Dopamine in C Minor

Welcome to Knowing Neurons’ Neuroscience Fiction Theater. Please note that the following story contains mild profanity and may be unsettling for younger audiences. Reader discretion is advised.

“I’m sorry, Art. What you’re asking for is illegal.”

Art’s neuroiatrist Abree stared unsympathetically at her patient from across the patio table of her San Diego estate. Her face was young and oddly round. Her eyes were beautiful, yet intimidating. The details of her iris appeared as tiny sapphire blades, cutting anything that gazed too deeply into them. Her sclera were pink with exhaustion, carrying heavy blood bled from the blue blade. An impenetrable woman. Very important for her line of work, Art reasoned. Preserves the patient-doctor relationship that would be ruined should the patient read too deeply the doctor’s thoughts.

Abree lit up a cigarette. The smoke blew in the soft breeze towards palm trees to the west behind Abree’s estate, slowly dissipating like life itself until nothing more could be seen. Her sapphire eyes shut, and Art noticed the broad lobes of her ears. She was ten year younger than him, about thirty, he thought. Through the patio window, Art saw the lavish interior of Abree’s home. Beside two antiques—a nineteenth century polished gramophone and a witty, vintage phrenological chart—a marble statue of the late physicist Steward Lawkins gazed back at Art.

“You smoke?” said Art.

Abree replied with another puff.

“You’re a medical doctor,” said Art.

“I know,” said Abree. Her eyes relaxed, appearing unfocused, as she began checking email. The information was fed directly to her visual cortex through the same neural virtual reality implant that Art had chosen to deactivate several years earlier.

“The operation can’t be illegal. I’ve read …”

“You’ve read about it being performed in extreme cases. Intractable depression.”

“What do you think depression is, Abree?”

“Huh? You know what depression is.”

“I know what I think it is,” said Art. “I want to hear what you think it is.”

“Depression is a chemical imbalance in the brain. Does that sound right to you?” she said after a cigarette puff.

“Depression,” said Art, “is not feeling anything.”

Abree smiled. “Why did you take out your implants?”

“I didn’t take them out,” said Art. “I deactivated them.”

“Why?”

“I wasn’t living anymore. I was just existing. Each day I had access to anything I wanted through this hole in my head. I had women, money, adventure. But they weren’t real. They were just electrical activity generated by a chip in my skull to trick my brain.”

“Who says they weren’t real?” said Abree.

“They weren’t real because they were free. I could have anything I wanted, and it cost nothing. So it was worth nothing.”

“You told me once that you wished you lived fifty years ago. Before virtual reality. Before neural implants.”

“I guess,” said Art. “I don’t even know what I want anymore.”

“It was a different time,” said Abree. “Neurology and psychiatry were two separate professions. The mind and the brain were still considered separate. People accessed the world through phones in their pockets. Is that what you want? A phone in your pocket instead of a hole in your head?”

“I want to access the world through … myself. Not a machine. Myself.”

A man with Abree’s strangely round face and very same broad ears stepped onto the patio. Aside from the goatee, graying hair, and square jawline, he looked like Abree herself, heavily costumed and aged with thick makeup.

“How’s it going sweetie?” said the man, bending down to kiss Abree’s forehead.

“Honey, I’m with a patient,” said Abree.

“A patient?”

Abree chuckled. “Art is the only patient I have who still visits my house. Every other patient does telemedicine through the VR implant.”

“And I pay twice as much for it,” said Art wryly.

“Ah,” said the man, stroking his goatee. “Nothing like a good in-call appointment.”

“Honey!” Abree said with a laugh, punching her tall doppelgänger’s shoulder before he disappeared back into the house wordlessly.

“Is that your … husband?” said Art, barely stopping himself from saying “father” instead.

“In a sense,” said Abree, turning cold again.

“I’ve never seen a couple that looks so alike.”

“It’s nice having a partner with the same personality.”

It dawned on Art before he could control his facial expression. Abree’s doppelgänger was exactly that. Or, more properly, Abree was her partner’s doppelgänger, a clone of her lover with the sex-determining Y chromosome replaced with a second copy of his X chromosome.

Abree blushed, cleared her throat, then adverted her gaze, examining her fingernails. It was an exquisitely rare moment, the neuroiatrist with her defenses down, thoughts naked, feelings exposed. Her eyes glanced back at Art again and softened. For a precious moment, Art could see something human. Her illicit relationship, the very circumstances of Abree’s conception, was a crucible of fear. She was vulnerable and weak now, brought down to his level.

“I’m done with the bullshit,” said Art. “I want the operation.”

“Art, you’ll want the stimulator deactivated just like the VR implants–“

“The VR implants don’t make me happy. Dopamine will.”

“You have a very simplified understanding of the brain’s reward circuit. Dopamine does not encode happiness, it encodes the salience and reward value of the stimulus. You’ve probably heard about the typical junkie that no longer feel happiness when he get his fix …”

“I have nothing to lose.”

Half a grin crept darkly across Abree’s round, young face, as if finally getting a morbid joke.

“You can’t receive the stimulator operation here, but … I have powerful friends who can help you. I’ll be sending you to a secret location soon. Have you been to Nossoip before?”

“Nossoip?”

“You’ll need a flight to Australia then a submarine ticket to the bottom of the ocean. Nossoip is the smallest city-state in the Marianna Federation. It’s a self contained research institution founded by a group of rogue scientists, doctors, and engineers. The UN has no jurisdiction there.”

“How much?”

“1000 bitcoins.”

Only a 1000 bitcoins! Despite all her resistance, Abree was giving Art a discount. Either she wanted quick cash all along, or she felt vulnerable having been revealed as a clone. Art reached forward to shake her hand, then stopped. Neither explanation felt quite right. Abree was wealthier than a cat sleeping in gold, and what should she care if a patient knew she was a clone?

“Are you taking the deal or not?”

Art shook Abree’s hand. After all, why had he come here?

* * *

“What do you do for a living, Mr. Six?” said the EEG technician.

“What’s it to you?” asked Art.

“Plenty. Not everyone comes to Nossoip asking for a nucleus accumbens stimulator.”

“I used to be a programmer,” said Art. “Was never interested in the assignments my employer gave me, though.”

The room was white and sterile, yet somehow organic, like the inside of an enormous seashell. The walls met the ceiling in a smooth curve, and besides the boxy medical equipment, the chamber itself abhorred sharp edges. There were no windows and no indication that Art and the technician were at the bottom of the ocean. With deft speed and precision, the technician attached each of several dozen small electrodes to the scalp beneath Art’s short hair, pipetting a thin layer of gel beneath each contact.

With the final electrode attached, the technician turned Art’s seat around to face the television monitor. A myriad of small squiggles appeared on the screen, each trace dancing forward with a similar rhythm.

“Please close your eyes, Mr. Six.”

Art closed his eyes and absorbed himself in the show of dark colors beneath his eyelids.

“How old were you when you had your VR implants, Mr. Six?”

“About twelve.”

“You have very weak alpha oscillations.”

“Alpha what?”

“Alpha is the EEG rhythm that appears when one is restful, focused, and at peace,” explained the technician, “The classic medical literature described it as being strongest over visual areas when the patient’s eyes are closed. For reasons not entirely known, the alpha rhythm has weakened in the EEG of the younger generations. We believe it is the influence of VR implants interfering with typical development of the visual system.”

“Good to know,” said Art.

“Well, the routine EEG is complete. No signs of pathology or interictal activity. Let me give you a rundown before we get started.”

A glistening hologram of a pinkish human brain appeared suspended in the air beside Art. The left hemisphere vanished, leaving the right medial surface of the brain exposed. The technician gestured to a small, subcortical structure at the base of the frontal lobe, beneath the genu of the corpus callosum.

“This is the nucleus accumbens. It processes salient or rewarding stimuli and modulates the release of frontal dopamine. It has been implicated in nearly every documented addiction … drugs, booze, gambling, sex. You need this part of you brain active to feel rewarded by life’s activities. In intractable depression, the patient cannot feel pleasure from life without direct, electrical stimulation of the nucleus accumbens. We are going to insert a several, small stimulating electrodes in the nucleus accumbens. The stimulator will be powered by the slow radioactive decay of plutonium. The battery will never need to changed.”

“Wonderful.”

“I’m ready to bring in the anesthesiologist. Are you sure you want to go through with this, Mr. Six? There’s no going back once we start?”

“It’s cheaper than cocaine,” said Art. “Let’s do it.”

* * *

A white, formless blur appeared, filling the void of nothingness, inhaling Art. A dull pain awakened in his head, accompanied by a savage thirst balanced with a queasy protest in his stomach. For a moment, Art thought that he had been swallowed by a polar bear. He wondered if he was being digested in the polar bear’s stomach or deep in its gut. The delusional fog cleared and, suddenly, an awareness shot through Art like a hot, purple spark. He was in the operating room in Nossoip, awakening from his surgery.

“Wakey, wakey Art,” said a familiar voice in his head.

“ABREE!” he said with a gasp. Those sons of bitches! They reactivated the VR implants!

“You’re lucky you didn’t have this operation 30 years ago,” said Abree. “Back when my husband was in medical school, they woke the patient up during deep brain stimulation surgery. Didn’t have a good understanding of where to place the electrodes without turning them on and asking the poor bastard how he felt.”

“Why are you doing this to me?” said Art.

“You’re getting the good end of the deal,” said Abree in his head. “A cheap operation in a modern facility. How long has it been since you felt real pleasure?”

As Abree spoke, a wonderful thing happened, perhaps beyond the comprehension of anyone who had never experienced it. The pallid world had color once more, and Art noticed the subtle beauty of the Nossoip architecture around him. The room was beautifully designed like a mother’s womb, warm and cozy, a place of new life. Art took delight in the purr of the medical equipment, the softness of his bed, the professional finish on the chrome machinery. A bright happiness swept through Art, and like a cup overflowing with water, he could not contain his enthusiasm for the world around him. Life was so wonderful, he couldn’t understand how he had missed it all these years! Like a man who had never been in love, everything finally made sense.

And then it went gray again.

“Did you enjoy it?” said Abree.

“Turn it on! Turn it back on!” said Art.

“If you’d like to experience that again, I have instructions for you.”

“This was never part of the deal!”

“I will decide what’s part of the deal,” barked Abree. “Nossoip is a enclave of the last brave scientists in the world. Shortly before the great physicist Stewart Lawkins died, he turned his research to the physics of the brain and the simulation of the mind. His brain was scanned with molecular resolution, synapse by synapse, so that a complete copy of his connectome containing all of his memories, genius, and personality could be digitally stored for eternity. The research staff of Nossoip have refused to share the conntectome with anyone outside of the city. I want you to find the conntectome and bring it to me, if you ever want to feel happy again.”

“How could you do this to me?” asked Art.

“It’s only fair. I help you, you help me. The city is largely isolated from the Internet, running on its own intranet. You’ll need to follow these instructions to find the hard drive containing Lawkins’ conntectome. Since you’re bedridden, the doctors here don’t view you as a risk. There is a computer terminal on this floor, only a few hundred feet away, room 367. We cannot hack the computer from California because it runs only on local intranet. You’ll need to sneak in through the ventilation shaft and steal the hard drive.”

“How will I find it if I’m coming from a ventilation shaft?” said Art.

“With the VR implants reactivated, I can see through your eyes and hear through your ears. I’ll guide you.”

Great, a demon in my head, possessing my soul, though Art.

“I heard that, too,” said Abree.

“How am I supposed to take the damn thing back with me?” said Art.

“Find a way. Hide it in your ass, if you have to. There are no cameras here … the doctors and scientists naively believe you’re a weak, feeble patient. Because they carefully monitor and control everyone who enters Nossoip, they assume that few further security precautions are necessary.”

“I am a weak and feeble patient,” said Art, feeling nauseated. Pain still shook his head like a hammer, and the contents of his stomach threatened to escape at any moment.

“Fine,” said Abree. “You’ll never feel relief from your life again.”

“I’ll do it, I’ll do it,” said Art. “Just shut up, and get out of my head.”

The air vent was installed seven feet or so above the floor, next to the main door of the hospital room through which a doctor might enter at any moment. Art scanned the white, sterile chamber for any object that might become a tool in Abree’s scheme. Beside Art’s bed sat a computer terminal carefully controlling the intravenous injection of morphine.

“Computer, remove IV catheter,” said Art. Recognizing the patient’s voice, the computer yielded to his command and painlessly withdrew the catheter from the vein in his left arm. A robotic appendage promptly covered the site of injection with a bandage. Slowly, like a man pushing himself to perform his thousandth sit-up, Art rose from the bed. The pain in his head attacked like a bolt of lightning, then subsisted as quickly as it had struck. With careful speed, he took his bed and rolled it on its plastic wheels towards the doorway. The wheels! They would make it useless as a stool. Art pulled off the sheets, folding them and placing them under the wheels of the bed such that it could not easily roll across the floor. Before climbing atop the bed, he realized he had no means of removing the grill of the vent without a screwdriver.

“Improvise,” said Abree. “Make a crowbar.”

“Shut up!” said Art. He looked around the room, eyes settling at last on the sharp metal edge of the tray holding the computer console, which had sat beside his bed. Art walked over to the console, grabbed the equipment and prepared to attack the vent. His head ripped with a terrible agony so powerful he considered resigning from his effort. The absolute bliss of the brain stimulator arose from his memory, and reluctantly he began his efforts afresh. Lifting the equipment, he stepped on top of the bed and fiercely thrust at the grill of the vent with the sharp metal edge of the computer equipment. The grill, made from cheap, malleable aluminum, quickly crunched inwards, creating a portal for Art to continue as Abree’s reluctant accomplice. Dropping the computer equipment, he climbed into the narrow opening only to be engulfed by the terrible grip of claustrophobia. The opening was barely wide enough to allow his body to pass through, and the shaft itself so small as to hardly allow room for maneuvering or crawling.

“Keep going before a doctor shows up,” said Abree.

“How am I going to get out of here after I steal the damn thing?” said Art.

“We’ll play it off as a psychotic episode. Might delay your departure a few days. Just keep it hidden in your rectum.”

Great, thought Art, I’m being screwed mentally and physically.

“Stop whining,” said Abree. “You need to turn right here, then continue for a hundred feet.”

Art crawled along like a naked mole rat–blind and vulnerable. So little light reached his eyes that he assumed Abree was navigating by dead reckoning using kinesthetic feedback from the VR implants. A hundred feet more and several twists and turns later, Art at last found himself looking out of a grill into a room softly buzzing with the quiet operations of many computer terminals.

“That’s it,” said Abree.

“How do I get in there?”

“Kick in the grill.”

A wave of nausea swept over Art. The urge of vomit was overwhelming, but with great effort he managed to allow nothing more than a small taste of his breakfast to seep into his mouth. Channeling his claustrophobia into his quadriceps, Art thrust his foot into the metal grating that stood between him and the elusive artifact his mistress hungered after. The aluminum caved in slightly but did not give completely. Sickening thoughts of being trapped eternally in the hospital’s ventilation shaft crept over Art. Resolute, he continued to channel his fear into strength, kicking furious at the soft grating until at last the grill crashed onto the floor of the chamber below. Cautiously, like a child preparing to tumble down an enormous slide from a great height, Art stuck his legs out of the opening and plunged to the floor, taking great care to absorb the fall with his knees by landing in a squatting position.

The room was dimly lit and circular, with about twenty small computer terminals lining its circumference, interrupted only by a narrow, frosted glass door. The floor, at first unnoticeable, was at second glance impressively decorative, a very faint yin yang symbol etched to fill its entire extent. After a brief moment of drinking in his surroundings, a bright light turned on automatically from the ceiling, and a soft, female voice spoke from surround speakers.

“Welcome to the Brain Physics Research Core. Please state your business.”

Having no business but that of a reluctant thief, Art answered with silence. There were twenty computers, any of which might hold Lawkins’ connectome.

Which one is it? said Art silently to his handler.

“Just start taking one of the hard drives,” said Abree. “With any luck, it should be backed up to all of them.”

With any luck?

“Hurry! I’ll review my notes while you go in case I find something helpful.”

Art turned to the computer closest to him and began prying apart the metal casing. As with the ventilation grills, more brute force would be required. His heart pumped and quivered like an overworked engine, as he quickly searched the metal casing for a vulnerable point.

“The doctor is too late,” said an unfamiliar voice behind him.

Art leaped to his feet. Before him stood a tall, almost expressionless, rather elderly woman with pink, braided hair. She had entered the room silently while Art clawed hastily at the computer casing,

“Who …”

“Edna Frost. The name means nothing to you, of course. I’m the lead scientist of this project and … how shall we say … both a friend and enemy of your neuroiatrist Abree Hale.

“Tell Edna they can do nothing to prosecute us,” said the voice in Art’s head. “The Marina Federation exists entirely outside of UN jurisdiction–“

“Shut up!” said Art.

Edna cocked an eyebrow.

“Sorry … Talking to Abree … Not you.”

“She’ll have to zip it and soak it all in while I talk,” said Edna with a laugh. “Last Abree heard, we still did not have the right model parameters to simulate Lawkins’ mind effectively. Unfortunately for her, we’ve finished the model in the past year. Lawkins is alive again, and through the grace of our model, cured of multiple sclerosis.”

“A weak body is better than no body! Tell her that!” said Abree.

“Hush!”

Edna smiled. “I knew the greatest neuroiatrist and cognitive scientist in California would not take the news well. But, there is a strange kink to all of this.”

“How so?” said Art after a brief silence.

“Well … See for yourself.”

Edna turned to a computer terminal and booted up a program that filled the screen with lines of symbols and code. A giant hologram of the late Stewart Lawkins’ head appeared above the center of the yin yang floor, between Art and Edna. Unlike every photograph of Lawkins Art had seen in textbooks as a child, this Lawkins had strong muscle tone and facial expression, yet the same powerful determination shining through small, blue eyes.

“I’m busy and haven’t time for appointments,” said Lawkins. Focusing his gaze on Art, he asked, “Who are you?”

“Someone out to steal your brain,” said Art.

“That’s a laugh,” said Lawkins. “A simulation wants to steal my brain.”

“Simulation? Look who’s talking.”

“Don’t take the patronization the wrong way. Only a year ago, my simulations could never express this degree of curiously and self awareness.”

“You’re dead!” said Art. “You died many decades ago of a horrible disease that took your body slowly.”

“Ah, is that what the graduate students wrote into the backstory this time ’round? Quite morbid, those lads are. I’m sorry, my friend, but I’m in perfectly good health. You’re in quite good health yourself, not having a physical body. Not only that, but there are now two simulations of yourself running! Whilst you were being operated on in silico, we made a complete copy of your brain to see how two minds might diverge from similar initial conditions! The other ‘you’ is still there in the operating room, a fact you’ll find hard to believe from the perspective that you are real and I am simulation. If this is too much of an embarrassment, we can–being sensitive to such concerns–have the other ‘you’ terminated, of course.”

His simulated brain will invent any explanation to insist on being more real than me, thought Art. Reminds me of those stroke patients who are blind but insist they can see, only because the brain invents new visual information for the speech areas to report.

“Do all connectomes give this delusional behavior when you run them with your model?” asked Art of Edna.

“I thought he was lying at first,” said Edna. “But after many conversations, I cannot prove that I am real and he is simulation.”

“Bullshit,” said Art. “All I have to do is show him that there are not two of me.”

“I’ll show you to the operating room,” said Edna with a soft sigh.

“Do as you please, lad,” said Lawkins hologram. “I’ll be off now.” The hologram flickered and disappeared.

Edna marched Art out of the chamber into a bright hallway lined with many scientific abstracts and conference posters. A bright sign at the end of the hall indicated the Neuroiatry Rehab Unit. Edna pushed the double doors open for Art. A swarm of doctors in scrubs parted for Edna, and Art followed hurriedly in their wake.

“I’m showing him to the operating room,” said Edna to white-uniformed security guard, who gave a quick nod. Opening the door, Edna gestured for Art to enter. The surgery was nearly over, the room dimly lit. A few doctors wearing scrubs were gathered around the operating table where a stereotactic device–looking almost like a sailor’s sextant—was slowly removed by robotic arm from the head of a man partly obscured by shadow.

“The patient is waking up,” said a surgeon briskly exiting the room.

Art locked eyes with the patient opening his own. He was gazing straight at himself. All of Art’s fear, hope, and pain swam in those eyes, an impossible reflection of himself through some perverted mirror. He reached with his hand, yet there was no glass. Seeing in third person for the first time in his life, Art realized a vulnerability, a weakness one never sees in the mirror. A frail body as disposable as any bit of scenery, like an extra shrub in the room, no guarantee that a private world existed in its head, no signature of the personal, internal life that was his own.

“Surely this is quite an embarrassment to you,” said a voice in his head, but it was not Abree. “Let’s make things right and do away with one of you. Who shall it be then? Him? Or You?”

The patient screamed.