Extreme Altruism and Psychopaths

Big Brains and New Opportunities

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Study after study has tried to pinpoint exactly what kind of people altruistic organ donors are. Identifying the specific personality traits or medical characteristics that compel someone to donate an organ to a stranger could help the medical community direct their focus on encouraging more of those people to give. Is religion a factor? Is volunteerism a gateway? Do you already donate blood or hair or clothes to others? I and many of my donor friends have been participants in these studies throughout the years. The notion that little ol’ me is helping advance an understanding of this science is pretty rad.

According to Georgetown University neuroscientist Abigail Marsh, who has been studying donor brains for decades, polar opposites of psychopaths are most likely candidates, as she explained in this recent NPR interview and this 60 Minutes segment. We have the likes of Vlad the Impaler, 15th-century Transylvanian ruler, on one end of the scale. And then we have donors like me on the other end. Vlad, who is the basis for all of the modern day Dracula movies, killed 80,000 people in his time. I, however, will spend hours escorting a disoriented Bee toward the open window to freedom.

They call it Extreme Altruism these days but there was a time when we were actually suspected of being “mentally unwell” or psychopaths of a unique sort. The idea that a person would want to give an organ to a stranger was alarming to the medical establishment until thorough understanding and analysis proved otherwise. I still cringe at using the “A” word in reference to myself but recognize that not everyone is as put off by the term as me. It’s why I choose the less flamboyant “non-directed” term over “altruistic” when I write about this part of my life. It’s less flashy. It’s less “look at me”. It’s less unattainable.

Marsh concluded that the answer to the question of extreme altruism lies in the amygdala, the part of the brain that stores our emotions. She found the amygdala of altruistic donors in her study to be 8% bigger than the average person. In that extra space we are equipped with a bigger dose of empathy which enables us to feel the pain of others. I can confirm this in myself. It's the kind of feeling that makes me want to solve all of the big impossible problems of the world, the little, relatively easy problems and everything in between. It’s the angst I still feel seeing Paul sleeping on the bench in front of my favorite Los Angeles library nine years after I first met him there. It stays with me.

"The patterns of brain activity we see when they are experiencing pain look very similar to the patterns when they're watching a stranger experiencing pain." Marsh, NPR

A “bleeding heart” they call me. “She wears her heart on her sleeve,” they say. Perhaps it's safe to assume the dimensions of my brain have contributed to a lot of actions I’ve taken in my life and a lot of early inaction that led me on this trajectory to eventually find ways to be helpful.

In 2001 I wasn't the only one to watch that woman covered in ash tearfully walk away from the twin towers as it crumbled to the ground. Droves of people ran toward that disaster but I wasn’t one of them. I wasn’t the only one sitting on the couch seeing the Indonesian city of Bande Ache get pummeled by the world's worst tsunami in 2004, killing 200,000 people. Humanitarian relief workers arrived but I wasn’t one of them. I still think about the helplessness I felt two decades ago watching those people suffer, and doing nothing about it. Feeling too small to make a difference. Feeling too insignificant to be useful. My how the times have changed.

Maybe it wasn’t that one volunteer gig twenty years ago that inspired me to volunteer more. Maybe it wasn’t faith. Maybe it was just brain science. Still, putting oneself in situations to be helpful must have a similar effect as an enlarged amygdala, right? According to Marsh, we can teach ourselves to be more empathetic regardless of our brain measurements. It’s all a matter of perspective. If it’s nature or nurture, something has me braving this unpredictable December weather spending money in a small town that could really use it. Maybe it’s both. Yet another way to build up our empathy reserves is to practice practice practice.

You don’t need to give away an organ to be an altruist, but definitely don’t rule it out, y’all. There are 100,000 people waiting for a lifesaving organ transplant, with 90,000 in need of a kidney. May 2025 bring you deeper meaning and profound joy in charting your course for a life you’re proud of.

I’m taking a respite but will be back in front of the keys in a few weeks. Happy New Year to you and your families. Mahalo nui loa.