How much of what we are, what we think and feel, and what we do is determined by the “wiring” of our brains? This question is at the heart of Switched On, a fascinating memoir of one man who was a participant in a TMS (transcranial magnetic stimulation) research study conducted at the Neurology Department of the Beth Israel Center, which is a teaching hospital of Harvard Medical School. TMS is a magnetic method used to stimulate small regions of the brain, allowing doctors to change brain activity without surgery or medication. It has been in research and development for over twenty years, which seems like a long time, but is actually quite short in the medical research field, which is why most of us have never even heard of it. I learnt of TMS during a Fresh Air broadcast featuring John Elder Robison, the author of Switched On, and the neurologist, Alvaro Pascual-Leone, who led the TMS study at Beth Israel and worked closely with Robison throughout the time he was receiving TMS. The main reason behind inviting Robison to be a participant in the study was that he has autism, and the researchers wanted to investigate whether a non-invasive technique like TMS could help in any way.

Much of the book is a methodically detailed log of the author’s day-to-day experience with the study, including how he met the researchers, how he was invited to participate, why he agreed, what he was hoping for, the buildup to every session, what happened at every session, and what were the effects that he experienced afterwards. He also shares details about his family, his work, his autism, and the impact that TMS had on different aspects of his life. These details, in and of themselves, are not especially riveting—after all, who wants to know about the mundane details of the day-to-day events in our lives?

What we do want to know, however, is—does it work? Does TMS change our brains and consequently, our emotions and our actions? And if so, are the effects temporary or long-term? And since Switched On is a first-person account of someone who has actually received TMS, we actually get to know the answers to some of these questions. Robison does a terrific job of describing both the short-term and long-terms effects that he experienced after each TMS session, including being much more open to people and experiences, the ability to “read” people a lot better and understand nuances which had earlier escaped him thanks to autism, and even the ability to be moved to tears by a sad story, even if it was just in the newspaper or told to him by someone he had just met. Fortunately, being so overcome with emotion that life becomes difficult was not a long-term effect of TMS. At the same time, having had the experience of empathy and connectedness—however short-lived—provided him with a “knowledge” of these emotions that is helping him to better understand “normal” (non-autistic) people on an ongoing basis.

Of course, Switched On is one person’s account of the effect of TMS, and it’s possible that other participants in the study experienced somewhat different reactions and effects. It would be good to know more, and I hope the TMS researchers can compile their findings not just into research papers for the academic community but also articles and books for the rest of us. It is fascinating to think that everything we think and do—including this thinking!—comes from our brain chemistry. Does this mean that at some point, we will be able to manipulate brains to create “designer thinkers,” similar to how we could potentially manipulate genes to create “designer babies?” Another interesting question, brought to the forefront by Switched On.

Switched On: A Memoir of Brain Change and Emotional Awakening
Author: John Elder Robison
Publisher: Spiegel & Grau
Publication Date: March 2016

Contributor: Lachmi Khemlani runs a technology publication in the San Francisco Bay Area.