Greetings! This is the newly reincarnated version of my long-running newsletter.
If you have come here for the first time, welcome to what I hope you will find an entertaining and edifying experience. I write the "Origins" column for the New York Times, and I write books about science (fifteen so far). In my newsletter, I riff on the subjects and ideas that grip me in those longer works. I also send out links to talks I give (in person, on the radio, online), as well as to things I've published.
If you are a long-time reader of "Friday's Elk," welcome back! You are no doubt noticing something different about it. For a number of years, I used a service called Tiny Letter to send out my newsletter. But now its provider is shutting it down and offering alternative plans that just don't suit me.
Wondering what to do next, I noticed that other writers I know and respect, such as Annalee Newitz and Ed Yong, were using a service called Buttondown. After checking it out, I decided that it would suit me too. So I've taken the liberty of rolling all you Tiny Letter subscribers into my new Buttondown list.
We are now deep into the Age of Newsletters. I'm sure many of you regularly cull your subscriptions to keep your inbox from turning into an infinite scroll. I get it. I won't take offense if you take this opportunity to stop subscribing to "Friday's Elk."
But before you do, could I beg your indulgence for a few more issues? I'm using the move to Buttondown as an opportunity to put some fresh energy into my newsletter and to find ways to make it of even greater interest to readers. See what you think!
For starters, I will be writing more in my newsletter about some of the broad themes I'm noticing in my regular work as a journalist and author. (You'll find an example further down below in this issue.)
I would also like to hear from you about things you'd be interested in reading about in "Friday's Elk." If you have some specific question about a story of mine, or if there's a question that's been on your mind that you'd like to see me address here, please get in touch.
If you would like to share the newsletter with friends who might want to subscribe, I'd be very grateful. I plan to keep "Friday's Elk" free to read, despite the fact that I am now using a paid service to bring it to you. If you would like to support this work, you can get an optional subscription at whatever amount you'd like to give.
As I settle into my new home, I expect to fumble around a bit with the appliances. I apologize in advance for any glitches in the experience of reading the newsletter. Please let me know of any missing images, dead-end links, or other problems, and I will fix them. Thanks!
The Long Wait For the Future
Writing about science is a delicate balancing act between the past and the future. The structure of many stories comes in three parts: In the past, we thought X. Now new research suggests Y. And in the future, Y might lead to Z. Of course, Z may or may not come to pass, and even if it does, we can't say with certainty when it will happen.
The balancing act gets particularly tricky when X,Y, and Z have to do with medical research. The research involves a disease, and the people who are suffering it, and the families who suffer along with them. For them, the story is not an interesting diversion. They want to learn about scientific developments that might lead to treatments. With that audience in mind, it's all too easy to start making false promises about research, about how soon Y will lead to Z.
I've been thinking about how to manage this balance for twenty years. In 2003, I wrote about comas and disorders of consciousness. A neurologist named Nicholas Schiff permitted me to tag along as he examined patients who had suffered terrible brain injuries years before--in car crashes, falls, and strokes--and now could only gaze into the distance.
Doctors traditionally treated these people as hopeless cases. Unless they regained consciousness in the months immediately after their injury, there was nothing more to do to help them. But Schiff thought many patients deserved more than nihilism. Their brain regions were largely intact; it was just the connections between them that had been damaged and could be rebuilt.
It was a privilege to spend time with Schiff's patients and talk to their families. Years after the injuries, they hoped their loved ones would get better--that they would speak some day. But it was also obvious to me that scientists like Schiff still knew very little about consciousness and what happened to it in a traumatic brain injury.
I published a story in the New York Times Magazine on Schiff's work. Schiff and his colleagues kept working, and they kept struggling to find opportunities to test ways to help their patients. Four years later, my colleague Benedict Carey reported that Schiff's team had implanted an electrode in one of the patients I had met. After they stimulated a hub in his brain's network, he started to speak a little. "He can say ‘Mom’ and ‘Pop,’ and ‘I love you, Mommy,’” his mother said at a press conference.
You might assume that once we journalists publish stories like these, Y has turned to Z. But the reality is messier. In the sixteen years since that single-subject trial, Schiff has not found an opportunity to follow up on it. These trials are immensely complex, requiring coordination between hospitals where the patients are cared for, surgeons who will carry out the procedure, and experts who can track the progress of the study. Even now, Z floats far ahead in the hypothetical distance.
But there has been progress along a parallel track.
Some people who go into comas recover their consciousness but nevertheless suffer from many frustrations for the rest of their lives. They can't hold down a job or stay in school. They can't focus on conversations or forget conversations they just had. Often, people with chronic disabilities from traumatic brain injuries just don't seem like their former selves any more. And there are a lot of these people: an estimated five million in the United States alone.
Schiff and his colleagues found evidence that stimulating the same network could help these people as well. Over the past few years they have implanted electrodes not in a single patient with chronic traumatic brain injuries, but in five.
This month I wrote about the promising results of this trial. To report the story, I got to speak with one of the volunteers, Gina Arata. Arata was a 22-year-old with plans to go to law school when she got in a car accident. Afterwards, she couldn't even hold down a job sorting mail. She lived with her parents. She lost all of her friends.
Arata entered Schiff's trial at age 40, after 18 years in this limbo. At least for her, the electrodes appear to have had an extraordinary effect. Schiff tested them at her bedside after surgery by asking her to name some things she might find in the produce section of a supermarket. She rattled off a list of fruits and vegetables. Then he asked her to list some things in the bread aisle.
"I was blank," Arata told me. "I couldn't think of anything."
Schiff had shut off the electrodes before asking her the second question. When he turned them back on, the blank was gone.
In the five years since the procedure, Arata says she has continued to improve. She reads books again. Her old friends tell her she seems her old self. "Now I'll be talking, and a word will come out, and I'll think 'Ooh, that was really smart. Where did that word come from?'" she told me.
Whenever possible, it's important to include the voices of people like Arata in stories like these. And yet stories are not data. For now, the data is far from definitive. Schiff and his colleagues carried out a series of cognitive tests on the five volunteers, and they all scored better than before they got the implants. Experts I talked to were heartened by the results, but only as a green light for more research. What is really needed is a large-scale trial that can measure the efficacy of the electrodes. Perhaps only some people will get the benefits that Arata is enjoying. Or perhaps the electrodes need to be designed differently to deliver the biggest benefits.
The comments readers have left on my story and the emails I've been getting about it have made me keenly aware all over again of the delicate balance of X, Y, and Z. Schiff's team would like to run a large-scale trial, but they have not yet secured the opportunity to launch it. If any "Friday's Elk" readers know someone dealing with TBI and want to find out more about a possible trial, please reach out. I can't make any promises, but I can pass along requests.
And In Other News
I wrote about how genes that boost our fertility may be cutting our lives short. A classic theory gets a new boost in the age of genomics.
Neanderthals may have been morning people. And if you are one, your Neanderthal genes may be part of the reason why.
Here's the recording of my Science Friday conversation with journalists Marion Renault, Maryn McKenna, and Jaime Green about The Best American Science and Nature Writing 2023. Maryn delivers a real kick in the teeth at the end.
That's all for now. Till next time!
Carl
If you'd like to learn more about my books, you can visit my web site
"Friday's Elk" is free. If you'd like to support my writing, you can pay what you'd like for an optional subscription