Wilder Penfield, Brain Maps, V.S. Ramachandran and Phantom Orgasms: The Man Who Mistook His Foot For A Penis

Canadian neurosurgeon Wilder Penfield performed pioneering experiments in the 1940s and 1950s. During extensive brain surgeries, he applied electrodes to different regions of the brain and stimulated them. He then asked patients what they felt. He recorded and correlated sensations, images, even memories, as reported by the patients. By this means he mapped the brain and found, for example, that the brain area involved with lips and fingers occupies as much space as the area which handles the entire trunk of the body. Of course, the lips and fingers are highly sensitive, and such a large dedication of neuronal space helps explain why. Interestingly, he found that the areas did not always correspond to places on the body. The genital area is not on the brain next the area for thighs. Instead, it is located next the area for the feet. This is a fact that has far reaching implications for the account which follows.

V.S. Ramachandran, University of California, San Diego, received a call one day. An engineer from Arkansas wanted to talk about something that was puzzling. Here is the narrative:

"Is this Dr. Ramachandran?"

"Yes."

"You know, I read about your work in the newspaper, and it's really exciting. I lost my leg below the knee about two months ago but there's still something I don't understand. I'd like your advice."

"What's that?"

"Well, I feel a little embarrassed to tell you this."

I knew what he was going to say but . . . he didn't know about the Penfield map.

"Doctor, every time I have sexual intercourse, I experience sensations in my phantom foot. How do you explain that? My doctor said it doesn't make sense."

"Look," I said. "One possibility is that the genitals are right next to the foot in the body's brain maps. Don't worry about it."

He laughed nervously. "All that's fine, doctor. But you still don't understand. You see, I actually experience my orgasm in my foot. And therefore it's much bigger than it used to be because it's no longer just confined to my genitals."

Patients don't make up such stories. Ninety-nine percent of the time they're telling the truth, and if it seems incomprehensible, it's usually because we are not smart enough to figure out what's going on in their brains. This gentleman was telling me that he sometimes enjoyed sex more after his amputation. The curious implication is that it's not just the tactile sensation that transferred to his phantom but the erotic sensations of sexual pleasures as well. ( A colleague suggested I title this book "The Man Who Mistook His Foot For A Penis.") (From Phantoms In The Brain: Probing The Mysteries of The Human Mind, by V.S. Ramachandran and Sandra Blakeslee. NY: Quill (Harper Collins): 1998

A Phantom Arm and A Bizarre Experience

My right leg seems trapped in time and space, at a day and place long ago. Along the leg runs a large scar that always tingles in the background of my consciousness, and which tightens into fear whenever I focus attention there. Yes, it is unmistakable fear, in memory of the event itself, and it is localized at the scar. How can fear be in a scar? I don't know. I can only tell you that's where it is. If anything touches the scar, my leg wants to pull away from the touch. This occurs and over-rules my reason. It simply happens. It is all a phantom of the mind.

Such phantoms are not unique to me. People have experienced them for thousands of years, but they received a name only in the Nineteenth Century. The Civil War was a gruesome conflict. My ancestor, Captain David Stewart, 28th Iowa Volunteer Infantry, spent part of the war as a field surgeon. He reached a point when he could no longer look at another gangrened leg, or another soldier quite literally biting the bullet to keep from screaming in pain as a limb was sawn through. Preferring being shot to cutting off another leg, Captain Stewart asked for a transfer to combat. I understand why. I have seen the saw he used for amputation. Its teeth could as easily cut through a tree limb.

After the Civil War, tens of thousands of soldiers had amputated limbs and told doctors of strange experiences. Silas Weir Mitchell, a Philadelphia physician, coined the phrase "phantom limb" shortly after the conflict, and did so to explain the phantoms that the veterans described. Fearing ridicule from colleagues, he published anonymously in a popular magazine, Lippincott's Journal, wherein he described the phenomenon. In the century and a half since, phantom limb syndrome has become part of medical and psychological literature.

Older medical journals contain hundreds of fascinating case studies. Some of the described phenomena have been confirmed repeatedly and still need an explanation. In one case, a patient experienced a vivid phantom arm soon after amputation, which is normal, and in a few weeks he developed a peculiar, gnawing sensation in his phantom, which is not normal. He was quite puzzled by the these new sensations and asked his Army doctor about them, but the physician couldn't help. The veteran finally asked, "Whatever happened to my arm after you removed it?" The doctor told him to ask the surgeon.

The veteran did just that. The surgeon replied, "Oh, we usually send the limbs to the morgue."

The man asked the morgue and asked, "What do you do with amputated arms?" They replied, "We send them either to the incinerator or to pathology. Usually we incinerate them."

"Well, what did you do with my arm?" They looked at their records and said, "You know, it's funny. We didn't incinerate it. We sent it to pathology."

The man asked the pathology lab. "Where is my arm?" They said, "Well, we had too many arms, so we just buried it in the garden, out behind the hospital."

They took him to the garden and showed him where the arm was buried. When he exhumed it, he found it crawling with maggots and exclaimed, "Maybe that's why I'm feeling these bizarre sensations in my arm."

He took the limb and incinerated it. His phantom pain disappeared permanently.

Blindsight: Graham Young Is Blind But Can See

Blindsight: Graham Young Is Blind But Can See

What is consciousness? You may say that it is to be aware. But what does it mean to be consciously aware of something? I can type this paragraph while outside my window a bird chirps, shadows dapple the window ledge, and here, inside, my fingers move on the keyboard, music plays on the radio, and so many other events also happen as I focus only on these words. I stop for a moment, and there they are, all these other things. Then I return my attention to the computer screen. In a sense, I see but I don't see. I am aware but I am not aware. Things are part of conscious and, so to speak, they are not.

Graham Young of Oxford, England is a case in point. When eight years old, he suffered a head injury that damaged the visual cortex of his hind brain, and this experience rendered him unable to see on his right hand side, while he can see on his left. This blindness affects both eyes.

He has a condition called blindsight, a term coined by Professor Larry Weiskrantz of Oxford University, and it has made Young a prime candidate for neuroscience experiments, particularly because his damage is quite specific and localized, making his situation one of the purest examples of a very rare condition.

If you put an object on his right side and ask, "What is it?" he cannot say.

If you move it, and ask "What direction?" he can tell you. Up, down, left, right. He can do this even though he cannot see the object.

If a neuroscientist moves an object to his left side, he will see it. As the experimenter moves it to his right he will announce the point at which the object disappears from his view. So long as the object remains motionless, Young can only say nothing is there. When a tiny light is moved, he can announce its direction, although he cannot see it.

The experimenter might say that Graham Young must be able to see it, to which he replies, "It's very easy for me to say to you, 'Oh, I saw that move up. . . ' And as soon as I say that, you're going to say, 'Ah, he can see!' No I can't."

Colin Blakemore, an Oxford scientist, thinks that blindsight is extraordinary in its implications for consciousness. The implications are staggering in that to some extent our brains do not depend on consciousness, and if that be the case, then precisely what is it that consciousness adds to our actions? Why do we need it for certain things?

Of his condition, Young says, " I'm aware of individual functions of sight. Sometimes I am aware of a motion, but that motion has no shape, no color, no depth, no form, no contrast. Sometimes I can tell you what orientation it's at, but then we lose everything else."

Blakemore says that Young lacks "the ability to put it all together, and to recognize an object, a thing, something with meaning. . . . so very, very different from what we would normally call vision." Blakemore again: "If there's one thing that this phenomenon of blindsight teaches us, it is that vision is not entirely seeing, that there can be a disconnection from the capacity to respond to visual information and the actual act of being visually aware of something. Those two things can be separated and probably are in our everyday lives. But the problem is that, obviously, we're not aware of the things that we're not aware of. We just don't know the extent to which they play a part."

Of University of California, San Diego, V.S. Ramachandran says, "It's almost as if the patient is using ESP. He can see and yet cannot see. So it's a paradox, it's almost like science fiction. How is this possible? Well, if you look at the anatomy, you can begin to explain this curious syndrome. It turns out from the eyeball to the higher centers of the brain where you interpret the visual image, there's not just one pathway. There are two separate pathways, which subserve different aspects of vision. One of these pathways is the evolutionarily new pathway, the more sophisticated pathway, if you like, that goes from the eyeball through the thalamus to the visual cortex of the brain. Now, you need the visual cortex for consciously seeing something. The other pathway, which is older evolutionarily, and is more prominent in animals like rodents, lower mammals, birds and reptiles, goes to the brain stem, the stalk on which the brain sits. And, from the brain stem, gets relayed eventually to the higher centers of the brain. Specifically, the older pathway going through the brain stem is concerned with reflexive behavior orienting to something important in the visual field, making eye movements, directing your gaze, directing your head toward something important. In these patients, one of these pathways alone is damaged--the visual cortex is damaged. Because that's gone, the patient doesn't see anything consciously. But the other pathway is still intact. And he can use that pathway to guess correctly the direction of movement of an object that he cannot see."

Reptiles depend on unconscious blindsight for their survival. Graham Young: "A lizard, if it wants to catch a fly, for example, it doesn't actually have to see a fly. It doesn't have to recognize a fly. It just has to be aware of something moving. So I suppose me and the lizard are distant cousins."

As I indicated in the opening paragraph, I must screen out certain events in order to write this article. Blindsight seems to enable us to focus on the task at hand. It allows all else to fall into the background. As for this background, Graham Young is completely unaware of anything happening in his right field yet he gets the event correct 90% of the time. While typing I may register events without becoming consciously aware of them.

Somehow we have consciousness, but have little idea how. Graham Young has no consciousness of certain things, and we are just beginning to understand how. Brain scans revealed that when this unconscious process was going on in Graham Young, a primitive vision pathway was being used by the brain to communicate the information. This is unlike normal vision, wherein much more of the brain is used.

Hamlet said that he could be bounded in a nutshell and count himself king of infinite space. Inside the nutshell that is our skull, that may well be what we are.(See Nova Online, "Secrets of The Mind," 23 Oct. 2001, and BBC, "All Seeing Yet Un-Seeing," 22 Aug. 2000, later shown on BBC2 "Brain Story")

Bird Brains and Theory of Mind

Humans are exceptional beings, so we like to think. The so-called lower animals lack complex syntax for language. They simply are not as conscious. Many philosophers believe only humans understand that others have their own personal thoughts, which philosophers term as having a theory of mind, without which we would lack our empathy and deception. So goes the point of view. Theory of mind has implications that reach far into our notions about consciousness. For one, experiments suggest that the degree of consciousness has no clear correlation to matter, brain size in this case.

Biologists are wary of exclusionary assertions for human beings. We are not, apparently, the only species with a theory of mind. Biologists have found it in various mammals, ranging from gorillas to goats. Two recent studies suggest that theory of mind can extend beyond mammals to birds. Consider a recent article in the Proceedings of The Royal Society, in which Bernd Heinrich and Thomas Bugnyar, University of Vermont, Burlington, describe experiments conducted on ravens. As birds, ravens are known to be clever and sociable, and for this reason, the scientists set out to find how the ravens would respond to human gaze.

Gaze response helps measure the development of theory of mind in human children. At about 18 months most children can notice another's gaze, follow it, and infer things about the gazer from it. Autism is revealed when a child fails to develop this skill, as the autistic child also fails to understand that other people have minds.

To test whether ravens could follow gaze, Dr Heinrich and Dr Bugnyar used six six-month-old hand-reared ravens, and one four-year-old. With the room divided by a barrier, the birds were placed, one at a time, on a perch. An experimenter sat about a metre in front of the barrier. He moved his head and eyes in a particular direction and gazed for 30 seconds before looking away. Sometimes he gazed up, sometimes to the part of the room where the bird sat, and sometimes to the part of the room hidden behind the barrier. The experiment was videotaped.

Dr Heinrich and Dr Bugnyar found that all the birds were able to follow the gaze of the experimenters, even beyond the barrier. In the latter case, the curious birds either jumped down from the perch and walked around the barrier to have a look or leapt on top of it and peered over. There was never anything there, but they were determined to see for themselves.

A suggestive result, but not, perhaps, a conclusive one. But while at the University of Austria, Dr Bugnyar conducted another study. Its results were published last month in ,, and it suggests that ravens may have mastered the art of deception too.

Wanting to determine what ravens learned from one another while foraging, in his experiment Dr Bugnyar noticed strange behavior between two male birds, Hugin and Munin, the first subordinate, the second dominant.

They had to figure out which color-coded film containers held cheese, then pry off the lids and eat the morsels. The subordinate male excelled at this while the dominant was rather slow in working things out. However, Hugin could only swallow a few bits of cheese before the dominant raven, Munin, bullied him aside. Although it comes as no surprise, this indicated that ravens are able to learn about food sources from one another. They are also able to bully each other to gain access to that food.

Something surprising did happen. Hugin, the subordinate, tried a new strategy. As soon as Munin bullied him, he headed over to a set of empty containers, pried the lids off them and pretended to eat. Munin followed, whereupon Hugin returned to the loaded containers and ate his fill.

At first Dr Bugnyar could not believe what he was seeing. Hugin, he is convinced, was clearly misleading Munin.

Munin grew wise to the tactic, and would not be led astray. He learned from Hugin and tried to locate food on his own. Hugin became furious. "He got very angry," says Dr Bugnyar, "and started throwing things around."

A Hairbreadth Difference and Heaven and Earth Are Set Apart: Theist, Skeptic

Why is there something rather than nothing? Lucretius

The skeptic: The universe is eternal. It simply is. There is no need for a creator. Moreover, If the universe has a creator, then it is impersonal, merely a force.

The theist: The universe couldn't have happened by itself. All results from an uncaused Cause, which is eternal, omnipotent, omniscient, purposeful, and personal. Astronomer magazine's Robert Naeye: "On Earth, a long sequence of improbable events transpired in just the right way to bring forth our existence, as if we had won a million-dollar lottery a million times in a row. Contrary to the prevailing belief, maybe we are special."

Stephen Hawking: There may or may not be a creator, but the Big Bang didn't necessarily depend on it. Hawking to a science writer who asked him about any connection between Hindu myth and Black Hole evidence: "It's fashionable rubbish. People go overboard on Eastern mysticism because it's something that they haven't met before. But as a natural description of reality it fails abysmally to produce results."

My comment: In our daily lives we can believe or disbelieve, but we can take away from quiet moments a different understanding of the matter. In that understanding, the questions no longer seem important. The understanding does not imply atheism or theism as the final truth, the ultimate meaning. Rather, it allows us to see things in a new light * by a method that is empirical and verifiable--not some abstract, debatable notion. Part of our discovery is that thoughts beget thoughts, that they are "mechanical" things requiring no thinker to think them. ( Empirical philosopher David Hume said as much in the Eighteenth Century.) In turn, self is created by mind, neurons if you want, and no ego, no little man or woman, presides over the course of our daily affairs. This understanding derives from a state that precedes all our usual questions and doubts. Unlike some scientists' claim, the state is not wrapped in mist, but is one of high, generalized, awareness. When asked what happened to him, Buddha said that he awakened. Buddha made no claims whether all was finite or infinite, godless, or godly. From the vantage of this state, the questions disappear and are seen as more creatures of the mind.

That is the meaning of the leader for this article's title, an old Zen saying by Seng-Ts'an--"The Perfect Way is only difficult for those who pick and choose. Do not like, do not dislike; all will then be clear. A hairbreadth difference, and Heaven and Earth are set apart." Theist and skeptic impose the difference that sunders Heaven and Earth.

* (In Zen, form is emptiness, emptiness form. Each enables the other and is the other.)

Daniel Dennett, along with various other researchers and thinkers, has arrived at this view of no-self without any "mystical" experience. Theirs, however, seems to remain a largely intellectual understanding. Articles on them can be found variously in this blog. As an example of scientific explanations that don't rely on Eastern thought, see Space Capsules & Eastern I-Told-You-So, 29 January 2004. Another example can be found at Shakey, Beavers, & Cartesian Theater, 12 February 2004.)