Imaging Albert Einstein's Brain

Simon D. Murray, MD: One of the things about internal medicine that really has frustrated me the most is how much I don’t know about things—about people, about human beings, about biology. I know what studies say, and I know what drugs are supposed to do, but there are so many things. People will say, “How come when I lie on my right side, my eyelid twitches?” And I go, “I don’t know. I have no idea.”

Frederick E. Lepore, MD: Sometimes you do knock it out of the park. You say, “OK, that makes sense.” But a lot of times you’re going, “I don’t know.” I got my MD in 1975…. Do you think we knew about Lyme disease in 1975? And HIV? In the 1980s, these people were losing their white blood cell counts and you’re going, “What is that?” And then in my own field, with the imaging, I’m old enough to remember when we didn’t have CT [computed tomography] scans. Can you imagine that?

Simon D. Murray, MD: Yeah.

Frederick E. Lepore, MD: We were doing scull x-rays and maybe angiography—or even worse, pneumoencephalography. I was studying in London in 1973 when I saw CT scans. I go, “Oh my, look at this thing.” The pixels were the size of checkers, but you’re going, “Whoa.” And then they came up with the MRI [magnetic resonance imaging]. I mean the technology, you know?

But now you’re getting this stuff thrown at you with so much data. You’re saying, “Well, now can I extract some signal from all that noise?” And we’re constantly trying to do that. Look at literature. We get overwhelmed with literature. What’s the signal? What is germane? To me, the help of a given patient. And presumably, we’re lifelong learners and we’re supposed to know how to do it, but it doesn’t get easier.

Simon D. Murray, MD: No. Albert Einstein supposedly had scull x-rays, and he supposedly had an EEG [electroencephalogram] somewhere. Are they around?

Frederick E. Lepore, MD: I don’t know if that was the topic of the conversation when Dr Thomas Harvey was pitching it to the son, but Einstein was good friends with a radiologist named Gustav Bucky. I’ve got a feeling that Bucky developed 1 of those filters. The guy was brilliant. He did a skull x-ray of Einstein. It was sold by auction for, I don’t know, $10,000 or maybe more. Who knows. I think Bucky probably said, “Let’s just get an x-ray of your skull.” And Einstein said, “OK, let’s go along with it.” And then the other 1 was in the 1950s, or 1951. The guys at Massachusetts General Hospital had him. And so did another resident genius of the Institute for Advanced Study, John von Neumann. They did EEGs on these guys.

And there is a great anecdotal story, which I think is in the book [Finding Einstein’s Brain]. Usually, if you’re doing an EEG, if you’re relaxed you get an alpha rhythm of 8 to 12 cycles per second. But if you get disrupted, it goes away. The alpha rhythm goes away. You’ve got other rhythms—beta rhythms or something like that.

Supposedly Einstein, when he was working on a problem, went into alpha. He’s in alpha. Then all of a sudden, they’re recording him and Wilder Penfield says, “All of a sudden, the alpha disappeared.” Einstein was sort of in his reverie, and they go, “Well, what happened, professor?”

And the guy says, “I realized I made a mistake on some calculations.” It was obviously jarring him, and now he lost his algorithm. But for you and me, alpha is sort of what you go into before you go to sleep. That was sort of his standard rhythm when he was dealing with these abstruse problems.

That’s fascinating stuff. EEG is an incredibly important field. But in terms of cognition, I think EEG is a great study for things like epilepsy and maybe certain types of coma, but you’re dealing with so many neurons. It would be like flying over a city and looking at all the city lights and trying to see how they’re blinking, and then trying to guess how they voted in the last election. You’re not going to get that information.

It’s pretty interesting stuff. You may get some information. But anyway, Einstein did go for that. So possibly, as a thoughtful, introspective guy, he really did wonder what was going on between his ears.

Simon D. Murray, MD: I’ll tell you an interesting Einstein story. He used to ride the Dinky [commuter train in Princeton, New Jersey], to go places when he would lecture. The trainman came by and found him on the floor and said, “Dr Einstein, what are you doing?” And he said, “Uh, I lost my ticket.” The trainman said, “Well, don’t worry about your ticket. We know who you are. Just forget it.” So he sat down and the trainman went up the train. He comes back. Einstein is back on the floor still looking for that ticket.

And he said, “Professor Einstein, don’t worry about it. I told you we know who you are and don’t worry about it.” He said, “Look, I know you know who I am, and I know who I am, but I don’t know where I’m going. I have to find that ticket.” I don’t know if that’s a true story, but that sounds like something Einstein would say.

Frederick E. Lepore, MD: I wish someone would assemble them more because there are a lot of these stories floating around Princeton about him doing kids’ homework and doing the plumbing in his neighbor’s house. This is not a biography. It’s a biography of the brain. But just spending some time with him, I think he was a really great guy.

Simon D. Murray, MD: I met a woman who played piano with him. She was about 90 years old, and she played the piano with him. She said he was not a very good fiddle player. But it was the passion that he had, and he did have that nob on his brain, didn’t he?

Frederick E. Lepore, MD: Yes, he did—the omega sign in his right frontal lobe. And that’s in the book. And you can google that. You can look up the omega sign. String players, because they’re doing more detailed fretwork with the left hand, will have this primary motor cortex strip. You’ll have this little bump in it, what they call the omega sign. Now, whether you develop that or you’re born with it and that’s what makes you a violin player, no one knows.

Transcript edited for clarity.