Improving Health & Medicine

Searching for the Source of a Fountain of Courage

The New York Times

In his 20 years as a firefighter and paramedic in Colorado Springs, Bruce Monson, 43, has had his little fist-bumps with death: a burning roof collapsing on top of him, toxic fumes nearly suffocating him.

Yet far more terrifying than any personal threats are what Mr. Monson describes as the "bad kid calls," like the one from a mother who had put her 18-month-old son down in his crib right next to a window with a Venetian blind and its old-fashioned cord.

"The kid had grabbed the cord and gotten it twisted around his neck, and the mother came in and found him hanging there," said Mr. Monson. "I'm the first one in the door, she's in a panic, and she shoves the kid into my arms, crying, ‘Please save him, please save him!' "

The child's body was blue, but Mr. Monson and his fellows met parental despair with professional focus and did everything they could. "We worked on him for over an hour," said Mr. Monson. "It's like a state of calm. You're so tuned in to what you're doing, you're not thinking about the reality of the situation."

Their best was not enough, however, and later, at the hospital, the terrible sadness settled in.

As Mr. Monson filled out his report, the mother sat in the trauma room's designated "bereavement rocking chair," rocking her dead son, saying her goodbyes, while family members filed in and wailed at the sight.

An image of that mother in her rocking chair comes to Mr. Monson's mind every time he answers another "bad kid" call, spurring him to keep going, to never give up or grow sloppy or cynical, to simply do his job; and through doing his job, he has saved far more lives than he has lost.

Only once did he allow the furniture connection to spook him — when his own wife was at the same hospital having emergency surgery for a ruptured ectopic pregnancy, and his young daughter happened to climb onto the bereavement seat. "I knew it was a totally irrational thing to do," he said, "but I made her get out of that chair."

Courage is something that we want for ourselves in gluttonous portions and adore in others without qualification. Yet for all the longstanding centrality of courage to any standard narrative of human greatness, only lately have researchers begun to study it systematically, to try to define what it is and is not, where it comes from, how it manifests itself in the body and brain, who we might share it with among nonhuman animals, and why we love it so much.

A new report in the journal Current Biology describes the case of a woman whose rare congenital syndrome has left her completely, outrageously fearless, raising the question of whether it's better to conquer one's fears, or to never feel them in the first place.

In another recent study, neuroscientists scanned the brains of subjects as they struggled successfully to overcome their terror of snakes, identifying regions of the brain that may be key to our everyday heroics.

Researchers in the Netherlands are exploring courage among children, to see when the urge for courage first arises, and what children mean when they call themselves brave.

The theme of courage claims a long and gilded ancestry. Plato included courage among the four cardinal or principal virtues, along with wisdom, justice and moderation.

"As a major virtue, courage helps to define the excellent person and is no mere optional trait," writes George Kateb, a political theorist and emeritus professor at Princeton University. "One of the worst reproaches in the world is to be called a coward."

Yet defining what it means to be courageous has often proved as thistly as distinguishing the wise ones from the fools. For Plato and many other authorities, courage is above all a martial art, most readily displayed on the battlefield — the iconic brave solder running into the line of fire to retrieve an injured comrade.

But Dr. Kateb points out that if courage finds its highest expression in war, then the trait paradoxically becomes an immoral virtue, ennobling war and carnage by insisting that only in battle can men — and it usually is men — discover the depths of their nobility.

Marilynne Robinson, the novelist and social critic, has observed that courage is "dependent on cultural definition" and "rarely expressed except where there is sufficient consensus to support it." Where religious martyrdom is lionized, there will be martyrs; where social or political protest is seen as glorious warfare in civvies, there will be a rash of red-faced declaimers, soapboxes on every street.

In pioneering work from 1970s and beyond, Stanley J. Rachman of the University of British Columbia and others studied the physiology and behavior of paratroopers as they prepared for their first parachute jump.

The work revealed three basic groups: the preternaturally fearless, who displayed scant signs of the racing heart, sweaty palms, spike in blood pressure and other fight-or-flight responses associated with ordinary fear, and who jumped without hesitation; the handwringers, whose powerful fear response at the critical moment kept them from jumping; and finally, the ones who reacted physiologically like the handwringers but who acted like the fearless leapers, and, down the hatch.

These last Dr. Rachman deemed courageous, defining courage as "behavioral approach in spite of the experience of fear." By that expansive definition, courage becomes democratized and demilitarized, the property of any wallflower who manages to give the convention speech, or the math phobe who decides to take calculus.

Through interviews with some 320 children aged 8 to 13, Peter Muris of Erasmus University Rotterdam and his colleagues found that children also equate courage with the conquering of one's fears, and more than 70 percent of the respondents claimed they had performed one or more brave acts, including rescuing a little brother who'd fallen in the swimming pool, saving a cat from a tree, biking home through the woods at night, and stealing money from one's mother's purse — yes, that will make the heart race, all right.

Joel Berger, a biologist with the Wildlife Conservation Society and the University of Montana, also distinguishes between animals that behave boldly for lack of experience — like mockingbirds unfamiliar with humans that will alight on the rim of a person's cup to take a drink — and those that are aware of a danger but proceed in the face of it.

He cited the time he and his colleagues had immobilized a young bison in preparation for taking blood samples, and when they returned, an unrelated adult male bison was standing guard over the yearling, refusing to let the scientists approach.

"He knew that he could be attacked by us, and there was no genetic kinship involved," said Dr. Berger. "Courage may be a human construct, but I'd call this a courageous, even heroic act."

Seeking to capture the sensation of courage in real time, Yadin Dudai, a neurobiologist at the Weizmann Institute of Science in Rehovot, Israel, and his colleagues scanned the brains of people with a known phobia toward snakes as they were confronted with a live, large, harmless but indubitably serpentine corn snake.

Lying in the scanner, the subjects could choose either to allow a box holding the snake to come closer, or to keep it away. As reported last June in the journal Neuron, the participants who squelched their terror and pressed the "snake approach" button showed activation of a brain region called the subgenual anterior cingulate cortex.

Located toward the front of the brain, the structure has been implicated in depression and, intriguingly, altruistic behavior, and is thought to help negotiate between emotion and cognition, impulse and calculation.

The thumb-size bundle of neurons acknowledges the yellow belly within but then moves to stanch its quivering power. And it does this in large part by dialing down the activity of the amygdala, long known as the brain's central headquarters of fear.

For the serious cowards among us, the chronic need to conquer fear can get tedious. Why not just skip the anterior cingulate reveille and muzzle the brain's fear response for good? The story of SM, a 44-year-old woman whose rare genetic condition has selectively destroyed the brain's twinned set of amygdala, shows the clear downside of a life without fear.

As Justin Feinstein, a clinical neuropsychologist at the University of Iowa, and his colleagues describe in Current Biology, the otherwise normal SM is incapable of being spooked.

She claimed to fear snakes and spiders, and maybe she did in her pre-disease childhood, but when the researchers took her to an exotic pet store, they were astonished to see that not only did she not avoid the snakes and spiders, she was desperate to hold them close.

The researchers took SM to a haunted house, and she laughed at the scary parts and blithely made the monster-suited employees jump. She was shown clips from famous horror films like "The Silence of Lambs" and "Halloween," and she showed no flickers of fright.

This fearlessness may be fine in the safety of one's living room, but it turns out that SM makes her own horror films in real life. She walks through bad neighborhoods alone at night, approaches shady strangers without guile, and has been repeatedly threatened with death.

"We have an individual who's constantly putting herself into harm's way," said Mr. Feinstein. "If we had a million SMs walking around, the world would be a total mess."

The bad calls would keep coming, and the rocking chairs never stop.

Improving Health & Medicine

Searching for the Source of a Fountain of Courage

The New York Times • • TAGS: Brain , Neuroscience , Senses

In his 20 years as a firefighter and paramedic in Colorado Springs, Bruce Monson, 43, has had his little fist-bumps with death: a burning roof collapsing on top of him, toxic fumes nearly suffocating him.

Yet far more terrifying than any personal threats are what Mr. Monson describes as the "bad kid calls," like the one from a mother who had put her 18-month-old son down in his crib right next to a window with a Venetian blind and its old-fashioned cord.

"The kid had grabbed the cord and gotten it twisted around his neck, and the mother came in and found him hanging there," said Mr. Monson. "I'm the first one in the door, she's in a panic, and she shoves the kid into my arms, crying, ‘Please save him, please save him!' "

The child's body was blue, but Mr. Monson and his fellows met parental despair with professional focus and did everything they could. "We worked on him for over an hour," said Mr. Monson. "It's like a state of calm. You're so tuned in to what you're doing, you're not thinking about the reality of the situation."

Their best was not enough, however, and later, at the hospital, the terrible sadness settled in.

As Mr. Monson filled out his report, the mother sat in the trauma room's designated "bereavement rocking chair," rocking her dead son, saying her goodbyes, while family members filed in and wailed at the sight.

An image of that mother in her rocking chair comes to Mr. Monson's mind every time he answers another "bad kid" call, spurring him to keep going, to never give up or grow sloppy or cynical, to simply do his job; and through doing his job, he has saved far more lives than he has lost.

Only once did he allow the furniture connection to spook him — when his own wife was at the same hospital having emergency surgery for a ruptured ectopic pregnancy, and his young daughter happened to climb onto the bereavement seat. "I knew it was a totally irrational thing to do," he said, "but I made her get out of that chair."

Courage is something that we want for ourselves in gluttonous portions and adore in others without qualification. Yet for all the longstanding centrality of courage to any standard narrative of human greatness, only lately have researchers begun to study it systematically, to try to define what it is and is not, where it comes from, how it manifests itself in the body and brain, who we might share it with among nonhuman animals, and why we love it so much.

A new report in the journal Current Biology describes the case of a woman whose rare congenital syndrome has left her completely, outrageously fearless, raising the question of whether it's better to conquer one's fears, or to never feel them in the first place.

In another recent study, neuroscientists scanned the brains of subjects as they struggled successfully to overcome their terror of snakes, identifying regions of the brain that may be key to our everyday heroics.

Researchers in the Netherlands are exploring courage among children, to see when the urge for courage first arises, and what children mean when they call themselves brave.

The theme of courage claims a long and gilded ancestry. Plato included courage among the four cardinal or principal virtues, along with wisdom, justice and moderation.

"As a major virtue, courage helps to define the excellent person and is no mere optional trait," writes George Kateb, a political theorist and emeritus professor at Princeton University. "One of the worst reproaches in the world is to be called a coward."

Yet defining what it means to be courageous has often proved as thistly as distinguishing the wise ones from the fools. For Plato and many other authorities, courage is above all a martial art, most readily displayed on the battlefield — the iconic brave solder running into the line of fire to retrieve an injured comrade.

But Dr. Kateb points out that if courage finds its highest expression in war, then the trait paradoxically becomes an immoral virtue, ennobling war and carnage by insisting that only in battle can men — and it usually is men — discover the depths of their nobility.

Marilynne Robinson, the novelist and social critic, has observed that courage is "dependent on cultural definition" and "rarely expressed except where there is sufficient consensus to support it." Where religious martyrdom is lionized, there will be martyrs; where social or political protest is seen as glorious warfare in civvies, there will be a rash of red-faced declaimers, soapboxes on every street.

In pioneering work from 1970s and beyond, Stanley J. Rachman of the University of British Columbia and others studied the physiology and behavior of paratroopers as they prepared for their first parachute jump.

The work revealed three basic groups: the preternaturally fearless, who displayed scant signs of the racing heart, sweaty palms, spike in blood pressure and other fight-or-flight responses associated with ordinary fear, and who jumped without hesitation; the handwringers, whose powerful fear response at the critical moment kept them from jumping; and finally, the ones who reacted physiologically like the handwringers but who acted like the fearless leapers, and, down the hatch.

These last Dr. Rachman deemed courageous, defining courage as "behavioral approach in spite of the experience of fear." By that expansive definition, courage becomes democratized and demilitarized, the property of any wallflower who manages to give the convention speech, or the math phobe who decides to take calculus.

Through interviews with some 320 children aged 8 to 13, Peter Muris of Erasmus University Rotterdam and his colleagues found that children also equate courage with the conquering of one's fears, and more than 70 percent of the respondents claimed they had performed one or more brave acts, including rescuing a little brother who'd fallen in the swimming pool, saving a cat from a tree, biking home through the woods at night, and stealing money from one's mother's purse — yes, that will make the heart race, all right.

Joel Berger, a biologist with the Wildlife Conservation Society and the University of Montana, also distinguishes between animals that behave boldly for lack of experience — like mockingbirds unfamiliar with humans that will alight on the rim of a person's cup to take a drink — and those that are aware of a danger but proceed in the face of it.

He cited the time he and his colleagues had immobilized a young bison in preparation for taking blood samples, and when they returned, an unrelated adult male bison was standing guard over the yearling, refusing to let the scientists approach.

"He knew that he could be attacked by us, and there was no genetic kinship involved," said Dr. Berger. "Courage may be a human construct, but I'd call this a courageous, even heroic act."

Seeking to capture the sensation of courage in real time, Yadin Dudai, a neurobiologist at the Weizmann Institute of Science in Rehovot, Israel, and his colleagues scanned the brains of people with a known phobia toward snakes as they were confronted with a live, large, harmless but indubitably serpentine corn snake.

Lying in the scanner, the subjects could choose either to allow a box holding the snake to come closer, or to keep it away. As reported last June in the journal Neuron, the participants who squelched their terror and pressed the "snake approach" button showed activation of a brain region called the subgenual anterior cingulate cortex.

Located toward the front of the brain, the structure has been implicated in depression and, intriguingly, altruistic behavior, and is thought to help negotiate between emotion and cognition, impulse and calculation.

The thumb-size bundle of neurons acknowledges the yellow belly within but then moves to stanch its quivering power. And it does this in large part by dialing down the activity of the amygdala, long known as the brain's central headquarters of fear.

For the serious cowards among us, the chronic need to conquer fear can get tedious. Why not just skip the anterior cingulate reveille and muzzle the brain's fear response for good? The story of SM, a 44-year-old woman whose rare genetic condition has selectively destroyed the brain's twinned set of amygdala, shows the clear downside of a life without fear.

As Justin Feinstein, a clinical neuropsychologist at the University of Iowa, and his colleagues describe in Current Biology, the otherwise normal SM is incapable of being spooked.

She claimed to fear snakes and spiders, and maybe she did in her pre-disease childhood, but when the researchers took her to an exotic pet store, they were astonished to see that not only did she not avoid the snakes and spiders, she was desperate to hold them close.

The researchers took SM to a haunted house, and she laughed at the scary parts and blithely made the monster-suited employees jump. She was shown clips from famous horror films like "The Silence of Lambs" and "Halloween," and she showed no flickers of fright.

This fearlessness may be fine in the safety of one's living room, but it turns out that SM makes her own horror films in real life. She walks through bad neighborhoods alone at night, approaches shady strangers without guile, and has been repeatedly threatened with death.

"We have an individual who's constantly putting herself into harm's way," said Mr. Feinstein. "If we had a million SMs walking around, the world would be a total mess."

The bad calls would keep coming, and the rocking chairs never stop.