In Praise of Imperfection
Author: Rita Levi-Montalcini

Overview

This autobiography of a Nobel prize winning doctor and neuroscientist is an exciting odyssey of the groundbreaking research she carried out to discover nerve growth factor, and a profoundly philosophical discourse exploring such themes as family, friendships, gender, culture, religion, politics, war, racism, love, loss, and death. The author’s perceptive personality and reflective nature are on display on every page of the book, and these are symbolised by the rather counterintuitive title she chose for her autobiography – a phrase which mirrors what she said was the ‘inexhaustible joy‘ she derived in the ‘imperfect ways‘ with which she lived her life and carried out her research. With excellent prose and inspiring story-telling, the book charted the author’s life as she transformed from a person plagued by self-doubt, into a confident and effective scientist – the result being ‘a lifelong alliance between me and the nervous system, an alliance I have never broken or regretted keeping’ (pages 5 and 143).

Synopsis

The author’s autobiographical narrative traced the early influences on her career, the most important being the anatomy course she took in the second year of medical school – an experience that determined the course of her career and her life. She attributed her fascination for the course to ‘the extraordinary personality‘ of the lecturer, Prof. Giuseppe Levi, who she said was renowned for his scientific reputation, his antifascist bent, and for his ‘terrible but short-lived fits of rage‘. It is pertinent that she developed a life-long master-disciple relationship with Levi who she depicted as ‘a master who had a real passion for his work’, and a scientist who had ‘a critical sense far superior to that of many biologists of the day’. Indeed it was Levi’s technique of ‘studying tissues in vitro‘ that she applied to make her pioneering discovery of nerve growth factor. Levi tasked her with two critical research projects- ‘counting the nerve cells of the spinal sensory ganglia in mice’ and determining how brain convolutions form in human foetuses – and these set her on the laboratory research path that she would follow for the rest of her career. The anatomy course was also relevant to her social life because it formed the beginning of her lifetime friendship with Renato Dulbecco, another future Nobel prize winner who the author lauded for his ‘unchallenged supremacy‘ in all his subjects (pages 50-60).

The second World War, and the anti-semitism that accompanied it, was a dominant theme of this autobiography as these dual threats greatly influenced the author’s life and career. For example, the book described how the fascist anti-semitic campaign in Italy leading up to the war prohibited her from pursuing a romantic relationship because it imposed a ban on ‘marriage between Aryan and Jewish citizens’. The racial laws instituted at the time also sadly accounted for her dismissal from anatomical and clinical posts, and resulted in her being ‘deprived of the right to practice medicine’. The sad consequence of this was that she left Italy for Brussels, only to return when Belgium itself was threatened by German invasion. It was a fascinating testimony to her determination that she pursued her medical practice ‘in clandestine fashion‘ by visiting patients in their homes. It was also revealing of her dedication to science that she persisted with her experiments by setting up a ‘miniscule laboratory‘ in her bedroom where she was ‘able to carry on…a research problem that absorbed all of my time’. Reflecting on how she was able to carry on her work ‘while German armies were advancing throughout Europe’, she referred to ‘the desperate and partially unconscious desire of human beings to ignore what is happening in situations where full awareness might lead one to self-destruction‘ (pages 67-68 and 85-95).

The book’s autobiographical narrative is strongly tinged by the author’s deep introspection, a trait that typified her personality. For example, in charting her early childhood in Turin, she recollected that she was beset by anxieties which she attributed to her ‘extreme timidity, lack of self-confidence, and fear of souls in general and of my father in particular’. It appeared that this capacity for self-reflection determined her general attitude to people which she said was ‘to look on others with sympathy and without animosity and to see things and people in a favourable light‘. It is also symbolic that soul-searching played a determining role in her decision to opt for an academic career over setting up a family of her own. This was a choice she made on realising that ‘the subordinate role played by the female in a society run entirely by men had convinced me that I was not cut out to be a wife‘. The decision was also swayed by her self-knowledge that ‘babies did not attract me’, and ‘I was altogether without the maternal sense so highly developed in small and adolescent girls’. Her self-examination was also evident when she attributed her scientific success to certain personality traits which included ‘the absence of complexes, a remarkable tenacity in following the path I believe to be right, and a way of underestimating the obstacles standing between me and what I want to accomplish’. Indeed she credited her research success to these inherent attitudes rather than to her intelligence or experimental precision. As for her decision not to practice clinical medicine, the author pointed out that it resulted from the ‘impotence‘ she felt as a Red Cross doctor after the war when she was unable to save the lives of refugees (pages 4-5,  15, 35 and 108).

The most awe-inspiring feature of the autobiography was the author’s depiction of the experiments she carried out which provided the phenomenal insight into the nature of nerve growth, and that led to the isolation and characterisation of nerve growth factor. She cited the seminal turning-point as the time she observed nerves growing out of the spinal cord of a chick embryo under the microscope, a scene she metaphorically portrayed as ‘a spectacle not unlike that of the maneuvers of large armies on a battlefield‘ with ‘thousands of cells…proceeding in long columns‘. She also used figurative language to depict the massive culling of cells she saw as ‘a battlefield covered with corpses’, and the overall strategy as ‘massive eliminations within the ranks of excess, unnecessary cells’. She similarly used symbolic imagery to convey the influx of macrophages to clear the debris, painting this as a scene of ‘corpses being removed from a battlefield by special crews trained and equipped for the purpose’ (pages 140-142).

The author helpfully documented the inspiration for her defining experiments, and the progress that culminated in identifying nerve growth factor, work that earned her a joint Nobel prize with co-worker Sidney Cohen. In establishing the catalysts for her research, the author referred to the earlier work of Hans Spemann, a previous Nobel prize winner who had discovered a factor that induces the differentiation of organs and embryos. She also credited Viktor Hamburger as a major influence in the development of her ideas, noting that he invited her to the United States to further her research on chicken embryo nerve cells because he was intrigued with how her results had differed from his own analysis. The author chronicled her experiments in which she noticed that nerves destined for the limbs are strongly attracted to sarcoma tissue, an observation she said was ‘without precedent in the rich case history of experimental biology’. She went on to describe the experiments she and Cohen performed to identify the humoral factor they rightly suspected was being released by the tumour, and which was causing ‘the precocious and excessive production…of nerve fibers’. The author’s narration conveyed the excitement that accompanied each stage of this work that characterised the full range of actions of nerve growth factor, and revealed its abundant presence in snake venom (pages 93-94, 113, 145-148 and 152-168).

Opinion

This is an exhilarating narrative that explores the makings of a major scientific breakthrough, but which also dwells on the nature of human connections and the vicissitudes of society. With unhurried prose and a deeply reflective narrative style, this book is a celebration of a rich life, both academically and socially, and it is replete with lessons, both practical and philosophical. A sort of academic rags to riches saga, it is also an inspiring ode to the qualities of facing challenges with determination, and of focusing on scientific goals whatever the circumstances or available resources. The author’s ingenuity and inventiveness in meticulously pursuing her research even as the world around her was breaking up is a remarkable feat of single-mindedness.

Overall assessment

This autobiography highlights several crucial factors in the success of any scientific enterprise, from humility and patience to collaboration and openness. The book also teaches profound lessons in its portrayal of the feasibility of research even under dire circumstances, and in highlighting of the value of supportive research mentors. The narrative also shows how these lessons are relevant across the spectrum of healthcare research and practice, and I recommend it to all doctors.

Book details

Publisher, Place, Year: Basic Books, New York, 1988
Number of chapters: 25
Number of pages: 220
ISBN: 9780465032181
Star rating: 5
Price: £100