As we saw yesterday, Dr Robert Galbraith Heath was a man of extraordinary curiosity – and in a position to follow his muse wherever it took him, or have one of his many subordinates do so on his behalf. Much of his life was devoted to exploring his theory that he could cure schizophrenia and other mental illnesses by delivering targeted electric pulses to the “septal” region of the brain’s subcortex, by means of electrodes through the skull. But while septal stimulation was the constant of his career, he engaged in an enormous variety of other work, publishing at least 425 papers.
Among these were his efforts to treat gay men by turning “repugnant feelings ... toward the opposite sex” into pleasurable ones – and similar work on “frigid women”. He experimented with dripping drugs deep into the brain down tiny pipes called cannulae, targeting the same regions as his electrodes. He tested a ‘brainwashing’ drug called bulbocapnine for the CIA, on both animals and (although he denied it for decades) on a human prisoner, as a small part of the vast and largely illegal “MK-Ultra” programme to explore the limits and limitations of the American body.
He talked a suicidal patient down from a roof. He injected horseradish peroxidase into the brain to see how it carried chemicals. He gave a talk to the army on electrical stimulation of the brain, after which his department was contracted to test psychoactive drugs on prisoners: the resulting paper, from 1957, is as macabre and gripping as the studies involving B-19, complete with detailed descriptions of the patients’ behaviour and hallucinations.
In 1972, the New Orleans Times-Picayune newspaper reported that Heath had been able to “record septal activity resulting from alcohol, tobacco, amphetamine, marijuana and sexual orgasm”. At around that time, he began testing the effects of marijuana on monkeys by blowing smoke into their cages: the equivalent of 250 joints a day. “Memo to the parents of New Orleans,” ran the resulting report in the Times-Picayune in 1974. “If you’ve been trying to persuade yourselves that the ‘pot’ that ‘Junior’ is smoking isn’t harming him, listen to this.” Marijuana, Heath claimed gravely, could cause brain damage, respiratory damage – and erectile dysfunction.
For all the volume and variety of his work, Heath’s contemporary reputation rested on one particular discovery – again the product of his work on the septal region. As well as stimulating the schizophrenic brain, Heath was studying it. He wanted to know what was different about the tissue, the chemicals, the genes that caused the anomalies he had found. Examining blood samples and brain matter from people with schizophrenia, he discovered a mysterious substance he called taraxein, which seemed to be generated in the septal area.
This was, he dramatically announced in 1956, not a by-product of schizophrenia: rather, it seemed to be its cause. If you took a serum of taraxein and injected it into monkeys, they started showing schizophrenia-like symptoms. A couple of hours later, they were completely back to normal. When he tried it on people, the results were the same. The report caused a sensation.
And in 1967, Heath doubled down, claiming that further investigation had revealed that taraxein was in fact an antibody produced by the brain. The first line of Tulane’s press release suggested this might well be “one of the most significant scientific advances in the field of psychiatry”, and it was hard to disagree. What Heath had discovered – as the global media eagerly reported – was that people with schizophrenia were, in effect, allergic to their own brains. There was talk of a Nobel Prize.
There was just one problem: taraxein didn’t exist. Or if it did, no one else could find it. Even some of the technicians charged with isolating and purifying the substance became convinced that it didn’t actually exist. James Eaton, a colleague of Heath’s who witnessed a failed demonstration for visiting dignitaries, says it became clear that the patients were acting crazy because that’s what they realised Heath wanted: when the “taraxein” was administered by other doctors, their behaviour was unchanged.
This controversy damaged Heath’s national reputation – already imperilled by a feud with Seymour Kety, who as the first director of the National Institute of Mental Health ensured that Heath was always denied federal funding for his work, and had to go cap in hand to private donors. But it did not change things in Louisiana: Heath continued to be given awards and positions, to be respected and venerated.
Yet a wider backlash against psychosurgery was stirring. It wasn’t just lobotomy, although that was increasingly discredited: there seemed to be a laundry list of damaging, dangerous or disturbing treatments being carried out around the US. Fears of mind control and brainwashing, stoked by the success of the film The Manchurian Candidate, cast suspicion on any research involving drugs and electrodes to manipulate the mind.
In 1972, a campaigning psychiatrist called Peter Breggin published an essay warning of the dangers of psychosurgery, including Heath’s work, which a sympathetic Congressman inserted into the Congressional Record. It caught the attention of Todd Ochs, a member of the Medical Committee for Human Rights (which provided care for civil rights activists across the South) who was working at a free clinic in the French Quarter of New Orleans – and as a paramedic at Charity Hospital. Ochs and his committee took up the cause, and he alerted his friend Bill Rushton, a gay rights campaigner and investigative reporter for the local Vieux Carre Courier.
The resulting piece, “The mysterious experiments of Dr Heath: in which we wonder who is crazy and who is sane”, was a broadside against Heath’s work. Published in 1974, it not only told the story of patient B-19 but also claimed that nurses at Charity would hide their patients from Heath’s lackeys when they came sniffing round for subjects. Heath attracted further negative publicity in Alan Scheflin and Edward Opton’s 1978 book The Mind Manipulators.
The most damaging critique, however, came in Elliott Valenstein’s 1973 book Brain Control. Unlike the others, Valenstein – now professor emeritus of psychology and neuroscience at the University of Michigan – was a member of Heath’s own profession. And he argued not that Heath was a monster, but simply a bad scientist.
Valenstein pointed out gently but firmly that because of Heath’s lack of controls, his habit of reading what he wanted into the data, and other experimental errors, much of his work was simply invalid. “My criticism of Heath,” he says today, “was really that he didn’t seem to know how to test his own conclusions for verification. He was always interested in results that were spectacular – like finding some protein in the brain that would evoke schizophrenia. He’d published papers of that sort but never really looked for alternative explanations, never tested the reliability of his findings, was very willing to rapidly publicise his findings, so that he was quite unreliable.”
Some people Valenstein talked to told him that even Heath’s vaunted pleasure centre wasn’t all it was cracked up to be: “[They] said that many of these patients were just stimulating their own brains because they thought that’s what he wanted them to do – it wasn’t really a pleasurable experience for them.” Heath admitted in print that septal stimulation had different effects on different people – generally serving to amplify rather than create emotions, especially in the case of arousal, and having much less effect on those who were already feeling happy and contented.
Despite the growing controversy, Heath retained his position and prestige – but Tulane was becoming increasingly worried about its reputation. In the early 1970s, donors to fund the electrode studies became harder to come by, as did official approval for procedures. Heath even took a brief sabbatical while the bad publicity died down.
Yet in terms of his ambitions, and his convictions about the brain, nothing of substance changed. Psychiatrist Marilyn Skinner remembers, as a young resident at Tulane, being given the case of a 22-year-old woman: “She was wild, you couldn’t get close to her, she was literally scarred – her whole body was a scar, from her own cutting and burning. She was going to kill herself, and somebody else too.”
Heath decided to carry out a radical surgical procedure – but couldn’t get permission to do it in New Orleans. So he found a sympathetic hospital in California, and when the procedure took place, something amazing happened, Skinner says: “They basically severed the connections between the two hemispheres [of the brain]. And I’m not kidding you, she was a dream after that. She showed warmth, and gratitude – she was able to talk about her feelings, and what happened, and was no longer suicidal or homicidal.” That is the tantalising thing about Heath: sometimes, his wild ideas actually came off.
Heath retired as chairman of his department in 1980, after 31 years at the helm, although he continued working for some years afterwards. Even before his death in 1999, at the age of 84, his reputation outside Tulane had become tarnished. He was known, if at all, not as the man who was the first to map out the pleasure circuit, or as one of the earliest and most passionate advocates for the biological causation of schizophrenia (now the established orthodoxy), but as a man whose work seemed closer to science fiction than practical medicine.
To some, he was a monster, plain and simple. He used vulnerable patients to hone his theories, to no therapeutic benefit, causing many of them very significant harm. He tested psychoactive drugs on the unwitting.
Harry Bailey, an Australian doctor who briefly worked with Heath on his electrode studies, accused him of picking out African-Americans for his experiments because, as he put it, they were “everywhere and cheap experimental animals”. The patients would be wired up and given a little box and “just went around, ‘pop, pop, pop’, all the time, continuous orgasms”. A woman called Claudia Mullen even testified before Congress in 1995 that Heath had, when she came to him as a child patient, engaged in all kinds of unethical practices before handing her over to the custody of the CIA, where she was used as a sex slave. He has been accused of mind control, of barbarity, of “Nazi science”, of using prisoners in Charity, Jackson and elsewhere as his playthings.
Yet his former colleagues almost uniformly tell a very different story. “Other than my parents,” says James Eaton, “he was the most formidable mentor and leader and ideal that I had.” For John Goethe, another who worked with him at Tulane, “Nobody was more devoted to trying to find a cure for the people he felt medicine had neglected. He was in psychiatry and neurology rather than cardiology and dermatology because he felt ‘We’re not paying enough attention to these folks.’”
Yes, he was arrogant and temperamental – “It would be easy for him to win a contest to see who could divide a room quickest,” says Goethe – but he was also inspirational. In an obituary, fellow Tulane neurologist Leon Weisberg called him “a true visionary ... an extraordinary clinician, teacher, administrator, scientist and friend”.
How to reconcile these two Bob Heaths? Certainly, it is easy to cast doubt on the wilder allegations. Bailey’s quotes come from a long, rambling, drunken speech, decades after the event – and he himself was a genuine monster, whose “deep sleep” therapy, based on the idea that the human brain would be more malleable if the patient were plunged into a barbiturate-induced coma, killed dozens of people. In fact, given New Orleans demographics, African-Americans appear to have been under-represented in Heath’s electrode studies rather than the reverse.
As for Claudia Mullen, her social worker and champion, Valerie Wolf, had her licence revoked over claims that she had exploited her clients and encouraged them to believe recovered memories that turned out to be false. Wolf is now dead and Mullen has long been out of the public eye; Alan Scheflin, the Santa Clara law professor (and co-author of The Mind Manipulators) who validated her claims of CIA abuse, refused requests for an interview.
Heath may have gone to extremes, but he had many companions in excess. In 1963, a different group of scientists at Tulane started transplanting chimpanzee kidneys into humans. Lobotomies, deep sleep therapy, “insulin shock” – Heath’s electrodes were, in comparison, a relatively delicate intervention. He generally used them, he insisted, on incurably sick patients for whom all other treatments had been tried and had failed – although the B-19 case and others suggest that is not entirely true. And while he did map out the “aversive” areas of his patients’ brains (including “a site which, when stimulated, would turn on intense killing rage, instantaneously”), and carry out that experiment with bulbocapnine on the CIA’s behalf, he also claimed to have rejected a request from the CIA to study the brain’s pain centre.
Yet this, in an odd way, is precisely what makes Heath so fascinating, and his career so relevant today. He was not a villainous outlier, cackling to himself in a basement, but the respected head of a major university department, someone who was not only in the academic mainstream but had defined, at least for Tulane, what that mainstream was. His excesses, and his flaws, and his failures to accept his limitations, were therefore all the more significant.
Heath’s central insight – that schizophrenia was a disease of the brain rather than the mind – has certainly been vindicated, and triumphantly so. Much of his research, for example in mapping the pleasure circuit of the brain or monitoring it during orgasm, was pioneering. Yet his 425 papers have left a remarkably small imprint on the wider field. By the time he retired – and, in truth, long before – it was clear that much of his work had been rendered moot by advances in antipsychotic medication; the idea of there being one single, fixable cause for schizophrenia also ended up being simplistic and overly optimistic.
Scientists are now, again, attempting to use deep brain stimulation to treat mental illness – such as intractable and crippling obsessive–compulsive dsorder. But a recent profile of one of the leaders in the field, Emad Eskandar, claimed the practice had only begun in 1987. Heath’s use of deep brain stimulation 20–30 years earlier has been largely written out of the history of neuroscience.
To modern eyes, the B-19 episode is the most controversial of Heath’s cases – even though there is some pretty stiff competition. But what is striking in the contemporary reports is how few people, in comparison to his other electrode experiments, seem to have raised any objections.
Take Elliott Valenstein’s book Brain Control. In it, he did criticise the experiment – but for its method, not its motives. His argument was that “orgasmic reorientation” – a behavioural therapy programme based around masturbation – seemed to get equivalent results for much less effort. The basic idea that it was a psychiatrist’s duty to “cure” gay people went unquestioned. Homosexuality was, until 1968, formally listed in the diagnostic textbooks as a sociopathic personality disturbance, a fear of the opposite sex that was thought to result – just like schizophrenia – from childhood trauma. It was still listed as a ”sexual deviation” until 1973.
Speaking today, Valenstein acknowledges that “the attitude towards homosexuality at the time was very different from what it is now”. What was different about Heath’s procedure, he says, wasn’t that he was trying to “fix” homosexuality – many people, including Heath’s mentor Sandor Rado, were doing the same. Heath’s work, and other such biological approaches, were notable mostly because they seemed to offer an easier and more lasting solution than long-term therapy.
A few years ago, says James Eaton, he was interviewed about Heath’s work for a potential documentary. At the end, he was asked about Heath’s apparent crusade to wipe out homosexuality. “I said: ‘What are you talking about? I myself am gay. I’ve known I’ve been gay all of my life. Heath knew it too. And out of 44 or 45 fellows or residents, he made me his chief resident, and he trusted me until his death. Now why would he do that? He never once alluded to the fact that I was gay.’ And that floored them. It just floored them.”
And what about the young man, B-19? Did Heath’s “cure” actually work? In the paper he wrote with Charles E Moan, Heath claimed that B-19 – who he identified in contemporary interviews as a male prostitute – had subsequently had a 10-month relationship with a married woman. While he had also returned to homosexual activity, this had only happened twice, “when he needed money and ‘hustling’ was a quick way to get it when he was out of work”. Heath added that “such acting out was not intended to be a replacement for sex with females, which he indicates he is definitely motivated to continue”. In an interview in 1972, he went further, claiming that B-19 “has solved many of his personal problems and is leading an actively and exclusively heterosexual life”.
Mission accomplished, then? Not quite. While Heath’s electrodes may have stirred up arousal temporarily, they didn’t actually change the patient’s basic nature. “At least at the time I knew [B-19], it was less about whether he was homosexual or heterosexual. He was sort of asexual. He just wasn’t that interested,” says John Goethe. “It was clear to me ... that his life stressors were – some were related to sexual orientation, but most were not.” He drifted between jobs, and “was not a happy camper about a lot of things”. He adds that it was B-19 who approached Heath for help with his sexuality – rather than having a “cure” imposed on him in exchange for leniency over drugs charges, as suggested by Bill Rushton at the time.
The best place to find the truth about B-19 and Heath’s other experiments would be his archives, which are held by his old department at Tulane. But the university (which is a private institution) refuses to let anyone have access to them, even though researchers have in the past been allowed to view the films of Heath’s experiments held by Tulane. While I spoke to several of Heath’s former colleagues, those still working at Tulane itself refused to comment. With the assistance of Ken Kramer of PsychSearch.net, who investigates cases of psychiatric malpractice, I was able to track down Moan, Heath’s co-author on the B-19 paper, but he refused requests for an interview.
Yet from the available evidence, it is hard to disagree with the judgement of Alan Baumeister, a Louisiana State University psychiatry professor and the leading academic expert on Heath, that the Tulane electrical brain stimulation experiments were “dubious and precarious” not just by today’s standards, but by those of the time. “Heath, throughout the history of his work, justified what he was doing on therapeutic grounds,” says Baumeister. “He said that it was done for the benefit of the patients. But some of the things he did couldn’t conceivably have been done for the benefit of the patient.”
He may not have been a god, but Heath was clearly a man of extraordinary gifts and extraordinary charisma – yet one whose self-belief blinded him to the flaws in his theories and his methods. “He, like many doctors, did not see any ethical problems from what he was doing,” says Todd Ochs. “He was trying to help people. And in a way it makes it more sad and also more dangerous – self-righteousness is something that reason doesn’t address. He thought he was helping gay men, he thought he was helping schizophrenics, and that his research was going to be transformative.”
During his long career, Heath made many claims about what stimulating his beloved septal region could do. First he thought it could “wake up” the brain from a sleep-like state; then that it could be used to compensate for schizophrenics’ defective pleasure centres; or to detect and disrupt epileptic fits; or relieve chronic pain.
Even in old age, he was coming up with new ideas, arguing that transplanting septal tissue from one person to another could enhance brain function and ward off the effects of ageing and Alzheimer’s: he’d already done it in rats, he told a Tulane colleague in an interview in 1986, and they’d tried it out on squirrel monkeys just the day before.
Yet what Heath had, ultimately, was a procedure in search of a purpose. Like his patients with their metal boxes, he could do something to the brain – septal stimulation – that was strange and fascinating and enthralling and mysterious. So, like them, he kept doing it, again and again and again.
This excerpt first appeared on mosaicscience.com and is republished here under a Creative Commons licence
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