Can fMRI solve the mind-body problem? Tim Crane, “How We Can Be”, TLS, 24/05/17

In the current TLS, an excellent article by Tim Crane on neuroimaging, consciousness, and the mind-body problem. Many of my previous posts here related to this have endorsed a kind of mild neuro-scepticism, Crane begins his article by describing an experiment which should the literally expansive nature of neuroscience:

In 2006, Science published a remarkable piece of research by neuroscientists from Addenbrooke’s Hospital in Cambridge. By scanning the brain of a patient in a vegetative state, Adrian Owen and his colleagues found evidence of conscious awareness. Unlike a coma, the vegetative state is usually defined as one in which patients are awake – they can open their eyes and exhibit sleep-wake cycles – but lack any consciousness or awareness. To discover consciousness in the vegetative state would challenge, therefore, the basic understanding of the phenomenon.

The Addenbrooke’s patient was a twenty-three-year-old woman who had suffered traumatic brain injury in a traffic accident. Owen and his team set her various mental imagery tasks while she was in an MRI scanner. They asked her to imagine playing a game of tennis, and to imagine moving through her house, starting from the front door. When she was given the first task, significant neural activity was observed in one of the motor areas of the brain. When she was given the second, there was significant activity in the parahippocampal gyrus (a brain area responsible for scene recognition), the posterior parietal cortex (which represents planned movements and spatial reasoning) and the lateral premotor cortex (another area responsible for bodily motion). Amazingly, these patterns of neural responses were indistinguishable from those observed in healthy volunteers asked to perform exactly the same tasks in the scanner. Owen considered this to be strong evidence that the patient was, in some way, conscious. More specifically, he concluded that the patient’s “decision to cooperate with the authors by imagining particular tasks when asked to do so represents a clear act of intention, which confirmed beyond any doubt that she was consciously aware of herself and her surroundings”.

Owen’s discovery has an emotional force that one rarely finds in scientific research. The patients in the vegetative state resemble those with locked-in syndrome, a result of total (or near-total) paralysis. But locked-in patients can sometimes demonstrate their consciousness by moving (say) their eyelids to communicate (as described in Jean-Dominique Bauby’s harrowing and lyrical memoir, The Diving Bell and the Butterfly, 1997). But the vegetative state was considered, by contrast, to be a condition of complete unconsciousness. So to discover that someone in such a terrible condition might actually be consciously aware of what is going on around them, thinking and imagining things, is staggering. I have been at academic conferences where these results were described and the audience was visibly moved. One can only imagine the effect of the discovery on the families and loved ones of the patient.

Crane’s article is very far from a piece of messianic neurohype, but he also acknowledges the sheer power of this technology to expand our awareness of what it means to be conscious and human, and the clinical benefit that is not something to be sniffed at. But, it doesn’t solve the mind-body problem – it actually accentuates it:

Does the knowledge given by fMRI help us to answer Julie Powell’s question [essentially a restatement of the mind-body problem by a food writer]? The answer is clearly no. There is a piece of your brain that lights up when you talk and a piece that lights up when you walk: that is something we already knew, in broad outline. Of course it is of great theoretical significance for cognitive neuroscience to find out which bits do what; and as Owen’s work illustrates, it is also of massive clinical importance. But it doesn’t tell us anything about “how we can be”. The fact that different parts of your brain are responsible for different mental functions is something that scientists have known for decades, using evidence from lesions and other forms of brain damage, and in any case the very idea should not be surprising. FMRI technology does not solve the mind–body problem; if anything, it only brings it more clearly into relief.

Read the whole thing, as they say. It is a highly stimulating read, and also one which, while it points out the limits of neuroimaging as a way of solving the difficult problems of philosophy, gives the technology and the discipline behind it its due.

2007: “Lifespan extension and the growing number of elderly people, once considered as catastrophic, are now viewed as an indisputable progress.”

Continuing my rather self-indulgent nostalgia trip, here is a blog post from 2007 (a decade ago!) on an then-upcoming conference. Note that I was unable to embed links!:


A rather melodramatic way of putting it – but that’s what the organisers of 19th World Congress of Gerontology and Geriatrics – They have two years, almost, to further encourage the “growing consensus” (and presumably take care of anyone who would dispute the progress that is lifespan extension)

Review of “Makers of Modern Medicine”, William Dormandy. Endeavour, June 2005

Original here

I wrote a few reviews for this journal of history of science – I think I lost confidence after having to confess a mistake in a review I wrote in the errata. I consulted Dormandy’s book more recently about something and founds it eccentricities a little off putting rather than charming.

Full-size image (13 K)

In recent years, historians in general and historians of science in particular have tended to shy away from approaching their subjects as ‘Great Men’ of history and providing a narrative account of their achievements. The story of science is no longer told as a series of eureka moments, with lone geniuses toiling away in the isolated pursuit of truth. Sociology, feminism and critiques of capitalism and imperialism – all have informed the new approach to scientific history.

Yet there seems to be an inexhaustible public demand for those Great Man (and, occasionally, Great Woman) stories. Books with titles like ‘The Man Who Changed Everything: The Life of James Clerk Maxwell’ and ‘The Man Who Invented the Twentieth Century: Nikola Tesla’ populate the shelves. The hunger that generates the demand for such books might reflect some deep-seated psychological need to believe in brilliant magi transforming the world. Perhaps it reflects a deeper truth: individual human beings do make breakthroughs and change practices, and although the more febrile romanticism of the Great Man school is evidently ridiculous, portraying science as the product of the interplay of impersonal social forces is equally misleading.

The subtitle of William Dormandy’s Moments of Truth: Four Creators of Modern Medicinesuggests that it is firmly of the Great-Man school. However, this is not the case. Dormandy firmly puts the lives of his subjects in their social and historical context, and explicitly states that it is necessary to do so in order to truly understand their achievements. His pithy, jaundiced tone is not one of blind obeisance to the ideas of progress and scientific omniscience, or to Great Men – self-proclaimed or elevated by others – in any sphere. However, Dormandy remains free from any ideological hang-ups and respects the individuality and humanity of his subjects.

The 19th century marked the birth of recognisably modern medicine. Dormandy has written about four medics whose lives spanned that century and, as they comprise a physician, an obstetrician, a surgeon and a pathologist, represent four major branches of medicine. He accepts a certain arbitrariness to his selection, but by covering the century and the fields that are the specialties of his subjects he hopes to achieve some kind of representative sample.

René Laennac was born in Brittany eight years before the fall of the Bastille in 1789 and would die of tuberculosis in 1825, four years after Napoleon. As well as engaging in epic battles with the blood-letters of the day, Laennac belonged to a new school of medical thinking that emphasized physical examination and the careful tabulation of results. He invented what would become the modern Caduceus: the stethoscope, thus earning his place in Dormandy’s quartet.

Ignác Semmelweis’ story is perhaps the best known of the four ‘creators’ among contemporary medical students. The Vienna hospital this Hungarian obstetrician worked in was divided into a section for wealthier women staffed by doctors, and a section for poor women staffed by midwives. There was a much higher rate of fatal puerperal fever among the wealthier women, and Semmelweis eventually proved that this was due to infection from necrotic material brought in to the ward by doctors from dissections they had conducted in the mortuary. This idea met with much resistance, owing to the medical politics of the era as well as Semmelweis’ abrasive nature.

Joseph Lister developed the principles of antisepsis; the careful avoidance of any possible source of infection during surgery that explains the ritual ‘scrubbing in’ of surgeons today. Walter Reed completes the quartet, and was a pathologist with the US Army Medical Corps. He established that yellow fever was spread by mosquitoes while he was working in Cuba, and this discovery helped to establish principles of modern infection control and prevention.

All four of these men were serious minded, and felt that they were in the vanguard of a new kind of medicine blowing away the superstition and stuffiness of the past. Dying young seems to be as beneficial for a posthumous reputation in medicine as in rock’n’roll or the movies. Of the four, only Lister had a long life, and Dormandy describes his evolution into ‘a slightly petulant enemy of many “new fangled” notions’.

As that little sample indicates, Moments of Truth is a pleasure to read. The writing is fresh and stimulating, judicious but unafraid of bracing judgement. The footnotes are as entertaining, if not more so, than the text itself. Indeed, I found myself with one hand wedged firmly in the back of the book to make sure I didn’t miss a trick. Another attractive feature of the book is a certain warmth and sympathy that is infused into the writing. Some medical histories read like the abstract manipulation of official memoranda and minutes, with the intention of proving some ideological or theoretical point or other – Dormandy’s stories are of living, breathing patients and doctors.