IAMA brain surgery survivor and I no longer feel fear because my right amygdala was removed along with 10% of my brain.

Have you seen the Mindfield episode on Vsauce about fear? There was a girl that had a damaged amygdala. She claimed that she couldn't feel fear, and so scientists did a bunch of tests with her to map out fear responses. What they found was that nothing phased her, until they got to suffocation. They simulated it by increasing her blood's CO2 levels to safely simulate suffocation without actually preventing her from breathing, and she became absolutely terrified despite being perfectly safe. They found out that the fear response from an increased level of CO2 (suffocation) is centered in the brain stem while everything else is in the amygdala. The whole Mindfield series on Vsauce is fascinating and worth watching, but when I read your post I instantly thought of that episode.

Ooh I will watch that! Thanks!

Edit: I have some insight! For context, my seizures were not your typical convulsions, it was all fear and dread. The bigger seizures gave me bigger fears, and one was that I am about to die. Not like "one day" or "I am going to get killed by __" I just had this sense that I was going to die. One of my first seizures confused me. I thought "I am going to die" and I was like "oh yeah whatever it's just a dream" and then realized it wasn't a dream. In a panic, and I started thinking "How could I be about to die? There's no external threat."

So I was quickly rationalizing which external threat was going to kill me. Carbon monoxide? Stroke? Heart attack? So I went outside, did the FAST stroke test, checked for signs of heart attack... and I texted my girlfriend "call 911 if I don't text you in 5 minutes, I don't know something just feels really wrong, might be carbon monoxide or something."

So the idea that the right amygdala has to work to identify the external threat, whereas those CO2 neurons just provide fear via the brain-stem/midbrain is especially interesting to me.

Second:

It was useful to see that my hypothalamus is what generates adrenaline, and I still have that. I imagine that is why I'm still getting adrenaline in some situations. I am curious about the people with amygdalae doing better at the CO2 breathing experiment. However, I think what's unexplained there is why I can still voluntarily hold my breath just fine. Like my brain stem isn't forcing me to surface when diving under water (I like to snorkel).

Third:

I think they've missed something: If we're gonna play with injecting CO2, they should play with directly stimulating the amygdala. Electric shocks to the amygdala showed s

Third: I am not tough enough to say "I'll fucking kill you" if a guy held a knife to my throat.

I was walking through a really bad area a few months ago and 3 "tough-guy" type dudes tried to surround meme to "ask me something" but I just kept walking (as I've learned to do growing up in NYC). However, I didn't think I could beat them all up or anything and I did check to see if they were following me, and I decided to avoid that block on the way back. Funny thing is that I didn't feel "fear" I just thought "Oh well, I guess they're going to grab me and empty my pockets and steal my phone. I hope they don't hit me very much. What should I do/say?"

Suffocate yourself and let us know what you think. Edit: please stop asking me for free nudes guys

Instructions unclear, experienced autoerotic asphyxiation and got the best orgasm of my life.

Guy had a chunk of brain gouged out and still has more sense of humor than most people i've meet...

Thanks! People would never guess that I have brain damage.

Forget what the instructions were, can you just write down how you did it?

Step 1 get epilepsy

step 2 get brain surgery,

step 3 do what strangers on the internet tell you to

step 4 Profit!

I work with someone who had his entire (I think) amygdala removed. He is a very smart guy, but his tolerance for BS is very low. Have you noticed a lower threshhold for frustration?

Also, have other things been affected, like forming memories?

When you think about a time when you were afraid in the past, what's that like? Can you remember the feeling?

1. My speech inhibition is lower, but that frustration level is complicated by medication. People with epilepsy are often prescribed a medication called "keppra" which induces something we call "kepprage" which sounds like what you're describing. I was more easily frustrated before surgery, while on Keppra, but I am (and have always been) a VERY VERY patient person.
2. Yes, memories have been a big problem. I confuse the "who" and "when" of memories VERY often, and it's been problematic in the romantic world. A girl I was dating definitely didn't like it when I recalled doing a kinky sex act with her, when it was actually with someone else who looked like her.
3. Yes I can remember the feeling, in fact I can feel it when I remember it strongly enough. I never thought about it that way, but it's especially easy to remember fear because the seizures themselves were all feelings of fear (and I had hundreds of them).

Hey OP, I was just diagnosed with a generalized epilepsy so I now take Keppra. Glad to know of someone else who takes it, and makes me feel better that I'm not the only one having troubles with aggression on it. I also take Vyvance for ADD and it somehow seems to counteract the aggression somewhat. Thanks for the AMA, hopefully life improves now that your surgeries are done!

I wanted to ask about your life with epilepsy? How long have you had it and how did you see your seizures change as time went on leading up to your surgeries?

Hey! Keppra side effects get better over time if you work hard at it, it took me about 1.5 years to figure it out. Try to notice yourself getting angry, and imagine yourself before taking keppra getting angry about this, and if you would get angry even before, how angry would you get?

That helped me control the kepprage. I'm off Keppra now, and I don't really know that I've changed much other than improved memory.

Thanks for the advice! I tell my wife and son to leave me alone for two hours once I take the pill, since that's when I become most vulnerable haha.

Also join /r/epilepsy !

Unprompted advice, so take it or leave it. I have memory issues caused by a neuromuscular disease. Solidifying episodic memories is a challenge for me.

I've found that journaling helps. Each night I write down anything of interest that happened that day. Sometimes it's one sentence, sometimes a whole page, doesn't matter. It seems to make a slight difference in how well memories will "stick".

Just an internet stranger's two cents. Thanks for the AMA, interesting stuff!

Thanks! Your advice made me realize that I don't find it problematic enough, at least not enough that journaling would be worth it. It only causes an issue less than once a month, so journaling everything for a month to hope that I wouldn't cause a problem would be a bit of overkill for me.

Without journaling, how can you be sure it isn't problematic more often? Serious question.

Because my memory isn't *that* bad, and I mean problematic in that I caused a negative experience for myself or another person, which I certainly do remember quite well.

Is the difficulty of who and when different for memories from before the surgery and after surgery?

Yes, MUCH worse after the surgery. It's truly embarrassing and the most problematic result of the surgery.

wait did the seizures cause fear BEACUSE they were in the amygdala?

Yes

So do you have any adrenaline rush anymore? Like when you ride a roller coaster or take a corner fast on racetrack type rush?

Hmm, I hadn't really thought of it in terms of adrenaline before. I think, generally for those kinds of stimuli, no; At least not nearly as much as I used to if at all. However for anticipation of exciting things like a great first date, yeah, and I get the same or more adrenaline in romantic situations.

you should really try some adrenaline rush activities. Even just going down hill on a bike or skate board. Id love to hear you describe a roller coaster ride or abseiling.

Yeah I think I gotta do a crazy roller coaster. I haven't done one since the surgery.

For what it’s worth, I recently watched Free Solo and I think you’d find it very interesting. It’s a documentary about a guy who loves climbing huge rock cliffs with no safety equipment. It’s a very dangerous sport.

During the movie he gets his brain scanned by some interested scientists and they find his amygdala is incredibly small. So basically, the conclusion is he has a really really hard time feeling fear, but the flip side is that means he also has a really hard time feeling the rush of excitement and thrill that comes with fear. Therefore, for him to feel any thrills in life he must do something very extreme and dangerous while the rest of us can get those thrills doing much safer activities, or we can often even get those thrills just watching others do things like in tv shows or movies.

It sounds like you are now very similar to him in the not feeling fear department.

Yeah I actually heard of that movie but I didn't know the last part about thirsting for more extreme experiences. I've noticed that some of my excitement for flying has gone away, and I wondered if the surgery was related or if I was just coping with the loss.

What about phobias? Spiders, snakes, clowns, heights etc any changes to what u used to be afraid of?

I didn't have any phobias

Do you find that you have think about things much more; because you can't use those biological warning signals?

Wow that's a thought-provoking question! Thank you, I had never considered that until now. The answer is kind of "yes" but it's more to say that I should think about some things more because I don't feel the warning signals. For example, last month I was hiking in Utah and I started to go somewhere really dangerous out of curiosity but started to slip and had to think for a minute before I decided I should turn around, and I very carefully backed down.

However, I also choose to leverage my freedom from the more primitive biological signals and carpe diem, like when I went on a two month road trip with someone I had just met. I've been that "say yes" type for the most part ever since.

Unfortunately, at first I was more likely to have blind faith in people because I hadn't really figured this out yet. Someone told me I was getting a good deal, so I just assumed I was because I didn't feel any red flags. Little did I know he was trying to scam me out of $2,000. Luckily I learned my lesson without losing the money thanks to a friend. I have to think a lot more about why I trust who I'm trusting now, and it's still weird.

I'll continue to search within myself and my experiences to ask myself your question, thank you!

I have to think a lot more about why I trust who I'm trusting now,

tbh it sounds like a lot of people nowadays should be getting your surgery lol

Yeah actually people have volunteered to have part of their amygdala removed due to anxiety issues, although that's hard to do or even illegal in most places.

I wouldn't mind doing this. Amygdala hijack has ruined so much for me.

Edit: https://en.wikipedia.org/wiki/Amygdala_hijack

Are you sure that you're not having a focal seizure?

If people approach you randomly (ie initiate contact) in public, be wary of them trying to fleece you or convince you to take a detour. X10 if in a city or touristy area. Act like a New Yorker and tell them to fuck of.

I mean, I am a NYer lol born and raised in lower manhattan

Do you feel the absence of fear is more of a benefit or hindrance in reaching the highest and best version of yourself? Does it make you more vulnerable to being cheated or tricked? Do you have to spend more time thinking over whether to act or not?

That's a tough one because many things have changed beyond just fear. I want to lean towards it being better because my day-to-day life is more pleasant without the fear of my inevitable death clouding my thoughts. However, I also am aware "ignorance is bliss" and so many more. I would much rather be fearless than have too much fear, but I think having some fear is healthy.

Since you mention cheating, I will share that I was married when I developed epilepsy. We wereon a two-month trip through EuropeI broke my ankle, so I suggested my wife continue to the trip and she did. She asked my permission to see an ex (whom I had met a couple weeks before) and I happily granted it, and well... she slept with him. I stand by that choice of mine being the "right" one, but I certainly was plenty trusting back then as well.

Still, I think I am more easily abused in relationships now, but that's not "fear" as much as it is "harm avoidance" (another function of the right amygdala). Since surgery I've (unfortunately) been happier in an abusive but exciting and passionate relationship than in a simple romantic relationship. Pre-epilepsy I used to be quite indignant about the slightest mistreatment, but my first partner whom I met only a month after brain surgery was quite intensely abusive, and I begged and crawled for her to love me while trying to make it work for 2 years.

However, what complicates things is that I also don't have the level of confidence that I used to have. I don't really know all of the reasons why, but I am less confident in both myself and my opinion than I used to be; Albeit I may have been a bit too confident in my opinion before.

so I suggested my wife continue to the trip and she did. She asked my permission to see an ex (whom I had met a couple weeks before) and I happily granted it, and well... she slept with him. I stand by that choice of mine being the "right" one, but I certainly was plenty trusting back then as well.

I don't want to stick my nose in your love life but I think you did nothing wrong. I consider trust in a relationship essential: it makes you vulnerable but at the same time paves the way for a deeper and happier connection.

Yes I agree it was the right choice, I was just illustrating that I both was and am very trusting

Fascinating, thanks. I'm super interested in changes to your political stance, in relation to a potential link between active amygdalae and conservatism.

Have you found you're relating better to anyone as a result of the surgery?

Haha I see you've read the same articles on politics as I have! I went in a Sanders supporter who voted Hillary in 2016, came out a Sanders supporter who will vote Biden in 2020. My Anterior Cingulate Cortex is unchanged, and so I am still very focused on error-avoidance and thus very politically correct.

However, you're 100% on the money with #2. I'm expressing and even experiencing my emotions FAR FAR FAR more than I was before. I have always been especially sensitive and somewhat feminine for a cis-hetero male, but now I'm way more empathetic than I was before. I used to be a very logic-focused person, and I still am, but now I value emotions and feel empathy for people like NEVER before.

One last tidbit on politics: I grew up with liberal parents in NYC. In my high school years I was a bit of a classic white male liberal-libertarian of sorts, but always considered myself a democrat. However, education and exposure to diversity of thought brought me left far before brain surgery. I'm not in lock-step with every bit of the far-left agenda, but I am certainly firmly on the left in the USA.

Amazing, thank you! I've noticed very gradual changes in myself, but I can't fathom waking up as a noticably more empathetic person, that must have been an intense first day!

And while I didn't mention politics to make value judgements, you sound like a great dude and I'm glad the surgery went well :)

Haha thanks! Hearing you use the term "Value judgements" I wonder if you know of nonviolent communication, authentic relating, or circling?

Hey I'm asking the questions here!

Nonviolent communication is the closest thing I have to a martial art, but authentic relating and circling aren't terms I've heard in this context. You have got me googling though, much appreciated. Any recommendations on sources?

haha nice, you should check out https://www.authrev.org/
AR is a practice, and the events invite people who seek deep interpersonal/emotional connection. I find that it's like Yoga for your EQ, and the self-selecting crowd is delightful and I imagine you'll fit in well.

There are a bunch of free and cheap online Authetic Relating (AR) events being held right now, and once COVID's in the past I recommend going to an AR game-night. It's

That’s so interesting! It makes sense that fear leans itself into responses to distrust and dislike things that we don’t know much about.

I’m curious if your increased empathy is because you don’t get that immediate fear response that perhaps we were born with to protect ourselves. It’s so sad how much fear is used to fuel hateful ideologies.

Yes, greatly increased empathy

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ICEBURN!!!1111one

Have you picked up any new hobbies since surgery that you may have been to scared to try in the past?

No, probably because I was actually quite the risk-taker before with skydiving and bungie jumping. I also was an amateur pilot and flew open-cockpit experimental airplanes.

Interestingly, another person asked if I still get adrenaline rushes, and that made me realize that I actually have been doing those things less often since the surgery. I wonder if it is because of the lower adrenaline rush...

Unfortunately many of the dangerous hobbies aren't safe for me to play with because of my epilepsy. I was a passionate amateur pilot and novice scuba diver, and I have chosen to give them up for the foreseeable future because of the chance my epilepsy may come back. There's a video of a guy who was 6+ years seizure free having a seizure while skydiving. Everyone called him an idiot, well... I get why he tried.

Do you still have seizures? How long did the surgery take? Were you awake?

I've been seizure free ever since! I was under full anesthesia for both surgeries, but I was awake for 7 days in between them so they could record my seizures. I had probes deep in my brain with wires coming out of my skull, and I wasn't allowed to walk because if I fell I might rip the probes through my brain. It wasn't fun, but I did get prescribed beer on the 6th day because alcohol can (and did) trigger a seizure.

Can you drink alcohol now?

Theoretically I can, but I abstain out of an abundance of caution. I'm aware that there is a small chance that drinking alcohol would cause a seizure, and the longer I am seizure-free the higher chance that it doesn't come back.

That is, if I had a beer and had a seizure, my chance of having a second seizure without a beer goes up higher than if I had never had a beer.

Is it any amount of alcohol? Like can you have one beer? Or can you drink kombucha?

My doctors say that I could have one or two beers but I choose to abstain because it's not worth the risk to me and I've had a seizure from less that one beer before

Have you observed a change in your overall personality as a result of this?

Do you find your decision making process to be different than before?

Are you leaning to be more risk acceptant in matters of finance, professionally, and in speaking your mind (less inhibited?)

1. That is the hardest question I've tried to answer since forever. Like, I've certainly changed over the past 2 years since surgery and 4 years since being diagnosed with epilepsy, but like... how much of that is just growth from all of the experiences I've had? I'm more careful now, less arrogant, more emotionally available, more considerate and empathetic, more talkative, less confident, and all sorts of changes. I can only clearly say that the talkativeness and the fearlessness is clearly surgery-related.
2. Yes, I find myself considering my choices for longer and depending less on my "gut" feelings on something.
3. I'm actually quite risk-averse financially and professionally because I am in debt due to being unable to work for an entire year after diagnosis (was an Uber driver and in my final semester of college when I was diagnosed). Since I am conscious of my health risk, I want to carefully plan my finances so I can do things I love (like travel).
   Otherwise, I speak my mind more often and I'm certainly less inhibited, but I still refrain from being mean. The lower speech inhibition expresses itself in that I interact with strangers more often, and I tell dumb irrelevant stories more often.

Is this is your superhero origin story?

Maybe! And if the villain shoots me above my right eye and it goes through my head, it won't hit any of my brain, so I'll live, and that's how I'm invincible.

I didn’t need any part of my brain removed to be talkative AND have a horrible sense of direction.

But enough about me. If removing those parts of your brain made almost no difference, how?, how much brain needs to be removed to make a definitive personality difference?

Also, how much of your brain was removed % wise?

10% of my brain removed and, well... to answer your "how" question, the rest of my brain is very high-functioning and able to compensate. If you've got a bad memory, you can write things down and get organized. If you have a bad sense of direction, you can diligently focus on recognizing landmarks. My doctors needed to do a neuropsych exam before considering surgery. The exam measures the ability of each individual lobe of your brain. They rated my left hemisphere in the top 1/1000th, my right temporal lobe function before and after to be top 40%, and overall IQ both before and after the brain surgery to be 135. After the exam, they told me that I won't be experiencing much functional problems in the long run because my other lobes will quickly compensate.

In addition, over the years of having seizures my brain automatically started re-wiring the functionality away from the epileptic parts. Thus, even though my right temporal lobe SHOULD be doing all the face-recognizing, my left temporal lobe is helping now as well.

That is extremely interesting. 90% of the brain and still going strong. How many seizures did you get on a daily basis and when did they start? You mentioned you were an Uber driver, so I am thinking sudden onset?

I usually had "simple-partial" "focal-aware" seizures that consisted purely of emotional sensations of fear and regret that each lasted <20 seconds. I had 3 of those a day. I had only one larger seizure, a "complex partial" where I lost about 20 minutes of memory and was mostly incoherent for that entire time. That's how I got diagnosed.

I was 26 when that big seizure happened, so it was somewhat of a sudden onset. Although for 6 months prior to that seizure, I now know in hindsight that I was already having those mini-seizures and thinking they were just anxiety.

Are you any good at video games? I think streaming yourself playing horror games would attract quite the audience, and it goes well with your new found talkitive-ness.

Haha interesting, never thought of that. I gotta pick up Dark Descent again.

Boo?

I'm calling the cyberpolice and charging you with assault

Can I hire you to kill the bugs in my room?

How much do you pay?

Do you feel lighter?

How did post op recovery go? How long were you in ICU? Is there physical or mental therapy you're doing?

What sorts of adjustments have you had to make? Have you binge watched anything good lately?

1. Hah, no, but I do "click" sometimes when going down stairs because my upper right temporal muscle is tangled with the titanium braces on my skull.
2. Physically, it went well. I walked out of the ICU in 2 or 3 days. However, I was very sensitive and disturbed by loud noises and big crowds for the first month. I was also very introverted, and had a hard time keeping up conversation for the first two weeks. I continued to be bothered by loud noises (my former seizure trigger) for a year. Beyond that, I developed ADD and I'm now on Ritalin. However, no therapy was necessary.
3. Funny you ask the last two questions together because one big difference is that I no longer watch TV. I find it uncomfortably boring to watch TV now, even though flashing lights was NEVER a trigger. I can play video games and watch the occasional movie, but the idea of watching (and not interacting) sounds EXTREMELY boring and unpleasant to me now.
4. The biggest adjustment I had to make was to give up my life's passion of piloting. That's because of epilepsy, not the surgery. Otherwise I just don't drink alcohol to play it safe. MY doctors say "limit to one or two drinks" but I am just abstaining entirely because I used to get a mini-seizure (aka simple-partial or focal-aware seizure) before I had even finished a bottle of light beer.

You said in an earlier comment you became more talkative as a result of the surgery, and you said you also take Ritalin now. I know my add medication makes me more talkative, so I wonder if that is from the surgery or the medication?

I'm actually mildly less talkative on Ritalin. I was WAY more talkative right after surgery, and I didn't start Ritalin until 2 years after surgery, so I am quite aware of the change :)
Thanks tho!

Don’t worry. Pretty much all pilots in the making from 2018-2020 have now given up on their dreams of finding a job before 2030. You could probably still do your PPL and fly, but you will never be the PIC/fly alone.

Haha thanks, luckily I gave up the dream of commercial flying about 2 years before my seizure but I was actually building a kit plane when I was diagnosed. I had sunk over $50,000 into building the kit and learning to fly, and I'm selling it for under $30,000 :(

I actually could continue to fly experimental aircraft with a sport license, but the thought of having a seizure-like sensation mid-air keeps me grounded for the foreseeable future.

So I'm selling my kit. If you know anyone who wants a partially built experimental light sport Excalibur for $14k, let me know haha

Have you noticed a decrease in intelligence or problem solving ability?

My IQ was measured by a neuropsychological exam before and after, and my IQ was actually unchanged! The only issue is memory and focus, which has been compensated for with note-writing and ritalin.

Scary movies are kind of pointless now?

Yeah, but I didn't like them before either

Alright that's it for me, I can't believe I just spent 4 hours answering questions haha

Is it easier to talk to women or is that "anxiety" rather than "fear?"

I'd say that would be anxiety, but the right amygdala also did speech inhibition. I'm therefore more outgoing now, but I didn't really have a problem talking to women before.

Same topic, is riskier sexual practices a fear?

Upon reflection I realize that I've been riskier with unsafe sex, and I only recently resolved myself to take protection more seriously due to an unwanted pregnancy being terminated when a partner lied about being on birth control.

So I study the amygdala in the context of pain. I’m interested to know if you notice any differences in how you experience pain?

Oooh since you study it I'll give great detail. At first I wouldn't say that my pain reaction has changed, but upon deeply picking my brain I can come up with these thoughts:
1. At the apex of my epilepsy, I broke my fibula while walking through snow. It was a C-fracture, complete separation, but I didn't feel much pain, and I'm not some sort of tough-guy. I could almost walk but it hurt quite a lot to put full weight on it. The EMT thought it couldn't be broken because of how little pain I was reporting.

1. I think I react to slight physical pain a bit slower. When I got bit by a spider a year and a half ago I kind of looked at it curiously to figure out what hurt, whereas before surgery I probably would have wiggled my hand a bit like one does if accidentally touching something that is too hot.

2. I am prone to migraines, rarely, and they are still just as unpleasant and my reaction is unchanged.

Ultimately, after remembering #2 above, I realize that I do react slower and less expressively to the few pains I've experienced, and I am somewhat better at ignoring pain.

Oh interesting! Thanks so much for sharing! It seems the amygdala, and especially the right amygdala, is important for pain but also the ‘unpleasantness’ that goes along with pain. It’s so cool to hear experiences from real people about this.

I think that is in line with my experience with physical pain since surgery. However, FWIW, I still am indignant about not wanting other people to cause me pain or scolding them for doing so.

Probably unrelated and TMI, but I do like a really hard (like as hard as a girl can) scratch on the head and back though. It doesn't hurt, even if I get a scrape, until it gets really raw and starts bleeding.

Are you scared for others?

I would say that's "worry" and yes, I worry about others' wellbeing. I'm vegan, after all :P

I've heard that during brain surgery you're required to remain at least somewhat conscious. This scares me a lot.

What was your experience?

I was not required to remain conscious because the parts of my brain that were being removed are (clearly) not essential for daily life. The people who remain conscious are usually having work done on their frontal lobe or left temporal lobe, and the doctors want to see if you're still acting human as they disable those parts of your brain with a medication before removing it.

Have you been in any dangerous situations that you likely would have avoided pre-surgery? This was one of the main concerns regarding this surgery mentioned to my class by a prof in undergrad.

Not really, but only because I was a risk-taking person before. I was scared of my inevitable death but I still went skydiving and went on some crazy adventures. I definitely found myself doing stupid things when hiking, like going off-trail a little too far and ending up somewhere dangerous. I was briefly less avoidant of bad neighborhoods, although I almost got mugged once so I am back to being smart.

I have tested my fear here and there, like looking over the edge of cliffs or putting my hand close to a fire, but I honestly can't think of something dangerous that I want to do. Fear just isn't in the equation.

Did you still feel like you are "you" shortly after your surgery? I always find the persistence of the self in the face of change to be fascinating.

Well I did about 2100 words of writing on that (follow part 0 through 5) https://www.evernote.com/pub/iagospeare/breakthrough
Short answer, "there is no spoon"

Why don't you still feel fear to some extent, since your left amygdala is still intact?

The left amygdala handles negative stimuli differently, and it's clear that I'm using it to process these stimuli because I'm having a typical thoughtful response where I appreciate the context and make a decision instead of having a reptilian "DO NOT WANT" fear response.

Were/are you religious? Did you fear God before? Or anything supernatural? Did that change?

Never, but I actually did have a breakthrough detailed here:
https://www.evernote.com/pub/iagospeare/breakthrough

​

The tl;dr is basically "If I am a purely physical being what defines me as different than salt dissolving in water? If I am a chemical reaction coming to equilibrium what changes when I die? I suppose I must have some spirit-like entity controlling my chemistry, that makes more sense than me being salt-in-water."

Do you jump when a spider lands on you?

Oddly enough this happened a few weeks ago, and I didn't. I don't find myself "jumping" anymore but I don't know how often I've experienced those kinds of stimuli.

Why do you look like Greg from Asapscience?

I dont think I do, but then again I cut out half the part of my brain that recognizes faces and I often either fail to see resemblances or see resemblances others do not.

Assuming you no longer feel fear of rejection, and assuming you’re single, Do you plan on cold approaching more women now?

No because I have many female friends who find that unpleasant, so I stick to dating websites and more subtle approaches.

Just wanted to say this has been one of the best AMA’s I’ve seen in years. Answering every question with thought, detail and honesty. Very interesting, wish you all the best.

Aww thanks!

how much are your medical bills?

I chose an insurance plan with a high deductible but low out-of-pocket maximum and thus I pay about $3,000 a year total. I usually hit out-of-pocket maximum by April. The biggest cost was the year of unemployment following my diagnosis as I was an Uber driver to support myself through college. I got my degree though, and my job gave me 6 months of paid disability leave for my brain surgery.

Have you thought about taking up a risky sport like big wave surfing, base jumping, or rock climbing?

No, but only because of the chance that my epilepsy comes back. I had to give up my life's passion, aviation, because there's a slight chance I could still have a seizure. I still desire happiness and getting injured or dying are not good ways to find happiness.

Since part of your right temporal lobe was removed, do you “fear” that you may one day be unable to recognize friends or family without other cues?

It actually has gone and will continue to go the other way! It's called "neuroplasticity" and the left temporal lobe will actually start helping or taking over the job of recognizing faces!

The facial-recognition issue was always mild. At worst I needed about 1 second longer to recognize a face than is normal, and it was unsettling, but it's gotten better over time. I still a bit longer to differentiate similar-looking people whom I don't know, but it's not problematic in my life.

The bigger problem has been remembering who I did something with. Like "did I tell you this already?" or "did you do ___ with me?" has come out of my mouth far too many times.

Having felt this dramatic change yourself, how much of our "personalities" do you think is just wiring?

I mean, a lot of people have bad memory or poor sense of direction, some are fearless, some are paralyzed by fear, some are patient, some go off for nothing. And their brains are intact.

How does one draw the line between what's a controllable idiosyncrasy and what's an inescapable brain architecture?

I wrote a lot about this here https://www.evernote.com/pub/iagospeare/breakthrough

I would say that this taught me that so much of our personalities are wiring, and I've become a lot more forgiving because of that. When my abusive ex would always have anxiety and let out her fears on me, I would just think "she's not a bad person, her right amygdala is just overactive." It took me a while to come to grips that even if it's not her "fault" it's still toxic to my life.

Does your brain/body/cognitive awareness detect an ongoing difference within from pre-surgeries? Physically, are you still completely about your wits when it comes to fine motor skills/acuteness or physical activities/exercise?

1. I'm not sure what you mean by "ongoing difference", but maybe I could answer by saying I don't feel fear, I talk more, and I'm more expressive of my emotions.
2. I actually had this tested 6 months after brain surgery and it seems I am the same as pre-surgery.

Do you recon your brain could learn or develop fear again? I.E get hurt or in trouble so brain thinks must avoid next time?

Yes, but that "learned fear" you're describing is primarily a function of the RIGHT amygdala! I do think that the left is starting to figure that out though.

I think, in some ways, other feelings are continuing to creep in to replace fear's function. I just haven't had enough stimuli that should be fear-inducing to really test a significant change.

Who are you voting for in November?

The person who doesn't want to remove my healthcare

Have you ever thought of going blind and beating up vigilantes in a cool red costume?

I'm too nice, I'd just try to listen to their problems and try to help them be happier in a nicer way

So, you're in your car and you look to the right and see a bus coming straight at you....

Nothing? You're like "oh shit better move" but you wouldn't feel fear? Terror?

I had something like this happen with a UPS truck turning a corner and I felt about the way I feel playing a soccer goalie right as someone is about to shoot towards my net.

Wow, this is really fascinating—thanks for sharing! Can you further describe the difference between how fear used to feel and how previously “scary” situations feel now? Is there anything you used to be afraid of doing that you can easily do now? I’m not sure I understand the difference between the “extreme stress” you described and actual fear. Might be a hard one to describe, sorry!

I haven't had a lot of experiences that would induce fear, but I find the new "scary" experiences to just require more contextual information before they become undesirable. I don't want to fall off of a cliff because I know it will hurt, I have to think that because my reptilian brain doesn't just instinctually work behind the scenes to generate the fear response.

I know fear well because my seizures began with fear. The feeling was without context, it was just a feeling of "something bad is about to happen. I might be about to die." If you've ever feared for your life, you'd know the difference between that and "I want to do a good job but I'm "afraid" that I will not do a good job." So I became very well acquainted with the difference. I'd just say that it means "fear of harm."

Try to contrast "I'm about to die right now" feeling with "I am about to lose this game", then contrast "I am scared of heights" with "I don't like competitive video games because they are too stressful." They aren't "scared" of the stress of video games, they just find it unpleasant. Someone who's scared of heights is experiencing a totally different sensation than someone who gets stressed out by Mario Kart. The latter is simply not fear.

Would you regain the 10% that you have lost (normal brain function)? If you could Also, do you remember the fear (how it feels) despite not being able to feel it since you had this surgery? I'm glad that this necessity of removal did not affect you in a purely derogatory sense ( as removing a large part of the brain will lead us to think so) Have a great future life

I would, purely because I want my memory back more than I am happy without fear. I had sharp, incredible memory for everything and I miss it very much. I didn't need a calendar, could repeat the most recent minute of a conversation, etc. Now I can forget what I am trying to say about 2/3rds of the way into saying it.

Thanks, you're really brave for sharing your story. Are you afraid that fear will come back for you?

Haha well, I don't know what to think about fear. It is probably useful. I was briefly anxious about death and I thought "Does that mean my brain is healing? Is my left amygdala doing fear now? That's kinda cool right?" But, well, I don't know what it will be like if I change again.

Are you still able to recognize faces?

Thanks for sharing, OP; you've been through a lot!

Yes, it just takes a second

Did the surgery stop your seizures?

Yes, been about 2.5 years now

This is all very interesting to me, and I feel weird about this, but what has stuck with me most is that I believe you inferred that right- and left-handed people have different brain make up? I assumed we all had different brain configurations, to some extent, but is there a more serious distinction between right- and left-handed individuals?

They are different because right-handed people are left-brain dominant; their left temporal lobe does the speech and the logic. Left-handed people are the opposite lateralization in the brain as well. In both, the brain controls the contralateral part of the body, e.g. the left hemisphere controls the right hand, and vice versa.

this question might sound like little bit philosophical. you recognize that you lost your emotion of fear but how about the opposite of fear emotion or what is the other side on the spectrum? are you able to make some connections to other emotions? At first courage, calmness, confidence comes to my mind personally but how about your experience?

Hmm, I am less confident but I'm not sure how much of that is the surgery. I am far less confident in my opinion than I was, and I do think that it's partially the surgery itself but also just valuing myself less because I'm less intellectually capable than I was before due to memory problems and less romantically desirable because I'm "disabled."

Have you noticed any changes with puzzles or math related tasks? Or is that not related

How about motor skills? Can you still run and jump etc like previously?

Good question! Epilepsy harmed my overall brain function, so I got worse at math, but my problem solving skills actually IMPROVED post-surgery because the seizures ended and all of that is in my healthy left temporal lobe!

Motor skills unchanged for the most part, although after surgery my left hand motor skills scored 10% slower at the neurospychological exam.

2q:

1/ Which fear is gone? Only "gut" fears (spiders!), or have you also lost the fear of e.g. going broke (so are you more 'cavalier' with money for example)

2/ I think I read you were american, and America is known as a prototypical country that is literally governed by fear. Fear of the unknown, of strangers, of 'boogiemen' (rapists, pedophiles, scary brown people). The US has perfected the art of the fearful response (gunsgunsguns and gated communities). Do you have any change of philosophy around this? Or am I way off?

1. Gut fears only
2. I was always left-wing and very accepting, but I have become more empathetic for people whom I previously would have categorized as "bad" or "dumb." This did, however, leave me accepting the abuse from an ex who was especially cruel to me because I saw the "good" in her.

You say you have trouble recognising faces. How upsetting could it be for you to not remember anybody you know personally's face? Also, since you don't really experience fear how great is it to watch horror films and not be too bothered anymore?

1. I do still recognize people, it just takes a second or two longer.
2. I don't know about great, like I can still be surprised by a sudden noise, and still feel anticipation or excitement. However, I never really liked horror, and I also mostly stopped watching TV and movies so I don't really have a good answer for that one.

You ever watch the movie One Flew Over the Cuckoo’s Nest? How do you feel about it before and after the surgery?

Haha no but people have recommended it to me. I actually find myself more disturbed by any movie about neurological problems.

Among several other less-interesting changes like becoming more talkative [...]

Just out of curiosity, have you noticed any other pro-social changes? I am typically pretty introverted and reserved. However, I have been prescribed medicinal ketamine for my depression and I have noticed that when I take my ketamine, not only am I more talkative but I am also much more likely to upvote stuff on Reddit.

Well, I am actually a little bit more avoidant of unorganized large-group socialization (like "let's all hang out at the bar") but I am more empathetic and desiring of emotional connections.

Man, I would love to be able to have a surgery that takes away my fear of dying and speech inhibition. I don't suppose there's a pill I can take for that?

Some people actually do elect for this surgery, I think you can get it in China or something

It's ok, humans only use like 5 percent of their brain mirite?

I assume you know that's a myth ^_^

How have your friends/family/partner dealt with and/or adapted to your surgery and healing process?

6 months after I was diagnosed, my wife of 4 years cheated. A week after coming out of the hospital for brain surgery, girlfriend of 9 months bailed (and I believe cheated). The thing is, I come off VERY normal. Most people don't really see me as anything other than normal. So if someone tells me something important and I forget, they might feel like I just didn't care enough to remember. If I mix up a story or forget to do something, they think I need to just try harder. In fact, the two exes I mentioned before both felt that I was not doing a good enough job dealing with my epilepsy or brain surgery. They just didn't understand what a good job looked like.

At the time I believed them, but in hindsight I realize that some of my proudest accomplishments are how well I did handle the epilepsy and the brain surgery. My friends, on the other hand, have been very accepting and nobody treats me poorly or avoids me because I can't drink or whatever. I will say that they don't go out of their way to include me, but meh, I'm doing alright.

My wife is a doctor and mentioned that if your amygdala is removed, you experience a hyper oral sensitivity where you feel you need to explore how things taste. You also lose your filter and potentially say inappropriate things. Have you found either of these happening?

1. Oral sensitivity? Doesn't sound familiar to me.
2. I did lose my filter to a degree, but usually that comes out as saying useless things or interrupting people unconsciously. I don't say mean or inappropriate things much more than I did before.

Do you find that you experience entertainment differently now? Is there, for example, a song, book, or movie that is more/less emotionally impactful for you now than it was before?

Glad to see you’re seizure-free!

Yes, especially Memento and The Mechanic. However, I also just stopped liking TV due to attention issues.

Have you ever tried to watch a horror movie to see if you could feel it? Or maybe stand close to a cliff edge?

I watched one horror movie and it felt a bit different but it wasn't very good, I'm not a huge fan of horror. I have tried cliff edges several time and that's how I know the fear is missing.

Hey OP I truly appreciate your thoughtful responses to all these amazing and articulate questions. In light of the spirit of these convos, if I offered to poke you in the butthole with a finger or two just for fun what would you say?

I'd say that you're a sexaddic and that sounds quite uncomfortable.