As mind/brain and spirit/body dualism have slowly broken down over the past century, puzzling consequences have been left in its wake.  Nowhere are these consequences more evident than in psychology and neurology.  We take seriously the charge to heal the mind and the brain.  We research it, learn about it, ponder over it, all in the hope that someday we will be able to cure illnesses that are currently untouchable. 

Dementia, Schizophrenia, Stroke, Traumatic Brain injury, to name just a few all have permanent and dire consequences for the individuals involved.  The individual’s very mind, consciousness, personhood, spirit, whatever you choose to call it–their very essence or being is changed,  irreversibly at present, by the disease.  To have a sick brain is to become less human in a very real sense.   

    The science that we use to tackle and understand these illnesses is decidedly materialist, teaching the mind is merely an emergent phenomenon of the brain, just as life itself is an emergent phenomenon of the body.  This is precisely backwards from the system of ethics that has governed medicine from its inception.   

     For most people, the point of medicine is to preserve quality of life.  This somewhat nebulous term is generally agreed to, at an absolute minimum, involves consciousness, the essence of what makes me a me.  We are taught in medical school that autonomy, dignity, justice and beneficence are the core guiding principles of the difficult decisions we need to help patients and families make.  All these principles rely on the idea that this individual, this person, this mind, or consciousness, have us act in their best interest.  In learning to treat the brain, I can’t help but wonder at what point we put the cart before the horse.

   Do we fundamentally change an individual by replacing damaged parts of the brain?  As we come up with neural implants, are we fundamentally changing the mind by adding them?  If we artificially boost intelligence, are we making the individual more themselves, through greater thought and agency, or less, as this is all artificially done?  Do all problems with the mind really have their root in physical problems with the brain?  If we dissect consciousness into pieces and manipulate them, is it possible to take it apart and put it back together again intact?  Does the mind then simply become something we manipulate at our own will, in lieu of the patients will?

    As neurologists, we work from the DNA, to the neuron to the brain tracts and areas, on up to the functioning mind.  Historically, we have stayed away from higher functions such as cognition, consciousness, etc.  However, this is changing more everyday as neuroscience ventures into these brave new frontiers. Psychology, on the other hand, has always done the top down approach starting with the mind, consciousness, cognition, etc. and using it to affect the brain and body to improve mental health.  We now know a lot of the medium and process the mind uses to do this is through neuroplasticity.  Obviously, in medicine both the neurology and the psychology approaches are useful.  Beyond psychology, Eastern medicine and most of civilization throughout history have always understood illness as a matter of balance, of mind, and of soul.  While this has had negative effects in stigmatizing disease as result of sin, it also has shown time and again the power of the body-mind connection.    Western allopathic medicine is actually the outlier in the way mankind has approached health and wellness.

      We now know neuroplasticity exists and that this functioning mind, which the materialists claim is just a side effect, can exert a will and remold neural connections into new directions and literally change the brain.  In light of this fact, I wonder how productive the bottom approach can really be.  Top down is natural, it is the way our body works.  Bottom up is the way modern medicine tries to cheat nature.  If the mind can physically change the brain, why do we still argue if it is real or not? 

For example, we also know certain orphaned children, who grew up in locked rooms with no human contact, arrest their brains’ development.  With absolutely no deficit in physical function, their brain becomes completely incapable of learning language, if kept in the dark, it no longer produces visual images and integrates visual input information.  Deprived of sensation, our brains weed out the unused parts as we grow and develop.  In this way, our brains are quite literally products of their environment.  The brain also becomes a product of itself as we exert our own will to learn certain subjects, as we learn a new language, we gain function that never existed previously.  We can learn overcome psychological difficulties, and literally change the functioning of our brains through a cognitive and behavioural approach.  If the mind does not exist, what caused the brain to change connections and functions and become something different than it had ever been before.  Even though modern neuroscientists will claim Descartes largely discredited, it still holds that “I think, therefore I am.”  Even if that thinking is nothing more than an emergent phenomenon of billions of neurons networked together, that thinking is undeniably fashioning new realities all the time.  The mind and spirit are real, and the reformation and refashioning of the brain are physical proof. 

    While the neuroscientist will argue that the mind is nothing, a mere ghost in the machine, as a Doctor I have to disagree.  In truth, the mind is everything.  It is the reason that we study the brain and body in the first place.  We are in the business of helping people.  The mind and conscious awareness are what makes me a me.  Dissecting it to pieces that lack it’s wholeness can never fully explain it.  

     I can’t believe reductionism will ever be able to comprehend the mind.  More to the point, I don’t see any advantage in it doing so.  In the end, even if the mind were a complete function of neural patterns and networks communicating in ways so complex it spontaneously becomes a self, that self is still what makes us us.  What profit is there to a science that tells us that all we are, all we dream, and hope for is an illusion or biological accident.   Because medicine is an applied science, tearing down the purpose of its application ultimately will make medicine into nothing.  Worse yet, it could conceivably do the same to mankind, making him no more than a mechanized, determined set of biological functions,  a machine.