My teenage daughter suffered a minor head injury in a swimming pool this week, and felt dizzy and lethargic afterward. I debated taking her to the emergency room, but opted for the pediatrician who was covering for ours that day. Dr. Fried did a quick neuro-check and diagnosed a concussion. Grace didn’t need a CAT scan, she told me. Too much radiation, and we already know what’s wrong. She prescribed something called “cocoon therapy” and gave me an article explaining neurologists’ most recent understandings of concussion and why cocoon therapy is the best treatment.
Dr. Fried’s cocoon therapy orders are for complete mental and physical rest. No exercise. No concentration, no reading, no studying her lines for the play she’s in. No texting, no Internet, no complex movies or TV shows. No loud noises, flashing lights, or crowds. Sleep, quiet and darkened rooms are the fastest track to recovery. The new Harry Potter movie, Dr. Fried said, is out of the question. “Don’t think about complicated things,” she advised, and Grace and I both laughed, but the doctor was serious. No contemplating the mind-body problem, the reality of free will, the existence of God or the problem of evil. Doctor’s orders.
The article explained why. Concussion disrupts the proper functioning of the brain, even when there is no structural damage. Cocoon care “set[s] the stage for rapid resolution of symptoms since it minimizes the possibility for further insulting the injured brain as it tries to heal itself.” Grace’s brain is busy trying to restore the connections that were lost when her head hit the stone steps in the pool with enough force to stun her. Managing stimuli, solving problems or learning new information would leach the resources her brain is using to repair itself. The less she does, the more she lies in the dark doing nothing, the more energy her brain will have to do the work it needs to do in order to restore her equilibrium, vision, and reasoning, all of which were impaired in the accident.
“How can a thought hurt me?” Grace asked me when we got home. “Agh! I shouldn’t be thinking about that!” We laughed, but I had the same trouble wrapping my unconcussed brain around the same problem. Nothing feels more insubstantial than thought. It feels less like a physical process than anything else your body does. If you sit still, you can feel your heartbeat and your breath, and the body certainly makes no secret of the phases of digestion. But thought feels like nothing at all. People working on a difficult problem joke that their brains hurt, but it’s impossible: the brain itself contains no pain sensors. Some ideas are dangerous, but none of them cause even the slightest bruise.
The idea that a math problem done at the wrong moment can hurt a child’s brain seems like the latest iteration the root questions that neurology keeps pestering us with anew every few months since the advent of Functional Magnetic Resonance Imaging: what is the human mind? And who is in charge of it?
Researchers have known since 2008 that with FMRI, they can predict a person’s decision seven seconds before the person believes that he or she has made a conscious choice. “Your decisions are strongly prepared by brain activity. By the time consciousness kicks in, most of the work has already been done,” said study co-author John-Dylan Haynes. Think about that: some force within your brain “knows” what you will do before you yourself “know” it. In that case, who might “you” be? Even more distressing, if not you, then who the hell is making the decisions? Humorist Ceil Kessler thinks the answer may be simple, if ominous. “Your brain,” she writes “is playing for its own team.”
Changing ideas about who or what within us is responsible for our decisions may have to alter our concepts of crime and punishment. David Eagleman’s fascinating article in this summer’s Atlantic poses questions about legal responsibility for actions that are the result of neurological conditions. If a previously sane, intelligent man goes on a killing spree, but is discovered to have a glioblastoma compressing his amygdala, is he responsible for the crime? What about the man who suddenly becomes a pedophile at age 40, but is later discovered to have a tumor in his orbitofrontal cortex whose removal eliminates all pedophilic desire and behavior? What about Parkinson’s patients whose medication turns austere, sober elders into compulsive gamblers who lose hundreds of thousands of dollars? If the criminal is not deciding to commit the crime, but is nonetheless committing it, should he go to prison? Eagleman writes:
The crux of the problem is that it no longer makes sense to ask, “To what extent was it his biology, and to what extent was it him?,” because we now understand that there is no meaningful distinction between a person’s biology and his decision-making. They are inseparable.
FMRI complicates the mind-body problem we studied in Philosophy 101 with new terms and tools; it does not solve it. Not at all.
The philosopher Alva Noë is having none of it, or at least, a lot less than John-Dylan Haynes is having. In the book Out of Our Heads: Why You Are Not Your Brain and Other Lessons from the Biology of Consciousness, Noë writes:
…the neuro-scientists…have really only succeeded in replacing one mystery with another. At present, we have no better understanding of how “a vast assembly of nerve cells and their associated molecules” might give rise to consciousness than we understand how supernatural soul stuff might do the trick. Which is just to say that the you-are-your-brain idea is not so much a working hypothesis as it is the placeholder for one.
We may know, or think we know, that the brain produces consciousness, our sense of ourselves as feeling, thinking, acting beings, but so far, at least, we have no idea how it happens, or why. And unless neuroscience comes up with a plausible explanation, which Noë believes that it can never do using their current models and hypotheses, he advises us not to drink the Kool-Aid of materialism.
Just as it is said that the devil’s best trick is to convince people he doesn’t exist, it may be the brain’s greatest triumph to create a sense of consciousness that feels invisibly, inviolably, invincibly sovereign; so much so, in fact, that it is difficult for some of us to believe that it does not survive the death of the body. But a purely neurological basis for consciousness still does not feel true to me and I suspect, to many others. It’s possible, of course, that this feeling, too, may be part of the clever prank my brain is playing on me (whoever she might be). No matter what I read about neuroscience or Oliver Sacks, or hear on Radiolab or at the pediatrician’s office when my child has a head injury, or even think in a rational moment, it still really feels like a soul in here.