The Frontal Cortex

Grey’s Anatomy and Neuroscience

You probably thought this post was going to be about how Meredith Grey (or perhaps McDreamy?) is a neuroscientist, or how Shonda Rhimes (the creator of Grey’s Anatomy) anticipated some surprising discovery of modern neuroscience. Alas, I have no such insights. Marcel Proust may have been a neuroscientist, but Grey’s Anatomy is still just an entertaining and delightfully dumb primetime soap opera. To be perfectly honest, I’m always slightly ashamed at myself after I squander 42 minutes of my life on the randy residents of Seattle Grace hospital.

The most recent episode revolved around a patient with a tumor in his frontal lobes, which led this poor man to do all sorts of impulsive things. For instance, he decided to marry a waitress he’d only known for ten days and, while camping in the woods, he started to pet a bear cub. (The mother bear then mauled his older brother. The plot really was that silly.)

This is a long-winded way of getting to the point of this post, which is that frontal lesions and tumors can often cause bizarrely impulsive behavior. One of the most vivid examples of this concerns the case of the married, middle-aged Virginia schoolteacher who, rather suddenly, started frequenting prostitutes, downloading child pornography, and seducing young girls. (You can read the journal article here.) His behavior was so brazen that he was quickly arrested and convicted of child molestation. The day before his sentencing, he complained of blinding headaches and a constant urge to rape his neighbor. The man was sent to the emergency room, where he started to proposition the nurses. After a routine MRI, the doctors saw the source of the problem: he had a massive tumor lodged in his frontal cortex, specifically the right orbitofrontal area. After the tumor was removed, the deviant sexual urges immediately disappeared. The man was no longer a hypersexual monster. Unfortunately, this reprieve was brief, and the tumor started to grow back within a year. His frontal cortex was once again incapacitated, and the urges of pedophilia returned.

Comments

  1. #1 Rachael
    April 28, 2008

    Pretending that the tumor had been successfully removed, I wonder, should his sentence have been removed as well?

  2. #2 Raúl Cervantes
    April 28, 2008

    As it turned out, the sentence should have been carried out, since the tumor grew back and so did his sexual urges.

  3. #3 greg sargent
    April 28, 2008

    Jonah, what do you think about Dr. House (from the TV show)?

  4. #4 Peter Reiner
    April 28, 2008

    Actually, this case is an important one for anyone seriously thinking about the role of neuroscience in the law, in particular in society’s standards for deciding how one should be sentenced for a crime. The example is instructive of the neuroscience-based view of the universe: one’s actions are based upon brain activity, irrespective of whether that activity is housed in a ‘normal’ brain or one with obvious pathology, as in the present instance. It also helps focus us on an important issue in neuroethics and the law: if we understand the neural basis of behavior to a sufficient degree, should we incarcerate or treat?

  5. #5 TK Kenyon
    April 28, 2008

    Stories like this one bring to mind the old argument about whether or not we actually possess free will. Our legal system insists that we do; otherwise, there is no crime, only crazy. Even religion insists that we can refuse to sin.

    Beyond even brain tumors to a more subtle subject: how about genetics? We know that mutant alleles of monoamine oxidase A (MAO A, promoter region mutants) are highly associated with violence and with a worse outcome in cases of autism. For someone with a low amount of MAO A, should we hold them less responsible if they murder?

    Personally, a world without free will frightens me, personally, but it’s possible that it is, neurologically speaking, true.

    Perhaps Crick was right, and we are all just a bunch of neurons.

    TK Kenyon
    Author of CALLOUS: A Novel, a story about free will, neuroscience, fate, and the End of Days. http://www.amazon.com/gp/product/1601640226

  6. #6 Art
    April 28, 2008

    Neuroscience may be one of the most important for determining who and what we are. And exactly how much free-will we actually have.

    Most people assume we have fee will. We can point to all sorts of sudden and unexpected decisions and claim that we made a choice. We exerted our will and changed our destiny and it had nothing to do with preprogramming or brain structure. Unfortunately there is very little evidence that anything we do isn’t just a consequence of genetics and structure.

    I’m fairly sure that all animals think they are acting out of free will. That at some level every amoeba thinks its choice to go toward water that is slightly more rich in nutrients is an act of free will and spontaneously inspired genius.

    Some time ago I sat down and thought about this a bit. My decision was that, to the extent possible, I treat myself as if I’m existentially responsible for where I am, what I do and how I think. But that, to the extent possible, I will treat others as if they are entirely behaviorally controlled and not responsible for their transgressions.

    Some times it seems to work. But how would I know. I may treat myself as if I’m existentially responsible but then again it might just be my particular genetic makeup and brain structure which determined that I would think about it this way.

  7. #7 Elizabeth
    April 29, 2008

    Free will vs determinism vs metaphysics aside, “blinding headaches and a constant urge to rape his neighbor” gave me greater pleasure than I’ve known all week. Sick, yes, I’ve been told.

    thanks, Jonah.

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