Sustained curiosity
Robert Charles Powell, MD, PhD
***
“Time after time I have pondered apparent minutiae that turned out to be very important.”
“My entire research career –
in history – in medicine – in religion –
in the history of “religion and medicine” –
has grown out of sustained curiosity
about unusual little details.”
Dr. Powell, a clinical neuropsychiatrist and
medical historian who
hangs around with clinical pastoral chaplains,
always starts off his research with
a nagging question that begs for an answer.
“Why do songs by ‘Queen” end up being
played at funerals
more than the songs by other ‘rock bands’?”
“Why do clusters of military folks
coming back from the war-zone tend to have clusters of odd lab results?”
“Why did those interested in ‘the after-life’ have more kinship with Freud
than did academic psychologists?”
“Why does a certain
'old' and 'cheap”'medicine now have so much new and expensive research behind it?”
“Why do some folks have
an almost total inability to explain
how they know what emotion they are feeling?"
“Why did the definite 'founder' of 'the
American psychosomatic movement” have a theology degree?”
“Why do certain 'drug addicts' – apparently
quite intelligently –
choose 'this' street drug and not 'that' one?"
A Progressive Expansion of Clinical Focus
>> The summary is below. These initial comments concern what drove this progression. <<
The summary below first was outlined in May 2024 – to clarify – mostly for me – as to how I got to “here”.
I write & re-write essays over a period of months – even years. If asked to speak at a meeting, I need a minimum of 3 months (preferably 6 months or longer) to allow “the back of my mind” slowly to come up with key thoughts/ sentences.
Sometimes I can create an entire short essay in my brain while driving – but that rapidity is rare.
I digest new understandings slowly but surely.
Once I start thinking about a topic, I end up accumulating a fairly definite bibliography of abstracts (mostly from PubMed) – so that I know both the key (frequently old) articles AND have come to appreciate what is NOT known as well as what probably is “known” incorrectly.
If I have written an essay (or book), a reader almost always has to acquaint him- or herself with the bibliography. I write in “verbal”. I try to hone my sentences until they more easily can go into a listener’s mind.
After realizing in 2003 that I was seeing a lot of war-zone returnees who had unusual neural, nutritional. and hormonal issues, I began researching and thinking out how to explain all this to trainees. Across the years, I shared draft chapters of my discoveries with the medical/ psychiatric residents, medical students, and colleagues with whom I was working.
I published the malnutrition studies in 2016.
I published the studies about getting patients to verbalize data about their level of ego organization in 2017. Then
I added some information about getting patients to verbalize data about soft neurologic and profound premenstrual issues in 2021 – when finally I published Listening Closely to Patients ….
Then I decided that, for a 2nd edition of that book, I really needed to add a lot more about
soft neurologic and
combined premenstrual/ neurologic issues –
so I revised a 2018-19 essay into at extra chapter and I drafted a complex set of data from 2019-20 into yet another extra chapter.
Separately, I published an extensive bibliography of abstracts on pentoxifyllyine -- an old medication
(with pro-circulatory & anti-inflammatory actions)
in 2015.
Then, after beginning to treat patients who had autism, it became clear that I needed to prepare a 2nd edition of that book – and to spin off a (forthcoming) subordinate book on
cerebral perfusion called Pentoxifylline & the Brain.
*****
~1968, first became curious about
cognitive factors in psychiatric
phenomena.
~1970, first became curious about
neurologic factors in psychiatric
phenomena.
~1973, began focusing more in depth on
cognitive factors – especially on how
patients do or do not
form & use concepts.
~1980, began focusing more in depth on
endocrine factors – especially on
estrogen, progesterone, &
T3/ liothyronine “active thyroid”.
~1996, began focusing more in depth on
neurologic factors – especially those
relating to
the autonomic nervous system &
the cerebral subcortical system.
~2003, first became curious about
nutritional, endocrine &
inflammatory factors.
~2010, began focusing more in depth on
nutritional, endocrine &
inflammatory factors – especially
calcitriol “active vitamin D” &
pentoxifylline for
TNF-alpha production inhibition.
~2022, began focusing more in depth on
cerebral perfusion factors.
Who knows what might intrigue me next?
As [Helen] Flanders Dunbar, MD, PhD
noted in the 1930s & 1940s,
the question is how to consider
“all of the above” & to ascertain
“a point of effective intervention”.
There is much more to learn!
All I know is that now
the patient & I can
“cut problems down to size”
much more rapidly. #
Fantastic!
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