THIS  BOOK  SHOULD  BE  MANDATORY  READING  FOR  ALL  GRADE  12  STUDENTS.  IT  SHOULD  BE  MANDATORY  READING  FOR  ALL  ENTERING  THE  MEDICAL  PROFESSION  -  Keith Hunt



THE  BRAIN'S  WAY  OF  HEALING


by  Dr. Norman  Doidge

A Bridge of Sound


The Special Connection Between Music and the Brain

Socrates: And therefore, I said, Glaucon, musical training is a more potent instrument than any other, because rhythm and harmony find their way into the inward places of the soul, on which they mightily fasten.

Plato, The Republic




I. A Dyslexic Boy Reverses His Misfortune


One day in the spring of 2008,1 got a telephone call from a woman I had never met, to tell me about Paul Madaule, the man who had saved her son. At the age of three, her son, whom I'll call "Simon," was showing disturbing signs. He wouldn't respond to his name or answer back; if a ball was rolled to him, he wouldn't roll it back. He crawled and walked late and was clumsy and developmentally delayed. His mother, whom I'll call "Natalie," told me that the psychologist she took him to said he might be on the autistic spectrum. Another clinician said he displayed some "autistic-like symptoms," though Natalie doubted this diagnosis. His occupational therapist suggested that Natalie take him to Paul Madaule. Madaule said Simon had the "peripheral" symptoms of autism; he agreed that he had major developmental problems, but Simon did not have what some saw as the core autistic symptom: the inability to imagine the minds of other people. Natalie told me that working with Madaule changed her son completely. Once withdrawn, he could now start up interactions with others, his movements and speech became fluid, and he was able to have "his first real conversation with me, ever."


But Madaule s techniques were so unusual, she confessed, that when she spoke of them to mainstream practitioners and parents of children with similar problems, they seemed not to believe her story: they were either skeptical or showed no curiosity about how a boy with autistic-like symptoms had lost them.

When I asked her what precisely Madaule had done, I could hear her preparing to tell me something she knew would sound far-fetched. Madaule, she said, had used music—usually Mozart, but modified in a strange way, together with modified recordings of her own voice—to rewire her son s brain. It had radically improved his ability not only to listen and relate, but also to perform, for the first time, many mental activities that had nothing to do with sound. This was music medicine: using sound energy to form a bridge into the brain, to speak its language.


Now, five years later, Natalie said, her son was "at the top of his class academically, has more friends than I can schedule in his calendar, is kind, empathetic, and hyperaware of social currency." His motor problems were gone, and he was a competitive swimmer, a soccer and cricket player, and a gold medalist in karate. "The work that Paul and his staff did has changed our lives in so many ways, and so profoundly. I don't know what I would have done if I hadn't come across it." She hesitated, then said, "I don't like to think about it."


Paul Madaule, I discovered, actually lived on my street in Toronto, in an old Victorian house from the 1880s, hidden far back from the sidewalk, off an alley, behind a wooden fence, surrounded by a botanical garden the size of a small park. He had bought the property when it was a run-down, dilapidated, termite-infested rooming house with open sewage pipes; its lot had been used as a local dumping ground.


He quietly moved into one of the rooms. Whenever a tenant moved out, he and a friend would reconstruct and resurrect that space. By supporting himself on the rents from his remaining tenants, he was able to fix up the place one room at a time. Over the years, with the help of his wife, Lyn, he brought the vacant lot back to life, cultivating it into a hidden paradise. He had a way of rescuing treasures no one else could—both in his work with children and in his personal life.


Madaule, a handsome, dark-haired Frenchman, has huge, receptive brown eyes, symmetrical Gallic features, and facial bones that suggest the appearance of a Mediterranean artist. He is a humble, sensitive, and unintrusive clinician (an essential trait in those who help developmentally disordered, hypersensitive children). His soft, slow, non-mechanical way of moving has a calming effect on any room. His strong presence neither dominates nor advertises itself. After spending some time with him, you can feel the quality and reach of his attention; it is indeed the focus of an artist. Even if he is observing you, you don't feel disturbed or imposed upon, but rather that he is immersing his humanity in yours. But what is most striking about him is his deep and beautiful, assured, sonorous, calming voice.


It was not always so….


Paul was born with a devastating learning disorder, in 1949 in Castres, a small, isolated town in the south of France, a time and place that had little understanding of children's brain problems. Paul's parents took him to every known kind of specialist available in France in the 1960s: psychologists, psychiatrists, and orthophonistes—speech therapists—because he mumbled in an incomprehensible monotone. He always had to ask people to repeat themselves (even though conventional hearing tests reported his ears worked fine). He failed four grades in school (and, he says, passed a few that he didn't deserve to). He was diagnosed with "dyslexia," a word he could neither pronounce nor understand, used to describe the commonest learning disorder, involving difficulties in learning to read. Like many dyslexics, he reversed the letters b and d, and p and q, and the numbers 6 and 9 when printing them.


But his dyslexia affected much more than his reading. He walked, he said, like a duck. He walked into posts because of his poor sense of space and absentmindedness. Like many children with learning disorders, he was teased by his peers and even his teachers for his clumsiness; his own physical education teacher picked up on the mockery and called him une oie grasse—a fat goose. This was his welcome to the world of dyslexia.


I have before me a little peach-colored booklet, four by five inches, entitled, in French, Carnet de Notes Hebdomadaires, Petit Seminaire de Castres, which is Paul's weekly book of marks for grade ten. At the end of each week, his teacher wrote his grade in each of his subjects in a column, followed by his class ranking for the week. As I go through the booklet, two things are apparent. His grade for conduct and effort was always a pass. His grade for all of his courses was failing—and he was rarely close to passing. In the first week, Math 1/20; Language 3/20; Spanish 4/20; English 8/20. The booklet also gives his class ranking: he was twenty-fifth out of twenty-five students and held last place for every week of the year. The worst part for him was the weekly devastation he felt when he had to bring that report card home for his parents to sign. As is true for many learning-disabled children, his uncomprehending parents thought him lazy, so every report card day was unbearable, resulting in screaming matches, slammed doors, yelling, and crying; as he would later write, "It was hell for everybody."


Paul grew up plagued with self-doubt, which became worse as each year he fell further behind in school. He wondered if he might go to vocational school, but he was so clumsy he couldn't even turn a screwdriver. In social situations, though his thoughts came quickly, he either couldn't put them into words or he stammered. As a teen, he retreated to his bedroom and listened to the same songs over and over for hours. The one form of expression he enjoyed was drawing, and he loved the art of the modern masters.


He failed grade ten, having failed every single subject that year. Because he had failed four grades in a row, and was three years older than his classmates, he wasn't allowed to take the grade ten examinations again. Finally he gave up and dropped out.


A Chance Encounter at the Abbaye d'En Calcat


Suddenly at eighteen, he was isolated, without school or a job. With endless time on his hands, he often visited a Benedictine monastery, a ten-mile bike ride from his home. He was drawn there because there were artists there, and he hoped that maybe he could become one, art being the one activity that he could see himself doing. At the abbey, called Abbaye d'En Calcat, he found peace. One day Father Marie, a monk who had taken an interest in Paul, told him that a physician was visiting the monastery and had happened to give a lecture on dyslexia. Father Marie said the doctor had described symptoms very much like Paul's.


The physician, Dr. Alfred Tomatis, had been invited to the monastery to make a house call under peculiar circumstances. Most of the monks had fallen ill and were struggling with exhaustion and symptoms that nobody had been able to explain. Seventy of the ninety once-hardy monks, who had often gotten by on about four hours' sleep, were now listless all day long, slumping in their rooms. A procession of physicians had been brought through the monastery, each dispensing recommendations. Some advised more sleep, but the more the monks slept, the more tired they became. Specialists in digestion recommended that the monks—vegetarians since the twelfth century—begin eating meat. They got worse.


The last physician to arrive was Tomatis, which seemed absurd, because he was an otolaryngologist, an ear, nose, and throat specialist. But he was known to be a genius at diagnosis and had an interest in mind-body medicine. Tomatis set up equipment in a small room in the monastery and trained a monk to administer tests to his ailing brothers. He also consented to see Paul, but first he had to be tested.


When Paul arrived in the monk's room, it was filled with electronic machines, which looked like they were for hearing tests. He put on headphones and was told to raise his right hand as fast as he could when he heard a beep in his right ear, and to raise his left if the beep was in the left ear. Then he listened to pairs of beeps and was instructed to tell the monk which sound was higher and which lower. It seemed to Paul much like the hearing tests he had already had.


But Tomatis did not do hearing tests. He did listening tests. He saw hearing as a passive experience involving the ear; "listening" was active and was about what the brain could extract and decode from what came in through the ear. At the end of the test, the monk gave Paul some graphs and told him to go meet the doctor in the monastery park.


"Tomatis," said Dr. Tomatis, introducing himself. He was forty-seven years old and stood very straight, a posture developed from years of yoga practice. He had a broad expansive chest, a shaven head (rare in those days), and funny pointed ears. He was an intimidating figure. But when he spoke, his voice was calming, soft, and warm, with a soothing murmur. He had a twinkle in his eye that made Paul feel he really cared. His voice was one, Paul said, "qui vous met en confiance—that made you feel confident in yourself, confident enough to confide to another person, so I felt at ease, right away."


After Dr. Tomatis looked over the test results, he took Paul on a walk in the park and asked him many questions about art, his home life, his sexuality, his religion, his hopes and dreams. He raised every topic except Paul's horrendous difficulties at school. He freely differed with Paul, yet always made him feel his own views counted.


Finally Tomatis explained to Paul the meaning of his lifelong symptoms—his "petite miseres" annoying little problems, in a way that made Paul understand, for the first time in his life, his difficulties reading and expressing himself, his extreme shyness, temper tantrums, anxiety, clumsiness, insomnia, and fear of the future. He explained too how these problems fit together, which seemed incredible, given that he had tested only Paul's listening. Paul thought, "He is the first person who ever talked to me; others talked to someone they saw." Tomatis invited Paul to come for treatment at his clinic in Paris, then inexplicably asked that he bring a recording of his mother's voice.


In Paris, in Tomatis's office, Paul was again asked to put on headphones and told that the treatment would begin with listening, every day for several weeks. At first, he heard only scratchy, indecipherable static with bits of a tinny-sounding, electronically manipulated Mozart.


Tomatis told Paul he could do whatever he wanted while he listened, so he chose to draw and paint. Every week or so he was given another listening test, then met with Tomatis.


Days passed, and slowly he made out isolated words behind some of the scratchy sounds. The words seemed far away, from a distant world. Then a phrase, or even a sentence, might pop out. Several weeks into the experience, he noticed that his listening was improving—he was getting better at understanding sounds—and his symptoms were beginning to decline. One day he suddenly realized that all this time, in some of the screechy recordings, he had been listening to his mother's voice.


At the end of four weeks, he was a different person. It would require years of study to understand how this transformation had occurred: how "mere" energy—the energy and information of sound waves—had helped him rewire his brain.


TO  BE  CONTINUED