The tireless and creative search for a way out or a solution to a problem implies, by default, the belief in the existence of that same way out. Just because no one has seen it before doesn’t mean it’s not real or possible. Therefore, imagination is an act of faith but, above all, of hope. See where others don’t see or see what others don’t even imagine. It is the common denominator of three figures whose imagination has changed the course of the history of medicine but, above all, that of thousands of patients.
Imagination was the path that allowed Santiago Ramón y Cajal to see the forest beyond the trees. And what a forest! Probably the most tangled – and unexplored to date – of all we know. He discovered that the nervous system, including the brain, is made up of countless individual cells called neurons. In doing so, he lit a beacon that has illuminated great advances in medicine and that many people follow today.
Santiago Ramón y Cajal (1852 – 1934), one of the protagonists of ‘Imaginators’, is considered the father of modern neuroscience and revolutionized the study of the brain through his discoveries about the structure and function of neurons.
One of them is Patricia González-Rodríguez, recognized worldwide for her contributions in the field of neuroscience, especially in Parkinson’s research. A neurodegenerative disease whose cure is still a mystery because, as the neuroscientist explains, humans still do not understand why some neurons die and others do not: “The main problem with Parkinson’s is that it is diagnosed very late. “70% of the neurons have already degenerated and there is already neuronal death.”
“I have imagined many times a cure for Parkinson’s and every day we work to make it possible.”
“I have imagined a cure for Parkinson’s many times and every day we work to make it possible,” explains Patricia, who has created the first animal model of Parkinson’s disease, something that no one had ever achieved before. “It allows us to see affected but healthy neurons. Since it is healthy, we can direct it so that it does not reach that second phase and stop the progression of the disease. It shows us the target, the path, so that a neuron does not degenerate,” he shares.
Patricia González-Rodríguez, another of the protagonists of ‘Imaginadores’, has led several advanced studies that seek not only to slow the progression of Parkinson’s, but to eventually eradicate the disease completely
This has meant “illuminating a very dark forest,” because brain research actually dates back just a century and a half when Ramón y Cajal illuminated the doctrine of neurons, a model capable of explaining the unidirectional transmission of nervous impulses. “The brain is a world that contains universes. An intricate and dark forest, where neurons branch like trees seeking the light of knowledge,” described the Spanish doctor who won the Nobel Prize in 1906.
Leap of faith and science
At that time, scientists often used drawing to illustrate what they observed under the microscope, which made accepting their findings, in many cases, an act of faith. Some researchers initially considered Cajal’s innovative histological drawings as mere artistic interpretations rather than exact representations of his preparations. However, they are undoubtedly faithful representations of the micro-organization of the nervous system, capturing the subtle structure of nerve cells and their connections.
Ramón y Cajal drew by hand everything that Patricia observes every day with a technology that is light years away from what the father of neuroscience could have dreamed of. Some “windows open to the soul of neurons”, as he himself described. Like Patricia, Cajal studied each phase of the life of neurons, opening a path that has led her to obtain two patents in the US related to Parkinson’s and to be considered a very important reference in current medicine.
Ramón y Cajal drew by hand everything that Patricia observes every day with a technology that is light years away from what the father of neuroscience could have dreamed of.
In its methodology, imagination is a constant, since solutions to hitherto unresolved problems necessarily travel through unexplored places. “We have a 95% failure rate in our experiments. If we were not optimistic, creative and imaginative we would not be here,” he responds. A premise that is also embraced by another medical adventurer: Gloria Villalba. Their object of desire is the same: the brain. Her area of approach is different: she is a neurosurgeon at the Hospital del Mar in Barcelona specialized in neuro-oncology.
The enemy is pain
Villalba is a pioneer in modern psychosurgery and a reference in neuromodulation techniques. At 48 years old, he has performed more than 5,000 brain surgeries, achieving unprecedented advances until now. One of his most special patients is Nuria Cuadra, who suffers from neuropathic pain. It is chronic pain, or its cure, its reason for being. “Patients with chronic pain are the most misunderstood and that has been my motivation to focus my work, surgical and scientific,” explains Villalba.
It is a very unusual surgery, for patients with neuropathic pain where there is no other treatment option and they even consider the option of euthanasia or assisted suicide. If this fails, there is nothing left.”
In Nuria’s case, she herself defines and classifies the pain she feels, whether it is permanent, burning, stabbing, electric: “If I have an attack I unconsciously try to transfer the pain somewhere else. “I can even self-harm to avoid screaming.” Electrode placement surgery, explains Gloria, interrupts this pain circuit, producing a reset of these circuits, which take another alternative. “And any alternative will be better because the existing one worked very poorly. It is a pain that tortures and makes them bitter,” says the doctor.
Gloria Villalba talks to her patient Nuria Cuadra just before the operation
These circuits that Gloria wants to reset today were observed for the first time by Ramón y Cajal. She, in turn, is also facing the results of neuromodulation for the first time. That is, procedures such as deep brain stimulation that allow the electrical activity of this organ to be modulated through electrodes implanted in the brain to correct dysfunctions and treat neurological and psychiatric diseases. “There is no experience. Neither us nor in the world,” he shares.
The last resort
“It is a very unusual surgery, for patients with neuropathic pain where there is no other treatment option and they even consider the option of euthanasia or assisted suicide. It is the last resort. If this fails, there is nothing left,” adds Gloria, one of the few neurosurgeons in the world who has applied deep brain stimulation to people with severe anorexia or patients in a coma. Now he is preparing a trial with deep brain stimulation in cocaine addiction that would be a pioneer in Europe.
When we ask her about Nuria’s case, the doctor does not hesitate: “The enemy is pain and we are going to attack them on two fronts.” However, his celebrated work goes beyond surgery. “Imagining is wanting to help. I imagine constantly because I constantly want to help. And it is not just carrying out a complex operation. Sometimes helping is listening, holding a patient’s hand or providing lay spiritual accompaniment,” he points out.
Gloria Villalba is one of the few neurosurgeons in the world who has applied deep brain stimulation to people with severe anorexia or patients in a coma. Now preparing a trial with deep brain stimulation in cocaine addiction that would be a pioneer in Europe
It’s not a way of speaking. Nuria cannot help but get emotional when she thanks the doctor for the attention and effort she gives to her and those, like her, who suffer from chronic pain: “I know that when I leave you think about me and my illness. Few doctors are like you.” The connection between doctor and patient is so palpable that it is difficult to imagine that it all began in 1888 when a young Ramón y Cajal, from the University of Barcelona, presented his discovery to the world.
‘Imaginers’
A docuseries from La Vanguardia with the participation of Movistar Plus+
Santiago Ramón y Cajal, Gloria Villalba and Patricia González-Rodríguez are the protagonists of ‘Illuminating the Brain’, one of the chapters of ‘Imaginadores’, a docuseries that comes to La Vanguardia and Movistar Plus+, coinciding with the year of the celebration of the Telefónica centenary. It is the first audiovisual project produced in La Vanguardia that is broadcast on a platform such as Movistar Plus+.
Five chapters and a documentary that collect inspiring stories of those who, thanks to their imagination, dared to change the course of history, transforming lives and improving the future of subsequent generations. A project that reviews the past, vindicates the present and is excited about the future. A tribute to the most human side of science and technology.
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