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Brain of a White-Collar Worker (2007) (thelancet.com)
66 points by agnosticmantis on Jan 23, 2022 | hide | past | favorite | 49 comments



For people not familiar with what a healthy brain looks like in a CT image, here [1] is a reference.

Fig. A in the original post corresponds to the same view (axial) of the brain as shown in the first image in [1].

The dark cashew-shaped blobs in the center of the healthy image in [1] correspond to what's labeled LV (for "lateral ventricles") in the original post. These cavities are filled with a fluid called cerebrospinal fluid (CSF) which serves to protect and clear waste from the brain.

Other examples of enlarged ventricles can be found, e.g., with a disease called normal pressure hydrochephalus (NPH) (example here: [2]).

So, needless to say, this case of ventricular enlargement is extremely severe, even compared to NPH.

[1] https://radiopaedia.org/cases/normal-ct-brain

[2] https://i1.wp.com/myneurosurg.com/wp-content/uploads/2017/11...


This is fascinating. Something like 80% or 90% by volume of this person's brain is "missing" but they are still able to function normally in society.

This goes to show the insane levels of plasticity that our brain has, and the great importance of the cortex.

I wonder at what age he developed this condition and if he felt any symptoms/signs while it was developing.


80-90% of brain mass are not neurons, but the "supporting" tissue, taking care of things like storing nutrients supply. It is entirely possible to loose that extra mass and still be fully functioning.


If most of the "power supply circuitry" can be stripped without much obvious harm, why isn't it more often? More "thinking" tissue with less support tissue could give clear advantages.

OTOH if the supporting tissue id not excessive, what are the circumstances when it's important? Will this person have hard time holding breath without fainting? Fasting without fainting? Act well under a high prolonged intellectual load?


Maybe this person is just one bad head injury from death where otherwise you and I with a similar injury would heal with hospitalization, or maybe just nurse a concussion for a day or two and be fine.


> More "thinking" tissue with less support tissue could give clear advantages.

You'll reach thermal and energy constraints.

Or, only half-joking here, you'll fall prey of a terrible depression and withdraw from all human company.


Presumably the giant ventricles are not functioning as proper supporting tissue though. So there's still a great deal of stress the brain has adapted to.


<former brain scientist> There is another famous case about a person who had a (physically) big head, to the point that people commented on it. Person ends up getting a Ph.D. in math, because hey, you know, big head, right?

Turned out that the head size was due to a hydrocephalic condition-- the person barely had any brain tissue, most of the contents of their skull was fluid.

Yes, the brain is pretty amazing.


I think the point of interest is the CT scans, but even after reading the text (is it a summary or the whole body? I can't tell), I still can't interpret the images. Is the dark area somehow empty space, or what? Also, the title is very strange. For a while I thought it was supposed to be the point of interest. I'm left pretty confused, as a layman.


In the main figure, all of the dark grey/black part of the image is cerebrospinal fluid, which usually is present in the 4th, 3rd, and lateral ventricles. These ventricles are usually much smaller than this patient. Usually, where the dark spaces are with this patient you would instead see cortical and subcortical regions. If you look up ‘brain MRI’ you will see a brain that has a lot of grey matter and much smaller dark regions which are the ventricles! Hopefully this makes sense, if not, I can clarify! :)


Ah ha, thanks, I was thinking "ventricle" referred to a region of brain tissue - and yet I know what a heart ventricle is, so I feel dumb. Something about the casual objectivity of science writing paired with such dramatic images made me unsure if what I'm looking at is as wild as it seems. And it is!


Ah no worries I don’t think it’s a normal thing to know and it is a super extreme patient! It’s my job to look at images like this, and even I was confused for a second because it’s such an extreme case!


Basically his brain has huge fluid sacs pressing most of his brain matter up against his skull.


For those curious about the terms "white collar" and "blue collar," there are a couple interesting articles on the differences in America [1] and the difference in Africa [2].

Before one ascribes too much education or status to those labeled "white color," consider this quote from the first reference:

“It is a fact with which every union workingman is familiar, that his most bitter despisers are the petty underlings of the business world, the poor office-clerks, who are often the worst exploited of proletarians, but who, because they are allowed to wear a white collar and to work in the office with the boss, regard themselves as members of the capitalist class.” -- Upton Sinclair, 1914.

[1] "Blue Collar vs. White Collar Jobs: What’s the Difference?" https://www.mentalfloss.com/article/640951/blue-collar-vs-wh...

[2] "White-Collar Workers" https://www.cambridge.org/core/books/abs/general-labour-hist...


I thought this post was some kind of societal joke until people started commenting.


It still functions as a societal joke in that we see a mostly functional (albeit low IQ) white-collar worker whose brain is 90% missing.


I know the title here is accurate to the original title, but what does this have to do with the fact that he is a white collar worker? Also, given the exceptionally low IQ, I am not sure it is truly “white collar” work as the term is normally used (normally referring more to knowledge workers). I assume whatever admin work he was doing was more akin to routine factory work with little agency.


Admin work is still white-collar work. Basically, if you can get grease or dirt on your clothes, it's blue collar; if you can't, it's white. (Because people didn't wear white shirts in jobs where they could get dirty.)


I understand the technical distinction but in common practice it seems to be used more and more as interchangeable with knowledge workers.


On this forum full of techies, perhaps, but in the more general social sphere of "America" it's understood that even menial admin work is white collar work.


> Basically, if you can get grease or dirt on your clothes, it's blue collar;

There are also orange-collar workers.


Wikipedia entry for orange-collar workers: "Prison laborers, named for the orange jumpsuits commonly worn by inmates." [0]

The article also defines pink collar workers (service workers in the working class) and purple collar workers (principally white collar workers who occasionally do blue collar tasks, like technicians and engineers; note there's no citation for this).

I personally don't think the other colors mentioned in the Wikipedia are useful, since the whole idea of blue vs. white collar seems to be a metaphor of referring to manual labour to office work.

[0] https://en.wikipedia.org/wiki/Designation_of_workers_by_coll...


What are these?


Exceptionally low ? 12% of the population is below 80 iq. 75 IQ is not exceptional, it's common.


The number increments get more significant the further from 100 you get. 75 IQ is under the fifth percentile -- definitely not common.


I recognize that this is kinda subjective, but I'm a bit baffled that someone wouldn't find 1-in-20 to be "common".

Though it's not homogenous, that's very conservatively the equivalent of one child in every classroom. It's millions of people, even in a small country.


To me, "common" means roughly 50% or more, with less than that being some degree of "rare."

1-in-20 I would definitely call rare.


Your definition of "common" is out of step with most people's. It means not-rare, or widespread, for example jobs in trucking, retail, and tech are all common in America without that implying any of them make up 50% of the country's jobs. Or another example, in the UK the NHS classes probability of side effects into groups where "very common" means "more than 1 in 10" and "common" means around 1 in 10+ (with the next grade being "rare" for 1 in 100+).


>Your definition of "common" is out of step with most people's.

This is uncharitable. Adjectives can be extremely contextual, and "common" is very much one of those words. The biggest factors are relativity to other things in the same domain, and deviation from popular perception. E.g. if most instances of X in a given domain are ~1 in N, people will generally use words like "common" and "unusual" for Y if it is greater than or less than 1 in N, regardless of what N is. Or say Y is exactly 1 in N, but people at large misestimate it at 2 in N. Now you might say it's "rare" despite whatever its relativity to the domain is. Now note that X and Y usually belong to effectively infinite domains, throw in the ambiguity of conversation, and it gets very fuzzy. This is basically a long way of saying that this is a semantic argument, and therefore may be divorced from the original implication of the adjectives being contested.


I once saw a website I think where histograms of each of such words were plotted, can't find it anymore though


You're probably thinking of this HBR article by Andrew and Michael Maboussin

https://hbr.org/2018/07/if-you-say-something-is-likely-how-l...

which is an updated take on the methodology of Dick Heuer's Psychology of Intelligence Analysis

https://prasadcapital.com/2018/07/03/book-summary-psychology...

, which itself was driven by the research into words of estimative probability by CIA legend Sherman Kent.

https://en.wikipedia.org/wiki/Words_of_estimative_probabilit...


Yes!


Yes, it's 4.77, about 1/20.


Depending on which scale is being used, it looks like 75 IQ is between 5-6 percentile of the population [0] so I think it is more exceptional than common, but I’ll grant that it is borderline and somewhat subjective.

[0] https://www.iqcomparisonsite.com/IQtable.aspx


This seems like a pretty objective assertion about what seems like pretty subjective semantics. Are there medical definitions of "exceptional" and "common" that are implicit in your post?


I'm guessing in medicine what counts as exceptional is something over 3 sigma in a normal distribution.


It may be common, but the US military has deemed that to be a level that they regard as unacceptable.


The fact that he is a white-collar worker is salient. The person is able to earn a living using the obviously highly-altered brain as the centerpiece of the work.


Interesting to note the low IQ scores. It is well below average and yet still functioning and performing a useful job for society.


... because you need to be smart to be a white-collar worker? Hell, that fluid pushes a little bit different, makes him a sociopath, and he'd be on track for CEO!

Have you been in the workforce long, because raw intelligence has very little to do with any of the jobs I have seen.


Are 90% of his neurons missing or is the scan giving the illusion of the neurons missing because their is too much cerebrospinal fluid above them? I'm betting for the latter, anyone knows?


The big dark areas are just fluid. He had some kind of shunt to drain fluid from his brain as a child because of too much pressure. And sometime in the next 30 years there was a problem with the shunt failing, which caused fluid to back up. And the reservoirs of fliud known as ventricles basically grew extremely large from the increasing pressure and squashed his brain.


I don't have access to the article, is there any chance his brain might improve somewhat if the shunt was repaired?


They mention fixing things but the scores not improving. It is not clear to me if they theorise it will improve over time.


Title of the research is misleading. The guy already had issues before hand


According to the text, he was more or less problem-free with small weakness issues that recently got worse. Perhaps I'm misreading it.


Seen in IT management.


[flagged]


This seems unnecessarily insulting, and not even technically right. The cavity is filled with liquid, not air.


I was referring to the IQ of the subject, which is technically called "Borderline" which technically rests above the designation of "moron" that resides at IQ 74 and lower. Good catch on that fluid not air correction.




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