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Hunting for Hedonia ENG

DVT/KH/KH/ML/KH 140319

1

01:00:32:15

01:00:37:15

<On a cold Sunday morning,>

<he passed a nurse in the hallway.>

2

01:00:39:04

01:00:42:12

<"How do I get to the 14th floor?">

<he asked.>

3

01:00:45:18

01:00:48:11

<There's something in me>

<I do not like.>

4

01:00:48:14

01:00:53:01

<It keeps making me do things>

<I don't want to do.>

5

01:00:53:04

01:00:56:01

<I don't want to be me anymore.>

6

01:00:58:11

01:01:02:08

You said they told you

you were dead, is that correct?

7

01:01:02:11

01:01:05:17

<They say they can change me>

<into someone else ->

8

01:01:05:20

01:01:08:11

<- put electrodes in my brain.>

9

01:01:08:14

01:01:11:18

<"I'm not sure I believe them,">

<he said.>

10

01:01:11:21

01:01:15:15

- Don't let me do it.

- I won't let you do it.

11

01:01:18:01

01:01:22:14

<The man almost jumped>

<on that Sunday morning 50 years ago.>

12

01:01:22:17

01:01:26:14

<But he was drawn back>

<from the edge by a doctor.>

13

01:01:27:19

01:01:32:04

<This was Robert Heath,>

<the psychiatrist who'd admitted him.>

14

01:01:32:07

01:01:35:04

We still have a feeling

that we're working in the dark.

15

01:01:35:07

01:01:37:19

We actually don't know

what's going on -

16

01:01:37:22

01:01:41:02

- and the real problem is

in understanding this thing here.

17

01:01:41:05

01:01:46:10

This is perhaps the most complicated

organ in the whole universe.

18

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01:01:49:24

The brain is the central integrator

of all behavior.

19

01:01:52:06

01:01:57:15

Bob was trying to focus on the idea

that there was a deficiency -

20

01:01:57:18

01:02:02:22

- an innate deficiency

in that quality of pleasure.

21

01:02:03:00

01:02:05:21

And began slowly trying to focus on -

22

01:02:05:24

01:02:12:06

- where in the brain that pleasurable

or those pleasurable areas might reside.

23

01:02:18:20

01:02:21:06

<Heath was on a mission.>

24

01:02:21:09

01:02:25:13

<He was searching for the seat>

<of pleasure in the brain.>

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01:02:29:17

<He called it Hedonia.>

26

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01:02:40:11

<Hedonia means pleasure ->

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01:02:43:14

- <and searching for the brain's>

<pleasure center ->

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01:02:46:07

<- would later get him into>

<great trouble.>

29

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01:02:53:00

<So much so that he was written out>

<of history and forgotten.>

30

01:02:57:03

01:02:58:24

<But 30 years later ->

31

01:02:59:02

01:03:04:15

<- the idea of going into the brain>

<to cure the mind arose again.>

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01:03:08:24

<Today,>

<the most ambitious neurosurgeons ->

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01:03:09:02

01:03:15:14

<- are targeting a broad range of different>

<brain diseases with neuromodulation.>

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01:03:21:13

Depression is going to be the first

huge public health problem -

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01:03:25:20

- that is addressed

with neuromodulation.

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01:03:30:22

Addiction, obesity and opioid abuse.

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01:03:32:20

01:03:35:05

Tourette works.

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01:03:37:17

OCD works.

39

01:03:37:20

01:03:42:15

<If the tools are there and the brain>

<is our new frontier ->

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01:03:45:22

<- what are we going to discover?>

41

01:03:46:00

01:03:48:08

What if we could open up

the potential -

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01:03:48:11

01:03:52:10

- of the brain to learn skills

and facts a lot better?

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01:03:52:13

01:03:54:16

People are going to want that.

44

01:03:57:09

01:04:01:16

<What kind of future lies ahead>

<for the human mind?>

45

01:04:02:21

01:04:08:01

<Will probing the brain>

<bring happiness or misery?>

46

01:04:08:04

01:04:12:02

We are exploring how brains

and machines work together, right?

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01:04:12:05

01:04:16:03

The dynamic between humans

and machines is ultimately changing.

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01:04:22:01

I get into ethical quandaries...

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01:04:22:04

01:04:26:15

You can imagine

all sorts of weird applications -

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01:04:26:18

01:04:30:07

- that hopefully

make people uncomfortable.

51

01:04:33:04

01:04:38:04

<What kind of legacy would these>

<grand ambitions leave behind?>

52

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01:04:44:10

There are explorers,

"conquistadores" -

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01:04:48:09

- in science,

and that's who they are.

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01:04:53:20

Some of them discover continents,

some of them drown in the ocean.

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01:05:16:13

01:05:21:08

<It was a revolution when the Food and>

<Drug Administration in the late nineties ->

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01:05:24:21

<- approved a new treatment>

<for Parkinson's disease.>

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01:05:27:16

<They called it>

<"deep brain stimulation".>

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01:05:28:17

01:05:30:17

<Instead of giving medications ->

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01:05:30:20

01:05:35:23

<- neurosurgeons would insert>

<ultrathin electrical wires into the brain ->

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01:05:39:09

<- to correct the debilitating>

<shaking and stiffness.>

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01:06:15:09

A little bit more room there.

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01:06:25:09

Here comes the fun part.

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01:06:29:20

Most people say that's the

most painful part of the whole deal.

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01:06:33:00

Ready? You will feel a little stick.

65

01:06:33:03

01:06:37:14

I want you to breathe in and out

slowly. One, two, three, breathe.

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01:06:39:00

01:06:41:08

He laughs at it.

67

01:06:41:11

01:06:44:03

Is that all you've got?

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01:06:57:06

Give me a second here.

I'll fix that back.

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01:07:15:22

We're going to put a little pad behind

your neck to make it more comfortable.

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01:07:18:08

What kind of music do you want?

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01:07:22:10

You don't have any early Beatles,

do you?

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01:07:25:00

We have early Beatles.

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01:07:47:06

<The system is simple.>

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01:07:51:02

<A battery under the skin>

<feeds a stimulator ->

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01:07:51:05

01:07:54:17

<- that delivers a current>

<directly to neurons.>

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01:07:59:13

<To find the exact spot in the brain>

<and the right current ->

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01:07:59:16

01:08:03:17

<- the patient has to be awake>

<during the operation.>

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01:08:15:02

Alright, are you ready?

Loud noise.

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01:08:24:17

01:08:30:08

That drill bit... stops itself,

if it hits something soft.

80

01:08:30:11

01:08:34:05

As long as it's pushing against

something hard like bone...

81

01:08:34:08

01:08:36:14

You're having fun?

82

01:08:37:15

01:08:40:09

Most people, when they train

in movement disorder -

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01:08:40:12

01:08:43:24

- you see somebody who is shaking,

you see a funny walk -

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01:08:44:02

01:08:48:20

- you see eyelids closing too much,

a neck twitching, you see a tick...

85

01:08:48:23

01:08:52:19

Why does that happen?

Why is this movement happening?

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01:08:52:22

01:08:55:14

The brain is amazing and beautiful -

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01:08:55:17

01:08:59:05

- and the most complex object

in the known universe.

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01:09:01:00

01:09:04:17

There are a hundred billion neurons -

89

01:09:04:20

01:09:08:12

- each with an average of a thousand

connections to other neurons -

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01:09:08:15

01:09:12:24

- and so the complexity and

connectivity of this organ -

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- sort of dwarfs the kidney.

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01:09:17:04

01:09:21:02

And your brain is you.

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Your kidney is not you.

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01:09:28:07

You can take a kidney out

and you're still you.

95

01:09:28:10

01:09:33:03

But if I injure part of your brain -

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- I take away a part of you.

97

01:09:39:02

01:09:42:21

There's still some background at 18.6.

98

01:09:43:24

01:09:47:12

The green there, that's actually

noise out of your brain.

99

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01:09:52:00

It's just noise. We often say

this is like driving through Europe.

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01:09:52:03

01:09:54:24

As he goes through different regions

of the brain -

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01:09:55:02

01:09:59:03

- it's like when you drive through Europe

and they speak different languages.

102

01:09:59:06

01:10:03:01

In Amsterdam or the Netherlands

they speak one language.

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01:10:03:04

01:10:07:19

The border speaks a different language,

when they ask you for your passport.

104

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01:10:11:22

You head into Germany, guess what?

The language changes again -

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- and then down to Italy for some wine.

Same thing.

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01:10:20:22

As he goes from top to bottom here

he's gonna look for different languages -

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01:10:24:13

- and then Dr. Barmore on your

right side, one of the neurologists -

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01:10:24:16

01:10:28:02

- is going to move your arms and legs

around with Dr. Almeida -

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01:10:28:05

01:10:31:12

- to see which cells

are responding to movement.

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01:10:31:15

01:10:36:18

That tells us where

the motor regions are in the brain.

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01:10:56:01

01:11:00:17

One of the amazing things in retrospect

about a guy like Bob Heath...

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01:11:03:21

We are talking about 1950.

113

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01:11:15:10

65 years ago,

when he was doing this every day.

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01:11:21:05

We calculate our coordinates

from the X-rays -

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01:11:21:08

01:11:25:14

- make the adjustments in

the various planes on the machine -

116

01:11:25:17

01:11:28:15

- then we're in a position to drill

the barrel holes -

117

01:11:28:18

01:11:31:02

- and to lower the electrodes

into place.

118

01:11:31:05

01:11:35:09

Electrodes are carried down

by means of rather stiff guides -

119

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01:11:39:07

- and after they're lowered

to the proper depth -

120

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01:11:42:04

- determined by

this millimeter scale here -

121

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01:11:47:02

- we clamp the wires into place,

and turn this back up.

122

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01:11:49:22

After they're fixed

with a plastic button -

123

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01:11:54:20

- we're in the position to do our

recording and to give treatment.

124

01:11:55:22

01:12:01:16

And you've told me you had

these voices that troubled you.

125

01:12:01:19

01:12:04:18

- Yeah.

- Tell me about those.

126

01:12:04:21

01:12:08:21

Bob was trying to focus

on this bizarre syndrome -

127

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01:12:12:07

- that we're calling schizophrenia.

128

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01:12:17:06

Looking for pleasure,

believing as they did, as Bob did -

129

01:12:17:09

01:12:22:11

- with the first few people,

who had electrodes placed -

130

01:12:22:14

01:12:27:06

- that the septal area did seem

to show abnormal electrical activity -

131

01:12:27:09

01:12:33:19

- which changed when a stimulus

was somehow placed there.

132

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01:12:47:16

... and we'll send you home.

133

01:12:47:19

01:12:51:03

- Alright, congratulations!

- See you later.

134

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01:12:52:21

Good job!

135

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01:12:57:22

<After hundreds of operations>

<surgeons began to compare notes ->

136

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01:13:01:15

<- and something unusual came to light.>

137

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01:13:02:21

<Once in a while ->

138

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01:13:08:05

<- a Parkinson's patient would react>

<strangely and surprise everyone.>

139

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01:13:13:07

I had met this patient, you know...

many times, several times.

140

01:13:13:10

01:13:17:07

I'd never seen her smile before,

and she always seemed pretty miserable.

141

01:13:17:10

01:13:22:05

As I was turning the voltage up,

the most remarkable thing happened.

142

01:13:22:08

01:13:26:07

Michael Okun is talking to her

while we were doing this -

143

01:13:26:10

01:13:29:02

- and he says,

"What are you feeling?"

144

01:13:29:05

01:13:33:16

As she says, "I feel happy!"

145

01:13:34:21

01:13:38:09

We had tapped into

an interface in the brain -

146

01:13:38:12

01:13:43:16

- between the motor

and the limbic behavioral functions.

147

01:13:43:19

01:13:46:16

When we submitted it for publication -

148

01:13:46:19

01:13:51:04

- the response was

"No, this can't be real".

149

01:13:51:07

01:13:54:19

Now we know,

fast-forward a couple of decades -

150

01:13:54:22

01:13:57:20

- that this has been reproduced

all around the world.

151

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01:14:01:14

<What looked to most surgeons>

<to be an odd side effect ->

152

01:14:01:17

01:14:04:02

<- was really a breakthrough.>

153

01:14:04:05

01:14:08:19

<And in 2001, this was picked up on>

<by an outsider.>

154

01:14:08:22

01:14:10:20

<Neurologist Helen Mayberg ->

155

01:14:10:23

01:14:13:19

<- who had long researched>

<the mechanisms of depression ->

156

01:14:13:22

01:14:18:19

<- became the first to try deep brain>

<stimulation to understand mood.>

157

01:14:18:22

01:14:23:08

We'd been thinking about

this thought experiment for a while.

158

01:14:23:11

01:14:26:19

The most amazing thing

about that first time -

159

01:14:26:22

01:14:30:00

- was in fact that nobody knew

what to expect.

160

01:14:31:15

01:14:35:18

So to actually have a patient change

state in front of our eyes -

161

01:14:35:21

01:14:40:18

- was very emotional.

How can it not be?

162

01:14:40:21

01:14:44:09

You just want nothing bad to happen

to this patient -

163

01:14:44:12

01:14:49:15

- while you indulge in testing an idea.

164

01:14:51:19

01:14:54:11

And all of a sudden

her face changes.

165

01:14:58:09

01:15:01:01

That was the moment where I said:

166

01:15:01:04

01:15:04:15

"I don't know what this is

or what we are doing -

167

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01:15:07:16

- but we better figure this out -

168

01:15:07:19

01:15:11:15

- because maybe this really is

the start of something."

169

01:15:21:13

01:15:24:24

The circuitry that controls

your emotional state -

170

01:15:25:02

01:15:28:15

- and the circuitry that controls

your ability to move -

171

01:15:28:18

01:15:30:18

- they're the same.

172

01:15:30:21

01:15:34:23

And interwoven within that circuitry

in the human brain -

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01:15:35:01

01:15:38:12

- are the representations for mood -

174

01:15:38:15

01:15:41:22

- how you feel,

the representations for emotions -

175

01:15:42:00

01:15:47:19

- the representations for what we call

associated circuits, how you think.

176

01:16:22:00

01:16:25:10

You're gazing from a window to life -

177

01:16:25:13

01:16:30:09

- but it's impossible for you

to take part in life.

178

01:16:30:12

01:16:33:20

You're just gazing

through this milky window -

179

01:16:33:23

01:16:36:23

- and see people,

what they're doing -

180

01:16:37:01

01:16:40:16

- what... there is life and there...

181

01:16:40:19

01:16:45:21

Just take part in life -

182

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01:16:48:10

- but I can't.

183

01:16:50:12

01:16:55:13

You're like locked in your own world.

184

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01:17:03:23

It's like a foggy dew -

185

01:17:04:01

01:17:08:20

- when I try to remember

the last time I was happy -

186

01:17:08:23

01:17:15:03

- I was lucky,

I felt these feelings.

187

01:17:15:06

01:17:20:01

We have a pleasure

if we eat something really good.

188

01:17:20:04

01:17:23:01

Our system really immediately knows -

189

01:17:23:04

01:17:26:09

- that's something good,

that's something to be repeated.

190

01:17:26:12

01:17:31:18

Hedonia is one of the key

driving factors -

191

01:17:31:21

01:17:35:01

- not only of us,

actually of all vertebrates.

192

01:17:35:04

01:17:39:05

Hedonia tells you what's good for you -

193

01:17:39:08

01:17:42:09

- in a not so subtle way.

194

01:17:42:12

01:17:45:04

And Hedonia is very important

for sex drive -

195

01:17:45:07

01:17:49:14

- for our reproduction,

romantic love, music.

196

01:17:49:17

01:17:53:10

All of these functions are

no longer there in depression.

197

01:17:58:01

01:18:01:17

At this point in my life -

198

01:18:01:20

01:18:06:20

- I wouldn't say that it is a life.

199

01:18:06:23

01:18:09:16

Life is very far away.

200

01:18:12:22

01:18:17:18

I once read the expression

'cancer of soul'.

201

01:18:17:21

01:18:20:04

It very likely means what it says -

202

01:18:20:07

01:18:26:01

- because it destroys your soul and

your feelings and your thoughts -

203

01:18:26:04

01:18:30:20

- and so you're at the point

where you say:

204

01:18:30:23

01:18:34:03

"I can't bear the pain anymore.

205

01:18:34:06

01:18:37:16

And I don't want to live anymore."

206

01:18:43:09

01:18:47:24

I'm pretty much always depressed,

have been since I was nine.

207

01:18:51:20

01:18:58:09

I become very isolated.

208

01:18:58:12

01:19:05:01

I'm like sliding down into

the bottom of a well.

209

01:19:05:04

01:19:07:24

It's very, very dark...

210

01:19:09:20

01:19:13:06

There's no one there.

211

01:19:13:09

01:19:16:18

There's really no light.

212

01:19:20:22

01:19:23:16

I feel that...

213

01:19:25:10

01:19:29:12

... that I have no contribution

to make whatsoever -

214

01:19:29:15

01:19:31:16

- that I'm basically worthless.

215

01:19:31:19

01:19:36:16

So why even make the attempt

to get out?

216

01:19:36:19

01:19:43:22

Many of these patients are basically

stuck, without options.

217

01:19:44:00

01:19:49:21

They live in a purgatory

that to me is indescribable.

218

01:19:49:24

01:19:54:10

They don't respond to therapy

or any of the multitude of drugs -

219

01:19:54:13

01:19:59:10

- they failed ECT. Those patients

are at the end of the line.

220

01:20:01:04

01:20:03:15

I get away with it, because...

221

01:20:05:06

01:20:08:21

... my husband is...

222

01:20:10:08

01:20:15:13

He's a really good man.

He takes good care of me.

223

01:20:16:16

01:20:18:21

As a resident -

224

01:20:18:24

01:20:23:22

- I met a very, very desperate patient.

225

01:20:24:00

01:20:28:18

He was a government employee and

he was afflicted with a horrible destiny.

226

01:20:28:21

01:20:31:24

He had repetitive depression -

227

01:20:32:02

01:20:35:11

- and I met him at his seventh episode.

228

01:20:35:14

01:20:41:05

He came to the clinic in Bern where

I worked at the time and he said:

229

01:20:41:08

01:20:44:12

"Oh, doctor.

It's depression striking again.

230

01:20:44:15

01:20:52:05

Please, please, please, don't make me

participate in group therapy again."

231

01:20:52:08

01:20:55:03

Which I thought was an odd thing.

232

01:20:55:06

01:21:00:14

I said, "OK, I'll talk to my boss."

I went to the boss and the boss said:

233

01:21:00:17

01:21:05:24

"Oh yeah, this is a cathartic moment

in the life of this patient.

234

01:21:06:02

01:21:10:04

He shows some aggression.

This aggression is good.

235

01:21:10:07

01:21:14:06

Aggression against his depression,

we need to use it.

236

01:21:14:09

01:21:16:13

He will have group therapy.

237

01:21:16:16

01:21:20:22

What doesn't kill a patient

will make him stronger."

238

01:21:22:09

01:21:25:10

This was a particularly stupid statement -

239

01:21:25:13

01:21:30:24

- because this patient hanged himself

six weeks later.

240

01:21:34:08

01:21:39:09

This destiny impressed me tremendously

and I'm not against psychotherapy.

241

01:21:39:12

01:21:43:08

Psychotherapy is very useful

in every patient.

242

01:21:43:11

01:21:46:21

We couldn't treat a depression

without psychotherapy -

243

01:21:46:24

01:21:49:18

- but sometimes patients need more.

244

01:21:49:21

01:21:55:11

And I like action in psychiatry.

I like that something is going on.

245

01:21:55:14

01:22:00:10

I dislike months and years of talking

with patients about same thing.

246

01:22:00:13

01:22:03:23

If they suffer so hard

something needs to happen.

247

01:22:14:23

01:22:19:17

When I was Chief of Psychiatry

in New York State, the census then -

248

01:22:19:20

01:22:24:13

- in all of the New York State Hospitals

approached 90,000 people.

249

01:22:27:10

01:22:31:03

90,000 people permanent... quote:

250

01:22:31:06

01:22:36:11

"... permanently assigned

to various mental hospitals".

251

01:22:36:14

01:22:39:13

It was a massive, massive thing.

252

01:22:42:15

01:22:48:14

There was essentially nothing to do

so far as treatment was concerned -

253

01:22:48:17

01:22:53:09

- for some of those

who were lobotomized.

254

01:22:53:12

01:22:56:17

There was electroshock -

255

01:22:56:20

01:23:01:02

- and we would sometimes give them

two, three, four a day.

256

01:23:01:05

01:23:06:01

Enough to where they were reduced

to slobbering pieces of protoplasm.

257

01:23:06:04

01:23:08:19

There really was no treatment.

258

01:23:08:22

01:23:11:01

Those days...

259

01:23:11:04

01:23:14:20

How does one put it? Those people

were locked up and forgotten.

260

01:23:16:09

01:23:20:18

And we were all young and vigorous

and wishing we could do better.

261

01:23:26:02

01:23:29:09

<Robert Heath was making his way>

<in New York ->

262

01:23:29:12

01:23:32:23

<- the promised land>

<of American psychiatry ->

263

01:23:33:01

01:23:38:10

<- with a practice on Park Avenue>

<and tenure track at Columbia University.>

264

01:23:38:13

01:23:41:07

<He caught the eye>

<of an ambitious dean ->

265

01:23:41:10

01:23:45:18

<- who wanted to make Tulane University>

<a 'Harvard of the South'.>

266

01:23:45:21

01:23:48:06

<Robert Heath dazzled the dean ->

267

01:23:48:09

01:23:53:10

<- and Tulane offered the young man>

<the keys to a kingdom of his own.>

268

01:23:54:21

01:24:01:05

<Chief of both neurology and psychiatry>

<at just 34!>

269

01:24:01:08

01:24:03:16

<It was unheard of.>

270

01:24:10:03

01:24:16:23

This would have been

the summer of 1952-53.

271

01:24:17:01

01:24:19:04

If you were sitting in a room -

272

01:24:19:07

01:24:23:01

- and you wanted to, in your mind,

conjure up -

273

01:24:23:04

01:24:26:13

- the most magical person -

274

01:24:26:16

01:24:31:00

- good-looking, filled with authority -

275

01:24:31:03

01:24:35:14

- filled with all sorts of confidence -

276

01:24:35:17

01:24:41:12

- who was that man? That was Dr. Heath,

Head of Psychiatry and Neurology.

277

01:24:41:15

01:24:45:08

First word that comes to mind

is imperious.

278

01:24:45:11

01:24:52:06

Gregory Peck in kind of appearance.

Very glamorous and...

279

01:24:52:24

01:24:54:11

... suave.

280

01:24:54:14

01:24:59:02

He took me on a tour of his lab -

281

01:24:59:05

01:25:02:15

- which I felt was really amazing

for an undergraduate -

282

01:25:02:18

01:25:06:02

- to have him spend time doing that.

283

01:25:06:05

01:25:11:15

He started to talk about

what was going on in that lab.

284

01:25:11:18

01:25:15:17

He already, from what I could tell -

285

01:25:15:20

01:25:19:07

- was wondering

how he might transpose -

286

01:25:19:10

01:25:25:14

- that whole concept of behavioral

anhedonia, lack of pleasure -

287

01:25:25:17

01:25:27:24

- to neurophysiology -

288

01:25:28:02

01:25:31:24

- and began slowly trying to focus on

where in the brain -

289

01:25:32:02

01:25:37:04

- that pleasurable or those

pleasurable areas might reside.

290

01:25:42:00

01:25:47:10

He realized this is not an emotional

problem, this is a brain disease.

291

01:25:47:13

01:25:52:19

Most psychiatrists looked at it as,

"Oh well, they have a psychotic break."

292

01:25:52:22

01:25:57:09

But Heath was trying to figure out

what happens in the brain.

293

01:25:59:03

01:26:02:17

<This is the old Charity Hospital>

<in New Orleans.>

294

01:26:02:20

01:26:07:05

<Robert Heath went here every day>

<to walk the halls of the third floor ->

295

01:26:07:08

01:26:09:22

<- and make his rounds.>

296

01:26:12:07

01:26:17:20

<He wanted his psychiatric ward to be>

<the most modern in the country.>

297

01:26:17:23

01:26:20:17

<Today, the hospital is abandoned ->

298

01:26:20:20

01:26:24:13

<- and plans are being made>

<to tear it down.>

299

01:26:26:24

01:26:29:17

They did it first with cats,

a couple of animals -

300

01:26:29:20

01:26:33:06

- to show that there was abnormal

electrical activity -

301

01:26:33:09

01:26:36:09

- when one put a wire down deep.

302

01:26:37:19

01:26:40:09

You'd walk through the halls -

303

01:26:40:12

01:26:43:19

- and there'd be six Rhesus

monkeys sitting in chairs -

304

01:26:43:22

01:26:49:11

- with wooden collars around their necks

with wires hanging out of their heads.

305

01:26:49:14

01:26:55:01

It was a pretty exotic thing

for a medical student to see all that.

306

01:26:55:04

01:26:59:12

But ultimately, of course,

he began using that on humans.

307

01:27:04:02

01:27:10:05

That sound we are hearing now

is coming from the normal brain.

308

01:27:10:08

01:27:16:00

In some ways it's comparable to

the distant roar of a four-engine plane.

309

01:27:21:05

01:27:23:22

This is a mentally ill patient.

310

01:27:24:00

01:27:27:17

Notice the difference in sounds

coming from his brain.

311

01:27:30:17

01:27:34:23

It sounds like a plane

with its engines misfiring.

312

01:27:35:01

01:27:37:14

In a way

that's just what's happening.

313

01:27:39:10

01:27:42:22

A dramatic approach

to say the very least!

314

01:27:43:00

01:27:47:00

To insert these microelectrodes

deep into the brain -

315

01:27:47:03

01:27:50:16

- and have them stay there

for periods of time -

316

01:27:50:19

01:27:52:21

- to measure and stimulate.

317

01:27:52:24

01:27:58:08

And we bought into it, because

it was new ideas. It was thrilling!

318

01:27:58:11

01:28:02:22

Just the fact that you could record

what was going on in the brain -

319

01:28:03:00

01:28:06:23

- and talk to the patient and then you

could stimulate an area of the brain -

320

01:28:07:01

01:28:11:03

- and have him tell you

how it changed his feelings.

321

01:28:11:06

01:28:13:15

I thought that was fascinating.

322

01:28:14:11

01:28:17:15

I didn't know whether I was

at the frontier of American science -

323

01:28:17:18

01:28:19:22

- and he was bringing me there -

324

01:28:20:00

01:28:25:10

- or I was doing experiments on humans

that had no right to be going on.

325

01:28:25:13

01:28:31:11

The next patient, she will be known

as P6, with her father...

326

01:28:31:14

01:28:35:01

<Schizophrenia was always>

<Robert Heath's big passion.>

327

01:28:35:04

01:28:40:05

<He called it 'the most disabling>

<disorder in all of medicine'.>

328

01:28:40:08

01:28:43:22

<Robbing young people of their lives>

<and crippling whole families ->

329

01:28:44:00

01:28:46:15

<- with its massive stigma.>

330

01:28:46:18

01:28:50:10

<He was sure he would succeed>

<in curing schizophrenia.>

331

01:28:50:13

01:28:55:05

<And even if it is one of the most complex>

<disorders of the human mind ->

332

01:28:55:08

01:28:59:18

<- the task perfectly matched>

<his ambition for greatness.>

333

01:29:01:19

01:29:04:09

How is your mood?

334

01:29:04:12

01:29:06:15

It's so hard to say.

335

01:29:06:18

01:29:08:24

Tell me as best you can.

336

01:29:10:21

01:29:12:07

Mediocre.

337

01:29:12:10

01:29:14:15

Mediocre?

338

01:29:16:15

01:29:19:06

- 60 pulses.

- Is there a difference?

339

01:29:19:09

01:29:24:20

Not sure I do right now.

I feel a little wiggly and...

340

01:29:26:05

01:29:28:13

90 pulses.

341

01:29:28:16

01:29:31:07

- What are you laughing about?

- I don't know.

342

01:29:31:10

01:29:35:01

- Are you doing something to me?

- What makes you think that?

343

01:29:35:04

01:29:37:09

I have no idea.

344

01:29:38:21

01:29:42:16

- What in the hell are you doing?

- Tell me what you thought.

345

01:29:42:19

01:29:45:07

Maybe you're stimulating

some goodie place.

346

01:29:45:10

01:29:48:20

What makes you say

we're stimulating a goodie place?

347

01:29:48:23

01:29:51:04

Well, I wouldn't be laughing.

348

01:29:51:07

01:29:54:17

Somehow the word got out that what's-

her-name had shown this huge response.

349

01:29:54:20

01:29:58:24

Everybody was running around

as if they were on dope.

350

01:29:59:02

01:30:02:11

Eureka! Look what we've discovered!

351

01:30:02:14

01:30:07:10

It was like that. This is happening.

It looks like we've done it!

352

01:30:07:13

01:30:09:21

And they went on

to do other patients of course.

353

01:30:09:24

01:30:15:08

I guess you could say that I'm really

disturbed about feeling good.

354

01:30:15:11

01:30:19:04

- Because it's foreign?

- It's completely foreign.

355

01:30:20:07

01:30:25:01

So you've never felt this way

in your life? Felt this good in your life?

356

01:30:25:04

01:30:30:03

No. I've... I've been trying

to pick out something -

357

01:30:30:06

01:30:35:20

- trying to find something in my background

that I can relate it to, but I can't.

358

01:30:35:23

01:30:39:24

- Does it have any bad effects on you?

- No bad effects at all.

359

01:30:40:21

01:30:43:00

If I could buy one

I would take one home.

360

01:30:43:03

01:30:46:02

- You want to take one home?

- Yes. I'd be glad to.

361

01:31:07:00

01:31:09:14

It's on the dock.

362

01:31:21:01

01:31:25:19

Now I can write my name

so I can read it, and...

363

01:31:28:08

01:31:32:15

It seems like

I can do anything now.

364

01:31:34:03

01:31:37:20

Some things a 70-year-old can't do,

but he thinks he can -

365

01:31:37:23

01:31:42:13

- when he thinks he's still 20 and

then he looks in the mirror and thinks:

366

01:31:42:16

01:31:47:19

"Who's that old guy looking at me?

I don't think he can do this anymore."

367

01:32:13:01

01:32:15:11

Essential tremor...

368

01:32:15:14

01:32:19:03

As soon as you put your hands out

they start shaking right away.

369

01:32:19:06

01:32:22:15

Now mine, I put them out -

370

01:32:22:18

01:32:28:17

- and they just don't.

371

01:32:32:22

01:32:37:13

And I feel like almost normal again.

372

01:33:06:18

01:33:10:15

You know that this is

an experimental study.

373

01:33:12:05

01:33:15:17

We cannot guarantee

that you will respond -

374

01:33:15:20

01:33:21:11

- that everything will be hunky-dory.

That would not be a realistic expectation.

375

01:33:21:14

01:33:26:14

But the chances that you could profit

from it significantly are great -

376

01:33:26:17

01:33:30:03

- judging by the patients

we've already treated.

377

01:33:30:06

01:33:36:10

I really hope that next year

it will be like it used to be again.

378

01:33:36:13

01:33:40:07

The chances are relatively great.

379

01:33:42:08

01:33:47:09

What is the current situation with your

family and parents? Are you in touch?

380

01:33:47:12

01:33:48:17

It's difficult.

381

01:33:48:20

01:33:56:02

I haven't had any contact with my father

since my suicide attempt this year.

382

01:33:56:05

01:33:58:17

Since your suicide attempt?

383

01:33:58:20

01:34:02:11

Why is that a reason for breaking off

a contact?

384

01:34:04:00

01:34:10:12

Because he blames me for the fact

that I would do this to him.

385

01:34:11:15

01:34:15:22

And so he avoids having

contact with me now.

386

01:34:22:13

01:34:29:10

Katherine, today is week 24

of the open stimulation.

387

01:34:29:13

01:34:33:13

And although we will see you

next week again -

388

01:34:33:16

01:34:36:21

- today is the primary end point of...

389

01:34:36:24

01:34:40:13

- The big day.

- Actually the big day.

390

01:34:41:15

01:34:43:21

Let me just show...

391

01:34:46:00

01:34:51:06

Today is May 22nd.

How are you doing?

392

01:34:51:09

01:34:53:14

Good!

393

01:34:54:21

01:34:59:11

I am happy more than not.

394

01:35:03:06

01:35:06:13

I experience joy in...

395

01:35:08:05

01:35:12:13

... almost everything I do.

There's always something about it -

396

01:35:12:16

01:35:16:18

- even if it's just the fact

that I'm doing it.

397

01:35:18:23

01:35:22:04

I usually find...

398

01:35:22:07

01:35:26:13

... some kind of joy.

I enjoy my life.

399

01:35:26:16

01:35:30:06

Never have before.

Never really had a life before.

400

01:35:30:09

01:35:34:08

So, it's kind of like, you know...

401

01:35:35:10

01:35:39:05

Well as Jim calls me,

Catherine 2.0.

402

01:35:39:08

01:35:42:05

You improved on the old one.

403

01:35:42:08

01:35:45:15

You've always had this feeling?

404

01:35:45:18

01:35:49:23

Can you tell me any more

about this?

405

01:35:50:01

01:35:53:22

I can't do anything.

I know everything is going on -

406

01:35:54:00

01:35:56:21

- but it seems like

I can't be a part of it.

407

01:35:56:24

01:36:00:00

You can't be a part of it.

408

01:36:00:03

01:36:05:21

- You feel like you don't belong?

- Yeah, I didn't want to leave home.

409

01:36:05:24

01:36:09:09

And it seems like the other part

of the world was just something -

410

01:36:09:12

01:36:12:18

- that I didn't belong in.

Some kind of a dream.

411

01:36:14:02

01:36:17:11

You think you feel just as bad now

as before the operation?

412

01:36:17:14

01:36:18:19

Yes.

413

01:36:18:22

01:36:21:09

Now the treatment is started.

414

01:36:21:12

01:36:24:14

She's receiving a very minute amount

of current.

415

01:36:24:17

01:36:28:07

Actually, it amounts to only

five thousandths of an ampere -

416

01:36:28:10

01:36:31:13

- delivered to a very specific region

in the brain.

417

01:36:31:16

01:36:34:12

But I don't like to feel me.

418

01:36:34:15

01:36:38:21

- No, I just want to hit something.

- You want to hit something?

419

01:36:38:24

01:36:44:10

But I wouldn't feel any different, so I

just want to get something and tear it up.

420

01:36:44:13

01:36:47:16

You want to get something

and tear it up.

421

01:36:47:19

01:36:53:06

- You feel you want to tear that up?

- Yeah. Take it, so I won't.

422

01:36:53:09

01:36:58:03

Now the current has been reduced. She is

receiving four thousandths of an ampere -

423

01:36:58:06

01:37:00:15

- and is changing in behavior.

424

01:37:05:12

01:37:07:20

Look at that smile you've got now.

425

01:37:07:23

01:37:12:12

Why does that make me do that?

I don't like to do that.

426

01:37:12:15

01:37:15:17

You really told me off.

Remember?

427

01:37:15:20

01:37:18:16

I know, but I couldn't help it.

428

01:37:18:19

01:37:22:04

I didn't have any control over it.

It was just coming...

429

01:37:22:07

01:37:25:08

I was just thinking things

and I couldn't help it.

430

01:37:25:11

01:37:29:03

- Tell me what you were thinking?

- I wanted to slap your face.

431

01:37:29:06

01:37:32:04

I wanted them to cut that off -

432

01:37:32:07

01:37:37:13

- and I was mad at you

because you wouldn't tell them to.

433

01:37:40:20

01:37:46:07

I saw her and I said,

"What was the stimulator put in for?"

434

01:37:46:10

01:37:50:23

And she said,

"I was suicidally depressed."

435

01:37:51:01

01:37:54:15

And I said, "Did it work?"

436

01:37:54:18

01:38:01:19

And she said, "I'm alive and I'm not

depressed. It's what saved my life."

437

01:38:01:22

01:38:05:19

I'm thinking

"My Lord! This stuff really did work."

438

01:38:05:22

01:38:09:10

- Hi! How are you feeling?

- Hi! I'm just fine.

439

01:38:09:13

01:38:13:15

Good. How is everything at home

with that big girl of yours?

440

01:38:13:18

01:38:19:13

Oh, she's just fine.

She is a handful sometimes, though.

441

01:38:19:16

01:38:23:11

We're beginning to make correlations

between the mind and brain activity -

442

01:38:23:14

01:38:28:09

- and hope this will be helpful particularly

in treating the major mental illnesses -

443

01:38:28:12

01:38:30:01

- the psychoses.

444

01:38:30:04

01:38:33:16

So, in the not too distant future

it won't be necessary -

445

01:38:33:19

01:38:39:08

- for one person out of ten spending

some time in the mental hospital.

446

01:38:39:11

01:38:42:22

We in the field even dare to hope

that the mental hospital -

447

01:38:43:00

01:38:46:04

- will be a thing in the past.

448

01:38:52:02

01:38:54:19

I remember it vividly.

449

01:38:56:13

01:39:01:02

Bob's weekend place in Mississippi.

A small place that he'd go to -

450

01:39:01:05

01:39:06:17

- take some people, and do some

fishing, was called Hedonia.

451

01:39:06:20

01:39:11:03

A little farm.

He called it Hedonia.

452

01:39:36:01

01:39:41:04

This is where he's talking about whether

it's an autoimmune disease, schizophrenia.

453

01:39:41:07

01:39:45:21

So, I guess they're still considering

that as a possibility.

454

01:39:48:06

01:39:53:03

I remember very distinctly trying to get

a feeling for what his relationship was -

455

01:39:53:06

01:39:56:11

- to his son and I never knew,

never could tell.

456

01:39:56:14

01:40:01:21

He never became a presence. That's

why I wonder whether he survived -

457