The Dangerous Joy of Dr. Sex and Other True Stories (9 page)

Georg Gabriel leans back in an office chair, so that it makes little creaking sounds underneath him. We're in a narrow room in an NIH complex. A lab assistant is standing behind Gabriel, running a tape measure around his scalp and carefully parting tufts of his white hair to mark him up with a Sharpie pen. Gabriel, who has been measured and Sharpied a lot these days, barely notices. “They told me that my life expectancy with this affliction was about five years,” he tells me, with disarming good cheer. He's pink with apparent health, this 78-year-old man who until recently swam several miles a week. This morning, for his last session of
tDCS testing, he's dressed in business casual: button-down shirt, “Nantucket red” slacks faded to a soft pink and boat shoes. He looks entirely put together. What you can't see is his brain: the nerve cells are dying off throughout the cortex; and the parietal lobe—that switching-house of sensation—may have already shrunk down. Gabriel has a rare condition called corticobasal syndrome, a degeneration of brain tissue with symptoms that often mimic Parkinson's disease. His movements are slow and dreamy. Earlier this morning, the lab worker put him through a battery of tests to rate his motor skills. On a finger-tapping test, Gabriel punched at a lever with such labored movements that I found myself leaning forward in my seat, willing him on.

Now the lab assistant glues one sponge electrode just above and behind Gabriel's left ear and another above his right eye; Gabriel is about to perform all the tests again, this time under the influence of tDCS stimulation. While the lab worker winds tape around his head, Gabriel tells me that the NIH researchers have asked him for permission to do an autopsy on his brain. He remarks, crossing one leg over the other casually, that he's inclined to give it to them. “That's a ‘no brainer' decision,” he quips, and then chortles at his own joke.

When the tDCS machine is on, Gabriel says he can't feel it at all. No tingling. No nothing. Neither Gabriel nor I know whether this is a “sham” stimulation or real. The electrodes might be attached to some area of the scalp where they would have little effect on motor function, or they could be aimed at prime real estate in the brain, one of the spots that the researchers hope will respond to exactly this kind of stimulation.

During most of the testing—Gabriel has to kiss the air, pretend to vacuum and wave goodbye—he continues to move in slo-mo. But on the finger-tapping test, he suddenly seems to gather himself. He looks as if he's been put on fast-forward, his hand jerking so fast that it doesn't seem part of him. His high score without the electrodes was 49; now, electrified, he fires off 66 taps. Even the lab assistant blinks with surprise.

After the testing is over, we learn that Gabriel was in fact receiving real rather than sham stimulation. Today, the positive electrode was placed over the area of the scalp that corresponds to the parietal lobe. However, until the data is compiled for all the patients in the study—and further studies that will surely follow this one—it's impossible to say whether DC stimulation can in fact enhance the plasticity of damaged brains.

“All of our good results to date have been in healthy subjects. I haven't seen convincing evidence that you can do much to help a brain that is badly damaged. It may be that there's no point in trying to polarize busted tissue,” according to Eric Wassermann, the chief of brain stimulation in the Office of the Clinical Director at NIH's NINDS and one of the designers of this study. Despite inconsistent results so far, he and other researchers continue to explore DC stimulation for patients with widespread brain degeneration.

Such patients have been bypassed by recent advances that have helped, for instance, sufferers of Parkinson's Disease. In the past few years, surgeons have begun to use a technique called deep brain stimulation (DBS) to quiet the tremors and stiff gait that become debilitating during a Parkinsonian decline. After drilling small holes in the scalp, the surgeon threads wires deep into the brain to implant a chip near the cluster of cells that is sending out errant signals. For Gabriel, such a focal intervention would not work. In cases such as his, where disease sprawls across a lobe, tDCS could offer an edge. And, too, a cheapo electrical thinking cap, if it works, would offer a huge advantage over other stimulation techniques: No drills bore through the skull. No wires snake through brain tissue. No pacemaker-like machines get implanted under the skin.

I ask Wassermann what the tDCS machine might look like, if it ever hit the market—would it resemble an iPod?

“The brain-pod!” Wassermann jokes. “It should play music, receive calls and…shoot like a gun.” Then he grows serious. “It could be very simple and wearable.”

Wassermann believes that if we're ever to have a Brain-Pod in the United States, it would likely be tested and developed by the military first. But he doesn't rule out the chance that a private company would bankroll tDCS, if it continues to perform in the lab. “It is unlikely that any [company] would do this unless they were guaranteed a market share, and the only way they could be guaranteed a market share would be if they had a patent on some important part of the process. I think we know so little about it at this point that there may be patent-able parts.”

However, Wassermann is not eager to put this device into the hands of consumers; he's concerned about the ethical problems it poses. “I would not be in favor of this being an iPod. Not yet. Not until the issues of safety and fairness have been resolved.”

A while ago, someone suggested to Wassermann that he take some tDCS machines to a nearby university and wire up half the students in a classroom before they took a test. Would the battery-powered
kids do better? “I thought the ethics of that sort of application were questionable because you don't want to advantage people who can afford something that others can't,” Wassermann says.

Of course, these machines could be as cheap as clock radios or coffee makers. So arguing about the ethics of Brain-Pods might be an exercise in futility; if tDCS turns out to produce strong effects, the machines will pop up everywhere, whether we like it or not. “It's an interesting phenomenon, if this were an effective treatment, to have it get completely loose,” Wassermann says. “I'm not excited enough about [tDCS] as a panacea or a great social evil at this point to be very worried. But if it were very potent, it will be all over the place. The Chinese would flood the market with gizmos. This could get completely out of control. It could be like blogging. Everybody could be a brain manipulator.”

In October, a group of researchers gathered around a conference table at the Harvard Center for Noninvasive Brain Stimulation. Fregni, his hair slicked to the side in the manner of a 1920s tycoon, wielded a remote control, flashing images onto a white board. About twenty-five scientists—from Thailand, Brazil, Bolivia,
Israel, and Germany, among other countries—crowded the room. Most of them knew little about tDCS, and so Fregni was delivering an introductory lecture, what might have been called Brain Zapping 101. The graphs Fregni projected on the wall created a frisson of excitement. The audience oohed and aahed. They lifted digital cameras and snapped photos. You could feel it—the buzz that this technology is beginning to generate among the clique of researchers enchanted by both brains and gadgets.

At the end of his lecture, Fregni announced he would demonstrate tDCS. Did anyone in the audience want to try it out? Silence. The scientists gazed around, waiting for someone else to shoot a hand into the air. And then the room erupted into laughter at the collective reluctance to be wired up.

Before I quite realized what I was doing, I heard myself say, “I'll do it.” My hand waved in the air, seemingly of its own accord. It was one of those moments when your body reacts while you're brain lags a second behind. My heart seemed to beat everywhere, my hands, my feet, my face. Why hadn't anyone else—any of the experts—volunteered? Now, I was teetering toward the front of the room. Shirley Fecteau, another Harvard researcher, guided me to a chair.

She and Fregni placed the sponge-covered electrodes on the top of my head, in the two spots where I might grow bunny ears, if I were a character in a fairy tale. This position, which targets the prefrontal cortex, is used to treat depressed patients. Someone wrapped an Ace bandage around my head so tightly that I began to feel headachy. I have lots of hair, and so the bandage began to slide upward. Someone pushed it back in place and I could feel fingers on my scalp, checking the position of the electrodes. Clearly, the Ace bandage alone wouldn't do the job. So Fecteau found a giant elastic band and stretched it vertically around my head so it cut into my cheeks. For the rest of the experiment, it squashed my windpipe, like an especially tight strap of a birthday-party hat.

Fregni showed the control box to the audience, a black brick with a meter and a few knobs on its face. The wire from that box dangled along my arm and went up beyond the line of my vision—to my head. That's when it hit me: They really were going to send electricity through my skull. Fregni turned the switch. The sponge on the left side of my scalp began to prickle, the way poison ivy will after you scratch it. The elastic band made me gasp for breath. The Ace bandage strangled my forehead. The room flashed as members of the audience took photos, and I tried not think about how
I must look with all the elastic pinching my face and my hair sticking every which way. Rather than an elevated mood—which the treatment was supposed to bring on—I felt mortified to be on display in mental-patient drag.

Fregni kept me hooked up for only five minutes, long enough to demonstrate the equipment but not to have much of a clinical effect. Then he freed me. I shuffled back to my chair, still trying to smooth my wet hair back into place. And now, as if by delayed reaction, euphoria overwhelmed me. I felt all fluttery, as if I'd just stepped off a roller coaster. Maybe the electrodes gave me the high. Or maybe I was just elated to leave the stage. It's hard to say.

In the midst of my intoxication, a thought came to me: I've touched my own brain. Before this moment, I had always thought of my brain as imperious and remote, like a queen who issued commands from a red-velvet room high up in a tower. “Worry ceaselessly!” my brain might decree, and I would have no choice but to obey. But now, I had tried to turn the tables. I had sent my prefrontal cortex a command made out of electricity. “Cheer up!” I'd ordered. And now, maybe, just maybe, it had heard me.

Vermin Supreme—a 43-year-old activist and street-theater performer—swaggers toward Faneuil Hall to take on the Democrat groupies. Inside the building tonight, nine candidates will debate each other live on CNN. Vermin Supreme plans to stay outside, where the TV trucks splash spotlights onto the cobblestones. A tribe of John Kerry people wave blue signs and scream in unison: “Ker-REEE, Ker-REEE.” Many of them wear that mob-zombie expression on their faces—the glassy look of people who have been yelling one word for so long that it has turned into nonsense.

Vermin Supreme pushes his way toward the Kerry-ites. A few of them have to hop backward in order to avoid the pointy wingtips of the eagle lashed to his torso. He hoists his megaphone—which confers upon him the electronic voice of authority. “Where does John Kerry stand on mandatory tooth brushing?” he demands. “Is he soft on plaque?” A few college kids break off to listen to the tirade. You can see it in their faces; suddenly, they're no longer members of the Kerry gang. They're just their ordinary selves again, exchanging glances with each other. Who is this guy?

As he passes through the crowd, Vermin Supreme spreads that kind of puzzlement wherever he goes. He has spent years figuring
out how to transform a group-thinking throng back into a bunch of individuals. This is his art form.

“Vote for me,” he tells a gray-haired lady, peering at her from under the rubber boot stuck on his head, the foot end of which points up at the sky. “I'm running for…something.” In fact, in the past fifteen years, he has set his sights on a number of political offices, all of them fictional: Tyrant, Mayor of the United States, Emperor of the New Millennium.

He seems at first to be a flamboyant-yet-sane hippie who is making a point about civil rights. With his wife, Becky (who asks that her last name be withheld), he roams the country to present his own brand of performance art at anti-war rallies and Republican pancake breakfasts. The couple fund their peripatetic activism by paying as little rent as possible and working odd jobs. But it's not as simple as that. When he goes home—to a shack in the woods of Massachusetts—he's still named Vermin Supreme. He's Vermin Supreme twenty-four hours a day, every day, no vacations.