- •Contact us
- •About us
- •Advertise with the FT
- •Terms & conditions
© The Financial Times Ltd 2013 FT and 'Financial Times' are trademarks of The Financial Times Ltd.
November 25, 2011 9:57 pm
The adult brain is approximately 1.5kg in weight and the size of a small melon, although, when removed from the body, it is as soft as blancmange. It is peculiar how quickly food analogies spring to mind considering its singularly unappetising appearance. Seeing a whole brain resting in a bottle, or sliced thinly and spread flat on a glass slide, it is hard not to be reminded of a burgeoning cauliflower or a thickly sliced slab of baked macaroni and cheese. It is all a bit inappropriate considering you’re describing the most elaborate object in the known universe.
Yet this sums up the way the brain has been both highly prized and curiously mistreated throughout history. While we are alive, it is the seat of our intelligence, the centre of all that is unique about ourselves. After death, however, it suffers a precipitous drop-off in usefulness. It cannot, after all, be transplanted like the liver, kidney or heart. Even the ancient Egyptians, who took great pains to remove and store most internal organs prior to mummification, declined to keep the brain. Instead, they preferred to insert a long, slightly hooked tool through the nose of the body and swirl it around like a swizzle stick in a cocktail before tipping the deceased’s head forward and pouring the remnants out. To them the brain was the dregs of life.
Considering such hostile treatment, it is no wonder that disembodied brains have taken to huddling together in subterranean repositories known as brain banks. These collections of brains have, over the past 100 years, become essential to medical research. This is the story of three such banks – one of the past, one of the present and one of the future. Each one tells a story of our changing relationship to these highly valuable, infinitely mysterious, and quease-inducing organs.
. . .
Displaying terrific school spirit, the Yale medical library is built in the shape of a Y. Its grand reading room holds original copies of the works of Vesalius, the 16th-century founder of modern anatomy, as well as rare early editions of Hippocrates and Galen. Yet wend your way through the library’s airy reading rooms and down into the dark underbelly of the building, and you’ll find the most fantastic artefact of all.
Squeezed into a curlicue of space deep in the building’s basement are more than 400 lead glass bottles containing a rich scotch-coloured liquid that twinkle on backlit shelves. Amid the room’s twilight and wood panelling you could be forgiven for thinking that you had wandered into an exclusive speakeasy. But your thirst will immediately dissipate once you realise that resting in each of these bottles is a human brain.
Collected in the first decades of the 20th century by Harvey Cushing, they are drawn from a time when brain surgery was akin to playing Russian roulette, albeit with worse odds. Doctors lacked effective techniques and anaesthesia, and specialised tools, and attacked the skull in desperation. As a result, the mortality rate was close to 90 per cent. Through the invention of new devices, compulsive record-taking, and a slow, painstaking approach to surgery, the mortality rate of Cushing’s patients dropped below 10 per cent.
Perhaps most revolutionary was the empathy Cushing displayed with those on whom he operated. His patients were so devoted to him that when asked if they would give him their brains after their death they willingly agreed. And so, in concert with the many drawings and photographs he had made of his patients, Cushing created a unique research resource that attracted the greatest minds of his time. When the experimental physiologist Ivan Pavlov visited Cushing to pay his respects, he was amazed by an electrosurgical knife Cushing had designed. Wanting to test it out, and with no patient around, he used it to sign his name on a piece of meat, which was displayed in a bottle beside the other specimens under the label “Pavlov’s beef-steak”.
Not long after Cushing died in 1939 his collection was bizarrely lost. It was not until the 1980s that a group of carousing Yale medical students discovered the brains languishing in the sub-basement of their dormitory. Visiting them swiftly became a macabre rite of passage, until Dr Dennis Spencer, the Cushing Professor and chair of the Department of Neurosurgery, decided they had to be restored to their former glory.
A new museum was designed to house the entire collection and when it was opened last year, neurosurgeons from around the world flocked to view the father of modern neurosurgery’s work. Beautiful as it is – and making brains beautiful is no easy task – is there something wrong about aestheticising the battered organs of long-suffering, long-dead patients for our own enjoyment?
“I have no ethical problem with it,” declares Spencer. “If we can display them in a way that looks beautiful, we are honouring them much more than if we throw them in the garbage, or stick them in the sub-basement of the school dormitory. We have a moral responsibility to show them off.”
The brains do speak of an age of pioneering surgery, of survival against terrible odds, and with each brain cross-linked to Cushing’s careful photos and notes, the collection seems less a freak show than a memorial to those who were the raw matter of medicine. Indeed, sitting inside their bottles, a gentle breeze wafting over them to spirit away any possible leaking fumes, this might be the best place a brain could be, outside of a body.
. . .
If you want to open a brain bank, the first thing to do is acquire a dead human body. Lie the body on its back and stand above the head. With a scalpel or other sharp implement, cut away the skin exposing the skull. You’re doing great. Now, put down the scalpel and pick up a saw and proceed to cut the bone all the way around the head in line with the top of the ears. You will smell something akin to burnt feathers. Put down the saw and pop off the top of the skull. You’re almost there. Now snip off the cranial nerves, cut the spinal cord and with the greatest of care – remember, blancmange – place the brain gently in a vat of formalin to firm up for a week or two. Well done. Your bank has its first deposit.
The headquarters of the West London Mental Health NHS Trust occupies the yellow brick buildings and looming panopticon of the old Hanwell Pauper and Lunatic Asylum, which in 1831 became the first purpose-built asylum in England. Although the asylum was renowned as one of the most enlightened of the Victorian era, preaching the gospel of “therapy employment”, the squash courts on the site date from a later period. Not that this makes them immune to the locale’s fixation with the head, for these two courts, still with game lines marked on their walls, house about 6,000 brain specimens of the Corsellis Collection, moved from their original home at a hospital in Essex.
Crammed on to institutional grey shelving and lit by harsh strip-lighting, brains dating back to the 1950s are kept in sealed plastic pots ignominiously labelled “food container”. The liquid they swim in is cloudy, and many of the brains are noticeably scarred like a coalface, having been plundered for their hippocampus or medial frontal lobe. Although there are thousands of beautiful fractal-like slides created out of stained slices of brain, these are shut away in black filing cabinets. There is something grimly utilitarian about these brains. They have not been accorded the comfortable afterlife of the historic brains of the Cushing Collection. These are distinctly working brains. Their demeanour is, in some ways, a reflection of their collector, J.A.N. Corsellis. Unlike Cushing, who socialised with his patients, Corsellis was a loner, largely due to an early case of tuberculosis that precluded him from working with living patients.
At Runwell Hospital in Essex, a pioneering mental institution famed for its bucolic setting, whose grounds flourished with “neurosis villas” and “pavilions for the infirm”, he devoted himself to seeing how the form, structure and configuration of the brain changed when it was beset by illness.
From the 1950s to the 1990s a steady flow of brains trickled in from across the country to be added to his collection. While most brain banks specialised in a single malady, this one touched on many, housing hundreds of brains from epileptics, schizophrenics, manic depressives, brains of boxers (whom Corsellis diagnosed as suffering from “dementia pugilistica”) and even a small collection of suicides. By the time of Corsellis’s death in 1994, his collection of brains was one of the largest and most picked over in the world.
To understand what a brain bank such as the Corsellis can offer medical research these days is really to witness the triumph of the tangible over the digital. While a Magnetic Resonance Imaging scan (MRI) can provide a resolution of a brain down to 1mm, with an actual brain you can go down to the level of microns. “You can actually look at cellular properties [of the brain] which you can’t do with an MRI,” says Dr Michael Maier, curator of the collection and head of the London Specialty School of Psychiatry. If a researcher is in need of, say, the basal ganglia of a brain suffering from Huntington’s disease, they can send in a request to the Corsellis for a sliver of that specific section. The collection is kept busy with about a dozen orders a year, some of which can add up to hundreds of individual specimens. It used to send out whole brains but was forced to halt this practice after they found brains were not being returned.
What is somewhat sad is that the samples sent out are now anonymised. There is no record of which brain helped with what research. Even if there was, the medical records affiliated with the brains are remarkably thin. “In the 1950s patients were seen maybe once every six months,” laments Maier. With the Corsellis Collection the brain went from being a wonder to being a simple workman.
Cushing and Corsellis were not alone. From the late 19th century through to the middle of the 20th century, there was a brain-collecting craze among men of science. Whether it was sparked by the dying embers of the phrenology craze, or the wish to purge religion from science, a huge number of brain collections came into being with the belief that much could be learnt about human psychology by studying the brain’s anatomy.
Of paramount interest was the quest to “diagnose genius”. The Cornell Brain Society collected the brains of “educated and orderly” persons to see if they differed from those of the uneducated criminal. The Moscow Brain Research Institute mapped the brains of famous Russian writers, politicians and poets, including that of Lenin, while the members of the Mutual Autopsy Society of Paris, certain of their own genius, donated their brains to one another, to be dissected upon their death.
In one hideous example of this quest, after Albert Einstein’s death, his brain – in direct contravention of his wishes – was sectioned into 200 pieces, which were stolen and hidden as if they were holy relics. But despite such fervour, no one has yet revealed a significant relationship between brain structure and extraordinary function.
. . .
Everything appears to be transparent at the Brain Observatory at the University of California, San Diego. Its glass walls hold glass refrigerators that contain clear buckets containing something pale, luminous and familiar: brains. Yet even these bundles of opacity display a certain transparency, for everything you could want to know about these brains’ past lives has been painstakingly wheedled out of them.
For months, even years, before dying, each brain has undergone a barrage of neuropsychological assessments, personality and IQ tests, not to mention a sprawling oral history (in which questions range from “What’s your favourite joke?” to “Have you ever fought for a political cause?”). Hence each brain kept here, while poor in body, is rich in character. There are two reasons for such inquisitiveness. First, is the attempt to draw ever closer lines between brain structure and human behaviour. While the concept of “genius” may be too difficult to locate within a brain, perhaps something simpler and more directed, like a love of politics or an affinity for knock-knock jokes, can be found.
The second reason is a wish to rehumanise the brain, to give it a biographical body, so to speak. As Dr Jacopo Annese, the eminence behind the Brain Observatory, explains, “People think that brain donation is only interesting if there’s a disease, but I’m interested in why somebody is an entrepreneur, why somebody has a certain culture ... This has to be a social experiment. It’s about people realising that what they are and what they do has a lot to do with their brain.”
This meticulous process of collating a person’s life is matched by the process that goes into preserving the brains after death. Soaked in formalin until they are firm and rubbery, the Brain Observatory’s brains are then placed in a mold filled with liquid gelatin. Once the gelatin sets, the brain is frozen and mounted on a microtome, a special tissue-slicing machine. It is cut into slices 70 microns thick, no thicker than a human hair. Each gauzy sliver of brain is stained and placed on slides and, in the Brain Observatory’s most radical step, scanned into a computer and digitised.
The laboratory’s best-known case so far is that of the famous amnesiac known simply as H.M.. His brain was cut into 2,401 separate slices in a process that took 53 hours and blunted five microtome blades. Annese, who is part computational anatomist, part carnival barker, streamed the whole operation live on the internet, drawing an audience of nearly half a million viewers.
Ultimately Annese’s aim is to create an open-access, three-dimensional atlas of the human brain – a Google brain, if you will – which neuroscientists across the world can inspect from the comfort of their own computers. It seems likely to succeed, for it combines the painstaking and humanistic approach of Cushing with the variety and utility of Corsellis’s collection. “I thought that the brain can have a face,” declares Annese. “I wanted to bring it out of the basement.”
George Pendle’s most recent book is ‘Death: A Life’ (Three Rivers Press). To comment on this article, please email firstname.lastname@example.org
Copyright The Financial Times Limited 2013. You may share using our article tools.
Please don't cut articles from FT.com and redistribute by email or post to the web.