1
On a cold Sunday morning, he
passed a nurse in the hallway.
'How do I get to the
14th floor?', he asked.
There's something
in me I do not like.
It keeps making me do
things I don't want to do.
I don't want to be me anymore.
You said they told you you
were dead, is that correct?
They say they can change
me into someone else
put electrodes in my brain.
I'm not sure I
believe them, he said.
- Don't let me do it.
- I won't let you do it.
The man almost jumped on that
Sunday morning 50 years ago.
But he was drawn back
from the edge by a doctor.
This was Robert Heath, the
psychiatrist who'd admitted him.
We still have a feeling that
we're working in the dark.
We actually don't
know what's going on
and the real problem is in
understanding this thing here.
This is perhaps the
most complicated
organ in the whole universe.
The brain is the central
integrator of all behavior.
Bob was trying to focus on the
idea that there
was a deficiency -
an innate deficiency in
that quality of pleasure.
And began slowly
trying to focus on
where in the brain
that pleasurable or
those pleasurable
areas might reside.
Heath was on a mission.
He was searching for the seat
of pleasure in the brain.
He called it Hedonia.
Hedonia means pleasure
and searching for the
brain's pleasure center
would later get him
into great trouble.
So much so that he was written
out of history and forgotten.
But 30 years later
the idea of going into the brain
to cure the mind arose again.
Today, the most
ambitious neurosurgeons
are targeting a broad
range of different
brain diseases with
neuromodulation.
Depression is going
to be the first
huge public health problem
that is addressed
with neuromodulation.
Addiction,
obesity and opioid abuse.
Tourette works.
OCD works.
If the tools are there and the
brain is our new frontier
what are we going to discover?
What if we could open
up the potential
of the brain to learn
skills and facts a lot better?
People are going to want that.
What kind of future lies
ahead for the human mind?
Will probing the brain
bring happiness or misery?
We are exploring how brains and
machines work together, right?
The dynamic between humans and
machines is ultimately changing.
I get into ethical quandaries...
You can imagine all sorts
of weird applications
that hopefully make
people uncomfortable.
What kind of legacy would these
grand ambitions leave behind?
There are explorers,
conquistadores
in science, and
that's who they are.
Some of them
discover continents,
some of them drown in the ocean.
It was a revolution
when the Food and Drug
Administration in
the late nineties
approved a new treatment
for Parkinson's disease.
They called it Deep
Brain Stimulation.
Instead of giving medications
neurosurgeons would
insert ultrathin
electrical wires into the brain
to correct the debilitating
shaking and stiffness.
A little bit more room there.
Here comes the fun part.
Most people say that's the most
painful part of the whole deal.
Ready?
You will feel a little stick.
I want you to breathe
in and out slowly.
One, two, three, breathe.
He laughs at it.
Is that all you've got?
Give me a second here.
I'll fix that back.
We're going to put
a little pad behind
your neck to make
it more comfortable.
What kind of music do you want?
You don't have any
early Beatles, do you?
We have early Beatles.
The system is simple.
A battery under the skin
feeds a stimulator
that delivers a current
directly to neurons.
To find the exact spot in the
brain and the right current
the patient has to be
awake during the operation.
Alright,
are you ready? Loud noise!
That drill bit stops itself
if it hits something soft.
As long as it's pushing against
something hard like bone...
You're having fun?
Most people, when they
train in movement disorder
you see somebody who is
shaking, you see a funny walk
you see eyelids
closing too much,
a neck twitching,
you see a tick...
Why does that happen?
Why is this movement happening?
The brain is amazing
and beautiful
and the most complex
object in the known universe.
There are a hundred
billion neurons
each with an
average of a thousand
connections to other neurons
and so the complexity and
connectivity of this organ
sort of dwarfs the kidney.
And your brain is you.
Your kidney is not you.
You can take a kidney
out and you're still you.
But if I injure
part of your brain
I take away a part of you.
There's still some
background at 18.6.
The green there, that's actually
noise out of your brain.
It's just noise.
We often say this
is like driving through Europe.
As he goes through different
regions of the brain
it's like when you
drive through Europe
and they speak
different languages.
In Amsterdam or the Netherlands
they speak one language.
The border speaks a
different language,
when they ask you
for your passport.
You head into
Germany, guess what?
The language changes again
and then down to Italy
for a little wine.
But everybody's speaking
different languages. Same thing.
As he goes from top
to bottom here,
he's gonna look for
different languages
and then Dr. Barmore
on your right
side, one of the neurologists
is going to move your arms and
legs around with Dr. Almeida
to see which cells are
responding to movement.
That tells us where the motor
regions are in the brain.
One of the amazing
things in retrospect
about a guy like Bob Heath...
We are talking about 1950.
65 years ago, when he
was doing this every day.
We calculate our coordinates
from the X-rays
make the adjustments in the
various planes on the machine
then we're in a position
to drill the barrel holes
and to lower the
electrodes into place.
Electrodes are carried down by
means of rather stiff guides
and after they're lowered
to the proper depth
determined by this
millimeter scale here
we clamp the wires into
place, and turn this back up.
After they're fixed
with a plastic button
we're in the position to do our
recording and to give treatment.
And you've told me you had
these voices that troubled you.
- Yeah.
- Tell me about those.
Bob was trying to focus
on this bizarre syndrome
that we're calling
schizophrenia.
Looking for pleasure, believing
as they did, as Bob did
with the first few people,
who had electrodes placed
that the septal area did seem to
show abnormal
electrical activity
which changed when a stimulus
was somehow placed there.
...and we'll send you home.
- Alright, congratulations!
- See you later.
Good job!
After hundreds of operations
surgeons began to compare notes
and something
unusual came to light.
Once in a while
a Parkinson's
patient would react
strangely and surprise everyone.
I had met this
patient, you know...
many times, several times.
I'd never seen her
smile before, and
she always seemed
pretty miserable.
As I was turning the voltage up,
the most remarkable
thing happened.
Michael Okun is talking to
her while we were doing this
and he says, 'What
are you feeling?'
As she says, I feel happy!
We had tapped into an
interface in the brain
between the motor and the
limbic behavioral functions.
When we submitted
it for publication
the response was 'No,
this can't be real.'
Now we know, fast-forward
a couple of decades
that this has been reproduced
all around the world.
What looked to most surgeons
to be an odd side effect
was really a breakthrough.
And in 2001, this was
picked up on by an outsider.
Neurologist Helen Mayberg
who had long researched the
mechanisms of depression
became the first
to try deep brain
stimulation to understand mood.
We'd been thinking about this
thought experiment for a while.
The most amazing thing
about that first time
was in fact that nobody
knew what to expect.
So to actually have a patient
change state in
front of our eyes
was very emotional.
How can it not be?
You just want nothing bad
to happen to this patient
while you indulge
in testing an idea.
And all of a sudden
her face changes.
That was the moment
where I said:
I don't know what this
is or what we are doing
but we better figure this out
because maybe this really
is the start of something.
The circuitry that controls
your emotional state
and the circuitry that
controls your ability to move -
they're the same.
And interwoven within that
circuitry in the human brain
are the representations for mood
how you feel, the
representations for emotions
the representations
for what we call
associated circuits,
how you think.
You're gazing from
a window to life
but it's impossible for
you to take part in life.
You're just gazing through
this milky window
and see people,
what they're doing
what...
there is life and there...
Just take part in life
but I can't.
You're like locked
in your own world.
It's like a foggy dew
when I try to remember
the last time I was happy
I was lucky, I
felt these feelings.
We have a pleasure if we
eat something really good.
Our system really
immediately knows
that's something good,
that's something to be repeated.
Hedonia is one of the
key driving factors
not only of us,
actually of all vertebrates.
Hedonia tells you
what's good for you
in a not so subtle way.
And Hedonia is very
important for sex drive
for our reproduction,
romantic love, music.
All of these functions are no
longer there in depression.
At this point in my life
I wouldn't say
that it is a life.
Life is very far away.
I once read the expression
'cancer of soul'.
It very likely
means what it says
because it destroys
your soul and
your feelings and your thoughts
and so you're at the
point where you say:
I can't bear the pain anymore.
And I don't want
to live anymore.
I'm pretty much
always depressed,
have been since I was nine.
I become very isolated.
I'm like sliding down
into the bottom of a well.
It's very, very dark...
There's no one there.
There's really no light.
I feel that...
...that I have no contribution
to make whatsoever
that I'm basically worthless.
So why even make the
attempt to get out?
Many of these
patients are basically
stuck, without options.
They live in a purgatory
that to me is indescribable.
They don't respond to therapy or
any of the multitude of drugs
they failed ECT.
Those patients are at
the end of the line.
I get away with it, because...
...my husband is...
He's a really good man.
He takes good care of me.
As a resident
I met a very,
very desperate patient.
He was a government
employee and he was
afflicted with a
horrible destiny.
He had repetitive depression
and I met him at
his seventh episode.
He came to the
clinic in Bern where
I worked at the
time and he said:
Oh, doctor. It's
depression striking again.
Please, please,
please, don't make me
participate in group
therapy again.
Which I thought
was an odd thing.
I said, OK,
I'll talk to my boss.
I went to the boss
and the boss said:
Oh yeah, this is a cathartic
moment in the life
of this patient.
He shows some aggression.
This aggression is good.
Aggression against his
depression, we need to use it.
He will have group therapy.
What doesn't kill a patient
will make him stronger.
This was a particularly
stupid statement
because this patient hanged
himself six weeks later.
This destiny impressed
me tremendously
and I'm not against
psychotherapy.
Psychotherapy is very
useful in every patient.
We couldn't treat depression
without psychotherapy
but sometimes
patients need more.
And I like action in psychiatry.
I like that something
is going on.
I dislike months
and years of talking
with patients about same thing.
If they suffer so hard
something needs to happen.
When I was Chief
of Psychiatry in
New York State, the census then
in all of the New York State
Hospitals approached
90,000 people.
90,000 people permanent...
quote:
...permanently assigned
to various mental hospitals.
It was a massive, massive thing.
There was essentially
nothing to do
so far as treatment
was concerned
for some of those
who were lobotomized.
There was electroshock
and we would sometimes give
them two, three, four a day.
Enough to where
they were reduced
to slobbering pieces
of protoplasm.
There really was no treatment.
Those days...
How does one put it?
Those people
were locked up and forgotten.
And we were all
young and vigorous
and wishing we could do better.
Robert Heath was making
his way in New York
the promised land of
American psychiatry
with a practice
on Park Avenue and
tenure track at
Columbia University.
He caught the eye of
an ambitious dean
who wanted to make Tulane
University a 'Harvard
of the South'.
Robert Heath dazzled the dean
and Tulane offered the young man
the keys to a
kingdom of his own.
Chief of both neurology
and psychiatry at just 34!
It was unheard of.
This would have been
the summer of 1952-53.
If you were sitting in a room
and you wanted to,
in your mind, conjure up
the most magical person
good-looking,
filled with authority
filled with all
sorts of confidence
who was that man?
That was Dr. Heath,
Head of Psychiatry
and Neurology.
First word that comes
to mind is imperious.
Gregory Peck in kind of
appearance.
Very glamorous and...
...suave.
He took me on a tour of his lab
which I felt was really
amazing for an undergraduate
to have him spend
time doing that.
He started to talk about what
was going on in that lab.
He already,
from what I could tell
was wondering how
he might transpose
that whole concept of behavioral
anhedonia, lack of pleasure
to neurophysiology
and began slowly trying to
focus on where in the brain
that pleasurable or those
pleasurable areas might reside.
He realized this
is not an emotional
problem,
this is a brain disease.
Most psychiatrists
looked at it as,
'Oh well,
they have a psychotic break.'
But Heath was trying to figure
out what happens in the brain.
This is the old Charity
Hospital in New Orleans.
Robert Heath went
here every day to
walk the halls of
the third floor
and make his rounds.
He wanted his
psychiatric ward to
be the most modern
in the country.
Today, the hospital is abandoned
and plans are being
made to tear it down.
They did it first with
cats, a couple of animals
to show that there was
abnormal electrical activity
when one put a wire down deep.
You'd walk through the halls
and there'd be six Rhesus
monkeys sitting in chairs
with wooden collars
around their necks
with wires hanging
out of their heads.
It was a pretty
exotic thing for a
medical student to see all that.
But ultimately, of course,
he began using that on humans.
That sound we are hearing now
is coming from the normal brain.
In some ways it's
comparable to the
distant roar of a
four-engine plane.
This is a mentally ill patient.
Notice the difference in
sounds coming from his brain.
It sounds like a plane
with its engines misfiring.
In a way that's just
what's happening.
A dramatic approach
to say the very least!
To insert these microelectrodes
deep into the brain
and have them stay there
for periods of time
to measure and stimulate.
And we bought into
it, because they were
new ideas - It was thrilling!
Just the fact that
you could record
what was going on in the brain
and talk to the
patient and then you
could stimulate an
area of the brain
and have him tell you how
it changed his feelings.
I thought that was fascinating.
I didn't know
whether I was at the
frontier of American science
and he was bringing me there
or I was doing
experiments on humans
that had no right
to be going on.
The next patient, she will be
known as P6, with her father...
Schizophrenia was always
Robert Heath's big passion.
He called it 'the most disabling
disorder in all of medicine'.
Robbing young people
of their lives
and crippling whole families
with its massive stigma.
He was sure he would succeed
in curing schizophrenia.
And even if it is
one of the most
complex disorders
of the human mind
the task perfectly matched
his ambition for greatness.
How is your mood?
It's so hard to say.
Tell me as best you can.
Mediocre.
Mediocre?
- 60 pulses.
- Is there a difference?
Not sure I do right now.
I feel a little wiggly and...
90 pulses.
- What are you laughing about?
- I don't know.
- Are you doing something to me?
- What makes you think that?
I have no idea.
What in the hell are you doing?
Tell me what you thought.
Maybe you're stimulating
some goodie place.
What makes you say we're
stimulating a goodie place?
Well, I wouldn't be laughing.
Somehow the word
got out that what's-
her-name had shown
this huge response.
Everybody was running around
as if they were on dope.
Eureka!
Look what we've discovered!
It was like that.
This is happening.
It looks like we've done it!
And they went on to do
other patients of course.
I guess you could say that I'm
really disturbed
about feeling good.
- Because it's foreign?
- It's completely foreign.
So you've never felt
this way in your life?
Felt this good in your life?
No. I've... I've been trying
to pick out something
trying to find
something in my background
that I can relate it
to, but I can't.
Does it have any
bad effects on you?
No bad effects at all.
If I could buy one I
would take one home.
- You want to take one home?
- Yes. I'd be glad to.
It's on the dock.
Now I can write my name
so I can read it, and...
It seems like I can
do anything now.
Some things a 70-year-old can't
do, but he thinks he can
when he thinks he's
still 20 and then
he looks in the
mirror and thinks:
Who's that old guy
looking at me?
I don't think he can
do this anymore.
Essential tremor...
As soon as you
put your hands out
they start shaking right away.
Now mine, I put them out
and they just don't.
And I feel like
almost normal again.
Katherine, today is week
24 of the open stimulation.
And although we will see
you next week again
today is the primary
end point of...
- The big day.
- Actually the big day.
Let me just show...
Today is May 22nd.
How are you doing?
Good!
I am happy more than not.
I experience joy in...
...almost everything I do.
There's
always something about it
even if it's just the
fact that I'm doing it.
I usually find...
...some kind of joy.
I enjoy my life.
Never have before.
Never really had a life before.
So, it's kind of
like, you know...
Well as Jim calls
me, Catherine 2.0.
You improved on the old one.
You've always had this feeling?
Can you tell me any
more about this?
I can't do anything.
I know everything is going on
but it seems like I
can't be a part of it.
You can't be a part of it.
You feel like you don't belong?
Yeah,
I didn't want to leave home.
And it seems like the other part
of the world was just something
that I didn't belong in.
Some kind of a dream.
You think you feel just as bad
now as before the operation?
Yes.
Now the treatment is started.
She's receiving a very
minute amount of current.
Actually, it amounts to only
five thousandths of an ampere
delivered to a very
specific region in the brain.
But I don't like to feel me.
No,
I just want to hit something.
You want to hit something?
But I wouldn't feel
any different, so I
just want to get
something and tear it up.
You want to get
something and tear it up?
You feel you want
to tear that up?
Yeah. Take it, so I won't.
Now the current has
been reduced. She is
receiving four
thousandths of an ampere
and is changing in behavior.
Look at that smile
you've got now.
Why does that make me do that?
I don't like to do that.
You really told me off.
Remember?
I know, but I couldn't help it.
I didn't have any control
over it. It was just coming...
I was just thinking things
and I couldn't help it.
Tell me what you were thinking?
I wanted to slap your face.
I wanted them to cut that off
and I was mad at you because
you wouldn't tell them to.
I saw her and I said,
What was the
stimulator put in for?
And she said, I was
suicidally depressed.
And I said, Did it work?
And she said,
I'm alive and I'm not
depressed.
It's what saved my life.
I'm thinking My Lord!
This stuff really did work.
- Hi! How are you feeling?
- Hi! I'm just fine.
Good. How is everything at home
with that big girl of yours?
Oh, she's just fine. She is
a handful sometimes, though.
We're beginning to
make correlations
between the mind
and brain activity
and hope this will
be helpful particularly
in treating the major
mental illnesses,
the psychoses.
So, in the not too distant
future it won't be necessary
for one person
out of ten spending
some time in the
mental hospital.
We in the field even dare to
hope that the mental hospital
will be a thing in the past.
I remember it vividly.
Bob's weekend place
in Mississippi.
A small place that he'd go to
take some people, and do some
fishing, was called Hedonia.
A little farm.
He called it Hedonia.
This is where he's
talking about whether
it's an autoimmune
disease, schizophrenia.
So, I guess they're still
considering that
as a possibility.
I remember very
distinctly trying to get a
feeling for what his
relationship was
to his son and I never
knew, never could tell.
He never became a presence.
That's why I wonder
whether he survived
because Bob Heath worked
night and day, night and day.
The lab was open all the time,
his lights were on all the time
he worked every weekend.
It's amazing coming back here
and looking through some
of the stuff in the office
and seeing how
much of it there is.
And the whole concept of
his research kind of
being lost in a way
and then the same
sort of procedures
that he did back in
the 60s and 70s
are now being rediscovered
by modern physicians.
It's like... It's all here!
He has got all
these papers and
all these citations.
And what happened
to all of his stuff?
There are like
probably hundreds of
different papers
with his name on.
After a few positive results
in the operating room
Heath mounted a larger trial.
He carefully
selected 22 young men
and women with schizophrenia
facing a lifetime in
mental institutions.
Several years.
You've been having
these voices all
during that time?
Yes.
And what do these
voices say to you?
- I don't answer them back.
- You don't answer them back?
Why don't you answer them back?
I was scared.
Heath's group worked
for two years
operating, following up with
the patients, gathering data
and analyzing how the treatment
affected each one of them.
How long have you been working
for this engineering company?
- 11 months.
- Do you like that job?
Oh yes. It's not hard work.
People are very
nice and everything,
and I haven't been in trouble.
How about the symptoms that
were terribly distracting?
I don't have any
of those anymore.
Hallucinations?
And your rage for
impulses where you...
Oh no, none of those anymore.
- How are you getting on?
- I'm doing wonderful.
I don't have any more
trouble like I did have.
And I don't have those dreams,
I don't have those voices...
I have more control over myself.
It's just so much
different from the
way I was and the way I am now.
It's unexplainable really, you
can't... You can't
really explain it.
When it appeared
that the treatment
helped half of the patients
Heath decided to break the news
in an invitation-only seminar
where he presented
everything for
a select group of leading peers.
These men were some of the most
respected names in psychiatry
and they did not
approve of his methods.
They suspected that the patients
got so much attention and care
that the apparent
effect was placebo.
Most of the
discoverers are nerds
by the very nature of the work.
In contrast to the thick lenses,
the dirty shirt, and you know...
Bob was the anti-nerd.
First, he was a great tennis
player, a great golfer
absolutely at home
with himself socially.
He was very good
at raising money
and it was usually a sort
of charismatic interaction
with a wealthy family or a
foundation or
something like that.
He was one of these
guys you couldn't
stay away from. He was just...
How can I put it?
A temple of charisma.
The kind of guy, I think, that
many other academic people
from what I've seen
around, would wish they were.
Some of them, I
know, were waiting
for him to win the Nobel Prize.
That's how highly he
was thought of in
those days.
Oh yes, that's a Nobelist.
He put together neurochemistry,
neurophysiology.
And I think some of
them hated Bob for that.
I think it's the simplest,
most primitive kind of thing
that happens with we human
beings. It's called jealousy.
I fell in love with
him, actually.
That's the simplest
way to say it.
I wanted to become him,
which was common. Not uncommon.
He was so charismatic
and mysterious in a way.
In spite of his apparent
confidence, I got the feeling
that he was working
at being right.
We know a lot about how
the brain works now
and we know a
lot more about what
deep brain stimulation is doing.
I would say,
the days of 'we don't
really know what we are doing
but it obviously
works', is an exaggeration.
But I certainly
wouldn't say that
we are extremely sophisticated
and we understand every
aspect of what we are doing
because that's not true either.
You're doing a
procedure in the most
important part of the human body
that controls emotions,
decisions, cognition,
everything.
And we're still investigating
Gilles de la Tourettes
obsessive-compulsive
disorder, epilepsy,
depression and other
severe illnesses
where there is a chance and
hopefully it will
help some patients.
We started a study on
obsessive-compulsive disorder
and the day
that our study went on to
the NIH website, she called us.
She had contamination fears.
She knew that this
was illogical.
When her husband goes
out to the store
he has to buy all
of the groceries
and then there
is a transfer that
happens at the door
of their garage
where he opens the cereal
box and pours the cereal...
Just like in an
operating room, when
you transfer
something sterilely.
...pours the cereal
into her sterile
container and then
enters the house
and then throws away the dirty
containers from
the grocery store.
He comes home from
work and because he
has been out in a
contaminated world
he has to go through
decontamination procedures
to get into his own home,
or his wife can't handle it.
So he literally
drives his car to the
garage, closes the
door, strips naked
takes a shower in the
bathroom at the entrance
and then is allowed by his
wife to come into the house
naked and clean.
But to make a long story short,
I have pictures of her now
riding horses with her daughter
and she really
got her life back.
For OCD at least
it's become clear
that it's the posterior border
posterior superior border
of the nucleus accumbens
where we get our most
potent beneficial effect.
The nucleus accumbens
is the final common
pathway for pleasure
in the human brain.
It lights up in the
functional MRI scanner
when you give someone chocolate
or if you tell someone
to have a sexual fantasy
or you give a drug
addict his drug of choice.
That's the part
of the brain that
lights up most
reliably with reward.
He looked like a
sweet blond boy, but
he was confined in
a mental hospital
heavily drugged
and tied to a bed.
His parents found Robert Heath
while searching for a way
to get their son out of hospital
and give him some kind of life.
David was obviously retarded.
I don't know what his IQ is,
but it's probably around 70.
He was incarcerated in the
state mental hospital
because of his violence. He
could not be around
other people.
He was considered
the most violent
patient ever in a
state mental hospital.
That's saying a lot.
It was a mental
health counseling
appointment for
David and his family.
I remember we were
just all sitting
like this in the waiting room
and he... it was directed...
and just into the wall.
I'm gonna kill her... And
everybody heard it. Everybody!
The doctors come running
out and they took him.
And my mother cried and
cried and cried and cried.
From that day on,
it was the beginning
of him in and out of the home
and being taken
for periods of time
or then eventually the
confinement into Mandeville.
When he's home I'm always
definitely afraid
that he'll harm someone
away from the house.
We all know that
he self-inflicts
wounds upon himself.
Heath used a new version
of his brain pacemaker.
Donald Richardson
was the surgeon
who implanted the device
in David's cerebellum.
From the back of his neck it
would send gentle pulses
through to the damaged emotional
structures in David's brain.
After he got over
the surgery and
the stimulator was adjusted
he was able to leave
the mental hospital
and move back home
with his parents.
He got a job working in a Burger
King or some place like that
cleaning up
and was totally pacified.
Do you remember how
you felt when you
were doing all of that fighting?
Do you remember
the fight when you
attacked your dad
and your mother?
Yeah, I remember that.
That seems to be
under control again.
You know, it was hard for them
to see such great pain
and suffering and to know
that he has been helped.
What do you think about it,
David?
You've done good!
Only doctor Heath
took care of me.
Well, we tried.
You tell Dr. Richardson... you
planted a real
good device in him.
Tell him what happened
in Washington DC.
Security guards grabbed
me out of the line.
What line?
Where was I taking you?
I was in The White House.
- And what happened?
- A service guy came and...
Why did they pull you out
and what did they do to you?
Thought you had a
knife or bomb on you?
You put it on AM and turn it as
low frequencies as it will go
and you pick up the magnetic
output from the stimulator.
Did you hear it? That was it.
Burp. It only stimulates for
very short periods of time.
Everything is going
great and Heath
is enjoying the
best of all worlds
until the arrival of the 1970s.
The counterculture
was booming then.
It was a time for
ripping down authorities.
Popular art and films like 'One
Flew over the Cuckoo's Nest'
show mental institutions
in a new and crude way.
The public mood is turning
against all of psychiatry.
And the exclusive
privileged world
of doctors is being questioned.
This turmoil reaches Congress
where Ted Kennedy puts
psychosurgery on trial.
Heath is summoned
to explain his work.
Rivals in his
field accuse him of
being the devil in a white coat.
I was very embarrassed for
Dr. Heath. I didn't realize...
...really the
antipathy most of the
field of that time
had for Heath.
He had...
...overly blessed his luck.
The Gregory Peck of the 1950s
becomes a crazy mad scientist
planting electrodes
in people's brains
turning them into
human pincushions.
People had the idea
that he just stuck
electrodes in everybody's head.
This also happened, remember
at a very strange political
time in this country.
And as one goes along in time
one begins to realize how
important sociopolitics is.
Not just in the
way countries are
run, but in the
way science is done.
Kennedy asks: Is
this not opening
the door to mind control?
Yes or no?
Heath does what he can but
when they're done on the Hill
psychosurgery is dead.
And Robert Heath who spoke
against lobotomy in the 1950s
is now being cast
as a lobotomist.
To Heath it's all
a waste of time.
He went back to the lab
to continue his work.
He saw the upheaval
as a minor blow.
But what came out next
would change everything.
In his quest for pleasure it was
natural for Heath
to study sexuality.
Experiments were
carried out in the lab
where he would measure
sexual arousal in patients.
And then an
opportunity arose that
played right into his
hunt for pleasure.
A young man was
admitted and diagnosed
as chronically
suicidal and depressed.
During therapy he
disclosed how he
wanted to be free of
his homosexuality.
At the time homosexuality
was registered in the DSM
the list of mental illnesses.
It was a time
when parents took
their sons to get
shock treatment to
their testicles
if they had
homosexual tendencies.
Heath offered the
young man treatment.
He saw an opportunity
to see if he could
change the brain's
pleasure preferences.
I myself... I'm gay, as
I think I mentioned to you.
And Bob knew it, we
didn't talk about it.
Because you don't talk about
things like that particularly.
I'm sure there
were people around
that...
would have wanted to do that.
I wouldn't want to do it now.
I probably might have
wanted to do it then
but...
It's a different time
and different ways.
In those days they thought that
homosexuality was a pathology
that should be treated like any
other kind of
psychiatric disorder.
Unfortunately the psychoanalysts
were the worst about that.
I knew that he had
turned his interest
but I didn't realize he had gone
so far as to do
a clinical study.
Electrodes were implanted in
the young man's pleasure center.
He had a remote control and
could stimulate himself.
He used it when watching
heterosexual porn
and after a while he
was ready to meet a woman.
A 21-year-old
prostitute was hired.
The young man and the woman
would be alone in the lab
with Heath and his
technicians recording
from his electrodes
in another room.
The young man had
intercourse with
the woman for the first time.
The results of the study proved
successful, but no one is sure
what became of the
young man after the study.
The research was published
in a scientific journal
but when it later reached the
public, the reaction was brutal.
Heath faced intense criticism.
Times had changed and new
voices celebrating diversity
were on the rise.
You can insert an
electrode and do
stimulation to either
block or drive.
So, if you do MRI on
me and I'm in love
with you and my wife
says no good
let's put an
electrode to block that
area,
so I'm not in love with you.
This is the consequence.
We never went that far.
It's unethical, it's not needed.
This tool it's too valuable
to be used for these issues.
You can have atom
energy to drive
boats and to get electricity
and you can have it to
make a bomb. Same thing.
A fool with a tool
is still a fool.
Maybe you have heard
that quote before.
So, I'm beginning
to get a little bit
worried and a little
bit uncomfortable
because we're going to put
something into the brain
and we're going to change
somebody's personality.
The personality changes,
people become more impulsive
and that's probably going to
change somebody's personality.
They are going to
seem a lot more
impulsive in the
store, on Amazon.com
and in casinos.
So, that's changing personality,
if we make you more impulsive.
Some people may change the
character of their personality
how friendly they are,
whether they're angry.
We published a number
of years ago in
the National
Institutes of Health
that we commonly would
make people angry,
with certain targets
in the brain.
That could be interpreted
as a change in personality.
I knew there would be a
change, but not
that I would be
clobbered over the head.
I got louder and more dramatic
and if it's something that
is disturbing the situation
then I start to get angry.
No filter, no filter whatsoever.
I don't have one.
I just say whatever
comes into my head.
I don't even stop to
think if it's going
to hurt somebody. It's just oh!
And I don't hesitate
to talk anymore, so...
- Would you have surgery again?
- Yes.
Yes! Absolutely,
there is no question.
It's a resounding
yes, because...
...it saved my life.
I probably would
not be alive right
now, if I hadn't had surgery.
Every psychiatric treatment
be it medication, be
it psychotherapy, changes
factors of emotion
and cognition,
which are parts of
personality too.
And if it wouldn't do that it
wouldn't be worthwhile to do it.
So yes, personality is changing
has to change, when we talk
about emotion and cognition.
Many people don't
want to have something
to do with illness, depression.
They want to push it away.
It means weakness,
illness is weakness.
You are not a full
member of society.
So, everything that is weak...
...perhaps reminds oneself
of their own weakness.
Perhaps there is a possibility
a very, very good possibility
to live again
and to be healed
or to get better.
It's not the end.
I try not to put too
much stress on it
because I don't want to be...
...too much disappointed.
But for me it's...
...the last possibility
that I could return to life.
I could feel good
feelings again.
I could see sunlight again
with feelings in my heart.
Otherwise
I will go on as a living dead.
Most of the human
trials that I've
been involved with were people
who had just miserable
lives with no hope.
And we offered them hope
and not just oh,
we hope this might work
but we had strong reasons to
believe that it would work
with enough evidence to convince
an institutional review board:
Hey! This is worth trying!
I would say I'm probably
on the aggressive side
in terms of moving to
human clinical trials.
And so,
obesity and opioid abuse are
the two biggest public
health problems
crises really,
in United States right now.
And this one application
of neuromodulation
has the potential to make a
huge difference in that domain.
If we can do that,
I think that's
going to be a huge game changer.
Maybe we could fix it with some
new molecular tool
down the line.
Am I going to stop what I'm
doing until someone does that?
Sorry that bothers you.
Let me introduce you
to a sick person.
Given that what we have is safe,
available and is
working, I'll take it.
What if we were soon
able to modulate
every aspect of the human mind?
This would open a
door to manipulate
things that we consider sacred
and essential to who we are.
What if, for example
you could take away the pain of
traumatic memories
with an electrode?
The veteran was part of the
initial attack on Iraq
which was in 1991.
He was working in a tank.
This battle lasted
all day and all night.
If you type in on the Internet
highway of death
you get images of this and...
Sorry, I didn't expect this.
It's a long highway of littered
tanks and bodies and vehicles
and pieces of this and that,
blown up and it's horrifying.
What happened is that after
the battle the next day
he and his unit were sent to
do a kind of damage assessment.
And that's when the most
traumatic experience
that basically changed
this man's life occurred.
He just saw these dismembered
and charred bodies.
And, there's one particular
image of a corpse
that was blackened
and scarred and
the man he describes has one eye
partly coming out of his head.
There were flies, you
know, it was hot.
You think that the
most traumatic thing
is that people are
trying to kill you
but the most traumatic thing
is killing other people.
Within weeks after that he
began having nightmares
of this charred corpse that
would actually envelop him
and he would
experience it, feel it.
He would wake up screaming
and sweating and he would...
The only thing he
could think of to
get rid of it was
to take showers.
Cold showers.
And he'd spend like
two hours in the
shower to wash the
contamination off
and try to get back to sleep.
He'd only sleep
again for like an
hour and then be woken up again.
He suffered with this
for more than 20 years.
Every day.
During the surgery
he experienced
positive images
from his childhood.
He described these
wonderful scenes
from his homeland, very colorful
and he could smell
fresh bread being cooked.
He'd say, Oh wow,
that feels good, Dr. Koek.
Leave it there! Don't change it.
Four to five months
after initiation
he stopped having nightmares.
And he's had a total of
three since then so that's...
...15 months ago.
I still take medication, I
still need some medication.
So, I tried to stop,
but I couldn't.
Too many things were going on.
I was angry, I was upset a lot.
I just
didn't feel right,
so I went back on it.
So, medication still
makes a difference.
Chemically something is going on
in there that needs to tweaked.
And whatever area of the brain
that's getting electrified
it's quieted the bad stuff.
It was literally like
being blind for 54 years
and somebody turned
the switch on
and the whole world is
there and you could see it.
Wow! OK, I've been in
a coma for 54 years
and I'm awake and there is
some cool stuff out here.
Heath was always a believer
in his technology
despite the heavy criticism
from his peers and the public.
It turned out he was not alone.
In 1977, The New York
Times drops a bomb.
The CIA's cold war
MKULTRA program is outed.
On top of the Vietnam atrocities
it now looks like
government agencies
are in the business
of brainwashing.
In the shadow of Watergate this
is the time for disclosure.
And thousands of secret
documents surface.
Heath's name is on them.
I think he became
totally seduced by
two very,
very attractive motivations.
One was a great deal of money
that the government
offered them to do that work.
And two, their belief often
that they were being patriots.
That this was good and
valuable to the country.
Heath was testing a new
drug, Bulbocapnine
a drug the Russians
were also testing.
This was not a drug
that you wanted
to test on regular patients
so Heath used inmates
from Angola Prison
the so-called Alcatraz
of the South.
He himself called it
a horrendous place.
- Don't you want to talk to me?
- No.
- Why won't you talk to me?
- I'm tired.
Tired of me talking to you?
Or are you angry at me?
The results were inconclusive.
Then the CIA asked him
to use his electrodes to do
work on the brain's pain system.
Inflict pain to patients
for the military?
This was where he drew the line.
If I had wanted to be a
spy, I would have been a spy.
I'm a doctor and I practice
medicine, he told
The New York Times.
But it was too late. He had
already fallen from grace.
Maybe that's the story of
pioneers, real pioneers
that don't just wanna be smart
but can walk into territory
that nobody else could or would.
I think in history, frankly
there have always been people
with original, unique ideas
and then rarely, when it works
become enormous heroes.
Those who fail almost
inevitably are seen as monsters.
They were doing this
for their own egos
they are monomaniacally
pursuing this direction
and they should be called
out for what they are.
These almost sadistic creatures
using patients as guinea pigs.
I think ultimately that's
what happened to Bob.
And monomaniacal would probably
be the last word in the world
that I would ever use to
describe a person
like Bob Heath.
The irony is of course
almost every idea he's had is
going to turn out to be true.
There is an odd cloud
that has tainted the legacy
that resulted from
a few experiments
and lines of research
that he conducted.
Family members are concerned
that the negative things
that have kind
of been allowed to
be swept under the rug by time
be brought back out, because
no objective story of his career
his research, could leave
those out and be legitimate.
You've got to include that.
Because that was the truth.
It actually happened.
So, as long as they
know the full story...
Maybe Robert Heath was
too far ahead of his time.
Culture changes and today our
perspectives on the brain
are radically different
than 50 years ago.
What used to be
frightening is now
for some an exciting
opportunity.
DARPA, or the Defense Advanced
Research Projects Agency
invests in breakthrough
technologies for
national security.
The agency that gave us
the Internet and GPS
has now invested
70 million dollars
in research of deep
brain stimulation.
10% of the 22 million
American veterans
that fraction, live with
neuropsychiatric
kinds of conditions.
So we asked the
question, is there
something we can do about this?
Can we develop new knowledge
and new technology
in order to solve this problem
of neuropsychiatric illness?
Treatment also opens up to the
possibility of enhancement.
Treating memory disorders
is one of DARPA's ambitions.
In Philadelphia Michael Kahana's
group is working with patients
to gather data trying to
understand how
memory is created.
To them, memory is the key
to understanding the brain.
Memories are what
make us who we are.
They are everything for us.
Our knowledge,
our experience, our identity.
My grandmother became kind
of my nanny as a child
and she had some profound life
experiences for example in WW2.
She never talked about them, she
never said anything about them.
I never heard about them.
But they
determined how she
reacted to things
then I find,
with my children here, how
many years later,
half a century later
that I'm reacting
to them in ways that
my wife or other people
may find strange.
Why am I reacting that way?
Because
of something in her memory.
And I don't even
know what it is,
right? It's just
carried through time.
I actually believe that we carry
around vastly more memories
detailed memories
of our past, than
we have an access
to at any one time.
Sieg Heil.
It's one small step for man.
Any second now
the Berlin Wall...
Some day people will
consider elective
restoration of
their own thoughts.
I know people will
find that scary, but
that's for other
people to figure out.
Today with my devices, I'm
recording my life in a way
because I'll just
have somebody infuse
it back through a
chip into my brain
when I can't have
those memories myself.
All technologies
across the board
can be used in a
variety of ways.
They could either be used
for good or be used for ill.
And that's a fundamental
property of technology.
In an age when both
sides have come to possess
enough nuclear
power to destroy the
human race several times over...
In order to stay
ahead of understanding
that technology deeply
we have to see all of the angles
and ask all of those questions.
We've got to understand the
technology in a very deep way.
You get better at it. And the
risk gets lower and lower
and a predicted benefit
gets higher and higher
and then the calculation
starts to blur.
Plastic surgery didn't arrive on
the scene as an
esthetic surgery.
I don't mean to
disappoint anyone.
It came because people had burns
and people needed
reconstructions
and people had accidents.
And then maybe it's OK to do
an operation to make someone
who has a normal
nose, have a pretty nose.
And at some point we're
going to do operations
to take people
who are essentially
normal and make them
function better.
Make their brains work better.
It's not a question
of if we're going
to do that,
but when that happens.
It's not going to
be about putting
wires in people
and changing them.
It will be a subsection
that will develop
and I'm not even going
to call them out by name.
It will be AI,
because that technology
is way beyond what we can do.
Is the brain more than just
a high-powered computer?
If a computer did simulate a
whole lifetime of experience
would we discover that the
computations that the brain does
are just not
possible for computers?
Or maybe we would
discover that it's easy.
I don't know.
It's a great mystery.
Today, when I hear a lot
people talking about AI alone
I think they're missing a
bigger part of the story here.
We're exploring how brains and
machines work together, right?
I think the dynamic
between humans
and machines is
ultimately changing.
It will certainly change human
behavior in fundamental ways.
Limbic circuits are
the most powerful
circuits that
control our behavior.
And if we take
someone who is doing
this in a normal way
and we turn him into
someone who is up here
their fundamental
behavior is going to change.
And we would have to adjust
to a whole new normal.
The commercial interest
is maybe at the
top of the list of
what I worry about.
And if it's not done
in an ethical way
and the steps aren't
taken correctly...
If somebody jumps the
gun, it can ruin
it for everybody else
that comes after.
The ethics become important.
When is it OK to do that? Who
should have an access to that?
Should it be wealthy people?
We have to make the
decisions right, keep
the train on the tracks
and move forward.
And we can be more than
incrementally a
step at the time.
We can take some leaps
but if we're just
going to capture
that multi-billion dollar market
I think we have already seen,
we could destroy ourselves.
We have entered a
new landscape with
great promises and
tempting horizons.
But we're also in
unknown territory.
The trail to discovery is open
and scientists with pioneering
minds are blazing
it at high speed.
How do we steer our
course into the future?
What will we find on our
journey into the brain?
And are we ready for
whatever that might be?