From the Editor

The dark side of the human brain

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When perturbed, a healthy brain that can plan and achieve much good is capable of carrying out a heinous crime



On July 20 of every year, I recall the transcendent wonder I felt on that day in 1969 when the entire world and I were glued to our television sets, witnessing one of the greatest achievements in the history of the human race: American astronauts landing on the moon and beaming pictures of their extraordinary celestial expedition to the billions of earthlings sitting on the edge of their seats.

Every year on July 20, I ponder the supreme and brilliant abilities of the human brain that transformed walking on the moon from an absurd fantasy to a thrilling reality. After becoming a psychiatrist, trained to observe everything through the prism of mind and brain, the moon landing represented the zenith achievement of the divinely evolved human neocortex, especially the prefrontal lobe of President John F. Kennedy, who established that lofty goal, and the advanced brains of thousands of NASA scientists and engineers, who set out to fulfill that towering expectation in less than a decade. That’s why every year on July 20, my abiding faith in the limitless capacities of the human brain to do great things is confirmed and reinforced.

However, this year was different as July 20 took on a much darker meaning. The tragic shooting in Aurora, CO that killed 12 people and wounded 58 others—perpetrated by the bizarre machinations of a graduate school student who had been receiving psychiatric treatment when he suddenly dropped out—rudely reminded me how, like the moon, the human brain has a dark side. A healthy brain that can envision, plan, and execute a magnificent moon landing is capable, when perturbed, of carrying out a dreadfully heinous crime. So henceforth, July 20 always will remind me of the zenith vs nadir dichotomy of the human mind potential in health and disease.

As a longtime academic psychiatrist, I have repeatedly witnessed the tragic disability my patients suffer when the frontal lobe—the most advanced component of their brains— becomes seriously impaired, rendering them dysfunctional. Unless driven by an intense delusion or command hallucinations, patients with schizophrenia rarely commit a murder. However, the media often has linked psychosis with violent crime, whether in movies1 or in news reporting, which has led to public misconception that every person suffering from psychosis is a potential mass murderer. The truth is that the vast majority of murders are committed by nonpsychotic criminals with severe antisocial traits.

Because of the shocking killings in Aurora, July 20 may become an annual reminder that perpetuates the unfair and ignorant notion that mental illness always is associated with horrendous crimes. That would further darken the discriminatory stigma of mental illness and may foster a hatred of and aversion to mentally ill individuals, the vast majority of whom are law-abiding citizens. Even the legally mandated “not guilty by reason of insanity” defense is being described as a spurious “excuse” and is under assault, which may lead to death sentences for medically ill persons whose actions are triggered by a severe brain pathology that impairs judgment and distorts reality testing of what is right or wrong.

The devastated families of the victims also are very much on my mind. For them, July 20 will become a dark anniversary of how their loved ones—most of whom were in the prime of life—lost theirs lives while watching a movie called The Dark Knight Rises. Their annual grief on July 20 will for many years reopen the deep wounds inflicted on their souls.

In the future, on July 20 I will no longer be merely inspired by the human brain’s potential for achievements. I now also will remember the potential for despicable and murderous actions when a sickened human brain and its convoluted mind go terribly awry. As an academic investigator dedicated to finding a cure for schizophrenia and related disorders, I regard the tragic events in Aurora on July 20, 2012 as another call to escalate the commitment of researchers to restore normalcy to the blighted brains of those afflicted by this cruel disease, or, better yet, to ultimately discover how to prevent schizophrenia from developing. Only then will the darkness of severe mental illness finally ebb and vanish.

Editor's Note: This editorial was written before Neil Armstrong, the first man to walk on the moon, died on August 25, 2012.

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