Brains, Bodies, Beliefs and Behavior
William J. Carl III
Eight years ago a physician appeared in my office in Dallas, Texas and said, “Bill, I am in charge of the program next year for the International Society for the Advancement of Humanistic Studies in Medicine (now known as SHIM, the Society for Humanism in Medicine). It’s an organization of physicians from all over the world who gather each year at a ski resort to discuss a topic relevant to our work, and next year the subject is ‘the brain.’ Next winter the meeting will be at Aspen. We have invited some of the world’s top cognitive neuroscientists to speak, including Michael Gazzaniga from Dartmouth, and we would like for you to give a lecture on the brain as well.” I said, “Henry, I know absolutely nothing about the brain,” went home and told my wife who replied, “That’s never stopped you before!”
After pondering both the challenge and the opportunity, I stopped and read about 50 books on cognitive neuroscience in order to make sure I understood the clinical side of things. It was fun re–visiting some material I had studied in a course on Child Linguistics while completing my Ph.D. at the University of Pittsburgh in the mid–1970s. I also spent time learning all I could from physicians and professors at the University of Texas Southwestern Medical School. Then I began developing a PowerPoint presentation that offered a philosophical and ethical perspective on the brain. In this presentation, I contrasted a more Hellenistic, Cartesian dualism, which separates mind and body with a more Hebraic, holistic world–view. The Hellenistic approach tends to represent the way medical education has been taught for centuries. It’s an approach that has doctors looking at patients as very uninteresting appendages to very interesting diseases. Suddenly, as a patient, you find yourself being referred to as ‘the appendix in Room 202’ instead of someone with a name, a family and a life. The Hebraic approach tends not to separate mind and body and finds physicians viewing patients as whole persons. My lecture on the brain, entitled “Brains, Bodies, Beliefs and Behavior,” demonstrates how the brain drives every part of who we are as human beings then outlines the difference between the Hellenistic and Hebraic views of patients showing how the latter approach actually helps with the healing process.
Because this lecture attracted so much interest in Aspen at what was primarily a more clinical conference, invitations began coming in from all over the country. As a result my homework only increased trying to keep up with the exciting new discoveries in the burgeoning field of cognitive neuroscience. So I continued to read and learn taking all the seminars I could find, especially at what is now a cutting edge research think tank, The Center For Brain Health in Dallas.
Since 2000, I have given the lecture at the University of Texas Southwestern Medical School, a healthcare retreat in Austin, Texas, as the Dean’s Special Lecture to the entire Freshman Class at the University of Arkansas for Medical Sciences, as the 50 th Annual A. Murat Willis Lecturer for CJW (HCA) Hospitals in Richmond, VA, at a conference in Orlando, at Cornell University, in Ann Arbor, Michigan, at a science and theology meeting in Birmingham, Alabama, in China at the Beijing Theological Seminary and the China Academy of Social Sciences. I’ve also shared it at numerous churches and religious conferences where lay people line up to learn what’s going on inside their heads. Why are physicians so interested in hearing a pastor–theologian talk about the intersection between mind and body from a philosophical and ethical perspective? I think it’s because the best physicians understand that they are only co–participants in this delicate balance between life and death, which we call the healing process, a dynamic dance that is both fragile and resilient. My overall premise is that our brains influence our bodies, beliefs and behavior and that our bodies, beliefs, and behavior impact our brains, less through a Hellenistic, Cartesian dualism and more through a Hebraic world–view that does not separate the mind–body equation. These two competing perspectives influence how healthcare providers view and treat patients.
I begin by reminding both physicians and lay people that there’s a lot we know about the brain, and a lot we don’t know. After all, research in neuro- science is exploding exponentially. Like outer space, this new ‘inner space’ has become the uncharted territory of the twenty–first century. As Baby Boomers age our interest in brain health rivals our sometimes halting attempts to exercise our bodies. Mental health is clearly as important to us as physical health, and both influence each other. You have to want to exercise before you actually do it and that thought starts in the brain. On the other hand, we know that regular physical exercise helps the brain function better. Though I used to get bored running around the block, I wasn’t as bad as another scholar I know who, when he gets the urge to exercise, lies down and waits for the urge to pass! But, now after having studied the brain closely for nearly a decade, I know the impact of physical well–being on my ability to memorize speeches, learn new languages, play the piano effectively and keep my mind working. I also know that using my body and my brain aggressively and actively might actually delay the onset of dementia and Alzheimer’s. As a Greek professor, I used that fact as a way to get lay people in my Dallas church to take the Greek classes I offered there. “Keep those neurons bouncing—Greek is good for you!”
There is a lot we know about the brain. We know it’s the shape of a walnut, roughly size of a coconut, the consistency of chilled butter and the color of uncooked liver. On the surface, it’s fat, boring, ugly and fragile, but at the same time it is also enduring, creative, beautiful, ever–active and ever–changing. It’s like a computer but more because a computer can’t re–wire itself. We know that billions of neurons are bouncing in your brain at this very moment, and you reply, “Only millions before my first cup of coffee!” We know about the different lobes (frontal, parietal, occipital and temporal) and sections. We know about the dendrites (from the Greek word dendron , which means “tree” because that’s what they look like) and synaptic connections (another brain word with Greek roots—which Sir Charles Scott Sherrington and his colleagues coined from syn meaning ‘with’ or ‘together’ and apto meaning “hold, cling to, or clasp,” not to be confused with the word “apse” in ecclesiastical architecture, which comes from the Latin absis meaning “arch” or “vault” and just wouldn’t fit into the tight spaces inside our heads). We know that synapses allow nerve cells to communicate with one another through axons and dendrites, converting electrical impulses into chemical signals. We know about neurotransmitters and neuro- transmitter receptors.
So, there is a lot we know about the brain. But we have to admit that there’s a lot we don’t know as well, which is a good thing. It keeps us humble and keeps us digging, probing and learning more. As Stephen Pinker noted in the preface to one of his ground–breaking books on the brain, “Any book called How the Mind Works had better begin on a note of humility, and I will begin with two. First, we don’t understand how the mind works—not nearly as well as we understand how the body works, and certainly not well enough to design utopia or to cure unhappiness . . . Second, I have not discovered what we do know about how the mind works. I have selected from many disciplines . . . .” I agree. If Pinker, who is the Johnstone Family Professor in the Department of Psychology at Harvard University and prior to that, was Professor of Psychology and Director for the Center for Cognitive Neuroscience at MIT, is humble when facing this topic, you can imagine how modest I feel when talking about the brain. Like Pinker, I draw from several different disciplines including medicine, psychology, philosophy and theology as well as the Hebrew and Greek languages to create the lecture “Brains, Bodies, Beliefs and Behavior.” In this lecture I talk in broad sweeps about how the brain works, how it influences our bodies, beliefs and behavior and vice versa, and how we tend to dissect and separate these things into limp parts instead of seeing them as a living, vibrant holistic persons needing our care whom healthcare providers call ‘patients.’
We know that our brains are the result of Genetics and Culture. You can pay your money and take your choice on which side of the Nature/Nurture scale to tip more heavily. Both are influential. Those of us who claim to be religious also contend that the brain is God–given. We know that the brain is more than neurons and neurotransmitters. It is somehow related to what we call the mind. But the mind is not the brain; it’s what the brain does. Pinker was right in saying that “the 1990s were named the Decade of the Brain, but there will never be a Decade of the Pancreas . . .” because the “brain’s special status comes from a special thing the brain does, which makes us see, think, feel, choose, and act.” 2 That special thing is information processing, or computation. But the information processing is for specific purposes.
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