Cooperating with your brain

I read an article in last week’s New Yorker and I thought it appropriate to make a comment, since the very long holiday weekend is now behind us and many are probably nursing the wounds of their various excesses.

The article I read was about brain surgery, particularly hemispherectomy. This procedure is defined as the removal of half of the brain. Christ! One half of it? Of course the first thing I thought of was my little comment at the top of this blog about my being a right-brained individual. I always thought it desirable to be what they call right-brained, because the right hemisphere controls the left side of the body and most often gets the credit for creativity. (As it happens the left brain is responsible for language, which as a writer is pretty important for me too. Thankfully, I don’t have to decide to part with any brain tissue at present.)

Hemispherectomy was initially attempted to cure cancer, removing the brain tissue that surrounded aberrant cells. This proved ineffective according to this article, as cancer had been shown to re-emerge in the remaining hemisphere. The treatment, if you could call it a treatment, seems to have evolved into one for debilitating seizures caused by structural deformities in the brain. The subject of the majority of the story is a two-year-old girl from Pennsylvania, who was experiencing something like forty seizures per day. So many seizures, that the affliction was interfering with her development. As a result, she had difficulty with movement on the left side of her body, and had not yet developed even the rudiments of speech.

I don’t believe there is any measurable certainty about why hemispherectomy is viable, but the brain is a remarkably resilient and adaptable organ. It reassigns available resources when it has been damaged, such as by stroke. People learn to walk and talk again after injuries. I once heard a story about the great jazz guitarist, Pat Martino, who had to learn the instrument all over again. But having half the brain removed? It works for severe seizures, if you’re young enough. If you take half the brain out of a stroke victim, you’re liable to kill the guy, but a child can learn to use the tissue that they have available. This article describes how recipients of hemispherectomy go on to be honor students and the like. The great void left in the skull of the recipient fills with the fluid that normally surrounds the brain, which is produced at about a tablespoon per hour. Drains are installed during the procedure that route the appropriate volume of the fluid into the body, where it can be absorbed naturally. The drains keep the fluid on the right replenishment schedule. Amazing.

It isn’t that simple, of course. In these seizure cases, even a small portion of the malfunctioning hemisphere will cause seizures to continue. One case required that the surgeons go in again, to remove a piece of the occipital lobe (in the back) no larger than the first joint of your thumb, which did the trick. Sometimes, the seizures are only made less severe, and still have to be controlled with medication. And don’t underestimate the effort required for all involved to train half a brain to function as a whole.

I found it so disheartening when the article described each time, post-hemispherectomy, that the girl would have even a small seizure. The brain is amazing, but still incredibly delicate. I think of this little girl and her little brain, fighting to develop and survive, her left foot vibrating uncontrollably, everyone waiting to see if she’ll squeeze out some sort of “normal” life, now that she has a shot at it.

After reading the New Yorker article last Friday, I listened to people at work talking about the upcoming holiday weekend. Some had gotten a head start, staggering in, bleary eyed, raving about how much alcohol they had consumed on Thursday night. I heard one guy talking about how he “couldn’t see straight.” A woman complained that her boyfriend had gotten a head start on Friday afternoon while watching a World Cup game at a bar, while she was stuck in the office, not drinking yet.

I don’t drink alcohol. I don’t understand the allure. After reading this story about how things can go so terribly wrong, I have not changed my mind. I wonder why so many people fill up their lives with drunken excesses. I haven’t gotten a straight answer out of one of them yet. The older I get, the more I see the effects in others. Their minds seem to work a bit more slowly, but I don’t feel mine slowing down. Is it because I never drank? I wish I knew. Alcohol has been the self-medicating drug in our culture for such a long time. Doesn’t everyone seem to have a distant relative who drank too much? Why do so many people think it’s what they’re supposed to do to enjoy themselves? Maybe they haven’t been provided with enough alternatives. Maybe they haven’t thought to seek them out for themselves. Regardless, their brains are drying out a little more every weekend. What a drag.

If you sit quietly, can you feel your brain? How much have you taken it for granted? What would it be like if it refused to cooperate with you? Can you visualize it as the container for everything you are and have ever experienced? It is. How much of it can you part with? Half?