2022/Jul/31 The Magicians of Paris: A Two-Act Play & commentary on neurology, magic, and medicine with Alan Chien

The following fictional skit is inspired by real people whose influence culminated in “The Psychology of Prestidigitation,” authored by French psychologist Alfred Binet in 1894.

Magicians of Paris

Setting: Classroom at Pitié-Salpêtrière University Hospital in Paris, France, during the late 19th century.

Characters:

Jean-Martin Charcot as the Father of Neurology

Alfred Binet as a Psychologist and budding Neurology Student

Madeline, a seventy year old Patient admitted to the hospital this morning

 

Act 1

CHARCOT walks onto stage and breaks the fourth wall, speaking directly to the audience.

 

CHARCOT

Welcome class. Nice to see you again! Féré! Richter! Janet! Glad you could make it. I would like to introduce you all to a recent patient whom I have carefully chosen from the thousands here at Salpetriere.

Charcot steps aside and reveals as if by magic the PATIENT, who was previously unseen by the audience.

CHARCOT (cont’d)

Madeleine, everyone. Everyone, Madeleine. She was admitted to the hospital this morning for shaking.

Charcot pulls out of thin air a hat with a long feather and places the headwear onto the patient. After a second, the feather begins to oscillate.

CHARCOT (cont’d)

Beautiful!

To you this may just be a fashionable accessory, but to a neurologist, this is a critical diagnostic tool for tremors. It seems like the shaking originates from the head, but do not be fooled. Where does it actually originate?

Charcot turns towards the audience and questions.

CHARCOT (cont’d)

How about you? What do you think?

Charcot then begins to circle the patient, holding different parts of her body starting with her legs and then her arms. When Charcot finally stabilizes her torso, the shaking stops.

CHARCOT (cont’d)

The tremor begins from the body and then echoes to the head. Vois-là!

 

As the audience applauds, the lights fade to black.

 

Act 2

Charcot stands onstage alone, packing up his materials including a reflex hammer and electrotherapy apparatus. BINET enters.

 

BINET

Amazing lecture and performance, Dr. Charcot. I could see the patient’s tremors from across the room.

Charcot places a woman’s hat filled with feathers in a drawer.

CHARCOT

Had the tremors been any more obvious, the patient might have flown away!

Charcot chuckles.

CHARCOT (Cont’d)

What do you think is the diagnosis?

Charcot removes the woman’s hat from the drawer and places it on his head, mimicking her tremor for Binet.

CHARCOT (Cont’d)

You noticed that when the torso was held down, the tremors stopped?

Charcot pauses in his imitation.

BINET

They did not have such lectures in psychology school at Lycée Louis-le-Grand. We saw some patients who returned from the Franco-Prussian War with some shaking, but none like this. I have yet to learn all the causes of shaking. I am eternally grateful to learn neurology from you.

Charcot removes the hat from his head and hands it to Binet.

BINET (Cont’d)

I stopped by primarily to share my compliments. I do not mean to offend, but do you ever find any of the demonstrations…grandiose?

Binet places the hat on his own head.

CHARCOT

Grandiose? No. Excessive? Not in the least. I deal in the realm of performative disorders.

BINET

I don’t quite understand how an affliction is a performance…?

 

Charcot observes the motionless feathers of the hat on Binet carefully as he stands still.

CHARCOT

Seems quite stationary to me. Today, I am tired, but do return next Tuesday and I shall explain.

BINET

Yes sir.

CHARCOT

Binet, I have the following reccomendation: if you desire to see things as they really are, you must be prepared to proceed without any preconceived notions.

 

THE END

_______________________________________________________

In the 1880s Alfred Binet moved to Paris, France to train with neurologist Jean-Martin Charcot and further understand brain disorders. As highlighted in this play and in the historical accounts of Charcot, performance was aspect in differentiating disease, like Parkinson’s disease and multiple sclerosis. Charcot echoed these physical pathologies during public lectures with an attention to lighting and the patients’ most subtle movements.

In 1891, Binet left Salpetriere Hospital and his neurology training with Charcot in order to begin working at Sorbonne Université in pursuit of understanding psychology. Thanks to the advancements in chronophotography and with the help of Georges Melies and magicians Gustave Arnould and Edouard-Joseph Raynaly (Thomas et al., 2016), Binet utilized rifle-looking cameras to film classic illusions at sixty frames per second. By studying these photographs, Binet revealed a distinction between gross sensation and perception.

 

Vanishing Crochet ball

Fifteen images of vanishing crochet ball illusion taken with chronophotograph, 1894 (Thomas et al., 2016)

While I can only imagine how these artistic and scientific giants interacted, their work as individuals undoubtedly advanced the fields of psychology, neurology, and the fine arts at an unimaginable rate.

Over a century later, the craft of magic—which is predicated on challenging expectations—is still regarded as a framework for studying the mind by neuroscientists and psychologists.

 

magic and ASD Khun

Exploring Cognition in ASD (Khun et al, 2010)

Specifically, neuroscientists are interested in a similar phenomena related to learning: when the brain makes a prediction error, which ultimately drives our ability to “learn from our mistakes.” Current FMRI technology suggests that bilateral caudate nucleus and left pre-frontal cortex activation are critical in the moment of expectation violation (Danek et al., 2015). These unique patterns of brain activation coincide with experience of positive emotions like joy, wonder, and surprise (Pekrun et al., 2017); which are critical to the exploration of learning (Vogl et al., 2019). Our understanding of magic may help reveal additional neural networks within the human brain.

My interest in magic and medicine began prior to medical school, when I worked as a semi-professional close-up magician in Los Angeles. Through magic, I connected with thousands of individuals in unexpected settings including speakeasy bars and inpatient adult oncology wards. Now as I begin my third year of medical school, I have the opportunity to integrate magic into medicine in the context of performance to improve physician wellness and our clinical understanding of certain conditions.

In April 2022, I was invited to speak about the intersection of magic and neurology at the Annual American Academy of Neurology Convention in Seattle, Washington. I shared numerous therapeutic interventions and benefits of magic which have been studied (Wiseman & Watt, 2018). Afterward, quite a few audience members approached me and confessed that they too dabbled in the dark arts or had considered using magic as a tool. One neurologist shared that in desperation to comfort children during the daily blood-draws during the HIV/AIDS epidemic, he had attempted to learn magic to distract them or relieve their anxiety. It was amazing to receive the support from and witness the curiosity of current neurologists to continuously improve the delivery of medicine and diagnostic processes.

As scientists continue to understand the phenomena of illusion, whether magic can engage medical patients and help physicians to diagnose and treat neurological illness remains a largely unexplored field. In my own training, I have begun to explore this question.

Magicians have a tool that allows them to control light, tossing it from hand to hand. During a recent well-child visit with a five year old, I brought the prop, which sat alongside my stethoscope and reflex hammer. When it came time to evaluate eye movement, I seemingly grabbed light from the computer screen which I proceeded to juggle from hand to hand. The child, eyes wide open, tracked the light across the room and even attempting to catch it. Through this simple game, I was able to develop rapport quickly with my patient but also assess developmental milestones including eye tracking and gross/fine motor skills.

This revealed to me that an element of play was a fantastic addition to a pediatric exam. During my family medicine rotation, I began bringing a squeaker toy to annual physicals with the hopes of easing anxious patients while doing a capillary refill test. Could a standardized set of easy to learn magic tricks help physicians gain important clinical information and develop rapport? Used at the right moment, I believe so. In the near future, I plan to share demonstrations and tutorials of the light illusion and more with the medical community to help assess developmental milestones. Ultimately, I hope to raise awareness regarding a forgotten tool to understand and engage the mind: magic.

alan chien biography

LinkedIn

https://www.alanchien.com/

Worked Cited

Danek, A. H., Öllinger, M., Fraps, T., Grothe, B., & Flanagin, V. L. (2015). An fMRI investigation of expectation violation in magic tricks. Frontiers in psychology, 6, 84. https://doi.org/10.3389/fpsyg.2015.00084

Kuhn, G., Kourkoulou, A., & Leekam, S. R. (2010). How magic changes our expectations about autism. Psychological science, 21(10), 1487–1493. https://doi.org/10.1177/0956797610383435

​​Pekrun, R., Vogl, E., Muis, K. R., & Sinatra, G. M. (2017). Measuring emotions during epistemic activities: the Epistemically-Related Emotion Scales. Cognition & emotion, 31(6), 1268–1276. https://doi.org/10.1080/02699931.2016.1204989

Thomas, C., Didierjean, A., & Nicolas, S.(2016). Scientific Study of Magic: Binet's Pioneering Approach Based on Observations and Chronophotography. The American Journal of Psychology, 129(3), 313–. doi:10.5406/amerjpsyc.129.3.0313

Vogl, E., Pekrun, R., Murayama, K., Loderer, K., & Schubert, S. (2019). Surprise, Curiosity, and Confusion Promote Knowledge Exploration: Evidence for Robust Effects of Epistemic Emotions. Frontiers in psychology, 10, 2474. https://doi.org/10.3389/fpsyg.2019.02474

Wiseman, R., & Watt, C. (2018). Achieving the impossible: a review of magic-based interventions and their effects on wellbeing. PeerJ, 6, e6081. https://doi.org/10.7717/peerj.6081

Historical Works Consulted

Binet, A. (1894). LA PSYCHOLOGIE DE LA PRESTIDIGITATION. Revue Philosophique de la France et de l'Étranger. 37:346-348.

Féré, C.(1893). “J.-M. Charcot et son oeuvre,” Revue des deux mondes, vol. 122 (15th March), pp. 410-424

Marshall, J. W. (2016). Performing neurology: The dramaturgy of dr. Jean-Martin Charcot (1st ed). Palgrave Macmillan.

Salomone, G., & Arnone, R. (1994). Charcot and his drawings: images from "les leçons du mardi à la Salpêtrière 1887-1888". Italian journal of neurological sciences, 15(4), 203–211. https://doi.org/10.1007/BF02339324

Walusinski, O. (2018). Jean-Martin Charcot and Parkinson's disease: Teaching and teaching materials. Revue neurologique, 174(7-8), 491–505. https://doi.org/10.1016/j.neurol.2017.08.005