Let me start by saying that these chapters were extremely interesting. So Damasio has laid out some systems that, when damaged, severely affect a person’s ability to plan and decide in social and personal situations. The systems play an important role in the processing of emotions. Somehow processing and understanding emotion is integral to our ability to make real life decisions. Having said that, I found this information to be disturbing as well. The evidence Damasio has presented is detrimental to our conception of personhood. Brain damage can do more than affect certain cognitive capacities like speech or memory. It affects that subjective thing we call “personality”-- something we’ve assumed has a certain degree of permanency. But the stories of Phineus Gage and Elliot indicate that brain damage can affect these subjective aspects more than we thought.
What bothers me is that the picture this paints of us is deterministic and reductionist. We are a combination of our machinery and the physical stimuli that go into shaping that machinery. If one part breaks, (like this decision making network) our entire personhood changes. I suppose this reductionism would be ok if we could fix our machinery, and while sometimes this is possible, most of the time it is extremely difficult to fully regain lost functions.
This brings me to another point. Neuroscientists have discovered that our brains are plastic. This means that, given the proper stimuli, brain maps can be rewired and the connections between neurons can either be strengthened or weakened. For instance, stroke victims who have suffered damage to those areas involved with language have been known to regain many of their language skills during rehabilitation. The victim's brain rewires itself; the speech center moves to a different area. I wonder if that same plasticity could be achieved in patients like Phineus and Elliot. Could their brains have rewired themselves to make up for their deficits given the proper therapy?