Review of Moonwalking with Einstein

For the prospective medically-oriented reader considering picking up this volume

Moonwalking with Einstein takes you on a trip from novice to expert alongside the author recounting his journey of the same. With thorough research and a teaching style that reflects the memorable methods memory champions use to achieve astonishing feats, the book envelops you makes you feel as though the impossible (memorizing the order of a deck of cards) is doable (memorizing 18 images of outlandish things in your house). What other feeling can you ask for after reading a book? A page-turner for any medical professional who deals with the limits of memory on a daily basis, this exposition on the mysterious abilities of the hippocampus is easily a 9/10 read that could potentially have a few more examples how to practically employ these techniques across domains.

For the reader who has leafed through its pages and would like a discussion

The intro to the book, consistent with the method of loci and ways to remember information shared in the book, was memorable. It was not quite the life-or-death situation that Simonides found himself in, but it had life or death significance to the family member who cared about where their loved ones were underneath all the rubble in the story. I immediately thought: how can I learn something from this book that could let me learn more effectively a subject that actually does have life or death circumstances, like medicine? When I heard of some of the memory champions learning poems at blistering pace, my ears perked up. Are there ways to go beyond memorizing simply meaningless playing card orders? I think by the end of the book I was a little less certain about this, surprisingly. There seems to be a lot of benefit in training our minds and learning some of these techniques, but I think the territory is largely unexplored in regard to practical applications (i.e. medicine). I'm glad that the book gave this impression, however, because I think in the memory space, like the book mentions, there is much advertising and false promises. 

The thing I really did like about the book was that even a description of the author’s initial meeting with Buzan was quite memorable, and I could very much picture the eccentric memory championship founder. The author's observation that images are very memorable to humans made me think of how on my rotations I very much remember patients' faces and clinical settings I've been to, to a near perfect degree, but less so remember details around those events. I've personally had great success memorizing details using sketchy images throughout my medical education with Step 1 in particular, so this resonated with me a great deal. As I've transitioned to clinical medicine, I have moved away from this technique, and this book is making me consider ways in which I can reinstitute this practice. Using such a memory palace technique, I imagined walking through the Wright State Student Union which ended up working wonders for me in a comedy class I was in to remember the various bits of my stand-up routine. I did not use the major system or the POA system, but the images reminded me of the general successive joke themes I wanted to go to. In this way, in the book's terminology, it was more like a memoria rarum (memory for things as opposed to the words themselves, memoria verbum). I could usually remember the wording once I had a general idea of the topic, and nevertheless it worked for me. If I was reciting scripture or something where every word needed to be exact, I would have needed to use a different method, but it worked perfectly for comedy where a certain degree of flow and spontaneity is encouraged and needed.

I loved the example of EP, one of the book's examples of those with significant memory impairment, only being able to remember lists of events by connecting them to previous items. The example helped elucidate what is core to memory with areas not near the temporal lobes (damaged via freak accident in EP), that is connections. I loved the quote “to think is to forget” in connection with this individual as well because in my own personal experience studying for practice exams and in the anecdotal memory championships where earplugs and painted over glasses abounded the importance of blocking out unnecessary information cannot be overstated for the human brain to function at its best.

The discussion about someone in the book trying to find ways to slow down time by establishing chronological landmarks, and remembering more from the year, was very interesting to me. This made me think about how research has been done on ways to make the patient encounter feel more memorable and meaningful to the patient. For example, just sitting down with patients makes the appointment feel longer and patients more satisfied.1 Are there ways that I can in my brief time talking with patients make things feel like they’re lasting longer and we are getting more done? Studies have shown that patients tend to forget a great deal of what they talk about with their doctor. One study showed 53% percent of patients made one or more errors about their therapy regimens when interviewed immediately after a clinical encounter.2 The findings of such studies are likely one of the reasons that after-visit summaries are becoming more popular. I wonder if using meta-memory techniques like describing treatment plans in vivid and hard-to-forget ways could be helpful in improving patient outcomes. Communicating via pictographs of treatment plans seems to help patient understanding,3 and also there is some scant case study evidence that mnemonics may help patients who have severe neurological impairment be more functional.4 I do wonder if it would be helpful to ask patients to use memory cues in their home for healthy lifestyle behaviors, so that, for example, whenever they pass the fridge, they do two push-ups (a sort of method of loci but also a habit formation technique). The discussion of explicit and implicit memories also made me think of how a mere exposure effect could be not only a cognitive bias in physicians, but be used for good in healthcare settings via patient education materials in the sitting room promoting healthy lifestyle choices. It could be a type of availability bias that you impose on patients by making such healthy things seem enjoyable (which they indeed are in many ways!). This could be particularly effective in psychiatric settings where healthy lifestyle behaviors like sleep hygiene, exercise, and healthy diet have been shown to help with a variety of disorders from anxiety to depression to PTSD.5,6 The deft handling of medical topics was impressive for the author who I don't think has much experience in the medical field per se, which demonstrates his attention to detail throughout the book.

The discussion around how society has moved from internal to external memories reminded me of the amazing resource UpToDate that provides encyclopedic medical knowledge yet remains entirely useless to a physician who doesn't know where to begin looking. The book talked about the history of scrolls being used for very important texts and how it would have been very hard to look up anything in a scroll. This emphasized the importance of internal knowledge and meta-memory techniques to uncover what you already know in ancient society. Though a lofty ideal, I want to know medicine in the same manner the Talmud is memorized and known by heart. To this point in my life, I have extensively relied on tools such as Anki, employing thousands of flashcards for learning. However, during every part of this book I was reflecting on ways I can utilize the "software techniques" being discussed of these memory champions to enhance the somewhat static hardware I've been given by God. My attending on this differential diagnosis rotation, Dr. Leeds, made the connection that what we are trying to do in medicine has great moral value in trying to relieve suffering. When I think about my purpose in medicine, it is all the more important that I read books such as Moonwalking with Einstein if they at all give me a leg up on the skills I am trying to develop to heal people.

I thought the discussion on how difficult tasks become automatic was particularly enlightening. I have experienced a number of “okay plateaus” in my own life (*cough* tennis) and am interested in breaking through imperceptible barriers. I think the aspect of getting feedback to stay in the cognitive phase of skill development is important in the aspect of medicine because sometimes there isn’t feedback on whether or not a patient actually did have a condition. For me, we would round on patients, give them an appropriate treatment plan, but often never see them again, at least on my month rotation at that location. In my professional stage of life, I think this translates to making sure I am continually doing practice questions that do provide such short-term feedback which can help build up my skills through purposeful practice (of which feedback is a requirement).

I thought the discussion about how creativity and memory are closely linked is interesting, because I worked on a significant project during my first two years of medical school to come up with mnemonics for a bunch of different flashcards in the Anking study deck. I published my study aids online to around 600 downloads and made some Youtube videos about them, and it was a lot of fun to come up with these mnemonics because it does activate a creative and enjoyable part of your brain that is rarely accessed when working hard in medical school. I tried to make the ways to remember as silly and as memorable as possible, and it worked to great effect for my personal academics as it did with the author of this book and how he memorized playing cards for a thrilling US championship victory.

It was interesting to listen to how Daniel the supposed savant might’ve been someone who was secretly methodically training. I think that is testament to the quality of his book as it has demystified some of my preconceptions around people who perform seemingly incredible mental feats. Good teachers demystify tough subjects, and I think this book does a fantastic job at that. I was of the opinion that even if Daniel was fibbing about his methods, it was still very impressive what he accomplished by training himself in a variety of techniques. I think it was bold of the author to include this hint of accusation, but it made for good reading. Even the discussion around Kim Peak (Rain Man) made him seem more relatable.

I found this savant discussion intriguing because I actually myself have known someone I would consider a “savant.” In my high school, one year ahead of me was a guy named Sam Blizzard who competed in academic challenge for our high school and was the second highest ranked player in the country throughout his time there. I joined the academic team for fun, and maybe subconsciously to try and learn some of his learning techniques, and when I asked him what particular things he used to study, he said he read a lot of Wikipedia. He had excellent standardized test scores and is now a resident physician. When writing notes, he would usually write two words and then an arrow between them on his paper, connecting the two concepts, which I have never really seen done before with notetaking. Whether it was simply hard work or other memory techniques he would use, I will never know. However, I think the idea of learning about learning is a fruitful discussion and something that has the potential to greatly enhance our ability as physicians if done well. I would give this book a 9.3 out of 10 as I thought it was thoughtfully put together and had a compelling narrative in the author's own journey of growth in memory techniques that tied together a lot of fundamental concepts about the mind 🧠.

References:

1. Swayden KJ, Anderson KK, Connelly LM, Moran JS, McMahon JK, Arnold PM. Effect of sitting vs. standing on perception of provider time at bedside: A pilot study. Patient Education and Counseling. 2012;86(2):166-171. doi:10.1016/j.pec.2011.05.024

2. Brody DS. An analysis of patient recall of their therapeutic regimens. Journal of Chronic Diseases. 1980;33(1):57-63. doi:10.1016/0021-9681(80)90086-7

3. Schraa JC, Dirks JF. Improving patient recall and comprehension of the treatment regimen. J Asthma. 1982;19(3):159-162. doi:10.3109/02770908209104752

4. Patten BM. The Ancient Art of Memory: Usefulness in Treatment. Archives of Neurology. 1972;26(1):25-31. doi:10.1001/archneur.1972.00490070043006

5. Rimer J, Dwan K, Lawlor DA, et al. Exercise for depression. Cochrane Database of Systematic Reviews. 2012;(7). doi:10.1002/14651858.CD004366.pub5

6. Correll T, Gentile J, Correll A. Healthy Lifestyle Interventions Augmenting Psychotherapy in Anxiety and PTSD. Innov Clin Neurosci. 2023;20(7-9):18-26.