In the other two piles, the subject receives double the reward—$100—for each card he draws, except when he turns up an occasional card that costs him $1,250—i.e., a rather substantial penalty. If he continues to draw cards from these two piles, he will lose a fortune over the long run.
Experimental subjects who are healthy (or have brain injuries that lie outside the frontal lobes) will begin by taking cards from all four piles while they try to determine a pattern in the game. After just a few cards, they will prefer the $100 piles, but before they have drawn 30 cards, they generally learn to keep to the low-risk piles. They will thus earn money from the game. They cannot say exactly why they choose the low-risk piles; they just have a vague (but correct) sense that they are profitable in the long run.
The orbitofrontally damaged subjects also begin by preferring the high-risk piles. But they never learn to shift to the other piles. Instead, they focus more and more on the losing high-risk piles. After 50 cards, they have lost everything and want to borrow money so that they can play even more.
Sometimes they can even explain rationally and persuasively that they should choose the other piles, or the investigator can simply inform them of that fact and bring them back in a few weeks to try the test again. And then they will again lose a fortune.
If we measure the subjects’ stress level by attaching electrodes to their skin (popularly known as “using a lie detector”), we can see that both the healthy and the ill subjects react to losing and winning money. There is no difference.
But the experiment shows that when a healthy research subject has played for a short time, a stress response is also detected when his hand merely approaches one of the high-risk piles. Although the subject is not yet conscious of the pile being risky, his body sends him a signal of danger and unease when he considers drawing a card from it. The longer a healthy subject plays, the stronger this signal becomes, until finally he is able to explain the system behind the game.
The Iowa Gambling Task strikingly and unequivocally demonstrates that subjects with orbitofrontal damage never develop this unconscious physical signal about approaching danger.
Similarly, if a researcher shows them photos of natural disasters, wars, or other scenes of human suffering, they do not show any fluctuation in galvanic skin response, such as is found in healthy subjects. Neither do they get gooseflesh when healthy subjects do, e.g., while listening to certain pieces of music.
These results led to Antonio Damasio’s Somatic-Marker Hypothesis, which he argues for in his book Descartes’ Error.
It is only when a healthy subject has been experiencing such corporeal signals for some time — about which action will be most advantageous — that he is able to explain the choices he makes. The Somatic-Marker Hypothesis says that a rational choice depends on first an emotion, then a physical reaction to the emotion, and finally an intellectual explanation of what the reaction signifies.
The title of Damasio’s book, Descartes’ Error, reflects its main thesis: a refutation of René Descartes (1596–1650). One of Western philosophy’s most influential figures, Descartes is known for, among other things, his theory of the separation of mind and body, and for his assertion “I think, therefore I am.”
According to Damasio’s theory of somatic markers, Descartes was mistaken in isolating the mind from the biological body. Damasio maintains that rational thought and ethical assessments cannot exist independently of the body and its physical reactions.
13
“This article explains everything!”
I run up to Niklas’s room to share it with him, but of course he isn’t home. From his window I look down the street to see if he’s on his way. But nobody’s there.
I hurry toward Frederik’s office to tell him but stop in the hallway. He won’t care, I’ll become unhappy, we might start arguing.
I could call Vibeke and Thorkild, but I can’t muster the energy. Then there are our friends, but many of them work at Saxtorph, and the vast majority are siding with Laust and the new administration; they hope that, if Frederik does get well again, he’ll be handed a heavy sentence.
One of the teachers we still talk to, and who doesn’t question Frederik’s innocence, told me that one day the male teachers started fighting during a faculty meeting because some of them referred to Frederik as a criminal and others wouldn’t stand for it.
Sometimes when I’m out shopping, random people come over to me and declare their support, while others shout “Swine!” if I take Frederik with me to the Irma supermarket in The Square, Farum’s one major mall.
I’d particularly like to phone Laust and tell him about the Iowa Gambling Task; maybe he can understand now how wrong he’s been. Yet I can’t bring myself to call him again. The few times I’ve tried, he’s slammed down the receiver — even though some nights he still calls me and drunkenly rants and weeps about his school. He keeps on saying that Frederik hasn’t just destroyed the lives of students and staff; he’s also made meaningless the lives of Laust’s father, grandfather, and great-grandfather.
I go down to the living room and look out the window again to see if Niklas is coming home yet. Though why should he?
Three boys run from our yard. Something about them tells me they’re not just out playing. I walk outside to find that they’ve spray-painted our house. SHITHEAD LIVES HERE! it says. I go straight for a stiff brush and a bucket of soap and water.
Half an hour later, dusk is falling and I’ve scrubbed off as much as I can. The air is chilly and damp, but I’m heated with the effort and walk around to the backyard, where neighbors and passersby can’t see me. Here I can also escape from the sight of the burnt grass and the faint hovering shadows on the front wall of the house, where the soap has removed old grime in a pattern that vaguely says SHITHEAD.
I sit down on the naked springs of the hanging sofa. How long ago is it now that Frederik and I blew off the neighbor’s summer party and sat here with a bottle of wine before going up to our bedroom? Was that about the same time we were doing the bathroom remodel?
The metal wires press against my buttocks, and I look up at the window of Frederik’s office workshop. It’s still dark; I ought to go in and turn on a light for him. He forgets to, every evening, and it’s wrecking his eyes.
My cell phone rings.
“Hello, it’s Bernard. Am I bothering you?”
“No, not at all.”
“You sound like you’re freezing.”
“Nah, not really. Has something happened?”
“I got an e-mail from Andrea in the support group. She said we should google Iowa Gambling Task. I did, and it makes a convincing argument that when Frederik was playing the commodities market, he wasn’t his real self.”
As he speaks, I can almost see the dew descending in the half darkness among the branches of the shrubbery. It falls and falls, it soothes without ever seeming to land. Bernard’s voice is that way too: deep and steady as it settles over me.
“She sent that to me too. I just read about it on the web — just now!”
“So you must be happy, right?”
“Yes.” I choose not to mention the graffiti on the wall, to say that even children hate us now. And it’s too complicated to explain that even when I’m “happy,” I still have an underlying angst, a feeling that if I exhale deeply and really relax for half a second, the world will collapse. Hopefully, if Frederik is acquitted, the anxiety will stop.
“You and Frederik should celebrate.” He notices my hesitation almost before he has a chance to draw a breath. “Well, Frederik might not be so interested. But when he’s better …”