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Do Brain Implants Change Your Identity?

The first thing Rita Leggett saw when she regained consciousness was a pair of piercing blue eyes peering curiously at hers. “I know you, don’t I? she said. The blue-eyed man replied, “Yes, that’s right. But he didn’t say anything else, and for a moment, Leggett just wondered and stared at him. Then it came to him: “You are my surgeon!”

It was November 2010 and Leggett had just undergone neurosurgery at the Royal Melbourne Hospital. She remembers a wave of loneliness as she waited alone in a hotel room the night before the operation and the fear she felt upon entering the operating room. She worried that the surgeon would cut her hair down to the waist. What am I doing here? she had thought. But just before the anesthesia set in, she recalls, she was like, “I deserve it.

Leggett was forty-nine years old and had suffered from epilepsy since birth. During the operation, her surgeon, Andrew Morokoff, had placed an experimental device inside her skull, part of a brain-computer interface that it was hoped would be able to predict when she was about to have a seizure. The device, developed by a Seattle-based company called NeuroVista, had entered a testing phase known in medical research as “the first in humans.” A research team from three large Melbourne-based epilepsy centers had selected fifteen patients to test the device. Leggett was patient 14.

His fits had taken many forms. At school, she went out to the zone, only coming when a teacher threw something at her or her classmates laughed at her. Once, as an adult, she was drying dishes when, with a little cry and without warning, she sent a plate flying through the air and then, oddly enough, managed to catch up with it. Not all seizures were so light. There was a time when she fell down the stairs and woke up a few days later in the hospital, her jaw so shattered that surgeons had to take a piece of her rib to reconstruct it. Leggett was a single mother of four and, another time she was hospitalized after a violent seizure, her teenage sons were accused of beating her.

When Leggett’s neurologist asked her if she wanted to participate in the NeuroVista trial, she didn’t hesitate. Two months later, she was in the operating room with a small hole pierced in her skull. Morokoff had carefully braided her hair, so that she lost as little as possible. Once he made the hole, he slipped a cross-shaped silicone strip inside and placed it on the surface of his brain. Sixteen electrodes were dotted around the strip, and Morokoff threaded them under Leggett’s skin, behind his ear, and down his neck to connect with a device he had implanted in his chest. This device would receive the data recording Leggett’s neural activity and wirelessly transmit it to an external processing unit, which she was supposed to keep with her at all times.

The outdoor unit was the size of two flip phones stacked together, and it took some getting used to. If the system predicted that a seizure was imminent, the unit would warn it with a red light and beep, even if it found the beep uncomfortably loud and turned off the sound. The company had her try carrying the device on a shoulder strap, which annoyed her, or in a small holster on a belt, which worked best. She was told to keep a journal, noting each time she had a seizure.

While Leggett was acclimating to the device, the device was actually acclimating to her. The electrical signals detected by the device in his head were transmitted to a lab, where a group of computers began to read patterns of his neural activity, building an algorithm to suit his needs.

Initially, the readings recorded by the devices of NeuroVista patients were so strange – unlike normal brain activity or typical epilepsy patterns – that the trial was almost abandoned. Later, the researchers realized that the brain reacts simply after being altered – the electrical equivalent of a postoperative wound. This disturbance subsided after a few months, and then the learning of the system began. After the device registered perhaps half a dozen typical Leggett seizures, researchers were able to refine the algorithm on the unique electrical signatures of his brain, preparing the interface to go from observation to observation. prediction.

The first time the device sent an alert, Leggett was at the hairdresser a few blocks from her house. The outdoor unit displayed a white light, then a red light. She still remembers the shock – the strangeness of having a machine communicate with her and tell her what was going to go through her head. He had been told that the device could warn him about fifteen minutes before a seizure occurred. This gave her time to leave the barber and safely go to bed at home.

Scientifically, the NeuroVista trial was successful, validating its underlying concept and generating a wealth of useful data. It was also successful for Leggett, but in a deeper and more complex way than she or the researchers had anticipated. The goal was simple: to improve his life by giving him more control over his condition. The effect, however, had been to make Leggett feel like an entirely new person. She had never had a self she could trust before. When I spoke to her, she spoke of the device as if it were a partner. “We were calibrated together,” she said. “We have become one.”

It’s almost a quarter of a century since the FDA first approved the use of a deep brain stimulation device – to treat essential tremors and advanced Parkinson’s disease. Today, at least two hundred thousand people around the world, suffering from a wide range of conditions, are living with a neural implant. In recent years, Mark Zuckerberg, Elon Musk, and Bryan Johnson, the founder of payment processing company Braintree, have all announced neurotechnology projects to restore or even improve human capabilities. As we enter this new era of extra-human intelligence, it becomes evident that many people develop an intense relationship with their device, often with profound effects on their sense of identity. These effects, although still little studied, appear to be crucial for the success of a treatment.

The human brain is a small electrical device of supra-galactic complexity. It contains a hundred billion neurons, with many more links between them than there are stars in the Milky Way. Each neuron works by passing an electrical charge along its length, which causes neurotransmitters to jump to the next neuron, which in turn ignites, usually in concert with thousands of others. One way or another, human intelligence emerges from this constant and thrilling choreography. How it happens remains an almost total mystery, but it has become clear that neural technologies will only be able to synchronize with the brain if they learn the steps of this dance.

For three years after his operation, Leggett lived happily ever after with his device. But in 2013, his neurologist gave him bad news. NeuroVista ran out of funding and went out of business. Leggett’s neural device should come out.

In January 2020, towards the end of the Australian summer, I drove fifty kilometers along the Riddoch Highway, past pine groves and secluded estates, to the small town of Penola, South Australia. It was a hot, dry day, but although fires are burning in most countries, they had not made it here. Rita Leggett lives on the outskirts of town in a lovely colonial-style house. Behind him, a gnarled gum tree more than a hundred years old spreads its branches over the old tracks of a disused railway.

Now in her late fifties, Leggett wore her long hair in a dancing bun. She was lively, oscillating between wacky jokes and a startling sincerity that seemed born out of a lot of pain. As she told me her story, I noticed her long fingers continuously moving, twisting, squeezing and pointing as she spoke. Born in 1961, the first of six sisters, she grew up in a small town in Victoria. Her father left the family when she was nine, and she remembers her mother driving her back and forth on many long trips to a children’s hospital in Melbourne. At school, Leggett had no friends and was often bullied because of his epilepsy. She never understood why people were mean to her because of something she couldn’t control. She wanted to hide all the time.

When she was twelve, a miracle happened: the seizures stopped and her doctors, after watching her for a while, told her that she no longer needed to go to the hospital. “I was normal,” she recalls. “Wow!” She left school at sixteen and quickly found a job at Target, saving her money to buy a car. But one day, when she was eighteen, she woke up confused and sore on a stretcher in the locker room at work, not knowing how she got there. The seizures were back and from then on she had one every week or so. They would only last a few minutes, but she never knew when they would come. She couldn’t drive or swim. She has seen many different neurologists and tried many drugs, none of which worked.

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