The Tale of the Dueling Neurosurgeons

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The Tale of the Dueling Neurosurgeons Page 38

by Sam Kean


  Pictures drawn by someone with severe visual agnosia in the brain. (1) A tree. (2) A man. (3) A boat. Notice that the man’s eyes appear outside his head.

  64. animals show subtle hemispheric differences: In contrast to most animals, nature herself is not oblivious to left-right differences, especially not on small scales. Some subatomic particles come in left- and right-handed varieties, and one of the fundamental forces of nature (the weak nuclear force) interacts with each version differently. Even more important, all known life on earth uses DNA that forms a right-handed spiral. (Point your right thumb toward the ceiling; DNA twists upward along the counterclockwise curl of your fingers.) Left-handed DNA would actually kill our cells, and yet biology textbooks can go through multiple editions showing “backward” DNA, without anyone noticing. Not that I should talk: the cover of my second book, The Violinist’s Thumb, shows a backward DNA strand, which I didn’t notice until an eagle-eyed reader pointed it out.

  65. Perhaps those aren’t just metaphors: Speaking of metaphors, there’s strong evidence that whenever we hear or read an action verb (run, hit, bounce)—or even when we use certain metaphors (he swallowed his pride, she juggled two careers, it stretched our understanding)—our motor centers start humming in response. Not enough to move the body, but something’s afoot. Apparently this stimulated physical activity helps our minds, well, grasp the concept. In this and other ways, much of language is literally embodied. For more on this subject, see the book Louder Than Words, by Benjamin Bergen.

  Chapter Twelve: The Man, the Myth, the Legend

  66. a process in a population: If you’re having trouble wrapping your head around the idea of consciousness not being a thing in a place but a process in a population, consider this wonderful analogy from V. S. Ramachandran. In his book Phantoms in the Brain, he considers an episode of Baywatch and then asks where exactly the episode is located. On the beach where the actors were filmed? In the camera that recorded the drama? In the cables pumping bits into your television? In the television itself? (And if so, where in the television—its electronic bowels, the LCD screen?) Perhaps the show is located in the storm of photons arriving at your eyes? Perhaps in your brain itself?

  After a few seconds it becomes clear that the question doesn’t make sense. Or rather, it misses the point. The real question isn’t where the episode is located but how the various pieces of technology transmit a moving picture across time and space and into your brain. Similarly, Ramachandran suspects that as we learn more about how the brain produces consciousness, we’ll care less and less about specific locations.

  67. remaining cognizant: The delightfully gruesome paper “Transcranial Brain Injuries Caused by Metal Rods or Pipes Over the Past 150 Years” covers a dozen cases of people whose skulls were impaled by metal objects, and in five of the twelve, the victims didn’t black out for even a moment. Two memorable cases include a drunken bow-and-arrow game called “William Tell” and an assembly-line accident in which a twenty-six-foot metal shaft plowed most of the way through a man’s skull before getting stuck. Because he never passed out, the man could feel it sliding through his head inch by inch.

  More anecdotally, during a domestic dispute in Mississippi in 2009, a woman got shot in the forehead with a .38. The bullet passed clean through her brain, front to back. And not only did she remain conscious, she remembered her manners: when a police officer knocked on her front door minutes later, he found her making tea, oblivious to her injury, and she insisted he take some.

  68. to be torn out again: Clive Wearing will never recover, sadly. That said, his amnesia was most acute during the first decade after his illness, and there’s some evidence that his symptoms have abated since about the year 2000—probably due to plastic changes in his brain that allowed him to recover some function. Neuroscientists have not yet documented this improvement with proper studies, so we have to be cautious. But Wearing’s wife, Deborah, who spends more time with him than anyone else, insists that Wearing has gotten better.

  For instance, Clive’s memory has improved to the point that he can have meaningful, if brief, conversations with Deborah, rather than just repeat the same things over and over. And while he still “pops awake” repeatedly, he’s gotten used to the epiphany now after millions of times, and no longer records it so zealously. He can even follow certain films a little (e.g., James Bond movies), and can be out in public without wandering off. Deborah discusses these and other improvements toward the end of her heartbreaking memoir Forever Today.

  69. will never abandon him: There’s one seeming exception to the rule that not even amnesiacs lose their sense of self. People who suffer from so-called memory fugues do seem to forget their personal identities: they’re more like amnesiacs on television shows, who wake up not knowing anything about their past lives. But even fugue victims retain something from their past: they might be able to log on to an e-mail account, for example, because of muscle memory. And fugue victims usually do assume a new identity, since the brain apparently cannot function without a sense of self.

  I’ve written up a bonus story about the most famous fugue victim in history, an American farmer named Ansel Bourne. You can read it online at http://samkean.com/dueling-notes.

  70. some modern historians: The historian who deserves the most credit for revising our view of Gage—and for demonstrating that Gage might well have recovered some skills and functions later in life—is Malcolm Macmillan, author of the delightful book An Odd Kind of Fame. Everyone who cites Gage’s case should read Macmillan first—he deserves a ton of props for taking on a popular but inaccurate legend. Macmillan also suggests that Gage’s story is worth remembering because “it illustrates how easily a small stock of facts can be transformed into popular and scientific myth.” Wise words.

  As long as we’re talking about inaccuracies, I should note that, obviously, I’ve had to simplify the Gage story and leave out some details. For instance, another doctor besides John Harlow did examine Gage a year after the accident—one Henry Bigelow, who provided important additional facts. I focused on Harlow’s account instead of Bigelow’s mainly because Harlow alone discusses Gage’s mental functions. See An Odd Kind of Fame for the full story.

  That said, I can’t resist including some biographical details about Bigelow, who had, shall we say, a colorful youth. As one historian noted, Bigelow is remembered today as a “heavily bewhiskered surgical giant” who entered Harvard Medical School at age fifteen. But while attending Harvard, Bigelow spent most of his time “making loud noises, joining drinking clubs… and manufacturing nitrous oxide for the customary annual binges of the chemistry class.” Bigelow was finally expelled from Harvard for conducting “pistol practice in his dormitory room,” a stunt that also got him “banned from the town of Cambridge for the remainder of the year. But despite his rustication he managed to graduate on schedule.”

  * This and all upcoming asterisks refer to the Notes and Miscellanea section, which can be found in the Table of Contents.

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  Contents

  Cover

  Title Page

  Welcome

  Epigraph

  Part I:

  Gross Anatomy Introduction

  Chapter One: The Dueling Neurosurgeons

  Part II:

  Cells, Senses, Circuits Chapter Two: The Assassin’s Soup

  Chapter Three: Wiring and Rewiring

  Chapter Four: Facing Brain Damage

  Part III:

  Body and Brain Chapter Five: The Brain’s Motor

  Chapter Six: The Laughing Disease

  Chapter Seven: Sex and Punishment

  Part IV:

&
nbsp; Beliefs and Delusions Chapter Eight: The Sacred Disease

  Chapter Nine: “Sleights of Mind”

  Part V:

  Consciousness Chapter Ten: Honest Lying

  Chapter Eleven: Left, Right, and Center

  Chapter Twelve: The Man, the Myth, the Legend

  Acknowledgments

  About the Author

  Also by Sam Kean

  Works Cited

  Notes and Miscellanea

  Newsletters

  Copyright

  Copyright

  Copyright © 2014 by Sam Kean

  Illustrations by Andrew J. Brozyna, ajbdesign.com

  Author photograph by Voss Studio, Austinville, Iowa

  Cover design by Will Staehle

  Cover copyright © 2014 Hachette Book Group, Inc.

  All rights reserved. In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher constitute unlawful piracy and theft of the author’s intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at [email protected]. Thank you for your support of the author’s rights.

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  First ebook edition: May 2014

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  ISBN 978-0-316-24225-7

  E3

 

 

 


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