June 21, 2009

Phantoms in the brain by V.S. Ramachandran & Sandra Blakeslee

Phantoms in the brain by V.S. Ramachandran & Sandra Blakeslee
(Probing the mysteries of the human mind).

Inside to inner working of human brain and the book shares many weird/interesting incidents caused by accidents which affected brain. Author brings out the relationship of our brain with cosmos and saying, both are integral part. The Self.

I did view some of his videos and decided to read this famous book.
(TED.com is one of favorite site)

Let me start with the most amazing story mentioned in the middle of the book.

Story of the Indian mathematical genius Ramanujan who at the turn of the century worked as a clerk in the Madras seaport. He had matriculated (8th standard) to the early part of high school, where he performed badly in all his subjects and he had no formal education in advanced mathematics. Yet he was astonishingly gifted in math and was obsessed by it. So poor that he could not afford paper, he would use discarded envelopes to scribble his mathematical equation, discovering several new theorems before the age of 22.

Since he was not acquainted with any number theorists in India, he decided to communicate his discoveries to several mathematicians in other parts of the world, including Cambridge, England. Both scholars of that time in Cambridge, G.H. Hardy & J.E. Littlewood who also went over the manuscripts sent by Ramanujan. Both luminaries quickly realized that Ramanujan was probably a genius of the higher caliber. They invited him to Cambridge where he worked for many years eventually surpassing them in the originality and importance of his contribution.

What is the reason for his unbelievable mathematical skill? Ramanujan’s own “explanation” – that the fully formed equations where whispered to him in dreams by the presiding village deity, Goddess Managiri- doesn’t really help us very much.

For in and out, above, about and below
‘Tis nothing but a Magic Shadow-show
Play’d in a Box whose Candle is the Sun
Round which we Phantom Figures come and go
- The Rubayat of Omar Khayyam.

The question the author gets same question in most of the time is “ When are you brain scientists ever going to come up with unified theory for how the mind works? My answer is that we are not yet at the stage where we can formulate grand unified theories of mind and brain.

Another true story – More than 50 years ago a middle aged woman walked into the clinic of Kurt Goldstein’s clinic. The woman appeared normal and conversed fluently. But she had one extraordinary complaint- every now and then her left hand would fly up to her throat and try to strangle her. She often had to use her right hand to wrestle the left hand under control, pushing it down to her side. Sometimes she had to sit on the murderous hand, so intent was it on trying to end her life.

The analysis turned out to be revealing. She had suffered a massive stroke in her corpus callosum so that the left side of her brain could not ‘talk to’ nor exert its usual control over the right side. Goldstein had unmasked the dual nature of brain function, showing that the two hemisphere are indeed specialized for different tasks.

Consider the act of smiling. You see a good friend and he smile. But what happens when that friend aims a camera at your face and asks you to smile on command? Instead of natural expression, you produce a hideous grimace. The reason these 2 kinds of smiles differ is that different brain regions handle them and only one of them contains a specialized ‘smile circuit’.

Another true story – The patient is a graduate student at Beth Israel Hospital, had a weird problem. Every time I have sexual intercourse, I experience sensations in my phantom foot (he lost her left leg in an accident). I actually experience my orgasm in my foot. And therefore it’s much bigger than it used to be because it’s no longer just confined to my genitals”.

The gentleman was telling me that he sometimes enjoyed sex more after his amputation.
What happens when the penis is amputated? Many of these patients experience a phantom penis and sometimes even phantom erections. In such cases you would expect that stimulation of the feet would be felt in the phantom penis.

“You never identify yourself with the shadow cast by your body, or with its reflection or with the body you see in a dream or in your imagination. Therefore you should not identity yourself with this living body, either – Shankara (Hindu Vedic guru).

Another true story – When Diane stepped into the shower one morning, she had no warning that the hot water heater was improperly vented. When propane gas ignited to heat a steady flow of water flowing past red hot burners, carbon monoxide built up in the small bathroom. Diane survived and recovered, but parts of her had forever vanished. When she woke from coma, she was completely blind. She had no difficulty indentifying people from their voices and could tell what objects were if they were placed in her hand.

Doctor showed her a vertical slit (actually a mail slot) and asked her to describe its orientation. She said, “I don’t know”. When doctor handed her a letter and asker to mail it through the slot, she took the letter from the doctor and moved it toward the slot, rotating her hand in such a way that the letter was perfectly aligned with the orientation of the slot.

Diane’s action was amazing because we usually think of vision as a single process. When someone who is obviously blind can reach out and grab a letter, rotate the letter into the correct position and mail it through an opening she cannot see, the ability seems almost paranormal. She carried out this instruction without any conscious awareness, as if that very same zombie had taken charge of the task and effortlessly steered her hand toward the goal.

If vision were simply a faithful copy of reality in the same way that a photograph captures a scene, then your perception should always remain constant if the retinal image is held constant.

Look at a Necker cube. Notice that this Skelton drawing of a cube cab be seen in one of two different way – either pointing upward and o the left or downward and to the right. The perception can change even when the image on your retina is constant. Thus every act of perception, even something as simple as viewing a drawing of a cube, involves an act of judgment by the brain.

Another true story – Dr. Larry’s patient (Drew) had an abnormal clump of blood vessels surgically removed from his brain along with some normal brain tissue in the same vicinity. Since the malformed clump was located in the right primary visual cortex, the procedure rendered Drew completely blind to the left half of the world – if he looked straight he could not see anything on the left side of the world. However if the experimenter put his hand in that region Drew reached it accurately. Without involving extrasensory perception, how do you account for blind sight – a person’s pointing to or correctly guessing the presence of an object that he cannot consciously perceive?

An important distinction must be made between perceptual and conceptual completion. To understand the difference, just think of the space behind your head now as you are sitting on your chair reading this book. You can let your mind wander thinking about the kinds of objects that might be behind your head or body. With your imagination, you can ‘fill in’ this missing space with just about anything, but since you can change your mind about the content, I call this process conceptual filling in.

Perpetual filling in is very different. When you fill in your blind spot with a carpet design, you don’t have such choices about what fills that spot; you can’t change your mind about it. Perceptual filling in is carried out by visual neurons. Their decision once made, are irreversible.

Another true story – Sudden appearance of intrusive images was apparent in the case of Larry MacDonald who suffered a terrible automobile accident where his head smashed into the windshield. As Larry recall, “The world was filled with hallucinations, bith visuals and auditory. I could not distinguish with was real from what was fake. Doctors and nurses standing next to my bed were surrounded by football players and Hawaiian dancers. Voices came at me from everywhere and I could not tell who was talking”.

While being interviewed by the author (Dr. Ramachandran), Dr. asked Larry
“Right now you are looking straight at me. It is not like you see something covering me right now, right?”

Larry said, “As I look at you Dr, there is a monkey sitting on your lap. Sometimes when I am looking for my shoe, whole floor is filled with show and I could not able to locate my shoe. More often the visions come and go, as if they have a life of their own, even though they are unconnected to what I am doing or thinking at that time”.

Another true story – Ellen had a stroke and after that she does not pay any attention to her left side. Sam her son began to understand the nature of his mother’s problem, the important distinction between blindness and neglect. His mother would ignore him, if he stand on her left side, but if he jumped up and down, and waved his arms, she would sometimes turn around and look.

When requested to draw a picture of a flower, Ellen drew only a half 9right side) of a flower. Same was told again, but her eyes closed, but the result was the same. She could draw, only right side of the flower.

When she was in front of a mirror, Dr. put a pen behind which she could see it in the mirror. Bt when told her to grab the pen, she said, “I cannot as it is behind the mirror”. She even tried peeking over the edge of the mirror to look for the pen. She could not identify the difference between reflection and actual.

Unlike other animals, humans are acutely aware of their own mortality and are terrified of death. But the study of cosmology gives us a sense of timelessness, of being part of something much larger. The fact that your own personal life is finite is less frightening when you know you are part of an evolving universe- an ever unfolding drama. This is probably the closet a scientist can come to having a religious experience.

‘Brahman is all. From Brahman come appearances, sensations, desires, deeds. But all these are merely name and form. To know Brahman one must experience the identity between him and the Self or Brahman dwelling within the lotus of the heart. Only by so doing can man escape from sorrow and death and become one with the subtle essence beyond all knowledge – Upanishads, 500 BC”

The Victorian era witnessed a vigorous intellectual debate between 2 brilliant biologists – Charles Darwin and Alfred Russel Wallace. Darwin believed that his principle of natural selection could account not only for the emergence of morphological traits like fingers or noses but also for the structure of the brain and therefore our mental capacities. In other words, natural selection could explain our talents for music, art, literature, and other human intellectual achievements.

Wallace disagreed. He concluded that Darwin’s principle might explain fingers and toes and maybe even some simple mental traits, but that certain quintessentially human abilities like mathematical and musical talent could not possibly have risen through the blind workings of chance.

According to Wallace, as the human brain evolved, it encountered a new and equally powerful force called culture. Once culture, language and writing emerged, he argued, human evolution became Lamarckian- that is, you could pass on the accumulated wisdom o a lifetime to your offspring. These progeny will be much wiser than the offspring of illiterates not because your genes have changed but simply because this knowledge-in the form for culture-has been transferred from your brain to your child’s brain. In this way, the brain is symbiotic with culture; the two are as interdependent as the naked hermit crab and its hell or the nucleated cell and its mitochondria.

Wallace argument is say, you take a barely literate young tribesman from a contemporary aboriginal society and give him education in NYC or Tokyo, and he will of course be no different than any other kids in those cities.
If so why did this potential intelligence evolve? It could not have arisen for learning Latin in English schools. It could not have evolved for learning the calculus, even though almost anyone who tries hard enough can master it.

What was the selection pressure for the emergence of these latent abilities? So how is it possible that these astonishing, latent abilities emerged in the prehistoric brain but have only been realized in the last one thousand years? Wallace’s answer, “it was done by God. Some higher intelligence must have directed the process by which the human nature was developed.” This human grace is an earthly expression of ‘divine grace’. This is where Wallace parted company with Darwin who resolutely maintained that natural selection was the prime force in evolution and could account for the emergence of even the most esoteric mental traits without the helping hand of a Supreme Being.

“Savants” are persons whose mental capacity or general intelligence is abysmally low, yet who have islands of astonishing talent. For example, there are savants on record with an IQ of less than 50, but they could with ease generate an 8 digit prime number, a feat that most tenured mathematics professors cannot match. One savant could come up with the cube root of a 6 figure number in seconds. Such individuals are a living refutation of the argument that specialized talents are merely clever deployments of general intelligence.

The realm of art and music are punctuated with savants whose talents have amazed and delighted audiences through the ages. Oliver Sacks describes Tom, a 13 year old boy who was blind and incapable of tying his own shoes. Although he had never been instructed in music or educated in any way, he learned to play the piano simply by hearing others play. He absorbed arias and tunes from hearing them sung and could play any piece of music on the first try as well as the most accomplished performer.

One of these most remarkable feats was to perform 3 pieces of music all at once! He could play the piano with his hand back to the keyboard, his inverted hands racing up and down the ivories. He seems to be an unconscious agent acting as he is acted on and his mind a vacant receptor where nature stores her jewels to recall then at her pleasure.

Nadia whose IQ measured between 60 & 70, was an artistic genius. At age 6, she showed all the signs of sever autism-ritualistic behaviors, inability to relate to others and limited language. She could barely put 2 words together. Yet from this early age, Nadia could draw lifelike pictures of people around her, of horses and even of complex visual scenes unlike the “tadpole like” drawings of other children her age. Her sketches were so animated that they seemed to leap out from the canvas and were good enough to hang in any Madison Ave gallery.

These examples show that specialized esoteric talents do not emerge spontaneously from general intelligence, for if that were true, how can an “idiot” display them?
(Story of Indian Mathematician who did perform outstandingly in mathematics as mentioned in the beginning of this page).

But even if it’s valid, bear in mind that that no savant is going to be a Picasso or an Einstein. To be a true genius, you need other abilities, not just isolated islands of talent. Most savants are not truly creative.

Shakespeare created 5 metaphors in a single sentence.
“To gild refined gold, to paint the lily, to throw a perfume on the violet, to smooth the ice, or add another hue unto the rainbow… is wasteful and ridiculous excess”

It sounds simple. But how come Shakespeare thought of it and nobody else? There is nothing complicated or esoteric about the idea that’s being conveyed. Yet you and I would never come up with an equally elegant set of metaphors by simply dredging up and randomly shuffling words in our minds. What’s missing is the creative spark of genius, a trait that remains as mysterious to us now as it did to Wallace. No wonder he felt impelled to invoke divine intervention.

Another true story – Mary Knight age 32 sat in Dr’s office for her pregnancy related concern. She was 9 months pregnant and sso far everything seemed to be going well. Now, she felt baby kicking for some time and suspected that labor was about to begin. Dr examined her; her abdomen was vastly enlarged and low, suggesting that the fetus had dropped. Her breasts were swollen, the nipples mottled. But something was not right. The stethoscope was not picking up a clear fetal heartbeat.

Dr learned about pseudocyesis or false pregnancy in medical school. Some women, who desperately want to be pregnant, develop all the signs and symptoms o true pregnancy. Their abdomens swell to enormous proportions, aided by a sway back posture and the mysterious deposition of abdominal fat. Their nipples become pigmented, as happens in pregnant woman. They stop menstruating, lactate, have morning sickness and sense fetal movements. Even thing looks normal except one thing – there is no baby.

The connection of mind and body is quite revealing in such incidents. Obviously mind can affect the body. A cheerful attitude might help accelerate your recovery from an illness by enhancing your immune system. There’s also the so called placebo effect we don’t understand completely-merely believing in a therapy seems to improve one’s well-being, if not actual physical health.

If the human mind can conjure up something as complex as pregnancy, what else can the brain do to or for the body? What are the limits to mind-body interactions and what pathways mediate these strange phenomena?

I mention these examples for 3 reasons. First don’t listen to your professors – even if they are from Oxford (or as my colleague would say, esp. if they are from Oxford). Second, they illustrate our ignorance and illuminate the need for conducting experiments on topics that that most people have ignored for no obvious reasons. Third, perhaps it’s time to recognize that the division between mind and body may be no more than a pedagogic device for instructing medical students – and not a useful construct for understanding human health, disease and behavior.

People have become increasingly impatient with Western medicine’s sterility and lack of compassion and this would explain the current resurgence of ‘alternate medicine’. We have no idea which ones work and which ones do not, although even the hardened skeptic would agree that there is probably something interesting going on.

So with all this medicine evidence staring them in the face, why do practitioners of Western medicine continue t ignore the many striking examples of direct link between mind and body? To understand by, it helps to have a feel for how scientific knowledge progress.

Most of the day-to-day progress of science depends on simply adding another brick to the great edifices – a rather humdrum activity that the late historian Thomas Kuhn called “normal science”. This corpus of knowledge, incorporating a number of widely accepted beliefs is in each instance called a paradigm. Year after year new observations come along and are assimilated into an existing standard model. Most scientists are bricklayers, not architects; they are happy simply adding another stone to the cathedral.

There are many examples in the history of science of anomalies that were originally ignored as bring trivial or even fraudulent but later turned out to be a fundamental importance. This is because vast majority of scientist are conservative by temperament and when a new fact emerges that threatens to topple the great edifice, the initial reaction is to ignore or deny it.

Consider the periodic table of elements, for example. When Mendeleyev arranged elements sequentially according to their atomic weights to create the periodic table, he found that some elements didn’t quite “fit” – their atomic weights seem wrong. But instead of discarding this model, he chose to ignore the anomalous weights, concluding instead that perhaps they had been measured incorrectly to begin with. And sure enough it was later discovered that the accepted atomic weights were wrong because the presence of certain isotopes distorted the measurements. There is much truth to Sir Arthur Eddignton’s famously paradoxical remark, “Don’t believe the results of experiments until they are confirmed by theory.”

The truth of all is this is not that we should have blind faith in the “wisdom of the East” but rather there are sure to be many nuggets of insights in these ancient practices. However, unless we conduct systematic “western Style” experiments, we’ll never know which ones really work and which ones do not.

As a person who born in India raised in Hindu tradition, I was taught that the concept of the self –the “I” within me that is aloof from the universe and engages in a lofty inspection of the world around me- is an illusion, a veil called ‘maya’.

The search of enlightenment consists fo lifting the veil and realizing that you are really “one with the cosmos”. Ironically, after extensive training in Western medicine, and more than 15 years of research on neurological patients and visual illusions, I have come to realize that there is much truth to this view – that the notion of a single unified self “inhabiting” the brain may indeed be an illusion. Indeed, most of your actions are carried out by a host of unconscious zombies who exist in peaceful harmony along with you (the “person”) inside your body.

What are these characteristics that define the self? Author and his doctoral assistant came up with following list.

1. The embodied self. My Self is anchored within a single body. If I close my eyes, I have a vivid sense of different body parts occupying space – the so called body image. In case of the patient I saw with Dr. Riita Hari in Helsinki claim that the left half of her body is still sitting in the chair when she gets up and walks!. If these examples don’t convince you that your “ownership” of your body is an illusion, then nothing will.

2. The passionate self. It is too difficult to imagine the self without emotions. If you don’t see the meaning or significance of something, in what sense are you really aware of it consciously? Recall that the “zombie” in the “how” pathway is unconscious, whereas the ‘what” pathway is conscious and I suggest the difference arises because only the latter is linked to the amygdale and other limbic structure.

3. The execution self. Classical physics and modern neuroscience tell us that you (including your mind and brain) inhabit a deterministic billiard ball universe. But you don’t ordinarily experience yourself as a puppet on a string; you feel that you are in charge. A self needs free will – what Deepak Chopra calls, “the universal field of infinite possibilities”- even to exist.

4. The mnemonic self. Your sense of personal identity – as a single person who endures through space and time – depends on a long string of highly personal recollections: your autobiography. Organizing these memories into a coherent story is obviously vital to the construction of self.

5. The unified self – imposing coherence on consciousness, filling in and confabulation: Another important attribute of self is its unity – the internal coherence of its different attributes. It is not difficult to see how such process could give rise to the mythology of a self as an active presence in the brain – a “ghost in the machine”.

6. The vigilant self. A vital clue to the neural circuitry underlying qualia (qualia simply means raw feel of sensation) and consciousness comes from 2 other neurological disorders – penduncular hallucinosis and ‘vigilant coma” or akinetic mutism.

7. The conceptual self and he social self. In a sense, our concept of self is not fundamentally different from any other abstract concept we have – such as “happiness” or “love”. Therefore careful examination of the different ways in which we use the word “I” in ordinary social discourse can provide some clues as to what the self is and what its function might be.

Our revels now are ended. These our actors,
As I foretold you, were all spirits and
Are melted into air, into thin air…
We are such stuff
As dreams are made on,
And our little life
Is rounded with a sleep.
William Shakespeare.

How we have become linked into this cosmic dimension is a mystery. Yet the linkage cannot be denied. What does it mean? What is Man that we might be party to such privilege? I cannot believe that our existence in this universe is a mere quirk of fate, an accident of history, an incidental blip in the great cosmic drama. Our involvement is too intimate. Through conscious beings the universe has generated self-awareness. This can be no trivial detail, no minor by-product of mindless, purposeless forces. We are truly meant to here.

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