Miracles: How science updates our old understanding of reality

Miracles do not necessarily require divine intervention, but are rather “something that is impossible from an old understanding of reality and possible from a new one”
-Charles Eisenstein

Miracles are traditionally defined as an extraordinary event manifesting divine intervention in human affairs (Merriam-Webster). I heard a seemingly more appropriate definition of a miracle today:

then a miracle occurs

Something that is impossible from an old understanding of reality and possible from a new one (Charles Eisenstein). Science is the best way for humans to progress in our understanding of reality from old to new. The very act of doing science is an attempt progress in our understanding of reality. Discoveries that are on the bleeding edge of science is what I would consider miracles. In my scientific and academic career thus far I’ve been fortunate enough to bare witness to miracles by this definition.

Essentially all medical and technological developments in our current boom of progress could be considered miraculous at the time of their release and use in the world. The miraculous development in our understanding of reality that I’ve been fortunate to experience is deep brain stimulation (DBS). Deep brain stimulation is used to alter the brain’s activity in movement and mood disorders. First developed for movement disorders like Parkinson’s disease and dystonia, when placed in a certain part of the brain, DBS has been shown to almost instantly relieve tremor or dystonic symptoms. If you haven’t seen an example of this miracle in movement disorders watch this video. As you can see, once the DBS is applied their tremors almost completely stop or are drastically alleviated. My miraculous experiences is with DBS for treatment-resistant depression (TRD).

Unlike DBS for movement disorders, it is more difficult to gauge when DBS for depression has worked. Until recently we have mainly relied on the patient’s subjective behavioral report of their feeling. As you’d suspect there are many issues with subjective report that aren’t specific to DBS for depression, but rather affect any study of behavior. None the less, I’ve had the experience of seeing patients sad or emotionally flat one moment and relieved, happy, and slightly overwhelmed the next. So far I’ve seen 11 or so patients. I see them once before surgery, during the surgery (some stimulation to test for the best stimulation site), when the stimulation is turned on indefinitely for the first time, and 6 months after the stimulation was first turned on. I’m in a unique position because I get to see the patients at distant enough time intervals to see a difference (MDs and other staff working with the patients see them every week or so). The difference DBS makes immediately and over time is a miracle. Most of the patients I’ve had the pleasure of working with have gotten so much better that they are nearly unrecognizable from their first visit. The immediate effects of DBS we see during the surgery and 1 month after surgery likely fit what most think of as a miracle (i.e. a specific event or instance). Patients report “feeling lighter, calmer”, “more connected”, “feeling warm, flushed”, “feeling aroused”, “more awake, aware, and reactive”, “feeling relieved”. It is one of the most incredible things I’ve ever seen. The evolution of my interactions with these patients is just as amazing. We go from quiet, flat interactions before receiving DBS to free flowing, jovial conversation during DBS. Even though I didn’t invent and am not one of the MDs implementing the treatment, seeing these patients progress and knowing that I’m the MDs team is by far one of the most satisfying feeling’s I’ve ever felt.

So, it’s a miracle, but not in the divine intervention, should have never been possible kind of way. DBS is currently considered a miracle because is part of the ‘new understanding of reality’ that technology, medicine, and incredibly brave people has made possible. DBS for depression came after the demonstrations of DBS working in movement disorders, but there wasn’t a particularly great reason for it to work. It very well might not have worked or even made the depression worse. Some confidence that it might work came from evidence that a certain part of the brain (Broadman’s area 25 or the subgenual cingulate) was consistently overactive in depression. Working with Andres Lozano, Helen Mayberg thought that DBS might alter area 25s activity. With development of the technique for placement of the electrodes in area 25, the success rates are great for a new medical treatment.

Given that DBS for depression very well might not have worked, it took another component of most traditional miracles, faith. The neurologist, surgeon, and most of all first patients had to have immense faith that DBS for depression would work. It still takes an enormous amount of faith from everyone involved that the DBS will work because of how dire the situation can be for these patients that have been depressed for 5 to 10 to 50 years! The miracle of DBS is one of the newest pieces of our understanding of reality. Our team of scientists are now trying to understand how and why DBS works for these various disorders. As we gain that knowledge it will further our present understanding of reality and make DBS a little less miraculous or magical for the world as a whole. Importantly, if your life has ever been saved, restored, or drastically improved by technology or medicine, it is a miracle, regardless of ‘OUR understanding of reality’, because in that case it has changed ‘YOUR understanding of reality’.

For a view into our work with DBS in depression watch this: http://www.youtube.com/watch?v=Lq5rIILcVgA

For a great talk on uses of DBS with helpful examples see: http://www.ted.com/talks/andres_lozano_parkinson_s_depression_and_the_switch_that_might_turn_them_off.html

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