This article appeared under the title Mind Control Guardian Online 26/9/05.

Sophie Petit-Zeman

Years ago, a nice doctor told me I’d find life easier if I didn’t feel I had to memorize and understand every ripple on every puddle. Not a classic prescription, but sometimes just being understood is as good as it gets.

His comment came back to me while watching Mind the Gap, a play which poses questions about how the brain works, and just how far we should go to interfere. Silas, descended from Winnesheik medicine chief of the Winnebagos, sells Kit Kats and crisps, and heals for free, from his kiosk on tube platform 2b.

Maya, her mind slowly crumbling away to Alzheimer’s disease, inevitably ends up with Silas when she forgets where she’s going, and mostly he looks after her. But he also gently challenges her to think about her dwindling memory in relative terms: “You haven’t remembered all the people in the supermarket yet, the vast range of tinned peas, the colour of the checkout girl’s hair, the pimple on her arm, the hair next to the pimple, the smell of the change in your hand, every groove on every edge of every pound coin…”

Playwright Abi Bown says Mind the Gap is about “the ethics of neuroscience” but adds: “That was all encompassing, so I found a nugget, about some who need to remember and some who need to forget.” And so she also puts on the platform Vijay, locked in the memory of his girlfriend being pushed under a train, and Dino, the drug-addict who killed her.

Vijay and Dino have lots of life they long to forget, which sets up the first of many conundrums: how much memory is the right amount? If you could take a pill to forget, should you? A magic memory bullet might ease Vijay’s pain, but would we let Dino have it, and so let him off the hook of remembering his actions? Then again, if Dino could have taken such a pill when much younger, wiping out the trauma he experienced at the hands of his abusive father, could that have saved him from spiraling into addiction and murder?

The killing in 2002 by Stephen Soans-Wade of Christophe Duclos fed Bown’s creativity. Like Dino, Soans-Wade was turned away from hospital, labelled by some a violent drug addict beyond help, while others said the tragedy reflected perennial inadequacies in psychiatric services for those with complex problems. And while Bown’s play is not about mental health per se, she says: “It’s impossible to cleave the social and political stories from the human stories being played out.” And the single strongest message I took away is indeed a human one: we’re in this life together, and if it or we are in a mess, it’s unlikely to be simple, or simply any one’s fault.

The futuristic aspects of Mind the Gap, which is written for teenagers, spark important questions about the nature of mental health and distress, and encourage us to revisit persistent dilemmas about treatment and care. While a forgetting pill might be disastrous in Maya’s hands, what about the “remembering pills” that exist today? Apparently able to slow progress of dementia, they are the focus of fierce battles between patients who want them, and the government, which has yet to decide.

Children having brain scans at school for anti-social behaviour sounds like dramatically-licensed science fiction, but it’s apparently less so if you live in America, where the President’s Council on Bioethics has also been discussing ‘erasing memory.’ Back home, the government’s recent report, Drugs Futures 2025, covers similar topics. While it arguably tries to do too much and consulted too few, it’s certainly tantalizing.

Questions about how our brains work, sometimes don’t, and how we should  tamper with them, will matter as much tomorrow as they do today. If, as individuals and society, we don’t try to find answers, someone else will. Who should define what’s ‘normal’ and what’s not? Should we even try? Do we risk medicalizing human variation so that treatment for mental distress spills over into attempts to create dodgy uniformity while drug companies make dodgy profits from treating invented illnesses? And what of ‘enhancement’: is it wise or possible to use psychiatric drugs to create hyper-happiness to ease grey days? Should we boost the brain with drugs, like steroids for sporting muscles? If it’s OK to send your child to the maths coach until they get through their GCSE, what about popping them a pill to do exactly the same bit of coupling or uncoupling of their synapses?

For now, these may be just mental exercises, imaginary scenarios, but don’t let that kid you that they don’t matter.

Dr Sophie Petit-Zeman is Director of Public Dialogue at the Association of Medical Research Charities. The views in this article are personal. Her book, Doctor, what’s wrong? Making the NHS human again, was published by Routledge, June 2005 (http://observer.guardian.co.uk/review/story/0,6903,1539499,00.html)

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