Keep Sharp - Sanjay Gupta, MD

Sanjay Gupta, M.D., is a neurosurgeon and associate professor of neurosurgery at Emory University. He is the chief medical correspondent for CNN, and is widely known for explaining complex medical issues to the public. He is a trusted, research-driven voice on brain science, longevity, and cognitive health.

To follow are two of the inspirations that I took away from his book.

Good with the numbers

In the Self-Assessment: Are you at risk for brain decline section of the book’s introduction, Sanja tells this wonderful true story:

The couple who inspired me several years ago and who showed me what to aspire to when it comes to “old age.” We all age and will one day live with an old brain, but that doesn’t mean it has to lose its sharpness. Looks can be deceiving. The husband was ninety-three years old and had been brought to the emergency room where I was on call. When my chief resident first told me about the patient, who was in serious neurological decline, his advanced age concerned me. I honestly thought he was too old to undergo an operation, should he need one. A little while later the CT scan showed a significant brain bleed that explained his symptoms. I went to the family in the waiting room fully expecting them to tell me not to pursue an aggressive, risky operation. A spry woman who looked to be in her sixties was nervously pacing the room with several other family members sitting earnestly in chairs. I was shocked to learn she was his wife and they had just celebrated their seventieth wedding anniversary. “I am actually older than he is,” she said. “I robbed the cradle.” She was ninety-four years young in perfect health, took no medicines, and had driven her great-grandkids to school earlier that day. She shared that my patient was still an avid runner and worked part-time as an accountant. His sixty-three-year-old son said they kept him around because “he’s such a whiz with numbers.” His brain bleed occurred after he fell from his roof while he was blowing leaves up there.

These nonagenarians were healthier than most of my patients, of any age. Since I started medical school, there has always been a truism: We consider “physiological” age more than chronological age. At the family’s request, I took the gentleman to the operating room for a craniotomy, which would fix the bleed. Before closing the dura, the outer layer of the brain, I took a few moments to closely inspect his brain, and what I saw surprised me. Given how active, cognitively intact, and sharp he was, I expected to see a large brain pulsating robustly and appearing healthy. But this looked like a ninety-three-year-old brain. It was more shriveled, sunken with deep wrinkles indicative of his age. Now, if this sounds disheartening to you, it should not. In fact, just the opposite.

Another truism in medicine is the following: Always treat the patient, not their test results. Yes, of course his brain had aged; he was ninety-three. But the brain—perhaps more so than any other organ in the body—can reliably grow stronger throughout life and become more robust than in years past. I will never forget that experience. There seemed to be a total disconnect between the brain I was staring at and the man whose skull it inhabited. He recovered quickly. When I visited him later on, recovering in the ICU, I asked him how the whole event affected him. He smiled and said, “The biggest lesson in all of this is no more trying to blow the leaves off the roof.”

Maybe we are not supposed to know

From chapter 1: What makes you you

When most of us think about the brain, we probably think about the element of it that makes us, well, us. We ponder the mind—the part that includes our consciousness and is reflected by that quintessential inner voice or, as some would say, that monologic chatter we listen to all day long. It is your you that bosses you around all day, raises important as well as inane questions, beats you up emotionally on occasion, and makes life a series of decisions. I also have been mystified that every moment of jealousy, insecurity, and fear we have ever experienced lies within the caverns of the brain. And somehow the brain can take in data and create hope, joy, and pleasure.

The mind is what first drove me to study the brain. Oddly, however, we still don’t really know precisely where consciousness resides in the brain or if it is even in the brain entirely. I find this to be a fundamentally important point. That state of being aware of oneself and one’s surroundings—consciousness—on which everything else is predicated, remains elusive. Sure, I can tell you where in your brain rests the networks for processing sight, solving a math equation, knowing how to speak a language, walking, tying your shoelaces, and planning a vacation. But I cannot tell you exactly where your self-awareness comes from; it is probably the result of a confluence of factors throughout the brain—the science of metacognition, activities that involve multiple regions of the brain in their interconnectivity.

…

Maybe we are not supposed to know where consciousness resides or how our personal perceptions and perspectives are neuronally born.

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