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Defending the Cavewoman: And Other Tales of Evolutionary Neurology

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Dr. Klawans was one of the last true Renaissance men of the 20th century--someone who's equally at home in the worlds of medicine, science, literature, painting, music, and, by God, even baseball! I'm really, really very sorry to learn that he has passed away last year, especially since I've been following at some remove his book-publishing career, and I had always been somewhat upset that he had never quite achieved the worldwide fame as he no doubt deserved. In many ways, I truly believe he's as brilliant and erudite as Oliver Sacks. With the immediate success of "Defending the Cavewoman," I was extremely happy to know that Dr. Klawans has finally been recognized as one of our finest science writers around. This book is--dare I say it--a crowning achievement of a distinguished career, as it sums up, in fascinating case study after case study, an entire life devoted to solving the intricate puzzles of neurology, the human mind, or perhaps I should just simply say the miracle of life. Who but Dr.Klawans could have taught us, with such elegance and charm, just why, among many, many other things, it's biologically natural for people to hate watching foreign films (because the brain isn't wired to read subtitles and absorb images at the same time!), why a pretentious literary professor suddenly lost his ability to read French and English but could still read Hebrew (because Hebrew reads from right to left, rather than the left-to-right of English and French: to learn more about how this works you simply have to read the book). If you have never heard of or read Dr. Klawans before, I strongly recommend that you begin with this book. I think you'll agree with me, after just dipping a little into the book, that with the passing of Harold Klawans the world has lost a brilliant mind, a caring doctor, a cultivated gentleman, and an amazing writer. (I don't know him personally but yet I think I can vouch for these qualities just from reading his books.)

This book is a real gem. Clinical stories are woven together with a neurological approach. In this book, I met some of the most fascinating cases involving the brain and behavior. I would think almost anybody could enjoy this book, and learn a great deal about how important our biology is in forming who we are and how we evolved, without ignoring individual differences and the environment. Klawans was not afraind to tackle the "big" questions like evolution of the mind/brain and bring them to the lay reader in such as fun way!

...especially the chapter on the three hundred retired welders with careers of exposure to manganese dust, only <<some>> of whom developed the symptoms of Parkinson's disease.

Reading this book is like having a dinner conversation with a good friend who has seen the world we live in much, much more clearly than most.

Neurologist Harold Klawans' sensitive and fascinating collection of clinical tales explores evolutionary neurology - how our brains are constructed and why - through the peculiar things that can go wrong in them.

A woman suffering from "painful foot and moving toe syndrome" demonstrates the remnant of dinosaur brain we still carry around in our spines; a musician who loses the power of speech to a stroke retains his ability to conduct music, an illiterate man shows how reading has changed our perspective on the world, an English professor loses the ability to read English (from stroke) and substitutes Hebrew.

The first half of the book explores brain function and what it can teach us about evolution. The second explores hereditary diseases, pain, and, in an informative piece on mad cow disease, external evolution, or human alteration of the environment.

Klawans pleasure at the elegance of evolution infuses each of his essays, many of which center around a 'eureka!' moment - an offhand comment or question leading to a breakthrough in understanding. For example, his daughter's quip that an authentic Arabic restaurant always plays "the Song," meaning all Arabic music sounds the same to her, makes him realize the fundamental similarity between music and speech. Both exist in all cultures and culture determines comprehension.

Klawans particular interest is the plasticity of the human brain. Bipedalism changed the human pelvic structure, which forced an evolutionary choice - small chimplike brains or small immature brains that would require years of maternal nurturing. The beauty of the choice made by evolution is the unique abilities fostered by environmental interaction with a developing brain.

Speech is the greatest of these and the title essay concerns the case of a six-year-old girl found locked in a closet in an abandoned building. Undernourished and undersized, she was unable to speak. But her "window of opportunity" remained open and once exposed to language her progress was amazing. An adolescent, however, never exposed to speech, never develops the brain constructs and never speaks or comprehends. It's the "cavewoman," Klawans says, who made our unique cultural abilities possible, the cavewoman's nurturing and the cavewoman's mitochondrial DNA (brain diseases passed by mitochondrial DNA indicate a crucial role in brain development). Klawans' final essay, "Whatever Happened to Baby Neanderthal?" poses a stunning theory of extinction. Big Neanderthal brains were big at birth, thus lacking human plasticity, precluding language ability. Interbreeding would not have helped. Human men fathering Neanderthal babies could not pass on mitochondrial DNA (passed only through egg) and human woman did not have pelvises big enough to birth half-Neanderthal babies.

Klawans ("Toscanini's Fumble," "Why Michael Couldn't Hit"), who died last year, was an engaging, clear-sighted, stimulating writer with an infectious enthusiasm. In making his way to evolutionary insights, he takes the reader through neurological diagnoses of real people with baffling problems and even lets us know how it turns out for them in the end.

Careful Readers of Dr. Klawans' work will recognize him as the compassionate and erudite face of the neurosciences. In this book he teaches and explains with the same passion and skill, sensitivity and sensibility with which he appears to treat his patients. The result is that this book is difficult to put down until the last page and even then, the elegantly espoused ideas sit with you. You leave with a new appreciation for the beauty and function of the human brain and a new compassion for the owners of these organs. The attention paid to the evolutionary accomplishments of women is well reasoned, understandable, and likely to be the new paradigm for our understanding of what it means to be human. Not a hunter, or a tool-builder, but a human. The distinction is delicate but important. Dr. Klawans' death is certainly a loss for a number of fields and would be even sadder if we did not have his excellent books to remember him by. This one is very personal and reads like a letter from your family doctor in places, never condescending, never failing to attribute and praise the various people who played their parts in the ideas within, but it still hits with the force of a powerful intuition and diagnostic skill. It would have to be an exceptional legacy for anybody...

...In this book, Dr. Klawans is meticulous, displays a wide range of knowledge, and is beautifully logical. His details of Parkinsonism are so well laid out that anyone who shakes or teeters occasionally may be tempted to self-diagnose. Detailed case histories are lightened by his continuing commentary on his love for classical music. He occasionally digresses into baseball and Italian pastries, but always ties his stories closely to his major theme of treating brain disorders.

Dr. Klawans had a great interest in evolution and the ascent of Man. He believes that "the ascent of Man, of Homo Sapiens, was due entirely to the females of our species." He discusses scientific theories that suggest all humans derive from an Eve who lived about 200,000 years ago.

Neanderthals and modern humans co-existed for thousands of years, but no traces of Neanderthals are found in people today. Neanderthals were bigger and stronger, with bigger brains, but were dumber. Dr. Klawans states: "The evolutionary race goes not to the strong, but to the more adaptable, the more wily, the more juvenilized."

One reason I chose to read "Defending the Cavewoman" was because of a book I read twenty years ago . . . "The Lives of a Cell" by Lewis Thomas. I picked it out of my bookcase and re-read several passages. I still enjoy Dr. Thomas' writing immensely.

A very entertaining read, but I prefer his earlier books. This book concentrates on several case studies that demonstrate how one can see the evolutionary process that took place to create the marvelous human brain by looking at that organ today. I'm sorry to hear that Dr. Klawans died last year, as I always looked forward to the release of his latest book.

Although I enjoyed Dr. Klawans' book immensely, I felt that the title, Defending the Cavewoman, was somewhat misleading. The volume purports to approach human evolution from the perspective of the brain, and the title suggests that the effect of women on the process would be a component of the discussion. While the effect of the maternal-infant bond is discussed briefly as a factor in language acquisition in the early part of the book, in general the rest of it consists of anecdotes involving the doctor's practice.

His stories are very interesting to me, since Dr. Klawans did his residency on the same ward, Station 50, at the University of Minnesota Hospital that I worked on early in my career as a nurse. As he mentions in the book, his mentor was our department head, Dr. Abraham B. Baker, a brilliant diagnostician. Dr. Klawans probably graduated from the institution a year or two before my arrival. While the stories are intriguing, they seemed to me to provide more illumination on the complicated process of diagnosis, especially of the more unusual neurological diseases, in particular the movement disorders (Parkinson's disease is the doctor's specialty) than they did a theory of evolution of the brain in humans. In fact it might be said that an understanding of the underlying principles of evolution would be of more use in unraveling the causes of neurological problems, than vice versa. Certainly an understanding of genetics, the very foundation of evolution, has lead to more advances with respect to the causes of some of the more exotic neurological problems, like Huntington's Chorea, Kuru, and Jacob-Croitzfelds syndromes.

By the end of the book, the author has completed his lengthy digression and returns to his main theme, the evolution of the brain, it's effects on our overall evolution, and the key factor that women contribute, namely the size of the birth canal. In his final chapter, Dr. Klawans discusses the importance of the immaturity of the human infant post-natally. Compared to other types of mammal, the human baby is essentially still fetal at birth, as Stephen Jay Gould points out in his book The Panda's Thumb. While the baby horse is ready to run independently within minutes of birth, the human baby is not able to walk for months. This is due to the fact that the nervous system is still too immature for the newborn to be autonomous. In order to accommodate the larger brain, a larger brain case is necessary. In order to deliver the child without killing the mother, the mother's birth canal must be wide enough for the head to pass through it and/or the brain/skull must be smaller. The baby's brain is still immature at birth and the plates of the brain case are not fully fused, allowing it to pass through the mother's pelvis.

Of interest was the doctor's suggestion that the bottleneck that caused the Neanderthal's demise and prevented a genetic mix with Homo sapiens was the contribution of maternal DNA and pelvis size to the situation. In a human male- female Neanderthal mix, the mother's pelvis and DNA would lead to a more mature infant with fuller sized head and nervous system, a situation that would provide less of an opportunity for learning. As the author writes, "The greater maturation of the Neanderthal brain at birth would have been a biological advantage only so long as survival depended more on a classic survival of the fittest than on the acquisition of knowledge within a human-manipulated environment (p. 240)." On the other hand, with a Neanderthal male-human female mix, the mother's smaller pelvis and the infant's larger head size would probably have killed them both.

The book digresses extensively, but that does have its appeal.

This is a wonderful book for anyone slightly intereseted in understanding the brain. As a molecular biologist, I was never bored, even when Dr. Klawans was defining a gene. Each of his amazing neurological discoveries has a beautiful human story behind it. Dr. Klawans is a sensitive doctor who loves humanity as much as he loves science.

This is a wonderful book. It is extremely readable, with each chapter making a story of some aspect of neurology. It is also an excellent description of neurological problems, teaching me many things I didn't know even though I am a nurse practitioner working in the field of neurological research. Ocasionally Klawans digresses into descriptions of music or baseball, which seemed like filler rather than relevant material, but for the most part his stories are enthralling. His description of mitochondrial DNA is a little obscure. His ability to weave together different strands of neurology and biology to explain a theory of human evolution is riveting. My neice bought this book while I was visiting, and I couldn't leave until I had finished it.