Consciousness

I am parked in what my wife refers to as the Big Chair. She purchased this comfortable recliner as a birthday present for me last year. I picked the design, she chose the color. It is situated 2 meters from a large screen, high def TV. The USA vs England world cup match is today's feature. Four minutes into the match and we are losing 1-0. What does this have to do with consciousness? Multitasking. Can the human brain perform two functions simultaneously? Is the human brain distinct from the human mind? This is Descartes (I think therefore I am) and Nietzsche (god is dead) vs functional MRI.

As the world's oldest ER doc, I have had many opportunities to contemplate the great philosophical issues of the late twentieth and early twenty first centuries. Nurture vs nature is played out in the ER every night. A recent teenage patient was brought in by the police on an involuntary commitment. He was aggressive, abusing drugs and averse to getting any treatment. His mother was controlling, inflexible, and exhibited her own psychiatric pathology.

The young man required physical and chemical restraints to protect the ER staff from his violent attempts at escape. He was eventually placed in a psychiatric facility after more than 36 hours in the ER. My impression was that he was doomed at birth. Genetically he was handed the roots of mental illness. The environment of his home sealed the deal. Nature and nurture ganging up on this young man.

The genetic basis of mental illness and the environmental factors that increase the risk of development of mental disease have been well documented if not absolutely proven. Sociobiologists say that we are born with instincts and behavior imprinted in our genes. The environment in which we are raised may bring out the better traits, or the antisocial traits. When I treat a child for vomiting and the parent(s) are feeding the tyke cheese puffs, this construct seems all too accurate.

Mental illness, obesity, substance abuse, criminality, diabetes, and cardiovascular disease are all major players in the ER patient population. As my patients are often accompanied by family members, I get to see the genetic roots as well as the environmental enhancers of these conditions. My 27 years at the same hospital have allowed me to be the Jane Goodall of ER patients. Generations of patients from the same family with teenage births, low intelligence, and frequent ER visits make me feel like an anthropologist.

What is consciousness? Function MRI can demonstrate the sections of the brain that are active with viewing certain pictures, listening to sounds, voices and music and performing certain tasks. There is no separate consciousness. Mind=brain. Multitasking as practiced by my youngest nephew is an illusion. One cannot text, be on Facebook and study for school simultaneously. The USA vs England match is at the interval. I saw the goals only in replay because my brain was focused on this blog. Scribo ergo sum.