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decisions? What had happened to his brain? Damasio's first insight occurred while talking to Elliot about the tragic turn his life had taken. "He was always controlled," Damasio remembers, "always describing scenes as a dispassionate, uninvolved spectator. Nowhere was there a sense of his own suffering, even though he was the protagonist ... I never saw a tinge of emotion in my many hours of conversation with him: no sadness, no impatience, no frustration." Elliot's friends and family confirmed Damasio's observations: ever since his surgery, he'd seemed strangely devoid of emotion, numb to the tragic turn his own life had taken.
    To test this diagnosis, Damasio hooked Elliot to a machine that measured the activity of the sweat glands in his palms. (When a person experiences strong emotions, the skin is literally aroused and the hands start to perspire. Lie detectors operate on the basis of this principle.) Damasio then showed Elliot various photographs that normally triggered an immediate emotional response: a severed foot, a naked woman, a house on fire, a handgun. The results were clear: Elliot felt nothing. No matter how grotesque or aggressive the picture, his palms never got sweaty. He had the emotional life of a mannequin.
    This was a completely unexpected discovery. At the time, neuroscience assumed that human emotions were
irrational.
A person without any emotions—in other words, someone like Elliot—should therefore make better decisions. His cognition should be uncorrupted. The charioteer should have complete control.
    What, then, had happened to Elliot? Why couldn't he lead a normal life? To Damasio, Elliot's pathology suggested that emotions are a crucial part of the decision-making process. When we are cut off from our feelings, the most banal decisions became impossible. A brain that can't feel can't make up its mind.

    AFTER INTERVIEWING ELLIOT , Damasio began studying other patients with similar patterns of brain damage. These patients all appeared intelligent and showed no deficits on any conventional cognitive tests. And yet they all suffered from the same profound flaw: because they didn't experience emotion, they had tremendous difficulty making any decisions. In
Descartes' Error,
Damasio described what it was like trying to set up an appointment with one of these emotionless patients:
I suggested two alternative dates, both in the coming month and just a few days apart from each other. The patient pulled out his appointment book and began consulting the calendar. The behavior that ensued, which was witnessed by several investigators, was remarkable. For the better part of a half hour, the patient enumerated reasons for and against each of the two dates: previous engagements, proximity to other engagements, possible meteorological conditions, virtually anything that one could reasonably think about concerning a simple date.... He was now walking us through a tiresome cost-benefit analysis, an endless outlining and fruitless comparison of options and possible consequences. It took enormous discipline to listen to all of this without pounding on the table and telling him to stop.
    Based on these patients, Damasio began compiling a map of feeling, locating the specific brain regions responsible for generating emotions. Although many different cortical areas contribute to this process, one part of the brain seemed particularly important: a small circuit of tissue called the orbitofrontal cortex, which sits just behind the eyes, in the underbelly of the frontal lobe.
(Orbit
is Latin for "eye socket.") If this fragile fold of cells is damaged by a malignant tumor or a hemorrhaging artery, the tragic result is always the same. At first, everything seems normal, and after the tumor is removed or the bleeding is stopped, the patient is sent home. A full recovery is forecast. But then little things start to go awry. The patient begins to seem remote, cold, distant. This previously responsible person suddenly