Sometimes - not always - it's reassuring to know that there is a rational, scientifically-based explanation for your disease. Somehow, understanding what causes your discomfort makes it more bearable. Don’t ask me why, but it seems to. It is particularly true when one’s malady is behavioral. Being mentally "weird," not unlike being physically deformed, is no easy burden to bear. Mental aberration (like a large, hairy wart on the end of one’s nose) carries with it a cost that demands payment daily. Since with me, it is chronic, observable and, to put it politely, "well outside the norm" - like said wart on one’s proboscis - payments, in one form or the other, come due frequently. I have even expressed my despair in a previous BLOG.

Now, after many years of, first, anguish, and, finally, acceptance, I can finally explain precisely and scientifically what comprises my hairy, mental "wart." I can, but not without a considerable amount of shame, declare: I have an abnormal brain. [Cue Mel Brooks’ Young Dr. Frankenstein: "Abby Normal? You mean you brought me an abnormal brain?"] The wiring is simply all wrong. It’s one thing to wire a ceiling fan wrong and quite another to have a tangle of mismatched neurons. One causes a house fire; the other causes, well, moi.

This lightening bolt of revelation comes courtesy of the recent (December 3, 2007) issue of Time magazine. In this venerable periodical there is a revealing article titled: "What Makes Us Good/Evil" by Jeffrey Kluger. [For your dose of useless trivia for the day, know this: Kluger’s book, in collaboration with astronaut Jim Lovell, "Lost Moon: The Perilous Journey of Apollo 13" was the basis for Ron Howard and Tom Hanks’ movie, Apollo 13.] In the Time article, Kluger opened my eyes about exactly what plagues my dysfunctional mental apparatus. It’s a "good news/bad news" scenario, as are so many things in life. In scientific terms (I know, I know: b-o-r-i-n-g) I have an overdeveloped dorsolateral prefrontal cortex. That’s the "good news." Sadly, I have an underdeveloped medial prefrontal cortex - the "bad news." Big dorsolateral prefrontal, little (shrunken, atrophied, deformed, whatever) medial prefrontal cortex. Got it? OK, let’s move on.

Behaviorally, this is how it shakes out. I am really good with "cold cognition" and really bad at "emotion and social thinking." These are Kluger’s words, not mine, but they certainly fit. As I understand the anatomy and function, I make decisions much like Spock. For you non-Trekies, Spock was a half-Vulcan, half-human executive officer of the fictional (What? You didn’t know it was fiction?) Starship Enterprise. My decisions are (at least I like to think) based on logic and expediency. If there is a dilemma - moral, business, personal or otherwise - emotional considerations typically take a back seat (or, more likely, get in the trunk) to the basic and root question: what makes sense? I am the guy who, when asked "Does this dress makes me look fat?" answers, if accurate, "yes." As every normal man knows, the correct answer is always and without exception: "No! Absolutely not, honey!" Similarly, when asked "Wouldn’t you like to sit here with me and watch Steel Magnolias tonight?" I would answer, "Thanks, I’ve already seen it. I’ll just read a book or something." Any male with a standard-issue brain would answer in the affirmative, if for no other reason than he would like to sleep in his own bed that night. As someone recently described my infirmity, I am "socially retarded." To me, it had a very descriptive quality to it. I actually considered it genius in its brevity and clarity. See what I mean? I would assume such a label would offend most people; I thought it most rational.

As I understand it, these two areas of the brain - the cold, logical dorsolateral prefrontal and the socially aware, sensitive medial prefrontal cortexes are constantly at war within the normal mind. The article has several moral and ethical conundrums to gauge, colloquially speaking, "where your head is at". One is the crying baby:

My Answer: No brainer. Of course I could and would.

Crying Baby, the corollary:

My Answer: Absolutely and without hesitation.

After asking my office staff this question, I became acutely aware that my answers are not entirely typical. The youngest (female) of the staff answered a resounding "No!" to both inquiries. The oldest (also female) answered: "I wouldn’t want to live myself if I had to kill my child, so, no." I was somewhat relieved, however, when this lady quickly answered, "yes" to the Crying Baby Corollary. She seemed to have no hesitation with murdering an innocent baby as long as it did not spring from her loins. You see, there is a conflict between these two decision-making areas in the unflawed brain. It also points out that the idealism of youth wanes in favor of the pragmatism of maturity even in the female of the species. Further testing is clearly required to prove my theory.

I am, for all practical purposes, much like the famous neurological case of Phineas Gage. Poor Phineas was a railroad worker who was accidentally impaled by a steel rod blown from a railroad construction site near Cavendish, Vermont. The rod was several feet long and slightly over a inch in diameter. It hit Gage with such force that it was found - after passing through Gage’s skull - some 30 yards away. The strange thing about the gruesome injury was two-fold:

• Phineas Gage lived 12 years after the accident, and
• His personality was drastically and irreversibly altered for the rest of his life.

Gage was, by all accounts, a hard-working, responsible foreman who was popular with his men before the injury. Afterwards, his sociability dramatically changed. To whit, this report in the Massachusetts Medical Society, 1868:

"Gage was fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was 'no longer Gage." [Emphasis added]

It was after the Gage incident that neuroscience began to hypothesize that specific areas of the brain controlled certain behaviors. Less cheerily, one must report that these early investigations culminated with the widespread use of the "frontal lobotomies" in the management of the mentally ill and, sometimes, just for being what my eloquent friend labeled "socially retarded." [Rosemary Kennedy and Howard Dully are principle examples]

Since I, quite possibly, would have been, in pre-1950 America, a candidate for a lobotomy, I wonder if there are alternatives to treat my disability. There are currently games being marketed for "exercising" one’s brain, presumably for preventing (or, at least, delaying) dementia and early senility. Why couldn’t someone develop similar exercises for enhancing sociability and sensitivity? For those, like me, afflicted with the crippling debilities of an overactive "cold cognition" cortex (dorsolateral prefrontal cortex) and an atrophied social/empathy cortex (medial prefrontal cortex), couldn’t we change that? Isn’t there a remedy - beyond the drastic nature of opening the cranium and poking around - that could be offered for our tortured existence?

I have some ideas. Perhaps, a game machine or computer could have interactive exercises that would allow us to stimulate growth and reactivate the dormant "sensitivity cortex" and/or suppress or deactivate the "cold cognition" cortex? Maybe, there could be a negative feedback stimulus - say, an electrical shock - if we did not exhibit an appropriate response to a video displayed on the screen? We could determine the responses, possibly, by scalp electrodes to measures cortical electrical activity or, less invasive, one could read pupillary responses. Dilated pupils would signify interest and no response or contraction of the pupil would mean disinterest.

As for the content for viewing, one could use videos of smiling people, greeting us or asking us questions that normal people handle in typical social interactions. Those of us who suffer from "social retardation" could learn to not be uninterested and detached (after a sufficient number of electrical shocks) and be taught to react comfortably to these daily routines. To heighten our sense of compassion and sympathy, we could use still photographs or videos of tragedies from...well...any number of locations both in America and abroad. If tears well up in our eyes or our pupils dilate or our "sympathy cortex" exhibits an appropriate increase in electrical discharges, we can avoid the voltaic punishment. Through this process of Pavlovian "bell ringing," those of us with "shrunken sympathy cortex syndrome" (hereafter, abbreviated "SSCS") can get in touch with "the better angels of our nature."

If we can solve the comparatively insignificant problems of wilted penises, male-pattern baldness and the heartbreak of eczema, seborrhea and psoriasis, surely we can help those of us who have the unremitting angst of SSCS. Surely, the world would be a much better place curing my frailty than enabling 4-hour erections and clear skin! The workplace would become more cordial, there would be a dramatic rise in charitable giving and, quite possibly, a decline in divorce and road rage. The possibilities strain the imagination.

In the meantime, I will continue making psychological disbursements for my disability’s "cost." I will try to return the smiles and greetings of strangers, say "Thank you" to store clerks (they are just doing their damned jobs!), talk baby talk to newborns, and feign interest when the next person begins to "share" their impending holiday plans. When someone solicits a favor (that will really inconvenience me) or wants me to cut them some slack (for their screw-up, not mine), I will bite my tongue when I am tempted to utter my standard "It ain’t my problem." When a casual acquaintance starts to tell me the latest joke he heard, I will make every effort not to ask "Is this a long joke?" I do want to get better. Even though I still just don’t get it, I am told there is a great deal of pleasure in "being with friends," "connecting" with people and in "being spontaneous." For Heaven’s Sake, just look at how normal people cried during Pay It Forward! And, after one hears and sees this sort of behavior enough times, even those with SSCS have to believe it must be true. Right?

Reminds me of: "If it wasn’t true, we couldn’t say it on TV!", but that’s a topic for another time.