0:00:02 > 0:00:05We're discovering astonishing things about the human body all the time
0:00:05 > 0:00:08through people who are different from most.
0:00:10 > 0:00:12I'm Gabriel Weston.
0:00:12 > 0:00:17As a surgeon, I've spent years studying the human body.
0:00:17 > 0:00:21And the secrets of how it works are often revealed by the most
0:00:21 > 0:00:24rare and surprising of cases.
0:00:25 > 0:00:29So I've searched the world to find these extraordinary people
0:00:29 > 0:00:32and bring you their stories.
0:00:32 > 0:00:37This is my heart. I'm the only one that has this.
0:00:37 > 0:00:40I'm Jordy Cernick, and I can't feel fear.
0:00:40 > 0:00:43My name is Harnaam Kaur, and I'm a fabulous bearded lady.
0:00:43 > 0:00:47With the help of the doctors that treat them and some of the
0:00:47 > 0:00:49world's leading scientists,
0:00:49 > 0:00:54I'll be uncovering exactly what makes their bodies unique.
0:00:55 > 0:00:57'I'm going to show you the hidden
0:00:57 > 0:01:00'processes that make them exceptional.'
0:01:02 > 0:01:03Just look at that!
0:01:05 > 0:01:10I'll discover how they're leading us to the cures of the future.
0:01:10 > 0:01:14When we make a breakthrough like this, it is very exciting.
0:01:14 > 0:01:19And I'll use the latest technology to uncover the secrets of
0:01:19 > 0:01:24their bodies and reveal how all of these cases are giving us
0:01:24 > 0:01:29a new understanding of the most amazing natural machine on
0:01:29 > 0:01:31the planet - the human body.
0:01:46 > 0:01:49'There are some extraordinary people who have talents and
0:01:49 > 0:01:53'abilities that seem almost superhuman.
0:01:55 > 0:01:58'In this programme, we'll discover why this woman can see
0:01:58 > 0:02:01'millions of colours most of us can't...
0:02:03 > 0:02:07'..and why this man never forgets a face,
0:02:07 > 0:02:11'why this woman can smell disease before it happens
0:02:11 > 0:02:15'and why this man has never felt pain in his life.
0:02:17 > 0:02:21'I'll reveal how these remarkable people are helping us understand
0:02:21 > 0:02:26'the most complex and mysterious part of our body, the brain.'
0:02:29 > 0:02:31And I'm going to start with the strange case of
0:02:31 > 0:02:36a man who awoke one morning with an astonishing new talent.
0:02:40 > 0:02:44October 27th 2007 was a day
0:02:44 > 0:02:47that would change Derek Amato's life forever.
0:02:49 > 0:02:52I woke up and I could suddenly just play the piano.
0:02:53 > 0:02:57Derek had never touched a piano before,
0:02:57 > 0:03:01so how could he possibly become a virtuoso pianist overnight?
0:03:04 > 0:03:08It began with a misadventure that might have killed him.
0:03:08 > 0:03:12I was visiting some friends for a barbecue by the pool.
0:03:12 > 0:03:14We were throwing a little football around,
0:03:14 > 0:03:18and I just decided to go running along the pool and dive into the
0:03:18 > 0:03:20shallow end to catch the football.
0:03:22 > 0:03:26I struck the bottom of the pool with the upper left side of my head.
0:03:29 > 0:03:33There's a moment when you hit your head that you know that
0:03:33 > 0:03:37that noise is traumatic and you know something's definitely wrong.
0:03:38 > 0:03:40Derek was rushed to hospital,
0:03:40 > 0:03:43where he was treated for severe concussion.
0:03:43 > 0:03:46He was sent home and slept for five days.
0:03:46 > 0:03:48When he finally came round,
0:03:48 > 0:03:53he felt an uncontrollable urge to do something he'd never done before.
0:04:01 > 0:04:04My hands started basically understanding where they
0:04:04 > 0:04:07were supposed to go and my brain seeing these black and white
0:04:07 > 0:04:10squares telling my fingers what to do.
0:04:12 > 0:04:15And then my brain started seeming like I started racing, to the
0:04:15 > 0:04:16point where I was going...
0:04:18 > 0:04:21..and then I was on overload.
0:04:22 > 0:04:27What's so surprising is that Derek can't read a note of music.
0:04:27 > 0:04:30He'd messed around with a guitar and drums as a child,
0:04:30 > 0:04:34but he'd never actually learned to play an instrument.
0:04:35 > 0:04:39Now beautiful melodies were tumbling out of him.
0:04:42 > 0:04:47I had to play all the time, because it felt like if I didn't play,
0:04:47 > 0:04:49it was like it was building up,
0:04:49 > 0:04:53as almost if you were just pouring musical notes into my brain
0:04:53 > 0:04:55and it was just filling up.
0:04:57 > 0:05:00I just didn't know what to make of it.
0:05:00 > 0:05:02I didn't know if I should tell someone,
0:05:02 > 0:05:03because they're going to think I'm
0:05:03 > 0:05:07nuts anyway, because I already had a head injury and now I'm telling
0:05:07 > 0:05:11you I'm a piano player, so someone's going to have some questions for me.
0:05:13 > 0:05:17Derek's story seems unbelievable, but he's not alone.
0:05:20 > 0:05:24In 1988, Jon Sarkin, a chiropractor from New Jersey,
0:05:24 > 0:05:27suffered a massive stroke and went into a coma.
0:05:27 > 0:05:32When he awoke, he felt a sudden compulsion to draw and paint,
0:05:32 > 0:05:34and he's a prolific artist to this day.
0:05:35 > 0:05:39And in 2002, Jason Padgett, a furniture salesman from
0:05:39 > 0:05:44Washington, was attacked outside a bar and suffered severe concussion.
0:05:44 > 0:05:49When he recovered, he'd become a mathematical genius who saw
0:05:49 > 0:05:52the world in complex geometric shapes.
0:05:54 > 0:06:00It's a rare but recognised condition called acquired savant syndrome,
0:06:00 > 0:06:03and what happens in it is that after damage to the brain,
0:06:03 > 0:06:08an individual develops an ability that they never had before,
0:06:08 > 0:06:11and scientists are trying to figure out what's happening in the
0:06:11 > 0:06:14brains of these extraordinary people.
0:06:17 > 0:06:20Professor Berit Brogaard is a neuroscientist who studies
0:06:20 > 0:06:24acquired savant syndrome at the University of Miami.
0:06:24 > 0:06:28She's been using MRI scans to look deep inside Derek's brain.
0:06:31 > 0:06:34You see some white spots here, and there's
0:06:34 > 0:06:37a small white spot here that we are particularly interested in.
0:06:37 > 0:06:41These white spots are damage caused by Derek's concussion.
0:06:41 > 0:06:45One of them lies in a part of the brain called the prefrontal
0:06:45 > 0:06:48cortex that's involved in rational and logical thinking.
0:06:50 > 0:06:51With this part damaged,
0:06:51 > 0:06:54Derek now needs to use other parts of his brain.
0:06:57 > 0:07:01When you give up on logical thinking and rational decision making
0:07:01 > 0:07:05a little bit, you have the possibility of developing new
0:07:05 > 0:07:09talents or become more creative,
0:07:09 > 0:07:11more original, so original thinking,
0:07:11 > 0:07:15thinking that actually results from not using the prefrontal
0:07:15 > 0:07:18cortex but using other areas of the brain.
0:07:20 > 0:07:25Berit believes that Derek's brain has quite literally rewired itself.
0:07:28 > 0:07:31After brain damage, a powerful chemical called serotonin
0:07:31 > 0:07:36encourages nerve cells in the brain, or neurons, to make new connections.
0:07:38 > 0:07:41In Derek's case, these connections seem to have been established
0:07:41 > 0:07:44in a part of the brain involved with creative thinking...
0:07:46 > 0:07:49..which may explain his sudden musical talent.
0:07:53 > 0:07:57And Berit's research suggests we might also have hidden talents that
0:07:57 > 0:08:01could be unlocked by stimulating the brain in the right way.
0:08:03 > 0:08:07In the future, we can use magnetic stimulation
0:08:07 > 0:08:12or electric stimulation or perhaps a pill to unlock the abilities
0:08:12 > 0:08:16that we see unlocked in people with acquired savant syndrome.
0:08:16 > 0:08:19We can already improve people's drawing abilities and math
0:08:19 > 0:08:24abilities, and it will only be a matter of time before we can
0:08:24 > 0:08:29make people great musicians or great mathematicians.
0:08:31 > 0:08:34What I think is the greatest gift is human potential,
0:08:34 > 0:08:36and I think we have it in all of us.
0:08:36 > 0:08:40It's not just me. Maybe I hit my head just right,
0:08:40 > 0:08:44but I do believe that it's in all of us.
0:08:52 > 0:08:56Derek's case shows how a small change in the brain can have
0:08:56 > 0:08:58a huge impact on the person we are.
0:09:00 > 0:09:03And there's one case in the history of medicine that was the
0:09:03 > 0:09:08first to demonstrate just how much our brain controls.
0:09:10 > 0:09:14Phineas Gage was an American railroad construction foreman
0:09:14 > 0:09:19who, in 1848, defied the odds by surviving an accident in which
0:09:19 > 0:09:23a large metal rod was driven all the way through his head,
0:09:23 > 0:09:26nearly destroying his frontal lobe.
0:09:26 > 0:09:30Now, when people were done being amazed that he'd survived,
0:09:30 > 0:09:34what they noticed was that he was a different man.
0:09:34 > 0:09:38Previously reliable, he became unpredictable and impulsive,
0:09:38 > 0:09:43and he stayed that way for the last 12 years of his life.
0:09:43 > 0:09:48His was the first case to show that the brain affects the personality.
0:09:48 > 0:09:50Until then, it was believed that our
0:09:50 > 0:09:53personality and abilities were God-given.
0:09:53 > 0:09:55But this case demonstrated
0:09:55 > 0:09:58that they're actually determined by our brain.
0:09:59 > 0:10:01Nearly 200 years later,
0:10:01 > 0:10:05we're still only scratching the surface in understanding what
0:10:05 > 0:10:09all the different parts of our brain do and how they affect us.
0:10:11 > 0:10:14And to unlock some of its secrets,
0:10:14 > 0:10:18the next few cases I'm going to look at are remarkable people who
0:10:18 > 0:10:22see the world around them in extraordinary ways.
0:10:27 > 0:10:32James Rabbett is a man with an astonishing talent.
0:10:33 > 0:10:38He can recognise just about every face he's ever seen,
0:10:38 > 0:10:41even one he's only glimpsed for a few seconds...
0:10:42 > 0:10:44..an ability that's beyond most of us.
0:10:46 > 0:10:49Sometimes, when I'm going to meet someone on the weekend, I say,
0:10:49 > 0:10:51"Let's meet at Waterloo station."
0:10:51 > 0:10:55Because my brain is middle-aged, I can find it quite an effort looking
0:10:55 > 0:10:59amongst all the people there to try and pick out my friend
0:10:59 > 0:11:01or my brother or whoever it is I'm going to meet.
0:11:01 > 0:11:06But James is different. He's what scientists call a super recogniser,
0:11:06 > 0:11:10and he's about to have that ability tested to its limit.
0:11:12 > 0:11:13Hello!
0:11:13 > 0:11:18Dr Josh Davis is a psychologist from the University of Greenwich
0:11:18 > 0:11:20who studies super recognisers.
0:11:20 > 0:11:23He's trying to discover the full extent of their powers of
0:11:23 > 0:11:26recognition and what can explain them.
0:11:30 > 0:11:33Waterloo station, with these large crowds of people.
0:11:33 > 0:11:36You've got to try and find my four actresses,
0:11:36 > 0:11:40who have hidden themselves away in the crowd or be wandering around.
0:11:40 > 0:11:43- It's really, really difficult. - A big challenge, yeah?- Yeah.
0:11:43 > 0:11:48- It's really busy.- So, here you go. Here are four targets.
0:11:50 > 0:11:53What Dr Davis is asking him to do is have
0:11:53 > 0:11:57a quick look at four photos of actresses that he's never
0:11:57 > 0:12:02seen before and then look down on the concourse at Waterloo and
0:12:02 > 0:12:04pick out these individuals
0:12:04 > 0:12:07from in amongst thousands and thousands of other people,
0:12:07 > 0:12:10none of whom James has ever seen before.
0:12:12 > 0:12:15- I'm intrigued to see how you get on. - It's going to be really challenging.
0:12:15 > 0:12:18This is probably one of the hardest tests I've done, I think.
0:12:18 > 0:12:21It's only recently that the very
0:12:21 > 0:12:23existence of super recognisers was discovered.
0:12:26 > 0:12:30Interestingly, James was working already as
0:12:30 > 0:12:33a detective in the Metropolitan Police at Scotland Yard
0:12:33 > 0:12:38and part of his job was to look through hours and hours of
0:12:38 > 0:12:44footage of the 2011 riots, and he was much, much better at
0:12:44 > 0:12:48picking individuals out from the footage than anyone else.
0:12:48 > 0:12:52And he's actually become part of a very small team of detectives who
0:12:52 > 0:12:57are known to be super recognisers and who are able to look at lots
0:12:57 > 0:13:02and lots of photos of suspects and crimes and pick out the right
0:13:02 > 0:13:05person in order that convictions can be secured.
0:13:08 > 0:13:12So, what is it that gives these super recognisers their
0:13:12 > 0:13:14extraordinary powers?
0:13:14 > 0:13:17Well, we've only known about them for a short time,
0:13:17 > 0:13:21so scientists are only just now beginning to uncover their secrets,
0:13:21 > 0:13:26and it seems like the answer lies in a particular part of the brain.
0:13:27 > 0:13:30Within our brain, this part, the temporal lobe,
0:13:30 > 0:13:33is involved in perception and memory.
0:13:33 > 0:13:37Deep inside it, scientists have identified a small area on
0:13:37 > 0:13:41each side that becomes active when we recognise a face.
0:13:41 > 0:13:45It's known as the fusiform gyrus, and it's thought to process visual
0:13:45 > 0:13:50information from our eyes and allow us to recognise individual faces.
0:13:50 > 0:13:54Scientists are now beginning to investigate whether the
0:13:54 > 0:13:59fusiform gyrus might be especially powerful in super recognisers.
0:14:03 > 0:14:07It may be that in super recognisers, this area may be working more
0:14:07 > 0:14:12effectively, or it may be just passing information across
0:14:12 > 0:14:14the brain more effectively.
0:14:14 > 0:14:17We don't really know, but this is the sort of research that we
0:14:17 > 0:14:19are interested in doing in the future.
0:14:22 > 0:14:26At Waterloo station, James is about to try and identify four people
0:14:26 > 0:14:31he's never seen before after just a brief glimpse of their photos.
0:14:38 > 0:14:43- Black leather jacket, blue jeans. - Brilliant!- Pink laces!
0:14:43 > 0:14:46Well done, because I thought she was the hardest.
0:14:49 > 0:14:54- Is it the lady in the black jumper, cream top and blue jeans?- Brilliant!
0:14:54 > 0:14:56That was difficult.
0:14:57 > 0:15:01White top, blue jeans, sandals.
0:15:02 > 0:15:04Do you not think she looked so different in...?
0:15:04 > 0:15:07Yeah, they are very, very different.
0:15:07 > 0:15:11- This is her here with the handbag, blonde hair.- Yeah.- There she is.
0:15:11 > 0:15:13Brilliant, well done.
0:15:13 > 0:15:16- Congratulations. - Thank you. Cheers!
0:15:16 > 0:15:20It's impressive to see James do what's utterly beyond most of
0:15:20 > 0:15:25us and correctly identify all four faces in a crowd.
0:15:28 > 0:15:31When you were looking at the photographs at the start,
0:15:31 > 0:15:34what were you trying to learn when you were looking at them?
0:15:34 > 0:15:36I knew that they weren't going to be made up as they would have
0:15:36 > 0:15:39been on the evenings when they were out having these photographs taken.
0:15:39 > 0:15:43It's trying to get as much of the stable facial features as you can.
0:15:43 > 0:15:46With yours, I had to take myself away from the fact that you
0:15:46 > 0:15:50might have red hair or blonde hair or brown hair or whichever
0:15:50 > 0:15:52colour hair you decided to have on the day,
0:15:52 > 0:15:55so I just had to really focus on the nose, the mouth, jawline,
0:15:55 > 0:15:57because I know that they were not going to change.
0:15:57 > 0:16:01Robbie's wearing glasses. She's not wearing glasses in the photos.
0:16:01 > 0:16:04- And again, you still see through that.- Yeah.
0:16:04 > 0:16:07You've got a distinctive jawline, your nose, the mouth as well.
0:16:07 > 0:16:09You know, these features don't change.
0:16:09 > 0:16:11Do you not think that's quite impressive?
0:16:11 > 0:16:15- Could you have done it?- No! I wouldn't have been able to do it.
0:16:15 > 0:16:17It looks like we've done all right!
0:16:19 > 0:16:23It's clear from the point of view of criminal justice why people
0:16:23 > 0:16:26with this amazing extra quality are so useful.
0:16:26 > 0:16:30But for scientists, working with super recognisers like James
0:16:30 > 0:16:35is bringing a new understanding of how we all recognise other people
0:16:35 > 0:16:39and of the complex and vital relationship between our eyes
0:16:39 > 0:16:40and our brain.
0:16:46 > 0:16:52It's that connection between our brain and our senses - vision,
0:16:52 > 0:16:54hearing, touch, taste,
0:16:54 > 0:16:59smell - that tells us everything we know about the world around us.
0:16:59 > 0:17:02And our senses are some of the most intricate and sophisticated
0:17:02 > 0:17:04systems in our anatomy.
0:17:05 > 0:17:07And just look at the eye.
0:17:07 > 0:17:11It really is one of the wonders of the human body.
0:17:11 > 0:17:15Now, this complex biological camera delivers all sorts of
0:17:15 > 0:17:19information to us in three dimensions and technicolour,
0:17:19 > 0:17:21but I've come across a case recently
0:17:21 > 0:17:25of someone who can see even more vividly than the rest of us.
0:17:28 > 0:17:33I'm Concetta Antico, and I can see colours that nobody else can.
0:17:35 > 0:17:38Like any artist, Concetta has an eye for colour,
0:17:38 > 0:17:43but while most of see the world in a palette of a million colours,
0:17:43 > 0:17:46Concetta can see up to one hundred million.
0:17:50 > 0:17:52I really enjoy painting.
0:17:52 > 0:17:59My eyes were always drawn to light and things of beauty,
0:17:59 > 0:18:03things that were brightly coloured, and I felt this passion to
0:18:03 > 0:18:06paint those images or those colours that I was seeing
0:18:06 > 0:18:08from a very early age.
0:18:12 > 0:18:14It affects me from the moment I wake up.
0:18:14 > 0:18:17The light that's coming in is affecting my mood.
0:18:17 > 0:18:21I walk down the street, and I'm not just walking down the street,
0:18:21 > 0:18:24I'm looking at the colour of the little stones in the
0:18:24 > 0:18:26concrete in the sidewalk.
0:18:28 > 0:18:30Life with an almost superhuman
0:18:30 > 0:18:33ability to see colour can be pretty intense.
0:18:35 > 0:18:39'Shopping, for me, is difficult. It's too much.'
0:18:40 > 0:18:43Can we go back to the old days, where there was just one
0:18:43 > 0:18:46bottle of, you know, tomato sauce and one can of beans?
0:18:48 > 0:18:52As an artist and art teacher, Concetta spent years
0:18:52 > 0:18:56describing colours to her students that they simply couldn't see.
0:18:56 > 0:19:00She had no idea why she was seeing colour differently until by chance
0:19:00 > 0:19:04she heard of a rare condition called tetrachromacy that
0:19:04 > 0:19:06affects the eyes.
0:19:09 > 0:19:14It's the structure of our eyes that allows us to see colour.
0:19:14 > 0:19:19If I dissect into it here, you can see just how complex it is.
0:19:19 > 0:19:23At the front, we've got the iris and the pupil, the lens at the back,
0:19:23 > 0:19:27and just here is the retina, where the image is formed.
0:19:29 > 0:19:34On the retina are special cells called colour receptors, or cones.
0:19:34 > 0:19:37These cones are triggered by different wavelengths of light,
0:19:37 > 0:19:39and they fire off signals to our brain,
0:19:39 > 0:19:43which combines them to produce all the colours we can see.
0:19:45 > 0:19:50Most of us are trichromats, meaning that we have three types of cone.
0:19:51 > 0:19:55But research suggests that some people are tetrachromats.
0:19:55 > 0:19:58They have an extra fourth type of cone,
0:19:58 > 0:20:01and this could allow them to see millions more colours.
0:20:04 > 0:20:07To find out if she might be a tetrachromat,
0:20:07 > 0:20:11Concetta began to contact scientists working in the field.
0:20:14 > 0:20:18Dr Kimberly Jameson at the University of California, Irvine,
0:20:18 > 0:20:21has been studying how we see colour for 20 years.
0:20:25 > 0:20:28She agreed to test Concetta.
0:20:30 > 0:20:33We're going to look at three colours from the same colour group,
0:20:33 > 0:20:36and what I want you to do is pick the odd one out.
0:20:36 > 0:20:39One of the three colours is very slightly different,
0:20:39 > 0:20:42but only a tetrachromat would be able to see it.
0:20:44 > 0:20:49- What number?- 21.- 21. OK. That was correct. That's the odd one out.
0:20:49 > 0:20:51Three more. Look at them carefully.
0:20:54 > 0:20:55Yep!
0:20:55 > 0:20:58Good job, got all three correct.
0:20:58 > 0:21:02Kimberly put Concetta through a series of different tests.
0:21:04 > 0:21:07Try to make a smooth colour continuum and do it as
0:21:07 > 0:21:09quickly as possible.
0:21:10 > 0:21:13- That's kind of pulling them into the zone.- Mm-hm.
0:21:16 > 0:21:21- OK, I'm done.- OK.- Like that. - Let's see how you did.
0:21:21 > 0:21:2318, 19, 20, 21.
0:21:23 > 0:21:26Good job!
0:21:26 > 0:21:30So Concetta is able to detect minute differences between shades of
0:21:30 > 0:21:33colour that look identical to most of us.
0:21:33 > 0:21:37Kimberly has established that she IS a tetrachromat.
0:21:37 > 0:21:41That fourth type of cone in her eye explains the overwhelming
0:21:41 > 0:21:46range of colours she's been experiencing all her life.
0:21:49 > 0:21:51And what's really fascinating
0:21:51 > 0:21:57is that this extraordinary colour vision may only exist in women,
0:21:57 > 0:21:59thanks to our DNA.
0:22:00 > 0:22:06DNA is arranged in our cells into structures called chromosomes.
0:22:06 > 0:22:11Men have one X chromosome but women have two.
0:22:11 > 0:22:14And it's an abnormality, or mutation, on one of
0:22:14 > 0:22:18those X chromosomes that causes the crucial change to the eye,
0:22:18 > 0:22:21producing the fourth type of cone in the retina.
0:22:24 > 0:22:28This is why it's thought only women can be tetrachromats.
0:22:30 > 0:22:34But it's possible that this superhuman vision might not
0:22:34 > 0:22:36be quite so unusual in the future.
0:22:39 > 0:22:41Human visual systems are still evolving.
0:22:41 > 0:22:47Here we are, perhaps on a cusp of human tetrachromacy
0:22:47 > 0:22:50sort of mutating and emerging and being in a pipeline,
0:22:50 > 0:22:54trying to understand where human vision and cognition is going
0:22:54 > 0:22:57or could potentially go in future generations.
0:22:57 > 0:23:00It is sort of like an amazing problem and an
0:23:00 > 0:23:02amazing set of things to look at.
0:23:02 > 0:23:06Perhaps one day many more women will have the ability to see an
0:23:06 > 0:23:11astounding world of colour, like Concetta, but for now,
0:23:11 > 0:23:13she remains exceptional.
0:23:14 > 0:23:18It is a mutation. I call it a gift.
0:23:18 > 0:23:21Will it become more expressed in our world,
0:23:21 > 0:23:24and what does it all mean? I don't know!
0:23:24 > 0:23:29It's going to be things that I'll never know. I'll be long gone.
0:23:29 > 0:23:32But it's key to me and makes my life have meaning.
0:23:37 > 0:23:40Concetta's eyes, with their remarkable colour vision,
0:23:40 > 0:23:44give her brain a sensory overload,
0:23:44 > 0:23:47but some people perceive the world around them in unusual ways
0:23:47 > 0:23:51because a key part of the sensory system is missing.
0:23:54 > 0:23:58All our senses have vital connections to the brain,
0:23:58 > 0:24:02and I've come across a case recently that shows just how profound
0:24:02 > 0:24:06the impact can be if one of these senses is severed.
0:24:11 > 0:24:16There's one sensory experience that most of us do our best to avoid,
0:24:16 > 0:24:20but Paul Waters has never felt it in his life.
0:24:23 > 0:24:27'I don't feel pain. I feel everything else,
0:24:27 > 0:24:29'I just don't feel pain.'
0:24:29 > 0:24:30Come on, then!
0:24:30 > 0:24:35Paul has never experienced an ache, throb or sting like the rest of us.
0:24:37 > 0:24:39'I can feel pressure as opposed to pain.'
0:24:41 > 0:24:47If I cut myself, for example, I would feel that as a...
0:24:48 > 0:24:50..kind of...
0:24:50 > 0:24:56I would say pins and needles would be the easiest way to describe it.
0:24:58 > 0:25:01Paul's parents first realised something was wrong when
0:25:01 > 0:25:03he was just nine months old.
0:25:05 > 0:25:11There was an occasion where my dad had got in from work and
0:25:11 > 0:25:16he trod on my arm, and my mum jumped immediately and said, you know,
0:25:16 > 0:25:18"You're standing on Paul's arm."
0:25:18 > 0:25:20They then sort of stood back and thought to themselves,
0:25:20 > 0:25:23"Well, hang on a minute, Paul didn't flinch."
0:25:23 > 0:25:28It was a kind of a sign that perhaps they should take me somewhere.
0:25:28 > 0:25:33Doctors tested Paul and later his sisters and diagnosed them with
0:25:33 > 0:25:35an extremely rare condition called
0:25:35 > 0:25:39congenital insensitivity to pain, or CIP.
0:25:43 > 0:25:47For most of us, if we cut our finger with a knife,
0:25:47 > 0:25:50the cut activates nerve endings in the finger.
0:25:50 > 0:25:54The nerve endings send an electrical signal through special cells
0:25:54 > 0:25:57called pain neurons up to the brain,
0:25:57 > 0:26:01and this is what we experience as pain.
0:26:01 > 0:26:02But for some reason,
0:26:02 > 0:26:05this system wasn't working in Paul and his sisters.
0:26:08 > 0:26:13Growing up, me and my sisters would get up to a lot of mischief -
0:26:13 > 0:26:15jumping off of high objects,
0:26:15 > 0:26:17you know, at the risk of breaking a bone.
0:26:17 > 0:26:21If a child breaks a bone, they're going to be in pain,
0:26:21 > 0:26:23they're probably not going to do it again.
0:26:23 > 0:26:28None of those negatives were present in me or my sisters,
0:26:28 > 0:26:30so we used to do a lot of things
0:26:30 > 0:26:33as children that other children wouldn't do.
0:26:35 > 0:26:37An oven, to me, back then was a toy.
0:26:37 > 0:26:41I'd put my hand in the hob just to hear it sizzle.
0:26:41 > 0:26:44Now, it might sound like this condition is actually
0:26:44 > 0:26:47protecting people like Paul from pain and harm...
0:26:48 > 0:26:51..but our ability to sense pain is vital.
0:26:51 > 0:26:54It alerts us to danger and helps us avoid it.
0:26:54 > 0:26:58Not having it can be catastrophic.
0:26:58 > 0:27:02One of Paul's sisters died as a result of an injury she didn't feel.
0:27:03 > 0:27:07And Paul himself now lives with the consequences of
0:27:07 > 0:27:09a lifetime of broken bones.
0:27:09 > 0:27:13It's affected his height, and he needs frequent operations.
0:27:15 > 0:27:18Ready? Scalpel...
0:27:18 > 0:27:20Can we start?
0:27:22 > 0:27:27So, why doesn't Paul experience pain, like the rest of us?
0:27:27 > 0:27:31Well, his condition's very rare, so for years it's been a medical
0:27:31 > 0:27:36mystery, but now one scientist is trying to get to the bottom of it.
0:27:38 > 0:27:41Geoff Woods is a professor of medical genetics at the
0:27:41 > 0:27:43University of Cambridge.
0:27:43 > 0:27:48He had seen that CIP tended to occur in families, like with Paul and his
0:27:48 > 0:27:53sisters, and so he knew it was most likely caused by a faulty gene.
0:27:55 > 0:27:59It was such a rare condition that no-one had worked on it,
0:27:59 > 0:28:03really, no-one saw any potential benefits to the condition,
0:28:03 > 0:28:06and in some ways it was just forgotten about.
0:28:06 > 0:28:09It was that sort of realisation that we could do this,
0:28:09 > 0:28:11it could be a genetic disease.
0:28:13 > 0:28:15Geoff knew that if he could find this gene,
0:28:15 > 0:28:20then he might find the cause of CIP and perhaps even a cure.
0:28:22 > 0:28:26His team began examining the genes of families with the condition,
0:28:26 > 0:28:30searching for a mutation that they all had in common.
0:28:32 > 0:28:35After ten years of painstaking work,
0:28:35 > 0:28:37he eventually found what he was looking for,
0:28:37 > 0:28:43a mutation in one particular gene that all the families shared.
0:28:43 > 0:28:46He knew this had to be a key gene for controlling pain.
0:28:46 > 0:28:49It was called SCN9A.
0:28:52 > 0:28:56The day we sequenced SCN9A, my technician was looking
0:28:56 > 0:28:58through the sequence results,
0:28:58 > 0:29:01and all three families we used to map where the gene was,
0:29:01 > 0:29:05we'd found mutations in them, and so we thought,
0:29:05 > 0:29:07"Gosh, this could really exciting."
0:29:09 > 0:29:13I think people had not expected that a single gene would be able
0:29:13 > 0:29:16to control all pain sense in humans.
0:29:18 > 0:29:21When our nerve endings sense something painful, they
0:29:21 > 0:29:26trigger a surge of charged particles to flow into the pain neurons.
0:29:26 > 0:29:29This stimulates the electrical signal to be fired
0:29:29 > 0:29:31and sent up to the brain.
0:29:31 > 0:29:37The SCN9A gene controls this flow of charged particles, but in Paul
0:29:37 > 0:29:42the gene is faulty, and so the pain signal is never sent to his brain.
0:29:42 > 0:29:46Geoff had finally found the reason why Paul and others with CIP
0:29:46 > 0:29:49couldn't feel any pain.
0:29:51 > 0:29:55With our patients who can't cause that electrical stimulus to be
0:29:55 > 0:29:59fired, they've got their pain neurons sitting there but
0:29:59 > 0:30:02they just can't respond.
0:30:02 > 0:30:05Knowing the cause of CIP provides hope of
0:30:05 > 0:30:08a cure for future generations of people like Paul.
0:30:08 > 0:30:12But Geoff and his team realised that the discovery of
0:30:12 > 0:30:16a gene for pain has wider implications for all of us.
0:30:18 > 0:30:22If scientists can find a way to block the gene temporarily,
0:30:22 > 0:30:26then they'll be able to produce more effective painkillers in the future,
0:30:26 > 0:30:31essentially providing total pain relief for patients who need it.
0:30:33 > 0:30:38It surely should be a goal that pain is a controllable problem.
0:30:38 > 0:30:42The way we've made such huge strides in the understanding and the
0:30:42 > 0:30:45treatment of cancer, that must be possible, also, for pain.
0:30:47 > 0:30:48I would hope that,
0:30:48 > 0:30:52as a result of the research being done into my condition,
0:30:52 > 0:30:57that that can be used somehow to create something that would
0:30:57 > 0:31:01act as a block to pain to someone who suffers from too much of it.
0:31:02 > 0:31:07So use someone who doesn't feel pain as a way of helping someone who
0:31:07 > 0:31:08feels too much pain.
0:31:13 > 0:31:17Extraordinary people like Concetta and Paul are giving crucial
0:31:17 > 0:31:22insights into how our senses work, but every now and again an
0:31:22 > 0:31:26individual is discovered who has a sensory superpower with the
0:31:26 > 0:31:29potential to change the course of medicine,
0:31:29 > 0:31:33and I've come across a case recently that could provide
0:31:33 > 0:31:38a breakthrough in diagnosing one of the most devastating diseases
0:31:38 > 0:31:39of the modern age.
0:31:42 > 0:31:46Joy Milne can smell things that other people can't.
0:31:47 > 0:31:52As a nurse, I found I could smell a lot of things.
0:31:52 > 0:31:54Blood has a definite smell.
0:31:54 > 0:31:59I would say, "Oh, there's an awful smell in here," but I didn't
0:31:59 > 0:32:02realise other people didn't have that sense of smell.
0:32:02 > 0:32:07But even she was shocked to discover the true power of her nose.
0:32:07 > 0:32:10It began with her husband, Les.
0:32:11 > 0:32:14When Les was in his middle thirties,
0:32:14 > 0:32:17I began to nag a little about his smell.
0:32:17 > 0:32:19I just said to him he wasn't showering enough,
0:32:19 > 0:32:22and then I had to say he wasn't brushing his teeth well enough,
0:32:22 > 0:32:24and he was adamant he was doing both.
0:32:25 > 0:32:29At the time, Joy didn't think much of it, but a few years later,
0:32:29 > 0:32:32she noticed other changes in Les.
0:32:34 > 0:32:36He....would miss things.
0:32:37 > 0:32:40We were playing darts with the boys one night,
0:32:40 > 0:32:43and he let the dart literally go through the front of his shoe.
0:32:45 > 0:32:49Les was diagnosed with Parkinson's, a progressive neurological
0:32:49 > 0:32:53disease that causes tremors and difficulties with movement
0:32:53 > 0:32:55and can lead to dementia.
0:32:55 > 0:32:58As they began to encounter other Parkinson's patients,
0:32:58 > 0:33:01Joy noticed something extraordinary.
0:33:06 > 0:33:10It wasn't until we went to our first Parkinson's group that I came home
0:33:10 > 0:33:13and I said to Les, "They smell the same as you."
0:33:13 > 0:33:16And he sort of... He said, "Are you sure?"
0:33:16 > 0:33:18I said, "Yes. It has a smell.
0:33:18 > 0:33:22"It definitely has a smell. These people smell like you."
0:33:23 > 0:33:27'On the face of it, it seemed completely bizarre.
0:33:27 > 0:33:30'Was it really possible that Parkinson's had an odour and
0:33:30 > 0:33:33'that Joy could smell it?
0:33:34 > 0:33:36'She was determined to find the answer.
0:33:38 > 0:33:42'In 2012, she attended a talk given by Dr Tilo Kunath,
0:33:42 > 0:33:45'a Parkinson's expert at the University of Edinburgh.
0:33:48 > 0:33:52'At the end, she raised her hand to ask a question.'
0:33:53 > 0:33:57I just said, "Why aren't we using the smell of Parkinson's?"
0:33:57 > 0:33:59That was a pretty unusual question.
0:33:59 > 0:34:03I've never had that question posed before, and I have to admit, yeah,
0:34:03 > 0:34:06I was confused and I didn't know what you were getting at
0:34:06 > 0:34:09- at the time. - You were!- Yeah.
0:34:09 > 0:34:13Intrigued, Tilo contacted Joy after the talk
0:34:13 > 0:34:16and was shocked to hear how she had noticed the change in Les's
0:34:16 > 0:34:20scent before he was even diagnosed.
0:34:20 > 0:34:22- Hi! - Hello!
0:34:22 > 0:34:26And I asked you questions like "Can you describe the smell in words?"
0:34:26 > 0:34:31- Nasty.- And woody?- Yes, a heavy, musky smell.- Yeah.
0:34:31 > 0:34:33Tilo designed an experiment
0:34:33 > 0:34:36to put Joy's remarkable claims to the test.
0:34:36 > 0:34:39Could she really smell Parkinson's disease?
0:34:41 > 0:34:46He recruited 12 volunteers, six with Parkinson's and six without,
0:34:46 > 0:34:51and asked Joy to identify them based on the scent of their T-shirts.
0:34:54 > 0:34:58So, she told us who all the Parkinson's patients were,
0:34:58 > 0:35:01and then, of the six controls, she got five of them right.
0:35:01 > 0:35:04And we thought, "Pretty good, 11 out of 12, that's quite a good score."
0:35:04 > 0:35:08But nine months later, the patient that Joy had seemed to identify
0:35:08 > 0:35:11incorrectly as having Parkinson's
0:35:11 > 0:35:15was diagnosed with the disease. She'd been right all along.
0:35:17 > 0:35:20My jaw just dropped, and I couldn't believe that she could predict
0:35:20 > 0:35:23someone that was in the early stages of Parkinson's.
0:35:25 > 0:35:31The tests show that Joy really can smell Parkinson's and, more
0:35:31 > 0:35:36than that, she can detect it before a patient has any symptoms.
0:35:36 > 0:35:41So, how is this possible, and what exactly is she smelling?
0:35:44 > 0:35:48Every smell is a unique collection of odour molecules that
0:35:48 > 0:35:50travel through the air.
0:35:51 > 0:35:54These are picked up by chemical receptors at the back of our
0:35:54 > 0:35:56nose which then send a pattern
0:35:56 > 0:36:01of signals to a part of the brain called the olfactory bulb.
0:36:01 > 0:36:05It's this pattern of signals that we interpret as a smell.
0:36:11 > 0:36:14It could be possible that Joy's odour receptors are highly
0:36:14 > 0:36:18sensitive compared to the rest of us, but more pressing for
0:36:18 > 0:36:22scientists is to discover what exactly it is that she's smelling.
0:36:25 > 0:36:26Professor Perdita Barran
0:36:26 > 0:36:29is a a chemist at the University of Manchester.
0:36:31 > 0:36:35Tilo asked her to analyse the T-shirts from the experiments.
0:36:35 > 0:36:40But first, Perdita needed to know which part of them Joy had smelt.
0:36:42 > 0:36:44Contrary to what we had assumed,
0:36:44 > 0:36:47that the smell would be in sweat and therefore perhaps strongest
0:36:47 > 0:36:51in the armpit areas of the T-shirts, it wasn't,
0:36:51 > 0:36:53it was strongest in the middle of the back.
0:36:55 > 0:36:58The middle of the back contains a large concentration of an
0:36:58 > 0:37:02oily substance called sebum that protects the skin.
0:37:02 > 0:37:06Perdita knew that there must be a molecule in sebum that Joy
0:37:06 > 0:37:11could smell that was unique in people with Parkinson's disease.
0:37:11 > 0:37:13She analysed the sebum from the T-shirts and
0:37:13 > 0:37:17found 9,000 possible molecules.
0:37:18 > 0:37:22What we are really wanting to find out is what is the difference
0:37:22 > 0:37:26between 9,000 molecules in one person and 9,000 molecules in
0:37:26 > 0:37:29a Parkinson's sufferer,
0:37:29 > 0:37:33and potentially one or two or three molecules will be very different.
0:37:33 > 0:37:35So it is a needle-in-a-haystack situation.
0:37:37 > 0:37:42To identify the few molecules in 9,000 that are specific to
0:37:42 > 0:37:47Parkinson's disease, Perdita needs a much larger number of samples.
0:37:49 > 0:37:53So she's started a clinical trial involving sebum samples
0:37:53 > 0:37:57from 100 people who have Parkinson's disease and 100 people who don't.
0:37:59 > 0:38:03Perdita hopes that by identifying the molecule that Joy is smelling,
0:38:03 > 0:38:09it could transform the way doctors diagnose and treat Parkinson's.
0:38:09 > 0:38:13What we hope is that we will be able to develop a diagnostic test.
0:38:13 > 0:38:15That's our primary aim.
0:38:15 > 0:38:18We really hope that that will help to diagnose Parkinson's at an
0:38:18 > 0:38:20earlier stage than currently available,
0:38:20 > 0:38:22and at the moment there really isn't a test.
0:38:22 > 0:38:25And all of that is thanks to Joy.
0:38:27 > 0:38:31The possibility of an early diagnostic test for Parkinson's
0:38:31 > 0:38:36disease could improve the lives of millions of people around the world,
0:38:36 > 0:38:40all thanks to one woman and her very keen nose.
0:38:42 > 0:38:46Joy's acute sense of smell gives her a special understanding of
0:38:46 > 0:38:50other people, but, in fact, in all of us smell is inherently
0:38:50 > 0:38:54associated with the formation of memory and emotions.
0:38:54 > 0:38:57You might know this if a smell's ever reminded you of something.
0:38:57 > 0:39:01And if you look at the anatomy, it's clear why.
0:39:01 > 0:39:06Smell enters through the nose, and it comes up and is processed in
0:39:06 > 0:39:10the olfactory bulb before sending signals to parts of the brain
0:39:10 > 0:39:14called the amygdala and the hippocampus.
0:39:14 > 0:39:18These two areas of the brain are crucial in the formation of
0:39:18 > 0:39:20emotions and memory.
0:39:22 > 0:39:26How memory works is one of the deepest secrets of the brain...
0:39:28 > 0:39:31..one that scientists are unravelling thanks to
0:39:31 > 0:39:33a few exceptional individuals.
0:39:38 > 0:39:44This is Tracy Fitzgerald. Tracy lives in Boston, Massachusetts.
0:39:44 > 0:39:48She's a student advisor, which would seem to be a normal job.
0:39:48 > 0:39:54But Tracy has a completely extraordinary ability.
0:39:54 > 0:39:58'I'm able to remember every day as if it were yesterday.'
0:39:58 > 0:40:02She can remember precise events and the date they occurred going
0:40:02 > 0:40:04back decades.
0:40:04 > 0:40:06- INTERVIEWER:- Can you remember what might have happened
0:40:06 > 0:40:09- on February 11th 1990? - Yes.
0:40:09 > 0:40:13February 11th 1990 was the day that Nelson Mandela was released
0:40:13 > 0:40:14from prison.
0:40:14 > 0:40:1716th of October 1978.
0:40:17 > 0:40:22The 16th of October 1978, Pope John Paul was named Pope.
0:40:22 > 0:40:26November 9th 1989 was the day that the Berlin Wall officially
0:40:26 > 0:40:28came down.
0:40:28 > 0:40:31Do you happen to know the date that Diana and Charles got married?
0:40:31 > 0:40:34July 29th 1981. It was a Wednesday.
0:40:36 > 0:40:39Tracy doesn't learn these details by rote.
0:40:39 > 0:40:43Her extraordinary recall goes way beyond the day's headlines.
0:40:45 > 0:40:48I'll go back to 2010 and think of March 4th.
0:40:48 > 0:40:52It's almost instantaneous. It's kind of like a DVD
0:40:52 > 0:40:57is being put in and then set to play, and I'm recalling.
0:40:57 > 0:40:59A large portion of information will immediately hit,
0:40:59 > 0:41:02and then the rest kind of comes in like snow,
0:41:02 > 0:41:05almost like a game of Tetris, starting to fall into place.
0:41:07 > 0:41:09That year, on March 4th,
0:41:09 > 0:41:13members from my office decided to go have an impromptu after-work
0:41:13 > 0:41:14gathering at the local pub,
0:41:14 > 0:41:18so now I've just remembered that before I was able to go to that,
0:41:18 > 0:41:21I also had to go to a bank and make a credit-card payment, because
0:41:21 > 0:41:24my credit-card payment was due on March 4th, and I think
0:41:24 > 0:41:27I made the minimum, like, 85 payment that day
0:41:27 > 0:41:32and was able to take out some money, 20, to be able to go to the bar
0:41:32 > 0:41:36and join my friends that afternoon, so that information's coming in.
0:41:39 > 0:41:43Tracy can remember this kind of precise detail from almost
0:41:43 > 0:41:46every day of her life for the past 40 years.
0:41:46 > 0:41:50It's a condition called highly superior autobiographical
0:41:50 > 0:41:53memory, or HSAM.
0:41:55 > 0:41:57For someone with a normal memory,
0:41:57 > 0:42:00and certainly someone of my age who, I don't know,
0:42:00 > 0:42:04I feel like I'm losing memory and details all over the place,
0:42:04 > 0:42:08you watch her doing this and it's just completely astonishing.
0:42:08 > 0:42:13Sometimes I begin my day or I end my day thinking about that date
0:42:13 > 0:42:16and then going back in time to see if I can identify what I was
0:42:16 > 0:42:18doing for the past year or so.
0:42:18 > 0:42:23Those are some of the typical exercises that I do just for fun.
0:42:26 > 0:42:30'Tracy's memory skills are incredibly rare,
0:42:30 > 0:42:36'so what is it that enables her to have this exceptional recall?'
0:42:36 > 0:42:40One scientist is trying to unlock the secrets of what's happening
0:42:40 > 0:42:44inside the brains of people with this extraordinary condition.
0:42:46 > 0:42:50'My name is James McGaugh, and I'm a professor of neurobiology and
0:42:50 > 0:42:53'behaviour at the University of California, Irvine.'
0:42:55 > 0:43:00Over the past 15 years, James has studied over 60 people with HSAM.
0:43:02 > 0:43:06It's not that they have a very strong memory to begin with.
0:43:06 > 0:43:10As a matter of fact, we are as good as they are for 24 hours.
0:43:10 > 0:43:14So if you think about it, their autobiographical memory is just like
0:43:14 > 0:43:20ours for a period of time, then we forget and they tend not to forget,
0:43:20 > 0:43:22and that's the difference.
0:43:22 > 0:43:28It's not just a strong memory, it's a very severe inability to forget.
0:43:29 > 0:43:31To discover how this is possible,
0:43:31 > 0:43:36James's colleague Dr Mike Yassa has been using an MRI scanner to
0:43:36 > 0:43:39look inside the brains of people with HSAM.
0:43:39 > 0:43:42He's comparing the structure of their brains with those of people
0:43:42 > 0:43:46with normal memories, and he's found three intriguing differences.
0:43:50 > 0:43:51This area here, called the striatum,
0:43:51 > 0:43:54which is about the middle of the brain,
0:43:54 > 0:43:57this is a region that's been implicated in habit formation
0:43:57 > 0:44:02and habit learning, and that region seems to be slightly enlarged
0:44:02 > 0:44:04in individuals with this ability.
0:44:04 > 0:44:08There's a second area that's enlarged in people with HSAM,
0:44:08 > 0:44:13the parahippocampal gyrus, involved in learning and memory, and there's
0:44:13 > 0:44:17a pathway known to be involved in transferring information
0:44:17 > 0:44:20around the brain that's also more pronounced.
0:44:25 > 0:44:29So the scans have revealed what's different about the brains of
0:44:29 > 0:44:31people with HSAM.
0:44:32 > 0:44:35But to find out why these differences exist,
0:44:35 > 0:44:40James has begun an exciting new phase of research.
0:44:41 > 0:44:44'My name is Tyler. I am 13 years old,
0:44:44 > 0:44:47'and I have highly superior autobiographical memory.'
0:44:49 > 0:44:51Tyler is one of the youngest members
0:44:51 > 0:44:54of the group being studied by James McGaugh.
0:44:54 > 0:44:58He displays the same abilities as Tracy.
0:44:58 > 0:45:04What was Thanksgiving in 2014? That was two years ago.
0:45:04 > 0:45:06- The 27th. - Correct.
0:45:08 > 0:45:12Scientists think that Tyler might finally bring
0:45:12 > 0:45:16a breakthrough in understanding HSAM,
0:45:16 > 0:45:18not only because he's 14 and they can watch the condition develop
0:45:18 > 0:45:20throughout his life.
0:45:20 > 0:45:22Tyler brings a double opportunity...
0:45:24 > 0:45:26..because this is Chad...
0:45:28 > 0:45:31..Tyler's genetically identical twin brother.
0:45:31 > 0:45:33And he doesn't have HSAM.
0:45:33 > 0:45:37It's kinda cool, cos, like, if I don't remember a date for a certain
0:45:37 > 0:45:41thing, say my parents ask me, he always remembers it and can tell me.
0:45:41 > 0:45:43So, yeah, that's kinda cool.
0:45:44 > 0:45:50In 2013, what was the day of the week before Halloween?
0:45:50 > 0:45:51- Thursday. - Correct.
0:45:51 > 0:45:56- A Saturday? No, wait, Friday. Yeah.- Close. Not quite.
0:45:56 > 0:45:57Oh...
0:45:57 > 0:46:02Two people of the same age, same background, same family,
0:46:02 > 0:46:04and we'll find out, hopefully,
0:46:04 > 0:46:07why one of them is able to have it and one does not.
0:46:10 > 0:46:16Here's a couple of twins who share a genetic code who are going to
0:46:16 > 0:46:21provide Dr McGaugh with a remarkable opportunity to try
0:46:21 > 0:46:24and identify what it is that makes people with HSAM different
0:46:24 > 0:46:26from people without HSAM.
0:46:28 > 0:46:32If we can learn something about how their brains work and how
0:46:32 > 0:46:34their brain working differs
0:46:34 > 0:46:36from those of people who do not, that will
0:46:36 > 0:46:40be a new chapter in understanding the neurobiology of memory.
0:46:45 > 0:46:47Every waking moment,
0:46:47 > 0:46:51our brains are taking in a massive amount of information from
0:46:51 > 0:46:54our senses and adding it to the memories that are already
0:46:54 > 0:46:56stored there,
0:46:56 > 0:47:00and it's this wealth of information that enables us to survive
0:47:00 > 0:47:02and navigate through our lives.
0:47:02 > 0:47:07These extraordinary cases that we've been looking at are enabling
0:47:07 > 0:47:12scientists to work out just how the brain can do all this.
0:47:12 > 0:47:17But sometimes science can learn the most when the power of the
0:47:17 > 0:47:21brain is taken away, as our final case shows.
0:47:24 > 0:47:27'I remember just seeing complete black.
0:47:29 > 0:47:32'I guess my eyes weren't connected to my brain yet.
0:47:33 > 0:47:36'I felt like I was a prisoner in my own body.
0:47:37 > 0:47:40'This event changed my life forever.'
0:47:41 > 0:47:43Three-and-a-half years ago,
0:47:43 > 0:47:47Juan Torres was trapped in a seemingly vegetative state,
0:47:47 > 0:47:51awake but unable to communicate with the outside world.
0:47:51 > 0:47:54No-one expected him to recover.
0:47:54 > 0:47:59The very fact he's talking to us now is truly astonishing.
0:47:59 > 0:48:01CHATTER ECHOES
0:48:02 > 0:48:05I remember going to a party.
0:48:05 > 0:48:07And then I remember coming home.
0:48:10 > 0:48:13Juan has no memory of the events that followed.
0:48:13 > 0:48:17Mysteriously, something happened in the night that led to him
0:48:17 > 0:48:20having a respiratory arrest. He stopped breathing.
0:48:20 > 0:48:23And his mother, Margarita, obviously called the ambulance,
0:48:23 > 0:48:28where he was rushed to hospital and doctors attempted to save him.
0:48:28 > 0:48:31'They were struggling to keep him alive.'
0:48:32 > 0:48:36But there was a moment where they told us,
0:48:36 > 0:48:40"He's leaving, basically he's leaving. You can say goodbye."
0:48:41 > 0:48:43But Juan survived.
0:48:44 > 0:48:49When the doctors managed to get him through that period of time
0:48:49 > 0:48:52where they thought he might not live,
0:48:52 > 0:48:55the best that they were able to come to Margarita and tell
0:48:55 > 0:48:58her was that he was still alive but that he was in
0:48:58 > 0:49:01a vegetative state and would not recover.
0:49:03 > 0:49:06As his mother was being told that story,
0:49:06 > 0:49:10Juan was in the room hearing everything that was being said,
0:49:10 > 0:49:13recognising the world around him and knowing that
0:49:13 > 0:49:17he was still conscious, but in his case, he didn't even have the
0:49:17 > 0:49:21ability to blink his eyes to let someone know that that was so.
0:49:23 > 0:49:25It felt horrible.
0:49:25 > 0:49:27I couldn't even cry...
0:49:29 > 0:49:33..because I guess my brain hadn't got reconnected to my tear ducts.
0:49:36 > 0:49:40For over two desperate months, Juan remained in what's known as
0:49:40 > 0:49:44a locked-in state, conscious but unable to communicate.
0:49:46 > 0:49:50Margarita is clearly an amazing woman,
0:49:50 > 0:49:54and even in the face of doctors saying to her,
0:49:54 > 0:49:58"We're really sorry, we've done the best we can by your son,
0:49:58 > 0:50:02"he's alive and breathing but he's not there any more,"
0:50:02 > 0:50:05she just chose not to believe that.
0:50:07 > 0:50:11Sometimes, it was hard to stay positive because there would
0:50:11 > 0:50:14be many days and hours where you don't see a glimpse of anything.
0:50:16 > 0:50:18I love you, baby.
0:50:18 > 0:50:20Do you see the nice place?
0:50:20 > 0:50:24They have a beautiful garden outside, and park.
0:50:25 > 0:50:27And then, one day, without warning,
0:50:27 > 0:50:32for reasons that aren't understood, something truly remarkable happened.
0:50:33 > 0:50:37We took him with my husband, and it was a sunny day, beautiful day.
0:50:37 > 0:50:40That was the first day that he came out of the room.
0:50:41 > 0:50:44I remember being outside.
0:50:44 > 0:50:48And my mum said something like, "Come on,
0:50:48 > 0:50:51"you're always my little Snow White." And then I chuckled.
0:50:51 > 0:50:54And that's when they knew.
0:50:54 > 0:50:57Oh, my God. It's very...!
0:50:57 > 0:51:01'We were laughing. And so he started to laugh.'
0:51:01 > 0:51:04Sleeping Beauty? Yeah.
0:51:04 > 0:51:08'I remember feeling really happy.'
0:51:08 > 0:51:15That was to me a very specific sign that he was going to come back.
0:51:15 > 0:51:19Juan had finally been able to let the people around him know
0:51:19 > 0:51:22that he was still conscious.
0:51:22 > 0:51:24They were ecstatic.
0:51:24 > 0:51:26I felt joy.
0:51:27 > 0:51:31I remember I was just...kept telling myself that...
0:51:31 > 0:51:34I'm going to walk again. That's what drove me.
0:51:34 > 0:51:37The fact that I had it all,
0:51:37 > 0:51:40and I was going to return to having it all.
0:51:40 > 0:51:44THEY SPEAK IN SPANISH AND LAUGH
0:51:44 > 0:51:49Why he was suddenly able to start communicating like this is
0:51:49 > 0:51:52something that science can't completely explain.
0:51:52 > 0:51:57And how and why this happens in some patients and what triggers it
0:51:57 > 0:52:01are some of medicine's greatest unknowns.
0:52:01 > 0:52:05The difficulty for us doctors is in trying to establish exactly
0:52:05 > 0:52:10which patients are in a truly vegetative state,
0:52:10 > 0:52:14and which are aware of what's going on but unable to communicate.
0:52:14 > 0:52:18In short, which patients will get better.
0:52:20 > 0:52:24One man is trying to find a way to answer this question.
0:52:24 > 0:52:29Adrian Owen is a neuroscientist from the University of Western Ontario.
0:52:33 > 0:52:36He tested Juan when he seemed to be in a vegetative state.
0:52:36 > 0:52:39Down, roll over!
0:52:39 > 0:52:43And Juan's recovery offered a rare opportunity to discover how
0:52:43 > 0:52:47much he'd actually been aware of at that time.
0:52:47 > 0:52:51Once we heard he'd recovered, we very quickly brought him back
0:52:51 > 0:52:54here to London, Ontario, and we put together a memory test.
0:52:54 > 0:52:58We asked him things like which of these two people do you recognise?
0:52:58 > 0:53:01Of course, he could identify my research assistant who'd
0:53:01 > 0:53:03tested him on that day.
0:53:03 > 0:53:07What we have to remember is that, at the time, Juan appeared to be
0:53:07 > 0:53:11in a vegetative state. He was entirely non-responsive.
0:53:11 > 0:53:12His eyes were open but there was
0:53:12 > 0:53:17no evidence he was aware at all, yet he could remember people.
0:53:17 > 0:53:19He could remember places.
0:53:19 > 0:53:22And he could remember things we'd done to him.
0:53:24 > 0:53:28Dr Owen was only able to find out that Juan had been aware of
0:53:28 > 0:53:31what was going on after he'd already recovered.
0:53:31 > 0:53:36He needed a way to find out which patients were truly vegetative
0:53:36 > 0:53:41and which patients were locked in and had a chance to recover.
0:53:41 > 0:53:44He decided to look inside their brains.
0:53:46 > 0:53:51So, what Dr Owen's been doing is putting all of his patients,
0:53:51 > 0:53:55who are in a vegetative state, into what's called
0:53:55 > 0:53:57a functional MRI scanner,
0:53:57 > 0:54:01which is a machine that looks at the brain and,
0:54:01 > 0:54:05in response to certain questions, shows different levels of
0:54:05 > 0:54:09blood flow to try and identify that there's some function there.
0:54:10 > 0:54:12When you hear the instruction to begin,
0:54:12 > 0:54:16please imagine playing a game of tennis.
0:54:16 > 0:54:18We know that when people imagine playing tennis,
0:54:18 > 0:54:22a part of the brain, known as the premotor cortex, lights up.
0:54:22 > 0:54:25It's the part of the brain involved in moving your arms around,
0:54:25 > 0:54:27as if you were playing a game of tennis.
0:54:27 > 0:54:30If I say imagine playing tennis to you and your premotor cortex
0:54:30 > 0:54:34lights up, I know that you've understood the instruction
0:54:34 > 0:54:36and you've followed the command.
0:54:38 > 0:54:40By scanning patients' brains in this way,
0:54:40 > 0:54:45Dr Owen has found that nearly 20% of people who appear to be in
0:54:45 > 0:54:50a vegetative state are in fact conscious and aware.
0:54:51 > 0:54:53And now, thanks to this research,
0:54:53 > 0:54:56scientists are closer to understanding how more
0:54:56 > 0:55:01patients like Juan could be brought out of their locked-in state.
0:55:05 > 0:55:0720 years ago, when I started working in this area,
0:55:07 > 0:55:10nobody was interested in the vegetative state
0:55:10 > 0:55:12because it was thought to be a hopeless condition.
0:55:14 > 0:55:17Well, now we know that in some cases there is hope.
0:55:17 > 0:55:21Now we know that in one in five cases there is awareness when
0:55:21 > 0:55:23everybody else thinks there isn't.
0:55:25 > 0:55:28One in five is a staggeringly high number.
0:55:28 > 0:55:32But it's never going to be possible to take every patient
0:55:32 > 0:55:34in such a critical condition
0:55:34 > 0:55:38to an fMRI scanner to test their brain responses.
0:55:38 > 0:55:42And this could mean that not every locked-in patient is identified.
0:55:42 > 0:55:47The difficulty with fMRI scanning all of these patients
0:55:47 > 0:55:51is MRI scanners are very heavy and not movable.
0:55:52 > 0:55:57So, Dr Owen's come up with a brilliant solution to this problem.
0:55:57 > 0:56:02This is the EEJeep. It allows him to take his testing on the road.
0:56:03 > 0:56:07He uses a different technology to measure brain activity
0:56:07 > 0:56:11so that critically ill patients don't have to be transported to him.
0:56:11 > 0:56:12He can go to them.
0:56:16 > 0:56:19There are 129 electrodes,
0:56:19 > 0:56:23and each one of these will pick up a little bit of the electrical
0:56:23 > 0:56:27activity that your brain naturally and continuously produces.
0:56:28 > 0:56:32The way fMRI works is by measuring or by monitoring
0:56:32 > 0:56:35how blood moves around the brain.
0:56:35 > 0:56:38EEG works in a completely different way,
0:56:38 > 0:56:41which is that it detects the electrical signals coming
0:56:41 > 0:56:45from the activity of neurons in the brain.
0:56:45 > 0:56:48It's actually a different way of looking at the same thing,
0:56:48 > 0:56:52which is, essentially, which areas of the brain are active right now.
0:56:54 > 0:56:58Dr Owen's research is bringing us closer to understanding why
0:56:58 > 0:57:02patients like Juan recover and how we can identify others like him
0:57:02 > 0:57:06so that we can bring more people back from being locked in.
0:57:06 > 0:57:11Three years on, Juan is studying life sciences at university.
0:57:11 > 0:57:13And learning to walk again.
0:57:16 > 0:57:21You've got to put one foot in front of the other. That's how you learn.
0:57:21 > 0:57:22I'm going to be walking in a year.
0:57:22 > 0:57:25Exactly a year from now.
0:57:25 > 0:57:27Or less.
0:57:27 > 0:57:33I feel that we all appreciate life in a totally different...
0:57:33 > 0:57:35manner than we used to.
0:57:35 > 0:57:37It is amazing.
0:57:39 > 0:57:41Juan was brought back from the edge of oblivion,
0:57:41 > 0:57:44a terrifying experience.
0:57:44 > 0:57:49But from this and all the other cases we've explored comes a better
0:57:49 > 0:57:53understanding of the extraordinary power of the human brain.
0:57:53 > 0:57:58It reminds us of the super abilities that our brains give us
0:57:58 > 0:58:04and how they can sometimes recover, even in the most extreme cases.
0:58:05 > 0:58:11Next time, I'll discover why this man can run for three days straight.
0:58:11 > 0:58:14Some of the races I've run have been 200 miles.
0:58:14 > 0:58:17Why this woman has to battle the whole world.
0:58:17 > 0:58:19I'm allergic to everything.
0:58:19 > 0:58:22And why this woman once had two hearts.
0:58:22 > 0:58:25I always think of all the doctors, all the surgeons.
0:58:25 > 0:58:27I wouldn't really be here without them.