The Face Laughs While the Brain Cries

Starred review from April 1, 2023
A neurologist brings us into his unique, fascinating world. Hauser, director of the Weill Institute for Neurosciences and a leading researcher in the treatment of multiple sclerosis, is a skilled writer, and he offers many compelling insights into his career as well as necessary doses of subtle humor along the way. A neurologist is arguably the most intellectual of medical specialists, and their first step in any procedure is determining the precise location of a problem with a careful exam and the latest high-tech scans. "In the Jewish religion, life begins when the fetus is accepted to medical school," writes the author amusingly, though he maintains that he did not decide on a career until well into his studies at MIT, after which he attended Harvard Medical School. In addition to chronicling his own upbringing, Hauser writes about his youngest brother, who was born "severely handicapped, mentally and physically"; his best friend in elementary school, who died of a brain tumor; and his mother's closest friend, stricken with crippling temporal lobe encephalitis. Near the halfway point of the narrative--after recounting his education, marriage, and post-graduate work (three years in Paris!)--the author shifts the focus to his life's work: understanding and treating MS, an often devastating autoimmune disease affecting nearly 1 million Americans today, "a threefold increase in just one generation." No good treatment existed when Hauser finished training in the late 1970s. Explaining the immune system is not for the faint of heart, but the author does a fine job describing several decades of research, during which he and others teased out the specific cells and antibodies that wreak havoc in MS patients. Partly as a result of his work, the 1990s brought rituximab, the first drug to dramatically relieve MS symptoms, followed by ocrelizumab, which works even better. A winning mix of engaging memoir, accessible popular science, and a happy ending.

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