September 04

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NeuWrite Reads: “Lock In” by John Scalzi

Editor’s Note: This is the first in an occasional series where NeuWriters review fiction and nonfiction books about the brain.

A few weeks ago I wrote a post about locked-in syndrome, a rare and dramatic disorder in which a stroke or other traumatic event affects the brain stem and leaves the patient completely paralyzed but fully conscious.  While I’ve been aware of the syndrome for many years and it has always given me shivers to think about, my interest in it was reignited when one of my favorite authors, John Scalzi, released a novella called “Unlocked” that was intended as a prequel to an upcoming book entitled “Lock In”. It’s a sci-fi murder mystery that, in addition to being based around a neurological disorder, brings up some fascinating questions about the intersection of politics, science and society and are incredibly relevant to our own scientific community.

The Story

To begin with, I highly recommend reading the novella “Unlocked” before proceeding to the novel.  Much of the “science” of the novel’s world is to be found in it, and it provides context that simply cannot be gleaned from the Wikipedia-style prologue to the novel.  The book takes place in a world that has been deeply affected by the fictional Haden’s syndrome, which infected nearly a third of the population, killing many and leaving others with long term cognitive deficits or, in some cases, locked in syndrome.  The disease was named for its most famous sufferer, the First Lady who becomes locked-in during the beginning of the epidemic.   As a consequence, Congress passed the Haden Research Initiative Act (HRIA), suppling $3 trillion for research, innovation and treatment.

This funding led to the invention of two critical pieces of technology: a neural network that would integrate with the brain of a Haden’s patient and allow them to communicate with the outside world, and androids called “threeps” (short for C3POs) that could be controlled by the Haden’s patients via the neural network and walk around and interact with the world on their behalf.  This leads to extensive societal upheaval, much of it centering on the rights of Haden’s patients to be treated equally.  Despite this progress, the HRIA is cut after 25 years, moving future research funding and support for patients to the private sector.

The Science

First, how ludicrous is the science of the neural network and the threeps?  While the book does not go into detail about exactly how the network implants and the brain interact in order to produce communication, it is not entirely out of the realm of possibility.  For example, Dr. Andrew P. Schwartz and colleagues have done extensive work with implanting electrodes into the primate brain and training the animals to use neural signals to direct the movement of an external prosthetic arm [1].  They have been able to demonstrate that this is possible in humans as well, implanting electrodes in paraplegic patients and training them to use neural signals to do such complex tasks as grasping a bar of chocolate and feeding themselves (video can be see here).  Other groups are independently exploring the use of neural signals to control prostheses, including Dr. Richard Andersen at Caltech [2] and Dr. Nicholas Hatsopoulos, who is working on prosthesis that can sense and transmit sensation [3]. It’s not such a great leap to imagine that multiple electrodes, or indeed a full network of them integrated with the brain, could allow a locked-in patient to control a prosthesis, or in this case, a robot counterpart.

The Politics

What I found most interesting about “Lock In” was not the murder mystery that serves as the main plot, but the social and political issues of the fictional world, many of which are all too relevant to the non-fictional world.  Scientists in the real world, as in Scalzi’s novel, are struggling with the slow transfer of research funding from the government to the private sector.  Research funding in both worlds is becoming scarce, even for the most basic questions, and money from private corporations and institutions can often come with conflicts of interest that hamper progress.  The fact is that the NIH funds up to 90% of basic and biomedical research in this country; a cutoff of that money in order to transfer it to the private sector would be disastrous at the very least [4].  The competition for this money is incredibly fierce, with only 16% of grant applications actually being funded [5].  The struggle to fund research has been the end of many scientist’s careers, and I know that it is a major concern for younger scientists.  There’s a not unfounded fear that it will be next to impossible to fund a lab and find money to pursue the scientific questions that could change the future. The amazing scientific and technological advances portrayed in the book are the result of a focused effort of the public sector to pour money into research, and considerable time is spent on the consequences of the switch from public to private funding.

The Society

In addition to the political subplots, the book spends a considerable amount of time exploring the society created by the hundreds of thousands of Haden’s patients who find themselves interacting with the world in a completely novel way.  They live, in many ways by proxy, either through their threeps or in the virtual world called the Agora that they can access and interact with each other in.  While many of them try to reintegrate into society as close to “normally” as possible, many Hadens (as they call themselves) don’t feel the need to conform to the world of able-bodied people.  They don’t want to be cured; they want to be accepted as different.  This mirrors what we see with some communities in our world that are connected by a perceived disability, such as the deaf community, which is mentioned in the novel as being comparable to the world of the Haden’s patients.  The deaf community has often found itself splintered over how much they should feel the need to integrate with the hearing world, and how much deaf culture should be kept separate.  This too is an issue with Haden’s patients, with some wanting to integrate fully with the outside world through their threeps, and some preferring the Haden’s-only world created by the Agora.  There is also increasingly popular movement in our society towards embracing neurodiversity, and the idea that what we typically think of as a disease may not necessarily be something that needs a cure, particularly in reference to those who fall somewhere on the autistic spectrum [6].  Many of those diagnosed with autism don’t see the condition as being something that needs to be fixed, but as a different way of viewing and interacting with the world, an idea that is also expressed by some Haden’s patients. These perspectives are not something that should be ignored by the scientific community.  While there is still great value in understanding the neuroscience that underlies such conditions, it is critical that we as scientists and members of society understand that those with the diseases we study may not see themselves as needing the cure we seek.

But did you like the book?

I enjoyed the book immensely!  One of my favorite things about Scalzi is his writing style; it’s very approachable and his characters speak like real people, not like some writer’s idea of what people sound like.  As with many sci-fi novels, a lot of time is spent in world-building rather than the plot itself.  While the mystery and its ending was satisfactory overall, it did fade into the background more than it should have.  I would have liked some more explanation of some things, in particular the virtual world that the Haden’s patients use (how do people access it?  Is it an outgrowth of the Internet or is it something different entirely?).  These criticisms, however, are minor.  I found the book highly entertaining, hard to put down, and ultimately very thought-provoking.  I certainly hope we get to see a sequel in the future, if only because it would be a shame to see such excellent world-building not get more exploration.

 

“Lock In” can be purchased at Amazon, Barnes and Noble or your local independent bookstore.  If you’re in the San Diego area, John Scalzi will be at the Mysterious Galaxy bookstore on September 8th at 7 pm to answer questions, do some readings and sign books.  If not, check out his tour schedule to see if he’s coming to your city.  See you at the signing!

 

References

  1. Schwartz, Andrew B. “Progress toward a high-performance neural prosthetic.” Brain-Computer Interface (BCI), 2013 International Winter Workshop on. IEEE, 2013.
  2. Andersen, Richard A., Eun Jung Hwang, and Grant H. Mulliken. “Cognitive neural prosthetics.” Annual review of psychology 61 (2010): 169.
  3. Berg, J. A., et al. “Behavioral demonstration of a somatosensory neuroprosthesis.” Neural Systems and Rehabilitation Engineering, IEEE Transactions on 21.3 (2013): 500-507.
  4. “NIH Research is Ailing from the Budget Squeeze”
  5. NIH FY2013 Numbers
  6. “What Is Neurodiversity?”
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