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181 Hemingway’s Brain Tragedy – Farah-2

Hemingway's brain, CTE, TBI, ECT

Hemingway’s Brain Examined – TBI, CTE & Suicide

Every man’s life ends the same way. It is only the details of how he lived and how he died that distinguish one man from another.

~ Ernest Hemingway

Dr. Andrew Farah, is a forensic psychiatrist, psychopharmacologist, and the author of a remarkable new book: Hemingway’s BrainThis interview, our first CBJ discussion, is at once transcendent, entertaining, and prescient regarding the brain awareness changes today taking place in both our society and our neuroscience community.

This is a republication of our exceedingly popular earlier conversation at CBJ/114

Brief Bio

Dr. Farah is a native of Charleston SC and now serves as Chief of Psychiatry at the High Point Division of UNC Healthcare. In addition to this extraordinary piece on Hemingway, we’ve invited Andy back to CBJ for a serious discussion regarding the homocysteine theory of depression, and the use of reduced B vitamins for depression and neuroprotection, particularly the prevention of dementia challenges. Yes, he’s a neuroscience expert as well. Stay tuned for our next visit.

His Interest In Hemingway’s Brain

It’s important to note that Dr. Farah’s remarks in this engaging and remarkably informative interview arise from his love of Hemingway’s works. His passion for meaningful work as a writer is evident, his professional experience as a psychiatric/forensic investigative reporter is exemplary, as is his abiding personal drive to face the new, discoverable realities of Hemingway’s brain function.

If you have loved the troubled, insightful and metaphoric Hemingway, as we have over many years, you will most certainly find our discussion interesting. And you will genuinely appreciate Andy’s book.

From the historically documented challenges of Hemingway’s chronic traumatic encephalopathy, CTE, to alcohol abuse, to the challenges of global celebrity in this CBJ/114 episode, we discuss many interesting aspects of Hemingway’s life and mind. For decades his death and life challenges have remained so inexplicable because they occurred in times of ineffective brain diagnostic technology, only about 56 years ago. 

* Photo by Mariya Georgieva on Unsplash – Lake Como

Hem’s Medical Tragedy

Then, even at the esteemed Mayo Clinic, the extant standard of care overlooked Hemingway’s brain challenges as biologically relevant, measurable or correctable. 

Upon careful review, stigma and celebrity kept him from going to Menninger’s  for his depression, as he could appear more medical for the purported reason of hypertension at the medical Mayo Clinic. His celebrity kept him away from improved psychiatric care.

It’s reassuring to confirm how we’ve come such a long way in our understandings of brain injury in just a few years.                           

Hemingway’s Life & Friends – Brain Injury Matters

hemingway's brain, CTE, TBI

If the hoar frost grip thy tent,

Thou wilt give thanks when night is spent.

~ Ezra Pound, The Pisan Cantos

You will also appreciate Dr. Farah’s comprehensive grasp of those memorable years in the ‘Hemingway Times’ – including interesting insights regarding his relationships with extraordinary Lost Generation writing companions including James JoyceEzra Pound, and others. When you listen to Dr. Farah talk about Hem, it’s easy to think you’re with them all in Paris, sipping coffee with his crew of writing friends and expats over there at these extant haunts on the Left Bank.

First Observe The Face

Before you read further here, take a moment to look at Hem’s left side of his face just above the left eye. You don’t have to earn a degree in neuroscience to consider the meaning, the undeniable brain-function importance of thoroughly assessing the significance of that scar.

Hem’s Chronic Traumatic Encephalopathy

Also, we reviewed in detail his history and many medical findings that today contribute to current additional understandings of his suicide following multiple ECT treatments at the Mayo Clinic. This interview provides a valuable, in-depth resource for everyone from successful but lost celebrities, to emergent artists now in high school thinking about navigation markers to guide their lives ahead.

The standard of care for depression in those years dramatically differs from today. Today we know more about multiple causes of depression and, as Dr. Farah so articulately reports, the biology of brain deterioration for a complexity of biologically relevant reasons over time.

This Memorable Mix of History, Art, Metaphor, and Reality

Dr. Farah’s life lessons go beyond just memorable – to transcendent. Markdown this interview as unforgettable. – Thanks, Andy – …and thanks, Hem.

I was with you two, out there on Lake Como in northern Italy.


Dr. Farah Reports On Hemingway’s Brain: Art & Science – CBJ/181

  • Bill Smallwood writing about his last ten years sought me out to understand ECT
  • “He was awake a long time before he remembered that his heart was broken”
  • Brain injury is very timely – his multiple brain injuries began in childhood 
  • When he presented at the Mayo Clinic in 1961 an article suggested that manifest problem was a kind of accident neurosis – psychological not biological 
  • Hemingway himself described dementia pugilistica with boxers
  • ECT and psychoanalysis were the standard of care in those days
  • Hemingway did not have the monopoly on mental illness in the Lost Generation
  • Ezra Pound was another of the Lost Generation with serious mental challenges
  • Notes on conflict and transcendence 
  • When asked if he saw a therapist he credited his typewriter
  • Take the example of My Old Man as his effort to understand
  • His complexity of metaphors, mythology, and parallels with Joyce
  • The ability to cognitively convey is gone with dementia
  • Dumbing down the human experience with reductionistic labels
  • What would you have done with an opportunity to treat Hemingway
  • His metaphoric legacy with suicide
  • Stuck in the reality and illusion of celebrity
  • Must listen to this poem on celebrity, illusion, and depersonalization 

Our Best Single Supplement Recommendation For Brain Recovery


To wrap yourself in the perceptions of others,

and then to enact the emptiness of those perceptions,

even a master illusionist is sometimes taken in by that reality,

and dragged offstage in the mouth of the tiger.

~ Jon Brehm – Help Is On The Way


Previous CBJ Interviews on Trauma, Stress, TBI, CTE and Brain Recovery


Website, Book & References

  • Hemingway’s Brain – Farah, 2017 – Global Amazon Link
  • Correlation of Clinical Response With Homocysteine Reduction During Therapy With Reduced B Vitamins in Patients With MDD Who Are Positive for C677T or A1298C Polymorphism: A Randomized, Double-Blind, Placebo-Controlled Study, Arnold W. Mech, MD, and Andrew Farah, MD, DFAPA; Guest Editor, Psychiatric Annals
  • A Paradigm Shift in Depression Treatment – ’09 – Andrew Farah, MD
  • The Idaho Hemingway – ’99 – Arnold & Smallwood – Global Amazon Link


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Until next time, thanks for joining us here at CBJ again. Have some feedback you’d like to share? Leave a note in the comment section below. If you enjoyed this episode, please share it using the social media buttons you see at the bottom of the post.

Also, please leave an honest review for the CoreBrain Journal Podcast on iTunes. Ratings and reviews are extremely helpful and greatly appreciated. Reviews do matter in the rankings of the show, and I read every one of them.

If this post with these several references is helpful, please take a moment to pass it on.


In closing, if you have any questions, drop a comment on any posting here at CBJ, and I’ll get back to you. This discerning show of world-class experts is here for you, your families, and your clients – to tighten our collective dialogue for more precise answers.

And finally, don’t forget to subscribe to the show on iTunes to get automatic updates, or if you’re on an Android Device subscribe for timely updates at Google Play. Yes, these extraordinary experts with hundreds of years of combined experience are free.

Again, special thanks, Andy, for your fascinating yet utilitarian insights on Hemingway, ECT, CTE, TBI, art, and celebrity. We look forward with considerable anticipation to our next discussion here at CBJ on your homocysteine and depression insights.

*Photo by Mariya Georgieva on Unsplash – At, as they say in Italy, Lago di Como – From Farewell To Arms


Next CoreBrain Journal Guest

182 William Shaw, Ph.D., is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry – with a profound interest in brain toxins. Before he founded The Great Plains Laboratory, Inc. in Lenexa, KS, Dr. Shaw worked for the Centers for Disease Control and Prevention (CDC), Children’s Mercy Hospital, the University of Missouri at Kansas City School of Medicine, and Smith Kline Laboratories. This is a republish of his previous well-received interview here at CBJ/125.

I’ve followed his work for many years, use Great Plains Laboratory for biomedical testing every day in my practice, and am exceedingly pleased to share these moments with his profound experience for our CBJ listeners. Recently Dr. Shaw added GPL-TOX to measure brain toxins to Great Plains Labs armamentarium of essential mind tools. This CBJ Special 1-hour review will help listeners understand this possible next step for treatment failure globally.


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About our mission, Dr Charles Parker

Our CBJ hosting objective is critical: upgrade mind and brain data through informed dialogue with neuroscience experts to build more predictable, more comprehensive, more understandable solutions for you and your family. Today's technology drives significantly improved mind-prognosis - beyond traditional psychiatric measures. Inaccurate labels, speculation, and guesswork are out - critical thinking, data, and measurement are in. Let's work together to connect advanced biomedical wisdom with everyday street reality. Start today. Advance informed care. Stay consistent. Measure for accuracy. Subscribe here. Pass it on.

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