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Strange BehaviorReview - Strange Behavior
Tales of Evolutionary Neurology
by Harold L. Klawans
WW Norton, 2001
Review by Stephanie D. Preston, Ph.D.
Jun 11th 2002 (Volume 6, Issue 24)

Originally published under the title Defending the Cavewoman, this book by the late Dr. Harold Klawans uses case studies in clinical neurology as the basis for the author’s speculations on complex issues in evolutionary psychology, such as how language evolved, why the hominid brain increased in size and complexity, and the effects of technology on survival and adaptation.

Each chapter of this very readable book revolves around a case study taken directly from the clinical experience of the author, and follows a progression from meeting the patient, through the interview and examination, to diagnosis. This includes a detailed description of the author’s thought processes throughout, with all of the background information upon which he drew to come to his conclusions. The final section of each chapter consists of the author’s thoughts about the case, how the case exemplifies general facts about the structure of the body and the brain, and elucidates issues in human evolution.

I found the descriptions of the clinical cases to be the most interesting parts of the book, but this is also the area where I have the least expertise. I suspect that even an experienced neurologist or neuropsychologist would find these cases interesting because they recount patients with rare disorders, or common disorders with unusual (even bizarre) stories behind them. For example, Klawans consulted on the case of “Lacey”, a girl discovered at approximately six-years old, locked in the closet of a building that was about to be demolished. She had presumably spent her life locked in this closet, being fed and interacted with only minimally. As a consequence, Lacey was malnourished and did not speak when she was first discovered, but during her subsequent hospitalization she quickly improved, picking up basic phrases from other people and from television. Such “wild child” cases are thankfully rare, and the few highly publicized cases (The Wild Child of Aveyron, “Genie”) are considered natural experiments that inform the nature/nurture debate and the existence of critical periods for learning. Cases such as these are both extraordinary and instructive, shedding light on biological mechanisms and human nature.

While it is legitimate to use these cases to teach people about basic concepts in behavioral neuroscience, the background information is usually too detailed and not explicitly linked to the case at hand. It comes across as if the author pasted textbook-like sections into each chapter in order to demonstrate his own knowledge, more than to help the reader (displays of knowledge on issues scientific and cultural are characteristic of the prose). For example, in chapter ten, which recounts the transmission of Huntington’s disease through a particular family, Klawans devotes five pages to a lesson on basic genetics, including everything from how sexual reproduction works to how proteins get produced from the RNA, derived from DNA etc. In reality, one could understand and appreciate the story with just a paragraph’s worth of information on how Huntington’s disease occurs through abnormal replication of a segment of DNA, and how the number of these replications affects the patient’s presentation and age of onset.

The evolutionary speculations can be interesting and fulfilling as long as you approach the book as the entertaining science diary of an intelligent, well-read man who thinks about big questions. Unfortunately, like the popular science-fiction writer Kurt Vonnegut Jr. (who is invoked throughout Strange Behavior), Klawans does not distinguish between medical fact and pure speculation, putting the onus on the reader to know which is which. Many books written by academics for the lay-person have this quality, in part because the raison d'être of such books is to allow the author to publish relatively unfounded beliefs that may turn out to be prescient, but are nevertheless discouraged in peer-reviewed journals. So, maybe you can blame the author only to the extent that you can blame publishers and editors for allowing such material to pass as nonfiction, or to the extent that you believe readers are not responsible for making these distinctions for themselves.

This is a book worth reading. I qualify this enthusiasm with two pieces of advice: 1) Do not get bogged down with the scientific background information; ultimately you don’t need it to appreciate the story and 2) do not be too seduced by the evolutionary theories at the end of each chapter; ultimately they are musings, rather than tested, challenged, or supported hypotheses.  Klawans’ long, distinguished career obviously exposed him to a wide variety of interesting and instructive cases, yielding a thought-provoking book that demonstrates how medical diagnosis is an art as much as it is a science.


© 2002 Stephanie D. Preston


Stephanie D. Preston, Ph.D., University of Iowa Hospitals and Clinics


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