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Dan Agin

Dan Agin

Posted: January 16, 2011 10:06 AM

The booboisie is rattled. A 22-year-old kid in Tucson walks into a gunshop, puts down a credit card, buys a Glock machine pistol, goes to a shopping center and shoots more than a dozen people, killing a nine-year-old girl, a Federal judge, various civilians, and severely wounding a U.S. Congresswoman. During the following days, throughout the country, media journalists and their editors and producers bombard the public with cogitations about "motivation"--and think they're doing a public service.

In psychiatry, "motivation" is a nonsense term in the context of severe mental illness. For the severely mentally ill, analysis of motivation gets you nowhere: the rules of reason of the mentally ill are not the rules of reason of the rest of us.

A schizophrenic girl can easily "reason" that if all nuns are virgins and she's a virgin, then she's a nun. Or if all dogs have four legs, and a cat has four legs, then a cat is a dog. In terms of logic, she's "reasoning" that if two sets have a partial overlap, the sets are identical. That's the "reasoning" of a haywire brain -- not the reasoning of the rest of us.

The "mind" is behavior produced by a biological tissue -- the brain -- and if the brain develops in a haywire fashion, so does the mind. Or if the brain suddenly goes haywire, so does the mind.

In 1966, Charles Whitman, twenty-five years old, an ex-Marine and student at the University of Texas, suddenly murdered his wife and mother, then went up to a tower on the campus with a high-powered rifle and plenty of ammunition and shot 48 people, killing 16 of them. What's notable about this case is that he complained of severe headaches for weeks prior to the massacre, was treated only with headache pills, and then on autopsy he was found to have an aggressive brain tumor, a glioblastoma. He had a haywire brain, and to talk about "motivation" was and is a booboisie entertainment.

Does the brain have to be severely damaged in order for the mind to go haywire? Absolutely not. Here's an example:

A few years ago, a 53-year-old businessman was hit by an automobile while crossing a street in Kyoto, Japan. We'll call him Hiroshi (not his real name). He suffered fractures of his pelvis and the fibula bones of his legs. In a hospital emergency unit, a conventional CT (computed tomography) image of his head revealed only minor bleeding under the scalp but outside the skull. After four months healing of his bones in the hospital, he was discharged and he went home to his wife and family.

Soon after his arrival at home, Hiroshi's wife noticed dramatic changes in his behavior. He seemed apathetic and indifferent. He frequently left the house to wander around the neighborhood. He'd get angry at some memory of the past and then direct the anger at his family. Hiroshi's business involved the lease and operation of construction cranes, and now at work he began leasing the land that he used to park his cranes to other operators. He continued leasing his land at unreasonable rates, and soon he had to find new land to park his own cranes. He made random purchases and signed contracts with no apparent understanding of their contents. Finally, one year after his accident, his wife brought him to neuropsychiatrists at the Kyoto University Brain Research Center.

This time Hiroshi was in the hands of neuropsychiatric specialists. His personality changes and strange social behavior were recognized as typical changes following traumatic injury to the orbitofrontal cortex, the part of the brain immediately behind the forehead and directly above and behind the eyes.

The damage to Hiroshi's brain had not been visible in low-resolution CT images at the emergency unit following his accident. But high-resolution MRI images now clearly showed the small-lesion damage.

Hiroshi's case illustrates some ideas about frontal lobe damage. His case makes clear that damage to the frontal lobes too minor to be initially recognized by a low resolution brain scan can still cause severe personality change. That large-scale damage to the frontal lobes can cause important personality changes has been well known for more than 150 years. Recent cases like Hiroshi's have demonstrated that minor anatomical changes can also distort human personality.

The idea that personality, both ordinary and aberrant, is linked somehow to the anatomy and chemistry of the brain has always lurked in the wings as a sensible notion. What is happening now is that the notion has been shaped by evidence and is slowly wiping out several centuries of myths about how the brain works and what may be happening when the brain goes haywire.

Journalists and their editors and producers are doing society a great disservice by promoting myths about the recent tragedy in Tucson and its origins in the "motivations" of the killer. If they promote myths about the human mind because they think the myths are truths, they must be imbeciles. If they promote myths to pay their rent because they know the public will buy myths, they must be--well, you know what they must be.

Reality: When society puts a Glock machine pistol into the hands of a man with a haywire brain, society is as crazy as the patient. Either we find a way to prevent that, or we find a way to get rid of guns altogether. We do owe it to that nine-year-old girl now in her grave.

(Parts of the above text are adapted from Dan Agin's recent book Autism: Aspects of a Medical Riddle, Spectrum Focus, 2011.)