Diane speaks with Dr. Roger Kligler who is living with advanced stage cancer on why he's suing the state of Massachusetts for the 'Right to Die' and with Dr. Jessica Zitter, and intensive care and palliative care specialist on why better communication is so needed between doctors and patients facing end-of-life issues.
Guest Host: Steve Roberts
Before the era of MRIs, CT scans and EEGs, extremely little was known about the workings of the human brain. Observation was one of the best tools scientists had — especially when a head injury was followed by behavioral changes in the patient. A new book tells the history of brain science through stories of tragic and often bizarre accidents, from the tale of railroad foreman Phineas Gage, who lived a dozen years after an iron spike pierced his skull, to the thousands of Civil War amputees who experienced phantom limb syndrome. We discuss how neuroscientists used case studies to advance knowledge of the brain.
- Sam Kean science writer and author of "The Disappearing Spoon" and "The Violinist's Thumb."
Read An Excerpt
Excerpted from the book THE TALE OF THE DUELING NEUROSURGEONS by Sam Kean. Copyright © 2014 by Sam Kean. Reprinted with permission of Little, Brown and Company.
MR. STEVE ROBERTSThanks so much for joining us. I'm Steve Roberts of George Washington University sitting in today for Diane Rehm. She's out with a cold. Long before modern day neuroscience, researchers learned about the brain primarily from observation. A new book describes what was gleaned over the centuries from the way people changed after a brain trauma. The author argues that despite advanced brain-scanning equipment, injuries remain one of the best ways to make inferences about the brain today.
MR. STEVE ROBERTSThe book is titled, "The Tale Of The Dueling Neurosurgeons." The author, Sam Kean, a well-known writer on scientific subjects, joins me in the studio. And, Sam, delighted to have you this morning on "The Diane Rehm Show."
MR. SAM KEANWell, hello. Thanks for having me. And I'd like to say, first of all, a happy birthday to my mother, Jean Kean. So happy birthday, mom.
ROBERTSGlad you got that one in. And I should say that the subtitle of your book, "The History Of The Human Brain As Revealed By True Stories Of Trauma, Madness, And Recovery." And would like your stories, not necessarily about trauma and madness, but certainly of recovery. We're delighted to have you join us, 1-800-433-8850. Email, email@example.com. And of course, you can communicate via Twitter and Facebook.
ROBERTSAnd, Sam, one of the things that struck me is this idea that, even today, with all the advanced diagnostic tools and brain imaging, that still these stories of injury where normal functioning is impaired, and those are the moments when science has a window into how the brain operates.
KEANYeah. As you said, even today, these stories of people, you know, having a malfunction in part of their brain or, you know, a tumor or some sort of accident, and part of the brain goes down. These stories still provide a lot of insight into how the brain works today. It's basically how we got all the major insights we have into how the brain works throughout neuroscience history. And, you know, there are still cases popping up today where this really provides some of the most basic insight we have into how the brain works.
ROBERTSAnd of course, you can't, from an ethical point of view, deliberately impair the brain.
ROBERTSSo you don't really have the ability to create controlled experiments. So you really need these kinds of abnormal incidents to provide an insight.
KEANYeah. And that's how neuroscience has basically progressed, is neuroscientists sort of waiting around for these accidents to happen to people. And in a lot of the cases, they were just normal, everyday people like you, like me, who just happened to have something go wrong in a very specific part of their brain. And their mind changed in some sort of unusual or very exotic way.
ROBERTSBut also, one of the things that you emphasize in the book is that these are real people. These are not just scientific experiments. These are not abstractions. And one of the things you try very hard is to tell, as you put it, the whole story of their lives. And that you point out that they're not just their injuries, but in many ways, their recovery from these injuries, in your words, are stories of...
ROBERTS...resiliency and courage.
ROBERTSYeah. So the stories do focus on the deficits sometimes, because that's how we learn about how the brain works. You know, parents who can't recognize their children suddenly. Or people who become pathological liars or lose all fear of death. But on another level, these people, you know, have the same hopes and fears that we do. They suffer the same disappointments that we do. And it's really only by looking at their entire life, by really digging into the story of what it's like to live with these, you know, deficits or disabilities, that you can really understand how the brain works overall.
KEANSo you can take these stories and focus on the deficits and understand how pretty much every single part of the brain works. But if you really look at the entire story, in a lot of cases, as you said, it's a story of courage and resiliency and how people overcome these difficulties in the end.
ROBERTSAnd I was struck, in one of your comments where you say that this is not just a book about science. It's a book about humanity. And you need to master as a writer, not just the science of the subject but understanding the lives of these people, to write the whole story.
KEANYeah, I would say that stories probably mean more to neuroscience than maybe any other scientific field, because you are dealing with people's entire lives. You know, how they relate to other people, their emotions, how they love other people, all of these sorts of things play in to how our brains work. And you have to know about those things in order to do neuroscience.
ROBERTSAnd also, it's a reflection of the nature of this particular organ, the brain, that as you point out in so many of these stories. One part of the brain might be damaged.
ROBERTSBut other parts continue to function. Or in many cases, people will adapt. The other parts of the brain will adapt to the lack of one function by finding new pathways -- new sensory pathways, new ways of learning information, when one pathway is closed off.
KEANYeah, there are stories, for instance, of people who cannot speak anymore. They lose the ability to speak. But they can still sing. So it's really incredible to think about someone who can't respond to you speaking, but they can sing back to you. Gabrielle Giffords, for instance, the Congresswoman from Arizona, after she was shot a few years ago she lost the ability to speak. But she could sing afterward. And she actually helped herself relearn how to speak by singing in part. And so, again, there are all these stories of people. They lose one thing but something else comes up to kind of help them overcome it.
ROBERTSOne of the stories that I know is one of your favorites, where this is a striking example, is James Holman, the man who lost his sight and yet traveled the world and saw in different ways. Tell that story.
KEANYeah. He was active right around, you know, 1810, 1820, something like that. And he was the most prolific traveler the world had ever seen up to that point. He traveled something like a quarter of a million miles, which at that time is incredible. It's like going to the moon, basically. And he did it all while he was blind. He had a cane with a hard tip on the end. And basically he would tap it onto the ground and echoes would shoot out. And then he would sort of triangulate where he was based on how the echoes were coming back to him.
KEANIt's a lot like how a bat senses what's going on around it. And the really incredible part about this story...
ROBERTSI was thinking about marine mammals.
KEANOr a dolphin or something like that.
KEANYeah, it's exactly the same thing, kind of using sonar.
KEANYeah. So he -- the really incredible part is that there are people today who can do a similar thing. And when you look at what's going on in their brain, the vision parts of their brain actually do light up on brain scans. So basically their brain has kind of remapped itself, taken over the vision part and is using that in order to navigate around. So it really does cause these incredible changes inside the brain. One thing goes down but another thing kind of jumps up and takes its place.
ROBERTSAnd that example -- so what you're saying is that in a certain sense he could see. But he saw it through the sound waves, not through the normal pathways.
KEANRight. It's sort of a philosophical question at some point. Can he really, really see?
KEANBut if the vision parts of your brain are working, are processing the information, in some sense, yes, you are seeing. And he wasn't like, you know, just kind of walking around with someone holding his hand. He climbed Mount Vesuvius in mid eruption. He went, you know, to places with wars going on. He helped hunt down pirates. He was really an active, active person.
ROBERTSFascinating. Another subject you deal with -- each one of your chapters has a different subject -- but one that I found fascinating was the issue of phantom limbs. The Civil War, I think you report that there were 60,000 amputations during the Civil War. And out of that tragedy did come an understanding of this phenomenon of people feeling a sensation in a limb that was no longer there.
KEANYeah. The Civil War was really the first large-scale production of phantom limbs because of new types of weaponry, new types of bullets. And all of a sudden you had people who'd be missing arms, legs, things like that. And before it, you know, a lot of people didn't want to talk about it because they thought they might be considered crazy if they were feeling sensations...
KEAN...in a hand or a leg that wasn't there. But a very famous doctor named Silas Weir Mitchell ended up doing a lot of work on these patients and realizing that it's actually very tied into how the brain perceives our limbs in space, how we deal with pain sensations, all of these sorts of things. And you can really get into a lot of interesting neuroscience about how the brain works based on phantom limbs.
KEANOne of my favorite stores was about a little girl who was actually born without either of her forearms. So she didn't have either forearm, either hand. But she still felt the phantom sensations in her arms, to the point that when she had to do arithmetic at school, she would do the arithmetic on her phantom fingers, even though she had never had fingers in her real life. And what that goes to show you is that the body does have this sort of hardwired mental scaffold inside it, where it expects to find four full limbs, all of your fingers, all of your toes, things like that.
KEANSo that's part of the reason why people feel phantom limbs, is because the default setting in the brain just wants to feel them.
ROBERTSSo it wasn't just amputees who once might have had those limbs.
ROBERTSThis was someone who had never had them and still had the same sensation.
KEANA girl who had never had any sort of sensations because she'd never had hands before. But she was still able to do math on her phantom fingertips. She got away with it.
ROBERTSThat's fascinating. One of the other well-known cases you write about is Phineas Gage, the famous case where a railroad foreman who -- explosion drove a metal spike through his head in 1848 and lived for a number of years afterwards. And you point out that many people saw -- discerned as a result of this, a change in personality. And that became a famous case.
KEANYeah. He's probably the most famous name in neuroscience. Whenever I mention the book, people say, oh, Phineas Gage. I love the story of Phineas Gage because it's just such a miracle that he survived. Unfortunately, a lot of people have heard one story of Phineas Gage that might not be true. I think most people hear the story and think that he became sort of this disreputable character, sort of a drunk or a criminal, someone running around kind of scamming people.
KEANAnd there's actually not a lot of evidence that that happened. And in fact, there is some evidence that he recovered after his injuries and led something like a normal life. So one of the most famous cases in neuroscience history. But again, there's good evidence that he might have been one of those cases of people who recovered somewhat. And I think that's a really powerful message of hope. If even Phineas Gage ended up recovering, you know, there's a lot of hope for other people out there as well.
ROBERTSWith a spike in his head.
KEANWith a spike through his head. It was a three-foot, seven-inch long spike that rocketed through his skull and landed, like, 25 yards behind him. And he lived.
ROBERTSSam Kean, his new book, "The Tale Of The Dueling Neurosurgeons." I'm Steve Roberts sitting in today for Diane. I'll be back with your calls and your comments. Stay with us.
ROBERTSWelcome back. I'm Steve Roberts sitting in today for Diane while she's out with a cold. And my guest this hour is Sam Kean, science writer, author of the National Best Seller "The Disappearing Spoon." Sam's new book is called "The Tale of the Dueling Neurosurgeons: The History of the Human Brain as Revealed by True Stories of Trauma, Madness and Recovery." And the title story, Sam, the dueling surgeons involved, a king of France and one of the important advances in neuroscience as a result of what happened to him. Talk about it.
KEANYeah, so the title story involves King Henri II of France who was alive in the mid 1500s. And he was sort of a macho king. He liked to, you know, joust, ride around on his horses, things like that. And he ended up getting clobbered one day during a jousting match. He got hit right in the face and ended up suffering a brain injury. So they called in the two best neurosurgeons in Europe to help him, one named Andreas Vesalius, one named Ambroise Pare.
KEANAnd Pare and Vesalius realized that the king was in grave danger even though his skull did not get fractured. There wasn't, you know, a gory wound, anything like that. They were proponents of a controversial new diagnosis called a concussion. Not many people had heard of it at that point but they said, no, we think his brain really is in danger here. We think he's really going to suffer.
KEANAnd the king ended up dying. They ended up proving right. Even though they were rivals they sort of banded together on this case to try and help the king. They couldn't end up saving him but it was the first real time where someone important had been diagnosed with a concussion. And I think it's an interesting story because it shows how neuroscience kind of got started way back when in the 1500s and sort of shows how -- you know, the genesis of the entire field of neuroscience.
KEANBut it's interesting too that we're still dealing with a lot of these same issues today. You hear about professional football players suffering concussions. You hear about soldiers with traumatic brain injuries, things like that. And in a lot of cases people had the assumption, well you know, there's no blood, there's no crack in the skull. This person must be fine when in fact there is and there can be underlying brain damage that just doesn't show up as readily. So we're still dealing with some of these same issues almost 450 years later.
ROBERTSYou know, when you mention that in writing, as I have occasionally about soldiers with traumatic brain injuries, some have even said it would almost be easier if I had a visible wound. People could see the effects of what I've been through. But that so many sufferers don't have visible effects. And particularly for soldiers, this is very difficult because their injuries are not visible.
KEANYeah, the brain is encased in the skull and it protects it. But if the brain, you know, hits the inside of the skull, it can cause damage. And there's sometimes not a lot you can point to specifically and say, you know, here I have an injury. Here is something wrong with me. But, you know, as the case of King Henri shows and as we're dealing with today, there are these sub-lethal injuries that do arise and that do affect brain function, even if they're not visible from the outside.
ROBERTSAnd another dimension of that story, your title story that I found interesting was, it also was an early use of autopsy to help advance science in terms of since the wound was not visible, they got permission, which was, I gather at the time, a very unusual practice of doing an autopsy that did help them learn lessons from this example.
KEANYeah, back then in the 1500s, if you were going to do an autopsy it was usually on a criminal. You would sentence them to death and autopsy, to sort of wring some extra punishment out of them, I guess, afterward. But the Queen of France did allow Pare and Vesalius to do an autopsy on the king. And that was very important because they were able to confirm their suspicions and assumptions. That's what you need to do in science. You need to test your theories. And in this case they were able to confirm what actually went wrong with King Henri.
KEANAnd one of the interesting things they found was that even though he got hit in the front of the head, the damage was sort of localized in the back of his brain. It's what's called a counter coup injury. It's very common with head injuries where you get hit on one side but the brain will smack into the skull on the other side. So again, an early case of getting this peak into how the brain works and how it can get injured.
ROBERTSNow speaking of scientific experiments, one of our astute listeners David Fresco writes to try to correct something that I said. "Steve Roberts just made the comment that you can't do an experiment on the brain. That is not entirely true," he writes. "Using techniques such as trans magnetic cranial stimulation, one can either temporarily knock out or actually increase the activity in a focal region of the brain."
KEANThey do have the -- they call them virtual lesions I think sometimes. So you can sort of, you know, buzz one part of the brain and knock it out for a little bit.
ROBERTSWell David, thanks for your email and the correction. Also one of the stories you tell what I found most fascinating was this condition called synesthesia, if I'm pronouncing it correctly, where people see sounds as colors. I've read novels where people have this condition but not a scientific work. And I was particularly taken by your account of Franz Liszt, the famous composer.
KEANYeah, so synesthesia's basically when two senses kind of blend together in this very trippy way where you start, you know, hearing colors or when you see certain numbers or letters, they pop off the page in a different color, And there have been a fair number of artists who had it. Franz Liszt, as you mentioned. There was one day when he was talking to his orchestra and he was sort of berating them. He wanted them to play the passage more blue, I think is what he said.
KEANThey had no idea what he was talking about obviously but that's how he understood music was in terms of color. And those are the most common forms of synesthesia but actually any two senses can really blend together. There are stories of people who certain fabrics give the -- or certain textiles sensations give them an emotion. So an orange might make them feel embarrassed or, you know, Denham might make them feel sad or something like that, so again, all these really incredible ways of our senses blending together inside of us.
ROBERTSWe have a lot of callers who want to share their perspectives of this story, Sam Kean. And I want to turn first to Chris in Johnson City, Tenn. Chris, you're on "The Diane Rehm Show." Welcome.
CHRISThank you for taking my call. And thank you for your guest today because I am a 27-year survivor of a brain injury. I was hit by a taxi in Brooklyn in '87. They didn't know that much about head injuries at the time. The one residual effect that I have been dealing with and trying to get help with is emotional control, figuring out is there anybody doing any research on emotional rehabilitation? I ask for a facility and they look at me with blank stares.
CHRISAnd how would I donate my brain once I am, because since my head injury I have had several technical certificates. And after seven years, I finally graduated East Tennessee State University with a Bachelor's Degree. So there's some reason up there, but how would I donate so they can figure out how to fix some of these problems?
ROBERTSChris, stay on the line and let's get Sam's reaction.
KEANYeah, so one of the real driving themes I think of the past few decades of neuroscience is sort of taking emotions more seriously and realizing that, you know, they're not just about feeling happy or sad, but they interact with lots of different parts of the brain. And you -- even things like reasoning, which we think of, you know, usually as sort of being the opposite of emotions, even reason draws on a lot of emotional reservoirs in our brain. We need emotion in some cases in order to sort of reason properly.
KEANSo there is a lot more work nowadays going on into how we deal with emotions and what emotions do inside of our brains. As for donating the brain...
ROBERTSAnd are there -- excuse me, the caller's question was, are you seeing that -- as the understanding grows that there are therapy regimens also being -- I know you're not a physician but therapy regimens being developed to deal with the kind of problem our caller raises, the emotional side of brain injury?
KEANI think there are because I think there is a better appreciation of what the emotions do for us and how we do it. I don't know of any specifically. As you said, I'm not a physician so I'm not familiar exactly with them. But I do think we are sort of understanding and appreciating better the role that they need.
ROBERTSAnd a lot of what you mentioned, the area of traumatic brain injury for soldiers and combat veterans from Afghanistan and Iraq, given the nature of the explosives in those war zones, this is an area where the military doctors are focusing a lot on the emotional and the psychological aftereffects of these injuries.
KEANYeah, that's a good point. They're doing a lot of things, you know, with post traumatic stress disorder or even just dealing with things day to day that, you know, maybe don't quite qualify for that. Just dealing with, you know, emotions and other things kind of bubbling up.
ROBERTSAnd Chris had one more question about donation.
KEANYeah, about the donation, I would say probably the best bet would be to contact a local university or a local hospital and inquire through them. I think they would probably know the outlets and know exactly what to do and where to go for that.
ROBERTSChris, since you're in Tennessee perhaps Vanderbilt, an excellent medical facility, might be a good idea.
CHRISI moved back to Nashville so yeah, I was just thinking that. Thank you.
ROBERTSOkay. Thanks for joining us, Chris, and sharing your story. We appreciate it. Let's go to Shulumete in Annandale, Va. You're on "The Diane Rehm Show."
SHULUMETEHi, thank you. Yeah, in 2004 I was -- an SUV hit me where I sat as I was driving, hit me pretty hard, but it didn't hit my head. And brain scans showed no brain injury and they told me I was lying that I had any serious problems. But I couldn't remember to make meals, brush my teeth, pick up my kids from school. Didn't know what day it was. My 5- and 8-year-old quickly learned to remind me over and over to do basic things.
SHULUMETESo when I finally started driving again, sometimes I would be driving and all of a sudden have no clue where I was but I had to trust that I got there so I must be in the right place, so I'd keep driving until something looked familiar again. And they told me that -- when the doctors finally figured out that, yes, I had a problem that -- it took about six months to get a diagnosis, that they told me there was about two years to recovery and then you didn't get better after that.
SHULUMETEIt turns out ten years later I've noticeably measurably improved about every six months. I've done a lot of work with professional therapists and gotten cognitive rehabilitation and it helps.
ROBERTSWell, that's good to hear. Sam, your reaction to Shulumete.
KEANYeah, it was sort of a dogma in neuroscience for a long time that once you, you know, lost some faculty or suffered some sort of injury that it was sort of a permanent deficit that you would not be able to recover at all from that. But I think most neuroscientists, neurologists and rehabilitation people are recognizing nowadays that actually you can recover from some of these things. You might not get everything back but there's certainly no reason to just give up hope and pretend like, you know, after two years or whatever there's no hope of getting any better.
KEANIt does take a long time and it can be very frustrating but the brain can sort of route information around deficits or relearn how to do certain things. So yeah, there are certainly lots of tales of, you know, recovery out there as well.
ROBERTSAnd Shulumete, if you don't mind sharing, what do you think made the most difference? Was there a particular therapy, a particular advice that really helped you on this road to recovery?
SHULUMETEAbsolutely. If it's okay to say specifically, I worked with someone named Debbie Gale who does -- she's a -- she has a speech and language pathology background. She does what she calls cognitive rehabilitation. Speech and language pathologists started out working with stroke victims to talk so their history is working with weird brain damage. And she was able to help me with so many things because I didn't know what day it was. It's ten years later. The big clock in my living room still says the day, the date and the time.
SHULUMETEBut one of the things that she taught me was -- she did things with me during therapy to help me learn how to compensate for the things I couldn't do and learn how to practice my brain just like muscles, so that it would get better. And she -- when I finished I had a lot of really good ideas of what I needed to keep doing to keep improving my brain. And so I continue -- it's been ten years. I continue to always look for things that will improve my brain. And at 50 I see my friends complaining about their brains going down while mine continues to go up.
ROBERTSGood for you. Thanks so much for...
KEANOh, thank you.
ROBERTS...thanks so much for sharing that story. We deeply appreciate it. I'm Steve Roberts and you're listening to "The Diane Rehm Show." Let's turn now to other callers. And we have Crystal in Edinboro (sic) , Ind. Crystal, welcome. You're on "The Diane Rehm Show."
CRYSTALWell, thank you for taking my call. I'm a semi driver and I travel from city to city and do my best to follow with your all's show. I had a simple question about, let's say that there were no injuries involved whatsoever but yet there are still people who have post partum or the PTSD. It's more of an emotional or a mental brain injury, so to speak. Not necessarily an injury but there's an issue there.
CRYSTALMy question is, is there -- besides therapy -- because for a lot of people it does not work -- is there any studies being done for those type of things that are continuously happening, to make those people feel better so to speak? I know a lot of war personnel, they end up committing suicide. And it's not usually right away. It's after the nightmares and the dreams and I can't sleep because I'm afraid to sleep or -- and that goes for any of them actually.
CRYSTALWomen that deal with severe post partum, they have issues in their own mind. I dealt with that whenever I had my son. And, you know, still now I feel as if because of the way it made me feel that I am a bad parent, however, you know, I'm not. I actually watch my son and take care of my son and do what I can more so than what I was done, for lack of money reasons, when I was a child. But my question, I guess, goes to is there anything being done outside of a physical injury to the brain?
ROBERTSThank you very much for your call. Again, I understand you are not a physician and a neuroscientist but what's your response to Crystal's call?
KEANOne of the things I really think we're learning is that, you know, there's not a hard and fast boundary between the mental and the physical, that we can look at physical things, you know, chemical balances and imbalances in the brain. And we're starting to be able to figure out how those kind of scale up into, you know, our psychology and how we approach the world, how we feel about ourselves, things like that. So we're kind of making the transition from really small scale things to larger things.
KEANAnd we are starting to get a better understanding of how to bridge those two gaps. So, as you said, even though there's not necessarily an injury there, you can still, you know, some people do respond to therapy, some people don't. Some people respond well to drugs, things like that. So there are a lot of studies out there about how to take something like brain chemistry and then try to figure out what's going to be the large-scale effects on people. So it's an area...
ROBERTSThis is one of the areas of fascinating research of drug therapies that can compensate for the imbalances -- the chemical imbalances in the brain.
ROBERTSSam Kean. His book "The Tale of the Dueling Neurosurgeons." I'm Steve Roberts sitting in today for Diane. We're going to be back with more of your calls, more of your comments. We've had some wonderful ones already. Thanks for sharing with us this morning and we'll be right back.
ROBERTSWelcome back. I'm Steve Roberts, sitting in today for Diane. And my guest is Sam Kean, the well-known science journalist whose new book is called, "The Tale of the Dueling Neurosurgeons." And, Sam, a number of our wonderful listeners are checking in with answers to some of the questions people have posed.
ROBERTSBeverly writes, "Harvard has a brain and a donation program," in answer to one of our callers. "My brain is going to Harvard after I'm done with it," she says. Another, Pat writes to us. "For the caller who sustained a TBI when hit by a taxi so many years ago, contact the Brain Injury Association of America. Through their state affiliates, the caller can find the resources she needs." Perhaps we can put this email up on our own website here. It's www.biausa.org. But we'll try to put that so folks can check that out and link to it.
ROBERTSAnd then we've got several emails about synesthesia. Susie writes, from Canaan, N.H. "My 10-year-old daughter is very gifted in math and she sees numbers in different colors. To her it was very surprising when she realized that this was not the case for everyone. To her it was just another normal sense."
KEANYeah, people who have synesthesia are often -- they feel kind of disappointed for the rest of us because we can't experience the world in the rich and interesting way that they do.
ROBERTSYeah, another email says something very similar. David writes, "My only experience with synesthesia used to happen when I ate eggs with a soft yolk. They always made me think of the color purple." And here's a question for you from Robert. "Can people who have been blind since birth dream?"
KEANYeah, people do -- people who are blind do dream. They dream in a little different way. They don't obviously see pictures and things in the same way that we do. But they do experience dreams. And they experience, you know, different senses and things like that in the dream. So, yeah.
ROBERTSWe have a number of other callers who want to share their experiences with us. And let's go to Robert, in Franconia Notch, N.H. Robert, welcome. You're on "The Diane Rehm Show."
ROBERTWell, good morning. Thank you for bringing this program to light. My name is Robert Zaliers (sp?). I'm a wounded warrior, private book writer now. They based my situation on the fact that I'm able to follow birds now very, very well. And I'm understanding -- I'm finding my way through nature. And -- but these things are like humble -- this sinister thing, is that what you call it?
ROBERTSThis is the condition where one sense triggers another sense.
ROBERTYeah, well, there are things that trigger my headaches that come on, particularly post-migraines, as well. I was hit in the head with a big beam that came flying off of a truck, thrown by somebody else. And since then I've had multiple aneurisms on my heart. And I'm a Persian Gulf veteran. So they linked it to chemical sensitivity, as well.
ROBERTThere are several different things like certain smells that trigger my headaches.
ROBERTAnd then when you say stuff like the numbers, to call you, I got the call, you know, 1-800-833-4350, well, that was the wrong number.
ROBERTAnd then there was 433-8850. So writing things is another thing that happened.
ROBERTIt, you know, but I'm really grateful and living a privileged life. And I'm glad that you're bringing this to light. Please check out my book at Wounded Warriors, "Healing Through Birds." Thank you so much.
ROBERTSThanks for joining us. A response, Sam?
KEANYeah, you know, again, talking about -- we're learning a lot about, you know, the effects of war and the sort of sub-lethal injuries on what the brain -- where you might not necessarily see a specific wound, but you can infer some things about how the brain works. And people are having these problems.
ROBERTSAnd what about his point about healing through nature and particularly following birds. Is there a neurological basis for that?
KEANI think we do, you know, human beings do have this ability to recognize and appreciate animals. And in fact, one of the stories that sort of inspired me to write the book was hearing about people who would get injured in one part of their temporal lobe, on the side of the brain, and then suddenly they couldn't recognize any animals whatsoever.
KEANSo dogs, cats, elephants, all looked exactly the same to them. They simply could not tell them apart. So we do have specialized circuitry in our brains for recognizing and appreciating animals. And, you know, in some people it's more well developed, in some people it's not so well developed.
ROBERTSAnd does that relate at all to the growing concept of pet therapy?
KEANIt could. You know, they're -- pets are also very tired into our emotions, as well.
KEANDepending on how they look, they might, you know, remind us of small children if they have big eyes or big paws, things like that. So they tap into a lot of different parts of our brain.
ROBERTSIncluding the nurturing part.
KEANYeah, we want to take care of things. We're mammals who really appreciate doing that. So it does tap into that as well.
ROBERTSLet's turn to Julie, in Houston, Texas. Julie, welcome. You're on "The Diane Rehm Show." Julie? No? Okay. Let's move on to -- let's move on to Jim, in Cleveland, Ohio. Jim, you're on "The Diane Rehm Show."
JIMGood morning. I just finished a very interesting book on the brain called "Grain Brain." And it discussed nutrition and its ability to heal the brain. And I was wondering if your guest had any thoughts on nutrition.
ROBERTSGood question. Thanks. What do you think?
KEANI don't go into nutrition, specifically. I do talk about, you know, some of the effects on chemicals that we ingest into our bodies and what those might do to the brain. For instance, we have this blood-brain barrier basically, that prevents a lot of drugs from getting into our brain. It's a protective sheath around our brain cells. But it does prevent, you know, things that might be able to treat Parkinson's, Alzheimer's, from getting into our brain. So there is a lot of work into how these molecules we ingest, either eating or through drugs, have effects on our brain.
ROBERTSWell, and this really connects to something we were talking about earlier. That one of the more promising areas of therapy involves brain chemistry and understanding the chemistry and developing drugs that can affect and rebalance the chemistry. It would stand to reason that nutrition, at least, theoretically can have some of the same positive effects, if the science could discern what diets and what nutrition can really make a difference.
KEANYeah, you know, the things we eat are just a chemical in a different form, that bringing into our body. So if we could figure out, you know, the possibilities of eating something or ingesting something that could help us, you know, that could happen.
ROBERTSLet's turn to Catherine, in St. Louis, Mo. Catherine, welcome to "The Diane Rehm Show."
CATHERINEGood morning. I just wanted to add that -- I heard the woman speaking earlier about using a speech language pathologist to help her rehabilitation continue. And I'm an occupational therapist and there's a lot of occupational therapists working all over the country, in cognitive rehabilitation, helping those that have survived brain injury to return to their most engaging and meaningful activities.
CATHERINEAnd they do do interventions to work on emotional regulation and time management and things like that. So I just wanted to add to the conversation that anybody that has experienced this could seek O.T.s out.
ROBERTSWell, I very much appreciate that. From your clinical experience, what are some of the things that you've learned that really can make a difference?
CATHERINEWell, a lot of O.T.s do things -- they do a lot of different interventions. I'm actually a pediatric occupational therapist. But I work at Washington University in St. Louis. And there's a lot of O.T.s that I know do do interventions with those that have had brain injuries. So that's -- I just wanted to make sure that people knew that that was there as an intervention.
ROBERTSExcellent. We appreciate the…
ROBERTS…helpful comment. Thanks, Catherine. Let's turn to Kimberly, in Evansville, Ind. Kimberly, you're on "The Diane Rehm Show." Welcome.
KIMBERLYHi. How are you guys? I had a serious question. I haven't had a brain injury or anything. And I was wondering does your life circumstances affect your brain in any way? Because I'm 21 years old and I work at a manufacturing plant. And every day my body goes through this hard labor intense process. And every two hours my brains seems to wipe out what I had done before. And it's like I forget most of my day because of my job. And I was wondering how does that affect your brain? Like, the things that you go through in day to day. And is there a way to help that?
KEANYeah, pretty much anything you do affects your brain in some way. You know, sometimes it has good effects, bad effects, but when people talk about, you know, technology changing their brain or things like that, you know, even reading, or something like that, really changes how your brain works. So almost anything you do will affect how your brain works. As for specifically remembering things, yeah, you know, there are things you can do to help improve your memory, to, you know, remember some things better.
KEANAnother way, though, I think of looking at it, there was a story in the book about a man who couldn't forget anything. He had probably the best memory anyone has ever seen. He was actually a synesthete, which helped him remember things because he would always associate these bright colors and pictures with things. But he ended up living a life that was really awful because he could never forget anything about him. So I talk, in the book, I talk about memory as being sort of a sieve, where it lets some things through, but it captures other things.
KEANAnd I really think that is important, is we do need to forget about some things. Even, you know, daily things that we don't necessarily need to remember. So it can be a blessing sometimes that you're not remembering every single thing going on.
ROBERTSIn fact, as you -- several of the callers talking about the trauma of war, and the flashbacks. It's the memory that plagues them.
KEANThe memory and also the deep emotions that it dredges up. So there might be -- you can imagine, you know, therapy sort of trying to decouple the emotion from the memory. So you can have the memory, but not necessarily feel the terror over or something like that.
ROBERTSKimberly, thanks so much for your call. We appreciate it.
KIMBERLYThank you for taking it, you, too. Bye.
ROBERTSOkay. Bye. Let's turn to Sarah, in Fort Myers, Fla. Sarah, you're on "The Diane Rehm Show."
SARAHOh, hello. Thank you for taking my call. Can you hear me all right?
ROBERTSWe got you fine. Speak up.
SARAHOkay. Wonderful. I am a psychotherapist. And I, five years ago, began incorporating neurofeedback into my practice. And it's blown the roof off of success with my patients. And I was really responding to the call with -- from the woman who, I believe she said drives a truck for a living and she had questions about depression. Neurofeedback is used a lot with people with brain injury. I work more with people that have neurodevelopmental delays, also depression, anxiety and I have worked with veterans.
SARAHAnd I have more than 90 percent success rate with achieving positive results with people. It's not always the results people wish they had in some situations where there is very significant damage. I work a lot with kids with fetal alcohol syndrome, but I see very consistent, positive results. And an example is work that I did with a veteran who…
ROBERTSCan you hold on just -- Sarah, hold that thought for just one second.
ROBERTSI got to do some business here.
ROBERTSI'm Steve Roberts. You're listening to "The Diane Rehm Show." Okay. Continue, please.
SARAHOkay. A veteran that I worked with who had been shot and had been in therapy long term and could not get thoughts of suicide out of his mind, really from a moment-to-moment basis. And after three session of neurofeedback -- and this isn't always typical, but he was relieved of those thoughts. And that is a kind of amazing story that has become kind of the norm in doing neurofeedback.
ROBERTSLet's -- let me get Sam's reaction here because we don't have too much time left. Sam, neurofeedback.
KEANYeah, I've heard of neurofeedback. I don't go into it much in the book. But yeah, it's another example of one of these really interesting therapies that are coming up nowadays. Sort of because people just believe nowadays that there's a possibility for recovery. Again, neuroscientists for a long time didn't think there was much you could do about the brain. Another example is phantom limbs, for instance. This has been a problem since as far back as we've had wars. People experiencing phantom sensations.
KEANAnd in the past few decades we've developed very simple therapies with just looking in a mirror, basically, and moving this -- moving your arms in a symmetrical way to try to overcome some of these phantom sensations. And sometimes people get the first relieve they've known in, you know, a quarter of a century from this -- from phantom limb. So, again, it's an example of a lot of different things that we're able to do with the brain to help rehabilitate it nowadays.
ROBERTSSarah, if there is a particular website or a particular source of information on neurofeedback that would be helpful to our listeners…
ROBERTS…why don't you send us an email here at firstname.lastname@example.org.
ROBERTSAnd we'll post that link, as well, on our website. So many of our callers have been very helpful with suggestions, and we'd welcome that.
SARAHWonderful. Thank you…
SARAH…for taking my call. Bye, bye.
ROBERTSWe appreciate it very much. Thanks a lot. We've got time for one more quick caller. And let's turn to Chet, in Jacksonville, Fla. Chet, you're on "The Diane Rehm Show."
CHET…call. I suffered TBI due to -- I had brain surgery in 1999 because I had an eight-centimeter brain aneurism that had not popped. And the surgery required dual bypass, along with 36 coils, basically to fill up the aneurism. They had to take a third of my skull bone and keep it in the freezer for about six months while my brain swelling went down. The first 18 months were pretty rough, but what I'm trying to impress upon the listeners is recovery can happen. I went off and got myself a master's degree, became a substance abuse therapist.
CHETAnd since 2009 -- I took myself off the anti-seizure meds. And I have been seizure-free. And my, you know, I do see a neurologist every couple of years. And he says the brain has a healing process of about a decade from the type of surgery I had. You want to comment about the type of healing that the brain goes through after a severe brain surgery like I had?
ROBERTSExcellent question, Chet. Thanks for sharing your story. This has been a theme we've seen a lot this morning, about one of the messages here is recovery is possible. And there is hope for a lot of people like our caller who have been through these traumas.
KEANYeah, the stories about neurosurgery are some of the favorite ones that I have in the book. They're just incredible, incredible stories about, you know, people getting large parts of their brain removed or -- I don't know if a lot of people know it, but a lot of times patients are awake during neurosurgery. They're interacting with the doctors. The doctors are, you know, stimulating parts of their brain, looking at what sensations they're experiencing. So there's really incredible stories about people being awake. And, yeah, there are incredible stories of people recovering, as well.
ROBERTSWell, it's a wonderful, hopeful note to end this fascinating conversation. And thanks particularly to our wonderful callers for sharing their stories, as well. Sam Kean, his book, "The Tale of the Dueling Neurosurgeons: The History of the Human Brain as Revealed by the True Stories of Trauma, Madness, And Recovery." A very important theme of our conversation this morning. And thank you, our wonderful listeners, for joining us. I'm Steve Roberts, sitting in for Diane. She has a cold today. She'll be back soon. Thanks for spending your morning with us.
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