Lone Frank has written The Pleasure Shock: The Rise of Deep Brain Stimulation and its Forgotten Inventor about the early brain stimulation work of psychiatrist Robert G. Heath in the 1950s and 1960s. Frank draws well on her background as a neurobiologist to create a portrait of Heath as both a misunderstood pioneer and an overambitious opportunist that is compelling for both the layperson and the specialist. She provides an engaging first-person account of her investigation into Heath's career, and contrasts this with developments in the use of modern DBS for mental illness, punctuated with cameos by several of the current thought leaders in the field to provide scientific context for this cutting-edge field.
At Tulane University (New Orleans, LA, USA), Heath established the Department of Psychiatry and Neurology, and chaired it from 1949 to 1980. During his tenure, brain electrodes were implanted into more than 50 patients to investigate the physical manifestation of human emotion—particularly pleasure and reward—and its role in psychiatric conditions. This work preceded the discovery of antipsychotic medications, and came at a time when mental illness represented a major social burden: asylums were full and available treatments—including lobotomy, electroshock therapy, and insulin-induced hypoglycemic coma—were ineffective and troubling.
Heath focused on electrically stimulating the septum, the subcortical reward centre containing the nucleus accumbens that is widely connected to several structures that were resected during topectomy procedures. He made several interesting observations, including the careful documentation of stimulation-induced euphoria that he used to reach withdrawn patients with schizophrenia. Heath eagerly presented mixed preliminary results suggesting improvement in a subset of patients, which were met with initial interest but also harsh criticism that his methods were uncontrolled and fraught with bias. This became the prevailing critique of Heath's work: he was quick to present sensational findings without using established scientific methods to verify his conclusions.
Heath's work also raised ethical concerns. It is unclear whether legitimate informed consent for invasive brain stimulation procedures was obtained. In many cases, additional electrodes were placed throughout the brain to measure responses to septal stimulation, without therapeutic benefit to the patient. Some experiments had questionable scientific merit—most infamously, Heath attempted homosexual conversion of a gay man by stimulating the septum while the patient engaged in sexual acts with a female prostitute. In another questionable experiment, his group isolated a protein he called taraxein from people with schizophrenia that purportedly induced the disorder in prisoners; this finding was dismissed when results were not reproducible outside Heath's laboratory.