Updated: Feb 9
Our brains are our most powerful and also our most fragile organs. As a doctor, I am constantly amazed by the self-healing powers of our bodies. Many of our medicines can help with some symptoms and maybe facilitate the body in fighting infection or inflammation, but the body does a miraculous job of healing itself most of the time.
However we have mostly also learned through experience that healing does not happen as quickly nor as completely, the older we get. And by middle age, many of us have accumulated injuries that may come back to trouble us from time to time, like maybe that trick knee or shoulder that’s always a bit stiff.
We accept that we may not be as quick or as strong as before, but with a little training many of us can certainly keep up a respectable level of fitness. For some of us, we may even be in better shape at middle age than we ever were in our youth.
When I was in medical school in the 1980s, we didn’t believe that brains were capable of regenerating or healing, but we have since learned that brains do have the capacity to change and remodel by forming new neural pathways, a process called neuroplasticity. And just as our bodies show wear and tear over time, so too do our brains.
Traumatic brain injury
I think of my brain as being an incredibly complex and fragile organ, and I’m grateful that Nature has done her best to protect it by housing it in my strong bony skull. She has floated my brain in a bath of cerebrospinal fluid (CSF) which is meant as a kind of natural shock absorber with layers of nourishing and protective membranes. My brain is further protected by the blood-brain-barrier which blocks many harmful chemicals or proteins from crossing over from the bloodstream.
The most serious brain injuries are caused by major head trauma, like concussions. We have come to see that any head trauma must be treated carefully, both to heal existing damage but also to avoid compounding the injury. Emerging research is also showing us mechanisms whereby neurodegenerative diseases like Alzheimer’s and Parkinson’s are triggered by repeated traumatic brain injury.
There remains a degree of controversy around prevention of traumatic brain injury by avoiding certain sports like boxing or football. And protective gear like helmets can be helpful to some degree for other sports.
Stroke is perhaps the next most damaging kind of injury. We tend to think of clogging arteries as having to do with coronary arteries and causing heart attacks, but the exact same clogging process is going on in our brain arteries as well. Strokes are the brain version of heart attacks, where the artery gets completely blocked off by a blood clot and brain tissue dies off because it is starved of oxygen.
Major strokes can be devastating, causing paralysis and speechlessness, but minor strokes and microscopic brain injury can accumulate over years, eventually causing dementia. When it comes to preventing stroke, what’s good for the heart is good for the brain. Managing blood pressure, cholesterol and blood sugar as key risk factors, as well as exercise and nutrition.
Exposure to toxins like tobacco, alcohol, and environmental pollutants also cause cumulative injury to our brains over time. Even certain foods such as sugary drinks can cause inflammation and oxidative stress at the molecular level, leading to microscopic injury in many bodily tissues including the brain.
Healing our brains
My brain has a limited capacity to deal with toxins and to heal itself, and I know that most of what my brain can do has to happen during sleep. There is definitely nothing in my toolkit as a doctor that can help me to heal myself as well as basic exercise, good nutrition and sleep.
My brain is my most valuable and powerful asset, and caring for it deserves my best effort.
And yet when I advocate for patients to work on improving these fundamental self care practices, I find that there are all kinds of obstacles to doing so. The most common excuse has to do with time scarcity - there is too much to do and not enough time to do it. Many women tend to value taking care of others (e.g. children, parents), viewing self-care as being indulgent.
I’ve come to see that the best and only way for me to help my brain to take care of itself is by making healthy choices to take care of myself. I like to think of using my brain to manage the obstacles and justifications, thereby helping it to pave the way to a more healing lifestyle. My brain is my most valuable and powerful asset, and so caring for it deserves my best effort. No excuses.