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I am holding a pill in my hand. It is a capsule, small, black and easily swallowed. I am debating whether or not to swallow it.

It’s a difficult problem. I spent much of my life in search of difficult problems. You’d think I’d be happier to have this one.

* * *

I was a child prodigy. By the time I was five, I was reading at a third-grade level and doing math at a fifth-grade level. As soon as I was old enough, my IQ was tested. It was 195. (What this means, in practical terms, is that I am 95% more embarrassed than average whenever I do something stupid.)

Because I was so far ahead of my peers intellectually, people often assumed I was ready for equally great emotional challenges. When I was ten, my parents showed me Schindler’s List.

If you’ve seen this movie (if not, what are you waiting for?) you remember the final scene. Oskar Schindler, played superbly by Liam Neeson, is surrounded by a huge, grateful, loving crowd of people — men, women, children, a whole community he’s kept alive through the war. And he is weeping with remorse — not just sorrow, remorse — that he didn’t save even more people, sell more of his possessions so he could put more names on his list. He was in a situation where money could buy lives, so now he regrets every single deutschemark he ever spent on anything else.

This scene — I know this was not Spielberg’s intention, but it made me very, very angry. And I couldn’t even say who or what I was angry at. If anyone had noticed and asked, I would have said I was mad at the Nazis, which would have made sense even if it wasn’t the exact truth. All I knew was that there was something terribly wrong somewhere if this man, out of everyone in Germany at this time, felt like a murderer.

Just to make the point, soon afterward came the execution of the Nazi psychopath Amon Goeth. He seemed very much at ease. When they hanged him, his last words were “Heil Hitler.” (As I learned later, Hitler himself died with no regrets — not even that he failed, because he blamed that on everyone else. The last words he ever committed to paper were “The aim must still be to win territory in the east for the German people,” which gives you an idea how much he’d learned from the whole World War II experience.)

* * *

For as long as I can remember, people — parents, friends, teachers — were telling me I was destined to achieve great things. I chose to study medicine because it seemed to offer me the best chance of living up to their expectations. I chose the study of neuroscience because it was the most challenging.

But it wasn’t analyzing the structure of the brain that led me to pursue the line of inquiry that has brought me here. Nor was it my interviews with abuse victims, or with the survivors of disasters and massacres. That part of my work came later.

In fact, when I first went to medical school I really didn’t have any plans at all, beyond learning what there was to be known and seeing if it gave me any ideas. This wasn’t a bad plan — if there was one thing I’d learned, it was that fresh knowledge is the food of inspiration.

It was an embarrassingly minor incident that set me on this path. One day I was taking a little walk off campus, on my way to buy a latte at one of those independent coffeehouses where they take such pride in not being a Starbucks that they feel entitled to charge even more than Starbucks does… and there was a homeless man outside the coffeehouse.

“Spare change?” he said.

I shook my head and stepped inside.

Of course I had spare change. My parents were paying my way through medical school, and granting me an allowance, and on top of that I had a part-time job. I knew exactly where my next meal was coming from, and where I would be sleeping. I had two credit cards that I wasn’t even close to maxing out. That man out there had none of these things, and here I was buying a disgracefully overpriced latte and telling him I didn’t have any money.

When I stepped outside, I handed him the change from the latte. And as I walked away, I felt the warm glow of… more guilt. For all I knew, he was an addict. For all I knew, I’d just helped him self-destruct a little more.

And then I thought — what the hell? I can’t be having the same reaction to giving him money and not giving him money! That makes no sense! In order for there to be a wrong decision, there has to be a right decision!

I had just caught my conscience in a contradiction. On the surface, nothing had changed — not even my feelings. What had changed was how I felt about my feelings… my meta-feelings, for want of a better word. The guilt was still there, but now it seemed somehow alien, like a propaganda broadcast from an enemy nation. I might be subjected to it, but I didn’t have to agree with it.

And then I went on about my business… but I kept turning it over in my mind. I asked myself why I’d given him the money. Was it because I thought he ought to have it, or just to keep myself from feeling bad? Then I realized this line of inquiry was also a trap. If I did it to feel good, or to keep from feeling bad, that was self-indulgence, not virtue. If I did it out of a sense of duty, then shame on me for not enjoying it.

As I said, it was a minor incident, but the experience reinforced the lesson I’d learned from Schindler’s List. Guilt and remorse are the ultimate maldistributed resources — hoarded in great quantity by people who have no right to them at all, while those who should be wallowing in them have to go without.

It seemed to me that somebody ought to do something about that.

* * *

I am holding a pill in my hand. It is a capsule, made mostly of gelatin, with 200 milligrams of the active ingredient. The lab assistants who made it could have made it any color they liked. They chose to make it black. It should go without saying that taking the pill will not change in any way the nature or the consequences of my actions.

* * *

Twenty years went by. An M.D., a Ph.D., a marriage and a divorce. No children, but a German shepherd rescued from a shelter. (If you’re interested, the dog’s name was “Daisy.”) Twenty years, and I would be lying if I said I pursued my dream with single-minded obsession.

You can’t really do that these days. Science is a cooperative enterprise, and no one starts at the top. You start out working on other people’s projects, and hopefully one day other people will help you with yours. And everything has to be justified to a grants committee. The modern medical research establishment is not kind to the Frankensteins, Moreaus and Raymonds of the world, if indeed there are such people. It’s not that anyone objects to tampering in God’s domain — they just don’t pay you for it.

And it’s not as though I was the only one interested in the neurological basis of moral reasoning. About the time I was getting my Ph.D., scientists were discovering that using transcranial magnetic stimulation to suppress activity at certain junctions in the brain could temporarily diminish a subject’s capacity to feel a whole suite of emotions, including terror, anxiety, pity, guilt and shame.

But I was working towards my goal. I found projects to work on that corresponded with my interests — studies of survivor’s guilt, social anxiety, and other cases of what you might call conscience gone wrong.

And I did other things. I played, and still play, the cello in a string quartet. I learned to golf, largely for career reasons. And when I was finally ready to do my own work, I had a solid reputation in the field and the work of other scientists to draw upon.

* * *

I am holding a pill in my hand. It isn’t cyanide or anything like that — I am not contemplating suicide. In fact, we plan on offering this pill as a prescription drug some time in the near future. It could improve the lives of many people and there seem to be few side effects, but, like a lot of prescription drugs, it does have a certain potential for abuse.

* * *

This was what I had to work with at the beginning of the experiment:

Twelve people. Eight males, four females, all… biologically human. The youngest was Skyler H., a 15-year-old boy with a history of cruelty to animals who had just been convicted of sexual assault on a younger girl. The oldest was Walter B., a 43-year-old man who had embezzled over a quarter of a million dollars from the nonprofit where he worked. The others were in their twenties or thirties.

Some of them were violent offenders. Others were not. The one thing all of them had in common, besides the fact that they had all fallen afoul of the law, was that when given the most up-to-date version of the PCL-R by professional psychologists who did not so much as know their names (let alone their crimes), all of them showed many signs of psychopathy. MRI scans of their brains bore this out — the same key parts of their brains, particularly the temporoparietal junction, were underdeveloped or simply missing.

As far as anyone could tell, not one of these people was capable of looking at another human being and seeing anything other than an obstacle or a means to an end. They simply didn’t have the right hardware for that. The question was whether it was possible to give them the right hardware.

At Johns Hopkins, there was a new tool for this. The doctors could create stem cells from adult human tissue, re-specialize them in the general direction of neurons and glial cells, inject them into the brain at carefully chosen spots and then stimulate existing neural structures to grow and incorporate the new tissue. This technology was still in the experimental stage, and had such a wide variety of potential applications (treating PTSD, repairing brain damage, countering the effects of Alzheimer’s, etc.) that it took all the clout I had just to get on the waiting list.

The time spent waiting was not wasted — in fact, my team needed that time to find twelve people who (a) fit the criteria for the experiment and (b) were willing to have their brains experimented on in exchange for consideration at the next parole hearing. They were told it would “improve their mental health” and might even boost their IQ as a side effect, all of which has the virtue of being true. We didn’t tell them exactly what it was meant to do, but we suspected most of them would figure it out for themselves.

Meanwhile, the team at Johns Hopkins had become experts at running double-blind experiments with the neural tissue injector. They would be doing most of the work, but no one who interacted with the subjects in any way (including us) would know which of them was really undergoing the procedure, and which of them was not.

We had already collected and re-specialized the stem cells. The weekend before the injections were to begin, I… got cold feet. This is a perfectly normal reaction to the prospect of altering the brains of half a dozen strangers in an unpredictable and irreversible way. Oddly, I wasn’t afraid that something might go wrong, or that the procedure might have some unexplained side effect. Instead, I began to seriously question whether I was doing the right thing — and whether I had the right to do it in the first place.

Nothing about the people I was about to experiment on elicited my sympathy. Some of their crimes I’ve told you about already. Others… I could describe them, but it would only make you angry. In fact, knowing as much as I did made me angry, and I knew very well that anger is not conducive to good decision-making. Was I letting my disgust at their actions cloud my judgment?

But the experiment was not intended as a punishment. If we hated them and wanted to punish them, we could simply leave them where they were and let the prison system do it for us.

And was it even appropriate to hate them? Unquestionably, if allowed to go free they would constitute a hazard to public safety and well-being — but the same could be said of them if they had been infected with drug-resistant tuberculosis, and they would have had just as much choice in the matter. It wasn’t as though any of them had asked to be psychopaths.

Or… had they? One thing we’ve discovered in recent years is that although the human brain does shape the mind, the process also works in reverse. After a stroke, physical therapy and cognitive exercises can help the brain rewire itself, bypassing damaged areas. Perhaps that is what the mind is — the process by which the brain shapes and reshapes itself. In the case of these twelve, something had gone wrong fairly early.

So — were they entirely victims, or was some of the damage self-inflicted? Were “free will” and “personal responsibility” completely meaningless in cases like this? Why, exactly, were they the way they were? Philosophers have debated the question of the ultimate origin of evil for thousands of years. I needed an answer by Monday.

So after some thought, I narrowed the list of suspects down to four:
Other people (or society in general). If these people had become what they were as the result of bad parenting, societal indifference, or some sort of abuse, then it was not only my right but my duty to fix what was broken in them, if I could.
Themselves. If they were in fact to blame for their condition, if they had shaped their own brains through years of bad mental habits, did I have the right to undo their self-actualization? Well… yes, I did, actually. They gave me the right when they signed the waivers. (Except for Skyler H., whose mother had signed the waiver for him, but that was close enough.) If doctors have the right to treat chain-smokers for lung cancer, then I had the right to do this.
Nature. If this was just another kind of birth defect or developmental disorder, there was no ethical issue at all. I’m a medical scientist. “Letting nature take its course” is exactly what they pay us not to do.
God. This was another way of saying “nature” but with the implication of plan and purpose which it would probably be a bad idea to interfere with. The problem — assuming God existed, I could neither know His will nor test the assertions of anyone who claimed to. All I could do was what seemed right to me.

When I talked it over with my co-workers, I found that the only thing they were really worried about was that it might not work. I was the only one, it seemed, questioning the basic concept. So I pushed my doubts aside.

The injections took six days. We gave them each three more days to recover, then returned them to the system… and waited.

* * *

Three months have gone by since then. We have results.

Of the six members of Group A, four of them report definite changes in their outlook towards other people. They say they feel greater empathy for their fellow human begins, a clearer understanding and respect for the rules that govern society, and a fervent desire to dedicate their lives to honest work and charitable deeds as soon as they are released from prison.

Group A, of course, is the control group. One of them refuses even to pretend he has become a different person. He seems to be too proud to lie. Another one, a serial rapist, claims that he can no longer bring himself to come into physical contact with a woman. Apparently he never figured out what the treatment was supposed to do.

As for Group B, those who actually received the treatment… we are fairly certain it had the intended effect. It’s difficult to be sure, however.

You see, five of them have committed suicide over the course of the past month.

When the first one died, we tried to schedule interviews with the rest of them. When two more killed themselves on the same night, we had the rest of them put on suicide watch. The last two eventually managed to convince the guards the impulse had passed, get themselves out of observation, and then…

Looking back, it seems rather obvious. I can almost hear my ex-wife… Well, what did you expect, Mr. IQ-195? You’ve had a conscience all your life, you learned to cope with guilt and shame as a child — but they never did! They never had to until you came along! And after a lifetime of doing God knows what horrible things on top of whatever got them sent to prison… really, Mr. I-have-a-Ph-D, what did you think was going to happen when you did THIS to them?

The only one still alive is Skyler H., who has been transferred to a mental health center after several suicide attempts. I interviewed him myself. He was not very articulate, but it was clear that the treatment had had more or less the effect we intended:

“It didn’t used to matter. Didn’t used to matter and now it does and I can’t stop thinking about it. I can’t. I just…

“The worst part is I still want to… do stuff. You know? I still want to and it makes me sick! Why couldn’t you fix that? Huh? If you were gonna fix my head, why couldn’t you fix that?”

I didn’t have an answer that would satisfy him. All I could say was “We don’t know how. We’re working on it.”

At least his counselor is pleased. So is his mother, who’s calling it “a miracle.” She says it’s the first time he’s cried since he was two. Before long, he may be returned to her care. I would feel better about that if not for the fact that she was the one who brought him up in the first place.

And, of course, that still leaves five people we can’t interview. Five people who also had families. Five people who might not have been the world’s Most Valuable Players, but we’re not in the business of making judgments like that. Five people we put through so much pain over the course of three months that they decided life was more trouble than it was worth.

I wonder if anybody else on my team has any regrets. The reigning attitude seems to be that didn’t work, but we learned some new things. For a scientist, a very instructive failure is almost as good as a success. The next logical step would be to try the experiment on younger cases, who had less to feel guilty about and for whom emotional change and development was more a part of life.

I’m not sure we could get funding for that — or even permission. It seems… well, “counterintuitive” is about the nicest way of putting it. “That thing we just did that drove three men and two women to suicide? Now we’re going to try it on kids.”

We meant to heal those people, and we did. We just… didn’t think through the implications. As I said at the beginning, 95% more embarrassed.

* * *

I should mention that this experiment is not the only thing I’ve been working on for the past few years. I’ve also headed another project, and this one is far more successful.

Which brings me back at last to the pill I am holding in my hand. The antiautecthic. I had to coin that word myself to describe the active ingredient, a complex synthetic protein that tricks its way past the blood-brain barrier and occupies certain specific receptors in the amygdala, blocking certain neurotransmitters, inhibiting certain natural responses to a given situation… well, the truth is, it’s nothing but an unusually specific painkiller.

And not even all that specific. If you’ve survived a plane crash or a shooting spree, and a part of you feels as though even living through something so horrible constitutes a kind of complicity, this pill will make that feeling go away. If you’ve been subjected to some sort of sexual assault and some part of you feels soiled and unclean, this pill can help you. If you just have someone in your life who enjoys guilt-tripping you and happens to be good at it, this pill is your ally. (Although it might be a better idea just to avoid that someone.) If you have difficulty approaching others because of the fear that they will in some way judge you and find you wanting, this pill will take care of that. And if you’re a scientist whose ill-thought-out experiment has caused the deaths of five other human beings… well, you get the idea.

The antiautechthic can give you two to three days without guilt, shame, self-loathing or other affiliated emotions. It can’t tell you if this is what you really need. It especially can’t tell you if this is what you deserve. At the end of the day, it’s just a pill, and I have to decide for myself whether to take it or not.

My conscience is telling me don’t you dare, but I think I’ve mentioned that I don’t fully trust it — especially now that I am in effect threatening it. I’m not so sure I trust the rational part of my mind, either. That’s the part of my mind that looked at this project and didn’t see any way it could go wrong.

There isn’t anyone else I can ask, either. Why would they answer? My feelings are of no interest to anyone but me. Whatever I decide, the dead will stay dead.

And so I am holding this pill in my hand, and trying to choose…

And now I’ve thought of something even more depressing.

It doesn’t matter. I could flush this pill down the toilet. I could resign from this job. I could spend the rest of my life trying to atone for my sins.

And still it wouldn’t matter. No matter how much I flagellate myself, there is and will always be a little voice inside my head that says I chose to feel this way. I chose to accept guilt. I can’t be that bad, or I would have taken the pill without a second thought. It’s an annoyingly smug, self-satisfied little voice and I don’t like it very much, but it happens to be right.

I put the pill back in the bottle. I choose to do without it today.
I tried to think of a way to rewrite this story, and couldn't. I tried to come up with a better title, and couldn't. Still, I think it deserves at least a small audience. So here it is, such as it is.

(Oh, and that transcranial magnetic experiment is real. Sweet dreams.)
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Submitted on
April 5, 2015