I am undone

By now, you’d think we’d have a pretty good idea who we are. I mean, we’ve been assessing and predicting things about each other since… well, a long time. And because each of us feels a pretty unbroken identity from when they were a child, it probably makes sense to assume others do as well. ‘I am that I am,’ is the transliteration of what the voice in the burning bush told Moses. Identity is fixed; it’s only the attributes that change… Or are they actually co-dependent?

Is there another way of assigning identity other than by characteristics, or traits? One obvious way is by appearance, of course, although that changes over time. So, what is the form of identity for which we are searching in, say, a long lost friend? What are the interpersonal interactions all about? What is it that makes her that same person you knew, even if she now seems… different? Imponderables all.

I began to wonder if the whole question of what I’ve relied on to determine a friend’s identity may be couched in my expectations -as if they were buried, somehow, in what their peculiarities had meant to me, and therefore, perhaps, in what I hoped to get out of the  encounter. Who I, not they, in other words, had become.

Not certain if this was a helpful insight, I decided to keep an eye peeled for writings touching on the subject. An article, written by the journalist Carlin Flora, a former features editor at Psychology Today, but writing this time in the online publication, Aeon, seemed close: https://aeon.co/essays/are-novelists-or-psychologists-better-at-describing-people

Entitled ‘Indescribable You’ she asks ‘Can novelists or psychologists better capture the strange multitude of realities in every human self?’ She starts by quoting a paragraph of an author describing some of the attributes of a character in his novel which ‘touches upon [her] looks, social class, psychology and behaviours. It’s hard to imagine a better description, and it’s certainly superior to what people provide to each other conversationally or on dating websites. And yet, any particular reader will project his or her own stored images, memories and worldview upon [her]… we’re constantly describing ourselves and others.’

But, ‘Writers search for emotional granularity, consequential details and apt metaphors, while sociologists and personality psychologists have come up with sorting tools such as the ‘Big Five’ personality traits – extraversion, neuroticism, agreeableness, openness to experience, and conscientiousness… But across time and contexts, any of these characteristics can change… A million tiny human factors – tone of voice, brand of shoes, frequency of smiles – form a gestalt as difficult to pick apart as it is to pin down. If a person contains multitudes and is perhaps even infinite, how can we compare infinities? … This fluid state of affairs is often captured best by writers, who tend to have an agenda when delineating characters.’

Indeed, ‘Novelists know that behaviour is always more revelatory than a grocery list of traits… writers often expose not the ‘truth’ about someone, but rather the gaping distance between how they see themselves and how others view them.’

We seldom have omniscience, however: what we experience, is what we get, and any analysis is, by necessity, only temporary. Even if we have used the ‘Big Five’ personality traits in an attempt to categorize their tendencies, as Flora writes, ‘Tendencies, while real, are not as revealing as countertrends: a friend is an extravert, except when she’s with her colleagues. A daughter is agreeable at school, but pretty cranky at home.’ We are all contextually fluid in other words, and our -and their- personalities, quirks, and preferences are all bundled together.

This was on my mind when I saw her: the short thin woman apparently holding court with a friend in the middle of the Food Area of a large shopping mall. With her shock of fluffy red hair, and gesticulating arms it was typical Jane. If there were people around, she’d find a table somewhere amongst them, hoping for inquisitive glances that she could return with interest.

She had always been like that -all through university, at any rate. But I hadn’t seen her since graduation. We were frequent lab-partners in our biology classes because our last names both started with the same letter. Even when we first met, it was as if I’d known her for years -and since I hadn’t, there was a lot of ground for her to cover. Her curiosity was insatiable, both about me, and about whatever classes we shared.

I remember the time of our first assignment, when I found it difficult to risk dissecting the long-dead-and-pickled Taenia solium (pig tapeworm). I tried, unsuccessfully, to hide behind my eyes I think, but she just laughed, picked it up with her bare hands, and pointed out its frightening scolex through a magnifying glass she’d brought for the occasion. Jane was like that.

She was always a pleasure to be with, even if I didn’t want to talk. And if I didn’t ask her a question about something, she’d answer as if I’d meant to ask -always with a warm smile that threatened to break into a laugh if she caught me staring at her.

We both enjoyed each other’s company, so I’m not sure why we lost track of each other, but I imagine my being shy didn’t help. And then, of course, our career paths diverged and, well, new memories greeted us both.

And yet I never forgot her, so when I saw her unmistakable hairdo even from across the Food Court, I knew I had to say hello. I waited until her friend left to pick up their orders, and decided to walk over and say hello.

“Hi,” I managed to rasp, feeling dizzy because my heart was pounding so fast.

She looked up from her coffee with a start, and managed an embryonic smile for me. “Hi,” she answered, warily, and stared at me for a moment.

There was an awkward silence.

“I… I’m G,” I stammered, using the nickname she’d always called me. “Biology at McMaster…?”

The smile never left her lips, but her eyes scanned my face as if it contained a barcode somewhere that might help.

There was no question in my mind that it was Jane. She had the same olive-green eyes, the same slightly lob-sided grin she had always unleashed whenever she was puzzled in Biology class. “We were lab partners, in Biology… maybe nine or ten years ago…” I explained to the still baffled face

But, except for the little grin, her face remained a blank slate, and her eyes continued to sample my expression, hoping for a clue. Suddenly, they stopped, mid-scan and seemed to fixate on my hair. It was always bursting with unruly curls that I’d never been able to tame.

“Oh, yes… Now I remember you,” she said slowly, and a little uncertainly for my liking. “Didn’t you have trouble with a tapeworm or something…?”

I nodded hopefully.

“It’s nice seeing you again,” she added, obviously pleased with herself for remembering, even though her voice didn’t seem that happy I’d suddenly re-appeared in her life.

The painful silence returned and obviously neither of us could think of anything more to say. The thousand questions that had been bubbling through my mind seemed suddenly inappropriate. Things had changed.

I suppose time does that, though…

He’s mad that trusts in the tameness of a wolf

I am an obstetrician, and not a neuropsychiatrist, but I feel a definite uneasiness with the idea of messing with brains –especially from the inside. Talking at it, sure –maybe even tweaking it with medications- but it seems to me there is something… sacrosanct about its boundaries. Something akin to black-boxhood -or pregnant-wombhood, if you will– where we have a knowledge of its inputs and outputs, but the internal mechanisms still too complex and interdependent to be other than interrogated from without.

I suppose I have a fear of the unintended consequences that seem to dog science like afternoon shadows -a glut of caution born of reading about well-meaning enthusiasms in my own field. And yet, although I do not even pretend to such arcane knowledge as might tempt me to meddle with the innards of a clock let alone the complexities of a head, I do watch from afar, albeit through a glass darkly. And I am troubled.

My concern bubbled to the surface with a November 2017 article from Nature that I stumbled upon: https://www.nature.com/news/ai-controlled-brain-implants-for-mood-disorders-tested-in-people-1.23031 I recognize that the report is dated, and merely scratches the surface, but it hinted at things to come. The involvement of DARPA (the Defense Advanced Research Projects Agency of the U.S. military) did little to calm my fears, either –they had apparently ‘begun preliminary trials of ‘closed-loop’ brain implants that use algorithms to detect patterns associated with mood disorders. These devices can shock the brain back to a healthy state without input from a physician.’

‘The general approach —using a brain implant to deliver electric pulses that alter neural activity— is known as deep-brain stimulation. It is used to treat movement disorders such as Parkinson’s disease, but has been less successful when tested against mood disorders… The scientists behind the DARPA-funded projects say that their work might succeed where earlier attempts failed, because they have designed their brain implants specifically to treat mental illness — and to switch on only when needed.’

And how could the device know when to switch on and off? How could it even recognize the complex neural activity in mental illnesses? Well, apparently, an ‘electrical engineer Omid Sani of the University of Southern California in Los Angeles — who is working with Chang’s team [a neuroscientist at UCSF] — showed the first map of how mood is encoded in the brain over time. He and his colleagues worked with six people with epilepsy who had implanted electrodes, tracking their brain activity and moods in detail over the course of one to three weeks. By comparing the two types of information, the researchers could create an algorithm to ‘decode’ that person’s changing moods from their brain activity. Some broad patterns emerged, particularly in brain areas that have previously been associated with mood.’

Perhaps this might be the time to wonder if ‘broad patterns’ can adequately capture the complexities of any mood, let alone a dysphoric one. Another group, this time in Boston, is taking a slightly different approach: ‘Rather than detecting a particular mood or mental illness, they want to map the brain activity associated with behaviours that are present in multiple disorders — such as difficulties with concentration and empathy.’ If anything, that sounds even broader -more unlikely to specifically hit the neural bullseye. But, I know, I know –it’s early yet. The work is just beginning… And yet, if there ever was a methodology more susceptible to causing collateral damage, and unintended, unforeseeable consequences, or one that might fall more afoul of a hospital’s ethics committee, I can’t think of it.

For example, ‘One challenge with stimulating areas of the brain associated with mood … is the possibility of overcorrecting emotions to create extreme happiness that overwhelms all other feelings. Other ethical considerations arise from the fact that the algorithms used in closed-loop stimulation can tell the researchers about the person’s mood, beyond what may be visible from behaviour or facial expressions. While researchers won’t be able to read people’s minds, “we will have access to activity that encodes their feelings,” says  Alik Widge, a neuroengineer and psychiatrist at Harvard University in Cambridge, Massachusetts, and engineering director of the MGH [Massachusetts General Hospital] team.’ Great! I assume they’ve read Orwell, for some tips.

It’s one of the great conundrums of Science, though, isn’t it? When one stretches societal orthodoxy, and approaches the edge of the reigning ethical paradigm, how should one proceed? I don’t believe merely assuming that someone else, somewhere else, and sometime else will undoubtedly forge ahead with the same knowledge, is a sufficient reason to proceed. It seems to me that in the current climate of public scientific skepticism, it would be best to tread carefully. Science succeeds best when it is funded, fêted, and understood, not obscured by clouds of suspicion or plagued by doubt -not to mention mistrust. Just look at how genetically modified foods are regarded in many countries. Or vaccinations. Or climate change…

Of course, the rewards of successful and innovative procedures are great, but so is the damage if they fail. A promise broken is more noteworthy, more disconcerting, than a promise never made.

Time for a thought experiment. Suppose I’ve advertised myself as an expert in computer hardware and you come to me with particularly vexing problem that nobody else seemed to be able to fix. You tell me there is a semi-autobiographical novel about your life that you’d been writing in your spare time for years, stored somewhere inside your laptop that you can no longer access. Nothing was backed up elsewhere –you never thought it would be necessary- and now, of course, it’s too late for that. The computer won’t even work, and you’re desperate.

I have a cursory look at the model and the year, and assure you that I know enough about the mechanisms in the computer to get it working again.

So you come back in a couple of weeks to pick it up. “Were you able to fix it?” is the first thing you say when you come in the door.

I smile and nod my head slowly. Sagely. “It was tougher than I thought,” I say. “But I was finally able to get it running again.”

“Yes, but does it work? What about the contents? What about my novel…?”

I try to keep my expression neutral as befits an expert talking to someone who knows nothing about how complex the circuitry in a computer can be. “Well,” I explain, “It was really damaged, you know. I don’t know what you did to it… but a lot of it was beyond repair.”

“But…”

“But I managed to salvage quite a bit of the function. The word processor works now –you can continue writing your novel.”

You look at me with a puzzled expression. “I thought you said you could fix it -the area where my novel is…”

I smile and hand you back the computer. “I did fix it. You can write again -just like before.”

“All that information… all those stories… They’re gone?”

I nod pleasantly, the smile on my face broadening. “But without my work you wouldn’t have had them either, remember. I’ve given you the opportunity to write some more.”

“But… But was stored in there,” you say, pointing at the laptop in front of you on the counter. “How do I know who I am now?”

“You’re the person who has been given the chance to start again.”

Sometimes that’s enough, I suppose…