One was a middle-aged man who refused to get into the shower. The other was a teenager who was afraid to get out.

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Christopher Capozziello for The New York Times

Karen Quintal, with a Leksell frame screwed into her skull before surgery for a tumor.

Brain PowerThe New Psychosurgery

For all that scientists have studied it, the brain remains the most complex and mysterious human organ — and, now, the focus of billions of dollars’ worth of research to penetrate its secrets.

This is the fifth article in a series that is looking in depth at some of the insights these projects are producing.

Previous Articles in the Series »

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Graphic Psychiatric Neurosurgery

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Nicole Bengiveno/The New York Times

Before Ross, 21, had brain surgery two years ago, his obsessive-compulsive disorder kept him from leaving the house. “It saved my life,” he said.

The man, Leonard, a writer living outside Chicago, found himself completely unable to wash himself or brush his teeth. The teenager, Ross, growing up in a suburb of New York, had become so terrified of germs that he would regularly shower for seven hours. Each received a diagnosis of severe obsessive-compulsive disorder, or O.C.D., and for years neither felt comfortable enough to leave the house.

But leave they eventually did, traveling in desperation to a hospital in Rhode Island for an experimental brain operation in which four raisin-sized holes were burned deep in their brains.

Today, two years after surgery, Ross is 21 and in college. “It saved my life,” he said. “I really believe that.”

The same cannot be said for Leonard, 67, who had surgery in 1995. “There was no change at all,” he said. “I still don’t leave the house.”

Both men asked that their last names not be used to protect their privacy.

The great promise of neuroscience at the end of the last century was that it would revolutionize the treatment of psychiatric problems. But the first real application of advanced brain science is not novel at all. It is a precise, sophisticated version of an old and controversial approach: psychosurgery, in which doctors operate directly on the brain.