DR. COHEN:  Yes.  I pretty much concur with everything that Dr. Michel said, but I would add maybe to just the force of his comments the fact that there are technologies that at the moment compliment, but at least in the foreseeable future might begin to replace MRI in certain settings that are much more portable.

Optical imaging, where you actually shine light into the skull and measure the refraction characteristics or the frequency spectral characteristics of the return light to provide another way of measuring blood flow, which is effectively what most forms of functional MRI are measuring now.

And there are attempts to develop extremely portable versions of this. There is a guy at the University of Pennsylvania who has developed what he calls I think — and I think somewhat glibly the Cognitron, which is — I think it is a couple of gram device that you can affix multiple ones of on the scalp, and he has a picture that he shows when he talks, and he says this is Britten Chance of a classroom of Japanese students where he has done a study with this thing in a math class.

And 10 of these devices on each of their heads.  Now, right now the information that that device is giving us is rather imprecise and nowhere close to the kind of information that Dr. Michels is describing.  But I would conjecture that it is at most a matter of time before it comes close.

CHAIRMAN KASS:  Thank you.

DR. COHEN:  With MRI, we are much, much closer to that sort of precision and non- probablistic sort of information.  Studies are getting done now on choice preference behavior that are close to being able to reveal meaningful information about individuals from a single scanned section.

And with regard to what their preference is for, say, Coke versus Pepsi in a double- blind study, where you can look at the brain and figure out what they are going to prefer.  So in some domains I think it is getting remarkably close to the sort of scenario that was described.

CHAIRMAN KASS:  Thank you.  Dan Foster.

DR. FOSTER:  You know, let me just follow up on that, because if you look at the experience from laboratory science, let's say, in molecular biology and so forth, the more we go, the more it gets more complicated.

You know, you used to have a gene, and a messenger RNA, and one protein, and that used to be the dogma; one, one, one, you know.  We now know that is multiplied in dozens of ways.  I mean, you splice the messenger RNA differently, you know, and then you put on different carbohydrates and so forth, and it is much more complicated.

It seems to me that you are talking about events, even with what you just said with shining light in, in the most, I suppose the most complicated organ that we have in the body.  I would find it very difficult to determine what a specific — let me just be crude. 

You light up a PET scan, and you are looking at glucose metabolism, or blood flow, or whatever, which are really when you look at it pretty crude compared to what the neuronal networks and interactions, and if you watch these things grow when you are growing them as the biological people in the brain are doing, it is hard for me to sit here and believe that you are in a meaningful sense going to be able to predict whether — you know, whether somebody's whole neurobiological life — maybe that is right.

But I can't believe that this most sophisticated organ is going to be easier to understand than less sophisticated, but very — you know, things along this line. 

I hope — I don't know if I hope that it is true or not, but it seems to me that there is a huge jump from what we have got right now with functional MRI, and I think you can — and I am sure that you are going to talk about this.

You can tell what — you know, give a thought game, and making a moral decision, and see what part of the brain lights up or something.  But the sort of things that you were talking about Dr. Michels, it seems to me that they are going to be very difficult, because almost always their final common pathways are in memory.

I mean, hearing gives you something different, and you end up in the same place, but writing, or verbal, or visual, how would you — I mean, why are you — I guess what I am saying is why are you — you started off by saying that you don't want to hide things.

But why are you so certain as you seem to be that we are going to be able to do that?  I am just interested.  I am not arguing, but I am just interested.

DR. MICHELS:  As I said, I tend to be provocative.  I am pleased that I have at least in one case succeeded.  I am not certain, but I think this.  The brain is a black box, and it has been a black box forever. 

It is only within the last decade or two that we figured out how to look inside the black box in life, in humans, and we have found that we have knowledge in that box that correlates with socially discernible important variables, an entirely new area.

We have never had this available to us before, and our techniques are growing in potency by leaps and bounds.  I think it is unimaginable that we won't have relevant knowledge that increases significantly the precision of the predictions we have long made on psychological and social grounds.

Those predictions are so important about human life that anything that increases the precision of them is ethically relevant.  My guess is that those increases are moving so fast that they are going to be relevant to every day social decisions about what class to put a kid in, about whether we are — and we are almost at the point now where we can give meaningful advice about what technique to use to teach a dyslexic child based on information that we obtain without talking to the child.

Now, that is pretty startling to me, and not terribly far from deciding whether a kid is going through an adolescent crisis, or is a future probable, highly probable, violent criminal.  Those are morally relevant decisions, and morally significant information about them that we have to decide how to cope with.

And I don't think that those kinds of things are terribly far away.  Again, I back away.  We have experts in the room that can comment.  I am glad you came out on my side on this one. 

CHAIRMAN KASS:  I have Michael Sandel, and then Alfonso. I have got a queue and I think I have noticed everybody that wants in.  Michael, please.

PROF. SANDEL:  Well, this is just two questions of clarification for Professor Cohen.  The functional MRI is an MRI whose purpose is to determine what parts of the brain are functioning when certain experiences — and that scenario with the Japanese school kids in the math class with scanning devices on their brains, that was to determine how they learn the math, or it was to teach them the math?

DR. COHEN:  It was definitely measurement and not intervention. It was an attempt to see in that case the frontal lobes, which were more activated in one case than in another.  A very, very crude study.

I don't want to overdramatize the findings, nor the method, other than to say it answers the question that was asked, which is how portable can we imagine these methods being, and the answer is possibly very portable.

PROF. SANDEL:  If the knowledge of the function of the brain became precise enough could we use such devices to teach the math as well in principle do you think?

DR. COHEN:  Well, no, because these are measurement devices, and they are not producing any signal that influences the brain, but Dr. Michels did refer to one method, transcranial magnetic stimulation, TMS, which is also in principal a very portable device, that can influence the brain, and is in fact already beginning to see some clinical applications.

So it is being used, for example, as a potential alternative.  It is being explored I should say as a potential alternative to electroconvulsive shock therapy.

Where in effect you produce a localized seizure that carries with it possibly much less memory loss and lesser risks than those that are associated with generalized seizures.  So that method is in fact already seeing clinical use, and is also beginning to see perhaps even more extensive use in basic research.  I will say more about that later if people are interested.

DR. MICHELS:  A footnote to Dr. Cohen's comment.  I think it would be immensely — have immense impact on teaching if you could tell by methods such as this when the students have learned what you were teaching them.

If you could tell when the brain pattern shifted, because they got it, and then they were processing it differently than they were before, as an educator, I would find that very, very much powerful in shaping my intervention. 

DR. COHEN:  Can I have a quick response to Dr. Foster's comments before we move on to another question?

CHAIRMAN KASS:  Please.

DR. COHEN:  Actually, nobody is more sympathetic to the concern in the question that you raised than myself.  I mean, it is my view that neuroscience as a whole has missed the boat on the complexity of the brain, and there are many consequences to that realization that neuroscience has not taken on that I think are absolutely essential, and I will say a word about that in my talk.

You know, appreciating the anomaly of dynamics, and the need for formal theory in a way that we see in every other discipline that confronts such complexity.  So you get on and saying that these methods are not going to unravel the whole thing in the next 5 or 10 years. 

That said, there is no predicting as a scientist or from any other perspective what is going — what knowledge is going to yield the simple description, and what knowledge is going to require more deeper and more complex understanding.

And in every other domain of science some very powerful things have come from some rather simple insights, and then others have required much more sophisticated theories. 

So the extent to which I agree with Dr. Michels is in saying that as we suddenly gain new methods that we didn't have before, and are able to peer inside a box that we couldn't peer inside of before, some things are going to lend themselves very quickly to discovery, and perhaps to simple accounts, and to simple correlations that will have great impact.

Others, perhaps most, no doubt will require much, much deeper understanding, and much longer research programs.  But just as in genetics, you know, knowing the entire code doesn't tell us very much about the makeup of the person in all the rich ways that we think are relevant to their day to day function.

Nevertheless, it allows us to predict some very important things, like whether or not they are going to have Tay Sachs disease, or whether they are going to have Huntington's chorea, or a whole host of other things that have immediate medical impact. 

And I think the scenario is going to be the same in neuroscience.  There is going to be a host of things that are going to be upon us before we knew what hit us that we can predict, and then a whole lot more that is going to take a lot longer to understand.

DR. FOSTER:  Thank you very much.  I would say that I have a sentence that I always say, that I never say never, and I never say all ways in medicine or science.  So, I am not saying never.  I am just making a comment.  Thank you very much for your clarification.

CHAIRMAN KASS:  The queue has now grown, and so let me ask people to be fairly succinct so we can get everybody's questions.

PROF. SANDEL:  You could scan them to see how long their question is going to be before you call on them.

CHAIRMAN KASS:  Actually, I have a simpler method.   Alfonso, please. 

DR. GÓMEZ-LOBO:  I am going to go back to the little Japanese boys, the mathematicians, because I am expressing a perplexity here, and it has to do with the following.  From your explanation, of course, these devices would be measurement devices of the brain activity while engaging in methodical thought.

But of course that will not tell us which of the answers they provide to certain equations which are true and which are false, first of all.  In other words, there is this problem with the mind that we want to know the truth, and from what I hear here, the truth about mathematics, about a mathematical statement, is certainly not going to come from the brain, right?  Okay.  Let me try another one. 

PROF. SANDEL:  Can you say that again with your microphone on?

DR. COHEN:  I don't know.  I mean, I am not entirely sure what you are asking. 

DR. GÓMEZ-LOBO:  Well, that's wonderful, because then I am going to get more time to make my point.  Let me make it in a slightly different form now with Dr. Michels. 

I thought that your description of examining the six months old children to determine whether they were going to be alpha, beta, or gamma children — I mean, I am parodying you know what.

No, it is not the brave new world.  I am parodying Plato's Republic.  You know, you take a look at the children that are born, and if there is gold there, fine, and they go to the upper class, and if there is silver, they go to the gardens, and if there is copper, they go to the merchants, et cetera.

But the problem then would be, well, would this be just, would this be fair, and nothing I think it seems in the brain is going to tell us whether this is just or fair.

In other words the question about the truth of the judgment made on the fairness of that distribution is to be found in another domain.  In the case of math, it is certainly the actual system that determines the truth of a claim of mathematics. 

I just cannot fathom say decidability theorems that Goedel decided by scanners.

DR. COHEN:  Well, it is interesting that you picked Goedel, because Goedel was among the mathematicians that pointed out what the limitations of any particular proof system can prove, and it may be that the most profound impact that the eventual understanding that we have of how the brain works will be on understanding what the actual fabric of our conceptual systems are, and what constrains them.

And although at the moment I don't think we are anywhere close to being able to look to the brain to develop prescriptive principles of ethics or knowledge in general, it is not inconceivable to me that ultimately as we understand how the brain works that we will gain new insights into the very basic or the very bases of what knowledge is.

And I will actually — and that is in part the main focus of the talk that I will give. 

DR. GÓMEZ-LOBO:  All right.  I will wait until you give your talk now.

DR. MICHELS:  Just a very quick response.  Certainly we are not going to know whether it is good or bad to do this based on studying the brain.  The brain doesn't tell us that, but we have never before have been able to make precise predictions very early about what the child's individual capacities are in many areas where those predictions will become available.

We then have not a strategy to use, but an interesting dilemma of what to do with that potential knowledge; discard it, exploit it, expunge it, reveal it.  Those are the things that I think this group is interested in.

CHAIRMAN KASS:  Frank Fukuyama. 

PROF. FUKUYAMA:  Well, thank you.  That was really fascinating.  I just want to ask a factual question that was not clear from your presentation.  You have the brain's genotype, and then you have its phenotype, but then beyond that, it seems to me that you have the actual — you know, what is actually contained in the phenotype, which in an analogy would be software in a computer.

The same hardware can contain different programs towards memory and so forth.  Now, it is not clear to me from what you have said which of those three things are measurable by these external devices.

I can certainly see that you could see something about the genotype, and I presume when you are talking about predicting the capabilities of a developing child that you are looking at the phenotype, and how that might develop in the future based on certain physical characteristics of the brain.

But how much are you saying that you can actually measure things in that third category which have to do with what actually fills the content of a given phenotype?

DR. MICHELS:  I don't think that those categories are adequate for the brain.  The genotype, the genes, present constraints or limits on the structure of the brain.  Much of the structure though is not determined genetically, but is a function of various post- genetic determination because of various environmental conditions or whatever, and experience.

And of course the content is heavily shaped by experience.  The techniques that we are talking about measure the sum of all three.  The content is really part of the phenotype, and the content influences the structure of the brain.

So one's experiences influence the relative size of one's hippocampus and one's amygdala, and the balance between them, and those in turn shape future experience.

PROF. FUKUYAMA:  Okay.  Could I just modify that then.  Does the content actually have to result in a physical modification of the brain for you to be able to measure it, or is there a way of getting at the content directly without — in a case where there is no physical difference?

DR. MICHELS:  To a contemporary neuroscientist, it is impossible for there to be content without some physical modification.  It may be at the molecular level, and it may be at the semantic level, but what does it mean to say that the content is different, but the brains are physically identical?  That would discard science, and speak to some type of spiritual notion.

Every thought is connected with some structural, or functional, or chemical difference in the brain. 

CHAIRMAN KASS:  And I assume that somebody that disagreed with that is simply — has a different structure of his brain?

DR. MICHELS:  I would say momentarily until I talked to him.

CHAIRMAN KASS:  Okay.  Then the question of truth becomes somewhat — it is, I think, what Alfonso was getting at earlier, but let me not intervene.  Mary Ann.  I have got a long list, but let's try to get through everybody before the break.  Mary Ann Glendon, and then Bill Hurlbut.

PROF. GLENDON:  As a non- scientist, I have been debating with myself whether I should even enter this conversation, but it was so interesting.  Your question of what would a society be like if these probabilities became socially relevant. 

And it occurred to me maybe we know a little bit about that already.  I would start with what social scientists know, that in the 1990s, until the 1990s, more than half of the inhabitants of the world lived in small farming or fishing villages of fewer than 2,000 people.

I might be more the only person in this room that grew up in one of those kinds of villages, but there is an intense interest in heredity among farmers, and they just don't apply it to animals.

And when you live in a society that is not very mobile geographically you have a little laboratory, where you see generations and generations.  And I think we already know a little bit about — I mean, certainly they have a lively sense of heredity and probability, but they know that it is just a probability business, and they also have a lively sense of variations, and things that aren't determined.

So what you know is that there are some characteristic advantages and disadvantages, and the disadvantages are the ones that make a lot of us move out of small villages.  You tend to get families — whole families tend to get typecast, and there is — well, I don't have to go into it.

But on the other hand, there is also this sense — you posed the question how would we know what is good about this.  There is this sense of maximizing the opportunities for people to perfect their own gifts, whatever they are.  That would be the other side of the coin.

So I was just wondering if maybe in our highly mobile societies where we have lost that kind of little experimental knowledge that maybe at least in the near term fancy science will get us to the point that agricultural societies that were not very mobile had already been.

CHAIRMAN KASS:  Let me continue down the row.  I have Bill Hurlbut, Gil, Paul, Bill May, and Mike Gazzaniga, and then we will break then.  Anybody who wants to speak after that, we will do it in the next session.  Bill. 

DR HURLBUT:  I wanted to jump back upstream on our conversation a little to Daniel's comment.  I wholly concur with the concern that we not fall into neurologic reductionism and simplistic notions of how things work at the level of behavior.

(Inaudible) seemed to me to be very important because the information as Dr. Cohen has mentioned, the certain things that might correlate, are actually beginning to emerge in the evidence. 

If it is true that there is a long journey between genotype and phenotype, and if you think of the genotype as fundamentally expressing the genes, which are then greatly modified and they kind of play out in these complex patterns interacting with one another, and you think of those as pigments, and you think of the phenotype maybe as the picture that finally is expressed with the pigments of the paints, still what we are doing here now as Dr. Michels has mentioned is that we are further upstream in that process of the patterning out of the person.

And the point is that now we are not looking at something as primordial as the genes.  We are looking at something just a layer or two before expressed behavior.  And there are in fact already at least six papers which now correlate fMRI patterns with the expression of single allelic differences.

There are papers associated with brain derived neurotrophic factors, and better memory, serotonin transporters, anxiety, stress, proclivities toward depression in some genotypes; amygdala and anxiety correlations, and correlations between phenotypic expressions of pain, and of course neuro or dopamine transporters, and some of the work that Dr. Cohen has done between dopamine receptors and phenotype.

These seem to me to be highly relevant in their ethical implications, and so that I just don't end up making a statement, I want to ask you a question.  Do you think that we will get to the point where we will discern these transitions in learning that you mentioned, and also discern the very pharmacologic intervention that provokes them, and get to the point where education is no longer just kids sitting in desks, and trying to concentrate, but actually neuro- enhanced sessions, maybe with short- acting psychotropics; that now it is time for your math drug, and now it is time for your literature drug?

DR. MICHELS:  That sounds scary, but I think the answer is basically yes.  I don't think that it will happen that way.  I think what will happen is the 6- month- old will be scanned and evaluated, and we will find that this is a nice, sweet, wonderful  6- month- old.

You see, that little gyrus there is a little bit twisted, and the balance of neurotransmitters is a little atypical, and kids like that have trouble with spacial learning link.  He will need a boost when he gets to calculus. 

So instead of giving him a drug for learning disability for years, which he doesn't need, or giving him nothing and dooming him to a lacuna in his final capacities, we will know that in that week of lessons a little bit of a push might have minimal side effects and will help him through what his brain is limited for, and he will be happier as a result.  I think that is foreseeable.

CHAIRMAN KASS:  Gil Meilaender, and then Paul.

PROF. MEILAENDER:  I would just like to think with you a little bit about this.  I am not quite sure where or what I am about to think about these, but you had said that the notion that we might have two brains exactly different, or exactly the same, but the choice was different, was sort of inconceivable. 

If you had the two brains, the thing would have to come out, and I found that I don't find that inconceivable at all, but of course I am not a neuroscientist. 

You said what would that mean, and the answer is freedom, and that is what I want to think about a little bit.  What I want to know is whether there is any place in here for chance, or willfulness.

There are fascinating things in Augustine's City of God, where he is thinking about free will, and he talks about the astrologers, and he wants to argue against astrology, and about how he finally uses these examples about how the son of the master and the son of the slave were born under precisely the same astrological signs, but turned out entirely differently.  I am just wondering if there is anything analogous to that in this area, and obviously in much more sophisticated ways.

But if you can tell something about my brain, that I always choose Coke rather than Pepsi, what does always mean?  Is there room for chance, or is there room for willfulness, where I just don't want you to know about that?

And if this doesn't make any sense, then what do we say about freedom?

DR. MICHELS:  A huge question obviously.  First, I would not lump chance and willfulness.  To me, they are opposite.  Willfulness is —

PROF. MEILAENDER:  There are many different ways of breaking the pattern is all that I had in mind.

DR. MICHELS:  But willfulness implies determinism.  It means —

PROF. MEILAENDER:  No, I was thinking of willfulness as something that stands outside the whole system of causes.  It means free will.

DR. MICHELS:  Well, clearly —

CHAIRMAN KASS:  Dostoevsky's Notes From the Underground maybe.

DR. MICHELS:  To a neuroscientist, I think the notion of chance or something outside of the causal system doesn't mean anything.  It does not fit the language and discourse that that community is involved in.

PROF. MEILAENDER:  Is that a scientific point or a philosophical one?

DR. MICHELS:  It is clearly philosophic.  That is not the result of a science.  That is an organizing frame within which the scientist formulates and addresses questions as I understand scientists.  We have a couple in the room. 

CHAIRMAN KASS:  I think his brain is wired differently.

DR. COHEN:  Well, I think on that point that I would take a slightly different stand, and I would distinguish between free will and chance.  I would say within all of science that there is the notion of chance.  I mean, right down to the quantum mechanical level. 

I mean, that is built on the notion of chance, that there is indeterminacy in the physical world is the essential notion in modern physics.  And I think the same is absolutely going to apply at the level of neuroscience, and so is there an opportunity for what we technically call symmetry breaking?

You have two identical brains confronted with slightly different environments, and they may go the same way and they may not.  So, absolutely it is an essential notion, and in fact we formalize it in many of our mathematical models as noise, and it turns out that has important properties well beyond the scope of this discussion.

But just to say that not only is it possible, but it is embraced theoretically in an extremely important concept that there be chance, or randomness, or noise, in the operation of the nervous system.  That is distinct from the notion of free will, where that will comes from some material or plasma that is outside of the physical or material realm.

And there I agree with Dr. Michels.  I say that as a neuroscientist, and not speaking as a metaphysician, or a philosopher, but as a neuroscientist.  It makes no sense for me to talk about any things outside of that realm.

I am willing to be agnostic as to whether or not there is ectoplasm that exists outside of the material world, or some force of nature, or God, or whatever you want to call it, that has influence.

But as a scientist that is not the game that we play.  The game we play is what can we explain in terms of physical cause and material existence.  And from that perspective as a neuroscientist, I don't think it makes much sense to talk about influences that exist outside of the material world, and with regard to neuroscience, the relevant material is the brain.

PROF. MEILAENDER:  Just a sentence?  Your agnosticism though then would have to mean that it might be possible that your predictions could be falsified by something that is outside of the realm that you are working in?

DR. MICHELS:  I think this is going to take us longer to work out than we have, but if you are asking for falsification in a material form, the answer is no.  That is the game of science. 

You give me material evidence and that is perfectly good, and I am going to say it always has to be material evidence and so we are back to the scientific game. 

DR. FOSTER:  But just one sentence then.  You have already talked about the quantum mechanics and everything.  The uncertainty principles apply everywhere.  So in one sense, you can't — it is too much to talk about right now.

But there is inevitably with, whether it is a photon through the Schroedinger's Cat experience and so forth.

CHAIRMAN KASS:  My electrode says that Paul McHugh wants to speak. 

DR. MCHUGH:  Thank you very much, Bob, for that interesting fairy tale.  I have been listening to this fairy tale for so long.  Look, first of all, we are already now working with our understandings of potential, and organizing the environment of children, and probably maybe with some further knowledge of brain structure, we can do it a few years earlier than we do.

As you know in the public school systems of New York City right now, children at age 6 are selected to go to Hunter Grammer School out of the basis of their scores on psychological tests and it works out pretty well. 

The predictions are extremely well, and we are doing it right now, and if you could do it at age four rather than at age six, that might be an advance.  But knowing the gelatinous layer or gelatinous appearance of a six month old brain, having looked at a lot of them, I am quite sure that there are limits to what you are on about.

And it was that that brings me to my question.  You say appropriately that we are going to get more precise, and I want to know where the limits come given that at the moment none of the neuroscientists can tell us anything about how consciousness emerges from this material. 

If you can't tell us how consciousness emerges from this material at all, you can't tell us what makes us see red when we see red.  How do you really think that you are going to do all the things that you tell us you are going to do before you can answer that question? 

I acknowledge what Dr. Cohen says, that there are going to be surprisingly simple things that are going to emerge from this, but that is not the picture that you are depicting for us for our ethical concerns.

You are depicting for us a sense in which we are all powerful and are capable of doing things that this neuroscience is going to do it.  Do you think that there are limits to what you can achieve given that I don't see in the next hundred years that you are going to solve the brain mind problem. 

CHAIRMAN KASS:  As long as you would like.

DR. MICHELS:  A point of personal privilege.  I am delighted that Paul considers me a spinner of fairy tales.  I couldn't imagine a higher status to achieve in the world or in his eyes.

He is conflating the two categories that I talked about.  One is the implications of our new knowledge for our understanding of the species of cognitive psychology, and then indirectly of moral discourse.

I don't know how consciousness emerges from this gelatinous mass, but I do know that it wouldn't be very helpful to me sitting with a patient, or with my 6- month- old granddaughter, to know the answer to that question.

It might be helpful to me to know whether next year I should enroll her for ballet lessons or for learning how to play the violin, or maybe for ice skating.  That would be useful information. 

And I think that is the kind of information that we are going to get from studies of individuals.  We are not going to progress the way consciousness emerges. 

Before that, we are going to learn that memory is complex concept, and that emotional and cognitive records aren't filed in the same cabinet, and that might get us to rethink some of our notions  about the nature of man.

But again that isn't what is going to influence the way that I make decisions about my granddaughter's education, or assign kids to school.  I agree thoroughly with what Paul said.  We make these predictions all the time based on strategies that we have used for a hundred- thousand years.

Within the last 20 years, for the first time, we have an entirely new class of data never before available to us which promises much more precise and specific knowledge on which to make therefore more precise predictions.

They will still be probablistic, and they will still be predictions, but that is a quantal leap that may have qualitative significance in terms of its social implications. 

Partly because that information will be available to some groups and not others; partly because it will raise questions of resource distribution and fairness; partly because it will raise questions of whether or not we want to make decisions based on such information, or only use our traditional sources of information because they are "more natural."

All of those are not new ethical issues.  But this area will make them have a different concrete significance.  I think that Paul is agreeing with that, and so I think it is a very important fairy tale that we would suffer if we ignored.

DR. MCHUGH:  I agree with you up to a point.  The issue that I am trying to raise with you is the issue that Gil is talking about, too.  That is, that we are people of body- mind continuum, and the issue of developing and recognizing that the brain is important, and that particular parts of the brain are important, and particular parts of the brain are in action when we have a thought, and this work is very interesting, and I would agree very important up to a point.

I am concerned that it is being over- hyped, and we are getting so far from what in our promise for what we would deliver that we are trying to scare people  about what our limits are, and all I am saying is that for me, that if you can't tell me how the brain produces this conscious experience at all, and then let me remind everybody that we can't do it at all.

And yet you think that we are going to be in a process of a kind where people would likely to be in a situation where we are putting stuff in the drinking water and reproducing Walker Percy's example in Love in the Ruins.  I just think that is a fairy tale.

CHAIRMAN KASS:  Bill May and Mike Gazzaniga, and we will take a break.

DR. MAY:  You seem to be claiming that there are proffering a fairy tale, but scaring people with a nightmare.  So far we have talked about the potentiality of this with medical interventions, and then we got into the discussion of education.

But I couldn't help but think about this potential for personal relationships.  I mean, there is nothing more daunting for a young man to declare his love, and it exposes him to extreme vulnerability, potential humiliation, and awkwardness and so forth.

But if I could get a hold of her black box, then think what that would do, and embolding me in overtures, and of course from her side, there might be the feeling that transparency is not all that good a thing, and one would retreat to the ancient wisdom women have of the importance of veiling, and the importance of that in human affairs.  It is a frivolous comment, but it comes towards the end of this session.

CHAIRMAN KASS:  This is an argument for ignorance or for a certain kind of ignorance.

DR. MICHELS:  A quick one- liner, Leon.  In the Hasidic community in New York City, you don't go out on a date without first checking the genome of your potential partner for recessive genes that might cause trouble.

It probably will be at least 5 or 6 years before they will add an MRI to the genome before that date. 

CHAIRMAN KASS:  Looking for what, rabbis?

DR. MICHELS:  For fittedness that will survive, rather than lead to conflict that will disrupt the family.

CHAIRMAN KASS:  Mike Gazzaniga.  He is going to clear this up.

DR. GAZZANIGA:  Welcome to neuroscience everybody.  So, Bob, your talk takes me back to Cornell and many grand rounds and so forth, and I can of hear a couple of things from your talks.  You have always had sort of a love- hate relationship with science.

So let me see if I have this right, and you correct me if I am wrong, because I think you can offer us a possible insight here.  As I remember, you came out of the psychoanalytic tradition, but you were every scientifically fascinated, and you learned, and you loved to talk about it.

And then you studied for years people who were severely mentally disordered, and schizophrenia, Tourette's and a bunch of diseases, and with manic- depressives, and let's take one for example, schizophrenia, and along comes dopaminergic hypothesis, or it clears up what the hell is going on here.

And there is a solid biopsychiatry brainstorm.  And people take the appropriate drugs, and they feel better, and they behave better, and so forth, but nowhere in there was there any understanding of why they thought they were the King of Siam, you know?

I mean, the person was sick, this dopaminergic problem or whatever which one, a neurotransmitter problem or whatever.  Yes, it fixes the brain, but it doesn't explain why we have been dealing with this patient for years.

Now, that revolution sort of puts psychoanalysis on the junk heap of ideas for most of us, and you lived through that.  And I am trying to get at why — I hear that you are fascinated with neuroscience, but you are also quite clear that it has severe limitations on what it can explain, because you know this fact.

You know that neuropsychiatry didn't answer or ever answer that question.  They just moved on.  They didn't know why these people had all these crazy thoughts.  They can just fix their brain chemistry.

Now having lived through that, and having had to rethink — I assume you had to rethink all those things in your mind, can you apply the principles that you learned from that to what this problem is about our increasing knowledge of neuroscience, and what it may mean for normal human cognition?  Does that make any sense to you, that question?

DR. MICHELS:  I am not sure, Mike.  I am today a practicing psychoanalyst.  I never left that.  I was a scientist, a laboratory scientist, before that, and not after that, and so I am not exactly in the history that you outlined.

But I certainly have had a life- long interest in both.  I have no doubt that there will be unanswered questions at any point along the way, and I have no doubt that our traditional fascination with symbols, and meaning, and extra personal socially determined communication is part of our notion of being.

And all that is important in making one human isn't within your brain or your skin, because it has to do with things like language that certainly can't be understood within a single nervous system.

But I think — my view is that the neuroscientific explosion of the last few decades has opened a black box.  We only have glimpses in the box, but we never were able to open it before, and that new knowledge is trivial compared to what is unknown, but immense to what was known, and it is going to make some differences.

CHAIRMAN KASS:  Before the break, might I just clarify one point, Bob.  I take it that you think — rather than think about the actual interventions, you think that the most important first set of topics that we should be thinking about are the implications of a new kind of probablistic, but nonetheless predictive, and more specifically predictive knowledge for thinking about the future, especially of children?  Would that be a fair —

DR. MICHELS:  No, I will go back.  I divided my thought into four parts.  I think the first thing that I would be interested in is the implications of this new knowledge for your view of man.  The lessons of modern cognitive psychology for your discussions of moral psychology.

The second part would be the implications of knowledge about individuals, analogous to genetic knowledge, but far more important and further — and I forget if it is downstream or upstream, but further or closer to the output that we are clinically interested in.

I think interventions are much further down the pike and much less important, and much weaker, and probably in general will be starting as most interventions do, well within the current medical model, and I think that many of the issues of intervention you have already discussed, and they are not new ethical issues, because the intervention happens to be above the neck rather than below the neck.

CHAIRMAN KASS:  Thank you very much.  I thank you all.  We will take 15 minutes, and we will look forward to Dr. Cohen's presentation.

(Whereupon, at 3:33 p.m., the meeting was recessed, and resumed at 3:54 p.m.)