A Savant Odyssey: From wmhi.hospital to www.web

Darold Treffert MD

I met my first savant my first day on the job as a psychiatrist. And I have been intrigued with that extraordinary condition ever since.

I had just completed my residency at University of Wisconsin (UW) Hospitals and was assigned, under the Career Plan, to start a Children’s Unit at Winnebago Mental Health Institute. I had developed an interest in autism even in medical school because Dr. Leo Kanner, who first described Early Infantile Autism in 1943, had been a visiting professor at UW Hospitals at that time. His careful description of this intriguing, permeating condition still is unsurpassed in accuracy, and his interest in the mystery of that condition was infectious.

On the unit that first day in July, 1962, I was greeted by a lad, otherwise very disabled, who had memorized the bus system of the entire city of Milwaukee. Another boy, equally impaired, was a walking history almanac. Another lad, after you placed a 500 piece jigsaw puzzle in front of him, even with the pieces face down devoid of any picture, would put that puzzle together methodically, with the rhythm and accuracy of a sewing machine, relying only on the geometric shapes. Another youngster made free throws with uncanny accuracy; feet always meticulously in exactly the same spot, then using the same precise trajectory over and over again.

I was struck by the jarring juxtaposition of these astonishing “islands of genius,” as I called them, immersed in a sea of otherwise permeating, severe mental handicap. “How is that possible? How do they do it? What does this tell us about brain function overall and hidden potential, perhaps, in all of us?” I asked myself then, and continue to ask myself now.

The coexistence of pervasive disability and prodigious superiority, in the same person, is savant syndrome It is a rare condition in which persons with serious mental handicap from autistic disorder, other forms of developmental disability, or brain injury, have permeating mental disabilities that coexist along side some astonishing abilities, typically in one of five areas: music; art; calendar calculating; lightning calculating; and mechanical or spatial abilities. Why, considering all of the skills in the human repertoire, savant skills narrow to these particular areas, including the obscure skill of calendar calculating, remains an intriguing, unanswered question. Whatever the special skill, it is always linked with phenomenal memory of a special type — incredibly deep, but exceedingly narrow.

There have been several hundred cases described in the literature since Dr. J. Langdon Down first named the condition idiot savant in 1887. At that time “idiot” was an accepted scientific term for an IQ below 25 and he combined that term with the word “savant” derived from the French word savoir, meaning “to know.” Actually the term was a misnomer since almost all reported cases occur in persons with IQs above 40. In the interest of accuracy, and dignity, savant syndrome has replaced that earlier term.

My interest in savants accelerated markedly when Leslie Lemke came to Fond du Lac to give a concert in June, 1980. Leslie is blind, mentally retarded and has cerebral palsy. He has never had a music lesson in his life. Yet at about age 14 he played back flawlessly Tchaikovsky’s Piano Concerto No. 1 having heard it but one time as a theme song to a Sunday Night Movie. The miracle of this blind, mentally handicapped lad, with cerebral palsy that disappeared when he sat at the keyboard, playing and singing masterfully from his extensive and complex repertoire was so startling the television crew that had taped the program for broadcast brought the tapes to me, as Director of the local Mental Health Center, to vouch for authenticity of the performance, and to provide, if possible, an explanation.

I indicated such prodigious talent in a handicapped person was indeed a miracle, but it was also a condition known as idiot savant. There happened to be some news wire reporters in the audience and the story of Leslie’s miracle was carried that day nationwide. On December 19, 1980 Walter Cronkite used the story of “a young man, his handicaps, his foster mother, a piano and a miracle” as his Christmas message on the CBS Evening News. Leslie was a celebrity, and savant syndrome was introduced to a nation. There were numerous follow-up TV appearances.

Then in October, 1983 60 Minutes did what I consider still to be the gold standard piece on savant syndrome, featuring George the calendar calculator, Alonzo the Sculptor and Leslie the musician. Watching that broadcast was Dustin Hoffman, who was “moved to tears” by Leslie’s tremendous musical ability over against his obvious disabilities. When the script for the movie Rain Man came into Hollywood in 1986, inspired by a phenomenal savant, Kim Peek, who writer Barry Marrow had met in 1984, Dustin Hoffman was originally slated to play the brother, Charlie Babbitt. But because of the impact Leslie had on him, Mr. Hoffman decided to play the savant, Raymond Babbitt, instead. I was writing my book, Extraordinary People: Understanding Savant Syndrome, at the time and because of my work was asked to be a consultant to that movie.

While the movie originally was to be about a mentally retarded person and his brother, a major change was made in the script to feature an autistic individual instead because there had never been a portrayal of autism in any major film to that time. While the main character in the movie, Raymond Babbitt, is not based on a single individual, each of the abilities seen — memorizing the phone book, instantly counting 246 toothpicks before they hit the floor, computing square roots yet being unable to comprehend simple addition and subtraction, etc. — are based on actual demonstrated abilities from a number of real life savants. The film, so accurately and sensitively done, is really about two conditions: autistic disorder and superimposed savant syndrome. Not all autistic persons are savants (only about one in ten) and not all savants are autistic (only about 50%—the other 50% have some other form of developmental disability or brain injury).

That 1988 film won four Academy Awards, and in its first 101 days did more toward educating the public about savant syndrome, and autism, than anything that had happened in the 101 years since Dr. Down’s original lecture on this topic. Fortunately for me, my book, Extraordinary People, was published that same year. There was a whirlwind of television talk shows on the topic because of the movie, and savant syndrome became even more visible and well known.

Following that film, interest in Savant Syndrome accelerated markedly. I decided to set up a information clearinghouse for interested researchers, teachers, students, parents and care takers through the State Medical Society of Wisconsin Foundation, using some funds generated from an exhibit by sculptor Alonzo Clemons hosted by the First Interstate Bank of Denver, Colorado. Through this clearinghouse, articles and videos of savant syndrome were made available at no charge to interested persons. Interest was steady, but inquiries were limited because there was really no consistent method of making the existence of the clearinghouse widely known.

Enter the Internet. In the Fall of 1997, again through the Wisconsin Medical Society Foundation, and working closely with its Executive Director, Renee Reback, a savant syndrome website was established at http://www.wisconsinmedicalsociety.org/initiatives/savant/default.cfm. While it took some time to be incorporated in all the major search engines, now that the website does have that kind of visibility and linkage, it is a vibrant, interactive resource and network, worldwide, bringing together a wide variety of persons with interest in savant syndrome.

The inquiries are multiple: students doing term papers, graduate students doing theses, researchers from diverse fields, psychiatrists and other bringing new cases to my attention, teachers looking for illustrative materials, journalists and broadcasters seeking reliable information and, most poignantly, parents whose inquiry usually starts with “I’ve got a son or daughter who….” It is that latter inquiry that is the most difficult to respond to because it points up so vividly the shortage of individualized resources not just to maximize the potential conduit toward normalization the special savant abilities can provide, but pointing up as well the universal shortage of available and reliable treatment resources for persons with autistic disorder and other forms of developmental disability and central nervous system (CNS) injury.

The website has been a rich resource for me for new savants from around the world, cases I would never have known about without this tremendous interactive tool. And it has put me in touch with researchers around the world as well, sharing investigations and insights as they happen rather than waiting out the 18- to 24-month delay that publication in the ordinary journals necessarily and invariably entails, an inefficient and cumbersome way to communicate.

There are some exciting new discoveries with respect to savant syndrome, with wide ranging implications for not just understanding this astonishing condition, but in better understanding brain function, including memory, overall. Especially intriguing and far-reaching is neurologist Bruce Miller’s work at UC-San Francisco which documents 12 cases now of newly emerged savant-like artistic or musical skills in previously non-disabled persons whose special abilities emerged only after the onset and progression of frontotemporal dementia (FTD). What does the finding of such new, special skills in previously non-disabled persons say about buried potential, perhaps, in some, or maybe even within all of us? SPECT imaging of these dementia patients showed predominantly left sided (dominant hemisphere) dysfunction, a finding which correlates well with other CT and MRI studies on savants, implicating left hemisphere damage with right brain compensation as one of the major dynamics in the etiology of savant syndrome.

In even more recent work, Dr. Miller and his coworkers have done SPECT imaging on an 11-year-old artistic savant and strikingly the same left (dominant) hemisphere defects as in the FTD patients were documented. Additionally, recent findings regarding “cerebral refreshment”, including latent stem cell activation, as a mechanism of central nervous system recruitment and repair, has implications for brain compensation and repair not only in savant syndrome but in stroke and other forms of central nervous system damage as well. Could it be that Alzheimer’s Disease is not so much the loss of neurons in the CNS as we learned in training, but instead is the loss of the ordinary neuronal renewal system that continually operates in the brain (which we didn’t learn about in our training — I was taught neurons do not regenerate).

Many interesting new savants have come to my attention: A polyglot (language) savant in England who can learn a new language (albeit not entirely comprehend it) in an afternoon, an internationally known composer in Japan whose CDs are popular worldwide, a renowned artist in Scotland, a pinball wizard, a “bookie,” a black belt karate champion, and many others, each extraordinary, but special in their own way.

There is an accelerating interest in savant syndrome, and its interface with prodigies and geniuses, especially in the United States, England, Australia and Japan. There have been several very well done television documentaries on this topic, and even more are currently in production. The availability of PET and SPECT scanning now to examine brain function, not just brain structure, opens tremendous frontiers in understanding not just savant syndrome, but brain function overall. Since so many diseases in Psychiatry are not necessarily disorders of brain architecture, but rather are disorders in brain function, the years ahead hold much research promise.

But there is more to savant syndrome than brain circuitry, neurons and hemispheres. There are also important lessons to be learned about the immense inspiration and power that flows from the love, hope, determination, belief and acceptance that the families of these remarkable people so often demonstrate. I have been as struck by the human interest stories this remarkable condition holds as I have been by whatever scientific interest it contains. And I have learned as much from the remarkable and caring families, teachers and therapists of the savants as I have learned from the extraordinary savants themselves.

I have learned that we do not have to have the precise scientific evidence for the anatomic site of “hidden potential” before we go in search of it. I have learned that the special skills the savant demonstrates are more than a “Gee Whiz” phenomenon, and that those special abilities are not frivolous. They are instead the manner in which the savant communicates with us, serving as a powerful tool — a conduit toward normalization — which can provide welcome and useful gains toward more independence and improved language, social and daily living skills. And, I have learned, reassuringly, that all of those gains can be accomplished without the fear of some dreaded tradeoff or loss of special skills as the price to pay for higher level functioning. Those miracle skills do not disappear; they continue and they flourish. Finally, I have learned anew about the tremendous impetus and force that unconditional positive regard — love — from family and friends can provide for help and hope for all handicapped persons.

What solving the mystery of savant syndrome might mean for discovering the hidden potential in the rest of us remains to be seen. By my odyssey with this fascinating condition thus far has convinced me we need not wait for those results to begin to search for, and nurture, potential wherever we find it, and in whomever it exists. That inquiry is already underway, and continues, propelling us along further than we have ever been in understanding not only the human brain, but in understanding and appreciating human potential as well. It has been, and continues to be, a most interesting odyssey.

George, the calendar calculator, can tell you all the years in which your birthday fell on a Thursday. He can also tell you which years in the next 100 Easter will fall on March 23. His calendar calculating abilities span 40,000 years backward or forward. He also remembers the weather for every day of his adult life.

“It’s fantastic I can do that,” George says.

It truly is.

Extraordinary People: Understanding Savant Syndrome was reissued with an update in 2006 by iuniverse.com and is available through that company, Barnes & Noble.com or Amazon.com.

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