Saturday, September 22, 2007

Use It or Lose It

Just as multiple systems are at work in our brains and bodies, we need to examine behavior, disorders, and human nature from a variety of perspectives--look at one aspect to the exclusion of all others and you get an incomplete picture. If we had read only LeDoux this week, I'd be left with the uncomfortable understanding that we are machines and little else; but when neurons don't communicate properly, or glutamate is overactive, or an injury occurs, it is not a machine that is affected, but a person. (Such is also the reason, I think, that Hirstein is approaching confabulation from the angles of neuroscience and philosophy, as well as others: limit the ways of looking at something and you limit what you learn.)

The four people we read about this week all suffered losses, either of memory or vision (or both), and psychological loss (either because of their memory and vision problems, or, in the case of Franco the artist, psychological loss was the root of his suffering). Zasetsky's loss was the most tragic, because even if, as Sacks claims in his foreword to The Man with a Shattered World, "A life, a human life, is not a life until it is examined; that it is not a life until it is truly remembered and appropriated; and that such a remembrance is not something passive, but active, the active and creative construction of one's life, the finding and telling of the true story of one's life," Zasetsky's journal was never a creative construction, but a repetitious infinity nightmare. It is almost impossible to comprehend his problems with memory and sight; and while I understand that automatic writing comes from a different part of the brain, not the same area he injured, it's difficult to understand how he could write at all, given the problems he described. I also wondered why no part of his brain could begin to make up for some of the deficits; the damage was just too great?

Virgil's experience was also tragic, but the irony of his case is that it may have been less tragic if he had never regained his sight to begin with. Problems with his new vision were similar to many of Zasetsky's problems: understanding space and distance, reading, ideas slipping from his mind. And like Zasetsky could write if he didn't think too hard about the task, Virgil could use his fork and knife when he first sat down to eat, but as time went on, it became too difficult. He had to learn to see just as a sighted person does from birth, and it's no wonder that faces were just blurs of color; though the concepts seem related, recognition is not about sight.

The two artists, Mr. I and Franco, were luckier. One of the most interesting aspects of Mr. I's story was that his injury (or stroke) didn't cause him to forget the entire concept of color, but in time that happened. And while Franco was tortured by his obsession and his memory was his gift, he had things in common with the amnesiacs we've read about, like his ability to remember things long past, and his dismay at seeing his sister's face reflecting her true age.

Hirstein mentions "nature's general use-it-or-lose-it strategy," which seems to be relevant to all of this week's case studies. Zasetsky didn't have much choice in what he could use and what he lost, but imagine if he didn't work so hard to retrieve the knowledge that he could; what shape would he have been left in then? Virgil hadn't seen since he was a little boy and lost his ability to understand what he saw. His brain had compensated for his sightlessness and perhaps he could never retrain the necessary parts to go back to their original purpose. Mr. I first lost his ability to see color and then, in time, lost even his memory of color. And Franco feared that a return to his hometown would put a stop to his visual memories. It didn't, but it did change the way he envisioned it. (I wonder what would have become of Franco if he never started painting: Would the visions have ceased? Would he have retreated into himself, a prisoner of his obsession? Would he have "lost it"?)

Hirstein also mentions materialists and eliminative materialism. These thinkers believe that "all of the amazing qualities of our mental lives are actually physical properties" and "in the future we will not speak of beliefs or desires, but rather will adopt entirely new ways of speaking about the mind based on the findings of neuroscience." It's intriguing, but I don't think the messy human aspects of mental life is something we can afford to lose.


What I found the readings of this week to emphasize is the hierarchical and the complex entanglement of the brain’s systems. We learn that the brain is organized by specific sections, which themselves sectioned down to the smallest degree of specialization. There are the large divisions of the forebrain, midbrain, hindbrain, left hemisphere and right hemisphere. And then there are the more characterize sections of those general areas like the occipital lobe, pariental lobe, and vestibular lobe. Even lobes are composed of even smaller systems of synapses and particular neurotransmitters, which communicate very specific processes. Despite the divisions in the brain that Le Doux and Hirstein explain, the authors as well as the case of Zasetsky demonstrate the interconnected nature of the brain. The various circuits of the brain have a huge communication network that makes it possible for humans to understand the infinite intricacy of the world. Zasetsky makes it clear just how important having these specialized processing systems is and how essential it is for those systems to have lines of communication. The specific circuits act as a way to process and comprehend a multitude of object, images, language, ideas, problems, etc. in the world. By assigning an anatomical and biological hierarchy to specific systems basic human survival is protected. It ensures that if a human were to suffer from brain damage their more superfluous brain functions would be sacrificed before the systems that make it possible to live.

Such is the case for poor Zasetsky who can still eat, sleep, have a heart beat and such but can no longer understand the world. In some ways, as Zasetsky also conveys, it is almost worst to be living and breathing in the world but not a contributing member, only a body of a person, than to be dead. It is a dilemma that arises when talking about neurological disorders. What toll does the illness or disability take on the person? Is it possible to be physiologically and emotionally resilient? What changes in a person’s spirit because of a mental illness? Is it really worth living if you are a “shadow of a person” as Zasetsky?

I believe it is at this point where philosophy and science do not meet, like Hierstien illustrates how they interact. He conveys that the two disciplines influence each other and that in fact neuroscience originated from philosophy. Heirstien also notes that many other disciplines like the arts and humanities come into play when thinking about mental disorders. The readings to an extent approach and exemplify this by including narratives, scientific reasoning, and more philosophical debates. They also act as a metaphor for the interconnectedness of the brain in this way. We see that must draw upon varying fields, like drawing upon varying circuits in the brain, in our attempt to answer the questions that rise out of neurological disorders.

Friday, September 21, 2007

Romantic Science and the Machinery of Mind

The readings this week form a diverse assemblage of case studies (Sacks) neuroscience minutia and brain composition and chemistry (Hirstein, LeDoux) and a wrenching first-person account of brain damage accompanied with interwoven scholarly commentary (Luria). They present an interesting counterpoint of the technical and the personal, balancing science vs. the human experience, and the overarching theme that emerges from them is one of terrible loss and the struggle to regain, or adapt, the missing skills and memories. I am thinking of Jonathan I. in Anthropologist on Mars and Zasetsky as related through his journal entries in The Man With a Shattered World in particular.

Let's begin with the "scientific," rather than the romantic. Chapter 3 of LeDoux offers a highly mechanistic account of brain workings, the dendrites and the axons, and seems to reduce all function of the mind -- every thought, memory, hope, dream, desire, fear, and regret -- to the workings of component neurons, a vast and synchronized machine that somehow manages to elicit this end result, the complicated system of a human being. Is it possible that we as humans are nothing more than an immensely complex organic computer? Luria calls his field of study a "romantic science," but in LeDoux, we see only the bare logistics of it, as simple and straightforward as high-school biology class. Is this the way to define a person? We tend to romanticize our aspects of self; we imagine that something more mysterious and inexplicable is at work, even going so far as to call it a soul, an ethereal, iridescent substance apart from the factory housing of the brain, and in this sense, it is indeed a romantic idea. Can our secret crush, our deepest ambition, our childhood memories, really be only the result of a synapse spanning a neuron, firing up our internal processors? Are we walking IBM terminals? Are people so reducible to component parts? If we all have the same internal circuitry, why are we still such a mystery to ourselves?

The second half of the readings explore what happen when all this delicate wiring goes awry. In The Man With a Shattered World, we are introduced to L. Zasetsky, who was wounded in the head in the battle of Smolensk during WWII, and the consequences were catastrophic. He lost his memory, his perception of self, and his ability to read, speak, and organize his thoughts coherently -- he lost the grounding framework of language that we learn as children and never give much thought to. In this era of text-message, IM, email, we employ words more than ever; we have learned our language as a child without conscious effort, hearing it used around us. Now imagine being an adult, seeing letters as nonsense symbols, unable to speak -- locked in the damaged housing of your own head, unsure where the right side of your body is, where you are, who you are, and if you are anything else than a fatally defected version of the vast human computer; that bum laptop you had to return to Circuit City the other day since it wouldn't boot up or kept running out of battery. The idea, for most of us, is unfathomable. We take our perceptions and orientations for granted; we never really give active thought to the space we are occupying, the reflections we are having even subconsciously, where our body is, the letters we're scanning -- maybe not even reading, but we register the meaning anyway. To be so drastically dispossessed is something we can't even imagine. You are skewed, broken, an abstract painting, a fractured window. Death may even seem preferable to living so halfway.

Zasetsky, through persistent and agonizing effort, learned to recall the language which he knew before -- Russian -- and to write again, his only way of thinking, since any other thoughts would flee from his shattered mind. To be able to chronicle such disjunction, and to be unable to remember it or even to read what you have written is a sobering and profoundly moving thought. He suffered from a profound amnesia and language aphasia, and his journal is the record of these thoughts, which he cannot express to others with spoken words or even to himself. And yet, how far removed from the world is he, really? The end of Shattered World is almost unbearably sad. This man, who has had a full life and a brilliant mind utterly removed from him by the fragment of a bullet, writes, "Were it not for war, the world would have become a great place to live long ago [....] soon there will be flights to outer space -- first to the moon and then other planets. This will give us an even greater chance to enrich life with rare elements and substances that may be more plentiful on planets other than the earth. We could do this, were it not for war...."

Perhaps his amnesia is too dense for him to recall the precise form he gave these words, but it is doubtful that the sentiment ever leaves him. And he is only one of many, illustrating the brutal cost of humans destroying each other, leaving minds and lives in disarray. Zasetsky will never recover from his injuries; the trauma is permanent, leaving him encased in a cracked and splintered glass shell of a mind, struggling to express in transient words what has been taken from him forever in speech.

In Oliver Sacks' second book of case studies, An Anthropologist on Mars, we meet another extremely gifted individual who has suffered a cataclysmic loss, in The Case of the Colorblind Painter. Jonathan I. is a talented artist whose car accident has left him bereft of color and in a world that is completely black-and-white, like an old television set. Even his dreams and memories are empty of it. Like Zasetsky, he deeply mourns this loss -- he is unable to paint as he is used to, can only compose canvases in varying shades of gray -- but unlike him, Jonathan I. eventually reconciles himself to his new situation, even gaining a new appreciation for the complexities and textures of a world that lacks all color. Even when there is a chance to cure him of his achromatopia, Mr. I. refuses, having settled into a new perception that no longer requires color -- he finds the idea as alien and jarring as he first found the lack of it. What began as a disability has become a gift.

And what if it should work in the reverse -- if an inherent neurological handicap should be conceived and accepted as part of the self, to the point where its "cure" becomes the burden? The other reading in Sacks, To See or Not to See, investigates Virgil, who has been almost totally blind since the age of three and finally, at the age of forty, is given the chance to see again by utilizing cataract removal surgery. The blind man given sight is an archetypal parable, but for Virgil, it is not -- since he has been without sight for so long, he has no idea of how to formulate his world with it. He can get by with touch, shaping the contours of his world with his hands, but cannot connect it to the faulty images provided by his suddenly re-functioning optic nerves. What would be a gift to most people has become an inconvenience to him -- his brain does not process by means of sight, as he has developed so many mechanisms for functioning in its absence. We all find the idea of blindness to be naturally horrifying -- unable to watch sports, TV shows, movies, read books, see the faces of friends and family, to navigate alone, to be truly independent, to drive to the store at night to pick up milk, a movie -- to be caught in a world of blackness and shaping the world with only hands and ears. And yet, Virgil, who has been blind so long, receives a second blindness brought on by illness as a sort of benevolent gift. He is safe now, back in his comfortable sphere -- perversely, where we would be if we were temporarily blind and then regained our sight. Free of the burdensome need to connect his finger-pictures with his eye-pictures, he can at last find his way with assurance. Is this the blind man who can see better than those of us with eyes in perfect working order?

Sacks' second case studies are quite different in this book than The Man Who Mistook His Wife for a Hat. They are longer, far more in depth, cite the positions of other scientific researchers on the topic, and explain the symptoms and the lobes of the brain that are affected. Where Hat was a string of amusing, touching, and thought-provoking vignettes strung together, Mars feels more like a clinical chronicle of the affected patients and their symptoms. One thing Sacks does not lose sight of, however, is his subjects' deep and essential humanity. Reading the cognitive neuroscientific diagrams of LeDoux and Hirstein, it is easy to forget that beneath that "organic computer," there is in fact a human being with desires, hopes, fears, and dreams just like any of us, powered by the same enigmatic ether, whatever defects may have occurred in the processing. A disorder does not make us the same as that faulty laptop; we feel, we know, we are conscious and we understand pain, whether ours or theirs. And that may be, in fact, the most romantic science of all.

Monday, September 17, 2007

Thoughts on the Individual and Equillibrium

"In disorders of excess there may be a sort of collusion, in which the self is more and more alligned and identified with its sickness, so that finally it seems to lose all independent existence, and be nothing but a product of sickness." (91 Sacks)

"My notion of personality is pretty simple: it's that your "self", the essence of who you are, reflects patterns of interconnectivity between neurons in your brain." (2 Synaptic Self)

After being diagnosed a year ago with ADHD, and especially after experimenting with stimulant drugs as treatment, I have often wondered where the line can be drawn between me and my "deficit". Like Witty Ticky Ray, I became used to defining myself by my condition, with its pros and cons, as someone that deftly connects trains of thoughts to the extent that an inner world is created. Like Ray, I often wonder which is the real me, the Adderall me or the ADHD me, feeling "forced into levity" and "forced into gravity" and truly forced into every state of being I find myself in, unable to find a true balance.

I agree with Sacks that DSM-IV hasnt got the whole picture in its computeristic classification of neurological conditions. By its determination, there are people with "normal" brains and people with "abnormal" brains, implying that the abnormal brains could, in theory, be "fixed", and that they are incapable of fixing themselves. Sacks disagrees with this inflexible categorization, and yet he continues to try and force the idea of a "soul" onto an individual, believing that once enough damage is done to certain parts of the brain this "soul" is lost. He suggests this with characters who he is unable to relate to, such as in "A Matter of Identity", and only retracts this idea once he can find some deeper level to connect with them on. And yet... isnt the superficiality shown by the man in that story a very human defense mechanism? I certainly know many individuals who act like he did on a normal basis. As we have seen, people with neurological disorders often find other senses, or defenses, heightened as the brain struggles to find an equillibrium. And the Brain Science chapter on confabulation suggests that even normal people have similar overcompensational responses, because the main function of the brain is not only to process information but to link this information together in a way that is coherent.

Therefore, havent all the patients we have read about had brains that, in fact, are still functioning with the primary goal that they are meant to? Although the certain information processers are broken, the brain struggles to compensate for them in order to preserve a centralized "identity" and coherent understanding of the world. Isnt this what makes us human?

Clearly, there is this internal struggle within ALL individuals, as is shown through our art and literature, yet in those with neurological disorders it is more difficult and pronounced. This is why I was offended by Sack's initial instincts to dehumanize, or de"Humean"ize, his patients. (Although, of course, the point of these stories is to help the reader connect with the individual.) More and more these readings are convincing me that there is no "normal" brain that has a clear understanding of the word and a clear identity. The struggle to create and preserve identity through the connection of information is inherently human because of the way our brains work, and it is the connection that we can claim to all of Sack's patients.


Sunday, September 16, 2007

Everyday Confabulation

When I started taking abnormal psychology and studying all of these different diseases, I was convinced that I suffered from every single one. It wasn't until my professor explained that everyone expresses certain symptions or tendenacies but that those suffereing from mental illness exhibit them on a scale much higher than the "average person." So, apparently, the only thing I really was suffering from was hypochondria or maybe I'm allergic to suggestion. It was quite interesting to me today to find that that these small white lies I've told my whole life (yes, I did my homework; I totally called you yesterday; I lost track of time) actually stem from somewhere: confabulation.

Now, me, I'm an actor so I have always leaned towards embellishment, even with the smallest story. My goal has always been to make people to have good time, to simply entertain. Of this (Which I hate to admit) I've always been aware but I hadn't realized that I did it to myself. All of these internalizations and rationalizations. "This happened because of this; he didn't mean to be so rude it's because he's having a bad day; you didn't get the part but it's not because you're a good actor." To me a day without rationalizations can be quite depressing! We tell ourselves these stories to keep going. Well, we tend to confuse ourselves and our narrative with these confabulations.

I know that sometimes I've told a story to people and I've had to work it into my narrative because that's part of how they percieve me, or they ask me to tell it again or they have told others. Now clearly I know that these things MOSTLY aren't true. This may be philosophical but is this confabulation or truth because that's where it's been based or simply wrong. Consider this in both ways, involving me and those the story gets to. For me there may be doubt (Which is the main point that kills confabulation) but what about the people who hear the story? They have no doubt because they have no reason to, so for them what would it be?

Consider this excerpt from the essay when looking at my next few questions, " Our fundamental tactic of self-protection, self-control, and self-definition is not spinning webs, but telling stories, and more particularly concocting and controlling the story we tell others-- and others-- about who we are" (5).

Okay, I'll be the first to admit it. I lie sometimes, I fib and I completely embellish. My question is why? Are we trying to assert some kind of control over an otherwise unpredictable and uncontroable world? Improve ourselves around others? Edit history to our liking? Don a facade that really isn't like our own?

Enjoy the weekend,