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The Tale of the Duelling Neurosurgeons:
The History of the Human Brain as Revealed by True Stories of Trauma, Madness and Recovery
When a hand is amputated, a big part of the brain map goes blank. But the blank area is rapidly colonised by neighbouring neurons, in this case, the face, which is 'next' to the hand on the map. This happens very quickly, often within days, and over neurological distances of up to an inch. Happens so fast that it is very unlikely that new neurons have sprouted. Instead it is probably exploiting existing circuits that were not being used while the hand was continuously sending data, but which restarted when the hand went silent.
But the old hand circuits are still there, and still expecting data. So that part of the brain still registers the phantom limb, and as well, misinterprets some of the signals coming in - stroking the face might be interpreted as stroking the hand as well.
People often experience pain in their phantom limb. What seems to be happening is that the brain sends signals to the absent limb 'squeeze the hand' but doesn't get a response, so shouts louder 'squeeze the hand hard' then 'squeeze the hand harder'. The body knows that working muscles really hard causes pain, and it is upset at the failure to activate, so the hand-clench circuits and the pain-register circuits get wired together, so whenever the brain tries to rouse the amputated limb, the pain sensors fire as well.
Late C19 American doctor Silas Weir Mitchell pioneered many treatments for mental illnesses. He was particularly harsh on female hysterics. He got one woman out of bed by threatening to climb in with her. She resisted until he got his trousers off. In another case he dealt with a woman faking a mortal illness by setting her sheets on fire.
Pituatary gland problems cause both dwarfs and giants. If a child gets a tumour in the gland, all the extra cells pump out too much growth hormone, and the child becomes a giant. But if the gland is crushed by a cyst, the hormone is greatly reduced, and the child becomes a dwarf.
Lesions in the temporal lobe can have a huge effect on sexual desires. Can flip from gay to straight, and v.v. Someone with a suppressed sex drive can, after surgery, suddenly develop an insatiable sexual appetite. One patient suddenly began begging for sex from any passerby, and, if they weren't ready to go, would start masturbating, no matter where she was. Hospitalized after a seizure, she escaped from her bed within half an hour, and was found under the sheets of an elderly man who had just had a heart attack, fellating him. As a doctor said "One person's syndrome is another's lucky day."
We have a picture of our rational mind and our emotional mind, and the concept that one is the master of the other. But studies of patients whose emotions have been taken right out suggests that the emotive part 'tags' choices we make as good or bad based on what we've experienced in the past. Without that, our decision making is paralysed.
We all seem to have mental circuits that predispose us to spiritual feelings. But temporal lobe seizures seem to hypercharge these circuits, leaving the victims intensely religious. Even when they don't get super-religious, their personality changes in predictable ways - they completely lose their sense of humour, they become become preoccupied with morality, and are unable to have a conversation without degenerating into a lecture.
The geography of everybody's brain map is different, and it changes over time.
Thinkers have always compared the brain to the tech marvels of their times. Roman doctors likened it to aqueduct system, Descartes saw a cathedral organ, in the Ind Revn they saw looms or clocks, in the early C20 it was like a telephone switchboard.
Study of face-blind people showed that although they could not name anyone in sets of photos shown to them, their galvanic skin response showed that they 'knew' their friends and relatives. Implies that our brain has two distinct circuits for identifying people. One circuit names the person, the other fires off an emotional response. In Capgras Syndrome people the emotional circuit is disabled or disconnected, the person doesn't get the expected 'glow' from seeing them, and so concludes that the other person is actually a robot or an alien replica of the real person (because that is a far more satisfying explanation than thinking there was something wrong with your brain).
Stroke victims often lose speech skills. People fluent in two languages may lose one completely, since they draw on different circuits, depending on whether they are native or acquired later. Commonly, people who struggle to string together a sentence can sing easily. Victims can be retaught speech by singing pop songs they recall.
Reading is a very recently acquired human skill (last 5000 years) which means existing circuits have been co-opted. If brain damage in Wernicke's area, the eyes recognize the shapes of letters just as before, but the data doesn't get processed and so is unrecognized. Farcically, they can still easily write a sentence "I like beer", but then are unable to read what they wrote.
Siamese twins born British Columbia 2006. Can't be separated bc brains linked. Skulls fused and a stretch of axons connects the two brains. prick one for a blood test and the other winces. One twin likes catsup; the other hates it and tries to scrape it off her tongue when the other eats it. They also fight like two separate people - one girl will slap the other, and then grab her own face in pain.
Pro athletes at end of their sports career. After being told what to do every day of their lives for years, they suddenly lose all structure. After being feted and pampered, they are suddenly alone. Millionaires at twenty, now they are broke, and jobless. No wonder they have problems with depression.
Surgeons removed the adrenal glands of a white South African housewife to stop cortisol over-production. Cured that, but the adrenal glands hold the pituitary in check, and that started churning out the hormone which produces melanin. her skin turned bronze, then light brown. Anywhere else in the world this wouldn't have mattered much, except in apartheid South Africa. She got tossed out of whites-only facilities, her husband and son deserted her, and she was even banned from her father's funeral.
Yawns: some people paralysed by a stroke can stretch out their arms if induced to yawn, because the reflex is controlled by the brainstem, not by the motor cortex, and accesses the muscles via different channels. Only chimps and humans can 'catch' yawns, and babies don't pick it up until they are about 4 or 5, implying that the brain has to develop a certain level of social intelligence. Autistics often never develop it. We get infected by loved ones more strongly than friends, and them more than strangers.
The first crude polygraph machine was invented by a then-Harvard undergrad named William Marston. he later went on to invent Wonder Woman.
Extra notes by the author
THE HUMAN brain is the most opaque and unknowable of organs. For centuries, the only way for surgeons to work out what went on in its deepest recesses was to study how freakish accidents, traumas and other misfortunes affected people's behaviour. Taking us from the 16th century to the present day, Sam Kean's grimly entertaining book charts some of the most curious and quirky of these cases.
Kean starts his survey in 1559 with the story of the French king, Henri II, who was struck by a lance in his right eye during a jousting tournament (hence the book’s title). His personal physicians thought he would survive the injury because there was no fracture to the skull, but the two surgeons ordered to attend him, Andreas Vesalius and Ambroise Pare, both of whom had honed their skills on the battlefield, knew that head injuries can be fatal even if there is no damage to the skull. Henri’s queen, Catherine de' Medici, helpfully ordered the beheading of several criminals so the surgeons could mimic the king’s injury, but to no avail. The king died 10 days after the accident, and when the autopsy was performed the extent of the brain damage was revealed. In a world that still thought in terms of humours, it was the beginning of an understanding that the brain is a delicate and essential organ.
Kean's book canters through the history of how we have come to our modern understanding of the brain, using both case histories and the biographies of individual doctors. Some of his stories are astonishing. Take the tale of the explorer James Holman, who in the 1820s wrote a bestselling book about his journeys to Siberia, Tasmania, Jerusalem and South Africa. Nowhere seemed beyond his reach, but what made this lone traveller so famous was that he was completely blind. Holman had lost his sight at 25, but was able to travel unaided because he had developed his own personal radar system, using his cane for sound. Clicking the walking stick on the ground in front of him, he could triangulate his position from the minute differences in the noises that came back to him.
Holman’s advanced use of echo-location is cited by Kean as an example of the brain's ability to rewire itself. Today, brain scans of blind people often show clear signs of activity in the visual cortex, as if these individuals are 'seeing' through their ears - or, more accurately, as if the brain is doing the seeing with the tools it has available. Some blind people can 'read' the emotions on people's faces and even catch yawns - all because the brain is responding to signals from the limbic brain, which, operating alongside the conscious mind, deals with such things as emotion, behaviour and motivation.
Bestselling books such as Daniel Kahneman's Thinking, Fast and Slow have taught us to be wary of letting our limbic system take over when making decisions, but Kean’s book is full of examples of what happens when there is damage to it. People with Kluver-Bucy syndrome (damage to the limbic circuits), for instance, exhibit all kinds of distressing behaviour, from individuals who are unable to feel pain to the carpenter who was sexually titillated by safety pins. Kean cites the case of 'Elliot', a man who had brain surgery in the 1970s to remove a tumour that was crushing his frontal lobes. After the operation, he lost the ability to make decisions: he couldn't even decide between eggs or cereal for breakfast. Elliot lost his job, his savings and his marriage, and although his IQ was unchanged and he could discuss abstract situations quite lucidly, when it came to his own life he was completely unable to discriminate.
This finding poses some difficult questions about our responsibility for our actions. Take the schoolteacher who suddenly started downloading child pornography and made advances to his eight-year-old stepdaughter - he was about to be sent to prison when he was diagnosed with a brain tumour. After the tumour was removed the paedophilia stopped, and when it eventually reappeared the doctors found that the tumour had grown back. Not all paedophiles have brain tumours, of course, but this kind of insight does pose real questions for the criminal justice system: should people go to prison, for instance, for something they really can’t help?
The neurosurgeons in this book are often deeply flawed men (and they are all men), quite willing actually to get into people's heads to prove their own theories. One of the greatest of them, the mid-20th-century Canadian-American surgeon Wilder Penfield, said that “brain surgery is a terrible profession. If I did not feel it will become very different in my lifetime, I would hate it.” Things have come a long way, though, from the days of Walter Freeman, nicknamed 'the lobotomist', who travelled across America in the 1950s, performing operations on children as young as four with a rubber mallet and an ice pick.
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