The brain: the new frontier

IN APRIL 2013, US President Barack Obama launched a research program aimed at uncovering the “enormous mystery of the human brain,” for which he sought $100 million in funding from Congress. The public mind has mostly associated American scientific research with the exploration of outer space. And so it comes as a pleasant surprise to know that advanced science is redirecting some of its lenses from the vast cosmos out there to the tiny mass of tissue inside our heads.

BRAIN, or Brain Research Through Advancing Innovative Neurotechnologies, according to a White House statement, “aims to help researchers find new ways to treat, cure, and even prevent brain disorders, such as Alzheimer’s disease, epilepsy, and traumatic brain injury.” Much of the preliminary work has to do with mapping brain activity—“how individual brain cells and complex neural circuits interact at the speed of thought.”

I have always been interested in cognitive biology as a complement to a longstanding fascination with human cognition and consciousness.  But knowing how the brain works—or, more broadly, how the nervous system functions—held no practical significance for me, except during those few times when I wondered if my occasional forgetfulness was not a prelude to dementia.

I am a biker, and the thing I dread most about riding motorcycles is not so much breaking a bone as suffering a concussion as a result of a bad spill. I have felt, and have seen in my riding buddies, the immediate effect on the consciousness of falling from a bike. For a split second, you are dazed and disoriented: You don’t now where you are or what you were doing. You feel nothing. Then, slowly, you remember you were on a bike, and so the first thing you ask is: “Where is my bike?” It dawns on you that you have dropped it, and that you’ve had an accident. Only then do you start searching yourself for any injury.

The brain is amazing in that sense. It suspends the pain while you are recovering your bearings. Then it gives you the will, and a boost of strength, to do something to get you out of danger. It happened to me the first time I took a spill one evening while rounding a bend on my new Ducati. A low-side spill instantly separated me from the bike, dropping me near the apex of the road and sending the bike across to the other end. In the dark, I looked around wondering where I was. “Whoa, I fell!” I told myself moments later, rushing to pick up the 200-kilogram bike. Only then did I notice the blood on my left hand. Shaken, I felt my head and felt relieved to find that I had a helmet on.

Instead of being a passive register of the surrounding reality, the human brain appears to operate according to its own internal dynamics, almost irrespective of what’s happening in its environment. When the operational unity of that system is disturbed for any number of reasons, its relationship to its environment is also altered. One can see this in people who have suffered a brain stroke. The neural circuits shut down, or go haywire, sending unstable electrical pulses to nerve cells throughout the body.

Last month, I watched my younger sister’s brain literally flicker as she sank into a deep stupor following a hypereosinophilic attack on her vital organs. Hypereosinophilia is an auto-immune condition, in which white blood cells called eosinophils, which normally help combat infection in the body, turn against the body itself. “They become a wandering army of ronins or samurais without a master,” said the cardiologist Dr. Michael Jaro. In my sister’s case, the eosinophils began attacking the lining of her blood vessels until her entire body became swollen.

Her supervising physician at the National Kidney & Transplant Institute (NKTI), the pulmonologist Dr. Joselito Chavez, quickly assembled a team of the best Filipino specialists to manage this rare medical condition. He brought in the hematologist Dr. Lynn Bonifacio to control the hypereosinophilic attack, the infectious disease specialist Dr. Myrna Mendoza to address the source of infection that might have triggered the sudden rise in eosinophils, Dr. Michael Jaro to monitor and alleviate the impact on the heart, and the neurologist Dr. Abdias Aquino to minimize the damage on the nervous system and on the brain itself. Later, the psychiatrist Dr. Reynaldo Lesaca was called in to help my sister cope with the insomnia and the depression that typically set in when patients find themselves overwhelmed by a terrible illness.
The wonder of professional teamwork, of medical science at its best, and of the world-class quality of hospital care at NKTI brought my sister back to us. My family is eternally grateful to these wonderful doctors. Just as we helplessly watched her gradually lose control of her limbs, of her speech and cognition, today we see her slowly regaining all the faculties we associate with being human. Before her brain switched off for three weeks last July, I remember her last attempt at communication: “This is not me, this is not me.” The other day, while visiting her in our home in Betis, she thanked me for being there, and said, “I’m sorry for having caused all of you this trouble.” I smiled, happy that this sensitive soul is once more awake, and told her: “Welcome home, dear sister!”

“The first thing we learn from studying our own circuitry,” writes the neuroscientist David Eagleman in the book “Incognito: The secret lives of the brain,” “is a simple lesson: most of what we do and think and feel is not under our conscious control. The vast jungles of neurons operate their own programs. The conscious you—the I that flickers to life when you wake up in the morning—is the smallest bit of what’s transpiring in your brain.”
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