deep brain johnny cash


carl elliot (opens new window)

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Twelve years ago, a fifty-nine-year-old Dutchman checked into an Amsterdam hospital to have two small electrodes implanted in his brain. The patient, “Mr. B,” had a forty-year history of severe obsessive-compulsive disorder. Neither drugs nor therapy had helped, and he was prepared to try an experimental treatment called deep brain stimulation (DBS). Powered by neurostimulators placed under the skin, the implanted electrodes would deliver regular five-volt electrical pulses to a region of Mr. B’s brain called the nucleus accumbens.

It was a radical treatment, but it worked. After about six weeks Mr. B was better able to resist his compulsions. No longer was he seized by anxiety and panic. Along with the relief, however, came an unusual side effect: Mr. B developed an inexplicable attraction to the music of Johnny Cash.

Until the electrodes were implanted Mr. B had no particular interest in music, least of all country music. If he listened to music, it was usually the Beatles, the Rolling Stones, or Dutch rock bands. Six months after the DBS began, however, Mr. B had a transformative moment: he heard Johnny Cash’s song “Ring of Fire” on the radio. From then on, Mr. B listened to Johnny Cash and nothing else. In the journal Frontiers in Behavioral Neuroscience, his doctors wrote, “When listening to his favorite songs he walks back and forth through the room and feels like he finds himself in a movie in which he plays the hero’s part.”

Mr. B’s devotion to the music of Johnny Cash was not compulsive. His desire to listen didn’t feel alien, urgent, or irrational. He simply felt there was a Johnny Cash song for every experience in life. And as long as the neurostimulator was on, Mr. B never got tired of the music. But if the batteries ran down or the neurostimulator malfunctioned, all of Mr. B’s interest in Johnny Cash vanished. It was as if a flame had been snuffed out. As soon as the battery power was restored, however, Mr. B’s love of Johnny Cash returned.

Should we find this transformation disturbing? Mr. B was certainly not bothered by it. And the notion that we should be true to some kind of fundamental character can seem quaint and old-fashioned, a relic from the writings of Kierkegaard. In fact, if we are to believe Lone Frank, the author of The Pleasure Shock, the very idea of an authentic self has been scientifically debunked. “The concept of this stable inner core is ancient and tenacious, but it is an illusion,” she writes. “It fits poorly with what science has discovered. Apply a bit of voltage here or there, and you become someone else.”