'...If New Orleans is a city with an overripe id, it is also home to Tulane University Medical School and its unique department of neurology and psychiatry. ... In 1950, [Dr. Robert G.] Heath first put depth electrodes into the brain of a human mental patient. ... His electrodes charted the circuitry of pain in some of the illest brains in Louisiana. It was the first time electrodes had been used inside human brain tissue (except very briefly during epileptic operations just to guide neurosurgeons around the homogenous macaroni of the cortex), and so Heath's operations were controversial, to say the least. The Orgasmic Brain
[Quotes from The Three-Pound Universe,
0-874-77650-3, 419 pg pb
by Judith Hooper and Dick Teresi, 1986; 1991
[from pages 152-161 of the paperback edition]
In the years from 1950 to 1952, he implanted brain electrodes in twenty-six patients. Some of them suffered from incurable epilepsy, intractable physical pain, Parkinson's disease, and other medical conditions, but most came out of the dimly lit back wards of the state mental hospitals. With dental burr-drills, Heath and his co-workers drilled through the patients' skulls, guided the electrodes carefully into specific sites, and then left them there, at first for a few days, later for years at a time. ...
"By implanting electrodes and taking recordings from these deep-lying areas," he explains, "we were able to localize the brain's pleasure and pain systems. We'd interview a patient about pleasant subjects and see the pleasure system firing. If we had a patient who flew into a rage attack, as many psychotics did, we'd find the 'punishment' system firing." The pleasure system includes the septal area and part of the almond-shaped amygdala; the other half of the amygdala, the hippocampus, the thalamus, and the tegmentum (in the midbrain) constitute the punishment system.
... Whenever a mental patient flew into a violent rage or turned into a catatonic zombie, the EEG was almost certain to display the telltale sawtooth pattern. If the patient got well, the spike disappeared. ...
"The primary symptom of schizophrenia isn't hallucinations or delusions," he tells us. "It's a defect in the pleasure response. Schizophrenics have a predominance of painful emotions. They function in an almost continuous state of fear or rage, fight or flight, because they don't have the pleasure to neutralize it." ...
It turned out that electrical stimulation of the pleasure center automatically turned off the punishment system -- what Heath calls "the aversive system" -- and vice-versa. And so Heath tried to cure mental illness with direct electrical stimulation of the pleasure neurons. "If we stimulated their pleasure systems, violent psychotics stopped having rage attacks," he says. "We even stimulated the septal area in people suffering from intractable cancer or arthritis pain and we were able to turn off the pain." ... By stimulating the septal pleasure area, he could make homicidal manias, suicide attempts, depressions, or delusions go away -- sometimes for a long time. ...
As it turned out, it took more than a few pulses of current to exorcise madness. Heath had to devise safer electrodes that could be left in the brain for years so that a patient could be restimulated at intervals. Then, in 1976, the "most violent patient in the state" -- a mildly retarded young man who had to be tied to his bed because of his savage outbursts -- received Dr. Heath's first brain pacemaker.
The pacemaker is an array of tiny battery-powered electrodes that delivers 5 minutes of stimulation every 10 minutes to the cerebellum, at the very back of the brain. Its power source, a battery pack about the size of a deck of playing cards, could fit neatly in the patient's pocket. (Later it was miniaturized to matchbook proportions and implanted in the recipient's abdomen; it requires recharging every 5 years.) The cerebellum, Heath learned, is a better entryway to the brain's emotional circuitry. Stimulating a precise half-inch of its cauliflowerlike surface automatically fires the pleasure area and inhibits the rage centers, and so it was no longer necessary to invade the limbic areas farther forward in the brain.
The first pacemaker patient soon stopped trying to slash himself and his caretakers and went home from the hospital. All was well, for a while. Then the man inexplicably went on a rampage and attempted to murder his parents. Before he was subdued, he had severely wounded his next-door neighbor and narrowly missed being shot by the sheriff. Heath's X rays quickly spotted the problem: broken wires between the pacemaker and the power source. Once the wires were reattached, the rage attacks waned again. The young man is now in vocational rehabilitation and doing well.
In 1974 a pretty, intelligent twenty-one-year-old librarian was shot in the head during a holdup. After an operation that removed much of her frontal lobes, she had frequent seizures, was barely conversant, and had to be fed through a tube because she stopped eating. By the end of the next year she was in a continual frenzy. She lashed out at anyone within range and once tried to stab her father. She screamed whenever she was touched and complained of constant, excruciating pain all over her body. Her brain pacemaker was installed in November 1976, and, magically, the rage episodes subsided. She started eating; her memory improved; and her doctors began describing her personality as "pleasant" even "sparkling."
Another patient, a severely depressed former physicist, was troubled by voices that commanded him to choke his wife. When he got one of Dr. Heath's pacemakers in 1977, the infernal voices vanished, along with his perennial gloom. He and his wife began to visit relatives and dine together in restaurants for the first time in years. But *his* wires eventually broke, and once again his wife was threatened with strangulation. When the gadgetry was mended, so was the man's psyche.
Ironically, the many technical snafus that plagued the pacemaker gave Heath the perfect controls for his experiments. ... Even so, the cerebellar pacemaker is not a psychiatric cure-all. By Heath's estimates, about half of the seventy-odd patients have been substantially rehabilitated -- no mean feat, given that pacemaker recipients come from the ranks of the "incurable" -- but other have never emerged from their private hells. For some reason, depressives and patients prone to uncontrollable violence have benefitted most; chronic schizophrenics the least.
Fortunately for posterity, Heath and his colleagues filmed many of their bold journeys into the human emotional apparatus. ... A woman of indeterminate age lies on a narrow cot, a giant bandage covering her skull. At the start of the film she seems locked inside some private vortex of despair. Her face is as blank as her white hospital gown and her voice is a remote, tired monotone.
"Sixty pulses," says a disembodied voice. It belongs to the technician in the next room, who is sending a current to the electrode inside the woman's head. The patient, inside her soundproof cubicle, does not hear him.
Suddenly, she smiles. "Why are you smiling?" asks Dr. Heath, sitting by her bedside.
"I don't know ... Are you doing something to me? [Giggles.] I don't usually sit around and laugh at nothing. I must be laughing at something." "One hundred forty," says the offscreen technician.
The patient giggles again, transformed from a stone-faced zombie into a little girl with a secret joke. "What in the hell are you doing?" she asks. "You must be hitting some goody place."
The "goody place" is the septal pleasure center, which the unseen technician is stimulating with an electrical current. "She was a mean one," Heath muses. "She was hospitalized for years for a schizoaffective illness. ... This film was made in 1969, and the treatment has held on her -- she's doing well."
[From another patient story:] "There -- see the big delta wave appearing in the septal region," Heath tells us. Sure enough, large, languorous waves are now coming from the lead to the septal electrode. "There's almost an exact correlation," he adds. "When he gets a rush of good feeling, the record shows large-amplitude waves in the pleasure system." ...
Along with depth electrodes, Heath's team would often surgically implant a sort of tube, called a canula, through which they could deliver precise amounts of a chemical directly into the brain. Oriental sacred texts (and Aldous Huxley's Brave New World) mention a legendary bliss drug called "soma", the food of the Himalayan gods. The real life version might be acetylcholine, a natural chemical neurotransmitter. When the Tulane researchers injected acetylcholine into a patient's septal area, "vigorous activity" showed up on the septal EEG, and the patient usually reported intense pleasure -- including multiple sexual orgasms lasting as long as thirty minutes.
"I can show you a film of one of the recordings," Heath offers, fishing through some of the reels on the shelves. We half expect a neurologic peep show, but the film he digs out is the raw EEG record of a woman patient, who was being treated for epilepsy, under the influence of acetylcholine. A flat, clinical voice-over accompanies the staticky march of brain waves across the screen:
Now we're coming to the start of the changes ... It's in the form of a fast spindle, about 18 per second ... first in the dorsal right anterior septal, then it spreads to the other septal leads. ... This is still correlated with the same clinical findings of intense pleasure and particularly of a sexual nature.A half hour after the acetylcholine injection, the patient is still having orgasms. Heath points at an ominous-looking scrawl on the EEG and notes, "See, it looks like almost like the spoke-and-dome pattern of epileptic seizure. It's a very explosive activity."The flip side of joy is pain. The next film shows a patient having his "aversive system" stimulated. His face twists suddenly into a terrible grimace. One eye turns out and his features contort as though in the spasm of a horrible science-fiction metamorphosis. "It's knocking me out ... I just want to claw..., " he says, gasping like a tortured beast. "I'll kill you...I'll kill you, Dr. Lawrence."
... When [Heath] first showed his movies to an assemblage of psychiatrists, neurologists, and other scientists, some were outraged. Murmurs of medical hubris, mind control, and unsafe human experimentation circulated -- in large part because of the film we just saw. But what looks like a scene from the Spanish Inquisition, Heath assures us, is no more than electrical stimulation of the rage/fear circuits. Unfortunately, the audience, back in 1952, misread it.
"They thought we were hurting him," he tells us. "But we *weren't* hurting him. We were stimulating a site in the tegmentum in the midbrain, and all of a sudden he wanted to kill. He would have, too, if he hadn't been tied down... He started remembering a time when he lost his temper -- when his shirts weren't ironed on right and he wanted to kill his sister. That showed us we'd activated the same circuit that was fired by his spontaneous rage attacks." ...
"As soon as we turned off the current he went back to normal," Heath recalls. "We asked him why he had wanted to kill Dr. Lawrence (not his real name), and he said he had nothing against Dr. Lawrence; he was just there. He's like a psychotic person on the street who lashes out at whoever is around." ...
Heath tells us some of his patients were given "self-stimulators" similar to the ones used by Old's rats. Whenever he felt the urge, the patient could push any of 3 or 4 buttons on the self-stimulator hooked to his belt. Each button was connected to an electrode implanted in a different part of his brain, and the device kept track of the number of times he stimulated each site.
Heath tells of one patient who felt impelled to stimulate his septal region about 1500 times per hour. He happened to be a schizophrenic homosexual who wanted to change his sexual preference. As an experiment, Heath gave the man stag films to watch while he pushed his pleasure-center hotline, and the result was a new interest in female companionship. After clearing things with the state attorney general, the enterprising Tulane doctors went out and hired a "lady of the evening," as Heath delicately put it, for their ardent patient.
"We paid her fifty dollars," Heath recalls. "I told her it might be a little weird, but the room would be completely blacked out with curtains. In the next room we had the instruments for recording his brain waves, and he had enough lead wiring running into the electrodes in his brain so he could move around freely. We stimulated him a few times, the young lady was cooperative, and it was a very successful experience." The conversion was only temporary, however.
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