THIS BOOK HAD ITS ORIGINS DURING TWO PERIODS WHEN I WORKED
in Kenya. The first was as a medical student when I went to work for four months with the embryonic Kenyan Flying Doctor Service. Like so many others, I was captivated. The landscape, the people, the game were overwhelming.
One day I drove out of Nairobi, over the Ngong Hills and down, down into the bottom of the Rift Valley. There, at a place called Olorgesailie, is one of the most immediately striking of the sites left behind by ancient humans. Dated to somewhere around 700,000 years ago are thousands of the artefacts we call hand-axes littered over a several-acre site. These axes smashed into my consciousness with a force I have never forgotten. Who were the people who made these objects? Where did they come from? Where did they go to? What relationship did these people have to us?
Ten years later I was back in Nairobi as a professor in the brand-new medical school, helping to get it started. Also teaching there, with a lab just down the corridor from mine, was Alan Walker, who has since become one of the world's leading palaeoanatomists, researching ancient human and prehuman fossils dug out by himself, by the Leakey family and by other researchers. Alan always had those bits of bone lying about, some from people who were around at the time that the Olorgesailie site was being created, some earlier, some later. The sight of these ancient bones reinforced my interest in the evolution of humans which had been triggered a decade earlier. Ever since, I have maintained a strong interest in all that has happened in the field of evolutionary studies.
In the middle of a long vacation in Nairobi I heard a lecture by Howard Bern, the distinguished Professor of Zoology from the University of California at Berkeley, who was visiting Kenya. His subject was prolactin, a hormone produced by the pituitary gland in the middle of the skull. Prolactin helps breasts grow and stimulates milk production but must also do something else, since males have almost as much prolactin as do females. Howard's research had shown that prolactin is a universal regulator of water and salt metabolism throughout the animal kingdom. For example, it is the hormone which enables young salmon to migrate from fresh water down to the sea, and provides the required adjustment when, as mature adults, the salmon return to their home river. I was fascinated by the story and this started a ten-year period during which the effects of prolactin on humans became one of my major research interests.
About a year later, several colleagues and I published a paper in the medical journal the Lancet describing some actions of prolactin on human kidneys which we had observed by injecting the hormone into ourselves. As a result of this article, I received a letter from Gwynneth Hemmings. She runs the Schizophrenia Association of Great Britain, an organization mainly for people with schizophrenia and their relatives. She pointed out that the drugs then used for schizophrenia caused massive secretion of prolactin in both sexes and asked if I would give advice to the Association about the possible consequences.
And so I came to know something of the strange and sometimes terrible world of schizophrenia. The more I found out about the illness, the more interested I became. The study of prolactin gave me new ideas as to what might be the biochemical basis of schizophrenia. I became obsessed with the strange features of the illness, not just the unusual behaviour but the resistance to pain and arthritis, and the improvements in symptoms which could occur during fevers such as those caused by malaria. However, I did not expect that my schizophrenia research would ever link with my interest in human evolution.
But that is what happened. A series of observations by me and by many others led inexorably to the view that the origins of schizophrenia and the origins of humanity were intimately related. Schizophrenia has a unique pattern of distribution: it is found to approximately the same extent in every racial group throughout the world. This almost certainly means that schizophrenia was present in humanity at the time of the development of the first true humans before the races separated. Second, although schizophrenic patients themselves are often disabled, their relatives are often extremely high achievers. Einstein's son was schizophrenic, James Joyce's daughter was schizophrenic and a good case can be made for the idea that much of Isaac Newton's behaviour was what we call schizotypal, or part way between normality and frank schizophrenia. As will be seen later, schizophrenia and another related serious mental illness, bipolar disorder or manic-depression, are found remarkably frequently in the families of those who have reached the highest levels of creative achievement in many fields. There appears to be a genetic link between extremes of creativity and schizophrenia.
We are clearly distinguished from our immediate pre-human ancestors by our exceptional creativity, whether it be in science and technology, in the arts, in religion or in political and military organization. These skills are typical of those seen commonly in the families of schizophrenic patients. Gradually, over the years, the logic of what I was doing forced me to think more and more about a surprising possibility. If schizophrenia and bipolar disorder, present before the races separated, are responsible for much of human creativity, madness may have played a critical role in the emergence of modern humans.
This book sets out my intellectual odyssey and the conclusions I have reached. These conclusions are leading to new understanding of our origins, to new respect for the several genes which, when present together, cause schizophrenia, and to new approaches to the treatment of schizophrenia. This research programme, which started at Olorgesailie so many years ago, provides a new story about our human origins. More importantly, it also provides a new approach to the treatment of the illness. It links our past and our future in surprising ways.