A brain awaits slicing. (left)
Douglass came from Cuba in 1970 with little English and limited education. Of her work with brains, she said, “You have to put your heart, your soul and your mind into it.” (right)
Studying suicide, slide by slide
Manuela Douglass might be considered a footnote in suicide research to some, but she’s an important one.
Douglass has cut more brain specimens than any other person in North America, possibly even the world.
For the past 17 years, she’s sectioned brains in northern Manhattan at the Columbia University Medical Center campus for clinical research on suicide. She cuts them at a width of 20 microns—or 0.000787 inches—and mounts them on slides.
When asked how many she’s created, she laughs and points to several rows of shelves, each holding hundreds of boxes of slides. Thirty-one massive upright freezers scattered around the building are also filled with her handiwork.
She guesses she has made upwards of hundreds of thousands of slides.
“I’ll be honest with you,” she said, “Sometimes I cry when I’m doing this. I have a person in my hand. Every slice, every piece that I cut is a person.”
She didn’t start her career as a brain slicer.
At age 22, she moved to the U.S. from Cuba with her husband.
The year was 1970, and neither of them spoke English fluently or had much education.
Two weeks after arriving in Washington Heights, a relative got them both janitorial jobs at the Columbia University Medical Center.
Douglass’ story is an American dream, fueled by a strong work ethic and a passionate desire to help people. She learned English and impressed her supervisors with her dedication to even the smallest tasks. Higher ups, including Steven Papp, the former deputy director of administration at the New York State Psychiatric Institute, or PI, recognized she was someone very special.
Douglass’ husband died prematurely of a heart attack.
She kept working and raised her two young daughters alone. For 25 years, she worked her way slowly through different and better jobs. She washed floors and dishes. Eventually she found work in a research lab, taking care of animals, feeding them and cleaning their cages.
When that research lab moved to Brooklyn, Douglass wanted to stay in Manhattan.
“This institute is like my second home,” she explained. “It would be very difficult to leave.”
She asked Papp with help in finding a new job at PI. He arranged an interview with Dr. Victoria Arango, the associate director of molecular imaging and neuropathology.
Dr. Arango hired her on the spot. She took the time to teach Douglass the fine art of creating slides of gray matter. The breathtakingly delicate work requires working in very cold temperatures and is exacting.
“Sometimes I pray while I do this work,” Douglass said.
The slides are used by a team of researchers headed by Dr. J. John Mann, director, and Arango, at PI.
Drs. Mann and Arango have researched suicide since 1986 at three different institutions—Cornell Univeristy, University of Pittsburgh and Columbia University.
Their pioneering research revealed that that people who commit suicide have a deficit in the orbital cortex region of the brain, located in the frontal lobe just behind the eyes. “That region is involved in stopping behaviors—or behavioral inhibition,” Dr. Arango said.
They also discovered abnormalities in the receptors getting signals from the serotonergic system, which is linked to the brain’s ability to inhibit actions. “We found there are changes in the number of cells that are there,” Dr. Arango said. “There is a loss of cells.”
The slides Douglass creates reveal that the brain of a person who died by suicide is different from a person who was depressed and died of natural causes.
“The changes in suicide are much more localized and the changes in the depressed person are much more widespread,” explained Dr. Arango.
She added that there is a lot of unnecessary stigma around suicide.
It is an illness that is no one’s fault.
“The people who do it are sick,” she said. “We can see that under the microscope. We can find out more with research, and then we hope we can prevent suicide.”
The goals of the research are one of the reasons that Douglass treats her work so reverently.
“It’s a small piece of work, compared to what Dr. Arango does,” she said. “But you have to put your heart, your soul and your mind into it. It’s not an easy job.”
Dr. Arango called Douglass humble.
“Manuella is very, very talented,” said Dr. Arango. “She is able to take brain specimens, without wrinkles, without anything, and put those pieces of brain on a glass slide. Without that, we wouldn’t be able to do any of the studies.”
To listen to Manuella Douglas and Dr. Victoria Arango discuss their work, please visit bit.ly/MT_72.
To observe brain section slicing, please visit bit.ly/MT_71.