The Brain Formally Known as Robert

September 25, 2014

Some of you may believe the old myth that we only use 10% of our brains. And while interactions with various customer service representatives (or incompetent lab partners), may lead you to believe in the veracity of such claims, this ‘fact’ remains conclusively false. But, despite much proof to the contrary, the myth has lived on. Why? Because the workings of the human brain are still so mysterious to neuroscientists and because of the astonishing results of the brain’s inherent neuroplasticity. The brain continues to surprise, both in how it operates while healthy, but also how it reacts to injury. As I draw closer to perfecting the process of revitalizing dead tissue and rehabilitating my subject, the brain remains a source of some concern for my partner and myself.

Almost all brain injuries leave victims with disabilities that, depending on the part of brain injured, can affect behavior, memory, cognition and bodily function. Because of lack of oxygen and injuries from Robert’s demise, it is impossible to know exactly how the subject’s brain will function.

Traumatic Brain Injury and Personality Change: Past and Present

The most famous case of unusual brain trauma is Phineas Gage, who survived a penetrating head injury in the 19th century. You probably learned about the remarkable case during high school. He’s the guy with the railroad pike through his head? It was not only his survival that drew attention to his case, but the reported changes in his personality after the frontal lobe injury. John Harlow, the physician who cared for Gage and documented his case, wrote the following of his personality after the accident:

 “A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage”.

"Phineas gage - 1868 skull diagram" by s:Author:John M. Harlow, M.D. - [1]. Licensed under Public domain via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Phineas_gage_-_1868_skull_diagram.jpg#mediaviewer/File:Phineas_gage_-_1868_skull_diagram.jpg

“Phineas gage – 1868 skull diagram” by: John M. Harlow, M.D. – [1]. Licensed under Public domain via Wikimedia Commons

Famously, Gage became a primary example to support the theory that personality is localized in the brain, and that brain damage can fundamentally change who a person is post-accident. However, as one digs further into the literature, there’s much debate about the extent of real change in Gage. The evidence and testimonies of his behavior are limited and unreliable. This question of “personality”, “self” and “consciousness” as it relates to the specific anatomy and physiology of the brain, remains largely unanswered.

It is a question that still catches the attention of tabloid magazines, with public figures like Playboy Playmate Kerri Parker who felt that her personality completely changed after surgery to remove a cancerous brain tumor earlier this year. Kerri kept a vlog leading up to her surgery. I haven’t had time to watch it yet, but you can do so here.

The Lobotomy Craze

The intentional application of brain surgery as a response to mental illness very popular in the 1930-60’s. So much so that Antonio Egas Moniz was awarded the Nobel Prize in 1949 for developing the prefrontal lobotomy, a procedure that separated the frontal lobe from the rest of the brain. These surgeries also exist as evidence of the kind of changes that occur after brain damage. Moniz claimed this procedure rendered patients with severe mental disabilities more docile, entering them into what would later be called ‘a surgically induced childhood’ by Walter Freeman. In a time where mental health facilities were packed to overflowing, Walter Freeman, an American neurologist taken with Moniz’s procedure, developed the lobotomy into an outpatient surgery and toured the country in his ‘lobotomobile’ extolling the greatness of the procedure and performing demonstrations. There were 40,000 patients in the US who lobotomized; Walter Freeman himself performed over 3,000 of these procedures (despite the fact that he had no formal surgical training). Fifteen percent of his patients died from the procedure, while many became worse. The most famous example was John F. Kennedy’s sister, Rosemary Kennedy, who underwent a lobotomy at 23 years old for mood swings and came out severely disabled: with the mental capacity of a two-year-old and an inability to walk or speak.

Walter Freeman and partner James Watss examine an X-ray before performing a psychosurgical operation

Walter Freeman and partner James Watss examine an X-ray before performing a psychosurgical operation

Today, lobotomies are often used as a key example of medical brutality. However, as with Phineas Gage, the topic is more complicated than not. There were some success stories, and Angelene Forester has been outspoken about the positive effects a lobotomy had on her mother. You can listen to her description of her mother’s behavior both before and after the surgery here.

The tide has turned on lobotomies. They went from being universally celebrated to being a key example of unethical treatment of the disabled. But, given this modern perspective we’ve accepted, how do we reconcile Angelene’s positive feedback? Must we just entirely disregard her experience? Or can we decide that, in her mother’s case, this grossly ‘unethical’ treatment was the right thing to do?

The same questions can be asked of my own work. I, like Angelene, feel that for this time and the technologies we have available to us, my work with Robert is worthwhile. Even if we don’t know who the person on the other side will be. We owe it to the memory of Robert to find out.

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Hi, I’m Victoria Frankenstein, almost-doctor and host of the web series “Frankenstein MD.” You can go ahead and start referring to me now as “Dr. Frankenstein,” just so you’re used to it when it actually happens. Which will be any day now.

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