Mainstream media loves to sensationalize the Downtown Eastside, illustrating stories with pictures of emaciated men and women openly shooting up in garbage-strewn alleys. Stereotypes of reckless outcasts persist concerning those who call Canada’s poorest neighbourhood home.

Max Cynader has another take. According to the director of Vancouver’s Brain Research Centre, nowhere is the breadth of diseases of the brain more apparent—and more overlooked—than in the Downtown Eastside.

“The people in the Downtown Eastside have neurotrauma, fetal-alcohol syndrome, addiction, schizophrenia, or depression, which is a mood disorder,” Cynader told the Georgia Straight in an interview at his office “They might have two or more. All five of those are brain diseases.”

“We spend a billion dollars a year trying to help people on the Downtown Eastside, but we’re not doing that good. Step one is to realize that these are brain diseases and conditions, then to come up with actual treatments. These are medical problems. You can demonize them [the people who live there], but that’s not going to help.”

If Vancouver is home to some of the world’s leading researchers, Cynader is among the best of the best. Born in a displaced-person’s camp in Berlin in 1947, he moved to Montreal when he was four. The father of three studied neuroscience at McGill University before earning his PhD at the Massachusetts Institute of Technology.

“You feel pretty humble in a place like that [MIT],” he said. “There are so many damn smart people everywhere.” Cynader taught at Dalhousie University for 14 years before moving to Vancouver, where he eventually became head of UBC’s ophthalmology research group. In 1997, he was appointed as founding director of the Brain Research Centre, a partnership of UBC, its affiliated teaching hospitals, and Vancouver Coastal Health. He also holds the Canada Research Chair in brain development at UBC and is a fellow of the Canadian Academy for Health Sciences. He has earned numerous honours, the highlight being inducted into the Order of Canada.

But for all his accolades, Cynader really just wants people to understand the pervasiveness and impact of brain diseases.

“Fifty thousand people [in Canada] per year have strokes,” Cynader said. “They’re walking around with neurotrauma, but you don’t see that. You don’t know who they are. When someone smashes up their knee in a car accident and is walking around on crutches, you can see that. But when someone shatters their brain in a car accident, you just think, ”˜What an asshole; that guy can’t control his temper.’ Well, you know what? He really can’t control his temper.”¦He’s not any more guilty than the guy who can’t walk, but he has damaged his brain. It’s not fair the way society responds to it, because you can’t see brain injury. It’s just, ”˜He’s stupid or emotionally screwed up,’ or this or that.”

One area that piques his interest in particular is critical periods of brain development, or, as he put it, “how using your brain early in life affects later functioning”. As an example, he cited a study done on mice that found that if one eye was kept covered during a certain period of neural development, the mouse would go blind in that eye. But if you try the same thing on older animals—or human beings, for that matter—their vision would not be affected. There was nothing wrong with the mice’s eyes; the problem was with the neural connection.

“You have to learn to see,” Cynader explained. “At the height of the critical period, the pathway from the eyes to the brain is formed. We discovered that if you don’t use it, you lose it.”

Synaptic plasticity, which refers to changes in the function of synapses, is at the root of all learning and memory.

“My dream is to be able to reinstate critical periods in the brain,” he said. “What is it about plasticity during the critical period, and can we enhance that? Can we take a critical period–enhancing pill?”

Cynader is optimistic. “We don’t have the plasticity tools to repair the spinal cord—yet,” he said. He hopes that eventually, people who have suffered brain injuries will be able to have their brain function restored.

Cynader, who speaks Yiddish, German, and Norwegian, said that the Brain Research Centre has some of the world’s top researchers, pointing to people like Ann Marie Craig, who discovered a new class of molecules called neuroligins. It turns out that a mutation in neuroligins increases the risk of autism.

Then there is Yu Tian Wang, who, along with Antony Phillips, discovered a means to block the communication between brain cells that triggers drug cravings.

Cynader said that the field of neuroscience is as exhilarating as it is depressing.

“Diseases of the brain are going to kill us all,” he says. “It’s incredible how prevalent these diseases are.”¦If you make it to 85, there’s a 40-percent chance of having at least the beginning of Alzheimer’s. There will be one million Canadians with Alzheimer’s in the next 20 years. And that’s one disease.

“What’s the most expensive disease in Canada today? It’s depression. Somebody in your office or several people in your office have depression. Two-thirds of them are women. The burden is enormous, and there’s a tremendous loss of social and human capital. The biggest consumer of hospital beds in Canada today is schizophrenia. It’s a huge problem that ruins people’s lives. It’s a disorder of thought, and there is a genetic predisposition.”

He emphasizes that brain diseases affect the young and old, from developmental disabilities like dyslexia, attention deficit hyperactivity disorder and autism to various types of dementia. Then there are eye diseases such as macular degeneration, glaucoma, and diabetic retinopathy, which are all the result of a loss of neurons.

“You’ll be blind or deaf if you make it to 100,” he said.

The good news is that the field of neurobiology is exploding.

“It’s unbelievable,” Cynader said. “I’ve been doing brain research for 45 years and I’ve never seen so much progress and it’s never been so much fun. We’re at the confluence of computer science, imaging, genomics, molecular biology, proteomics [the study of proteins], robotics, screening, crystallography”¦ Technology is evolving at a spectacular rate. Our ability to do things has crazily leapt forward. It’s really a revolutionary phase in neuroscience.”