CANCER VICTIM Adhesive notes made Steve Jobs’s face on the Apple Store in Munich.       Christof Stache/Agence France-Presse – Getty Images




The New York Times, November 1, 2011, by Denise Grady  —  Was Steve Jobs a smart guy who made a stupid decision when it came to his health?

It might seem so, from the broad outlines of what he did in 2003 when a CT scan and other tests found a cancerous tumor in his pancreas. Doctors urged him to have an operation to remove the tumor, but Mr. Jobs put it off and instead tried a vegan diet, juices, herbs, acupuncture and other alternative remedies.

Nine months later, the tumor had grown. Only then did he agree to surgery, during which his doctors found that the cancer had spread to his liver, according to the new biography by Walter Isaacson. Cancer eventually killed him.

The sequence of events has given rise to news articles and blogs based on 20/20 hindsight, speculating that if only Mr. Jobs had had the surgery right away, doctors could have caught the cancer early, before it spread, and saved him.

But there is no way in this life to know what might have been — not in politics, baseball, romance or the stock market, and certainly not in sickness and health. Mr. Jobs’s wish to avoid or delay surgery was not unusual. And given the type of tumor he had and the way it was found, his decision to wait may not have been as ill considered as it seems at first blush.

His wife, Laurene Powell Jobs, declined requests for an interview and for permission to speak to Mr. Jobs’s doctors. But she did allow one of them to comment briefly: Dr. Dean Ornish, a friend of Mr. Jobs who is also a well-known advocate for using diet and lifestyle changes to treat and prevent heart disease.

Dr. Ornish said that when the diagnosis was first made, he advised Mr. Jobs to have the surgery. But in an e-mail message, he added:

“Steve was a very thoughtful person. In deciding whether or not to have major surgery, and when, he spent a few months consulting with a number of physicians and scientists worldwide as well as his team of superb physicians. It was his decision to do this.

“This type of surgery is a big deal and not to be taken lightly. He had surgery when he decided it was what he wanted to do. Nobody could have been more thoughtful and intelligent about how he went about this.

“No one can say whether or not having surgery earlier would have made any difference because of the possibility of micrometastases.”

Micrometastases are the tiny cancers that form in various organs when a tumor starts to spread and seed itself around the body. Dr. Ornish’s comment means that in theory, Mr. Jobs’s tumor could already have spread invisibly to his liver by the time it was first diagnosed. If it had, operating earlier probably would not have made a difference.

Dr. Edward M. Wolin, co-director of the carcinoid and neuroendocrine tumor program at Cedars-Sinai Medical Center in Los Angeles, said that among patients with the kind of cancer Mr. Jobs had, “when they are first found on a scan, about 60 percent of the time it’s already metastasized to the liver.”

Another expert, Dr. Steven K. Libutti, said that based on his reading of the new biography, it seemed likely that Mr. Jobs’s tumor had spread by the time it was found, and the delay in surgery probably did no harm. Dr. Libutti is director of the Montefiore Einstein Center for Cancer Care in New York and of its neuroendocrine tumor program.

(Neither Dr. Wolin nor Dr. Libutti treated Mr. Jobs or knew the details of his illness.)

The tumor was a rare type. The usual type (which killed the actor Patrick Swayze) is notorious for its high death rate and rapid progression: After five years, only 5 percent of patients are still alive.

But Mr. Jobs had another disease: a neuroendocrine tumor, meaning that the cancer affected the cells that make hormones like insulin. Neuroendocrine tumors account for only about 3 percent of the 44,000 cases of pancreatic cancer each year in the United States.

Neuroendocrine tumors are much less deadly than the usual type of pancreatic cancer. Some can be cured. Patients’ five-year survival is much higher, 50 to 60 percent, and many live 10 years or more, Dr. Libutti said.

In Mr. Jobs’s case, the tumor was discovered almost by accident, when he had a CT scan for something else.

The increasing use of CT scans and the improving clarity of the images mean that more and more tumors too small to cause symptoms are being noticed incidentally in various organs, including the pancreas. Deciding what to do about these growths, and whether it is ever safe just to watch them, is something that “the field is wrestling with now,” Dr. Libutti said.

Most doctors would advocate removing a neuroendocrine tumor of more than two centimeters (about three-quarters of an inch), Dr. Libutti said, though he said size alone was not a foolproof gauge. Small tumors can be vicious, big ones innocuous. A biopsy can give clues to how dangerous a tumor is. (Information about the size of Mr. Jobs’s tumor has not been made public.)

“The real challenge for us with better CT scans and incidental findings is if you get a small one-centimeter tumor in the pancreas, do they all have to be removed right away, or can you just observe them?” Dr. Libutti said. “I don’t think anybody has an absolutely comforting and soul-satisfying answer right now.”

Dr. Wolin said he recommended removing any neuroendocrine tumor in the pancreas within a few months of the diagnosis. “If you find it early, that’s the time to do it,” he said. “Just because it has a really good prognosis and it’s small doesn’t mean you should ignore it.”

Some doctors opt to wait if there is uncertainty and the surgery would be extensive, Dr. Libutti said. The pancreas has a head and a tail, and tumors in the head require more arduous surgery. Mr. Jobs ultimately had a type of operation that normally involves the head of the pancreas.

Dr. Libutti said that when a tumor is discovered incidentally, by a scan for a symptom like back pain, patients sometimes oppose surgery — arguing that without the scan the tumor never would have been found, and maybe it will never bother them.

“It’s not magical thinking,” he said. “In some ways it’s common sense. We can’t say ‘Yes, it absolutely will kill you, and if we take it out, it won’t kill you.’ ”

But if the tumor is large, he said, he will try to talk the patient into removing it.

“Some physicians are more comfortable saying ‘Take them out; at least we’ve done everything we could,’ ” Dr. Libutti said. “Others say, ‘What if you’re taking it out for no reason, and there are complications, even though complications are rare?’ That’s why guys like me lose our hair.”



Why the Algorithm Might Soon Be The Only Game in Town

Dr. Michael S. Gazzaniga     Photo by George Fousham



The New York Times, November 1, 2011, by Benedict Carey, ST. HELENA, Calif. — The scientists exchanged one last look and held their breath.  Everything was ready. The electrode was in place, threaded between the two hemispheres of a living cat’s brain; the instruments were tuned to pick up the chatter passing from one half to the other. The only thing left was to listen for that electronic whisper, the brain’s own internal code.

The amplifier hissed — the three scientists expectantly leaning closer — and out it came, loud and clear.

“We all live in a yellow submarine, yellow submarine, yellow submarine ….”

“The Beatles’ song! We somehow picked up the frequency of a radio station,” recalled Michael S. Gazzaniga, chuckling at the 45-year-old memory. “The brain’s secret code. Yeah, right!”



Jim Wilson/The New York Times

Michael S. Gazzaniga is a psychology professor at the University of California, Santa Barbara.



Michael Gazzaniga, in striped shirt, with his family in 1945.



Dr. Gazzaniga as a student at Caltech in 1963.



LEFT BRAIN, RIGHT BRAIN Dr. Gazzaniga with his colleagues John Sidtis and Jeffrey Holtzman, in lab coats, in the van they used at Dartmouth for studying the brain’s hemispheric division of labor.




Dr. Gazzaniga, 71, now a professor of psychology at the University of California, Santa Barbara, is best known for a dazzling series of studies that revealed the brain’s split personality, the division of labor between its left and right hemispheres. But he is perhaps next best known for telling stories, many of them about blown experiments, dumb questions and other blunders during his nearly half-century career at the top of his field.

Now, in lectures and a new book, he is spelling out another kind of cautionary tale — a serious one, about the uses of neuroscience in society, particularly in the courtroom.

Brain science “will eventually begin to influence how the public views justice and responsibility,” Dr. Gazzaniga said at a recent conference here sponsored by the Edge Foundation.

And there is no guarantee, he added, that its influence will be a good one.

For one thing, brain-scanning technology is not ready for prime time in the legal system; it provides less information than people presume.

For another, new knowledge about neural processes is raising important questions about human responsibility. Scientists now know that the brain runs largely on autopilot; it acts first and asks questions later, often explaining behavior after the fact. So if much of behavior is automatic, then how responsible are people for their actions?

Who’s driving this submarine, anyway?

In his new book, “Who’s in Charge? Free Will and the Science of the Brain,” being published this month by Ecco/HarperCollins, Dr. Gazzaniga (pronounced ga-ZAHN-a-ga) argues that the answer is hidden in plain sight. It’s a matter of knowing where to look.

The Split Brain

He began thinking seriously about the nature of responsibility only after many years of goofing off.

Mike Gazzaniga grew up in Glendale, Calif., exploring the open country east of Los Angeles and running occasional experiments in his garage, often with the help of his father, a prominent surgeon. It was fun; the experiments were real attempts to understand biochemistry; and even after joining the Alpha Delta Phi fraternity at Dartmouth (inspiration for the movie “Animal House”), he made time between parties and pranks to track who was doing what in his chosen field, brain science.

In particular, he began to follow studies at the California Institute of Technology suggesting that in animals, developing nerve cells are coded to congregate in specific areas in the brain. This work was captivating for two reasons.

First, it seemed to contradict common wisdom at the time, which held that specific brain functions like memory were widely — and uniformly — distributed in the brain, not concentrated in discrete regions.

Second, his girlfriend was due to take a summer job right there near Caltech.

He decided to write a letter to the director of the program, the eminent neurobiologist Roger Wolcott Sperry (emphasizing reason No. 1). Could Dr. Sperry use a summer intern? “He said sure,” Dr. Gazzaniga said. “I always tell students, ‘Go ahead and write directly to the person you want to study with; you just never know.’ ”

At Caltech that summer after his junior year, he glimpsed his future. He learned about so-called split-brain patients, people with severe epilepsy who had surgery cutting the connections between their left and right hemispheres. The surgery drastically reduced seizures but seemed to leave people otherwise unaffected.

Back at Dartmouth, he couldn’t stop thinking about it: Totally unaffected? Combing the literature, he found that the best attempt to detect an effect had found no changes in thinking or perception among 26 patients who had had the surgery at the University of Rochester.

Could that be possible? Mr. Gazzaniga was so eager to test the patients’ perceptions himself that he wrote another letter, this time to the surgeon — and got permission to do so.

“It’s spring break, I get all my gear together, I get all the way over there, and the guy changes his mind,” Dr. Gazzaniga said. “Like, ‘Hey, buddy, go home!’ ”

After graduating, he headed straight for Caltech.

“It wasn’t just ambition, it was something else — he was gutsy,” said Mitch Glickstein, who was in Dr. Sperry’s lab at the time and is completing a book, “Neuroscience: A Historical Introduction.” “Here’s this junior in college, he knows all about the split-brain patients, and he’s ready to do original research. At 20 years old.”

Caltech in those days was like a frat house for Nobel Prize contenders. Here’s Richard Feynman, the physicist, parking himself in the lab unannounced and making wisecracks about the experiments. There’s Dr. Sperry, annoyed, wondering how to one-up Dr. Feynman. One afternoon Dr. Sperry’s young student scrambled out into the hallway on all fours after an escaped lab animal and nearly kneecapped Linus Pauling, the eminent chemist. (“Why don’t you try anesthetizing a bowl of jelly instead?” Dr. Pauling remarked icily.)

And then there were the experiments, each one a snapshot into the dark box of the brain. In the early 1960s, Dr. Gazzaniga, then a graduate student, teamed with Dr. Sperry and Dr. Joseph Bogen, a brain surgeon, to publish a string of reports that dramatically demonstrated hemispheric specialization in humans.

The researchers devised a way to flash a picture of a bicycle to the right hemisphere alone. When split-brain patients were asked what they saw, they replied, “Nothing”: Because of the severed connection, the left hemisphere, where language is centered, got no visual input and no information from the right hemisphere. So the right hemisphere — which “saw” the bike — had no language to name it.

But here was the kicker: The right hemisphere could direct the hand it controls to draw the bicycle.

In other studies, the three scientists showed that the right hemisphere could also identify objects by touch, correctly selecting, say, a toothbrush or a spoon by feel after seeing the image of one.

The implications were soon clear. The left hemisphere was the intellectual, the wordsmith; it could be severed from the right without loss of I.Q. The right side was the artist, the visual-spatial expert.

The findings demolished the theory that specific functions were widely and uniformly supported in the brain. It also put “left brain/right brain” into the common language, as shorthand for types of skills and types of people. Still, in a field defined by incremental, often arcane advances, the Caltech team had achieved a moon shot.

Dr. Gazzaniga, now all of 25, could write his own ticket. He soon had a grant for a study to record the electronic chatter between the two hemispheres in the brain of a cat.

The Interpreter

The Beatles song that surged through the receiver in that experiment provided Dr. Gazzaniga with something almost as valuable as insight: a good story. Yet it also served as a rude reminder that he and his colleagues were missing something important in their assumptions about the brain.

“The question, ultimately, was why?” Dr. Gazzaniga said. “Why, if we have these separate systems, is it that the brain has a sense of unity?”

Even as he built his early triumph into a career, moving from Caltech to U.C. Santa Barbara and eventually to Dartmouth, with several stops along the way, the same question hung in the air, without a satisfactory answer. In the late 1970s, with the psychologist and linguist George A. Miller, he founded the field of cognitive neuroscience, a marriage of psychology and biology aimed at solving just such puzzles.

It didn’t happen, at least not quickly. In the decades to follow, brain scientists found that the left brain-right brain split is only the most obvious division of labor; in fact, the brain contains a swarm of specialized modules, each performing a special skill — calculating a distance, parsing a voice tone — and all of them running at the same time, communicating in widely distributed networks, often across hemispheres.

In short, the brain sustains a sense of unity not just in the presence of its left and right co-pilots. It does so amid a cacophony of competing voices, the neural equivalent of open outcry at the Chicago Board of Trade.


It turned out, yet again, that people who’d had the split-brain surgery helped provide an answer. Dr. Gazzaniga, now at Dartmouth, performed more of his signature experiments — this time with an added twist. In one study, for instance, he and Joseph LeDoux, then a graduate student, showed a patient two pictures: The man’s left hemisphere saw a chicken claw; his right saw a snow scene. Afterward, the man chose the most appropriate matches from an array of pictures visible to both hemispheres. He chose a chicken to go with the claw, and a shovel to go with the snow. So far, so good.

But then Dr. Gazzaniga asked him why he chose those items — and struck gold. The man had a ready answer for one choice: The chicken goes with the claw. His left hemisphere had seen the claw, after all. Yet it had not seen the picture of the snow, only the shovel. Looking down at the picture of the shovel, the man said, “And you need a shovel to clean out the chicken shed.”

The left hemisphere was just concocting an explanation, Dr. Gazzaniga said. In studies in the 1980s and ’90s, he and others showed that the pattern was consistent: The left hemisphere takes what information it has and delivers a coherent tale to conscious awareness. It happens continually in daily life, and most everyone has caught himself or herself in the act — overhearing a fragment of gossip, for instance, and filling in the blanks with assumptions.

The brain’s cacophony of competing voices feels coherent because some module or network somewhere in the left hemisphere is providing a running narration. “It only took me 25 years to ask the right question to figure it out,” Dr. Gazzaniga said.

“One of the toughest things in any science, but especially in neuroscience, is to weed out the ideas that are really pleasing but unencumbered by truth,” said Thomas Carew, former president of the Society for Neuroscience and dean of the New York University School of Arts and Sciences. “Mike Gazzaniga is one of those in the field who’s been able to do that.”

Dr. Gazzaniga decided to call the left-brain narrating system “the interpreter.” The storyteller found the storyteller.

Emergent Properties

Knowing the breed well, he also understood its power. The interpreter creates the illusion of a meaningful script, as well as a coherent self. Working on the fly, it furiously reconstructs not only what happened but why, inserting motives here, intentions there — based on limited, sometimes flawed information.

One implication of this is a familiar staple of psychotherapy and literature: We are not who we think we are. We narrate our lives, shading every last detail, and even changing the script retrospectively, depending on the event, most of the time subconsciously. The storyteller never stops, except perhaps during deep sleep.

But another implication has to do with responsibility. If our sense of control is built on an unreliable account from automatic brain processes, how much control do we really have? Are there thresholds of responsibility, for instance, that can be determined by studying neural circuits? Dr. Gazzaniga and his wife, Charlotte, raised six children, so like any parents they had to determine levels of responsibility on the fly, just to get someone to set the table.

Yet questions like these became increasingly difficult to ignore for Dr. Gazzaniga, as he took on a more prominent role advising policy makers on the applications of brain science. He was appointed to a Congressional technology panel in 1991; in 2002, he took a position on the President’s Council on Bioethics. And in 2007, he became the founding director of the John D. and Catherine T. MacArthur Foundation’s Research Network on Law and Neuroscience, which tracks and evaluates applications in the legal system.

There, in particular, brain science has had a growing impact. In recent years lawyers have begun to present brain images as evidence, usually to mitigate responsibility for a crime or to test veracity of testimony, as in a polygraph; increasingly, those images have been admitted. And more are coming: In imaging studies, for instance, neuroscientists have identified cortical areas that are highly active when people suppress impulses or other behaviors.

But there are clear shortcomings in the application of each of these methods in courtrooms. Brain images are snapshots, for one thing; they capture a brain state at only one moment in time and say nothing about its function before or after. For another, the images vary widely among people with healthy brains — that is, a “high” level of activity in one person may be normal in another. Can brain science tell exactly where automatic processes end and self-directed “responsible” ones end?

Not now and not likely ever, Dr. Gazzaniga argues in his book. Social constructs like good judgment and free will are even further removed, and trying to define them in terms of biological processes is, in the end, a fool’s game.

“My contention is that, ultimately, responsibility is a contract between two people rather than a property of the brain, and determinism has no meaning in this context,” he writes in “Who’s in Charge?”

Like generosity and pettiness, like love and suspiciousness, responsibility is what he calls a “strongly emergent” property — a property that, though derived from biological mechanisms, is fundamentally distinct and obeys different laws, as do ice and water.

Dr. Gazzaniga is not the first scientist making this case. It is far from a settled matter, in part because researchers do not yet have a complete picture of how automatic and deliberate systems interact biologically.

“I see Gazzaniga’s point, and it would indeed be easiest if we could ignore conclusions derived from brain science and psychology when it comes to legal issues,” said Ap Dijksterhuis, a psychologist at Radboud University Nijmegen, in the Netherlands, in an e-mail. “However, I do not think we can do this forever, and at some point, some key legal concepts such as accountability or responsibility will have to be redefined.”

Until then, Dr. Gazzaniga’s advice is to look for them where they’ve always been: in the hearts and moral intuitions of human beings, in their laws and customs.

And, it should be said, in their stories.




Michael S. Gazzaniga (born December 12, 1939) is a professor of psychology at the University of California, Santa Barbara, where he heads the new SAGE Center for the Study of the Mind. He is one of the leading researchers in cognitive neuroscience, the study of the neural basis of mind.

In 1961, Gazzaniga graduated from Dartmouth College. In 1964, he received a Ph.D. in psychobiology from the California Institute of Technology, where he worked under the guidance of Roger Sperry, with primary responsibility for initiating human split-brain research. In his subsequent work he has made important advances in our understanding of functional lateralization in the brain and how the cerebral hemispheres communicate with one another.

Gazzaniga’s publication career includes books for a general audience The Social Brain, Mind Matters, and Nature’s Mind. He recently published The Cognitive Neurosciences III, from MIT Press, which features the work of nearly 200 scientists and is a sourcebook for the field. His book The Ethical Brain was published by the Dana Press in June 2005.

Gazzaniga founded the Centers for Cognitive Neuroscience at the University of California, Davis and at Dartmouth College, the Neuroscience Institute, and the Journal of Cognitive Neuroscience, of which he is the Editor-in-Chief Emeritus. Gazzaniga a member of the President’s Council on Bioethics. He also is the Director of the Law and Neuroscience Project, a project to study the intersection of law and neuroscience.


Dr. Michael Gazzaniga



Gazzaniga Key Study

Key Study Sheet

Area of Psychology: Split brain. Split brain is a procedure when there is severe epilepsy in one hemisphere of the brain and the surgeons cut the corpus callosum to stop the spread of epileptic seizures from one hemisphere to the other. In general, this procedure is successful as the patients’ seizures are reduced and sometimes eliminated.

A brief introduction to split brain and split brain patients:

Title of Study: Gazzaniga (1984) Split brain observations. This is a natural experiment.


Figure 1: The Dual Brain Development


Figure 2: The Split Brain



Researchers: Roger Sperry and Michael Gazzaniga. Michael Gazzaniga (born December 12, 1939) is a professor of psychology at the University of California, Santa Barbara, where he heads the new SAGE Center for the Study of the Mind. Some of his famous books are The Social Brain, Mind Matters, Nature’s Mind, The Cognitive Neurosciences III and The Ethical Brain. He worked under the guidance of Roger Sperry, with primary responsibility for initiating human split-brain research. Roger Sperry (August 20, 1913 – April 17, 1994) was a neuropsychologist, neurobiologist and Nobel laureate who won the 1981 Nobel Prize in Medicine for his work with split-brain research.


Figure 3: Professor Michael Gazzaniga


Figure 4: Roger Sperry



Aims: To investigate hemispheric specialization with split brain patients. A split brain patient’s two hemispheres are functionally isolated, in effect, their right brain doesn’t know what their left brain is doing (and vice versa). “Each hemisphere is indeed a conscious system in its own right, perceiving, thinking, remembering, reasoning, willing, and emoting, all at a characteristically human level, and both the left and the right hemisphere may be conscious simultaneously in different, even in mutually conflicting, mental experiences that run along in parallel”.– Roger Wolcott Sperry, 1974


Procedures: In one of Sperry’s experiments, split brain patients were asked to stare at a spot on a projection screen and then draw/name the objects he saw as they flashed up on either side or both sides of the screen. Therefore split brain patient ‘Joe’ was asked to look at a screen with a dot in the middle of a computer screen and then name/draw the objects he saw as they flashed up on either side or both sides of the screen.

Figure5: A split brain patient asked to stare at the dot on the projection screen


Figure 6: The conflict between your right and left stare at the dot on the projection screen brains (hemispheres)


Here is a video of the split brain patient ‘Joe’:


Findings: In Sperry’s experiment when pictures of various objects were projected to the right of that spot, they could name the object. And, with their right hands they could pick them out of a group of hidden objects. However, when pictures of objects were shown on the left side of the screen, something changed. Patients could pick out the objects by feeling them with their left hands, but they couldn’t say what the objects were! In fact, when asked objects they saw on the left side of the screen, split brain patients usually said “nothing”. So, when Joe focuses on a point (right visual field), everything to the right of the point goes to his left brain, the area associated with language and speech. When a word or picture is flashed on the right side, Joe is easily able to name it. When information to the left of the point (left visual field) goes to the right hand side of his brain, Joe is unable to name the object but he is able to draw the object with his left hand (which is controlled by the right half of his brain).

This can be easily understood through a GAME:



Figure 7: Experiment on split brain patients


Figure 8: Another experiment on split brain patients



Conclusions: The different hemispheres have separate functions (left- language/right- spatial tasks). The mind is made up of several independent agents and they can carry out activities outside of our conscious awareness, they are integrated at one point, which Gazzaniga believes is in the left hemisphere. Part of the explanation for these strange results lies in the fact that nerves cross over before entering the hemispheres. The left cerebral hemisphere receives information only from the right side of the body and the right half of the visual field. So the left hemisphere can match an object shown in the right visual field with information received by touch by the right hand. Conversely, the right hemisphere of the brain receives information only from the left side of the visual field and the left side of the body. So, the right hemispheres can match an object shown in the left visual field with information received by touch from the left hand.



Figure 9: Description of the split brain and split brain patients’ experiment




Criticisms/ Evaluation (MECG): It was a natural experiment so there was a lack of control over variables. The participant’s mental abilities may have been atypical before the operation. There are also theoretical problems like; more recent research has revealed differences between the left and right handed people. This research was carried out on a right handed participant.

Why can’t split brain patients name an object shown in the left visual field?

For the great majority of people, language ability is concentrated in the left cortex of the brain. In most split brain patients, the right hemisphere of the brain cannot verbally identify the object that is “seeing” in the left visual field, even though the object can be picked out by touch using the left hand.
The results of these and other tests indicate that the two cerebral hemispheres not only are connected to opposite sides of the body, but also specialised in different functions. For example, damage to the left hemisphere often results to severe language problems, whereas similar damage to the right hemisphere seldom has this effect.



Split Brain Research

Right Brain vs Left Brain

The Social Brain

The Interpreter

Free Yet Determined – Michael Gazzaniga

What We Are – Michael Gazzaniga

The Distributed Networks of Mind – Michael Gazzaniga

The God Debate

Evolution of Mind and Brain