When Neurology Becomes Theology

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A neurologist’s perspective on research into consciousness.

Early in my neurology residency, a 50-year-old woman insisted on being hospitalized for protection from the FBI spying on her via the TV set in her bedroom. The woman’s physical examination, lab tests, EEGs, scans, and formal neuropsychological testing revealed nothing unusual. Other than being visibly terrified of the TV monitor in the ward solarium, she had no other psychiatric symptoms or past psychiatric history. Neither did anyone else in her family, though she had no recollection of her mother, who had died when the patient was only 2.

The psychiatry consultant favored the early childhood loss of her mother as a potential cause of a mid-life major depressive reaction. The attending neurologist was suspicious of an as yet undetectable degenerative brain disease, though he couldn’t be more specific. We residents were equally divided between the two possibilities.

Fortunately an intern, a super-sleuth more interested in data than speculation, was able to locate her parents’ death certificates. The patient’s mother had died in a state hospital of Huntington’s disease—a genetic degenerative brain disease. (At that time such illnesses were often kept secret from the rest of the family.) Case solved. The patient was a textbook example of psychotic behavior preceding the cognitive decline and movement disorders characteristic of Huntington’s disease.

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WHERE’S THE MIND?: Wilder Penfield spent decades studying how brains produce the experience of consciousness, but concluded “There is no good evidence, in spite of new methods, that the brain alone can carry out the work that the mind does.”Montreal Neurological Institute

As a fledgling neurologist, I’d already seen a wide variety of strange mental states arising out of physical diseases. But on this particular day, I couldn’t wrap my mind around a gene mutation generating an isolated feeling of being spied on by the FBI. How could a localized excess of amino acids in a segment of DNA be transformed into paranoia?

Though I didn’t know it at the time, I had run headlong into the “hard problem of consciousness,” the enigma of how physical brain mechanisms create purely subjective mental states. In the subsequent 50 years, what was once fodder for neurologists’ late night speculations has mushroomed into the pre-eminent question in the philosophy of mind. As an intellectual challenge, there is no equal to wondering how subatomic particles, mindless cells, synapses, and neurotransmitters create the experience of red, the beauty of a sunset, the euphoria of lust, the transcendence of music, or in this case, intractable paranoia.

I couldn’t wrap my mind around a gene mutation generating an isolated feeling of being spied on by the FBI.

Neuroscientists have long known which general areas of the brain and their connections are necessary for the state of consciousness. By observing both the effects of localized and generalized brain insults such as anoxia and anesthesia, none of us seriously doubt that consciousness arises from discrete brain mechanisms. Because these mechanisms are consistent with general biological principles, it’s likely that, with further technical advances, we will uncover how the brain generates consciousness.

However, such knowledge doesn’t translate into an explanation for the what of consciousness—that state of awareness of one’s surroundings and self, the experience of one’s feelings and thoughts. Imagine a hypothetical where you could mix nine parts oxytocin, 17 parts serotonin, and 11 parts dopamine into a solution that would make 100 percent of people feel a sense of infatuation 100 percent of the time. Knowing the precise chemical trigger for the sensation of infatuation (the how) tells you little about the nature of the resulting feeling (the what).

Over my career, I’ve gathered a neurologist’s working knowledge of the physiology of sensations. I realize neuroscientists have identified neural correlates for emotional responses. Yet I remain ignorant of what sensations and responses are at the level of experience. I know the brain creates a sense of self, but that tells me little about the nature of the sensation of “I-ness.” If the self is a brain-generated construct, I’m still left wondering who or what is experiencing the illusion of being me. Similarly, if the feeling of agency is an illusion, as some philosophers of mind insist, that doesn’t help me understand the essence of my experience of willfully typing this sentence.

Slowly, and with much resistance, it’s dawned on me that the pursuit of the nature of consciousness, no matter how cleverly couched in scientific language, is more like metaphysics and theology. It is driven by the same urges that made us dream up gods and demons, souls and afterlife. The human urge to understand ourselves is eternal, and how we frame our musings always depends upon prevailing cultural mythology. In a scientific era, we should expect philosophical and theological ruminations to be couched in the language of physical processes. We argue by inference and analogy, dragging explanations from other areas of science such as quantum physics, complexity, information theory, and math into a subjective domain. Theories of consciousness are how we wish to see ourselves in the world, and how we wish the world might be…

more…

http://nautil.us/issue/49/the-absurd/when-neurology-becomes-theology

WIKK WEB GURU
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