AANS Neurosurgeon | Volume 27, Number 4, 2018


In Review - The Pleasure Shock: The Rise of Deep Brain Stimulation and Its Forgotten Inventor

Lone, F. The Pleasure Shock: The Rise of Deep Brain Stimulation and Its Forgotten Inventor. (2018). Dutton. New York.

This book tells the story of Dr. Robert Heath, professor of neurology and psychiatry at Tulane University 1950-1980. Dr. Heath was an incredible pioneer. Although most neurosurgeons, including those who specialize in deep brain stimulation, have never heard of him. Starting in 1950, he implanted electrodes deep within the brain of dozens of psychiatric patients with conditions ranging from schizophrenia to depression. This was done several years before the first psychotropic drugs for treating mood and behavior had been discovered. During the 1950s the popular treatments were electroshock and surgical lobotomy. In 1949, Egas Moniz had won the Nobel Prize for treating schizophrenia with frontal lobotomy.

Dr. Heath decided to treat mental illness by stimulating discrete areas within the brain. He believed that the septum verum served as a focus for emotions, desires and lust. To facilitate putting an electrode into this tiny structure, the patients underwent a pneumoencephalogram and then, under x-ray control, a wire could be passed into the septum. Stimulation was then applied to see what changes could be observed.

At Charity Hospital in New Orleans, he discovered a gold mine of degenerate, raving syphilitics, catatonic psychotics, melancholics who had completely disappeared into themselves and volatile paranoids who had to be constantly restrained. Obviously, true informed consent was a problem with this group, but their relatives were desperate for change. His initial results were so encouraging that Dr. Heath formed a new professional association – the Society for Biological Psychiatry.

He then heard about the discovery that the cerebellum had connections to the limbic system, which could influence emotional life. This lead to 38 patients having stimulating electrodes placed over their cerebellums.

During his tenure at Tulane, Dr. Heath obviously needed neurosurgeons to carry out his procedures. In 1950, Dr. Francisco Garcia came with him from Columbia University as his surgeon. Later, Dr. Donald Richardson would become his man in the OR. Dr. Richardson was a great supporter of Dr. Heath’s innovations. In the book he is quoted as saying, “Most neurosurgeons don’t like to think. Unfortunately, they also don’t care much about innovation and trying something new.”

Heath got into major trouble when he decided that deep brain stimulation could convert homosexuals into heterosexuals. His work on gay men resulted in angry demonstrations. The book begins with the story of this chapter in Dr. Heath’s experimentation. The scientific community did not support him and rejected him for failing to design his experiments according to current scientific and ethical standards. Ultimately, in 1973 he was subpoenaed by the U.S. Senate’s subcommittee on Labor and Public Welfare.

Dr. Heath was a man before his time. As this book says, “He was an original, willing to stick his neck out. But he was too headstrong to garner acceptance for his ideas and too exclusive to participate in the scientific community.” If he were still alive, he would be thrilled to know that in 2013 the U.S. Defense Advanced Research Projects Agency (DARPA) announced that they had $70 million to develop the next generation of deep brain stimulation to fix damaged brains.

Author Dr. Frank has written a thoughtful, always interesting book that demonstrates key aspects required for successful innovation – many of which Dr. Heath ignored. Dr. Heath gets his due in this attentive and engaging book.

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