The Bespoken Image: History, The MGH-NMR Center, fMRI

Photo by Matt Rosen, MGH Martinos Center for Biomedical Imaging

By Jo Anne Fordham

 

“How do you spell ‘phosphorylation’? …”

“First we will have dinner …”

“I love the research; it’s the writing I hate …”

 

Past the second door and after a moment at its only slightly interested security desk, a huge, empty space rose quietly from a pool emanating a steady, subdued trickling of water within a filtered light.

The image should bespeak design, not myth: The architects who refurbished this space in the Charlestown Navy Shipyard deserve their nod too.

When I first entered it, Building 149 was sparsely occupied. Outside, the Constitution had not yet been refurbished, and the Nantucket lay at anchor close by. The water taxi to the North End ran at half-hour intervals; the drive to Logan could be extremely quick.

Uninformed, I bypassed scanning bays and reading rooms, winding past intermittent concrete pillars toward a modest slope of steps that eventually would lead to conversations, coffee, sweets, and the suppers needed to keep working during bleary-eyed pre-submission hours on yet another draft, or its annotation, or its biosketches. In the early years, NMR Center nouns were mass or plural. Quantitation implied the action of many, readily singular, but not reduced. First names were sufficient.

The walk was punctuated by faintly illuminated, tasteful offerings of the sort that hospitals archive behind glass. There were schematics, maps, architectural plans, faint sets of line succeeding fainter sets, each documenting a design by which the building had been constructed, or its work accomplished. If this memory is accurate, the archivists’ arrangements conveyed a prodigious anticipation, as well as history.

Rather than with any of these, though, my certainty of the time rests on snippets, like those above, elided from longer discussions, usually over a manuscript. That era would see the Belliveau et al. Science report introduce fMRI mapping of the human brain at work. It would pause at the Kwong et al. BOLD report in PNAS, which eliminated the need for exogenous contrast in fMRI studies. It would parlay an extraordinary series of studies into successful grants, to which faculty, fellows, trainees, and grad students from a range of backgrounds contributed what appeared from my side to be a good deal of their all.

I remember remarking during preparations for a site visit that what I envied most about science at that moment, and at that lab, was its ability to bring in expert collaborators to critique concepts on-site—relentlessly, in discussions, during presentations, throughout breaks or meals—for every concept under development. The critiques were thorough, painstaking, serious—and they were heard. The humanities progress without that level of funding, although their investigations into factors underpinning life, innovation and productivity are equally crucial. Perhaps humanities disciplines are stymied by the time required to measure outcomes—across generations, often—perhaps by the apparent familiarity of their approaches vis-à-vis the complexities they seek to address. Human experience is neither neat nor discrete, nor is it consistently wrought, as contemporary neuroscience corroborates.

It was during this time that I learned to operate at the rugged distance required by peer review: a reviewer had chided us on the omission of a (lower case) pet Topic. To this day I can visualize that topic’s mention—at the top of page 2, no less!! How could it have been missed? To my incensed complaints, Bruce replied, “Jo Anne, you can’t just say, ‘Look, you idiot, learn to read!’” Instead I learned to say—and over time to understand the value of saying, since prose is only as meaningful as the reader’s grasp—“We sincerely thank Reviewer X for pointing out the insufficiency of our earlier explanation of pet Topic. Our previous text, at the top of page 2, has now been clarified to read … ”

“Assuming you can…” is not only unnecessary, it is the devil that, unchecked, has the potential to obfuscate contributions important to more fully characterizing moments in science, as well as other practices in human life. Qualm and exclusion do not constitute absence; they critically reduce.

Which leads me to the one essential point I want to make here.

That site’s and that moment’s coincidental collaborations—which yielded proofs-of-concept and urged the potential reach of fMRI studies and others—generated an energy and maturity that brought the creativity of youthful visionaries, routinely named or not, to the forefront of neuroscience. Despite their differences, they found ways to work together, some soberly, some giddily determined to show that brain function could be investigated—as it transpired—by NMR imaging techniques. They “Cheslerized” snags, and as Friday lab meetings drew to a close would turn to ask, “Mike, what do you think?”

No quick study can mine the communications through which a range of NMR Center investigators brought their best to the experiments that would launch fMRI, change history, and render all involved, as Mark noted in the memorial for Jack Belliveau, “…buddies forever.” In fact, no study, no history, can do so: paradoxically, the critical ingredient in distilling events into a comprehensible narrative is elision.

A brief exchange about the War in Vietnam with Tom provided me with perhaps my most compelling understanding of how this happens. We had each lived through the 1960s, but quite differently. Turning at a remark he made about how that war had influenced his course of studies, I mentioned that I would “…never forget the war’s beginning in 1964.”

“No.” Tom was certain. “It was in 1965.”

I looked at him—he is tall, and I am not, so I had to look up. “I remember it very clearly, Tom; it was fall, 1964. My brother was in the 101st …”

“It was 1965.”

More than the ceding of 1775’s Lexington Green to Philadelphia in 1776, more than 1979’s summative claim on Iran’s 20th century revolutions, Tom’s certainty brought home to me how time and events are articulated in the construction of knowledge.

To fix our sights too willfully on too much leaves us with no beginning, no closure—something unendurable for people themselves fated to be born and to die. Stories help us counter the fact that everything we do floats in the full context of human experience, endlessly referential, anchored briefly and indiscriminately against the unfathomable.

For Tom, the student-become-physician and professor, the War in Vietnam began in 1965. For me, the youngster-become-writer, it began with my older brother’s 30-day combat leave and the unforgettable, greyish cast to our mother’s face throughout those late November, early December weeks, a pallor having nothing whatsoever to do with the impending birth of her youngest child.

fMRI, like despair or hope, like our communities in a shredded world, presents histories that are incomplete glimpses, at their best substantiated by evidence pinned to perspective, to artifact, to interpretive longing and urgent desire. Nothing we write at the 25th anniversary of the seminal fMRI studies can convey their most jubilant stories.

In their place, each fMRI study itself contributes two critical stories towards capturing its own history and establishing its own place within a genre which, like literature, seeks nothing less than to model consciousness and explain behavior.

The first of these stories arises in the study’s characterization of evidence for a time course of perception and response more rapid than human awareness, and for changes in traces reflecting each across time. This story opens to history and the law explorations not even imaginable before November 1, 1991. We can name and point out the evidence; we now ask the questions, and must answer to error.

The other story, I am going to suggest, spans the chasm of human experience like one of Unamuno’s rickety bridges. This story, with its sturdy, hapless imprecision, is vital to surviving our various positioning within human chance, to contributing to newer conversations, to observing and imagining, and to approaches that may someday be recognized as hopeful, textured, inclusive, and sound, for the traceable instants of creativity and judgment that matter.

Each fMRI study ensconces the paradox of that second story—its iconic, noisy, utopian avowal that twenty-five years ago, in Boston and its environs, a group of people—many more than may be named, through contributions to bioscience, imaging, and the analytical and mapping techniques required to render those models meaningful—succeeded in creating a revolution by the measuring, rather than the spilling of blood.

This paradoxical modality, with its transformative iteration of cognition, responsiveness, and erudition, confers a gift in the Maussian sense. fMRI presents to us all, not just a glimpse into organ function, nor perpetual indulgence in mirror-stage mapping, but a collaboratively drawn image of human possibilities, of differently measured connections and obligations—ones that might even turn to hopeful purpose—by the very demonstration that they already exist.

 

Jo Anne Fordham was the writer and editor with the MGH-NMR Center (now the MGH Martinos Center for Biomedical Imaging) during preparation of the initial fMRI reports—and, she tells us, a volunteer subject for early BOLD fMRI studies in the Center. She is now with the Center for Bioethics and Medical Humanities, University of Mississippi Medical Center, Jackson, Mississippi.