"Tonight I saw a miracle."
Those were the words psychiatrist Darold Treffert, M.D., recalled his daughter saying when she arrived home breathless after hearing a piano recital in 1980.
It was not an unreasonable description of what the young girl had witnessed. The pianist, Leslie Lemke, was blind and had been born prematurely with cerebral palsy and brain damage; for much of his childhood he could not feed himself, stand, walk, or talk.
But at the age of 16, Lemke was listening with his adoptive parents to a recording of Tchaikovsky's Piano Concerto No. 1. Not long after, his mother awakened one morning to hear Leslie playing the piece on the family piano. He had never had a lesson.
In time Lemke was giving concerts like the one in Fond du Lac, Wis., where Treffert's daughter witnessed her "miracle."
As a psychiatrist, Treffert was asked by a local broadcast station to comment on the remarkable Lemke. In part because of that exposure, Treffert was consulted in 1983 when "60 Minutes" ran a segment titled "Genius," featuring three individuals who, like Lemke, were severely disabled yet possessed startling abilities.
Then in 1987, Treffert was called on again—this time by Hollywood writers working on a screenplay. The movie would be called "Rain Man," and its main character—Raymond Babbitt—was inspired by the real-life experiences of another prodigiously talented though deeply disabled individual named Kim Peek.
The movie starred Dustin Hoffman and won four Oscars including Best Picture in 1988. It gave international prominence to the phenomenon of "savant syndrome" (the term has replaced the archaic "idiot savant").
Since that time, Treffert, an APA life fellow, has become one of the world's leading experts on savant syndrome. He befriended Kim Peek, who died in December 2009 (see Rain Man's Inspiration), and has interviewed many other savants. He published the book Extraordinary People in 1979, and his new book, Islands of Genius, is due out in April.
The story of savant syndrome is a story of the brain's remarkable plasticity, the astounding process by which parts of the brain compensate for severe impairments in other parts. The result is that individuals who are socially or linguistically crippled may have the capacity to calculate a mathematical equation instantly, produce breathtaking music or art, or state without thinking twice that July 19, 1857, was a Sunday.
"Since we have had functional brain imaging to look at the brain as it is working, we have been able to see how one area of the brain can be recruited to substitute for another damaged area," Treffert told Psychiatric News.
"I think what we are finding from this functional imaging is that it is not so much that the brain is producing new skills, but that it is releasing dormant capacities."
He added, "For me it raises the really interesting question about the dormant capacities in us all."
Treffert's first encounter with savant syndrome was in the early 1960s after his residency, when he embarked on two years of service to the state that had subsidized his training. Though not a child psychiatrist, he was assigned to start a children's wing at a Wisconsin state psychiatric hospitals in Oshkosh.
During his time there he was to meet, among the hundreds of children who passed through the unit, a child who had memorized the entire Milwaukee bus system; another who was severely autistic and essentially mute but could put together a 250-piece jigsaw puzzle, picture-side down, in minutes; and another who could state on demand what had happened on any given date in history.
"It was so striking—here were these children and adolescents who had marked disabilities alongside what I came to see later as islands of genius," Treffert said.
He began to take an avocational interest in the subject. Fascinating as it was, it was too rare to build a career around: approximately 10 percent of persons with autistic disorder and about 1 percent of individuals with other forms of mental retardation or brain injury have some savant skills along a continuum from "splinter skills"—such as memorizing sports trivia or birthdates of friends and relatives—to "talented-level skills" in which music or art are more conspicuous and are above average peer-group skills. Very scarce—fewer than 100 known alive today—are the prodigious savants whose skills would be spectacular even if seen in a nondisabled person.
Treffert became superintendent at the hospital in Oshkosh and served there until 1979. Then he became administrator of a community mental health center in Fond du Lac, a position he occupied for 12 years before he switched to private practice and forensic psychiatry.
The success of "Rain Man" was a turning point—for savant syndrome and for Treffert. He noted that more has been learned about the condition in the 20 years since that movie than had been learned in the previous 100 years after the syndrome was first described in 1887.
Treffert said that a single unifying phenomenon in all savants appears to be one of left-brain damage and right-brain recruitment—most savants are deficient in left-brain skills associated with language and social fluency. He cited what he calls the "Three Rs" of savant syndrome: rewiring, recruitment, and release, the latter referring to the release of right-brain capacities that would normally be dormant.
Moreover, savants typically display their extraordinary skills in five general areas: music, art, mechanical ability, lightening calculation, and "calendar counting," or the ability to match days with dates.
Also typical is their extraordinary memory—sometimes called "memory without reckoning," since the savant commonly lacks comprehension of the meaning of their prodigious memories.
Treffert believes this is because there is injury to the higher cortico-limbic circuits used by most people and compensation by the lower-level cortico-striatal circuit for what Treffert calls "habit memory."
He noted that this process appears to mirror the mental processes employed by geniuses. "There is some overlap among prodigies, geniuses, and savants that may give us some insight into creativity itself, because savants and geniuses use the same sort of subcortical circuitry to do their work," he said.
For all that has been learned about savants in the last 20 years, some aspects of the condition point still to mysteries of the human brain yet to be discerned. Among these is calendar counting, a feat that savants do not study or learn but seem to know intuitively and that would seem to have no functional utility.
Treffert speculated that it may reflect so-called "genetic memory," knowledge deeply buried in the brain and passed down from generations ago when seasons and solar and lunar cycles were matters of survival. The notion can find some support in the science of epigenetics, which has revealed the ways that our genetic code can be altered by environment and culture.
"So many savants have this talent of calendar counting; it is almost universal," he said. "You have to wonder where in the world it came from, because savants seem to know things they never learned. I cannot help wondering if it is knowledge stored from a primitive time when the calendar was a matter of life and death."
Treffert is retired from psychiatric practice but says he is as busy as ever. He is chair of the Wisconsin State Controlled Substances Board and past chair of the Wisconsin Medical Examining Board, and he remains active in the Wisconsin Medical Society and Wisconsin Psychiatric Association. In his spare time, he tends a seven-acre property, chopping wood and caring for an orchard that includes 40 apricot, peach, apple, plum, pear, and cherry trees.
But his interest in savant syndrome has become a full-time avocation, with media inquiries coming from around the globe. He maintains a Web site with comprehensive information about the condition and fields e-mails from parents and caretakers with children who display islands of talent alongside pervasive disabilities.
Treffert said, "Since the first step in treatment is to make a diagnosis, I try to help steer these family members toward a knowledgeable resource in their area or country so that the underlying disability can be properly diagnosed and treated, and the ability can be nourished and nurtured."
Treffert's Web site is <www.savantsyndrome.com>.