier work. How I know what's not so, I think.

00:45:18.620 Oh, yeah, of course. Well, part of my PhD, I took a seminar with him.

00:45:24.300 Of course, with him. Any case, in his psychology of regret work, I mean, he wasn't the first to

00:45:29.020 make that distinction, but certainly to study it empirically, he was a pioneer. So we've got two

00:45:34.060 sources of regret, Richard. We've got regret due to inaction and regret due to action, right?

00:45:39.340 I regret that I cheated on my wife and now I'm divorced. That's action. I regret something that I

00:45:44.300 did. I regret regret due to inaction. You know, I decided to become a physician because my dad was a

00:45:50.700 physician, but I really wanted to be an artist. That's where, and I regret that I didn't follow

00:45:55.420 that path. Now, it may or may not surprise you, Richard, that over the long term, the biggest

00:46:02.220 regret that looms in people's psyche is the one due to inaction, the road not taken.

00:46:07.260 Sure, yes.

00:46:07.980 So having said that and set it up, you're still, hopefully, you've got many more years left in

00:46:12.700 your illustrious life. If I asked you today, what is the one or two big regrets that you'd be willing

00:46:19.340 to share? What would they be? Oh, I would have taken advantage of opportunities earlier in my life

00:46:26.620 as they came along. Professional opportunities. All sorts of opportunities for friendships, for

00:46:33.340 adventure, for travel, just to get to develop skills. On the other hand, you can't do everything.

00:46:44.620 So it's like, I, you know, you might say be wistful in a sort of way that, gee, I wish I had,

00:46:50.380 you know, been able to work with my hands more, for example. But, you know, I work with my head.

00:46:56.540 So that's what I do. So I don't have any regret about that. And yes, my father was a physician and

00:47:02.140 come hell or high water. I was going to be a physician just like him. I really wanted to

00:47:07.260 go into the theater because I liked, I was very good at it. But as an actor, yes, as an actor.

00:47:14.460 And looking, looking back at it, I don't regret that at all. Because when you're a doctor, you have,

00:47:21.980 you can, you can have all sorts of opportunities that you can take advantage of. You have all sorts

00:47:26.780 of choices before you. Whereas if I were an actor, then I'd be limited to what's available and

00:47:34.460 pounding the pavement and all that. So I've had a, I'm just blessed with having had the education

00:47:44.140 that I've had. And knowing that it's like, I have nothing to complain about, because I have lots of

00:47:51.020 resources. And if I ever feel sorry for myself, smack me. Well, gratitude is certainly part of

00:47:58.780 the recipe for happiness. Let me mention the book one more time, Where My Glasses, your latest book,

00:48:03.900 Your Stone Age Brain in the Screen Age just came out in early October. Check it out. Richard,

00:48:09.180 stay on the line so we could say goodbye offline. Thank you so much for coming and best of luck with

00:48:13.100 the book. Thank you. Cheers.

The Saad Truth with Dr. Saad - November 01, 2024

Neurologist Dr. Richard Cytowic - Your Stone Age Brain in the Screen Age (The Saad Truth with Dr. Saad_738)

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