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In the Blink of an Eye

by

Marian Abdel-Shahid

© 2008 Marian Abdel-Shahid
Published with permission
All rights reserved



A quiet room where the clock’s sound is the only thing that one can hear, a ray of sun coming in from a window is the only thing that proves life is still going on outside. He tries to get out of bed but he cannot. The sound of silence is even a hard thing for him to break with his voice. He even no longer tries to do so, for he knows no one can feel what he feels, nor can anyone know what he wants. Hours go by, and every day is just another burden that he has to carry waiting for the journey to come to an end. His only hope is that people around him would understand the very few movements that he can make with his eyelids.

This is not a chapter out of a tragedy. It was the daily life of Jean-Dominique Bauby, a French journalist who, at the age of 43, suffered a massive stroke. This stroke rendered his brain stem inactive. When he woke up twenty days later, he found he was mute and entirely paralyzed. Moving his head a little and blinking his left eyelid were the only movements that he could do. He was one of those who are “locked-in”. "Paralyzed from head to toe, the patient is imprisoned inside his own body, his mind intact but unable to speak or move. In my case, blinking my left eyelid is my only means of communication." Said Bauby in the book he wrote about his experience dictating it character by character (Bauby, pp. 12).

"locked-in" patients are fully conscious, yet totally paralyzed and unable to perform any voluntary muscle movement. This includes those who have amyotrophic lateral sclerosis (ALS), brainstem strokes, and spinal cord injuries. According to statistics, “around 5,000 people in the United States are newly diagnosed with ALS each year and the incident rate appears to be rising” .In the U.S. population living today, more than 300,000 Americans suffer from ALS. Those patients have no way of communicating with the outside world (Belsh).

For another case suffering from ALS, desperation from getting any better led the daughter of the patient to asking doctors to mercifully kill her mother who is totally paralyzed. "There are times, as certain as the sun rises in the morning, that someone isn't going to get better" said Dr. Stephen Hoffmann, an internist and member of the Massachusetts Medical Society Ethics Committee (Kovalich). Medicine alone stands hands folded in front of these cases, as there is nothing that doctors can do. However, with available technology, why should individuals have to suffer silence because of an inability to communicate?!
 
The joint knowledge of neuroscientists, computer scientists, mathematicians and EEG specialists may provide hope for those who lost it. It is in the new technology of “Brain Computer Interface” or BCI that a communication channel is provided for those, even if they can’t even blink. Something that each of these sciences, alone, would not have been able to achieve.

Brain Computer Interface is a new technology that translates the EEG brain signals of the patient into meaningful computer commands. In the case of ALS patients for example, the brain still produces the signals corresponding to the actual movement, but it is the muscles that do not respond. If, for example, the patient is thinking of moving his hand up or down, a corresponding signal is produced, yet the muscles do not respond. What BCI does, is that it first captures these EEG potentials from the surface of the scalp. Then, with the help of mathematical models and classification algorithms, figures out the corresponding meaning of that signal captured – whether it was moving the arm up or down in our example. The computer scientists, on the other hand, work on enhancing the efficiency of these classification algorithms and provide an end application that is controlled by the classified signal (Wolpaw). The end application can vary from a virtual keyboard for spelling, up to changing TV channels or moving a wheeled chair.

I did not realize the interdependency between all these sciences until I myself had the opportunity to work on a BCI project in my graduation thesis project. Being a computer science undergraduate student, my only knowledge was in the part related to programming. When we, my colleges in the project and I, decided to work on that area of research, we were motivated by the people like Bauby, hoping that we can do something that makes their lives better. But we alone were not able to carry that out. We had to refer to some EEG specialists to help us with the technical part of recording the brain signals. Asking for a neuroscientist’s help was also a must, for we had limited knowledge of how EEG signals look like, or where are they best present in the scalp. It was that experience of BCI that gave me an insight of what the real world nowadays is: knowledge in one area alone is not enough.

In the old ages, a human being could know -what at that time was- “much” in different areas of knowledge. In fact, most of the intellectual people during the past centuries were qualified in more than one field. Ibn Sina, the famous Persian polymath, was an astronomer, chemist, physicist and scientist, logician and mathematician, poet, soldier, statesman, theologian, and most of all physician and philosopher of his time (Avicenna). But the more time went by, the more human knowledge increased in different subjects. And as sand flows in a glass clock filling one side and leaving the other empty, so did a human’s knowledge in a particular field increase as it decreases in other fields. An individual started to “know better” in certain fields than the others.

It was by that time that the idea of “Job Specialization” in labor was introduced by the father of management Henri Fayol in the early twentieth century. The argument was that the more one specializes in an area of work, the more efficient he becomes and the more improved the methods he uses could be. Ironically, this idea is nothing new! The whole idea of “trading” that people knew for centuries is based on the same concept: being good in one thing, and share what you have with others. A carpenter, living in the first century, used to give away a chair, for getting a goat from a cattleman in return. The only difference is that the concept of specialization, by that time, moved from the level of single human beings to the scale of sectors within big organization. The same concept later developed into country levels, introducing the new concept of “globalization”: for a country focuses on producing something it is good at, and trade it with other siblings in the globe.
 
Nowadays, human knowledge increased to an extent that it became too much for a single mind to comprehend. It is becoming difficult for a computer scientist, for example, to comprehend all the information available on algorithms, programming languages, networking… etc. So, further specialization is now the default, to be able to work on a particular area. This rings danger bill, for when Fayol introduced his theory, he concluded that “too much specialization” will reduce the efficiency and increase boredom among the workers. And same thing exist in the case of computer scientist, the more he gets specialized in a single area, the narrower his scope of thinking is becoming. For our knowledge is like a window from which we observe the world. I guess that window is becoming too small for a deeply specialized computer scientist, and any other specialist, who knows nothing except in his field!

That is where the idea of liberal art is introduced. It is the current trend that everyone is convinced leads to the “win-win” situation. The scholar has to get specialized in one area where his limited-capacity mind can comprehend the huge amount of knowledge currently present in that area. On the other hand, he also gets exposed to other fields of life to widen the scope and enlarges that window from which he observes the world. Dr. Ahmad Mostageer, the famous Egyptian poet and scientist, once said that for someone to become a successful researcher, he has to have a wild imagination. How would it be possible for him to reach areas that no one thought of before if he did not have that imagination and creativity?!

Liberal art education also helps in achieving what a single science cannot. This basic general knowledge that a scholar in a liberal art education system acquires opens the door for possible cooperation and joint work with these different fields. For someone to be part of a team, he has to have the ability to see connections between things, to see through other people’s eyes and to think critically. All these qualities described earlier are developed in the liberal art education system. It gets one exposed to the vast knowledge that human beings have acquired through centuries and hence can appreciate the connection among these sciences. It also teaches the art of observation, communication and active listening. So, one graduates as a specialist in a field, yet able to positively cooperate with other specialists in other fields in multi-disciplinary projects. That is how breakthroughs are attained today. Research projects never, or rarely, include scientists from one field only. The genome center in Stanford University for example includes professors of biochemistry and genetics, software development, system analysts and technicians and lab assistants (Genome). The BCI technology is also an obvious example for that type of research.

Human knowledge never stops; it is expanding exponentially as time goes by. A single human’s mind can never absorb it all. There are yet a lot of technologies to be discovered and achieved, ones that are not present in our thoughts today. But theses technologies are like oasis that the caravan of specialization cannot reach; only the bigger caravan of joint sciences can lead to it. This joint caravan is the result of specialization and liberal art education to produce different - but cooperative- specialists from the vast sciences. And in this caravan only is the hope of human’s future to reach what no one has yet reached, areas where ALS patients can control their world with a blink of an eye. 
 
Works Cited

Avicenna. 11 Nov, 2007. < http://en.wikipedia.org/wiki/Avicenna >

Bauby, Jean-Dominique. “The Diving-Bell and the Butterfly”. Fourth Estate, London, 1997

Belsh,  J.M. and P.L. Schiffman (editors), Amyotrophic lateral sclerosis: diagnosis and management for the clinician, Futura Publishing Co., Inc., Armonk, NY,1996.
Genome Technology Center Staff. Stanford University. 12 Nov, 2007. < http://www-sequence.stanford.edu/staff.html >

Kovalich, Jennifer. “ALS case drawing national attention”. The Enterprise. 11 Nov, 2007.
< http://enterprise.southofboston.com/articles/2005/03/10/news/news/news02.txt >.

Wolpaw, Jonathan R. et al., “Brain-computer interface technology: A review of the first international meeting”, IEEE Transactions on rehabilitation engineering, vol. 8, no. 2, pp. 164-173, June 2000. 



© 2008 Marian Abdel-Shahid. Published with permission. All rights reserved.