Dr. Mark D'Esposito

So we're not, I guess another way of saying it, just having knowledge isn't what makes us who we are, right?

It's to be able to take that knowledge and present it in a way that allows us to live life based on our intentions and our goals and our desires.

Yeah, I mean, as I was saying earlier, the frontal lobes is a big place, and half of it is involved in these high-level executive functions, but the other half of it is part of the limbic system.

We call it the paralimic system that's involved in social and emotional behavior.

there's this intimate back and forth between these two areas of the cortex.

If you have just damage to these frontal, to these areas that are kind of in the frontal lobe, you will have

many different impairments that we would call sort of social or emotional impairments, and their executive function will be quite normal.

And then you'll have the opposite where patients with the lateral damage will have executive functions, but they seem emotionally intact.

But, you know, in real life, when we have both these intact, they're communicating with each other.

So, right, emotion and contacts is going to influence our

executive function.

We make bad decisions in stressful situations or situations we're not comfortable with.

It's where we might make a better decision if it's a quiet, you know, kind of a quiet place.

But it is something that we can, I think you're right, you can sort of get into a routine and learn how to do things, you know, if you haven't very much planned out.

But what's so unique about us is how we can be flexible and adaptable, right?

When

When something novel comes up or there's something unexpected comes up, we can adapt to it.

And that's really what the frontal cortex is really important for, not just sort of making these plans, routines, and setting all the rules, but being able, when things don't go right, how to right the ship, right?

Yeah, I mean, I can, you know, just historically, I grew up in a world when there was no smartphones as a resident.

And so one of the most difficult things I do in practice is have to take care of patients in the emergency room and there's a real emergency.