Brain tumor opens her mind to art

Sandy Allen always considered herself a "left-brainer."

Extremely organized and adept at math and science, she had an early career managing billing for her physician father. Six years ago, at age 40, she embarked on a medical career of her own, entering medical school at the University of Washington while single-parenting two sons. Her left brain -- believed in popular culture and some scientific circles to be the rational rule maker and taskmaster -- was in high gear.

Then came an unexpected diagnosis: Three years ago, doctors discovered a golf-ball-sized malignant brain tumor buried deep in her left temporal lobe, an area that governs language and calculation.

To save her life, surgeons removed the tumor -- and with it, part of her left brain.

Now Allen considers herself a right-brainer, by default perhaps, but also by gift.

"It's as though it turned on the right side of my brain," she says. And, she likes to joke, "It's like I've had my inhibitions surgically removed."

The same school of thought that believes the left brain is our analytical logic center holds that the right is the seat of our emotional, creative, intuitive output.

Since her surgery three years ago, Allen has seen her creative impulses flourish. Her brain can no longer handle the rigors of medical school. Instead, she views her shattered world through a freewheeling kaleidoscope lens, reveling in color and pattern. She's turned her home into a canvas and volunteers to encourage other brain-tumor patients to try "art therapy" to aid their recoveries.

It appears that the damage to the left side of her brain somehow unmasked capabilities that had been repressed in her right, unshrouding a hidden side of herself.

Scientists have long been fascinated by the hemispheric divisions in the brain, a field of research that grew out of "split brain" studies of epilepsy patients in the 1960s. Stroke research and experiments indicate that essential language functions are usually concentrated on the left, although in a minority of people, they are switched to the right.

The language hemisphere is known as the dominant hemisphere. The other side, considered the non-dominant hemisphere, generally handles spatial perception and non-verbal formation of ideas, neuroscientists say. It is also the part of the brain most involved in recognizing faces and gauging emotion.

This specialization of function between the two hemispheres gave rise to a more general theory of right-brain and left-brain personalities, a notion that took hold in pop culture. We are a dichotomized society: good guys and bad guys; the far right and the far left; the haves and the have-nots. Management gurus and popular authors alike seized on it as a convenient explanation for widely viewed schisms in personalities.

Today, though, most of that thinking has been debunked by more advanced brain studies. It turns out we aren't such simple binary creatures. The truth is much murkier and ultimately more rewarding. Although our brains may be split, the two sides depend on each other and interact in highly complex ways. Patients such as Allen continue to provide clues into the inner wiring of our neural networks.

Coloring outside the lines

Allen works a couple of hours a day, as the muse moves her.

"I couldn't even draw a stick figure before," she says, giving a walk-through of her home-turned-studio. Though both her mother and sister are fine artists -- her mother, Nola Allen, a respected watercolorist and her sister, also a painter -- Allen never thought she could be one.

"I still don't call myself an artist," she says. But she does claim the free spirit of one.

"I don't do things anymore because I have to, but because I want to," she says.

On this day, she's wearing a loose purple sweater ("my favorite color") and her blue eyes are framed in lavender glasses. She giggles with delight, counting through the art she's added to her kitchen.

"In this room, there are at least 80 things I've made," she says. A pencil cup, salt shakers, light switches, magnets, wastebasket, all covered in exuberant swirls of shape and color.

She counts them as though playing a child's game. Forgets, goes back, recounts. Stops and starts. Misses a few.

On most days, she scissors her way through stacks of magazines, searching for images to incorporate into her wall-sized collages. She claims no logic to her process, but the emotional effect of her work, with its subtle compositions of color and design, conveys something beyond the sum of the individual pictures with their literal meanings.

Many of her shapes are free-flowing and organic, rooted in years of study of biological form and function. Friends tease her that her shapes are vaguely "spermlike."

Her work has taken over other features of her house, as well. A backsplash encircles her kitchen in post-modern paisley watercolor. Her light switch covers are dotted in paint. A free-form papier-mâché sculpture sits lightly, like a twisted pelvis, on her dresser, as though a symbol of a birth to different kind of self.

Even the socks in her drawer are hand-colored.

"Certainly, it's another way for me to use my brain, explore other sides of me," she says of her drive to create.

"When I'm working, I forget what time it is. I forget I'm hungry," she says. "It pulls me in. I lose myself in it."

Margaret Arnett, an artist and therapist who runs a weekly art therapy group at the University of Washington School of Medicine, doesn't judge the art of her clients, but has nevertheless been amazed by the emergence of Allen's imagination. "It's like she's consumed by her muse," she says, noting that Allen's output has been prodigious. "The sheer volume of it" sets her apart from other students.

Allen's color sense has matured while working in the group, Arnett says, as well as her confidence in her designs.

"She has the freedom to do her own thing," she says. "She doesn't color within the lines."

Lost and found

Expressing herself in art is easier these days than in words. The tumor, a grade 3 anaplastic mixed glioma, nestled between the Broca's speech area and the Wernicke's speech area of the cerebral cortex, has cost her fluency of expression. She struggles to find words. Often, it's the simpler ones that prove most elusive.

Not long ago, she was walking with her son in her back yard and asked him, "What's this indented impression?" She couldn't think of the word for "hole."

In another quirk of the way the brain stores language, Allen can usually think of the first letter of a word but not the word itself. She and her boys, now 17 and 21, play a lot of "20 questions" trying to guess the words she's trying to say.

Reading is a struggle. She used to be able to cram through hundreds of pages of complicated medical text. Now she's trying to read her first book in three years. It's a book by Alan Alda. "Something about a stuffed dog," she says. She can't remember exactly. "But I like it because it's not complicated. Other books with long, drawn-out plots, I forget what's happening when I turn the page."

Tasks and instructions have to be broken into steps and written down.

"I get lost driving," she says. "Usually on the way home, when I have to reverse the directions."

She and two friends she met through brain tumor support groups sometimes go bowling together and joke that among the three of them, they have one brain.

Faced with a math problem, she can't remember whether to add or subtract.

"I was my dad's billing manager. I had to have math," she says. "Now it's really hard to balance a checkbook."

It makes her feel: "Hmmm, what's the word where you feel almost, not inhibited ... embarrassed? It starts with a d ...

"It feels not so good," she says. "How about that?"

Certain memories with strong emotional connotations -- finding out she had a tumor, the births of her children, her divorce -- these things she remembers.

"Things I had feelings about."

Where talent lies

Scientists have studied patterns of disturbances from various sorts of brain damage.

"Brain doesn't grow back," says Allen's neurosurgeon, Daniel Silbergeld of the University of Washington. "It's like the heart. Once the heart is damaged, it stays that way."

They know, for example, that damage to the right side of the brain can cause a number of peculiar effects, ranging from misreading of facial expressions and incapacity to accurately draw images, to inability to reassemble something from parts -- so-called "constructional apraxia."

Damage to the left side typically causes language disturbances. Injury near the Broca's speech area on the left results in the ability to understand, but not express, words, while harm to the Wernicke's area allows patients to speak, but not in a coherent way.

Having artistic output as a side effect of left-brain damage isn't common, neuroscientists say.

"Brain damage does not create anything new," says neuropsychologist Dahlia Zaidel of UCLA. "Millions of people have brain damage and don't become artists."

But it's also not unheard of. Studies of patients with some forms of left-brain dementia have shown an increase in artistic abilities.

Neurologist Bruce Miller of the University of California-San Francisco reported on an art teacher who had a form of dementia that struck only the left side of her brain. As she lost the ability to communicate with language -- her ability to name things and express words, for example -- her artistic talent appeared to intensify, according to a paper in the journal Neurology.

Many of the patients he sees with progressive loss of language function demonstrate visual creativity, he said. "It's not common, but it's not rare."

The language center is very good at ordering information. When that ability is taken away, the brain operates with a less orderly thought process, which may in turn enhance the creative process, theorizes William Calvin, a neurophysiologist at the University of Washington.

But neuroscientists admit much of this is theory, and not all agree.

"More likely, it's due to (a brain tumor being) a life-altering thing," Silbergeld says. "It's a pretty big roller coaster.

"People get religion. People get depressed. People get all kinds of things. Some people -- it turns them on in some ways -- kind of facing your life and facing your death."

Most do agree it's a myth that all of one ability or another is stored in a particular drawer of the brain that can be opened or shut.

"The brain is really complex," Silbergeld says. During surgery, "you can't just suck up someone's piano lessons."

Language, for example, is stored all over the brain -- but only a few parts are considered essential for it. The rest participate in one way or another in the process of recognizing, analyzing, interpreting and expressing speech or written language. Mostly, it's not well understood.

The Dalai Lama once asked Silbergeld for the chance to watch an "awake" brain-mapping procedure that surgeons use to home in on the essential language center of the brain.

"He had questions like, 'If you map the word love, does it map to a larger, different area than if you map the word dog?' " Silbergeld says. "I don't know. It's never been done."

Many brain functions can be done by both sides equally well. Others show varying degrees of localization, the way language does, Calvin says. Still others require complex coordination between the two sides of the brain.

With music, for example, one side identifies rhythms, while the other is better at identifying melodies.

A person's creativity, though, is even deeper and harder to compartmentalize.

Zaidel has studied artists who have sustained damage on either the right or the left sides of their brains. She has found that creative talent appears especially resilient to damage. She speculates the reason may be because art is an ancient type of communication system.

"The most famous communication system is language," she says. "But art is also communication. Artists communicate what is in the brain."

And the talent for it appears to draw in complex ways from all over the brain.

"This is what I've found," she says. "There is no one place in the brain where talent lives."

Whether damaged on the left side or right, artists go on doing art, she says. "Talent remains intact."

The most likely explanation for those cases where damage appears to create artistic talent is that it was already there.

In Allen's case, her brain damage likely didn't cause her talent, but it freed her to explore it, Zaidel says. "All along she had talent."

That holds a message for all of us.

"We have multiple talents," Zaidel says. But not all are expressed, often because we're not permitted -- or we don't permit ourselves -- to cultivate them.

The idea that the brain contains layers of talents we haven't tapped goes to the heart of questions about the relationship between the brain, the mind and the self.

For Allen, such questions have become much more real over the years since her brain surgery. The experience of discovering her tumor, which she knows will eventually return, has both changed her and made her truer to her essential self.

"It's given me the knowledge, the realization, that life ends," she says. "I want to make the most of the time I have.

"The other thing I believe is the reason I'm here on this planet is to learn. And so I'm learning in ways I never imagined."

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