Editor’s Column

A Psychiatrist as Top Neuroscientist

by Edward C. Leonard, Jr., MD, DLFAPA

All psychiatrists can benefit from exploring Karl Deisseroth’s Projections: A Story of Human Emotions. This memoir presents a brilliant mind explaining to himself and his readers how and why he studies the basics of behavior. In living animals, at the level of axon to specific cell, his research refined the techniques of optogenetics. After a neuron is genetically modified to express light-sensitive ion channels, light may be applied to activate or inhibit that specific cell. For tissue taken from animals, he developed a hydrogel-tissue chemistry technique that removes lipids and renders the structure of organs clearly visible to microscopic examination. Many expect that findings from these scientific tools will trigger a sea of change in medicine. Of great interest to our field is his presentation of preliminary studies exploring the basis of animal violence and human dissociation.

In medical school Deisseroth had planned to become a neurosurgeon, but psychiatry captured him through a startling encounter with a psychotic patient. Even though his main effort now is to run his famed neuroscience research laboratory, he still cathects his chosen specialty, which he calls “enthralling and mysterious.” He supervises residents in psychiatry for part of the year and treats some outpatients with autism and treatment-resistant depression. Importantly, the basic science techniques he develops follow his concerns about patients, and his book makes many scientific points by discussing patients. Their stories are so carefully written that the reader must stay alert to master the overlapping cognitions and emotions in both the patients and the author. He combines carefully chosen words into beautiful, convoluted sentences conveying complex images and ideas. Mateo came to Deisseroth’s emergency room distressed that he could not cry about the death of his pregnant wife in the automobile he had driven. This survivor’s plight introduces stimulating ideas about the evolutionary utility of tears. The reader will learn that other facial signs of emotion, like smiling, are easy to pretend. But the flow of involuntary tears moves those who watch in a powerful way, usually to assist the one crying. The author treats his patient-examples with respect, even allowing Winnie to tell her own experiences. She presents herself as a successful patent attorney who had survived lymphoma but believed that vampires were tapping into her brain. After leaving the hospital, rejecting treatment, and hiding at home, she gets a phone message that her spinal tap study found cells showing T-cell lymphoma. Deisseroth’s early aspiration was to become a writer, and the breadth of his reading shows in his choice of quotations. “Epigraph,” from a love poem by Jorge Luis Borges, structures his intense relationship to the reader: “I offer you explanations of yourself, theories about yourself, authentic and surprising news of yourself.” The “Preface” quotation from Finnegan’s Wake may hint that a shock (like lightening) may be needed to start the process of research: “After sound, light and heat, / memory, will and understanding.” I predict reading Projections will be a joy, but for those who prefer lectures, YouTube may be a substitute. An interview in his office, accompanied by one of his four young children who could not go to school that day, shows him as a tired, loving 49-year-old father. His academic neurologist wife covers later in the day, while he readies their children for school and makes their lunches. An older son is a medical student. Do enjoy a recent two-hour interview, Huberman Lab Podcast #26, “Dr. Karl Deisseroth: Understanding & Healing the Mind.” It even provides a table of contents usefully clickable to topics of your interest.