human patients, I could turn on that blue light, see what this research can really do. But the thing is, you cannot deliver the light without also delivering the virus. And so while the thousands upon thousands of lobotomized patients sometimes improved in ways that related to the symptoms they once exhibited, they also, just as often, became little more than shadows of their former selves, abandoned to the wasteland of bad, hasty science, left sitting in pools of their own drool. Remembering them makes me thankful for my work, how long it takes, how slow it is.
The “shocks” that my mother described have come a long way since they were first used in the 1940s and ’50s. We all remember that scene from One Flew Over the Cuckoo’s Nest, when electroconvulsive therapy was used not as a treatment for mental illness, but as a kind of mind control. Back then, the therapy was performed on anyone from the schizophrenics and depressives who needed mental health care to the homosexuals and “hysterical” women who neither needed nor asked for treatment, who simply lived outside the bounds of what society deemed “normal.” It’s hard to shake that image of people being forced to correct something that was never wrong. It’s hard to forget the primitive beginnings of this therapy, to stand by it. For many, like my mother, the “shock” of this treatment, the way it induces a seizure in order to treat something that is impossible to see, and often difficult to accept, feels like a bridge too far. But the truth is that electroconvulsive therapy can work, does work. It is often presented as a last resort, and it is just as often performed because the patient herself requests it in one final attempt to crawl out of the deep, dark tunnel.
The work that Katherine and those of us who are interested in finding bioengineering and neuroscientific interventions to treat psychiatric illness do is in many ways about moving beyond the last resort, the final attempt. When she returned to her practice, Katherine would become a psychiatrist who only accepted patients who had no other options left, patients for whom everything, even death, had failed. In addition to optogenetics, Katherine’s work at Stanford involved improving vagus-nerve stimulation, a treatment for treatment-resistant depression and epilepsy whereby a tiny device is implanted beneath the skin near a patient’s collarbone, delivering electrical impulses to the vagus nerve. It is a charger for the depleted battery of a depressed patient’s body. The frustrating thing about the technology is that, like with DBS for Parkinson’s disease, no one knows exactly why it works, only that it works imperfectly, using electricity that cannot differentiate one cell from another. If we could better understand these treatments, if we could come up with interventions that affected only those specific neurons that are involved in each particular psychiatric illness, then perhaps we could provide something better.
* * *
—
My mother crawled out of her deep, dark tunnel, but perhaps this phrasing is too imprecise, the image of crawling too forceful to encapsulate the relentless but quiet work of fighting depression. Perhaps it is more correct to say that her darkness lifted, the tunnel shallowed, so that it felt as though her problems were on the surface of the Earth again, not down in its molten core.
My aunt took me to church one last time. The pastor didn’t like me. He was resentful of my many refusals to get up on the stage, receive my healing. That day he preached about how stubbornness is little more than pride in disguise. He looked right at me when he said that the pride of the West was in its inability to truly believe.
“Yesterday, I heard about a miracle, a miracle that reminded me of the miracles we read about in this holy book. Our sister in America could not rise from her bed, and she has now risen. Glory to God,” he said, and the church said, “Amen.”
“Our sister in America needed the God of miracles and the God of miracles showed up, amen?”
“Amen!”
“Those in the West might look at her and say that it is simply a coincidence that she rose from her bed, but we who believe know the truth, amen?”
“Amen!”
“When God says rise, we rise.” He looked around at the congregation, many of whom were clapping and nodding and lifting their hands with praise, but our reaction did not satisfy him.
“I said when God says rise,