the german interior minister pledges to boost security for synagogues in the wake of wind these attacks against the country's duty to never again allow the rise of some of the. environmental action group extinction rebellion rallies around the world for a 4th day but the efforts to block infrastructure spark a backlash from locals. the only good morning to live in the home to my family will be the lead up to it and i'm sitting he'd like the needs of others even though what they run a bit like one of these and for all it's pretty and barmen. military operation against the northeast syria rages for a 2nd day with little trump now offering us mediation in the conflict stays off the

water in the withdrawal of american troops from the region. so if you go to come your way in just a few by which time that's you monoid back in one of those if you latest global news headlines then. hello welcome to sophie co fish and aries me sophie shevardnadze love hate or greatest ideas are born in our bodies one of the most fascinating and complex organ today asked to imagine who literally looks into and works with that the human brains dr henry marsh one of the world's top surgeons.

dr henry marsh great pleasure to be here with you and your wonder your lovely home thanks for having us pleasure so i had all of the questions 1st of all i know that you've set something like in medicine in general. you can never really be too certain i mean still if you go to a general practitioner ok he pursued a drug and let's see maybe worse and if it doesn't then he would try another drug but was you know couldn't try it wouldn't quite work that way what it was doctors we dealing probabilities is nothing is ever certain with any as a surgeon or this is a mere assertion what i do is not representative of all events and. when you if you recommend surgery to somebody what you're saying is well the probability of the operation doing more good than all is a bit better than the probability of you coming to harm and you doing to the

operation but these are probabilities so let's say i say well there's a 95 percent or chance the operational be successful removing a difficult brain tumor which is what i specialized in doing and a 5 percent chance you'll die and then the patient dies because of the operation and the family will be very cross they'll say you said there was a 95 percent chance of success and i said yes but i said there was a 5 percent shots of disaster and same with the way the full cost then they were wrong because all of the probabilities but from the patients point of view as patients and i've been a patient myself and my own son had a brain tumor we want certainty we want to know what would happen to me not a 95 percent this or a 5 percent that so it was a huge difference between the doctor's perspective and the patient's perspective we're going to actually swap roles and a little bit before i do that i know that you specialize in. brain surgery when

local anesthesia yes i think they look patient isn't sleeping. what is the reasoning behind it because with is any applies for certain sorts of jumah tumours which are actually part of the brain in the brain itself consisting in effect to bring tissue not of nerve tissue where the cells called lisl cells surround and support and kind a look off to the nerve cells and the tumor looks very much like the brain and feels like the brain it doesn't come with little sort of dotted black lines in a pair of scissors saying cut cut. and if the tumor is in the very important part of the brain for instance the speech area most. most most of us have speech or movement here just looking at the brain with the patient a nice that doesn't tell you where to stop because the edge of the tumor looks like

the brain. is the patient's awake you can ask the patient to do things you can also position to talk you can use electrical stimulation to work out roughly where you are so you ever seeing a significant change in a person's brain as you operate live so for say i gonna like yes and of kaizen there. was this common reason is something has an epileptic fit while you're operating and then they can become unconscious or paralyzed or stop talking things like that if if there's a problem with the operation and you actually start a new start damaging important brain the patient will start to lose the function of that part of the brains or occasion the patients who start to lose the ability to talk or become paralyzed on the opposite side of the body if it's a real risk it happens not very often that happens what makes operating brain

much more difficult and sensitive than operating something like hard or. do you think 1st of all the brain does not heal in the way bones and muscle and skin heals when you win you win every time you. the brain you damage it and it won't recover and secondly the brain is incredibly sent delicate if you can damage some parts of the brain you can kill the patient just by damaging in one of 2 millimeters the brain tissue other parts of the brain you can actually other parts of the brain can sustain quite a lot of damage in particular the front on the right without the person's leaving to suffer in a home. but is very vulnerable it's very delicate it has the it is the consistency of. crean's is the main the main surgical

instrument is a socket the minutes of action clean the brain surgery is horribly crude actually people think it's so terrible what he's high tech but with actual reality is actually quite crude compared to the incredible complexity of the brain you do have to like cut the skull something right you know that's these events or i mean it's that simple bits and that spits that you can do with the patient awake it like that and see it in the skin the problems all start once you open the membrane that covers the brain injuries and that's where the trouble starts that's where it becomes very dangerous but it's a bit like if someone has been doing this over and over again for years and years evan you know it is a job like anything else and you've said it yourself it's not the process is not a job like anything else because you're dealing in people's lives and if you make mistakes the consequence is a terrible night some surgeons and some doctors become very detached from their

patients and it depends on the culture you work in i've worked in countries all over the world and in some countries. really seem to have minimal human emotional contact with it was better to be emotionally involved. volved or to be that it's a question about it it's a question of what patients expect. in countries like don and nepal under certain stand ukraine all of it china will the patients and certainly the patients families often do not want to move troops and they really don't want to be told. how bad the disease is. in england and in america on the whole patients and their families ones and they have the truth more all this but even then. with diseases like cancer where we can't cure if it's accounts we can't cure or to get the balance right between. giving the patient who can being

realistic is very difficult and to get that balance right and you often fail you have to have some emotional rapport with the patients if you want to completely cold detached technician you will not you will not handle these problems well but what about the process itself i mean if you had someone in your life that you really laugh when you get a brain surgery would you rather do it yourself oh no you couldn't you'll fall to him and my son had a brain tumor so that's what i'm really would ask the dr that i linked i was a jet i was doing general surgery and training at the time he was only 3 months old and some people say who did you offer it yourself i think that way you couldn't because all your oriel detached all your mechanisms of self preservation and the taps meant it was simply too anxious i once operated on a close personal friend that one of my daughters i'm godmother with

a malignant brain tumor so unusual is going to die and the operation was simply well schooled a biopsy confirm the diagnosis and a very very simple operations a bit reluctant agreed to do it because the family were very keen i should because we were close friends and even that i found almost impossible. and i was so anxious because i was not detached it's just what's the hardest decision you had to me because i understand brain surgery is a large decision making events will progress i'd make many difficult decisions i think some of the ones. many regrets. over 40 years of practice and some of the most difficult decisions. when i treated people too much i should have stopped i operated really when there was no realistic hope and all i did was add to the patients and the family is suffering and i can think of quite a few patients where i did that on the other hand with surgeons who are cold and

detached they'll do that and it doesn't doesn't trouble them so you've sat they will actually never know how the brain works i think is unlikely i mean the whole point about the future is unpredictable so i think it's unlikely it will ever understand the brain and the way we can understand how a computer works or a clock works and i think it's unlikely that somebody once said you can't cut butter with a knife made of butter. but i think nick with the present technology we have. m.r.i. brain scanning electret implantation in monkeys and a certain extent and human beings is very limited to how much it will tell us and we can't experiment on ourselves now so we can't we can't say from our fellow humans brains and sit around them the experiments on we can do

a certain extent on chimpanzees and i feel rather sort of chimpanzees and who is becoming increasingly difficult ethical reasons so there are a major limits to what we can do this or actual scientific research we can do on the brain so following that logic you never really actually know what a patient's brain will do after the surgery surgery and all that has to be well i you know you know it was stents because i mean. we understand how various parts of the brain more important the something that said we need the areas to speak so. the vision. to get in the complicated ways we understand. but there it was with. a pretty good idea what you want you can get away with speak without damaging the patient. we're going to take. it all. stay with us.

join me every thursday on the alex i'm unsure when i'll be speaking to guest of the world of politics sports business i'm show business i'll see you then. on this edition of cross talk we demystify serious kurds almost all of the criticism launched against syria policy is not rooted in facts actually back criticism is driven by false narratives and the inability to admit that international proxy war to overthrow the damascus government has failed the sooner all american troops leave syria the better for syria and to me. the son of

a local. issue. mentioned. that because. of this connection to laugh and ask for the last 70 and seeing and on the day to day for the rights. commission so. branch who just. does in the. asian community no longer. need to mom. you know you look are so set on the open much to me mama says that are ya know.

and we're back with dr henry marsh one of the world's top neurosurgeons henry how closely are new or science and nearest surgery elated and incensed at the discoveries in your science actually make advances and well not not very what's called functional neurosurgery where you put electrodes into the brain for conditions like parkinson's disease and things like that. and again and

on very epilepsy surgery because it was quite literally involved you can take a look cool record and some single brain cells in the planning to do but in terms of the v.a. every day problems like operating on patients with hemorrhage is head injuries things like that people in here is is a completely different the world away from the everyday world than yours so you don't think of a human brain quake near scientists think of the huge computer you know on the on the as a as a surgeon i'm more like a plumber i mean that the diff the relationship between neurosurgeons and mirrors is rather like the relationship between plumbers and physicists who deal in the make the quantum mechanical properties of the metals in a way is a big gap so when you're operating on brains you can remove something great you can remove a belated to tongue or to see you know or to hear you had something new at some of

their press and they are and this has been there been sort of fashions for implantation maybe using fetal brains from feet to fetuses the stem cells. but none of this really work to get in terms of literally compliance not really i mean there are there are there are various computer brain interfaces where you put a lick troops on the brain i mean it's been you. some people can paralyzed and then some of them can then by thinking can actually move a reporting robotic arm i've read this crazy magical surgical records where it's at that human brain can be cut in half well it partially cuts in them that they don't have a name for that brendan cold callous or to me exactly brain is famous research done in 19 eighties get sneaker and spirit for certain sorts of epilepsy

dividing part of the brain in the middle the 2 cerebral hemispheres in the joint the 2 halls of the brain up here which then joined together with like the trunk of the tree the brain stem is the trunk you can't touch that if you touch that people die or lift terrible disabled but then the trunk splits into 2 main hemispheres like that and they're joined. i think all the corpuscle is in which is billions of nerve fibers connecting the top of the right side of the brain the top of the brain and if you cut part of that it can help certain sorts of epilepsy in particular a form of epilepsy where people as full on the ground called a drop attack and these people appear normal if you met them you wouldn't know a part of their brain had been cut in half but you can carry out experiments on them where. there's

a sort of barrier which divides the view what they're seeing the visual field so the right side of the brain can then you see things on the left and the left side of the brain can and see things on the right and supposedly they also suffer from split personality was not able to do in the sense yes because i mean sort of with this special experimental set set up. so to separate people in to a certain extent the same area so it out back in the other i think you got the story is told of one man who had a split brain operation and lost his temper with his wife and wanted to hit with his left hand which was controlled by the right hemisphere and then his right hand pulled it back that may not be true but it's an illustration of the way you end up with this sort of split personality so let's just roll forward i know you don't like this whole science fiction but we're not there yet i'm tired of something else

. let's say we do have this crazy technology to achieve it where 2 people it's a you and i we want to swap won hands here with another is it possible. no way they were ok there are. 85000000000 nerve cells in the human brain if you took one cubic millimeter of the serval cortex the surface of the brain. that can contain up 210-0000 nerves and 1000000000 electrical connections that is seriously complicated complicate what is the radically. theoretically the i mean the brain i didn't i didn't believe in the humans so i believe lives in you and i thinking and feeling at the moment is generated by their activity of our brains but we really don't. i mean yes we can we understand

a certain about vision movement but how consciousness arises how pain arises. and there's no way it happens it definitely for most people like myself. within the knowledge of the brain. thought and feeling all physical physical phenomena but the fact of matter is contemporary science even the political of quantum mechanics cannot explain it which means there's a big. though a very busy huge gap in our scientific understanding of the world already by the time wonders if where we're understand that's where our evolution of human race ends probably to that's why we don't know much about it anyway as you told me don't watch much t.v. so i don't assume you've watched this series altered carbon no it's pretty much about how you can take one person's brain and transplant it into another one sensor like shockley i'm sure you were at hand. this is funny it's there's no way we can

ever achieve well in the way that i'm not not in the foreseeable future more than the fools who. likewise the idea that some people have we can download all brains on the computer that's what it was in moscow saying i say that you can and hans human brain with that spirit that's variously because they're saying they already experiment in on this to this very to amount to. simple but our present level of mirrors and technology there's no way we can do it so this whole new fashion of maybe becoming immortal we're trying to miss yeah yeah. it's fairytales. fear of death written in another form of giving people of lost we have a deep fear of death we have is the need to to feel will live forever which until the modern age took the form of religious belief in an afterlife the need for that

belief is still there but not as some people dress it up in suit pseudo scientific terms all i'm saying is that when we seem to days in medicine how people are being rather test for for me it's like you can replace an organ when artificial already well so then you're asking yourself maybe someday in theory it's possible i won't say it's impossible but 85000000000 cells trillions of connections between them it's quite difficult so that like put this cyber port in your brain that's like not happening and there's sensors and sensors so tell us something if we do understand how memory is stored in a brain or in a very little there's no way we can remove what we don't want from the brain or i mean we understand some of the with the limited understanding put it this way we know which bits of the brain if they get damaged where we lose the ability to make

new short term memories and particular parts of the brain called the hippocampus in the form of these so called experiments of nature you see people who've had damage either from a head in real from an operation they can't make short term memories or long term memories which is what eventually we lose without sinus disease and dementia seem to be more to do with the brain as a whole row than any individual points but maybe he can they've kate. a memory in the brain there having said that we know that maps. located hippocampus is a famous study done on london taxi drivers you have an m.r.i. scanning which a london taxi drivers you have to pass this examination called the knowledge they have made the entire road map for london and not just the layout which a one way road which is the quickest way of getting from

a name from belsize park to. brompton road or something they take this to live and the hippocampus in these london taxi drivers runs a pos the test a bigger than the ones of people who failed the test likewise you know that professional pianists have bigger hand in the movement here of the brain than the norm in nonprofessional pinnace so i don't know if you've operated any real time cheney says but what their brain be any different from not what you can see i mean as i go as idea of an a lenin's brain was kept and einstein's brain was cut into slices this is a very simplistic show but by definition everybody's brain is different because we are all different we are all brains every time we think a thought that is a physical process in our brains so an awful lot of current mirrors take the.

cognitive neuroscience which is what psychologists call themselves is really does saying well yes when we think certain thoughts certain parts of the brain a more active than that individual explain anything because we know already that everything we think and feel is a physical process in our brains so you're a man of science i don't suppose you believe in anything like the afterlife or it so what it will put it this way i think it's unlikely that you can't prove or disprove it but it seems unlikely to me and and why is the nearest seems unlikely because i see. and have seen many many people who suffered damage to the front part of their brain which is where all social behavior and moral behavior seems to be organized because people have suffered particular head injuries and suffer damage to the front of the brain they suffer a personality change they saw

a personality change in terms of the behavior towards other people is also almost was for the worse they become crude of. course disinhibited and you can reverse it any way and and if if the moral is what we think makes us particularly human can be omitted by physical damage to our brain well when our brains die i reckon we die well i don't necessarily mean the moral part is more like a religious part but i'm just saying it could be anything but what would that mean that those billions and billions and billions of nerves that are connected to each other and their existence the minute person's heart stops to be well. there are some rather alarming work done recently in america looking at dead pigs brains where they went to an average. of this and took some brains out of pigs that are being killed if you. can show that some of the brain cells are still alive they'll die in time and or to means goodness no. likewise you knew some patients in what's

called persistent vegetative state because life without moving have been to be fit in is a bit they were a new live because of medical treatment some of them it seems a some kind of activity in their brains that we don't know what it means. all right harry thank solar is for a so it is very strange but still thanks a lot for sure at least some light into this strange world this for a myriad surgery costing lives is to say it's even more than the whole science. and then you find all new tools on the of a side to religion it's the other way rudd is a closed door and that all the christians are all with the wall street course you know and also on the whole new questions of him that's what's so interesting i suppose that's how life works in general. as we get older kind of. anyways bankers are like her wonderful chapter that any plan or time searching good could

lead over everything thank you very much right. about one of the worst cases of predatory baxter's defrauding and abusing the poor and sick that i've seen in a couple years you know we have energy issue to many instances of bankers preying on folks but this is this is really happening.

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