Lo que nos hace humanos: secretos del lóbulo frontal: Facundo Manes at TEDxBuenosAires 2012

Translator: James Haslam
Reviewer: Laura Díaz Aguirre (Indistinct audio) I’m sure everyone remembers this, when the pilot of that plane took off from LaGuardia airport
in New York and within minutes recognised two things: First, that he no longer had engine power and second, he didn’t have time
to return to LaGuardia, there wasn’t enough time
to return to the airport, and so he crash landed
in the Hudson river. If the pilot of this plane
had instead been a computer, everyone would have died. The lives of the 155 people on board
were saved because the pilot was a human being
and because he had a human brain. Specifically, because he had
a properly functioning part of the brain
known as the frontal lobe. The brain works through a series of networks; when we have cognitive thought,
almost all of it is activated but some areas are more critical than
others, a fact I will reiterate often. If there’s one part of the human brain
that links us to our personality it’s the frontal lobe. It’s what makes us different
from every other person here today… what distinguishes us from other species. If you get a lesion
on the rear part of your brain, which is central to the way
we perceive the world around us, undoubtedly, you’ll lack a full ability
to perceive the world, but you’ll be the same person. If you damage your frontal lobe,
you will never be the same as before, you’ll start to be different,
have a change in personality. The frontal lobe contains different
neurons to other parts of the brain. For example, we have neurons for
the olfactory system, our sense of smell. The network that controls
this sense of smell contains neurons which essentially
respond to olfactory stimuli. We have some that process
our vision by responding to visual stimuli. In contrast, as you would expect for
the most critical part of the human brain, the frontal lobe responds
to many different things according to the given situation. For example, they can be stimulated
by a dog or the sight of a cat, depending on the context. This part of the brain,
which is critical to us all, is fully matured
between the ages of 20 and 30. It plays a key role in various
intellectual and cognitive functions, for example those relating to
making plans and taking decisions, to memory, language, and social interaction. My brain is constantly changing
because I’m here, and your brains are also changing
as you listen to me; either you like what I’m saying
or you don’t. Social interaction changes our brains. Even in an elevator,
when we see someone else, we just have to say something to them, we evaluate whether they like us or not… Our brain becomes activated
and so does theirs. The human brain cannot be understood
as an individual entity; we have to understand it through
the interaction between two brains. If you were to put me on the spot and say, ‘Facundo, how would you sum up
the human brain?’ I would say, ‘Well, it’s a social organ’. And part of the human brain’s complexity, many researchers agree,
can be explained by the social complexity
that our species has attained. And if you don’t believe
in our social complexity, just look at everything we’ve created: the chairs, the microphone,
the broken computer, my shirt, and everything that we produce today. We’ve learnt a lot about the frontal lobe
through patients who, regrettably, developed neurological
or psychiatric problems. But we’ve also learnt a lot through
new technology, such as imaging. Today, we’re able to study the brain
with equipment that can see in real time the things that occur
in our brains when we imagine, when we memorise. And human memory is not a unitary system:
there are different types of memory. There’s memory for where and when:
I graduated on such a day at such a place. There’s memory known as episodic memory,
involving a key part of the hippocampus. There’s another memory
that I’m using now called ‘online’ memory: I’m saying words that I wasn’t
just a few seconds ago, for example. Or when I have a telephone number
in my head, I dial it, speak to the person, and then forget the number,
that’s basically ‘online’ memory. This type of memory depends
a great deal on the frontal lobe. But there are other types of memory which,
from lesions and animal studies, we knew were
largely independent from the frontal lobe or our semantic memory: knowing
that Montevideo is the capital of Uruguay; we don’t know when we learnt this,
it’s become a notion, like knowing what a shirt is. But now, through imaging technology,
we know the frontal lobe is activated by all these
human memory systems: with an autobiographical, semantic, ‘online’ or episodic memory, aside from the other parts of the brain
we already knew about – in animals and in humans – we now know that, the frontal lobe
plays an important role. And speaking of memory,
I’d like to tell you that advances in neuroscience
over the last few decades are owed to advances in genetics
and imaging technology. And that now, more scientists than ever
in the history of humanity have demonstrated that human memory
is the most advanced there is. When you recall a memory,
it becomes changeable and when you go back
to storing that memory, it is stored, and if the information you store
coincides with the event that took place, you’ll remember it in that way. But when you recall a memory,
if you start to add things and store the information with
different emotional contexts, or with different situations, what you will remember next time won’t be what actually happened but rather your last recollection. Basically – I’m repeating this
because it’s important – when a person recalls a memory,
that memory becomes changeable and then, it is stored again
like a Word document on a computer. Whatever you store
will be what you remember next time. If two people in love go on a trip
and one is more in love than the other and talks about it a hundred times,
while the other only talks about it twice, undoubtedly, the second person
will be more accurate because the one who told the story
a hundred times will add emotion to the trip
and the context which don’t have anything to do
with the reality. We have learnt that the frontal lobe
is responsible for making plans, managing the temporal role in language, and for emotion and rational thought by testing on patients. One of those tests is the lobotomy. The lobotomy is a procedure which,
thankfully, is no longer used, but which was very popular
in Europe and the United States several decades ago
until it ceased in the 1970s. Essentially, a thin metal instrument was forced up behind the eye socket
and into the brain, allowing them to destroy the frontal lobe
in patients with incurable depression; who had obsessions preventing them
from leading an independent life; or who were in intense pain. And there was a very expressive photo showing a person to be
extremely anxious before the surgery and completely liberated
with a Cuban cigar after. They had cured his obsessions, but he stopped being the same person: he was completely uninhibited,
unconcerned. And sadly, this led us to understand
the effects of a frontal lobe lesion. We also learnt
about the effects of a frontal lobe lesion following one of nature’s experiments which took place in the town of Cavendish,
Vermont. In Cavendish,
a company was constructing a railway and the foreman, Phineas Gage,
was very obsessive. He got to work early,
was the last to leave, everybody trusted his word, the company bosses trusted him, the workers that he managed
were very happy. He was a very trustworthy person,
until the moment when a mine exploded and a rod of metal cut across his frontal lobe. The rod exited his body;
it didn’t become lodged. The front part of his brain
had basically disappeared. He was taken to Boston,
and the rod remains at the Harvard Medical School today.
It’s a very famous case. I’m not breaking any
doctor-patient confidentiality; all the info I’m about to give
was widespread in the international media,
both scientific and not. First, Phineas Gage arrived conscious
at the hospital in Boston. Second, he was speaking perfectly,
he remembered everything that happened. He was discharged a week later, with a hole in the anterior part
of his brain. Medical circles in Boston wondered,
‘what does this part do?’ Because Phineas Gage left hospital
with the same level of intelligence. Science can’t fully measure
a person’s intelligence – humour, irony, bravery
can’t be measured – but certain aspects of a person’s
analytical intelligence can be measured. And Gage’s analytical intelligence
was preserved. His language skills, memory, attention skills
and spacial awareness were all preserved, he had no motor deficit. So the doctors in Boston asked,
‘What does this part of the brain do?’… and then they realised. Phineas Gage had become
completely uninhibited, he started to make financial decisions
that were against his own interests, as he did with social,
work and family decisions. I don’t want to make
any moral judgement about what is good or bad
with such decisions, but if someone used to make
advantageous decisions in life before having an accident, and afterwards started to make decisions that conflicted with their social,
work and family interests, clearly there is a decision-making deficit. The interesting thing is
that Phineas Gage’s deficit couldn’t be explained as if
he had lost the ability to reason; because his intellect, memory, attention, intelligence, language were all intact. So what had happened? The metal rod had cut across
his frontal lobe, which has another function,
a function I didn’t mention earlier: it controls our emotions and rationality. The frontal lobe is the part of our brain
that takes on the role of adapting the innate impulses
that we all have to suit society. We all want to throw a punch
back at the person who sucker punched us, we all do. But some people don’t. We are all drawn to sexual stimulation,
all of us. And we all want to tell a person
who’s annoying, who’s cynical or who lies that they are a liar, or a cynic. And that is what people
who have damaged their frontal lobe do. So, Phineas Gage’s deficit
was an emotional one, which guided his
‘rational’ decision making. And as human beings,
we’re constantly making decisions. Life doesn’t just lead us
to make decisions when we choose a career path, when we choose a job,
or which dish to eat in a restaurant, or when I consciously chose this shirt, looking to see
if I had a similar one or not. Obviously, these decisions
are conscious ones, and we make lots of conscious decisions, but we live our lives making decisions. What’s your name? Mercedes. Right now, Mercedes is making decisions:
whether to look at me, at the screen, or at that man; whether to think about what I’m saying
or what she’s going to eat later. We live our lives making decisions. And the brain, through evolution,
has developed a decision-making mechanism which doesn’t always evaluate
the pros and cons because we wouldn’t have time
to make the decisions we do. Because decisions aren’t just about
choosing a meal, or a shirt, or a career path. Having to make decisions is constant,
and through evolution, the human brain has developed
an automatic mechanism, which is often subconscious, that looks at the change in circumstances,
just like now with this talk: Before this talk I thought I had a frontal deficit,
but I’m managing ok. The context changed
and I’m able to adapt to it. The same goes for the pilot
of the airplane. Human decision making
isn’t a logical or computational process, rather it’s guided by emotion. Patients like Phineas Gage have what is known
as ‘myopia for the future’. Phineas Gage knew
what was right and wrong, he knew that the decisions
he took wouldn’t allow him to work. Frontal lobe patients know
what’s right and what’s wrong, it’s not a problem of knowledge. However, they opt for risk
in return for immediate reward. That’s why neurobiology often says
these patients have myopia for the future. They can’t resist immediate temptation, even when that immediate temptation
could be detrimental in the long term. And this biological theory
for decision making allows us to understand
certain aspects in a new light, not all aspects because they’re
complex phenomena with many factors. But take obesity, for example, there’s a tub of ice cream
in every supermarket, and some people can’t resist
eating it despite knowing that
they’re going to add 500 calories later that afternoon
or the next morning, or immediately after eating it. The same goes for severe drug addiction
or compulsive gambling. A compulsive gambler doesn’t gamble
occasionally in a casino, rather he can’t live
without gambling. There’s a case of a patient of mine
who spent months saving up for his honeymoon, and the day before the wedding
he gambled it. Clearly, he wasn’t thinking
about the future: that his wife was going to kill him. Now we’re going to listen
to a bit of music, and I’m gong to tell you
how it relates to the frontal lobe. (Music) This is Ravel’s Bolero. Unfortunately, Ravel suffered
from an illness that affected his frontal lobe. This is well evidenced
by medical documents. And many researchers believe in the theory that part of his artistic work
was influenced by his frontal illness. Because frontal patients
also persist; they are often obsessive. They’re unable to exercise
the cognitive flexibility necessary to survive. In the whole of the Bolero,
the same melody is repeated about 17 times and the scientific papers
of some researchers hold the theory that it was affected
by the illness. You can see that this persistence, this obsessiveness is good
when you’re a genius; the issue is when you persist
and you’re not a genius. It was thought that the frontal lobe
is bigger in humans than in other species. Today, we know it’s not. Today, we know that part
of the frontal lobe’s complexity may be due to the brain’s connections and not so much the size
of the lobe itself. This is a study that we did
when I lived in Cambridge, England, so you see, there have been
many cases like Phineas Gage in history. We studied a group of 30 patients
like Phineas Gage. Neurobiology doesn’t establish principles
based on a single case; there are many laboratories in the world that have spent decades studying
the phenomena that were first presented in Gage. Frontal lobe damage
doesn’t just result from injury, from an iron rod
or a cerebrovascular accident. This is a degenerative illness,
like Alzheimer’s, but instead of affecting
the hippocampus, which controls memory, it affects the degenerative frontal lobe. Here’s a photo from the New York Times,
showing an American senator for New Mexico who renounced his position
due to frontal illness. It’s interesting
that most don’t notice the illness because it doesn’t act like Alzheimer’s; it affects behaviour
rather than memory or sense of direction, and the patients are sometimes
more congenial. Here’s the photo I wanted to show you
about how obesity, compulsive gambling and also drug addiction are being researched
as resulting from decision-making deficits; the inability to resist immediate reward despite it being detrimental
in the long run. Modern man relies
on every possible resource to solve many of the most pressing
social problems, such as poverty. However, with social matters
comes emotion. When we speak to a boss,
there’s emotion; when we speak to our partner,
there’s emotion; when we run into competition,
there’s emotion; when we approach a person,
there’s emotion. Social matters involve emotion because they implicitly contain
power, submission, and personal gain. The focus on reason, on controlling human behaviour and anticipating behaviour has led to the mistaken concept
that we are ruled by reason. Human history is in clear contradiction with the fact that we are
completely rational beings. On a final note,
I want to say that myopia for the future is not linked solely to neurology. And I’d like to close
with a personal story, which I’m sure relates
to many of you, and that is the story
of Argentinian public school. Like many of you, I’m the product
of our country’s public school system. This is Arroyo Dulce,
a small rural village in between Pergamino and Salto. I went there for primary and secondary school, then to the University of Buenos Aires. After, I left the country
before returning to Argentina. Like many of you,
this public school system has allowed me to fulfill
my dreams and my goals. It wasn’t the only thing,
but it was an important basis that enabled me to fulfil
my personal dreams and goals. And this public education project, which differs from those
in other Latin American countries, and of which Argentinians are very proud, was conceived by a generation
of Argentinians who clearly didn’t have
myopia for the future, who were able to imagine
a system of education beyond their biological lifetimes. And for that reason I hope and wish, like I’m sure all of you hope and wish, that the next generations of Argentinians, including my sons, four-year-old Pedrito
and six-year-old Manuela, who are both in the audience, will say the same about us:
that we didn’t have myopia for the future. Thank you. (Applause)

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