How to get ahead in science
The future of neurology lies in a room full of Tupperware in Belmont
by Alicia Potter
At 12:30 P.M. in Grand Junction, Colorado, a 70-year-old man dies. His
family immediately places a phone call: 1-800-BRAINBANK. Less than 24 hours
later, the man's brain, packed in a cardboard box, arrives at a three-story
brick building in Belmont.
The building is the Mailman Research Center at McLean Hospital, and the box is
headed for a suite of offices on the second and third floors. This is the
Harvard Brain Tissue Resource Center, which staffers -- and everyone else
associated with the center -- simply call the Brain Bank. It is the world's
largest clearinghouse of donated brain tissue. Brains arrive here, on average,
once a day; like most of them, today's shipment from Colorado is nestled inside
an ice-packed Styrofoam cooler, in a white plastic container, in two clear bags
tied with a red twist tie.
At the Brain Bank, this is what's known as a "fresh one." It glistens. Slick
with cerebral spinal fluid and blood, this pinky-beige hunk of braided tissue
looks, ironically, like something out of a joke shop. Its lacing of blood
vessels is a disconcertingly deep blue, and, though it weighs about the same as
a cantaloupe -- two and a half pounds -- the organ appears too big to fit
inside a human head. It feels firm, cold, slippery; it smells faintly of
The Brain Bank is one-stop shopping for the neuroscientist, a nonprofit whose
mission is to collect posthumously donated brains from around the country,
dissect them, then distribute the tissue to researchers studying neurological
disorders. It specializes in three categories of organs: healthy "normal"
brains; brains with neurodegenerative disorders such as Alzheimer's,
Parkinson's, and Huntington's diseases; and brains affected by mental
illnesses, specifically schizophrenia and bipolar disorder.
"The reason you need human brain tissue to study these disorders is that they
are uniquely human," says Stephen Vincent, a neuroscientist and associate
director of the Brain Bank. "Animal models are useful only to an extent. These
disorders are ours and ours alone."
Progress in the field has been remarkable over the past decade. The medical
world has seen exponential gains in knowledge about the biology of mental
illness, many of which are directly linked to Brain Bank tissue. More and more
scientists are flocking to the field, upping the demand not just for brains
with schizophrenia and bipolar disorder but for neurologically normal
"The brain is biology's last, vast frontier," says Francine Benes, the Brain
Bank's director. "And within brain studies, those aspects of the brain that
give rise to thinking and feeling, cognitive function, and our ability to
reason really constitute the final mystery of biological science."
The enthusiastic pursuit of these mysteries puts considerable pressure on the
Brain Bank, which must now hustle to feed the scientific phenomenon it helped
It's not an easy job. For one thing, the nondegenerated brains science wants
most are the hardest to come by. And beyond that, getting people to part with
their brains is like, well, getting people to part with their brains. Given the
fact that the brain is the very source of our individuality, the psychological
issues around brain donation are formidable. They're even more deeply
entrenched for the mentally ill and their families, who have witnessed
firsthand the brain's potential as a source for torment and tragedy. In these
cases, the resistance to donation is daunting, the situations delicate.
To meet the challenge, the Brain Bank is launching a big publicity push to
keep the organs coming. How it's going about this, though, is hardly
conventional: armed with collateral materials, brain-shaped tchotchkes, and a
singing spokesperson, the Brain Bank is embarking on perhaps the most morbid
public-relations effort ever. The Brain Bank doesn't just want to change your
mind; it wants to collect it, too.
The Brain Bank is already eerily good at its job. From its sunny
offices, it "harvests" about 350 brains a year and ships up to 7000 tissue
samples to a hundred labs around the globe. Its collection -- 22 shelves of
gray fillets floating in formaldehyde-filled Rubbermaid containers -- totals
about 4000 brains.
Amid the hushed halls and friendly atmosphere, you might not guess that
brain banking is stressful work. Several times a week, Stephen Vincent is
paged, sometimes in the wee hours of the morning, to help a family make the
arrangements for delivery of a deceased loved one's brain. Time is crucial: to
prevent any major deterioration or changes in brain chemicals that could affect
research, a brain must be shipped within 24 hours of death.
"It's difficult to wake up and call someone I've never spoken to before, in
some other part of the country, and talk to them about the recent death of
their family member," says Vincent. "Often they'll call us just as grandma gave
her last breath, and they're in the room with her."
But unlike traditional organ donation, where you might already have your
preference printed on your driver's license, brain donation isn't something
most people pre-register for (though it is an option for anyone over 18). In
most cases, the legal next of kin is the one who makes the decision to
From there, Vincent contacts whoever is handling the body -- be it a hospital,
medical examiner's office, or funeral home -- to arrange for a pathologist or
laboratory assistant to remove the brain. For brains within a three-hour drive
of Boston, the Brain Bank uses its own lab assistant, who collects them for
Brain removal is a pretty straightforward -- albeit cringe-inducing -- task.
The pathologist makes an incision at the back of the head, from the top of one
ear to the other; lifts up a flap of skin to access the skull; then uses a
special saw to cut through the bone. Once the top of the skull is removed, the
brain is visible and easily released. The pathologist takes the organ out,
replaces the top of the skull, brings down the skin flap, sews in some sutures,
and combs the hair neatly into place.
"You can't even tell," says Vincent.
Not only is brain removal surprisingly easy, but transportation of the brain
to the Brain Bank is, too. The Brain Bank employs its own courier, who
specializes in transporting organs for research or transplantation. And when
the Brain Bank knows ahead of time that someone will be dying shortly, it even
provides its own shipping materials.
The days when brains arrive are, of course, red-letter ones at the Brain Bank.
"We get pretty jacked up," says Vincent.
The brain that travels 2268 miles from Colorado is an Alzheimer's case.
It waits on a cork dissection board, oozing a rosy puddle, as research
technician Alex Elliott slips into a lab coat and snaps on surgical gloves.
"It's a nice one," says Vincent, eyeing the brain's plump cerebellum, its
cute, cinnamon-heart-like pituitary gland. "Go to it."
Elliott begins the dissection. He grades the brain on a scale of zero to four
in terms of its overall degenerative appearance -- color, firmness, consistency
-- and marks his impressions on a record sheet. He then bisects the organ with
one slice of a 12-inch blade; it halves as easily as a soft round of bread.
From here, the brain's right hemisphere goes into a formaldehyde-like
fixative; later, the Brain Bank's neuropathologist will study it for definitive
signs of Alzheimer's (the disease can be diagnosed for certain only on a
postmortem brain). When he has completed the examination, the family and their
physician will receive a report of his findings.
Next, Elliott begins carving the rest of the brain as if it were a very
tender, very fragile roast. The slices, about a quarter- to a half-inch thick,
are the spongy consistency of tofu. With a spatula, Elliott places them onto a
digital-imaging board to be photographed for the Brain Bank's Web page
(http://www.brainbank.mclean.org:8080/), all the
while recording notes on his data sheet, which by now is spattered with
"This is the best part of the job," he says, slicing into the occipital lobe.
"Every time I look at a brain I wonder how it works."
Elliott then cuts about 18 smaller pieces from the most-requested areas of the
brain, including the sea horse-shaped hippocampus, which is responsible for
memory and learning. Next he freezes the slivers of the brain with liquid
nitrogen and places them in baggies for storage in a freezer, set at a frosty
-180° Celsius. Later in the week, when the pathologist's report comes in,
the brain's dissected right hemisphere will join row upon row of specimens in
the Fixed Tissue Room.
In just 40 minutes, the gentleman from Grand Junction's mind -- 70 years of
memories, ideas, and emotions -- has become brain No. 4508.
In 1978, Harvard endocrinologist Edward Bird founded the Brain Bank as a
means of procuring fresh brains for his research on Huntington's disease. It
started small, collecting fewer than a dozen brains a year, most of them with
Huntington's. (Brain research being very sparing with its tissue use, some of
those early brains are actively studied to this day.)
Since then, some 100 brain banks have sprung up around the country, most of
them small collections specializing in a particular disorder. Only four such
centers are federally funded; the Brain Bank was the first and is by far the
largest, most active, and most broadly stocked.
The relationship between brain banks and the direction of neuroscience
research has always been symbiotic. At this point, whether the Brain Bank is
responding to or creating a need for such specific types of tissue is hard to
tell. But one thing is clear: progress in neuroscience is directly dependent on
the ability of the Brain Bank to provide not just brains, but the right kind of
It's certainly no coincidence that the neuroscience area that's seen the most
advances in the past decade -- the neurodegenerative diseases -- is also the
one with the most brain tissue available for study. Nearly a third of all
incoming brains are Alzheimer's brains; another 20 percent are
With treatments, and even cures, for neurodegenerative diseases well under
way, the Brain Bank is now hoping to provide the same kind of tissue supply for
mental-illness researchers, specifically those studying schizophrenia and
bipolar disorder. Such research has already undergone tremendous growth in the
past decade as new scientists enter the field, new technologies emerge, and new
cultural attitudes accept biology -- not bad parenting -- as the root of these
Nowhere is the shifting of the Brain Bank's focus more evident than in McLean
Hospital's appointment of Francine Benes as director (she succeeded Bird, the
founder, who retired three years ago). Benes is also the director of McLean's
Laboratory for Structural Neuroscience, which she established to study the
neurobiological basis for schizophrenia. Not surprisingly, given her
background, one of her goals for the Brain Bank is to surpass its typical
intake of 25 mentally ill brains a year.
"For schizophrenia research to be able to make the progress that has been made
in the study of other brain disorders, we need to have numbers equivalent to
theirs," says Benes, who estimates that mental-illness research lags about 15
years behind that on the neurodegenerative diseases.
The catch is that degenerated brains -- brains affected by Alzheimer's,
Huntington's, and so on -- are simply much easier to come by. According to
Vincent, the reason is that the medically aware baby boomers are quite open to
donating the brains of parents and grandparents afflicted with these disorders.
"The diseases are hitting the baby boomers both emotionally and financially,"
explains Vincent. "They're thinking, `Gee whiz, I certainly don't want this to
happen to me.' " Consequently, he says, these families are more likely to
do what it takes -- brain donation included -- to help scientists find the
cause of the disease and, perhaps eventually, a cure or treatment.
Finding nondegenerated brains -- and, specifically, mentally ill brains -- is
a trickier mission. The Brain Bank's current publicity push is aimed largely at
building awareness among the families of mentally ill people (see "A Mind Is a
Terrible Thing to Waste," right). Benes points out that postmortem brain tissue
is instrumental in determining the genetic links of mental illness, identifying
abnormal cell and neurotransmitter activity, and examining the role of prenatal
trauma and overall stress in the development of schizophrenia.
A mind is a terrible thing to waste
Last year, Katie and Gene (who asked that their last names not be used)
were in the audience of an Alliance for the Mentally Ill meeting outside of
Boston where Jill Bolte Taylor, the "singin' scientist," performed. A few
months later, their 26-year-old son, who had schizophrenia, committed
"For some reason I can't recall," Katie says, "I looked at Gene and thought,
'We should contact the Brain Bank.' " Her younger son pulled up the Brain
Bank's Web page, and the family made the call.
"The next couple of days were pure chaos for us," says Katie. "The donation
was the only thing we did that made utter sense."
However silly Taylor's shtick may be, Katie admits that it got her thinking;
in fact, she believes she never would have gone through with a brain donation
if someone had simply suggested it to her after her son had died.
"If you can laugh about an organ," says Katie, "it becomes just another organ.
You have a heart. You have a liver. You have a brain."
Katie and Gene are even discussing donating their own brains to the Brain
Bank. For researchers, this is a critical decision: to study the genetic links
of mental illness, you need not only the brains of the mentally ill, but also
those of their closest relatives.
It seems the Brain Bank's message has gotten through. Says Gene, "The brain is
no different from any other part of the body."
And, she adds, this is only the beginning.
What's next, Benes says, "is completely dependent upon the willingness
of the public to donate."
To fathom just what an uphill battle Benes faces, one needs only to
consider the words of research technician Alex Elliott when asked if he'll
donate his brain to science: "Hell, no! I'm going out with whatever I came in
The entire organ-donation business is used to such reactions. According to the
most recent study of organ donation, a 1993 Gallup poll, only about
37 percent of Americans report that they are very likely to donate an
organ at all -- and, by all accounts, the brain is low on that list. Says
Melissa Christie, a hospital donation coordinator for the New England Eye and
Tissue Transplant Bank, "Families feel it's morbid to take organs and tissues
from a loved one. They want that person buried in one piece."
Further complicating matters for the Brain Bank is that donation for research
doesn't have the altruistic appeal of donation for a transplant. For many,
giving a brain doesn't count as giving "the gift of life." "With
transplantation, the organ is going to another human being," says Christie.
"It's living in someone. Research means just cutting it up."
And then there's the obvious reason for passing up brain donation, as summed
up by Larry Sussman, clinical manager of the New England Organ Bank: "Cutting
open a head is much more disturbing than an abdomen."
But what the resistance to brain donation really comes down to is this: unlike
such tidy machines as the liver, the corneas, and the lungs, the brain is
personal. For centuries, we've believed it to be sacred, the very seat of the
"The heart or the kidneys don't have a particular personality associated with
them," says Vincent. "They're almost abstract. But the brain . . .
that's where Aunt Betty lived."
On top of these attitudes toward the brain, the families of the mentally ill
have their own set of reservations about brain donation that make their
contribution, while particularly valuable, particularly elusive as well.
According to Vincent, these families are often angry at the medical community
and bewildered by a disease that strikes in the prime of life (schizophrenia
and bipolar disorder usually appear anywhere from the young-adult years to the
mid-30s). The mentally ill endure so much despair when they're living, their
relatives feel -- why literally uproot their minds when dead?
In addition, the circumstances around the deaths of mentally ill people are
many times not conducive to brain donation: they die alone or in particularly
shocking and tragic ways. "People with these disorders often die young," says
Vincent. "Because of accidents, because of suicide, because of drug overdoses,
because of unusual circumstances."
He adds, "It's a different kind of heartbreak."
And the brain, clearly, is a different kind of organ. That's what the
Brain Bank has decided in putting together its unusual marketing campaign to
reach the mentally ill and their families.
Subtlety, it seems, has fallen by the wayside, and the solemn intonations you
might expect have given way to a pitch that feels, at first, almost goofy.
Vincent wears a wristwatch imprinted with a brain and the Brain Bank's
toll-free number; he hands out magnets with little brains on them and the
slogan "From Knowledge Will Come a Cure." At his desk, he squeezes a
brain-shaped stress reliever; he intends to emblazon these with the toll-free
number and distribute them to "particularly helpful" pathologists and medical
personnel. Try that with a liver.
"Humor helps cut through some of the tension," says Vincent. "I find that even
with us here dealing with this on a daily basis, you really never get used to
it. Dealing with human body parts, particularly the brain, evokes a natural
The Brain Bank does rely on more-typical marketing tactics -- an attractive
Web page, a new newsletter, several donation-registration brochures, a booth at
the annual Society for Neuroscience conference -- but it has found that its
most effective efforts are the most lighthearted.
Jill Bolte Taylor, the former associate director of the Brain Bank and an
accomplished schizophrenia researcher, is now its national spokesperson. For a
little more than a year, she has been on the road to about 15 cities across the
country making presentations about brain donation to family support groups,
such as local Alliances for the Mentally Ill. She also attends major
conferences, such as that of National Alliance for the Mentally Ill.
Oh, and she sings.
Taylor calls herself the Brain Bank's "Singin' Scientist." With her guitar and
her cowgirl twang, the Indiana-based neuroscientist teaches audiences about the
importance of brain research, then warbles a few rounds of brain songs. There
are three on her set list right now: "I'm a Brain Banker," "Advocates for
Humanity," and a rap number called the Dendrite Dance. ("Doin' the dendrite
dance! Stimulate me!")
Taylor laughs. "Some people have to hear about brain donation five or six
times before they stop freaking out," she says.
Much of Taylor's knowledge about the brain comes not just from the lab but
from her own life. Taylor's brother was diagnosed as schizophrenic when he was
24 years old. Two years ago, at age 37, she suffered a stroke when a
golf-ball-size blood clot blocked the language center of her brain. She lost
all ability to communicate. After an operation and therapy, Taylor has
recovered her speech; however, she has permanently lost the ability to
Taylor is shrewd about the fact that she is a living, breathing example of the
resilience of the brain and the effects of brain research. "This stroke's been
a great thing!" she says.
One day soon, she hopes to write a book about her experiences. But Taylor
doesn't see the memoir as simply a chance to share her story: as with
everything she does, it seems she regards it as a chance to get more brains,
both those of the mentally ill and those of the neurologically normal. It's the
Brain Bank's big chance, she explains, to infiltrate the mainstream. Already,
she's seen the number of donations from the mentally ill jump from five brains
a year to the current 25.
"I go for the big numbers," says Taylor, who hopes to harvest 100 mentally
disordered brains a year. "Shoot, I told [Dr. Benes] my goal in life is to
have more brain tissue than she knows what to do with."
Taylor's ability to do that will have ripple effects in neurobiology. A
steady supply of brains, says Vincent, means a steady supply of scientists
gravitating to the field. That means better research in the long run -- but for
now, it means a continuing struggle in that building in Belmont.
"We find that if we drop off our effort in the area of mental-illness
collection at any point," says Stephen Vincent, "the number of brains very
quickly and dramatically drops off."
If they can keep the numbers up, this year Benes and her lab staff will begin
to study the extent of the role heredity plays in the onset of schizophrenia
and bipolar disorder. The study, if it's successful, may give new credence to
the argument that genetics outweigh environmental factors in the development of
these diseases -- and thus help change the way mental illness is studied.
Down the road, the Brain Bank's outreach to the families of the mentally ill
could influence brain donation for other disorders, including major depression,
obsessive-compulsive disorder, and panic and anxiety disorders. Currently, very
little tissue for studying these afflictions is available.
"This is a precious, precious commodity that's not easy to come by," says
Laura Lee Hall, director of research for the National Alliance for the Mentally
Ill. "The fact that so much tissue has already been gathered and distributed
already speaks to how important a resource it is. At this point, there's really
no other way of understanding these disorders; the fundamental treatment
advances are going to come from this type of biology."
Ultimately, increasing the flow of normal brains will be key to advancing
neuroscience's general understanding of not just how the brain breaks down, but
also how it works in the first place. Despite centuries of inquiry, our ability
to think, feel, and create remains a mystery.
"A tremendous void exists in our overall knowledge of how the brain works,"
says Stephen Vincent. "As much progress as there's been, there are still
unanswered questions. Then there are those questions we haven't even asked,
because we don't know enough now to ask them."
He understands that the brains won't start pouring in overnight; getting
people to embrace brain donation will take some time. Still, he's confident
that the packages will arrive.
"We always get our brain," he says.
Alicia Potter can be reached at firstname.lastname@example.org.