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|Our Serotonin, Our Selves? - Page 2|
As I sit in Arango's office, I know there's a large room down the hall filled with freezers that hold the brains of 261 people who've committed suicide. She and her collaborators have been collecting such brains for decades.
It isn't easy to collect the brains of suicides. Arango tells me that when she and her team were at the University of Pittsburgh, they used to get the brains from the coroner's office in Allegheny County, Pennsylvania. When they came to New York, they got their specimens from the Manhattan coroner's office. Then the Manhattan office abruptly cut off their supply, and they were forced to go abroad.
"Now we get our brains from Macedonia," she says. "We have a number of psychologists and psychiatrists there with whom we collaborate. We work closely with them to assure adherence to very strict protocols. We are looking for a very specific type of sample—there can be no drugs in the body, and the brain needs to be intact and free of neurological disease. The brain must also be frozen within 24 hours, but the earlier the better. That preserves the integrity of all the information in the brain we are looking for. Then, for each specimen, our people in Macedonia do what is called a 'psychiatric autopsy,' a structured interview with survivors, family members, and healthcare professionals to find out the healthcare history for each person, what the precipitants of their suicide were, and generally what the person was like."
She continues: "The findings are reviewed by a team of psychiatrists here and we come up with a provisional psychiatric diagnosis. For each 'suicide brain,' we must do a matched control—matched by sex, age, postmortem interval, and race—with which to compare it. So if we have a 40-year-old Caucasian man who died, say, by hanging, we need a matching sample of a white male between age 38 and 42 who died in a natural way, and who had taken no drugs for three months before dying. We don't want the drugs to confound the brain chemistry."
Later I see the details of one such matched pair in a study she gives me:
Suicide brain: 28 year old white female, brain stored for 4547 days, fell from a height, with diagnosis of major depression and eating disorder, post mortem interval 19 hours.
Match control brain: 27 year old white female, brain stored for 4313 days, died of a motor vehicle accident, no psychiatric diagnosis, post mortem interval 15 hours.
Given all these procedures, I think, it's remarkable they've collected 261 brains, and that it's taken them 21 years.