> It's not some special thing that sits apart from it. It is an integral part of the whole, no different than your kidneys or liver.
Except it is. The brain is a part of your body and the two are tightly integrated. Yet the brain is also not simply another organ. If you lose half of your liver, your personality might change due to the trauma, but you will still be you. If you lose a kidney, you’ll live on as if little happened (assuming modern medicine stops you from dying of infection). If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life. You’ll also likely experience drastic personality changes.
The brain is part of the body but it is also special. To my knowledge it’s the only organ with a dedicated blood barrier. It’s also the only organ that modern medicine can’t keep “you” alive without. If your body is on life support but you are “brain dead”, then “you” are gone. Your heart can be replaced with a pump. Your kidneys can be replaced with dialysis. Your stomach can be replaced by a feeding tube. Yes, all of these are pretty poor alternatives but they affect quality of life. They don’t end life. If modern medicine could replace your brain with a computer, no one would consider this a lifesaving intervention.
No one says they’ve lost a parent to kidney failure while the parent is still alive. Many people have said they’ve lost a parent to dementia while the parent is still alive.
> If you lose half of your liver, your personality might change due to the trauma, but you will still be you.
If your thyroid is damaged, it effects who you are through depression, lethargy, anxiety and significant behavioral changes. If your adrenal glands are overactive, it effects who you are through chronic stress, psychological conditioning and panic. Disorders of the gut effect who you are similarly, as does removal of parts of the lymphatic system. Hormonal changes from disease, consequences of genetics or supplementation can drastically change a person's personality.
Yep. The body is not independent of the brain. Your other organs and especially the hormones they produce absolutely affect it.
But the brain is still not “just another organ”. The brain is special, as evidenced by the fact that the body gives it a special blood barrier. The brain also is you, to a greater extent than any other organ. This is why your thyroid can be removed and with appropriate hormone replacement, you’re mostly unaffected. No amount of hormones will replace the loss of your brain.
Except that non/under-functioning thyroid can usually easily and cheaply be replaced with levothyroxin. Anyone who feels that they’ve slowly been getting more tired and just can’t stop gaining weight should ask their doctor to get their T3 and T4 levels checked.
Finding out mine was underfunctioning and getting the levothyroxin dosage right made a ton of difference in my energy levels and stopped (but didn’t reverse) my weight gain.
“If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life.”
Depends.
Patients who undergo hemispherectomy at a very young age can recover remarkably well; a testament to the incredible plasticity of the developing brain.
In adult brains, yeah, it’s a very different story. See also: stroke.
Honestly, you’re both right. It is only one of a multitude of highly interconnected interdependent organs; but it can (and usually does) do some truly incredible stuff while running within that system.†
--
† Assuming, of course, that Descartes/Wachowskis aren’t right after all.<g>
My google-fu isn't super great here, so I've not sources, but I know of a few cases of French postmen that 'suffered' from hydranencephaly, were married, with many children, and otherwise 'normal'. It's not super uncommon that people with otherwise good balance but who cannot ride a bike also 'suffer' from a lack of a cerebellum.
The wiki article on hydranencephaly is SUPER wild. Take a look at that picture of that baby! Though it is typically lethal, there are cases where those affected survive into adulthood
There's a huge family of "Neurosteroids"[1], which impact various receptors in the brain in lots of super complicated ways that aren't entirely understood. They are synthesized in all kinds of ways naturally, and when it comes to "what they do" in terms of personality... "probably something" is the best we can do.
There is massive complexity in all these things, all kinds of feedback mechanisms, genes and enzymes involved, etc. They do something but it's hard to say what exactly.
I know about this personally; one of the amazing things about transgender medicine is that there is a huge range of responses to the hormones involved, and there's honestly no way to predict what will happen with a given person.
There are tendencies in aggregate - like less testosterone = less libido - but how those come about biologically is unclear and the effect varies tremendously between different people.
It's a joke to pretend like we fully understand or can predict how any of these things actually impact our lived experiences beyond very rough, bulk tendencies.
I didn't mean to make this about transgender medicine. The evidence is pretty strong that hormone treatment improves wellbeing for transgender patients[1], and of course, they can always stop it if it doesn't. The fact that very few do is a good indicator of satisfaction overall. There is a very strong bias towards safety in the practice of transgender medicine.
I can also personally attest that transgender medicine has vastly improved my life. The changes in appearance reduce awkward interactions (I presented female almost always even before transitioning). The mental changes have all been positive and left me feeling much more in control of myself and my life.
There is a lot more science to be done and things to be discovered especially when it comes to brain impacts. Transgender medicine is a new field where there is much to be discovered. It's still a super important thing I'm glad exists.
In any case, I was using it as an example where these brain interactions become super visible and complicated, not trying to debate it directly.
I don't have statistics on-hand, but as I understand it, bottom surgery (SRS, GRS, whatever you want to call it) has one of the absolute highest patient satisfaction rates of any major surgery (including lifesaving surgeries).
> permanent genital mutilation which results in a potential lifetime of pain from daily dilation of an artificial orifice which is little more than a glorified wound
Pretty much every single word of what you just wrote is not only wrong, but highly offensive. Please don't speak of things you don't understand.
> I don't have statistics on-hand, but as I understand it, bottom surgery (SRS, GRS, whatever you want to call it) has one of the absolute highest patient satisfaction rates of any major surgery (including lifesaving surgeries
I think you really do need to cite these statistics given the controversial nature of the subject matter in hand.
It's actually not controversial at all among the people actually impacted by it. It's only "controversial" in that a lot of people are transphobic and are offended that trans people are allowed access to gender-affirming medical care.
Besides, nobody's asking for statistics on how many people are satisfied with surgery to remove cancer, or other "obviously" good surgeries. Why are we expected to justify the existence of gender-affirming surgeries?
> It's actually not controversial at all among the people actually impacted by it.
Confirmation bias much?
> a lot of people are transphobic and are offended that trans people are allowed access to gender-affirming medical care.
Again, stats please, ideally by country so we might have a proper discussion.
> Besides, nobody's asking for statistics on how many people are satisfied with surgery to remove cancer, or other "obviously" good surgeries.
Sorry, but that does actually happen, they're called survival statistic, most, if not all health care systems record them. People who survive cancer are generally happy they're alive.
> gender-affirming surgeries
There's no such thing as "gender-affirming surgeries", they're called sex changes. Gender is a role unlike biological sex.
I also find it incredibly disingenuous that everyone asking for The Statistics are asking after a very awfully specific surgery and don't seem to care whatsoever about mutilation performed on intersex people, or of metoidioplasty, or reconstructive surgery, or many other procedures in the area that are performed for all kinds of reasons.
Geesh, I'm actually kind of mad about it... as someone that has given birth to a child and about due with another one, I would love for HN commenters to talk about pelvic pain, vulvodynia, 4th degree tears, incontinence, prolapse, and other incredibly common postpartum issues that might require surgical intervention to the same degree that gender affirming surgeries are being questioned.
I've vouched for your comment which was flagged, I think you make some reasonable points, if somewhat clumsy, but are valid for discussion, especially in regards to children. If the parent poster is an adult then I'm fine with what they wish to do to their body.
I don't have an axe to grind regarding top or bottom surgery in adults. But given the current troubling reports about the activities of the Tavistock clinic, especially with regards to children being supplied puberty blockers etc and perhaps regrettable surgeries (offshore by ill informed parents), this warrants more rigorous study by the health profession.
Well, helping people cope and find acceptance could be a form of treatment. I am a little scared by the number of my friends who have gone on the medical transgender journey.
If you don’t support gender transitioning, fine, but don’t pretend that your concern is for the person transitioning as if they don’t understand the implications. Your agenda is painfully clear and has nothing to do with the ethics of prescribing hormones when we don’t fully understand them: “I'm saying hormones and plastic surgery do not make a woman”.
The reality is that we don’t understand any medicine particularly well, but we do our best to treat an endless array of diseases and disorders anyway, because it’s more ethical to attempt to ease pain and discomfort than to ignore suffering.
Also people do regularly get plastic surgery to address aesthetic concerns. Would you advocate that people with cleft lips should simply learn to accept who they are and we should consider it unethical to correct the deformity?
You're taking that one line out of context in his post. Yes of course the brain is special because it's the only organ that makes you, you. Just like the heart is special because it's the only major organ that if you removed, blood would stop flowing.
GP's point was that in the context of how medication affects our bodies, the brain and body are more connected than we tend to think. Medication doesn't either only affect our body or our only affect our brain. It affects the entire system.
> If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life. You’ll also likely experience drastic personality changes.
That's...not at all what the actual results of a hemispherectomy, in which you literally lose half of your brain, show.
That’s rarely performed on adults because the risks are so high. Even in children it’s a last resort reserved only for the most severe and morphine seizure cases.
And a change to your gut biome can have drastic effects on your personality, with many leading psychiatrists thinking there may be an inherent link to gut bacteria and clinical depression.
do you mean the brain as in what's contained in our skull or also the central nervous system which would include controlling (both automatically and consciously) everything else, as well as sensing all of what we define as reality?
Except it is. The brain is a part of your body and the two are tightly integrated. Yet the brain is also not simply another organ. If you lose half of your liver, your personality might change due to the trauma, but you will still be you. If you lose a kidney, you’ll live on as if little happened (assuming modern medicine stops you from dying of infection). If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life. You’ll also likely experience drastic personality changes.
The brain is part of the body but it is also special. To my knowledge it’s the only organ with a dedicated blood barrier. It’s also the only organ that modern medicine can’t keep “you” alive without. If your body is on life support but you are “brain dead”, then “you” are gone. Your heart can be replaced with a pump. Your kidneys can be replaced with dialysis. Your stomach can be replaced by a feeding tube. Yes, all of these are pretty poor alternatives but they affect quality of life. They don’t end life. If modern medicine could replace your brain with a computer, no one would consider this a lifesaving intervention.
No one says they’ve lost a parent to kidney failure while the parent is still alive. Many people have said they’ve lost a parent to dementia while the parent is still alive.