Essentials: Neuralink & Technologies to Enhance Human Brains | Dr. Matt MacDougall

Andrew D. Huberman (0:00)

Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health and performance.

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. And now for my discussion with Dr. Matthew MacDougall. Dr. MacDougall, welcome.

Matthew MacDougall (0:22)

Good to be here.

Andrew D. Huberman (0:23)

Just to kick things off, as a neurosurgeon and as a neuroscientist, could you share with us your vision of the brain as an organ as it relates to what's possible there? Surgeons tend to view the world a little bit differently than most because they like to fix and they like to mend. And in your case, have the potential to add things into the brain that don't exist there already. So how do you think about and conceptualize the brain as an organ? And what do you think is really possible with the brain that most of us don't already probably think about?

Matthew MacDougall (0:58)

The brain really is a collection of functional modules pinned together, duct taped together in this bone box attached to your head. And sometimes you see very interesting failure modes. So one of the most memorable patients I ever had was very early on in my training. I was down at UC San Diego and saw a very young guy who had just been in a car accident. We had operated on him. And as is so often the case in neurosurgery, we had saved his life potentially at the cost of quality of life.

When he woke from surgery with bilateral frontal lobe damage, he had essentially no impulse control left. And so we were called back by his 80-year-old recovery room nurse saying, you've got to come see your patient right away if something's wrong. And we walk in to see him, and he points at his elderly nurse and says, she won't have sex with me.

And, you know, it was apparent at that moment, his frontal lobes were gone, and that person is never going to have reasonable human behavior again. It's one of the most tragic ways to have a brain malfunction, but, you know, anything a brain does, anything from control of hormone levels in your body, to vision, to sensation, to, you know, the most obvious thing, which is muscle movement of any kind, from eye movement to moving your bicep, all that comes out of the brain. All of it can go wrong, any part of it or all of it. So, yeah, working with the brain is... the substance of the brain as a surgeon, very high stakes, but once in a while, you get a chance to really help. You get a chance to fix something that seems unfixable, and you have, you know, Lazarus-like miracles, not too uncommonly. So, it's extremely satisfying as a career.

Andrew D. Huberman (2:57)

Could you share with us one of the more satisfying experiences? Or what qualifies as satisfying in neurosurgery?

Matthew MacDougall (3:04)

Yeah. You know, one of the relatively newer techniques that we do is, you know, if someone comes in with a reasonably small tumor somewhere deep in the brain that's hard to get to, the traditional approach to taking that out would involve cutting through a lot of good normal brain and disrupting a lot of neurons, a lot of white matter, that, you know, kind of the wires connecting neurons.

Then the modern approach involves a two-millimeter drill hole in the skull down which you can pass a little fiber optic cannula and attach it to a laser and just heat the tumor up deep inside the brain under direct MRI visualization in real time. So you're, this person is in the MRI scanner, you're taking pictures every second or so. As the tumor heats up, you can monitor the temperature and get it exactly where you want it, where it's gonna kill all those tumor cells but not hurt hardly any of the brain surrounding it. And so not uncommonly nowadays, we have someone come in with a tumor that previously would have been catastrophic to operate on and we can eliminate that tumor with, you know, leaving a pokehole in their skin, even in cases that previously would have considered totally inoperable, say a tumor in the brain stem or a tumor in a primary motor cortex or primary verbal areas, Broca's area, where we would have expected to either not operate or do catastrophic damage. Those people sometimes now are coming out unscathed.

Andrew D. Huberman (4:38)

In your role at Neuralink and as a neurosurgeon in other clinical settings, surely you are using machines. It's, I think, a very exciting time in which engineers are starting to toss up big problems and go for it. And obviously, Elon is certainly among the best, if not the best, in terms of going really big. To the extent that you are allowed, could you share with us what the missions at Neuralink are and what the general scope of missions are? And then, if possible, share with us some of the more specific goals. I can imagine basic goals of trying to understand the brain and augment the brain. I could imagine clinical goals of trying to repair things in humans that are suffering in some way.