Neurology, week 7


The theme of the week was psychosis and the PBL case centered on schizophrenia. Schizophrenia literally translated from Greek means “split mind” and is a diagnosis which describes a mental illness characterized by disorganized thought processes, delusions and hallucinations. I’ve simplified it greatly but even from the few symptoms I’ve listed one can see how this might have a significant impact on social behavior. The class was lucky enough to have a speaker come in and talk about their personal experience with schizophrenia and the problems they faced as a long time sufferer. Of the points that she touched on the one that I thought was the most interesting was when she talked about how real the hallucinations and delusions were to her. I have seen this before with other patients – the mind has an incredible ability to rationalize the most irrational idea or thought. So – even though the though processes are disorganized and the individual delusional, on some level the rational brain is still working and seems to be trying to make sense of what is happening.

I find understanding the illness from the patient point of view perhaps one of the most helpful things that I can do at this point in my schooling. The more I am capable of putting myself in a patient’s shoes the better I am able to come up with strategies that will work in their case. Having a speaker attend class that had actually suffered from schizophrenia was a great way for me to gain a better understanding, as is reading case studies or seeing examples of other suffers. One such example that I have come across in other classes is that of Louis Wain and his cat paintings.

The case of Louis Wain is interesting because he was an artist who developed schizophrenia much later in life. The story goes that Louis Wain was a London artist born in 1860 who drew cats initially to amuse his wife while she was sick with cancer. His cat sketches and paintings were quite popular at the time and he apparently published collections of his work as well as illustrated calendars, etc. When Louis was 57 he developed schizophrenia from which he never recovered and was eventually institutionalized for. Supposedly, during the remainder of his life he continued to draw cats but in an increasingly erratic fashion (see pictures above) up until his death in 1939. His drawings are often cited as a way to gain insight into the disease process and the delusional state of Louis Wain’s mind. However, this may or may not be true …

The pictures and the idea that Louis Wain may have illustrated them during his disease may in fact be a myth. In an excellent article on the Mind Hacks blog (found here), the idea is present that the erratic cat pictures may be simply artist experimentation have nothing to do with Wain’s psychosis at all. In fact, later works by Wain were not as abstract and were much more conventional in nature. Regardless, current theories on schizophrenia seem to suggest that there are physical changes to brain prior to the onset of the disease. So in reality Louis Wain may have been painting for many years with the underlying disease present. The question could really be – how long did Wain suffer from schizophrenia before it was actually recognized and what did his work look like during that time? It may not be as dramatic but it could be interesting to see…

For more of Louis Wains art check out the Chris Beetles Gallery (here)


6 responses to “Neurology, week 7

  1. To further fuel you interest in the patient perspective, I think you may be interested in checking out the Arts and Health “Crossing Borders” blog

    Also, I’ve had occasional involvement with the Medical Humanities program at Dalhousie University. I commented on the medical students yearly art show, which is based on a different theme every year. Last year’s theme was “disconnec t”, featuring artwork that dealt with spinal cord injury. From what I could gather this has been a very rewarding activity for the medical students.

    You may want to consider starting your own annual medical student art show?

  2. Thanks for the links Tim –

    We’re lucky enough that there is a student art show put on annually at my school. It’s not themed and any medium, style or subject is accepted. It’s a small affair which isn’t advertised beyond the students and faculty. The level of skill and ability that some of my peers have is humbling especially given that I have no artist bent what-so-ever! It would be interesting to see what Dalhousie does and I’ll definitely be checking out the links to see if there are any ideas we can borrow for our own art show.

    Thanks again –

  3. Louis Wain suffered concussion when he was thrown from a horse bus at the age of 54. He apparently developed [noticeable!] ‘schizophrenia’ at the age of 57 – it is reasonable to suppose that his ‘schizophrenia’ was the result of brain injury – I would also point
    out that diagnoses of mental disorders were even more unrealiable in those days than they are now ……..

    • Hey CarriKP –

      It would seem that psychiatry is an evolving field, for sure. Mental disease, personality problems, structural damage – they all add to the overall gestalt. Our understanding of mental disease and disorders has come a long way from what it was and, no doubt, still has a long way to go.

      I find it interesting when there is another means to understand the disease process and art is a good example of that. Take the case of William Utermohlen, which I mentioned a while back (A post on November 2, 2006) where there is an obvious case of degeneration, which one understands better by looking at his art as time progresses. It would be great to be able to do this in other areas of medicine as well, like psychiatry. When referring to psychiatry and schizophrenia, the most often cited example is Louis Wain and his cat paintings. Unfortunately, as the Mind Hacks article suggests – it may be hard to distinguish whether or not the cat paintings are really a result of a schizophrenic mind or simple artist experimentation.

  4. In regards to Louis Wain, Oliver Sacks theorized in his book “Migraine” that the “schizophrenic” paintings could actually be paintings of the progression of a classical migraine aura.

    I’ll have to check out the art links – I love the melding of art and medicine. Perhaps my favorite so far are the glass creations of Luke Jerram

  5. Pingback: Луис Вейн (Louis William Wain) « Александр Гришаенков

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