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TEDx Talks
Published: 2013-10-16
Source: https://www.youtube.com/watch?v=esPRsT-lmw8
nest talk I'm going to give you the single most important lesson my colleagues and I have learned from looking at eighty three thousand brains but first let me put the lesson into contact I am in the middle of seven children growing up my father called me a maverick which to him was not a good thing in nineteen seventy two the army called my number and I
was trained as an infantry matic where my love of Madison was born but since I truly hated the idea of being shot at were sleeping in the mile I got myself retrained is an X. ray technician and developed a passion for medical imaging as our professors used to say how do you know unless you look in nineteen seventy nine when I was a second year medical
student someone in my family became seriously suicidal and I took her to see a wonderful psychiatrist over time I realized that if he helped her which he dead it would not only save her life but it would also help her children and even her future grand children as they would be shaped by someone who is happier and more stable I fell in love with psychiatry because
I realized had the potential change generations people in nineteen ninety one I went to my first lecture on brain spect imaging spect is a nuclear medicine study that looks to blood flow and activity it looks at how your brain works specter was presented as a tool to help sokaya trys get more information to help their patients in that one lecture my two professional lives medical imaging
and psychiatry came together and quite honestly revolutionized my life over the next twenty two years my colleagues and I would build the world's largest database of brain scans related to behavior on patients from ninety three country spec basically tells us three things about the brain good activity too little or too much here is a set of healthy spec scans the image on the left shows the
outside surface of the brain and a healthy scan shows full even symmetrical activity that color is not important it's the shape that matters in the image on the right red equals the areas of high activity and then a healthy brain they're typically in the back part of the brain here is a healthy scan compared to someone who had two strokes you can see the holes of
activity here's what Alzheimer's looks like where the back half of the brain is did Kyrie rating did you know that al's timers disease actually starts in the brain thirty to fifty years for you have any symptoms here's a scat of traumatic brain injury your brain is soft and your skull is really hard or drug abuse the real reason not to use drugs take damage your brain
obsessive compulsive disorder where the front part of the brain typically works too hard so that people cannot turn off their thoughts and epilepsy where we frequently see areas of increased activity in nineteen ninety two I went to an all day conference on brain spect imaging it was amazing and mirrored our own early experience Usain spat in psychiatry but at that same meeting researchers started to complain
loudly that clinical psychiatrists like me should not be doing stands that they were only for their research being a maverick and having clinical experience I thought that was a really dumb idea without damaging psychiatrist then and even now make diagnoses like they did in eighteen forty when Abraham Lincoln was depressed by talking to people and looking for symptom clusters Imogene way shelling us there was a
better way did you know that psychiatrists are the only medical specialists that virtually never look at the organ they treat think about it cardiologists look neurologists look orthopedic doctors look virtually every other medical specialties look Kyle Tristan for imaging I always felt like I was throwing darts in the dark at my patients and had heard some of them which horrified me there is a reason that
most psychiatric medications how black box warnings give them to the wrong person and you can precipitate a disaster early on our imaging work taught us many important lessons such as illnesses like eighty HD anxiety depression and addictions are not single or simple disorders in the brain they all have multiple types for example here are two patients who have been diagnosed with major depression that had virtually
the same symptoms yet radically different brains one had really low activity in the brain the other one had really high activity how would you ever know what to do for them unless you actually looked treatment needs to be tailored to individual brains not clusters of symptoms our imaging work also taught us that mild traumatic brain injury was a major cause of psychiatric illness that ruin people's
lives and virtually no one knew about it because they would see psychiatrists for things like temper problems anxiety depression and insomnia and they would never look so they would never now here's a scan of the fifteen year old boy who fell down a flight of stairs at the age of three and even though he was unconscious for only a few minutes there was nothing mile about
the end during a fact that injury had on this boy's life when I met him at the age of fifteen he had just been kicked out of his third residential treatment program for violence he needed a brain rehabilitation program not just more medication thrown at him in the dark or behavior therapy which if you think about it it's really cruel put him on a behavior therapy
program one behaviors really oppression of the problem not the prop researchers have found that undiagnosed brain injuries are a major cause of homelessness drug and alcohol abuse depression panic attacks eighty HD and suicide we are in for a pending disaster with the hundreds of thousands of soldiers coming back from Iraq and Afghanistan and virtually no one is looking at the function of their bright as we
continued our work which backed criticism grew louder so did the last judges and defense attorneys sought our help to understand criminal behavior today we have scanned over five hundred convicted felons including nine D. murderers our work taught us that people who do bad things often have trouble brags that was not a surprise but why did surprise us was that many of these brains could be rehabilitated
so here's a radical idea what if we evaluated and treated troubled brains rather than simply warehousing them in toxic stressful environments in my experience we could trucks save tremendous amounts of money by making these people more functional so when they left prison they could work a port their families I pay taxes Dostoevsky once said a society should be judged not by how well it treats its
outstanding citizens but by how it treats its criminal instead of just crime and punishment should be thinking about crime evaluation so after twenty two years and eighty three thousand scams single most important lesson my colleagues and I have learned it you can literally change people's brains and when you do you change their life you are not stuck with the brain you have you can make it
better and we can prove it my colleagues and I performed the first and largest study on active and retired NFL players showing high levels of damage in these players at a time when the NFL said they didn't now playing football cause long term brain damage the fact was they didn't want to that was not a surprise I think if you get most thoughtful nine year olds
together and you talk about the brain is soft about the consistency of soft moderates house in a really hard skull that has many sharp bony ridges you know twenty eight out of thirty nine year olds would go probably a bad idea for your life but what really got us excited with the second part of the study where we put players on a brain smart program and
demonstrated that eighty percent of them could improve in the areas of blood flow memory and mood that you are not stuck with the brain you have I make it better on a brains how exciting is that I am so excited reversing brain damage is a very exciting new frontier but the implications are really much wider here is the scan of a teenage girl who has ADHD
who was cutting herself failing in school and fighting with her parents when we improved her brain she went from dis and asks to a zombies and was much more emotionally stable here's a scan of Nancy Nancy had been diagnosed with dementia and her doctor told her husband that he should find a home for her because within a year she would not know his name but on
and intensive rain rehabilitation program Nancy's brain was better as was her memory and four years later she still knows her husband's name or my favorite story telestrator this point Xander a nine year old boy who attacked the little girl on the baseball field for no particular reason and at the time was drawing pictures of himself hanging from a tree and shooting other children Andrew was Columbine
Abrar and sandy hook waiting to happen most the cadres would have medicated Andrew asked a did Eric Harris and the other mass shooters before they committed their awful crimes but spect imaging taught me that I had to look at his bride and not throw darts in the dark at him to understand what he needed spec scans showed chest size of a golf ball occupying the space
of his left temple no amount of medication or therapy would have helped and group when the cyst was removed it's behavior come legally went back to he became the sweet loving boy I always one now eighteen years later Andrew who is my nephew owns his own home Floyd paste because someone bothered to look at his brain he has been a better son and we'll be a
