The Brain: The Power of Hope

We say Sweet dreams when we induce general anesthesia--but nobody dreams. Consciousness stops.With anesthesia, however, we know how to undo the spell. You wake up when the operation is over, and there you are again. Not so when you drop into the coma of an advanced brain tumor

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What woke my patient that Friday was simply his mind, forcing its way through a broken brain, a father's final act to comfort his family. The mind is a uniquely personal domain of thought, dreams and countless other things, like the will, faith and hope. These fine things are as real as rocks and water but, like the mind, weightless and invisible, maybe even timeless. Material science shies from these things, calling them epiphenomena, programs running on a computer, tunes on a piano. This understanding can't be ignored; not too much seems to get done on earth without a physical brain. But I know this understanding is not complete, either.

I see the mind have its way all the time when physical realities challenge it. In a patient stubbornly working to rehab after surgery, in a child practicing an instrument or struggling to create, a mind or will, clearly separate, hovers under the machinery, forcing it toward a goal. It's wonderful to see, such tangible evidence of that fine thing's power over the mere clumps of particles that, however pretty, will eventually clump differently and vanish.

Neuroanatomy is largely concerned with which spots in the brain do what; which chemicals have which effects at those spots is neurophysiology. Plan on feeding those chemicals to a real person's brain, and you're doing neuropharmacology. Although they are concerned with myriad, complex, amazing things, none of these disciplines seem to find the mind. Somehow it's "smaller" than the tracts, ganglia and nuclei of the brain's gross anatomy--but "bigger" than the cells and molecules of the brain's physiology. We really should have bumped into it on the way down. Yet we have not. Like our own image in still water, however sharp, when we reach to grasp it, it just dissolves.

But many think the mind is only in there--existing somehow in the physical relationship of the brain's physical elements. The physical, say these materialists, is all there is. I fix bones with hardware. As physical as this might be, I cannot be a materialist. I cannot ignore the internal evidence of my own mind. It would be hypocritical. And worse, it would be cowardly to ignore those occasional appearances of the spirits of others--of minds uncloaked, in naked virtue, like David's goodbye.

Dr. Haig is an assistant clinical professor of orthopedic surgery at the Columbia University College of Physicians and Surgeons

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