If, during your annual checkup, your doctor were to admit to having been influenced in their medical thinking by the deviant beat writer and heroin junkie William S. Burroughs, you might be a little wary of taking their prescription. But what if that doctor were Professor Andrew Lees, a legendary neurologist and one of the world’s foremost authorities on Parkinson’s disease?
My father was one of Lees’s patients. He had always had a deep distrust of the medical profession, but he came back from these appointments strangely revivified. “That Professor Lees is a fascinating man,” he would tell me. He took the medicines Lees prescribed, but perhaps the most effective one on offer was the doctor himself.
Lees, now 74 years old, has released three books in the last five years that transcend medical writing. They meld memoir with manifesto, polemic with poetry, and exude an unconventionality that is utterly bracing.
In Mentored by a Madman, Lees explained how Burroughs’s writings helped him challenge medical hierarchies and encouraged him to self-experiment with therapeutic drugs. In Brazil That Never Was, he went in search of a myth from his childhood—the doomed Fawcett expedition to the Amazon—and delved into the occult and the perilous mental trap of nostalgia.
Now, in Brainspotting, he recounts the roads less traveled that he has taken, and rails against the “robotic adherence to rigid guidelines and protocols,” as Lees wrote to me in an e-mail. The result is a portrait of a man who is both pre-eminent in his field and distinctly out of left field.
Birds to Brains
As a boy, Lees bird-watched in the northern English town of St. Helens. This led to an interest in cataloguing and organizing knowledge.
The nature poetry of the autodidact and asylum internee John Clare taught him “the power of passive attentiveness” and the ability of words to make things visible on the written page. This led him inexorably to medicine. Whereas before he had learned to identify a bird by its song, now he thought “that by listening attentively to the distress calls of patients I could determine the source of their complaint.”
Lees, who went on to study at the Royal London Hospital and the Hôpital de la Pitié-Salpêtrière, in Paris, before taking a post as a professor of neurology at the National Hospital in London, developed an almost supernatural ability to interpret his patients’ gestures, postures, and facial expressions.
He learned to listen not just to a patient’s words but to the “rate of speech, pause-to-speech ratio, the pitch, tone and volume of the voice.” Smell and even taste could provide clues to a diagnosis, but the most important sense to him is one that many would not think a doctor of brain diseases would require: “the intimate bond of touch.” This Lees praises as “an essential constituent of healing and another way of listening that never lies.”
Anyone writing a popular book about neurology must face comparisons with the late Oliver Sacks, who in The Man Who Mistook His Wife for a Hat and Awakenings gave many their first glimpse into the bizarre nature of the brain. Indeed, Lees and Sacks were friends for 40 years. But while Sacks sought to humanize his patients, Lees seems to write in order to humanize his fellow doctors, a tribe who can often seem cold and heartless and whom Lees, in his gentle yet radical way, is seeking to reform.
He is appalled by the overuse of diagnostic technology and of some doctors’ brusque and offhand dismissal of patients’ lives outside of their symptoms. In Brainspotting, Lees hopes to create what he terms a “soulful neurology,” one in which medicine is treated as much as an art as it is a science.
Evidence of this can be seen in his teaching, which always stressed the importance of the imagination. Lees would sometimes ask his students at the University College Hospital to diagnose patients just by looking at their empty beds. On other occasions he would take them on the London Underground to spot neurological illnesses—limps and twitches—in the wild, as it were.
“My intention was to try and encourage them to become doctors on whom nothing could be lost,” he notes in Brainspotting. It’s no wonder that Lees writes so lovingly about the influence of Sherlock Holmes on his clinical practice.
But whereas Holmes was frostily analytical, there is something poetic that goes hand in hand with the precision in Lees’s writing. Even when discussing the dissection of a brain in technical language, Lees can seem like a nature poet describing a tidal pool or distant nebula:
There was a profusion of star-shaped tufts, intermingled with radial fibrous arrays within astrocytes, and clumps of insoluble tau overloaded with phosphorous clogging up axons in the front cortex.
Brainspotting is rich, not just with neurological insight—such as the way in which patients’ throwaway comments often reveal the cause of their illness—but with an intoxicating sense of place. Whether it is Lees’s descriptions of the Liverpool docks of his youth, with their steamers chuffing out into the exotic, or of his time as a “mod” doctor, dressing sharp amid the ever changing tapestry of 1960s London, he seems bound to certain places in his past.
Lees told me that he suffers from “saudade and an insatiable yearning for the distant horizon,” and there is something melancholic that pervades his writing about the past. It’s as if he’s cradling his own brain in his hands, gently probing through its ridges and folds for something that is forever just out of reach. This is the tale of Doctor Faustus in reverse: of how to be a doctor without losing your soul.
Brainspotting: Adventures in Neurology, by A. J. Lees, will be available beginning April 5
George Pendle is an Editor at Large for AIR MAIL.His book Strange Angel: The Otherworldly Life of Rocket Scientist John Whiteside Parsons became a television series for CBS All Access. He is also the author of Death: A Life and Happy Failure, among other books
