ARCHIVE - November, 2001

Brain Disorders and Social Life
Greg Carey, Department of Psychology

My sister-in-law, Liz, had a brain disorder.  She was born with it: a small microscopic deviation in a few brain cells that made no difference during her infancy, childhood, adolescence, and emergence into adulthood.  During that time, however, these abnormal cells grew and developed into a structure that medics call by the jawbreaking name of craniopharangioma.

As this tumor developed, it pressed on the cells in a region of Liz's brain called the hypothalamus, a tiny but very important area that influences many of the body's functions.  Because the nerves from the eye to the brain pass through this region, Liz became functionally blind.  She could see what you could see if you removed one eye and then covered half of the remaining eye.  She became lethargic, would fall asleep at the drop of a hat, and spent most of her day in bed.  She lost her job.  Her appetite increased and she changed from a lithe young beauty into an obese beauty.  She became asexual.

But still in the midst of this, when Liz was alert and attentive, she was the same old Liz, humorous, nurturing, and gregarious.  Her brain disorder changed her body, but her reasoning and personality were intact.  Still, the brain disorder won out and she died.

Many other people suffer from brain disorders quite different from the one that plagued Liz.  These disorders do not involve a visible tumor.  Instead, they influence the chemistry in certain sections of the brain.  Unlike Liz, people with these disorders can see perfectly fine, talk perfectly fine, and walk just like normal folks.  The abnormal chemistry, however, changes those aspects of behavior that Liz's brain disorder left unaffected: personality and reasoning.  People with these types of brain disorders can be irascible, moody, illogical, paranoid, odd, weird, and, yes, even violent.  Medics call these people schizophrenics, bipolar manic-depressives, psychotic depressives, and a litany of other names.  Unlike Liz, few of the people with this type of brain disorder die because of it.

When I think of Liz, my emotions are a complex mixture of pity, empathy, sorrow, frustration and anger: a singular feeling that the English language lacks a word to describe.  Most of you, I suspect, experience the same emotion for Liz.  When I think of people with the other type of brain disorder, I have the same amorphous feeling.  Do you?

We scientists call these other brain disorders "functional brain disorders," a fancy, pedantic term used to denote the fact that we know that something is the matter with the brain but haven't a clue as to what the actual problem is.  People with functional brain disorders suffer from a difficulty in a physical organ of the body, the brain, just as someone with diabetes suffers from a problem with another organ of the body, the pancreas.  But society has a significant double standard depending upon which type of organ is affected.  We react with fatalistic remorse when social services removes the children of an uncontrolled diabetic because he/she cannot care for them, but condone the imprisonment (and termination of parental rights) of a psychotic depressive.  Failure to perform on the job is excusable if an accident breaks your leg, but you deserve to be fired if a virus infects your brain.  Missing a critical meeting is understandable if you must undergo kidney dialysis but inexcusable if you suffer the sedative side effects of psychotropic medication.  A detectable brain tumor mitigates your sentence to life imprisonment for murdering your children; a metabolic error in the brain condemns you to death.

Today, we scientists have no beacon to guide policy away from the shoals of ruin and toward safe passage on functional brain disorders.  We simply do not know enough about these phenomena to provide clear-cut guidelines.  Regardless of anyone's political leanings, our decisions will definitely make mistakes both by condemning the innocent (e.g., the Salem witch trials) and by pardoning the unrepentant (e.g., Willie Horton).  The only purpose of this essay is to increase sensitivity of the faculty and other campus personnel about functional brain disorders.  These are a medical reality about which we scientists know very little.  With no clear guidelines, I hope that we, CU faculty, staff, students, and administrators can minimize the mistakes that we will unavoidably make in implementing concrete policy decisions.

IN THIS ISSUE:

The opinions expressed in these articles are those of the authors, and do not represent those of the Boulder Faculty Assembly, CU faculty at large, or the University of Colorado.

Responses to these articles are welcome. We are developing our capacity to collect responses on-line. In the meantime, please send your comments via e-mail to Thomas.Mayer@Colorado.edu.

Click here for the names and contact information of the membership of the BFA Communications Committee.