Color Really is Only Skin Deep

By Elad I. Levy and Adnan H. Siddiqui

The tragic events that took place in Charlottesville have spurred numerous debates on race, religion and rights. The freedoms of groups espousing bigotry and intolerance have in turn spurred secondary discussions regarding Civil War monuments, with some even calling into question the legacy of this great nation’s Founding Fathers.

While Charlottesville catalyzed much-needed discourse reflecting upon the undercurrent of racial divide shredding the social fabric of our nation, we would like to take this opportunity to offer a unique perspective on race from the lens of an operating microscope.

As brain surgeons, we are reminded daily that color is truly skin deep. As soon as the scalpel scores the skin, all patients bleed the same color. Just underneath our epidermis is the subcutaneous tissue, which is the same yellow tint in all patients. Muscle – same red color; fascia – same white strands; bone – it all looks the same. Next, the organ in which reside all our thoughts, aspirations and biases – the brain. The magnificence of this most complex organ of creation generates the complexities of love, hate, hope, despair, bigotry and tolerance, all manifestations of biologic function with the same origins.

Our frontal lobes are in the same location, are similar in size and house our ability to express ourselves. While motor function and personality are always located in this vast portion of our brains, the choices that shape our individuality are in part learned from our experiential environment.

One of the most fascinating regions of the human brain is the amygdala. The amygdala has been shown to be a primary processing center for emotional reactions and memory. The amygdala can be considered our “emotional brain,” as stimulation in this region can produce anxiety and fear, or comfort and happiness. Positive reinforcement or anxiety-provoking stimuli augment learning and memory through emotional contextualization in the amygdala.

During the formative years, emotional learning can be quite powerful, creating memories and emotional responses imprinted in the amygdala, resulting in racial bias that can be challenging to invalidate.

Maybe because we spend most of our waking hours looking at people below their skin surface, we are bemused by skin color provoking such passion and vitriol. As a liberal Pakistani American Muslim and a conservative Israeli American Jew, one would think we are divergent ethnically, geographically and politically. Our commonality is bound by the relentless pursuit of excellence in patient care. People have color that permeates only skin deep, and after that, they are comprised of the same anatomy, physiology and someday (hopefully) share the same humanity.

In all the patients we have treated, of every race and ethnicity, the one constant that exists is that under the skull, all our brains are comprised of the same grey matter.

Elad I. Levy, M.D., MBA, is a professor and chairman of the Department of Neurosurgery at the University at Buffalo. Adnan H. Siddiqui, M.D., Ph.D., is a professor and vice chairman of the UB Department of Neurosurgery.

Reprinted from the Buffalo News