By Chris Kahn
There was something wrong with the schoolteacher with the headache - doctors could see that from the start.
Although charming and intelligent, the 40-year-old man couldn't stop leering at female nurses. He had been in trouble with the law for sexual advances toward his stepdaughter, and now he was talking about raping his landlady.
University of Virginia Medical Centre neurologists Russell Swerdlow and Jeffrey Burns had never seen a case like this.
| 'Some people simply don't have the frontal lobe capacity to stop what they're doing' |
The man had an egg-sized brain tumour pressing on the right frontal lobe. When surgeons removed it, the lewd behaviour and paedophilia faded away. Exactly why, the surgeons cannot quite explain.
"It's possible the tumour released some pre-existing urges," Burns said. "But that's a tough debate, we just don't know."
Continues Below ↓
The outcome raises questions not only about how tumours alter brain function, but also how they can influence behaviour and judgment.
Daniel Tranel, a University of Iowa neurology researcher, said he had seen people with brain tumours lie, damage property, and, in rare cases, murder.
"The individual simply loses the ability to control impulses or anticipate the consequences of choices," Tranel said.
| 'I've seen them make people hyperactive, forgetful, apathetic' |
Dr Stuart Yudofsky, a psychiatrist at the Baylor College of Medicine who specialises in behavioural changes associated with brain disorders, has also seen brain tumours can bend behaviour.
"This tells us something about being human, doesn't it?" Yudofsky said. If one's actions were governed by how well the brain was working, "does it mean we have less free will than we think?".
It's a question with vast implications in the criminal justice system.
The United States Supreme Court has ruled that executing mentally retarded murderers is unconstitutionally cruel because of their diminished ability to reason and control urges.
Chris Adams, a death penalty specialist for the National Association of Criminal Defence Lawyers, thinks the next logical step would be to exclude people with brain tumours.
"Some people simply don't have the frontal lobe capacity to stop what they're doing," he said.
Human behaviour is governed by complex inter-
actions within the brain. But scientists think most "executive functions" - decisions with serious consequences - are controlled within the frontal lobes, the most highly evolved section of the brain.
Tumours in that area can squeeze enough blood from the region to effectively put it to sleep, dulling judgment in a way that's similar to drinking too much liquor.
Only in rare cases would the tumour turn the person to violence or deviant behaviour on its own, Tranel said.
Dr Patrick Kelly, chairperson of the department of neurosurgery at New York University Medical Centre, said he had never seen a tumour turn someone into a paedophile. "I've seen them make people hyperactive, forgetful, apathetic," he said. "And it usually takes a fairly extensive tumour to do that."
The Virginia teacher did not respond to written interview requests through his doctors. But according to his case report, which Swerdlow and Burns wrote up in the Archives Of Neurology, the man did not remember having abnormal sexual urges for most of his life.
Eventually he couldn't stop himself, telling doctors "the pleasure principle overrode" everything else. When he started making subtle advances on his young stepdaughter, his wife called police. He was arrested.
The man was convicted and failed a 12-step rehabilitation programme for sexual addiction because he couldn't stop asking for sexual favours, according to the case report.
The day before he was to be sentenced to prison, the man walked into the hospital with a headache. He was distraught, Swerdlow said, and contemplating suicide.
He was "totally unable to control his impulses" Burns said. "He would proposition nurses."
A scan revealed the tumour and it was cut out days later.
The man's behaviour began to improve. The judge allowed him to complete a Sexaholics Anonymous programme. The man eventually moved back home.
About a year later, Swerdlow said, the tumour partially grew back and the man started to collect pornography again. He had another operation last year, and his urges again subsided.
- This article was originally published on page 15 of Cape Argus on July 30, 2003
|
StumbleUpon
Reddit
Digg
Delicious
Newsvine
Facebook
muti
Twitter
