Bastille of the brain

"You are in the universe and the universe is in you" is one of the poignant lines that scientist-writer Carl Sagan wrote and fleshed out in his works throughout his entire career. He opened the intellectual tunnel through which we arrived at an intimate truce between what lurks out there in space and what keeps us burning and alive in curiosity. But the two discoveries are separated by 119 years. That was the span of time between the human discovery that the Sun was the center of our solar system and that our Earth, together with the other planets, revolved around it, and the discovery of a more intimate "universe" within the human body. This was the time between the publication of Copernicus’ book On the Revolutions of the Heavenly Spheres in 1543 and the appearance of a couple of "natural philosophers" (they were yet to be called scientists in the 1800s) in Beam Hall at Oxford in 1662 to dissect a corpse to showcase the "human brain." This means that we have known about the physical set-up of our solar system longer than we have understood the very organ that makes it possible for us to understand it.

We are much delayed in knowing ourselves first and I had my personal reliving of that time lag as I felt like my brain was on a race against itself, reading a book about the human discovery of the nature and function of the brain entitled "Soul Made Flesh" by Carl Zimmer (Free Press, NY: 2004). Zimmer dissected the history of the discovery of the brain with the skill of a surgeon, carefully tracing through major and minor pathways, what and how humanity was delivered from a time when the human body was thought to be kept alive by four fluid elements called "humors" – black bile, yellow bile, blood and phlegm and the precarious balancing conditions like heat and cold, dryness and moisture. Every time someone fell ill of anything, the doctor’s only answer before modern medicine was to bleed him/her and make him/her excrete as much bodily fluids as he/she could, banking that the patient’s entire constitution would be renewed. It was a bloody way to get well but it was all they knew for a long time. It was a frightful time in the history of medicine, where they even believed that the neck’s function was to keep the sins of the "lower body" from contaminating its upper part (if this were true, then the giraffe would have been the holiest animal of all), and that the liver was the seat of the soul. When a patient had constant melancholy throughout their lives, or talked incessantly or believed themselves to be "wolves" or "dogs" and behaved as such, or when they would have convulsions that threw them to the floor, it was commonly treated with mystical prescriptions, since they thought that nothing in the human anatomy could make them behave as such being having been created according to the holy image. The only plausible explanation for them was that something outside it was causing these vicious disturbances and for a long time, the culprit were "evil spirits" or the devil himself who were possessing the souls of the afflicted. It also meant the possibility that the patients might have "deserved" their strange illness since they might have done something immoral that attracted the devil to avail itself of room and board like fungi. And since "evil" was an elusive culprit, nowhere and somewhere at the same time, and "morality" was a handy medicine in the form of published doctrine then, coupled with the fact that they knew about the stars first from Copernicus, Kepler and Galileo, people, until the 18th century, responded to illness, particularly "mental illness," with an unintelligible chorus of exorcism chants, clanging amulets that featured celestial objects and endless drips on to the basin from bloodletting.

If there were a star-neuron in the history of brain studies from Zimmer’s book, it would be Thomas Willis (1621-1675), father of neurology as he coined the term himself. He studied at Oxford as what would be the 17th century equivalent of a student assistant on a scholarship. He was a "servitor" who worked in Oxford and waited till other students of other categories had had their meals before he could pick and eat their leftovers. He was so keen in observing what had yet to be called "neurological conditions." He made connections between what people ingested and the behavior that resulted. In 1650, in the opening of the first coffee house in London, he did not drown in the celebration but instead made a note that caffeine did something to its drinkers that had to do with hyperactivity. He treated patients with old Greek medicine but extended his understanding more than what ancient medicine dictated and built a body of work and cases based on these new findings. Because of this, he was able to see and be compassionate to the mentally sick and helped enlighten the afflicted and others that they did not do anything wrong to deserve their condition. On that fateful day in 1662 at Beam Hall at Oxford, he led the dissection of the human brain and showed to the rest of the scientists present that the brain was connected to the rest of the body through the "Kings Highway" or the spinal chord, and to the senses. He finally brought a combination of anatomy, experiment and medical observation to treating the mentally ill. By the time his book The Anatomy of Brain and Nerves was presented to the Royal Society (a prestigious group of scientists) in 1664, he was on his way to becoming to be the most famous physician in all of England.

Another very important discovery we owe Willis is our perception of intelligence. People in that century referred to slow-minded people as "idiots" and to those who do not make sense, as "fools." Willis, by directing our understanding to what lies within our skulls, finally gave us a biological understanding of "intelligence." Because of his insight, intelligence was no longer a mystical gift which some deserved and some did not. While still far from the concept of "multiple intelligences," Willis already then pointed out that intelligence came in "degrees," something the modern world has now accepted. This "intelligence" has its seat in the brain that as Willis also discovered, is made alive only by blood running through it. In an experiment, he found out that blood that is halted by a block in the brain’s veins could find alternate routes to supply the area that needs oxygen-carrying blood. This loop is called the "Circle of Willis," a name all physicians are familiar with since it has retained that name since then.

Three hundred thirty years since neurology as a branch of medicine was born, enough time for a civilization to rise and fall, and our psychiatrists and neurologists now like the young couple I interviewed, Dr. Joseph Anlacan, a psychiatrist, and Dr. Michelle Anlacan, a neurologist, are even more frustrated with the conditions prevailing in the culture of their patients. "More" because with tangible proof from MRIs and CT scans that what happens to the brain, happens to "us" or parts of us, the links are clear and we have a shot at addressing our neurological problems. But despite this, a majority of their patients still think that mental illness is a sign of weak will or punishment from some displeased deity. Schizophrenia, for a fact, afflicts one percent of ANY population regardless of culture. There is no known cause although there are indications of it being highly genetic. It is a condition where one retains oneself but where delusions of being persecuted or punished take the form of voices. Dr. Anlacan says schizophrenics are often made to believe by people around them that they do not get well because they are too weak in character to fight it or that they do not pray hard enough. For neurologist Dr. Michelle Anlacan, she says epileptics delay taking their pills thinking that they can prevent convulsions with sheer will, thus prolonging their convulsions causing the death of their brain cells, and when brain cells die, it is forever. They cited that "albularyos" (quack doctors) and "exorcism" are the preferred first treatments of the afflicted or their families, worsening their conditions, without realizing that they sold out to an enslaving belief, one that Thomas Willis had already liberated us from over three centuries ago. The couple emphasized, and I agreed, that compassion could spring for a public scientific understanding of mental illness.

I confer to Willis the title of being the Bastille of the brain. He freed us from an enslaving and narrow view of the brain, and thus made us confront the working of our own minds, that which makes us who we are. He also was first to hint that we all come with minds with unique slants. By showing that the loftiest or the most mundane of thoughts or behavior finds its representation in the connections in this gray blob, which without preservatives, is mere wet and chalky goo, he handed back to us the keys to our understanding of the seat of ourselves, which before had been tucked away exclusively in sorcery chests or inside religious vests of authority. By showing that it is in the brain that the "soul" is made flesh, he brought our minds back home, and I think that that is liberty at its finest and in its most intimate.

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