My Stroke of Insight: A Brain Scientist's Personal Journey (2 page)

The week after the Miami convention, I arrived at McLean Hospital stoked and eager to start my new job in the Laboratory for Structural Neuroscience, the research domain of Dr. Francine Benes. I was all a-buzz and thrilled to begin my postmortem investigations into the biological basis of schizophrenia. Francine, whom I affectionately call the "Queen of Schizophrenia," is an amazing research scientist. Just watching how she thinks, how she explores and how she pieces together what she learns from data was a total joy for me. It was a privilege to witness her creativity in experimental design and her persistence, precision, and efficiency in running a research lab. This job was a dream come true. Studying the brains of individuals diagnosed with schizophrenia brought me a feeling of purpose.

On the first day of my new job, however, Francine threw me for a loop when she informed me that the infrequency of brain donations from families of individuals with mental illness had created a long-term shortage of brain tissue for postmortem investigation. I couldn't believe what I was hearing. I had just spent the better half of a week at National NAMI with hundreds of other families with

members diagnosed with severe mental illness. Dr. Lew Judd, a former director of the National Institute of Mental Health, had moderated the research plenary, and several leading scientists had presented their research. NAMI families love sharing and learning about brain research, so I found it mind-boggling that there could be a lack of donated tissue. I decided this was merely a public awareness issue. I believed that once NAMI families knew that there was a research tissue shortage, they would promote brain donation within the organization and resolve the problem.

9

The next year (1994), I was elected to the National NAMI Board of Directors. It was a thrill for me to be of service to this wonderful organization, a huge honor and responsibility. Of course, the base of my platform was the value of brain donation and the shortage of psychiatrically-diagnosed tissue available for scientists to do their work. I called it the "Tissue Issue." At the time, the average age of a NAMI member was 67 years old. I was only 35. I felt proud to be the youngest person ever elected to this board. I had lots of energy and was raring to go.

With my new status within the National NAMI organization, I immediately began keynoting at State NAMI annual conventions all around the country. Before I began this venture, the Harvard Brain Tissue Resource Center (Brain Bank
²
), which was positioned right next to the Benes Lab, was receiving fewer than three brains a year from psychiatrically-diagnosed individuals. This was barely enough tissue for Francine's lab to do its work, much less for the Brain Bank to supply tissue to the other reputable labs that requested it. Within a few months of my traveling around and educating our NAMI families about the "Tissue Issue," the number of brain donations began to increase. Currently, the number of donations from the psychiatrically-diagnosed population ranges from 25-35 per year. The scientific community would make good use of 100 per year.

I realized that early on in my "Tissue Issue" presentations, the subject of brain donation would make some of my audience members squirm uncomfortably. There was this predictable moment when my audience would realize, "Oh my gosh, she wants MY brain!" And I would say to them, "Well yes, yes I do, but don't worry, I'm in no hurry!" To combat their obvious apprehension, I wrote the Brain Bank jingle titled "1-800-BrainBank!"
³
and began traveling with my guitar as the
Singin' Scientist.
⁴
As I neared the subject of brain donation and the tension in the room began to rise, I'd pull out my guitar and sing for them. The Brain Bank jingle seems to be just goofy enough to effectively dampen the tension, open hearts, and make it okay for me to communicate my message.

My efforts with NAMI brought deep meaning to my life and my work in the lab flourished. My primary research project in the Benes lab involved working with Francine to create a protocol where we could visualize three neurotransmitter systems in the same piece of tissue. Neurotransmitters are the chemicals with which brain cells communicate. This was important work since the newer atypical antipsychotic medications are designed to influence multiple neurotransmitter systems rather than just one. Our ability to visualize three different systems in the same piece of tissue increased our ability to understand the delicate interplay between these systems. It was our goal to better understand the microcircuitry of the brain - which cells in which areas of the brain communicate with which chemicals and in what quantities of those chemicals. The better we

understood what the differences were, at a cellular level, between the brains of individuals diagnosed with a severe mental illness and normal control brains, the closer the medical community would be to helping those in need with appropriate medications. In the spring of 1995, this work was featured on the cover of
BioTechniques Journal
and in 1996 it won me the prestigious Mysell Award from the Harvard Medical School Department of Psychiatry. I loved working in the lab and I loved sharing this work with my NAMI family.

11

And then the unthinkable happened. I was in my mid-thirties and thriving both professionally and personally. But in one fell swoop, the rosiness of my life and promising future evaporated. I woke up on December 10, 1996, to discover that I had a brain disorder of my own. I was having a stroke. Within four brief hours, I watched my mind completely deteriorate in its ability to process all stimulation coming in through my senses. This rare form of hemorrhage rendered me completely disabled whereby I could not walk, talk, read, write, or recall any aspects of my life.

I realize you are probably eager to begin reading the personal account of the morning of the stroke. However, in order for you to more clearly understand what was going on inside my brain, I have chosen to present some simple science in Chapters Two and Three. Please don't let this section scare you away. I have done my best to keep it user-friendly with lots of simple pictures of the brain so you can understand the anatomy underlying my cognitive, physical, and spiritual experiences. If you absolutely must skip these chapters, then rest assured they will be here for you as a reference. I encourage you to read this section first, however, as I believe it will profoundly simplify your understanding.

1

R.B.H Tootell and J.B. Taylor, "Anatomical Evidence for MT/V5 and Additional Cortical Visual Areas in Man," in
Cerebral Cortex
(Jan/Feb 1995) 39-55.

2

www.brainbank.mclean.org
or 1-800-BrainBank

3

See Appendix A for the lyrics to the Brain Bank jingle.

4

www.drjilltaylor.com

For any two of us to communicate with one another, we must share a certain amount of common reality. As a result, our nervous systems must be virtually identical in their ability to perceive information from the external world, process and integrate that information in our brains, and then have similar systems of output including thought, word, or deed.

The emergence of life was a most remarkable event. With the advent of the single-celled organism, a new era of information processing was born at the molecular level. Through the manipulation of atoms and molecules into DNA and RNA sequences, information could be entered, coded, and stored for future use. Moments in time no longer came and went without a record and, by interweaving a continuum of sequential moments into a common thread, the life of the cell evolved as
a bridge across time
. Before long, cells figured out ways of hanging together and working together, which finally produced you and me.

According to the
American Heritage Dictionary,
to evolve biologically means "to develop by evolutionary processes from a primitive to a more highly organized form."
¹

Earth's molecular brain of DNA is a powerful and successful genetic program - not only because it adapts to constant change, but also because it expects, appreciates, and takes advantage of opportunities to transform itself into something even more magnificent. It is perhaps of interest that our human genetic code is constructed by the exact same four nucleotides (complex molecules) as every other form of life on the planet. At the level of our DNA, we are related to the birds, reptiles, amphibians, other mammals, and even the plant life. From a purely biological perspective, we human beings are our own species-specific mutation of earth's genetic possibility.

As much as we would like to think that human life has attained biological perfection, despite our sophisticated design, we do not represent a finished and/ or perfect genetic code. The human brain exists in an ongoing state of change. Even the brains of our ancestors of 2000 or 4000 years ago do not look identical to the brains of man today. The development of language, for example, has altered our brains' anatomical structure and cellular networks.

Most of the different types of cells in our body die and are replaced every few weeks or months. However, neurons, the primary cell of the nervous system, do not multiply (for the most part) after we are born. That means that the majority of the neurons in your brain today are as old as you are. This longevity of the neurons partially accounts for why we feel pretty much the same on the inside at the age of 10 as we do at age 30 or 77. The cells in our brain are the same but over time their connections change based upon their/our experience.

The human nervous system is a wonderfully dynamic entity composed of an estimated one trillion cells. To give you some appreciation for how enormous one trillion is, consider this: there are approximately six billion people on the planet and we would have to multiply all six billion people 166 times just to make up the number of cells

combining to create a single nervous system!

Of course, our body is much more than a nervous system. In fact, the typical adult human body is composed of approximately fifty trillion cells. That would be 8,333 times all of the six billion people on the planet! What's amazing is that this huge conglomeration of bone cells, muscle cells, connective tissue cells, sensory cells, etc. tend to get along and work together to generate perfect health.

Biological evolution generally occurs from a state of lesser complexity to a state of greater complexity. Nature ensures her own efficiency by not reinventing the wheel with every new species she creates. Generally, once nature identifies a pattern in the genetic code that works toward the survival of the creature, like a blossom for nectar transmission, a heart to pump blood, a sweat gland to help regulate body temperature or an eyeball for vision, she tends to build that feature into future permutations of that specific code. By adding a new level of programming on top of an already well-established set of instructions, each new species contains a strong foundation of time-tested DNA sequences. This is one of the simple ways through which nature transmits the experience and wisdom bestowed by ancient life to her progeny.

Another advantage to this type of build-on-top-of-what-already-works genetic engineering strategy is that very small manipulations of the genetic sequences can result in major evolutionary transformations. In our own genetic profile, believe it or not, scientific evidence indicates that we humans share 99.4% of our total DNA sequences with the chimpanzee.
²

This does not mean, of course, that humans are direct descendants from our tree-swinging friends, but it does emphasize that the genius of our molecular code is supported by eons of nature's greatest evolutionary effort. Our human code was not a random act, at least not in its entirety, but rather is better construed as nature's ever-evolving quest for a body of genetic perfection.

As members of the same human species, you and I share all but 0.01% (1/100th of 1%) of identical genetic sequences. So biologically, as a species, you and I are virtually identical to one another at the level of our genes (99.99%). Looking around at the diversity within our human race, it is obvious that 0.01% accounts for a significant difference in how we look, think, and behave.

The portion of our brain that separates us from all other mammals is the outer undulated and convoluted cerebral cortex. Although other mammals do have a cerebral cortex, the human cortex has approximately twice the thickness and is believed to have twice the function. Our cerebral cortex is divided into two major hemispheres, which complement one another in function. (Note: All of the pictures in this book have the front of the brain directed to the left).