Blood and Guts (35 page)

After drilling a series of holes in the man's head, Ervin and
Mark inserted electrodes into carefully selected sites in his brain.
The electrodes were connected to a plug in the patient's scalp,
which led to a 'pain box' – a controller that the man carried in his
pocket. When the pain got too much, all he had to do was push a
button and the agony would go away. If he kept the switch pressed
for more than forty-five minutes, the pain subsided for up to eight
hours, allowing him to get a good night's sleep for the first time in
months. The only side effect was that the device made him feel a
little drunk. But then, the patient figured, if you're dying of cancer,
that's not such a bad thing.

Few would argue against helping a dying patient, but the development
of devices that could change people's behaviour at the flick
of a switch had far more sinister implications. Delgado was well aware
of the potential of his technology, but downplayed any suggestions
that it might be used by sinister forces to control people's minds. In
his 1969 book
Physical Control of the Mind
he dismissed the idea of an
evil dictator standing at a master control centre stimulating the
minds of an enslaved people. But then he didn't reckon on the CIA.

In the mid-1950s the US intelligence agency had started toying
around with the idea of brainwashing individuals, invariably
communists. They had looked at using hypnotism or drugs, and
investigated the notion of using lobotomy to control antisocial
behaviour. A psychiatrist, Henry Laughlin, had even been
dispatched to witness some of Walter Freeman's operations. In his
report, Laughlin suggested that lobotomy might be used as a
'neutralizing weapon' to 'quench crusading spirits' or 'zealous and
fanatic communists'. If lobotomy could do that, just think what
brain implants could do.

Following the Detroit riots in 1967 and subsequent civil unrest
in deprived inner-city areas across the United States, Ervin and Mark
suggested that brain implants might be used to subdue black rioters.
In an article in the prestigious
Journal of the American Medical
Association
they proposed that urban riots and other 'acts of senseless
violence' could be prevented by surgery.

In 1972 psychiatrist Robert Heath came up with another idea.
Why not use brain implants to 'cure' homosexuality? With a long list
of ethically dubious research behind him, Heath conducted an
experiment on a gay man. The psychiatrist placed electrodes inside
the subject's brain and stimulated them while the man had sex with
a female prostitute. The aim of the experiment was to condition the
subject to want to have sex with women rather than men.

The backlash against using brain stimulation was swift. Delgado
was lumped in with Ervin, Mark and Heath, even though their
experiments were nothing to do with him. The rise of the implant
in science fiction did nothing to help his cause. More and more
conspiracy theorists claimed that the government had secretly
implanted chips in their brains, and books such as
The Terminal Man
(see Further Reading) painted a terrifying portrait of a medical
experiment gone wrong. That its author, Michael Crichton, was
once one of Ervin's students probably did little to help.
^*

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The reality was that if the government really wanted to control the population through mind
control, they would stick drugs in the drinking water, rather than go through the impractical
and messy business of implanting chips.

It looked as though it was the end of the line for the brain
implant. The research was discredited, ethical approval for brain
stimulation experiments became impossible to obtain, and funding
for studies simply fizzled out. However, unlike Freeman's transorbital
lobotomies, brain implants still held enormous potential.

London, 2006

Sixty-eight-year-old Stuart Carter felt trapped within his own mind.
He could think about moving but his body would not move. He
could not smile or laugh or frown or cry. He had lost his sense of
balance and could barely stand. When he placed his hand down on
a table he could no longer lift it up. His face was an expressionless
blank. He was a living statue watching life through a mask.

Carter had Parkinson's disease. This degenerative illness affects
nerve cells in the brain that coordinate movement. Whereas many
people with Parkinson's have uncontrollable tremors, Carter's body
froze. He found that his facial muscles would no longer react to
emotion and that his body would lock in a particular position.
Sometimes it took him an enormous mental effort to get moving
again. He knew that without treatment his condition would only get
worse, but the drugs he was taking were no longer working. His
mind remained sharp, but his body was gradually shutting down.

In 2006 Carter was offered the chance of having electrodes
implanted in his brain. In his case, the technology, known as deep
brain stimulation, would act as a jamming device. The implants
would block the nerve signals in the sick areas of his brain that were
causing him so many problems. The operation was not going to be
easy – surgeons needed to implant the devices at the base of the
brain, in an area called the basal ganglia. As it would be impossible
to cut open Carter's brain, the surgeons at the National Hospital for
Neurology and Neurosurgery would be operating 'blind'.

With a brace resembling a medieval torture device clamped to
his head, Carter lies on the table in the bright glare of the operating
theatre lamps. His head is marked with dots, and a large plastic
sheet is stretched across his balding scalp. He stares at the ceiling as
the final preparations are being made by the androgynous gowned
and masked figures around him. In the twenty-first century lying on
an operating table is still a nerve-racking experience, made worse if
you know you are going to be conscious when a man you barely
know starts drilling holes into your head. An injection of local anaesthetic
and surgeon Marwan Hariz is ready to start.

Hariz presses a scalpel into the top of Carter's head, slicing
deep to the bone. 'No pain, just noise,' explains the surgeon as he
holds an oversized dentist's drill to the incision. A thin trickle of
blood and tissue is sucked away with a tube as the drill penetrates
deeper. A syringe-like device is clamped over the aperture and a
wire implant is lowered into Carter's brain. Hariz guides the implant
deep through the folds and ridges of his patient's brain, careful
to avoid damage.

'You might feel something and you might feel nothing.' This is
the moment of truth. 'Whatever you feel, tell us.' The surgeon
presses the button to activate the implants. 'No special sensation?'
Carter starts to feel a tingling in his left foot. It's working – Hariz
has got the implants in the right place. Carter's brain has been
electronically enhanced.

Two years later Stuart Carter can walk, laugh and smile. When
he puts his hand down on a table he can pick it up again. He is free
from the mental trap that Parkinson's imposed. If you look carefully
at the top of his head, you can see two small bumps. You can even
follow the path of the wire leading away under his skin and down his
neck. It terminates in a flat box beneath his shoulder – the stimulator
that sends electrical pulses to his brain.

Today there are tens of thousands of people walking around
with brain implants. Some, like Carter, have electrodes deep within
the brain to stimulate or block nerve signals. Many others have
cochlea implants in their ears to cure deafness. Scientists are developing
implants to enhance memory, to help the blind to see, or
simply to connect our 'wetware' to computer software. Delgado's
vision of using electronic devices in the brain to combat disease and
disability is finally being realized.

Advances in brain surgery over the past 150 years have come at
tremendous human cost. From patients bleeding to death on the
operating table to victims of Freeman's crude lobotomies and brain
implants to 'cure' homosexuality, the history of brain surgery is full
of examples where surgeons have strayed well beyond the bounds of
what is morally or ethically acceptable. It is still difficult to read
Freeman's notes on Howard Dully without becoming angry, or
contemplate Ervin's and Mark's ideas on mind control without feeling
utter revulsion.

If you look back through the history of surgery, there are some
remarkable individuals: pioneering surgeons, such as Ambroise
Paré, Ignaz Semmelweis and Joseph Lister, who helped make operating
safe; surgeons such as Dwight Harken, Walter Lillehei and
Harold Gillies – brave men who had the courage to fail; but there
is also a third group – surgeons such as Walter Freeman
and Alexis Carrel – who seemed to operate in their own peculiar
moral universe.

Whether these people were brilliant, courageous or misguided,
the history of surgery is full of individuals who were prepared to
have a go to see what happens. Sometimes they succeeded, sometimes
they failed. Some patients lived, many others died. But even in
death, they will have helped future patients to live.

Without the surgeons who stole corpses from gibbets, who cut
into beating human hearts, or who first attempted to operate on the
human brain, modern surgery – from routine procedures to repair
a damaged knee to hi-tech operations to implant a device in the
brain – would not have been possible.

Nevertheless, despite all the advances, there are still many
things that challenge twenty-first-century surgery: artificial hearts
are cumbersome, organs still get rejected, reconstructive surgery
cannot always restore a face, a brain tumour can still kill. Even the
most minor surgery is not without risk: hospital patients still die of
major infections; anaesthetics are not 100 per cent reliable; the
knife can still slip.

Most of us know people who have gone into hospital for an
operation and never come out. Surgeons are remarkable people
but, despite the impression some of them might give, they are not
gods. There are good surgeons and bad surgeons, but even the best
surgeons are fallible. When we submit to an operation we put an
immense amount of trust in those who wield the knife. In most cases
our trust is fully justified, but the history of surgery suggests that
sometimes it is not.

If you need an operation, just be grateful that you are alive
today and not 170 years ago – the next patient on Robert Liston's
operating schedule.