NOTES FROM ACADEME

5,455 Brains and Counting

By LILA GUTERMAN

Belmont, Mass. USA.

The phone has been ringing all morning on Patricia A. Georgopoulos's desk, but the most important call comes around 10 a.m. "Samuel Curry. What time did he die?" she asks. "What's his diagnosis?"

Ms. Georgopoulos is the administrative coordinator for the world's largest brain bank, located at McLean Hospital, a psychiatric teaching facility of Harvard Medical School. It's her job to talk to prospective brain donors and their families as well as to coordinate, when donors die, the addition of their brains to the collection of more than 5,400.

That's what she's doing now, talking to the pathologist who will remove the brain and deliver it.

Ms. Georgopoulos finds Mr. Curry's paperwork. It dates from 1997, so she needs to make sure his wife still wants to donate his brain. It would be an important addition to the collection because Mr. Curry, 83, had bipolar disorder. The 12 staff members of the Harvard Brain Tissue Resource Center, as the brain bank is formally known, would like to have more brains of people who suffered from psychiatric diseases so that researchers can study the tissue to tease out the causes of mental illness.

Ms. Georgopoulos's voice shifts from animated to consoling when she speaks to Mrs. Curry. "Our condolences to you and your family," she says. "I certainly am very grateful to you for this."

This extraordinary act of selflessness, of donating one's own or a relative's brain, comes from a belief in the power of research, asserts Francine M. Benes, the bank's director. "Families that have a loved one with Alzheimer's disease think about research, and they think about brain donation."

The brain bank has far more difficulty recruiting healthy people as brain donors. But they're key to research: Scientists need to compare healthy brains to diseased ones.

Psychiatric cases are difficult to recruit, too, in part because of a lack of trust in scientists. Decades ago, patients and their families were alienated by psychiatrists, says Dr. Benes. "They were told that their loved ones had schizophrenia because of poor mothering. The field has never really been forgiven for that."

Also, many people still don't think of psychiatric diseases as brain disorders. But they are. Research on postmortem tissue has shown that schizophrenic brains seem to have miswired circuits of nerve cells. To do such research using brains from this collection, scientists send proposals to the brain bank requesting tissue from specific regions of brains with various disorders. A committee of scientists at the brain bank evaluates the proposal based on scientific importance, federal funding, and the productivity of the researcher making the request. Some proposals, such as those requesting tissue from people with autism or Tourette's syndrome, are sent to outside experts.

Dr. Benes predicts that research on brain tissue from psychiatric patients like Mr. Curry could lead to therapies in 10 to 20 years. That's why the brain bank, which has been in operation since 1978, has made psychosis one of its specialties, which also include Huntington's and Alzheimer's diseases.

Right now, though, the focus is on the latest deposit, Mr. Curry's brain. "We're always fighting the clock," Dr. Benes says. The sooner a brain gets cut up and frozen or chemically fixed, the more lifelike it will be for researchers who study it, because less degeneration will have occurred. And because death has no conception of time of day, one staff member is always on call, ready to handle a brain donation.

Mr. Curry's brain arrives just before 1 p.m., on a bed of ice inside a white plastic bucket. His brain is not tagged with his name (which has been changed for this article). Henceforth, it will be known only as 5,455.

George Tejada, the assistant director for tissue processing, suits up in a paper lab coat, paper booties, lab goggles, and double rubber gloves, tucking his sleeves into the outer pair. He explains that he's protecting himself from the brain's blood.

He lifts the brain out of the bucket and removes three layers of clear plastic bags. In his hands is an organ that just five hours earlier was creating thoughts and coordinating a living man's biological processes.

The brain is pinkish beige, squishy, and covered with a thin veneer of blood. Mr. Tejada holds it gently, as though cradling a baby. He weighs the brain. Three pounds of the world's most precious meat.

Using a 15-inch carving knife, Mr. Tejada carefully slices the brain lengthwise, dividing the two hemispheres. He leans in to point out the olfactory bulb to a visitor who is more taken by the brain's strong musty odor.

Mr. Tejada uses tweezers to pull away a network of blood vessels from the brain's exterior and then wields a scalpel and scissors to remove the hippocampus and amygdala, which play central roles in emotion. As he cuts, blood slowly drips off the cork cutting board onto a metal tray that ends in a spout into the sink. He puts the brain parts into a jar of formaldehyde to preserve them and stores the jar in a refrigerator. The rest of the right hemisphere goes into a larger container of the chemical, where it will stay for a few weeks until one of the brain bank's two staff neuropathologists cuts it up and examines it for signs of cellular distress.

Mr. Tejada begins on the left hemisphere. Using his knife, he carves off a half-inch-thick slice from the front of the brain. With a razor blade, he cuts that slice into 10 smaller pieces, four of which he stores in jars of preservative. He flash-freezes the rest in liquid nitrogen, pressed between two Teflon-covered plates. Next, he moves to another lobe important to emotion, the cingulate gyrus. Once he has removed critical parts of the brain, he begins slicing what remains, front to back, into 16 sections. Each slice bears the brain's characteristic wrinkles and crevices. He photographs each one before flash-freezing it in a Styrofoam box of dry ice.

When he takes the slices of brain out of the dry ice and liquid nitrogen, they've turned opaque and creamy beige, like cheese. Each slice gets its own plastic bag, which he seals and puts on ice within a larger bag. By 2:10 p.m., he is done.

After washing, disinfecting, or discarding everything that brain tissue or blood has touched, Mr. Tejada stores the frozen half of brain 5,455 in one of two rooms full of freezers set at -80 degrees Celsius. Each freezer contains 300 brains. Each room also contains one empty freezer as backup in case another fails.

The chemically preserved right hemisphere will end up in the brain bank's most famous room. Here, brains stored in 60-ounce Freezette Food Saver containers line floor-to-ceiling bookcases. The beige slices of brain float in liquid of various shades of yellow.

Dr. Benes picks up a container. "Here's the final resting place for old fifty-three eighty-nine," she says chummily. Confidentiality is so important to the brain bankers that they won't reveal which famous brains they hold. "One has to resist the urge to be voyeuristic," she says. The famous brains are assigned a number and treated just like the others.

Someday, hers may be one among the many. Though she says she has never considered her brain's fate, Dr. Benes guesses she probably will donate it.

Ms. Georgopoulos says she'd like to donate her brain but doesn't think her husband would consent. "Every time I have to threaten my husband," she says, "I tell him I'm gonna donate his brain."