Neurotheology Notes — "a neurologist on the brain and God"

There is a word almost nobody says in a hospital. It survives comfortably in song lyrics, and in eulogies, and in the sort of late conversation where people admit things they would not admit at noon. But say soul in a clinical setting and the temperature in the room drops half a degree. Everyone finds something interesting on the floor. Among those of us who work with brains and nerves for a living, the word carries a faint odor of the attic. It sounds like something our grandparents used before the scanners got good. And yet I keep meeting moments in my clinic where I have no other word available. A patient sits across the desk from me. The numbers explain a great deal and somehow not the main thing. The imaging is a map of territories, and the person in front of me is not anywhere on that map. I have never found a better name for what is missing from it. Part of the trouble is that the word has been handled badly for a very long time. For centuries it has been squeezed into one ...

Two patients, on the same afternoon, with more or less the same problem. Both told me, without being asked, that they prayed every day. The first woman said it the way you might mention that you walk in the mornings. When she talked about her prayer her shoulders came down an inch. The second woman said it with her jaw set. She prayed the way a person files an appeal — carefully, on time, in the correct form, aware that a failure of procedure might count against her. Her blood pressure that day was higher than it had been at any previous visit, and she apologized for it. For most of my career I filed that difference under temperament. Some people are calm and some are not, and faith gets poured into whichever vessel is already there. I am no longer sure that is the whole of it. There is a small, awkward, occasionally overstated body of research suggesting that those two women were not only in different moods. They may have been in different physiologies. The cardiologist they...

Suppose there is a rosary in your hand. At first it feels awkward. You say the same prayer, and then say it again. Ten Hail Marys make a decade, and there are five decades. Somewhere around the twentieth repetition your reason begins to file a complaint. What is the point of this? If once, sincerely, would do, why fifty times? To a modern ear tuned to efficiency, it sounds like pure waste. We were trained to make the point once, cut the redundancy, and treat a repeated sentence as laziness. Telling such a person to say the same prayer fifty times is nearly a provocation. And yet the secret of the rosary is hidden in exactly that inefficiency. The repetition is not trying to deliver meaning. It is trying to put to sleep, briefly, the part of us that weighs meaning. Set the complaint down and move the beads. Something shifts. As the words grow familiar, the burden of parsing them drops away and rhythm rises in its place. One phrase on the breath in, the next on the breath out. The f...

A man in his fifties came to my clinic with headaches he had carried for three years. The imaging was clean. The bloodwork was clean. He had been through the standard workup twice already at other hospitals, and he recited it to me the way people recite an address they have given too many times. Near the end of the visit we came to the line on the intake form about alcohol. He gave me a number, paused, revised it upward, paused again, revised it upward once more, and laughed at himself. I asked him when the drinking had started to matter. He gave me a year. Earlier in the visit he had mentioned, almost as an aside, a scar on his forearm and the accident that put it there. Same year. The headache was real. I want to be clear about that, because patients with headaches spend half their lives being told their pain is imaginary. But sitting there with his chart, I had the strong sense that the headache was the smallest thing he had brought into the room. For most of the last century, ...