(2013) Looks Could Kill

by David Ellis

  “That’s a lot to take in,” said Jim, “but there’s certainly an internal consistency to it all and we already know that your functional MRI scans are unusual, to put it mildly. And it won’t be the first time that a superstition turns out to have some basis in reality. In fact, some believe superstition is a sort of adaptive learning that’s useful from an evolutionary perspective and designed to protect rather than being ridiculous and a waste of time.”

  “So, where do we come in, Emma?” asked Mike.

  “Well, this is where I hope it gets exciting. When Daniel died, he left me a large sum to set up an organisation to be called the Daniel Armstrong Foundation and named me as the trustee. What I’d like to propose to you is that we dedicate the foundation to putting the clinical work I’ve done using my ability firmly on the map, which I hope will also keep religious fanatics like my grandparents off my back.”

  “And you want us to come up with the science to back this up, I guess,” said Jim.

  “Basically, yes,” said Emma. “And this is how I think we should do it. First off, I think in an ideal world we’d need to be scanning both the patient and myself to see how well my areas of activation match those of the patient who’s actually experiencing the pain. If it turns out that my brain response is accurate, then we shouldn’t need to scan the patient at all. It may be that you’ll still need to scan me for some more atypical patients whose pain doesn’t match the usual pattern and where other areas of the brain might get activated. Second, I think we need to see whether there are other people around who could be trained up to do a lower level of therapy, possibly with some sort of biofeedback to enhance any basic ability they have. I’m thinking here of psychologists who’ve been trained in CBT and have demonstrated good empathic skills. The sort of biofeedback I’m envisaging is EEG, and probably with some sort of high-resolution enhancement.”

  “That all sounds quite do-able from my point of view,” said Mike. “It’d certainly be difficult to get enough time on the functional MRI scanner to puts lots of patients through it.”

  “I guess the difficulty we still have is trying to explain what’s going on from a neurocognitive point of view,” said Jim. “I can just about get how you might be sufficiently attuned to pick up the emotional state of the patient, but actually influencing their cortical structures through your own cognitive processes is stretching things rather far. Do you have any ideas on that?”

  “Well, apart from suggesting that it’s something to do with quantum mechanics – which I suppose it could be – I was wondering whether it was something to do with refraction of ambient light with some sort of modulation created by heterochromic eyes that then gets assimilated by the patients’ eyes. Sorry, if that sounds a little far-fetched,” said Emma.

  “No, that’s an interesting hypothesis and it’s certainly something to go on with,” said Jim.

  “So, gentlemen, do we have a ’go’ for the project?” asked Emma.

  “It’s a ‘yes’ from me,” said Jim.

  “Same here,” said Mike.

  And so the Daniel Armstrong Foundation was born.

  July 2005

  A month in to the project and good progress was being made. Jim and Michael had come up with a way of simulating pain using cold or hot pads. Trials with subjects experiencing this simulated pain had shown that Emma’s functional MRI scans closely matched the activation shown by the subjects, so putting patients through the scanner wouldn’t be necessary for the pilot at least. However given that Emma’s ability was probably at the upper end of the evil eye spectrum, the team also had to think about how less able therapists might be trained up.

  Michael had come across some technology being developed in the Los Alamos National Laboratory with SQUIDs (not the cephalopod variety but superconducting quantum interference devices) which allowed MRI scanning at very low magnetic fields, but this was too early on in development for it to be something the Foundation might use in the near future. A more positive approach seemed to be enhanced electroencephalography, similar to that used on Emma’s mother, but designed to be more portable and with resolution sufficient to allow the sort of patient-specific mapping of activation that they’d need in a clinical setting. Jim contacted a manufacturer in the USA who agreed to send him a prototype of what they were describing as a ‘neuroheadset’ for evaluation.

  Recruitment of would-be therapists was the next issue. Jim recalled some research carried out in Australia looking at the qualities in psychologists that determine whether patients being treated for a problem like depression get better or not. Rather surprisingly, nothing obvious emerged from the research data and the paper’s somewhat ironic conclusion was that patients may improve simply because of the therapeutic relationship rather than the therapy itself. So adverts were put to recruit therapists from the surfeit of cognitive-behavioural therapists being trained for various NHS programmes. It was also quite difficult to tell the applicants exactly what sort of therapy they’d be doing, so they’d used some vague description of augmented empathic therapy which wasn’t too far from the truth. And in order to ensure that the right therapists were selected, Emma used her ability on interview panels to select those who seemed to have the best empathic skills.

  Once they’d recruited therapists and had demonstrated that the neuroheadset provided sufficient resolution and was reasonably comfortable to wear, Emma and her team moved onto the next phase of the project, which was proving that the therapy could work without her doing it. Two stages were involved: firstly, putting subjects and therapists in the functional MRI scanner and seeing whether areas of activation matched; and secondly, demonstrating with the neurobiofeedback that the therapist could cause some change without any direct link to the subject’s brain. Not surprisingly, most of the therapists fell by the wayside and indeed weren’t too pleased to have done so and threatened unfair dismissal. However, their contract had made it clear that they’d all signed up to a probationary period for their skills to be assessed, so they didn’t have a case.

  Miraculously, subjects proved to be readily available as a result of the connection the unit had with an American benefactor. Ethical approval also wasn’t a problem as the project seemed to be covered by rather over-inclusive approval granted for other studies being carried out in the unit.

  In general, there were very few casualties from the trials, although a few subjects required admission for further investigations. This was put down to the build-up of the sort of feedback loop that Emma had experienced earlier in her clinical work. One therapist found it all too much to cope with and was admitted to a psychiatric ward with ‘nervous exhaustion’.

  It didn’t take long for the team to feel that they finally had a robust technique that could be rolled out clinically as a pilot in a London hospital. Emma’s colleague Dr Janna Roit was also invited to join the Foundation as a fourth trustee. A date was set for a press conference with invitations sent out to all the major technology and medical correspondents of the national and international press and media.

  It was an exciting time for all and the Daniel Armstrong Foundation was ready to commence its pioneering work.

  August 2005

  DANIEL ARMSTRONG FOUNDATION – PRESS CONFERENCE

  “Thank you, everyone, for coming to this inaugural press conference for the Daniel Armstrong Foundation. As you will know from reports in the press and media, my husband, the late Daniel Armstrong, requested in his will that this Foundation should be established, and he named me as the sole trustee with responsibility for deciding the precise purpose and operation of the Foundation. Although I was of course honoured to be asked to take on this responsibility, I felt it only right and proper for this responsibility to be shared in a more democratic fashion.”

  “I would therefore like to introduce the three other members of the board of trustees for the Daniel Armstrong Foundation: Dr Janna Roit, Dr Jim Lawrence and Dr Michael Moore. As you will see from your press pack, each is a specialist in their
own field: Dr Roit in palliative care, Dr Lawrence in cognitive neuroscience and Dr Moore in functional imaging.”

  “Michael, perhaps you would like to continue:”

  “Thank you, Emma. Up until now, the management of patients with chronic or terminal illnesses like cancer has often been on an ad hoc basis, with chance playing a significant part in how pain and suffering is managed. Following on from some research carried out by Dr Lawrence and myself, in conjunction with Dr Jones, we now believe that we are ready for a fundamental paradigm shift in palliative care and pain management, involving functional imaging, neurobiofeedback and a cognitive neuroscience understanding of the countertransference process. The Daniel Armstrong Foundation will take this forward with research and practical implementation, and I am delighted to announce that this will commence with a pilot project in the Witherington Hospital, London, next month.”

  The audience applauded.

  “Thank you, Jim. Are there any questions?” asked Emma.

  “Tim Evans, Health Correspondent, ‘The Guardian’: Excuse me for my scepticism, but this does sound a bit like science fiction. Can you clarify how this technique actually works?”

  “Jim, would you like to respond?” asked Emma.

  “Certainly. Essentially there are two parts to this: human and technological. The human part is a therapist, a bit like a conventional cognitive-behavioural therapist as used in treating depression, but one who has a highly tuned ability to pick up a patient’s emotional state. The really innovative part is the technology we use – a combination of a functional MRI scanner and a biofeedback device that the patient wears – that enables us to modulate or modify the emotion before the therapist projects it back to the patient. It’s this vastly enhanced countertransference process that we believe will reshape the care of patients with chronic or terminal illnesses. And in case any potential competitors are watching these proceedings, I should add that a patent application is in the works.”

  The audience laughed.

  “Thank you, Michael,” said Emma. “I think we have another question from the second row.”

  “Yes, thank you. Frederic Boussain, ‘Paris Match’: Is there any risk of harm to the patient if the technique is wrongly applied?”

  “An excellent question,” said Emma. “As far as we know from extensive trials, the risk is extremely low, but it does depend on the quality of the therapist, just as would be the case with even conventional cognitive-behavioural therapy. And of course, our technology has sophisticated safeguards to prevent any harm to the patient.”

  “Any other questions?” asked Emma.

  “Yes. Dominic Quatermain, ‘The Financial Times’: Is there any truth in the rumour circulating on various social networking sites that the military might have an interest in funding this technology – for mind control, for instance?”

  The audience laughed.

  “I think I can answer that question, Emma, if you don’t mind,” said Jim. “The notion of mind control is pure science fiction; our technology scans but it cannot take control of the patient; the autonomy of the patient is always maintained.”

  “And I would like to add that the Foundation would never knowingly be bedfellows with any military or similar establishment.” Emma added. “The advantage of the Daniel Armstrong Foundation is that our own resources give us the freedom to use our technique as and when we choose – for instance, in our pilot project that will be provided at no charge whatsoever to the NHS.”

  The audience briefly applauded.

  “I think we have time for one further question.” said Emma.

  “Yes, Wyn Jones, Medical Correspondent, ‘BBC News’: Dr Jones – no relation of course – do you have a name for your technique?”

  “Yes, Wyn,” said Emma, “we’re calling it ‘Ocular-guided Augmented Empathy’ or ‘OAE’ for short.

  August 2005, one week later

  The phone rang and Emma picked it up.

  “Hi, Emma, it’s Michael. Look, sorry to bother you at home, but something has come up here and we really need you to come over pronto.”

  “What’s the problem then? Can’t it wait until tomorrow?”

  “Sorry, no, it’s all a bit, er, delicate.” said Michael.

  “Okay,” said Emma wearily, “I’m on my way. I should be there in 10 if the traffic’s reasonable.”

  Emma left the house wondering what on earth the problem was that couldn’t wait until the morning.

  A sizeable part of the problem became apparent as soon as she arrived at the Cognitive Neuroscience Unit, as two burly security guards seemed to be standing in for Doric columns on either side of the main doors. Emma showed them her security card and was surprised by their rapid transformation into servility, which included both of them opening the doors for her.

  Michael met Emma in the main hall and ushered her into a small seminar room just off the main drag of the ground floor.

  “You’re not going to believe this, Emma, but we’ve been taken over,” he said.

  “Not by aliens, I hope,” said Emma, half-jokingly.

  “I wish it was. No, it’s the benefactor who finances us who’s come in with the heavy brigade. Apparently, we’re now seconded to the US Department of Defense, or something along those lines.”

  “Christ, I don’t believe it! So, who exactly is this nameless benefactor whom we’ve never even met that’s sold us out?”

  “Let me check.” He glanced at some papers in his pocket. “It’s something or someone called ‘Armstrong Industries’.”

  The penny finally dropped; names open doors.

  August 2005, another week later

  Emma finished her coffee and turned off the kitchen hi-fi that had been playing Puccini’s ‘La Boheme’. She sighed. She was easily tired these days. She inspected the glass-fronted cabinet hanging on the wall. She undid the latches and swung open the glass door. Inside, there were row upon row of exquisitely beautiful butterflies with their names beneath them. She’d memorised these years ago and could recite them in her sleep: Long-tailed Blue, Purple Hairstreak, Clouded Yellow, Brimstone; the names tripped off her tongue as easily as they had when she was a child. She gently traced a finger across the wings of her first love, the Large White, and then moved her finger down to her last love, the Red Admiral. She carefully closed the glass door and fastened the latches.

  Emma went to the window overlooking the church where she and Daniel were married barely six months ago. Just behind the church, she could see the graveyard shielded by majestic beech trees, glistening greenly in the sunshine, and right at the edge, she could make out Daniel’s still virginally clean headstone.

  “You bastard,” she mouthed silently to the headstone.

  She turned and walked back to the table, grabbing her shoulder-bag, and started going downstairs. At least she still had three very important things left in her life: the house that Daniel had left her; her ability, which she had every intention of pursuing further whatever obstacles were put in her way; and the bundle of joy busily growing inside her.

  She patted her bump contentedly and didn’t think there was anything obnoxious at all about doing that - whatever some people might say. But she was already late for the antenatal clinic and she really quite enjoyed seeing the midwives bustling around in brown uniforms and sensible shoes. Any memories she had of a similarly attired woman in her mother’s bedroom had long since disappeared.

  On her way out of the front door, the builder due to do some work in the house greeted her: “Morning, Dr Jones, how’s the bump?”

  “Growing, Bob, growing, and I’m in a bit of a rush to get to the antenatal clinic.”

  “Before you dash off, could you remind me which room you want me to start on?”

  “Of course, Bob. It’s the one on the left; my late husband’s office.”

  “Okay, Dr Jones. I’ll see you later.”

  Emma thought it was about time that Daniel’s room was put back into use, and turning his therapy roo
m into the nursery seemed only appropriate given what she’d learnt about his activities.

  She just had enough time for the start of the OAE pilot before the baby was due; Department of Defense or no Department of Defense, she wasn’t going to allow that to be scuppered although it was always possible that her bump might have a say in the matter.

  Exactly how she was going to deal with the unholy alliance that the Foundation had been unwittingly dragged into with the US of A was for another day. And there were so many other questions that remained unanswered.

  Wheels within wheels, what had she got herself into?

  Bob couldn’t have agreed more and pulled a balaclava over his head.

  August 2005, an hour later

  Finding a parking space near the antenatal clinic had been the usual nightmare and her advanced stage of pregnancy hadn’t garnered any sympathy from a male driver who’d insisted on backing into a parking space just as she was about to manoeuvre her car into it. She caught herself just before she unleashed a furious glare; heart attacks or burst aneurysms whilst at the wheel of a car are very inconvenient for all concerned. Eventually, she found a parking space and this time the female parking attendant was sympathetic.

  The clinic was packed as usual and the summer heat seemed to be making tempers more fraught than usual. Emma made the tricky journey on the washed and slippery lino to the reception desk, dodging the pregnant abdomens along the way.

  “Hello, Dr Jones,” said the cheerful receptionist, “How’s the bump?”