“The comatose patients walked after two months.” It is December 1, 2022 and I am watching Marinos Dalakas’ speech online at the presentation of the book “Pathways to Understanding” by academician, mathematician and doctor Thanasis Fokas. I stand by this sentence from Professor Emeritus of Neurology at the University of Athens and Acting Professor of Neurology, Director of Neuroimmunology and Neuromuscular Diseases, Thomas Jefferson University, USA. The teacher, very calm and kind, with a refinement more suited to an artist or a man of letters. Interlocutors from the Academy of Athens tell me about the story of Mr. Dalakas, an important trip to the United States, the obstacles he encountered in Greece when he decided to contribute to the modernization of the field of neurology at the University of Athens, where he was elected professor in 1997, about his return to the United States, the new return to Greece in 2007 and his re-election as professor of neurology at the ‘EKPA for the second time in 2013.
25 years ago, Professor Dalakas tried, but without success, to contribute to the modernization of neurology in Greece by establishing a clinic at the Aiginite Hospital staffed with young Greek scientists, leaders in their specialty, who would also return to our country from major foreign universities. It may be unnecessary to dig up these stories again, let’s just say that, despite the support of the late professor of psychiatry Kostas Stefanis, obstacles appeared in the election of Greeks who will come from abroad and the plan was aborted .
The important thing is that in 2007, when he decided to return a second time, the United States National Institutes of Health granted instruments worth almost a million dollars to the professor for “build” his laboratory at the University of Athens. And today, for 15 years, this laboratory has been offering pioneering tests that guide patients towards innovative treatments for neuroautoimmune diseases such as multiple sclerosis, paraneoplastic syndromes, limbic and autoimmune encephalitis. Treatments so effective that even comatose patients whose condition is due to these diseases can wake up and lead a normal life after proper diagnosis and treatment.
– Why did you become a doctor? And why does the brain have to search for “why”?
– My parents wanted me to become a civil engineer. But I thought medicine had a lot of mysteries. I was immediately drawn to medicine. In school, I first went through different fields of medicine briefly, but neurology opened my mind and heart, I immediately loved it. I wanted to answer all the “whys”. Why do we think like this, why do our eyes move like this, why do we walk like this? Why are we drawn to whys? Because that’s how we are made.
“You said you were emotional. What does “I’m emotional” mean? Does an emotional person’s brain work differently? Or is it a question of culture?
– It is a question of culture. We have not found that there is a center of sentimentality. Perhaps there is a center of happiness. However, it is more a matter of culture. How were you trained from an early age to appreciate and love something. And the more you love, the more emotional you become. If hatred and jealousy leave us, then we are all emotional.
– Is being emotional a manifestation of intelligence? Does it take intelligence to let your feelings express themselves?
– Maybe yes. But you don’t get emotional for the show. Because then you reach the limits of narcissism.
I wanted to answer all the “whys”. Why do we think like this, why do our eyes move like this, why do we walk like this? Why are we drawn to whys? Because that’s how we are made.
– Is it difficult for such a brilliant teacher to avoid narcissism?
– No, narcissism is a dangerous pathology because narcissists alter reality and devalue you to others by building their self-image. If someone says to you “thank you very much, you made a good diagnosis, you are very good”, you will thank him and that’s it. Saying “I’m the best” is wrong.
– There were times when Greece disappointed you, but you came back. You left and came back several times. For what;
– I leave with disappointment, I return with excitement. I’m rebuilding my confidence in the plane. Greece moves me in many ways.
– Why are there breakthroughs in science and the arts in America that are never achieved in Greece?
– Because in Greece there is a lot of interaction between the different actors, which does not allow something to happen correctly and objectively like in America.
– In addition to neurology, you are an art collector.
– Art collector and wine collector. And I specify that I do not collect as a form of investment. I collect for happiness. For example, wines provide a form of happiness when enjoyed with loved ones and friends by expanding communication.
– Invest in happiness.
– Yes, mental health needs happiness.
There is no center of good and evil in the brain
– I heard that you are a collector of paintings.
– I started as a fanatical collector of Ten Florias (1897-1969), who lived in Corfu and Paris. I have many of his works. But my relationship to art has evolved. My collection began with the Washington School Impressionists and the great Greek Abstract Impressionists of the Paris School 1940-1970, but continued with the Abstract Expressionists. The magic of painting is that you look at a painting and you miss something. You look again and that something is revealed. The same is true when you listen to a Bach violin concerto. Each time, it turns out differently.
– If it’s all about interpretation and interpretations are constantly changing, then is reality as a whole a construct of our brain or is it objective and independent of the observer?
– Reality is reality, the brain recognizes reality. Of course, we are influenced by our environment and we can have a different perception of reality. Interpretations change, attitudes change.
– Does the brain have an innate sense of justice?
– No. Law comes from knowledge. The brain does not know what is right by itself. There is no center of good and evil in the brain.
– One of the heaviest experiences affecting the brain cognitively is death. Why does death affect us? Is it because what we call ‘me’ contains not only ‘me’ but also ‘the other’?
“We are certainly not alone. And when you live alone, it’s as if you were dead. When a person of yours or a pet leaves, a part of you is lost. Often, the loss of a pet is as heavy as the loss of a human being. And in fact, the animal never hurt you. He only offers you love, which you can’t say about people, since people, even your friends, who only offer love don’t exist. This is why the loss of an animal causes heavy mourning.
– Are you troubled by the fact that modern medicine often offers long life extension without a cure? Would you be in favor of the institutionalization of euthanasia in Greece?
– It’s true what you say about medicine, which keeps people alive without curing them. But I don’t agree with euthanasia. To take life is a very heavy thing.
Autoimmune and Thoughts
– In your speech at the Academy on the book by Thanasis Fokas, you left open the subject of the connection between the nervous system and the immune system. Could autoimmune diseases be caused by our thoughts “entering” the nervous system and affecting the immune system?
– Not in the sense that they are conscious thoughts. The brain is a regulator of many autoimmune diseases, even playing a role in response to immunotherapy. The pervasive thought that one has symptoms compatible with a neurological disease leads, when frequent, to what are called “functional neurological diseases”, which very often strike patients “without being sick”. Here, the persuasion and experience of the right clinician are essential before they turn into obsessive pathological perceptions.
We met at the traditional restaurant Fatsio in Pagrati (Efroniou 5). It’s not just the quality Greek and civil cuisine, but it’s also the calm, quiet and civilized environment of Fatsio, which makes for great conversations. We preferred the green salad, then Mr. Dalakas ordered mushroom penne and I ordered grilled chicken breast with baked potatoes. Everything was excellent. We resisted the wine and preferred water and coke zero, due to evening commitments after the meal.
The bill was just over 30 euros.