Friday, October 17, 2008

Fist Bump Neurology

When the first images of Barack and Michelle Obama’s controversial fist bump were televised, I was watching on my computer on the toilet in the small bathroom adjacent to my office. It was not a good time for me. For reasons neither I nor my Gastroenterologist Dr. Nadine Lippman had been able to discern, I had been seriously constipated for nearly a week. Not completely blocked, to be sure, but lacking in confidence or, as Dr. Lippman put it, “anything but uncompromised.” The result was that an act I’d almost always completed in less than ten minutes now took twenty or even thirty.

I was fortunate to have state of the art equipment in my bathroom, not just high speed Internet access and a laptop computer with a 17-inch flat screen built into the wall and a keyboard/cpu which fit comfortably on the desk that straddled my knees, but a new mouse which, through an ingenious combination of wireless and optical technology, allowed me to move my cursor with my head. Nod up, cursor up. Nod right, cursor advanced one letter. Delete a quick shake to either side. Etc, etc. Used in conjunction with a foot switch, it also offered left and right click options as well as scrolling. I’d never known such seamless union with my computer, never been able so completely to forget myself while working at it.

Dr. Lippman was impressed and even envious of my set-up, even more so after I referred her to, which offered not only a compendious bibliography, an overview of educational and therapeutic videos, and a history of constipation -- political, philosophical, literary and theological –but linked to Clarence Topalminck’s web site, which offered daily, sometimes even hourly, updates of his ground-breaking research at the Gates Institute of Neuroscience. As anyone knows who reads SCIENTIFIC AMERICAN or, for that matter, THE NEW YORKER, VANITY FAIR, or the science blogs of THE NEW YORK TIMES and the WASHINGTON POST, Topalminck was using the remarkable new bifocal functional MRI technology (so-called because, by simultaneous scanning of the brain and the organs it regulated, it permitted the most precise measure we’d ever had of neurophysiological processes) to investigate the effect of self consciousness on digestion, bowel function and (thanks to Topalminck’s work as a graduate assistant in the lab of the great researcher who gave the specialty its name, UCLA’s Dorothy Saperstein) “sphincterology.” As a source of distraction and therefore, to use Topalminck’s phrase, “interruption” of self consciousness, both television and the Internet figured prominently in his work. The bowel-media interaction was still a long way from understood but of all his work, none was more frequently mentioned on or the blogs to which it linked.

Excited by his website, Lippman sent Topalminck my chart as well as the Iphone images of my bathroom-office which I’d emailed to her. Not ten minutes later, both of us had invitations to visit his lab and, in my case, volunteer as a subject of his research. He was kind enough to say that he’d have invited me even if my bathroom had been less interesting because he was a devoted reader of my constipation blog. Forgive my immodesty, but I have to note that he was not unusual in this regard. At this point in time, the blog was receiving an average of 7000 hits a day, plus frequent mention in NEW YORK MAGAZINE’S blog review column as well as, Huffington Post and Salon. After (by return email, of course) I accepted Topalminck’s invitation, he asked and was granted permission to send me – UPS, next-day delivery – a Panasonic Bio-fax machine so that I could send him images of “product” evacuated while engaged with TV and/or the Internet. He also offered a micro-webcam for similar purposes but since my Iphone had a microscopic zoom, I assured him that the images I’d email would be more than sufficient for him, even if he wanted to publish them, especially because I often did so myself on the blog. The fax arrived one day later and two days before the fist bump. Indeed, it was sitting just to the left of Barack and Michelle when they touched knuckles on my screen.

Topalminck’s work of course was profoundly indebted to Eduardo Javier’s at Ohio State’s Institute of Self Consciousness. Since his first neurosurgical breakthroughs, Javier had more or less owned his specialty. Once his labels, or “tickets,” as he called them, were affixed in conscious brains, the amygdala’s role in self-identity was no longer questioned. This is not the place to elaborate on his research but anyone who wishes to study it can look at his web site, or for that matter any of the sites (more than 20 million, as of this writing) brought up by entering “self consciousness” on Google. Javier’s initial discovery was the pair of neurons in the Dorsal Amygdala that light up, one after the other, with a time delay of approximately .0056 attoseconds, at moments of self consciousness which, on an ascending scale of one to ten, his patients rated above five. In the absence of such excitations and the time-delay between them, he had never observed, in any brain, a state so-described. From brain to brain, the location of these neurons was consistent and predictable, so much so that Javier called the first-to-fire the “I-cell,” the second the “me-cell.” Patient after patient showed that damage to one or both cells left them without consciousness of themselves or, conversely, when Javier activated his micro-electrode, so hyper-conscious that Vital Signs like respiration, heart rate and pulmonary function were compromised. What’s more, the equation seemed to be reversable. “Deactivation of the Amygdala,” marveled Javier, “eliminates not only self-satisfaction but self-loathing!”

If Javier’s work had ended here, he’d still be, as rumored, a leading candidate for next year’s Nobel Prize, but his next step made his first look almost rudimentary. With state-of-the-art Pet Scans, MRI’s and microsurgical equipment, he set up adjoining tables in his Operating Room so that two patients could be investigated simultaneously. Thus did he find that the I- and me-cells are Mirror Neurons! They induce firing not only in each other but in brains proximal to them! Not one of the patients in his dual procedures remained deactivated if the other was not! The conclusion he stated on NEUROSCIENCE.COM was challenged by many but refuted by none: “Self consciousness moves from brain to brain like yawning, hiccups or infectious disease.”

If Javier wins next year, he’ll owe no small debt to Topalminck. What greater honor for a neuroscientist than to see his work applied to the most intimate of human functions? Thanks to Topalminck, no one in the field of neuroscience or intestinal pathology questions the effect of self consciousness on defecation. Search “conscious stool” on Google and “Topalminck” will come up almost as often as “Javier.” Of 1134 constipated patients he studied, 991 showed overactive Amygdalas, and he’d not found a single case of sphincter tension in those with a deactivated I- and me-cells.

Please believe that the reasons for this blog are not entirely private. It’s true that Topalminck has helped me, but I’d not be writing at all if his data had not been discovered by Fist Bump and Obama pundits like Hermine Pleasant on CNN and Nicholas Ranger on FOX. Like everyone else, both were impressed with what Pleasant called “the authenticity” of the gesture but Ranger called it “self conscious – another piece of Obama’s carefully constructed Mr. Natural strategy.” This was the beginning of a controversy which, in the view of many, may well affect the coming election. According to, more than nine million of the 14.5 million hits which “Fist Bump” produced on Google the following day were on one or the other side of what THE NEW YORKER called “the authenticity issue.” If Obama had been, as NEW YORK MAGAZINE put it, “sincere,” he had confirmed what most of his supporters felt about him, but if his act had been, as THE WASHINGTON TIMES said, “calculated” or, as THE NEW YORK POST wrote, “studied,” he was, as William Kristol wrote in THE NEW YORK TIMES “a shameless imposter.” Like most such brouhas, the controversy would have burned itself out with such name-calling but when Pleasant and Ranger, debating on WNET’s NIGHTLY NEWS three days later, cited Topalminck and Javier respectively, the argument became both sophisticated and concrete, subject to proof not speculation. Indeed, one day after Herbert Greenhaven’s piece in THE NEW YORK TIMES SCIENCE SECTION on constipation and the amygdala, a NEW YORK TIMES/CBS poll reported that 71.6% of Americans called Obama “authentic.”

In all modesty, I cannot doubt that my blog, which, according to Google’s calculations, was visited by more than a million readers the day after the Pleasant-Ranger debate, had some influence on this poll. Within moments of the Fist Bump, I experienced, as I reported, a complete evacuation which, according to both my Bio-faxed message and the Iphone image I emailed him, Topalminck called “a perfect example of Amygdalic deactivation.” It’s true I’d long been an Obama supporter and, as a former athlete, had often fist bumped with teammates and even an occasional opponent, but unless you deny Javier’s Mirror Neuron work or ignore his oft-stated view that “self consciousness and authenticity are neurologically antithetical,” you cant discount the possibility that Obama’s spontaneity led to my own. I’m writing now to say that both of us were unself conscious at that moment in time. I know I’d not have evacuated if I’d been consciously attempting to do so, and even without Javier’s data, I can’t believe I’d have free of such effort if Barack and Michelle had not been so as well.


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