Self Comes to Mind

Whatever they feel is achieved subcortically by the nucleus tractus solitarius and parabrachial nucleus, which are intact, as they have no insular cortex or somatosensory cortices I and II to assist with such a task. The emotions they produce must be triggered from the nuclei in the periaqueductal gray and must be executed by the cranial nerve nuclei that control facial expressions of emotions (those nuclei are also intact). The running of the life process is supported by an intact hypothalamus, located immediately above the brain stem and helped by an intact endocrine system and by the vagus nerve network. Hydranencephalic girls even develop menstrual periods at puberty.
    That these children give some evidence of mind process is not in doubt. Likewise, their expressions of joy, sustained as they are over many seconds and even minutes, and consonant as they are with the causative stimulus, can be reasonably associated with feeling states. It is compelling for me to assume that the delight they exhibit is real felt delight, even if they cannot report it in so many words. That being so, they would achieve the bottom riser of a stepwise mechanism leading to consciousness, namely, feelings connected to an integrated representation of the organism (a protoself ), possibly modified by object engagement, constituting an elementary experience.
    The possibility that they do have a conscious mind, albeit an extremely modest one, is supported by an intriguing finding. When these children suffer an absence seizure, the caregivers easily detect its onset; they can also tell when the seizure ends and report that the “child is returned to them.” The seizure appears to suspend the minimal consciousness they normally exhibit.
    Hydranencephalic individuals present a most troubling picture, one that informs us of the limits, in humans, of both brain-stem structures and cerebral cortex. The condition gives the lie to the claim that sentience, feelings, and emotions arise only out of the cerebral cortex. That cannot possibly be the case. The degree of sentience, feeling, and emotion that is possible in these cases is quite limited, of course, and, most important, disconnected from the wider world of mind that, indeed, only the cerebral cortex can provide. But having spent a good part of my life studying the effects of brain damage on the human mind and behavior, I can say that these children have little in common with patients in vegetative state, a condition in which the interaction with the world is even more reduced and that can actually be caused by damage to precisely the same regions of the brain stem that are intact in hydranencephalics. If a parallel could be drawn at all, once the motor defects are factored out, it would be between hydranencephalic children and newborn infants, in which a mind is clearly at work but where the core self is barely beginning to gather. This is in keeping with the fact that hydranencephalics may be first diagnosed months after birth, when parents note a failure to thrive and scans reveal a catastrophic absence of cortex. The reason behind the vague similarity is not too difficult to fathom: normal infants lack a fully myelinated cerebral cortex, which still awaits development. They already have a functional brain stem but only a partially functional cerebral cortex.
A NOTE ON THE SUPERIOR COLLICULUS
    The superior colliculi are part of the tectum, a region that is closely interrelated with the periaqueductal gray nuclei and, indirectly, with the nucleus tractus solitarius and parabrachial nucleus. The involvement of the superior colliculus in visual-related behavior is well known. But the possible role of these structures in the process of mind and self is rarely considered, although there are notable exceptions in the work of Bernard Strehler, Jaak Panksepp, and Bjorn Merker. 11 The anatomy of the superior colliculus is fascinating and all but compels us to guess what this structure is supposed to accomplish. The superior colliculus has seven layers; layers I through III are the “superficial” layers, while layers IV through VII are called “deep.” All the connections coming to and going out of the superficial layers have to do with vision, and layer II, the main superficial layer, receives signals from the retina and from the primary visual cortex. These superficial layers assemble a retinotopic map of the contralateral visual field. 12
    The deep layers of the superior colliculus contain,