Had three... got one... I'll work on the two that got lost...

Semi-Deep Thoughts

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I got a phone call today from Jake's doctor. He went over the results of Jake's images that were taken on Friday:

It turns out that Jake doesn't have an hemangioma...he has an Arterial Vascular Malformation - or AVM for short. He explained that an AVM is basically a "miswiring" of Jake's arteries and veins. He compared the arterial/vascular system to a tree: a tree has a trunk (arteries) and branches (veins) and it's anatomy gets smaller and smaller to the leaves (capillaries). Jake's AVM is like having 2 trunks put together - and it's caused a high blood flow situation (which is the "whooshing" he heard when he listened to the birthmark). The blood doesn't have the correct route to take (going to the branches and leaves). One great thing he said is that the AVM is not attached to Jake's skull at all, it's just at the scalp - so that makes treatment a bit easier.

He is going to have us meet with an Intervential Radiologist, and Jake will undergo an angiogram. He said this will enable them to get a more specific picture of which vessels are not formed correctly. He said the MRA showed all of the vessels, but the angiogram will be much more specific in it's imaging. The angiogram will consist of having a catheter inserted (most likely into his thigh) and floated up to his birthmark to take images of the vessels. During that procedure, he'll also undergo an embolization. That will consist of a slightly larger catheter being inserted, but they will be able to steer this catheter and have it go to where they need it to go. He will have a coil inserted into the vessels that are malformed, and this will cause a clot that will shut down the blood flow to the birthmark. The doctor said that Jake should start to have some shrinkage of his birthmark following this procedure, but it won't go away completely. After this is done, then we can start to look at getting the birthmark removed - which will be much safer after the embolization is successful.

On a "not fun to hear" note...the doctor did inform me that if Jake were to have a puncture wound to the birthmark, he'd run the risk of bleeding to death. I almost had to laugh at how the doctor told me this...he prefaced it with "Not to freak you out, but...." Yeah...it freaked me out a little. He said that if Jake were to sustain a wound to that area, to put firm pressure on it - which is what we've always done when it bleeds - good to know that we've been doing the right thing! Michael joked that since we now know the risks - we should tie a pillow around Jake's head... :)

The doctor has already started the process of scheduling Jake's angiogram and embolization, and we should be getting a letter in the mail in the next 2 weeks letting us know when that is. He said that he put us on a "first available" basis, but if we can't make it at the time listed, then we can reschedule. Thankfully, I work for wonderful people, who told me not to worry about scheduling, so we'll go at the first available time they give us.

I did a little research online before posting this - hoping to find a resource that would help explain this process a bit more. (Jake's doctor did a wonderful job explaining things to me - he spent 20 minutes on the phone going through everything with me. However, it's hard to remember EVERYTHING that was said, so I turned to the wonderful internet to beef up my knowledge) I found one site, that really does a good job of laying out the whole thing. However, it explains AVM's found on the brain. Jake's is on the outside of his skull (thankfully) so his isn't going to be quite as drastic as they describe on this site (no seizures or headaches). It also explains the embolization therapy as well. Take a look, if you'd like: http://www.cumc.columbia.edu/dept/cerebro/AVM.html Like I said, Jake's isn't as severe as what's described here, but it's a good "general knowledge" resource for his AVM.

Please keep praying!
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Will do!


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I got the two... that i said I lost...
here you go...


Paul Broks: The Neuropsychology of Pat Martino

from...

Paul Broks is a prominent British neuropsychologist who is featured in the documentary film, Martino Unstrung, where he conducts a real-life study of guitarist Pat Martino's famed memory loss and recovery.

Broks conceived the movie with director Ian Knox, and they completed the film with the help of a grant from the Wellcome Trust. In the film, Broks uses psychological testing, an updated MRI scan of Martino's brain, and other data, to arrive at tentative conclusions about the guitarist's well-known medical condition and his miraculous comeback as a jazz musician, spanning from the late 1970s into the 1980s. This is the most in-depth study of Martino's memory disorder and its implications yet to be done. In the process, Broks conducted himself with a rare combination of scientific objectivity and human compassion. Here are Broks' reflections soon after the filming was completed.

Chapter Index

1. Background and Filming
2. Getting to Know Martino
3. Martino's Memory Loss
4. Broks on Broks

Background and Filming

All About Jazz: What is the history of your friendship and association with film director Ian Knox?

Paul Broks: Ian wrote me a letter sometime in 2004. He set out Pat's story, which I didn't know, and invited me to join him on the project. I didn't take much persuading. We became friends along the way. I admire Ian's vision and energy. He can do things I can't and I think it's good to recognize that in an artistic collaboration.

AAJ: How did you and Knox first get the idea for Martino Unstrung?

PB: It was Ian's idea. We talked first about developing a fictional treatment, but it was the availability of funding that tipped us toward documentary. It was my idea to approach the Wellcome Trust for funding. It seemed to me the Pat Martino story was perfect material for their Sciart program—which encourages collaborations between artists and biomedical scientists. So we applied to Wellcome and here we are. They've been hugely supportive.

AAJ: When and under what circumstances did you first meet Martino?

PB: I first met Pat when he played at the Pizza Express jazz club in London in January 2006. Ian and I got together with Pat for a post-show beer and then we all met for lunch in Soho the following day.

AAJ: The film is done compassionately, yet it is almost brutally honest in some ways, for example with an MRI-scan of Pat's brain made explicitly for the film. What led to such frankness, as opposed to what could have been an idealized or softened portrait of Pat?

Paul Broks with Martino's surgeon, Dr. Fred Simeone

PB: Pat was courageous in allowing us to make the film the way we did. We were clear right from the start that we saw the project as a three-way collaboration. Four-way for the times that the brilliant cinematographer Nyika Jansco was working with us. But it required a degree of trust on Pat's part that neither Ian nor I had to invest. We were not interested in doing a hagiography—which would have been an artistic disservice to Pat - nor was there any temptation to sensationalize. Pat's story is sensational enough. He knew the kind of film we wanted to make and if at any stage he'd said he wasn't happy with the way things were going, we would have listened and taken stock. But the question never came up. Pat's approach to the film, I think, was somewhat like his approach to his music. Integrity is the word.

AAJ: What about the MRI?

PB: I saw the MRI scan as part of the continuing story. We really didn't know the extent of the surgery that Pat underwent. The original surgical records and CT brain images no longer exist and, in any case, brain imaging has moved on enormously since 1980. It seemed important—dare I say historically important—to establish definitively the condition of Pat's brain. What exactly was it that he'd recovered from?

This was, in fact, the first MRI scan that Pat had ever had and we ran a state-of-the-art volumetric procedure, measuring brain structure to a high resolution. Pat had undergone a CT (CAT scan) before his surgery, although not to my knowledge post-surgery. CT yields much less detailed images.

AAJ: What can you say in retrospect about Pat's aneurysm?

PB: In Pat's case, aneurysm is not quite the correct terminology, although it's often been referred to as such. An aneurysm is a balloon-like swelling in the wall of an artery. An arteriovenous malformation (AVM), which is what Pat had, is a tumorous (space-occupying) malformation of veins and arteries. Both are congenital (present from birth) and both are liable to hemorrhage, which indeed eventually happened in Pat's case. The neuropsychological significance in Pat's case is that his AVM was large and so quite likely led to some reorganization of brain function from an early age, perhaps with the right hemisphere taking charge of some functions that would ordinarily be controlled by the left. I speculate on this toward the end of the film. An aneurysm, being less bulky, would be less likely to result in reorganization of brain function.

Return to Index...

Getting to Know Martino

AAJ: From your close working relationship with Pat on the film, what are your impressions of him as a person and a musician?

PB: I got on well with Pat from the start. I'd taken a serious interest in his music in the year before we first met and had grown to love it. It also helped, I think, that he'd read my book, Into the Silent Land. Ian had sent him a copy. I was nervous about his reaction. It's a disturbing book in some ways, challenging our deepest intuitions about what it means to be a person. I wrote, among other things, about people who, like Pat, have undergone the severest possible challenges to their selfhood. But Pat grasped it straight away. He'd been there. He understood what I was trying to say.

AAJ: What did you get from your off-screen experiences and talks with Pat?

PB: Over the course of the days and weeks we spent together making the film Pat and I had many conversations on matters of psychology and philosophy, and much else besides. He has a sharp mind and is relentlessly inquisitive. I get the sense it's that aspect of his personality that drives him as a musician: plain curiosity. He is constantly in search of creative insight. In another life maybe he would be a neuroscientist or a philosopher, but thankfully for those of us who love music, not in this one.

Pat has remarkable energy and stamina. As a musician he is incredibly disciplined and professional. When he last came over to London to play Ronnie Scott's, I went to see him backstage before the show. He had a chest infection and looked so frail and ill he could have been at death's door. I was seriously concerned for him. And yet he went out and gave one of the finest performances I've seen him give. The guitar seemed to have a life of its own that night.

AAJ: Did you experience Martino's wry sense of humor along the way?

Pat Martino (wife, Ayako Akai, in background)

PB: Yes, that aspect really was contagious. There was a lot of laughter on this journey. Here's just one example. Pat had just played the Iridium in New York City and afterward we were sitting in a bar. There's a keyboard player and people are getting up from the floor to sing their party pieces—mostly old musical theatre stuff. It's a good atmosphere. Then a guy with the most astounding voice starts to sing. It's a deep wobbly voice, getting deeper and wobblier as he goes. It's so weird it could be an acoustic weapon designed to destabilize the rhythms of your internal organs. People start to look at one other in disbelief. I look at Pat. He looks at me. It's a question of who's going to give in first. Then the accompanist stops playing and says to the singer, I think with genuine curiosity, "Are we doing the same song?" At which point Pat and I are simultaneously just helpless with laughter.

AAJ: What further impressions of Martino occurred to you?

PB: Pat is the consummate professional, dedicated to his art, perfectionist, obsessive even, but with a capacity to totally let go and wind down once he's done the business. There is a darker side too, no doubt, the volcanic temperament that the film hints at. The moment, as Pat puts it, in the film, "when the ego steps forth." But I honestly never saw any hint of that, even though at times we must have really tested his patience; long, long days of filming and psychological testing. Invariably, at the end of the day Pat was ready to go out and eat and share a bottle of wine and talk late into the night.

AAJ: Pat's emphasis on living in the moment seemed to help him turn his memory loss into an asset. Do you think he acquired that attitude from Buddhism and other religious studies prior to the memory loss, or that the latter led him to such a philosophy?

PB: I think Pat is an original thinker. By that I don't mean he is a great intellectual or guru. But let's say he has a "turn of mind" which can be truly impressive. Perhaps that's what he expresses in his music. If I can make a sports analogy, elite players are all super fit and super skilful. They are capable of remarkable things in terms of technique, agility and stamina. What separates the great from the merely remarkable is "turn of mind," invention and originality, a certain way of anticipating moves and patterns, a unique way of seeing things.

Pat seems to have had a very spiritual outlook well before his illness and surgery. How much of that was shaped by the underlying brain disorder we can never know. I would very much like to look further into Pat's in-the-moment philosophy. And what, incidentally, is more in-the-moment than musical improvisation? The focus on "the now" is something that is very much a genuine part of his experience, it seems to me. I recently gave a talk about Pat at a neuroscience meeting. Professor Richard Gregory, a senior statesman of neuropsychology and a very distinguished neuroscientist, was in the audience. He immediately picked up on the question of Pat's perception of time and that's something I'd like to look at experimentally.

Return to Index...

Martino's Memory Loss

AAJ: Pat told me that his ability to play the guitar was completely lost. What is your professional opinion about this?

PB: The Pat Martino story is a wonderful legend. I didn't believe for a moment that Pat had literally forgotten how to play the guitar. If that had been the case we would have to radically revise our current understanding of the organization of brain function and I'd now be on my way to a Nobel Prize. It seems extremely unlikely that he completely lost the memory of the guitar, if by that we mean a total loss of skills and knowledge.

There are cases of musicians with dense and persisting amnesia—perhaps most famously the British musician Clive Wearing—who nevertheless retain their musical skills, even whilst denying they have any. In neural terms, musical skills—as "procedural" knowledge—are laid down in phylogenetically old structures of the brain, such as the basal ganglia and cerebellum. These regions were not affected in Pat's case. Other cortical areas are involved in the execution of musical skills, notably the motor regions of the frontal lobe, but these too were not directly affected in Pat's case. Clive Wearing has been studied for many years and his wife Deborah published an account of their story a couple of years ago. It is entitled Forever Today [2006]. Most recently Oliver Sacks has written about him in his recent book, Musicophilia [2007].

Pat certainly seems to have experienced a period of significant amnesia post-surgery and it may be that, like Wearing, he had no knowledge of having played the guitar. Certainly by all accounts he had no interest in picking up the instrument and seems to have been quite alienated from it. So, yes, "seemed foreign to him" would be an apt description. His father's well-meaning but emotionally intrusive efforts to encourage him to play were probably counter-productive.

AAJ: What enabled Martino to resume his guitar artistry after his virtually complete lack of recall for this part of his past life?

PB: At this distance in time it's hard to establish exactly when the amnesia began to resolve and when Pat picked up the guitar again, or indeed whether these phases coincided. I put these questions to guitarist John Mulhearn, perhaps our most reliable witness, who spent time with Pat immediately before the surgery and during the weeks and months that followed. John couldn't say for sure what the tempo of recovery was, but I got the sense it was certainly weeks and possibly a number of months before Pat started playing again.

It is even harder to establish the point at which Pat re-established a continuous sense of his old identity. As John describes it, when Pat finally did pick up the guitar again he seemed to rediscover his passion for the instrument and was playing and transcribing music almost maniacally. So I would say it was a resurgence of motivation and a rediscovery of skills rather than a relearning. This makes complete sense neuropsychologically. Musical skills are represented diffusely throughout the brain and include, as I've already mentioned, subcortical areas not directly affected by Pat's AVM and the surgical procedure to remove it.

AAJ: How does amnesia of Martino's type relate to brain structure and function?

PB: That is a most interesting question about the neuropsychological nature of Pat's post-operative amnesia. Why should he have become amnesic? After all, the key episodic and procedural memory structures are unaffected. In particular, our MRI scan shows the hippocampus to be intact left side and right. There are various possibilities we might speculate on, although his surgeon, Dr. Fred Simeone, would be better placed to offer a comment on the medical and surgical aspects here. One possibility is that the surgery had non-specific physiological effects on certain key brain regions involved in recall of episodic/autobiographical memory, which subsided as the brain readjusted physiologically post surgery.

Pat Martino and wife, Ayako Akai

There is no clear suggestion that Pat's new learning and recall abilities were affected post-operatively, which would tend to suggest that the hippocampus was functional. In any case, severe amnesia, at least of the sort associated with temporal lobe damage, typically requires damage to the hippocampus bilaterally. In Pat's case it was only structures adjacent to the left hippocampus that might have been affected. My hunch—and it's only a hunch—is that there were relatively temporary diaschetic, or knock-on effects in the frontal lobe in areas important for both motivation and autobiographical recall.

AAJ: What was the impact on Pat's memory over the long haul?

PB: It is difficult to disentangle genuine recall of remote memories from new learning acquired since the surgery. As Pat says in the film, he worked hard to re-learn and assimilate names of family members and to reconstruct his autobiography through the accounts that others were giving him. I'm inclined to think that his autobiographical recall comprises a combination of the two, to some extent, though I'm also confident that a good deal of genuine memory from childhood and early adulthood has been re-established.

Again, this is what you'd expect given the pattern of brain damage. Semantic (fact recall) memory is one area where Pat does seem to have some subtle problems, which is in line with damage to the left temporal lobe. There's a neat illustration of the difference between semantic memory and episodic (event recall) memory in the film. Pouring over a photo album, Pat speaks animatedly, and in detail, about being in Boston in 1963 on the day JFK was shot—episodic memory. But then on another occasion when asked to give the date of the assassination he struggles—semantic memory.

AAJ: Neurologically speaking and otherwise, what would explain Martino's ability to re-learn guitar playing, especially since jazz requires not only rote learning, but improvisation, creativity, and a feeling for the music, all of which are usually based on the sorts of experiences which Martino forgot?

PB: For reasons I've already given, Pat wouldn't have lost his amazing dexterity on the guitar. Nor would one expect him necessarily to lose the ability to improvise and imbue feeling. His emotional systems may have been recalibrated to some extent given the loss of adjacent brain tissue, but the basic brain structures of emotion remain in place. There is evidence to suggest that fluent improvisation depends upon dynamic interaction between different regions of the frontal lobes, which were not structurally affected in Pat's case.

It's interesting, however, that when he started playing again he lacked the confidence for a long time even to play familiar jazz standards without the crutch of having the chord sequences written out in front of him. So he quite likely suffered a loss of musical knowledge—semantic memory again—rather than basic skills. This would be consistent with the temporal lobe damage he suffered. So in some ways it's perfectly true to say that he had to learn his craft again, but not all aspects of the craft. What I'm saying in no way diminishes Pat's achievement in returning to the peak of his art. Given the knowledge we now have, Pat's return seems to me all the more heroic. This was an extraordinary recovery, believe me.

AAJ: On the face of it, music seems to be a luxury or pastime rather than an ingredient of the evolutionary imperative of survival-of-the-fittest. Can you tell us something about what you see to be the role of music in brain function and human evolution?

PB: Ethnomusicologists point to the collective functions of music, its use in ritual and ceremony, its contribution to the continuity and stability of cultures. Singing and dancing draw people together, synchronizing emotions, bonding the group in empathy and reflection or in preparation for action. The power of music lies beyond language and intellect. It comes from an emotional need for communication with other human beings.

But I think there is something prior even to that. Music goes deeper; it perfuses the body. It fuels our most primitive mental machineries, the systems of emotion, bodily sensation and action that constitute the core self, the embodied self of the present moment. Without coherence at this level there is no possibility of developing a stable personal identity or social relationships. Perhaps that's one of the basic functions of music: to tune up those engines of self-awareness. I don't believe, as Steven Pinker seems to, that music is mere "auditory cheesecake" with no primary adaptive function.

Return to Index...

Broks on Broks

AAJ: What were some of your impressions and comparisons of Philadelphia, New York City and London as urban environments as you were making the film?

PB: My work has brought me to New York on a number of occasions over the years and I've always been inspired by the place. I grew up with the New York of the movies, a place firmly established in the geography of my imagination and the reality doesn't disappoint. I hadn't previously been to Philadelphia. I was born and raised in the sprawling industrial conurbation of the West Midlands of England and in some ways, Philadelphia reminded me of our own great industrial cities. There is an earthiness and an edge to the place and, by the same token, an authenticity. I hadn't quite anticipated the atmosphere of the area of South Philly where Pat lives—the row houses and the corner stores and bars. That really did have a northern European feel to it, unexpectedly like the kind of place I was brought up. London? Like New York City, another city of the imagination that doesn't disappoint.

AAJ: How would you compare and contrast your own interests as a neuroscientist with those of Oliver Sacks?

PB: We share similar interests to the extent that we both write about neurological disorder and are drawn to unusual, striking cases. Of course, I followed his lead on that, as he had followed the pioneering Russian neuropsychologist, A. R. Luria. But there are differences in the way Sacks and I write about these things. My writing style veers more to the quasi-fictional; as well as writing about real cases, I sometimes make excursions into speculative fiction. Sacks writes inspiringly about human survival. My vision is darker, though I hope with shafts of illumination and inspiration.

Oliver Sacks is a neurologist and I'm a neuropsychologist by training, so we have taken rather different career paths in terms of clinical work. I've also spent time in basic research posts, including in the pharmaceutical industry. We share similar interests to the extent that we both write about neurological disorder and are drawn to unusual, striking cases.

AAJ: In the film, you become self-admittedly anxious when Martino asked you if you ever saw your own brain scan. What was triggered for you?

PB: First, it just hit me that this was a very unusual situation, like giving a clinical consultation but in front of the camera. I felt conflicted because I would have preferred to discuss Pat's MRI in private, yet here we were by mutual consent making a film and it was important for the film that we captured the moment on camera. And then into this unusual situation Pat flings a perfectly reasonable, but unexpected, question.

One that I would have welcomed in the privacy of the consulting room and perhaps used as an opportunity to talk about different personal reactions to brain imaging, but which now put me under the spotlight. The answer I gave was true. I have never been that much involved with brain imaging for research and have never sought out opportunities to be scanned, in common with most people who do this sort of work. Again, honestly, this is for no particular reason, though scans are still relatively expensive and researchers have budgets to watch so are not inclined to do such things purely for fun. Maybe if Pat agrees to take part in some further brain imaging for us I'll take my turn in the scanner and give him a picture of my brain to hang on his wall.

AAJ: Pat is a very spiritual person. By contrast, you are a neuroscientist and thus are basically materialistic in your work in terms of linking behavior and mentation to causes or correlates in the brain. What, if any, is the place of spirituality in your understanding of the personality and life itself?

PB: Spirituality and materialism are not mutually exclusive. I consider myself a spiritual person too—the spiritual intangibles of love, awe, inspiration, beauty, mystery and elevation are as important to me as to anyone else. I'm a materialist—"naturalist" is better—in the sense that I just don't believe in the spooky stuff of supernaturalism.

AAJ: Now that you've made a film, and in addition to your many other accomplishments, what do you see as your career path from here on in?

I still teach and have some involvement in clinical work but my aim now is to devote more time to writing. There's plenty to keep me busy. I'm working on a second book entitled The Laws of Magic, which explores imagination, memory and identity, and I've just been commissioned to write a regular column for the London Times. I also have a new play opening in London later this year, On Emotion, co-written with the brilliant director Mick Gordon. In addition, one hopes there might arise opportunities to develop Pat's story in other ways. Who knows?

Photo Credits
Photos and Stills from Martino Unstrung courtesy of Ian Knox and Sixteen Films

Visit the movie website for Martino Unstrung here and watch the film trailer here.

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and...
Martino Unstrung: A Brain Mystery

from...

Pat Martino
Martino Unstrung: A Brain Mystery
Sixteen Films
2008

Martino Unstrung: A Brain Mystery is a running commentary about a man, his music, his friends and family, and his philosophy of life. The man is living legend and jazz guitarist, Pat Martino. The film could be thought of as an intimate journey with Martino on the road of life. However, its emphasis is on his brain aneurysm, surgery, memory loss, and the remarkable recovery of his guitar-playing ability. It is about a true paradox well known to his fans: a great jazz musician suffers total amnesia, and cannot even recall that he ever played the guitar. Yet he recovers his playing ability to the point where most critics and top guitar players consider him at least as good as, if not better than he was during his early years, when he was an acknowledged prodigy. Consider that the music is jazz, so there is no question of rote mechanics here. The music has to be in the blood; it must be understood intuitively and its meaning grasped. How can that be, when a large chunk of the brain, a part that is essential for memory, is removed in emergency surgery? This is the conundrum that propels this film.

Martino Unstrung: A Brain Mystery was initiated through conversations between two friends in England: film director Ian Knox and neuropsychologist Paul Broks. Knox, a jazz fan and sometime musician himself had always loved Martino's music. When he discussed Martino's recovery with Broks, the latter became fascinated with the details of Martino's aneurysm, surgery, and recovery. Lights went on, and they decided to make a film about Martino, with Broks playing himself as an intrepid researcher such as one might encounter on the Discovery Channel. Knox approached Martino about the film when the guitarist was doing one of his frequent gigs at Ronnie Scott's club in London. The magic of the motion picture industry and funding from the Wellcome Trust allowed this film to be made on two continents, with a film crew and a host of short interviews in various locales, within a year or two of its conception.

I am close friends with Martino, and therefore this film is personal to me, yet I believe it has universal significance and will appeal to a wide audience beyond the jazz community. I've had the honor and pleasure of knowing Martino as his friend and journalist ever since I heard him perform at the then iconic and now defunct Zanzibar Blue nightclub in 2003. I know the story of his aneurysm. I know firsthand his brilliance as both a musician and an intellect. At the same time, I know his struggle to recall the simplest details of his life, and the sense he has made of his memory deficit by focusing on the meaning of the here-and-now. I also know of his universal love as it has manifested for me and others. So, what I am going to write is not a detached, unbiased analysis of a film, but an interpretation of that film influenced by my personal experience of the film's protagonist. However, I do hope I can detach sufficiently that I can present a view of the film that will be of value to the reader.

First of all, let me give a brief summary of the plot, such as there can be one in a film which covers so much territory. Neuropsychologist Paul Broks comes with an associate to Martino's home in South Philadelphia to interview and evaluate Martino regarding his memory loss. (Martino plays himself, as do all the people in the film, and so the movie is therefore to be classified as a documentary, although it has the feel of a dramatic story.) While together, Martino, his wife Ayako, and Broks travel out and about to the local neighborhood as well as the New Jersey Shore, New York City, and Los Angeles. They elucidate the phenomenon that is Martino by speaking with his ex-wife, the fashion model Geri Taber; his agent, Joe Donofrio; his musical cohorts Delmar Brown, Red Holloway, Les Paul, John Patitucci, Corlos Santana, Eric Alexander, John Mulhearn, Pete Townshend and others; plus an old friend, actor Joe Pesci, as well as Blue Note recording executive, Bruce Lundvall, and an anonymous man on the street in Harlem who confirms for Pat the erstwhile location of Small's Paradise, the famous Harlem jazz club where he got his start.

“This is one of the most riveting documentaries I have ever seen. It holds ones attention from beginning to end, partly because it rapidly shifts scenes effortlessly but powerfully.”

We are also introduced to Martino's surgeon, Dr. Fred Simeone. We meet up with him, strangely enough, in a museum of fabulous antique cars that Simeone created in a warehouse in Philadelphia. This off-center way of introducing a distinguished physician reflects the intimate, personal dimension of the film and its somewhat irreverent, fanciful way of capturing all the angles of the story. The film is thus rich with personal lore, striking locales, and wide-angle shots of cities that give it a feeling of the shifting landscapes in which the biography takes place.

The music, some improvised and some composed by Milton Merikides, is rich with blues, rhythmic, and monastic chant connotations, with excerpts from Martino recordings and at rehearsals and performances. The film culminates with an updated MRI scan of Martino's brain, graphically showing the large empty space that represents the chunk that was removed many years ago. The film does not resolve the paradox it sets out to explore, other than for the suggestion that Martino's musical talent was left unharmed, partly thanks to the surgical skill of Dr. Simeone. Rather the story ends like an eagle rising from the canyon of a dark cavity in the left temporal lobe of Martino's brain, that was transformed by personal heroism, friendship, and divine intervention into the restoration of a self who finds love and joy in the present moment, free of his past, instead of constrained by the lack of memory.

What can be said of this film by the present jazz journalist, an avid movie-goer, but by no means a seasoned cinema critic? I have many encomiums and a few minor points of criticism. First of all, this is one of the most riveting documentaries I have ever seen. It holds ones attention from beginning to end, partly because it rapidly shifts scenes effortlessly but powerfully. One minute you are in Martino's home studio, soon to cut to a wide-angle view of Philadelphia, next in a car on the Garden State Parkway, next at an Atlantic City hotel, then in a garden overlooking Hollywood, and so on (Knox makes creative use of vivid and lively images to convey both shifting moods and a sense of pulsating neural networks).

You meet with Santana, Red Holloway, the great Les Paul, who took Martino as a young man under his wing, and others who knew Martino and/or were strongly influenced by him at various points in his life. Knox is adept at getting his subjects to relax in front of the camera. A poignant moment occurs when Martino, visiting Pesci, recalls a time when they reunited backstage at the Blue Note nightclub (no relation to the record label) in New York after the latter's recovery. Ironically, Martino could remember Pesci's films, but he had no recollection of their close friendship from the early days, until Pesci mentioned Martino's favorite drink, and the memory came back in a vivid flash. The entire film is characterized by a taut yet spontaneous atmosphere, true both to jazz music and to Martino's persona as a dude from South Philly. The feeling of the film beautifully mirrors Martino's personality and musical style, and as such represents a high level of aesthetic achievement: art and life as one.

The cinematography and audio are of the highest quality, and Merikides' concatentation of music is splendid. If the film has a shortcoming, it is probably that some of the scenes may be puzzling to the viewer. Why meet Dr. Simeone surrounded by antique automobiles? (It is a long time interest shared by his friend, Jay Leno.) Why is Martino's wife, Ayako, lying on her back strumming a guitar? (She has a back problem, Martino taught her to play and sometimes performs duets with her, and she uses the guitar as a form of therapy.) What are Pat and Ayako doing in a garden overlooking the Hollywood Hills? (They have come to visit Joe Pesci.) Why are there geometric diagrams behind Pat in Merikides' studio? (Pat uses them to illustrate his theory of guitar.)

The film could also benefit from more of Martino's own insights into his recovery. He shares only minimally about his creative play with music and his spiritual explorations (mention is made of Pat's brief retreat to a Cistercian monastery, but he has studied and practiced diverse spiritual traditions during much of his life), both of which played a major role in pulling him out of his depression and getting started again.

On the whole, however, Martino Unstrung is a spellbinding documentary about music, the brain, and recovery from a life-threatening medical crisis. It is one of the most intimate and probing films about a jazz musician ever made. It touches the heart and provokes the mind in a way few films do. And it is truly entertaining, due in large part to Knox's ability to combine disparate elements into a coherent, artful "slice of life" with its suspenseful medical aspects, shifting scenes, Martino's inimitable persona, and a rich cast of characters.

It also has a profound message of renewal for those recovering from a serious medical condition. Although I claim in this instance to be neither a neutral observer nor a seasoned film critic, I would, with all due humility, give the film five stars and a "don't miss" recommendation. It is a must see for jazz fans as well as those interested in psychology and neuroscience, and the general public will also find it fascinating and informative. Furthermore, anyone who has suffered a serious setback in life or who has had a severe medical condition will find in this film inspiration, hope, and, above all, "the unbearable lightness of being."

Film Credits: Ian Knox: writer, director, producer, editor, photography; Paul Broks; writer; Jonathan Morris: editor; Nyika Jancso: editor, photography; Rebecca O'Brien: executive producer; Pat Martino: music; Milton Merikides: music.

Photo Credits
Stills from Martino Unstrung, courtesy of Ian Knox and Sixteen Films

Visit the movie website for Martino Unstrung here and watch the film trailer here.

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I know the two on the end are a like.... but they are different enough. (barely)

I woud type for you... but I don't know if your out there.... HELLOOOOOOOOO!