Review | The Tale of the Duelling Neurosurgeons- Sam Kean

I’m revisiting my pop-science book collection, partly to get back into a habit of reading and partly to look at the range of styles available in popular science writing. First on my list is Sam Kean’s The Tale of the Duelling Neurosurgeons.

Duelling Neurosurgeons initally surprised me by not opening with duels or with neurosurgery. Instead, it dives into the world of sleep paralysis, an experience often compared to possession or even alien abduction.

Once the sleep paralysis scene is set, Kean then pulls the rug out from under it by explaining how the near-supernatural experience is caused solely by physical circuits and responses. This unorthodox opening demonstrates his message- that small physical brain events can produce irrational, unexpected, and even spiritual/religious-seeming changes – in an accessible way which makes the idea easier to grasp.

From here we arrive at the beginning of neuroscience through the story of a duelling king and the warring neurosurgeons tasked with saving his life. Throughout Duelling Neurosurgeons, Kean expertly winds history, religion, science, and human quirks together. His approach doesn’t isolate neuroscience from its historical context but instead weaves in, almost competitively, connections between almost every field imaginable.

The tone and style of Duelling Neurosurgeons can best be described as the written equivalent of your very smart friend telling you the coolest parts of what they know while at the pub. That, or a younger, brasher Oliver Sacks- although I can’t imagine Sacks ever describing somebody as “one of the oddest ducks to ever waddle across the stage of history”.

Kean keeps complex surgeries and processes understandable through visceral, physical descriptions e.g. explaining a Confederate amputation process as “they made a 360-degree cut through the skin, then scrunched it up like a shirt cuff”. Similarly, explanations of brain anatomy are kept as concrete as possible through analogies; the temportal lobes are described as “wrapped laterally over the head like a pair of earmuffs” and the pituitary gland as “dangling below the brain as if it might fall off”. These descriptions may not be 100% anatomically appropriate, but they offer clear, distinctive images which help readers keep track during individual stories.

While this style and self-assurance could risk creating doubt in readers wondering whether a passage really happened as described, I ultimately felt that Kean had the knowledge to back up his delivery. However, his style may be a falling point for readers who find it overly tangiental and distracting, especially for people expecting a more linear approach.

Duelling Neurosurgeons clearly conveys knowledge and interest, but to judge how well it communicates science I need to know its aims. In Kean’s own words, he aims to connect the individual fibres of people’s stories up to “the full Persian carpet of the brain”. That’s a complex task to set in one book, so how well Duelling Neurosurgeons live up to these promises?

In my opinion, very well. In moving from base units like neurons, through to circuits and regulatory safeguards, then to complex ideas which emerge from circuits, the book successfully layers new ideas over each other without negating or contradicting lower layers. (However, as I’ve already learned about a lot of these ideas from uni, I can’t say how well complete novices would follow the structure).

Kean discusses a wide range of stories and situations, including neuroscience staples such as Phineas Gage, HM, and Clive Wearing as well as stories I had never heard before. He also links those stories back to each other to compare different effects from similar injuries or to compare how treatments and knowledge changed over time, which helps to keep the book cohesive.

Overall, I’d sum up The Tale of the Duelling Neurosurgeons as an engaging, humourous “human history” which stylishly maps 400 years of knowledge. If you’re curious about the gory, stumbling, and serendipitous parts of scientific history, I’d recommend reading this book.

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