Dr. Fred Bortz

A User's Guide to the Brain: Perception, Attention, and the Four Theaters of the Brain

by John J. Ratey, M.D.

(Pantheon, 2001, $27.50 hardcover, 404 pages)


Reviewed by Dr. Fred Bortz

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When he works with a patient, psychiatrist John J. Ratey's goal is to develop a user's guide to a limited portion of a unique human brain. In this task, he has the benefit of direct collaboration with the person in whose skull that brain resides. To succeed, Dr. Ratey and his patient need to discover a few effective models and a few useful techniques to understand and overcome maladaptive or problematic behaviors.

That can be difficult, because it is not always clear what portion of the brain needs attention, whether the patient properly perceives and clearly characterizes the problem, and whether the patient can apply the solution the collaborators come up with. Chances of success are good because Dr. Ratey brings to bear detailed knowledge of the human brain -- arguably the most complex system known to science -- plus analytical proficiency, social and interpersonal savvy, and a gift for communication.

As an author, Dr. Ratey has set for himself a more daunting assignment. He seeks nothing less than to develop a comprehensive user's guide for the possessors of countless human brains, with whom he hopes to interact indirectly through words and diagrams imprinted on paper. Though a book can be viewed as a collaboration between author and reader, it lacks the feedback and refinement that take place in a face-to-face encounter. Further, no two brains are alike in genetic endowment, environmental exposure, and history of use.

Worse yet, each brain is guaranteed to be flawed in ways that the owner may have difficulty detecting or understanding. And unlike a computer manual, A User's Guide to the Brain lacks model numbers and design specifications to guide the readers to sections that apply to their own imperfect unit.

Yet because of Dr. Ratey's command of detail, his skill in organizing information, his interesting viewpoint, and the assistance of ghostwriter Mark Fischetti (who earns a generous acknowledgment), the book skillfully surmounts all of these obstacles. Almost any reader will discover sections of this book -- if not the entirety -- that apply personally and directly.

If nothing else, readers will come to appreciate the guiding principles of "Use it or lose it," and "Neurons the wire together, fire together." They will be able to understand and analyze the workings of their own "four theaters." Information about the surrounding world (input, to use a computer analogy) enters through the doorways of perception. It gains form through the symphony orchestra of attention, consciousness, and cognition. The brain function (movement, memory, emotion, language, sociability) theater adds context and meaning. The output is behavior and identity. Like a river, this flow has eddies, back-channels, and upstream commerce.

Though no two rivers have the same chart book, and no two voyagers -- no matter how similar their journeys -- have exactly the same needs and vessels, Dr. Ratey's manual will serve as a useful and interesting navigational guide.

Pennsylvania-based physicist and children's writer Fred Bortz was instrumental in the development of the river-based educational programs of Pittsburgh Voyager.