Elegy Page 2

  Miriam I wasn’t suggesting –

  Carrie This is real and I want it.

  Miriam But look at how we treat pain. As a –

  Carrie I’m sorry, what?

  Miriam We treat the symptoms of physical pain all the time, without so much as a – A patient comes into the hospital, let’s say, with a very severe – Should we deprive them of pain relief because it might rob them of the full emotional experience?

  Carrie You’re not –

  Miriam Of the ability to learn from their mistake?

  Carrie You’re not comparing –

  Miriam What we do here is in many ways akin –

  Carrie But –

  Miriam Forgetting is one of the most beneficial processes we possess –

  Carrie Enough, enough –

  Miriam Okay –

  Carrie Stop, please, stop.

  Miriam Okay, all right, I won’t –

  Carrie I made a horrible, fucking, terrible, fucking, we don’t need to keep …

  She is upset. Beat.

  Will you tell her that I would like to see her again. Please. But that if she doesn’t, I’ll respect her, if she doesn’t want to, see me, then yeah, then of course I’ll respect that.

  Miriam You know what, despite what you may think of me, of the work that I do, I am sorry, Carrie.

  Carrie When is she being discharged?

  FIVE

  Miriam And any head pain?

  Lorna shakes her head.

  Nausea?

  Lorna shakes her head.

  Nothing at all?

  Lorna Nothing.

  Miriam Great. And how have you been getting on with the Myelinitol?

  Lorna No, fine.

  Miriam And what about the Symmetrel?

  Lorna Same. Fine.

  Miriam Is there anything you would like to ask me?

  Lorna I don’t know.

  Beat.

  Maybe you could explain what the stuff I’m taking does again?

  Miriam You bet.

  Lorna I thought I understood, but, I don’t know, maybe I’m, I’m not sure I did.

  Miriam Why don’t we start, let’s start with the Symmetrel. Which is a receptor antagonist. It attacks, or blocks, the over-production of a particular kind of neurotransmitter. Glutamate. Which causes cell damage. Which in turn impairs the brain’s ability to recover. To repair.

  Lorna … Okay …

  Miriam Alongside the Symmetrel, we also, the reason we have you taking Myelinitol, is because Myelinitol is a myelin stimulant.

  Lorna Myelin?

  Miriam Yes, Myelin is the, is a white matter, which coats, or rather insulates, axons from other nearby axons. Dramatically increasing the speed –

  Lorna Sorry, and, an axon is a –

  Miriam A long, thinnish fibre which extends between the cell body, what we call the soma, of a neuron, right the way across, enabling the transmission of information from neuron to neuron. And myelination –

  Lorna (wrapping her head around the word) Mye–lin–ation.

  Miriam Myelination is the process whereby these axons, these fibres, are coated, protecting and strengthening axons, which in turn protects the strength of the signals being transmitted. Meaning any new relationships, new connections, between either recovering neural pathways or indeed previously unconnected neural pathways –

  Lorna (it’s fucking baffling) Maybe I don’t, after all, maybe we don’t need to go over the – It’s quite a lot to try and –

  Miriam I’m sorry.

  Lorna No.

  Miriam We’re rebuilding.

  Lorna And what, if it, if the rebuilding doesn’t work …?

  Miriam The treatment has never not worked.

  Lorna But, for the sake of argument, I don’t know, what happens, if it doesn’t? And it comes back?

  Miriam You mean if the –

  Lorna If I become ill again, if the disease, if –

  Miriam That has never happened.

  Lorna Hypothetically –

  Miriam You know what, it’s hard for me to speak hypothetically because what you’re asking me is such an unknown –

  Lorna That’s why it’s a hypothetical, because I’m asking you to –

  Miriam Okay, well, let’s say, during a check-up, during an examination, let’s say in six months time, we find signs of deterioration. New signs of fresh deterioration –

  Lorna That’s what I’m asking you.

  Miriam (beat) Lorna, is there something the matter?

  Lorna I think, I don’t know, I think I – I thought that I had had a dream. But it was, I don’t know, I don’t know how to explain it. I don’t think it was a dream, I think it was a memory. Of, of the lady –

  Miriam Carrie.

  Lorna Yes, the lady who –

  Miriam Carrie.

  Lorna We were, we were, rotating.

  Miriam Okay.

  Lorna Close. She was, we were incredibly close.

  Miriam Okay.

  Lorna Incredibly close together. Rotating in circles together. There was a large group of people singing. It was like a burst, a shock, the image itself. It was, I don’t know, it was, for a flicker of a second, and then –

  Miriam Okay, you know what –

  Lorna Can you check, is there a way of checking?

  Miriam I’m not sure I understand –

  Lorna Checking what it was that I saw.

  Miriam I can tell you now, Lorna, it will not have been a memory.

  Lorna But how can you, you can’t know, how can you say that?

  Miriam Lorna, I know there is a lot, happening, at the moment, to take on board –

  Lorna You’re not listening to me! You’re not, you’re not listening to what I’m –

  Miriam Okay –

  Lorna I’m asking you to check, that’s all.

  Miriam You’re right. You’re right. We can investigate. We ought to be able to look into it, you’re right.

  Lorna Thank you.

  Miriam Leave it with me.

  Lorna That sounds – Thank you.

  Miriam Are you sure everything is all right, you’re feeling all right?

  Lorna Do you think I can trust her?

  Miriam You mean –

  Lorna Carrie, the lady –

  Miriam I’m not sure I understand the question?

  Lorna Is she honest? Is she to be taken at her word?

  Miriam It’s, you have to understand, it isn’t really for me to comment on whether or not –

  Lorna But you know her better than me, in the circumstances, you must, don’t you, you must have a view?

  Miriam Lorna, it would be, you have to understand –

  Lorna Did she love me?

  Miriam (beat) Why do you want to know –

  Lorna Because.

  Miriam Why is it important to you at this stage –

  Lorna Because I’m wondering if I ought to see her again.

  Beat.

  Miriam It’s very difficult for me to say with any certainty whether Carrie –

  Lorna Your opinion, your view, that’s all I want.

  Miriam It’s difficult, Lorna, not because I have any doubts, per se, over whether or not Carrie, might, but, it’s difficult because love, so-called, the experience we term love –

  Lorna I didn’t realise it would be so complicated …!

  Miriam Love isn’t a physical or chemical element. It’s a partially conscious state of the mind. And as we know the brain creates the mind, so in order –

  Lorna I don’t know what you’re saying, I don’t –

  Miriam From a neurological point of view, love affects the brain like, for example, anger, or fear, or grief. Like cocaine. You take a hit, and it lights up. The amygdala, you remember we talked about the, it’s the almond-shaped, the epicentre of fear, and some would say, though I’m sceptical myself, that falling in love sends the amygdala haywire, but –

  Lorna Hold on, this is, is ridiculous. Isn’t it? Either she
does or doesn’t, how can you –

  Miriam Carrie would certainly attest to loving you, yes. But as to whether or not that may be true, it’s impossible – I can look at the available evidence and deliver the most likely hypothesis, for example, but I don’t – Because if I can’t tell you what something is, then I certainly can’t testify to its existence.

  Lorna Well that is, wow, that is – I don’t even know what to say to that.

  Miriam Science, the work that I do, is a method of inquiry, not a view of the world, Lorna. Right or wrong, for better or worse.

  Lorna What about your children, your family?

  Miriam What about them?

  Lorna When they tell you they love you do you stop them and sit them down and tell them, stupid little almond brains hooked on crack, sorry kids, it’s a sham, it’s all a fucking hoodwink –

  Miriam Lorna, Lorna: I need you to calm down. All right?

  Beat.

  Lorna I think, the way she looks at me, I don’t know, I think that she is sincere.

  Miriam says nothing.

  And, now, what if, I don’t know, I could, I could get to know her all over again.

  Miriam You can do anything. And we can help you.

  Lorna I feel sorry for her, how do you explain that?

  Miriam Well, empathy –

  Lorna That was rhetorical, it was a rhetorical, I don’t actually –

  Miriam Okay –

  Lorna No more, no more science.

  Miriam ‘zips’ her mouth, perhaps.

  What would you do if you were me, if you were me in this situation, what would you do?

  Miriam You know what, I would focus on my recovery.

  FOUR

  Carrie Tell me again.

  Miriam Okay. Nano—

  Carrie Again how it would work.

  Miriam Nanobots are administered via an injection. From the information gathered, from this information, we are then able to construct an exact working replica of a particular brain. A holistic, real-time simulation which recreates all the electrochemical activity of a particular – Every neuron, every connection –

  Carrie So everything, it’s, you’re able to see –

  Miriam We are able to see, yes. Everything. Particular patterns of activity. Particular neurons, particular regions even, that may have been severely affected by the –

  Carrie And once you’ve, once you’ve got this, demo, this, you –

  Miriam We then, the team and I, take a meeting to decide upon our recommendations. In Lorna’s case –

  Carrie Yes.

  Miriam Though of course we won’t know for certain until –

  Carrie No, yeah, no sure, but –

  Miriam We would, I would suspect, be looking at discussing some kind of neural prosthesis. Depending on the scale of the damage wrought by the disease, that might involve replacing neurons with synthetic – Or, more likely, in Lorna’s –

  Carrie Yes.

  Miriam It might involve the removal and replacement of a particular area, or a particular network of neurons –

  Carrie And once you, once you’ve removed – Once it’s gone, it’s, yeah it’s just – Gone?

  Miriam The disease you mean, or the –

  Carrie No, the stuff, the memories, all the stuff that comes out with the bits you have to remove –

  Miriam In removing the disease – in order to ensure the removal of the disease in its entirety, we, yes – Anything associated, any memories associated with anything that is removed will, yes, will also be removed.

  Carrie And how much is that, by now, by this, at this point?

  Miriam doesn’t entirely understand the question.

  How many years are we talking? Infected, diseased –

  Miriam It’s – Memory doesn’t function in a linear fashion. Memories can be formed, can be, across several areas –

  Carrie But you can see, no? From the map, from the simulation, you can see exactly –

  Miriam I see, sorry, yes, I see what you mean now – Yes, from the simulation we would be able to ascertain what would be lost.

  Carrie So you know, from the first scan, that first map, when Lorna was diagnosed, you know –

  Miriam Yes, I see.

  Carrie That’s what I’m asking. A ballpark, if you had to –

  Miriam To answer your question exactly, in any sort of meaningful –

  Carrie I’m not asking for exactly. That’s not what I’m asking for.

  Miriam There, from memory, from the information we gathered in order to diagnose, from that replica … Fifteen, perhaps twenty, perhaps thirty years appeared to be –

  Carrie You mean the last twenty to thirty years, or you mean –

  Miriam It isn’t as straightforward as – I worry we’re in real danger of reducing an extremely complex –

  Carrie No, I know, I know, I get – I get that. I do. This isn’t about holding you to ransom to some figure. Some figure you’re about to give me, some number. This is about – I have to make a decision. I have to. And before, fucking, before I – I just. I just want to know everything you know. Or as much of it as you feel, yeah as you feel able to –

  Miriam The disease won’t progress in a linear fashion. And, as you know, nor is memory a linear process. We aren’t – Things aren’t stored. They can’t be uploaded or downloaded. But, yes, at the moment, from what I can remember, the damage caused by the disease seemed to be primarily focused around, associated with the last, more recent past events, namely the last ten, perhaps fifteen, perhaps twenty – Perhaps more.

  Carrie Years?

  Miriam But there were, and this is important, there were several exceptions, several memories from elsewhere in –

  Carrie But to be completely, just to be – If we do nothing, eventually, yeah eventually, it’ll just … If we do nothing she’ll just …

  Miriam We talked previously about the different stages and, yes, in the final stage Lorna will likely have difficulty talking, walking, eating. Incontinence. Delusions, hallucinations, possibly. Fear, anger, aggression. There are no rules, every patient I have ever worked with, over the years, has presented with a, a different cocktail of symptoms –

  Carrie And if we do do this, if we do do it, it goes, the disease, that’s it, she recovers?

  Miriam It’s a long process, involving, you know what, involving a great deal –

  Carrie Yes or no, I need a yes or no. She will, or she won’t recover. In your view. On this day, at this moment in time.

  Miriam The procedure’s success rate speaks for itself.

  Carrie Fuck. (Beat.) We met in our, fucking – We’d lived entire, other lives. Before we met. In our forties. We met in our, fucking, forties. So she, yeah, she won’t know who I am. She won’t recognise me.

  Miriam Correct.

  Carrie Because you will have taken, you will have removed …

  Miriam That’s correct.

  Carrie You know, don’t you, she had real, we had a long, before she got really bad, when she was still able to – We had this long, drawn out, and she has real doubts. Christ.

  Miriam Carrie, would you mind if I say something to you?

  Carrie shakes her head.

  For years, when I was training, during my training, the opposition to the work that I was interested in – Playing God, people would say. It’s unnatural. You’re tampering, you’ve not, what right do you have – And I nearly stopped, I nearly gave up on it all. And then like so many of us, when my – Because it’s all very well in the abstract, it’s all very well being oppositional when you haven’t – But when you have, when you have been through it, when you have had to look someone, someone you love, when you’ve had to watch them as they, the indignity of it all, once – It becomes impossible to look away. The work we do here, what we now know about the brain, hosts of intractable diseases, the dementias, Parkinson’s, schizophrenia, bipolar, depression – All understood. All treatable. And all curable. Over a hundred billion neurons and there
isn’t a single one of them –

  Carrie Yeah I get it. I get it. I get it. But it’s all so cruel, isn’t it, all this, pathways and removing and extracting, it’s gruelling – How about you tell me how to, fucking, cope for fuck’s sake, how about you tell me how I’m s’posed to do that …?!

  Beat.

  Will anything remain? Anything of me? And I’m not talking about memory, not talking about, I’m talking about – Any feeling. Any feelings toward me. Somewhere, some ghost.

  THREE

  Lorna I’m sorry, I don’t know where I am.

  Carrie It doesn’t matter.

  Lorna I’m sorry.

  Carrie It doesn’t matter.

  Lorna I was looking for a cup.

  Carrie Cup?

  Lorna I was looking for the –

  Carrie We have plenty of cups at home.

  Lorna No, I was looking for the cup.

  Carrie Which cup, you tell me, and we’ll go and find it.

  Lorna No, I don’t mean, I’m not – Ah fuck it.

  Carrie I’m listening.

  Lorna No, I don’t know. I thought we were choosing. Choosing the readings, for the … But now I don’t know.

  Carrie What readings?

  Lorna Fucking thing.

  Carrie Shall we go home now?

  Lorna I’m sorry.

  Carrie You don’t need to be.

  Lorna I’m so sorry.

  Carrie Darling, listen to me –

  Lorna You’re so good to me.

  Carrie Book, do you mean book?

  Lorna Yes!

  Carrie You were looking for a book?

  Lorna What? Yes. I think so. No, I don’t know.

  Carrie Is that why you came all the way here?

  Lorna This is such a beautiful place.

  Carrie It is.

  Lorna It’s my favourite shop.

  Carrie Shall we go home now?

  Lorna Right, reckon I’ve got it, found it, this is the one.

  Carrie Is it morbid?

  Lorna A bit, but what’s wrong with morbid?