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So much of what happens to us in life is not by plan, but rather by coincidence or serendipity. Thus it was with me and my career. After completing my residency in psychiatry I was assigned the responsibility of developing a Children's Unit at Winnebago Mental Health Institute here in Wisconsin. There were over 800 patients at the hospital, some under age 18. We gathered about 30 such children and adolescents and put them on this new unit. Three patients particularly caught my eye. One boy had memorized the bus system of the entire city of Milwaukee with exhaustive detail and precision. Another little guy, even though mute and severely disabled with autism, could put a 200 piece jig saw puzzle together--picture side down--just from the geometric shapes of the puzzle pieces. And a third lad was an expert on what happened on this day in history and even though I would study up the night before, knowing he would quiz me the next day, I could never surpass his recall of events on that day in history. [caption id="attachment_457" align="alignright" width="300" caption="Kim Peek, his father Fran Peek and Dr. Treffert meeting in Milwaukee"][/caption] I was stunned, and intrigued, by this jarring juxtaposition of ability and disability in the same individual and began to study all that I could about savant syndrome--"islands of genius" amidst a sea of impairment. Then in 1980 Leslie Lemke came to Fond du Lac to give a concert. Leslie--blind, cognitively impaired and with such spasticity in his hands that he could not hold a fork or spoon to eat--had become a accomplished pianist, never having had a piano lesson in his life. Somehow the hand spasticity magically disappears when he sits at the keyboard. The 1983 60 Minutes program, which many still remember, recounted in detail the astonishment of Leslie's mother, May Lemke, one evening, when Leslie, age 14, played back Tchaikovsky's Piano Concerto No. 1 flawlessly, having heard it earlier for the first time that evening as the soundtrack to the movie Sincerely Yours. I was not at the concert. But my oldest daughter Joni did attend. She came bounding home telling me "Dad, Dad, I just saw a miracle" and she told me the story of Leslie and his remarkable mother May, "the woman who willed a miracle" as depicted by Cloris Leachman in the movie by that title. A local television station was at that concert and they were also stunned by what they saw. So they brought the videotape to me as the local mental health expert to try to explain this extraordinary phenomenon of savant syndrome. I explained it as best I could. There was a reporter from the wire services in that meeting and the story of Leslie Lemke and his mother May was carried by the national press. Then Walter Cronkite used the story of a "young man, a piano and a miracle" as his Christmas story that December. And other programs such as That's Incredible carried the story. Leslie and May were instant celebrities. The October, 1983 60 Minutes program mentioned above was titled "Genius" and featured Leslie, the musician along with Alonzo, the sculptor and George, the calendar calculator. The program was very well done, and memorable, such that it put savant syndrome on the national and international radar screens. Following that program Leslie, Alonzo, George and many other savants made the rounds of all the talk shows and appeared in many other television network programs and documentaries. Then in 1989 the movie Rain Man, starring Dustin Hoffman as Raymond Babbitt, made 'autistic savant' a household term. I had the privilege of being a technical consultant to the movie which was very accurately and sensitively done.From meeting my first savant until now I have learned many lessons from watching and listening to these extraordinary people and their equally extraordinary families on my fascinating half-century journey with them. While I started that journey curious about the mind of the savant, along the way I have learned equally as much about the world of the savant. In so doing I have learned to care as much about the savant who has the condition, as I have about the condition the savant has. And therein lies a bedside manner clue for all doctors who always ought to devote as much attention to the needs of the person who has the disease as they do to the disease the patient has. Good bedside manner is not just caring for the patient, it is caring about him or her as well. Lessons learned: What are some of those lessons?An "island of intactness" First, savants have convinced me that no matter how impaired or disabled an individual might appear to be, within that person, somewhere in whatever form or quantity, there exists an 'island of intactness' and it is our task and opportunity to discover that kernel of ability, to tend it, to nourish it, to reinforce it and then to watch it grow and bring along with it better language, social and daily living skills. For some, such as savants, that island of intactness is an island of genius. But in others that island of intactness is even more buried, subtle and not as spectacular. But our mission still is to discover and tend that island of intactness, in whatever quality or quantity it exists. In that regard the families of savants are role-models for all of us in discovering and tending whatever special gifts might be hidden, and to focus on strengths rather than deficits. The families and caretakers of these special people celebrate what is there, without disappointment or regret with respect to what is missing, and they demonstrate mightily the power of untiring patience, indefatigable optimism, unfailing faith and unconditional love. They show convincingly that love is a good therapist too. "Training the talent": imitation to improvisation to creativitySecond, the savant skills of music, art or math are not merely frivolous or freakish abilities and they deserve more than a fleeting "Gee, whiz, look at that" glance before we return to our more ordinary inside-the-box observations. Instead it is through those extraordinary abilities that the savants speak to us. It is their language, and for some at first, their only language. But the good news is that, once recognized, by 'training the talent' the savant not only adds more depth to those exceptional skills, but more importantly 'training the talent' leads to improved language, social and daily living skills on a path toward greater independence. Interestingly, those skills also, over time, follow a predictable pathway beginning with impressive replication, then adding improvisation to finally creation of entirely new material. Thus savants are more than imitators or replicators. They can be, and are, creative in their own right. Self-esteem in abundance Third, I have been impressed with the general contentment and happiness that persons with savant syndrome demonstrate. Good self esteem abounds, as it should given their special abilities. Alonzo is one of the most mellow persons I have ever met. He has a perpetual smile, warmth and gentleness that is contagious. If there were a medal for being the most mellow man, I would give it to Alonzo. Savants are not a modest group; they are profoundly proud of their abilities, as well they should be. As George, the calendar calculator said on the 60 Minutes program: "It's fantastic I can do that!". And it truly is. No doubt some of that contentment and happiness stems from the unqualified acceptance and love they receive from their families and there is a lesson for all of us in that. Beyond that, if the savant, with whatever limitations he or she has can be content and uncomplaining, what lesson might also lie therein for the rest of us. The incredible complexity of the brain Fourth, savants have provided me with a greater appreciation, and awe for human brain and its capacity. The human brain and mind (even if they are not entirely the same) have always been of special interest and curiosity to me. That's why I chose Psychiatry as a specialty. And the more I learn about the brain through the special window into the brain that savant syndrome provides, the more impressed I am by its capacity and capability. Witness to that is a picture I have of "Winston", the computer that was the pinnacle of artificial intelligence, challenging humans to a game of Jeopardy. In the picture there are six or seven huge servers that comprise Winston's memory. Standing next to those behemoth memory banks is a man whose head, with approximately 3 1/2 lbs of grey and white matter can easily out distance Winston in many ways, including originality and creativity. After all, who programmed Winston? Can the brain transcend itself to explain itself? Fifth, with new technology now, such as functional MRI, we can for the first time see the brain at work, rather than are all the parts there (CT or static MRI). Brain research is the newest and most formidable frontier of human organ explanation and savant syndrome exploration contributes liberally to that important research. But a lingering question remains for me. While the brain can ultimately explain the heart, and the liver and the kidney, for example, can the brain transcend itself to fully explain itself? I don't know for sure but I think there may be a basic barrier to the brain going outside it self to fully understand itself. Yet this I do know.. No model of brain function will be complete until it can fully incorporate and account for savant syndrome and the co-existence of sometimes massive disability with extraordinary ability in the same person. That exploration is a work in progress. The dormant potential--the little Rain Man--within us all Finally, there is so much that is fascinating to me about savant syndrome. But I have always felt, from the moment I met my first savants that they hint at dormant potential---a little Rain Man perhaps--within us all. My recent encounters with 'acquired savants'--neurotypical persons who suddenly show extraordinary savant skills, sometimes at a prodigious level, after a bead injury, stroke or other CNS incident, cements that conclusion further. I invite readers to learn more about both congenital and acquired savants, and the dormant potential within us all, in my two books on these remarkable persons: Extraordinary People: Understanding Savant Syndrome or Islands of Genius: The Bountiful Mind of the Autistic, Acquired and Sudden Savant. And, there is additional information, including many videos, on the savant syndrome website, hosted by the Wisconsin Medical Society, at www.savantsyndrome.comA smoother pebble My journey with savants reminds me of what Sir Isaac Newton said reflecting on his journey with some laws of nature: "I do not know what I may appear to the world; but to myself I seem to have been only like a boy on the seashore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, whilst the great ocean of truth lay all undiscovered before me." To me savants are that smoother pebble and indeed a great ocean of truth remains undiscovered about them. Yet the more we learn and understand them, the further we will be in better understanding both the brain and human potential.